Health Longevity Secrets

The Power of Functional Medicine with Dr. Mark Hyman

• Robert Lufkin MD • Episode 214

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Ever wondered if you can truly turn back the clock on aging? Join us in this compelling episode as Dr. Mark Hyman shares his extraordinary insights on the power of functional medicine to rejuvenate the body and mind at any age. Discover how Dr. Hyman's personal and professional journey led him to uncover the foundational causes of aging and chronic disease, and learn about the vital distinctions between beneficial and harmful stress. We also delve into the fascinating concept of biological versus chronological aging and the transformative potential of lifestyle choices in reversing biological age.

This episode is sponsored by Rio.life. I am an advisor to Rio but I only advise companies that I believe in and would use for myself and my family. 

Our discussion takes a critical look at the current healthcare and medical education systems, shedding light on how profit-driven motives can undermine simple, effective treatments. Dr. Hyman introduces the concept of hormesis, explaining how small, beneficial stresses like intermittent fasting, cold showers, and saunas can activate the body's innate healing mechanisms. We underscore the crucial role of modern nutritional science in medical education, arguing for a more integrated approach that places lifestyle and diet at the core of health management.

In our final deep dive, we explore the complex relationship between aging, inflammation, and nutrition. Dr. Hyman discusses the hallmarks of aging and the importance of balancing what the body has too much of and what it lacks. This includes the impact of refined oils versus traditional oils, the benefits of higher protein intake for older adults, and the emerging technology of continuous glucose monitors. We also touch on the profound influence of social connections on health and longevity.

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Speaker 1:

Welcome to another session of the Reverse Inflamma Aging Summit Body and Mind Longevity Medicine, and I'm your host, Dr Robert Lufkin. I'm joined today by my co-host, Dr Steve Sidoroff. Hey, Steve, how are you?

Speaker 2:

I'm doing great, rob. It's a pleasure to be here with you and I'm very much looking forward to our speaker today. Dr Mark Hyman is a practicing physician and an internationally recognized leader, speaker, educator and advocate in the field of functional medicine. He's the founder and director of the Ultra Wellness Center, senior advisor for the Cleveland Clinic for functional medicine and a 14-time best-selling author on the New York Times best-selling list. So wonderful to have him here. I'm looking forward to our meeting.

Speaker 1:

Yes, go.

Speaker 2:

Welcome, Mark, and it's a pleasure to have you here.

Speaker 3:

Thanks for having me.

Speaker 2:

Thank you. Thank you and my co-host, Dr Rob Lufkin.

Speaker 1:

Great yeah, I'm excited.

Speaker 2:

Before we really dive into the subject really deeply, can you tell us a little bit about how you got interested in the area of aging and longevity?

Speaker 3:

Well, I'm getting older Out of self-interest and actually jokingly, but in part that's true and it's just the natural consequence of digging into the root causes of why we get sick and how we age. And functional medicine has been the work of my life and through that lens I've been able to understand where we're headed in medicine, what's emerging and what's important, and how we begin to rethink what we're doing from the perspective of creating health as a way of treating disease, rather than suppressing disease or aging with some intervention that blocks, interrupts something in the body. How do we activate the body's own innate healing?

Speaker 1:

system. I love asking our speakers and this is a question we ask just about everybody. Before we get into the details of it, let's step back and maybe just tell us, Mark, how you conceive of longevity and aging, why we age, what's the framework you use for that?

Speaker 3:

I think we've come a long way in our understanding of the biology of aging. It was thought of as this normal, inevitable consequence that we grow old, decrepit, frail and get chronic diseases. As we get older has the capacity to regenerate, rejuvenate, repair and reverse our biological age at any time, whether we're 30, 40, 50, 60, 70, 80, 90, 100 or more. We have that innate capacity. So unlocking that has really fascinated me and I've seen just remarkable things in my practice reversing what seemed to be end-stage diseases heart failure, kidney failure, late-stage diabetes and seeing what would be thought to be miracles. But they're not. They're just inevitable consequences of understanding the nature of biology and the laws of biology and how we can activate the body's own healing system through understanding what causes imbalance in the body and how to restore balance, which is really the fundamental framework of functional medicine. Take out the bad stuff, put in the good stuff and let the body do the rest.

Speaker 2:

Yeah, but it's really great and motivating to know that you have found ways of reversing some of these processes, of overcoming what a lot of people think is are inevitable. I'm wondering, in terms of body and mind, and and and what you're saying, what role do you think stress plays in this process?

Speaker 3:

Oh well, I mean, stress is, you know, is a ubiquitous phenomena, and it's not necessarily bad, it's. It's, in fact, some stresses actually help you live longer. In our thermoregulated and environmentally controlled perfect worlds, where we've sort of absolved ourselves from having to do physical work, from extremes of temperature and shifts in our ability to find food, we basically create an environment that's bad for us, and so I don't think that stress is bad. I think it's the mental stress that is the result of our thoughts and our beliefs and our ideas that often create the most harm.

Speaker 3:

Stress is not necessarily what happens to us. It's what we make of what happens to us. It's not the reality of what happens to us. It's the perception of the reality of what happens to us, and the biology of this is very, really clear. I think I don't know if it was Herbert Benson or somebody in medicine that defines stress as the real or imagined threat to your body or your ego. So it could be a real threat to your body, such as somebody having a gun to your head, or it could be that you think your wife is cheating on you, but she's really not, and you still have the same physiological response. So learning how to master our minds is a key part of maintaining our health, our lives and actually mindset and meaning and purpose are really happiness and optimism are really key parts of longevity.

Speaker 1:

Right, yeah, I love what you said about the event almost itself being neutral, and then the meaning we assign to it can either create stress or not stress, depending on how we interpret it. In some cases, that's an interesting concept. Yeah, backing up a little bit, you mentioned biological aging. Can you define that, and versus maybe chronological aging? And then also, what are, what are your go-to tools to measure biological aging? It's an area that's evolving very fast now yeah, well, chronologically, uh, we're getting older.

Speaker 3:

We can't do anything about that. I was born in 1959 and every day I get chronologically older. The question is, how is my biological age progressing or not? And I recently tested my biological age. I'm 63 and I'm biologically 43. So I think that's a really interesting phenomenon that we can actually get chronologically older as we get biologically younger.

Speaker 3:

I tested my biological age to a technique called DNA methylation, which is really relatively new type of test that measures our epigenome, which is really the piano player that plays the keyboard, which is our genes, and that determines our health or determines our level of disease or rate of aging. And so we have enormous influence over our epigenome. We can't change our genes they're fixed, unless we do gene editing or CRISPR. But we can change the expression of our genes by what we eat, by what we think, by how we move, by our environment, by toxins or removing them, by a level of nutrient density in our diet, by how we manage stress. All these things are read in our book of life and are literally read into our genes, and so we have enormous power at any age to transform that, and a lot of the research around longevity now is focused on the epigenetics of aging and how we can modify that through our environmental lifestyle, and that's really where the hope is that a lot of the things that we see as normal aging are really abnormal aging.

Speaker 1:

Yeah, I wonder, do you see you mentioned the DNA methylation sort of the epigenetic clocks, very popular sort of in longevity? Do you see those assuming a clinical role soon or currently?

Speaker 3:

Absolutely I mean, I use them. I use them in my clinical practice, absolutely. I think you know there are many ways to measure our biological age that are not a true biological age but are some indirect indicators, which we do all the time. We measure your cholesterol, your blood sugar, your blood pressure, we measure your hormone levels and we measure your nutrient levels, and there's all kinds of ways we can look at your biological functioning and see where you're on the spectrum of wellness to disease, right. So that's what functional medicine is really good at.

Speaker 3:

But what's really exciting is these new technologies that have been able to measure things like DNA methylation or telomere length or telomerase activity, which are more reflective of the rate of biological aging and are a metric which can be used to assess how you age and how what you're doing affects how you age. And so, let's say, you start on a lifestyle or diet program or supplement or medication. How do you measure your rate of biological aging? Well, now there are tools and techniques to actually do this clinically, which can help you identify whether you're on the right track or not. So this is what I do myself and with my practice, for sure.

Speaker 1:

Yeah, very exciting time.

Speaker 2:

Yeah. So I'm wondering, if you're, was this the baseline reading you took, where you found out you were 20 years biologically?

Speaker 3:

That was my first. That was my first try, First try. So I'm going to try to get to 25. We'll see how it goes. I'll keep you posted.

Speaker 2:

Well, I know in your work food is very important. In fact, you said food is the most powerful drug on the planet. As a psychologist and knowing about addiction and drugs, that resonated with me because I know we can use drugs in a good way. We can use drugs in a bad way. So what is your perspective on that?

Speaker 3:

every day. We don't almost think twice about what we're eating, except does it taste good or how does it make us feel? In the moment, we don't understand that we're not eating just for energy or pleasure. We're eating to regulate every single function of our bodies. It's the most important thing we do every day to interact with our world, and it's transmuted into biological signals that control every aspect of your health your microbiome, your immune system, your energy system, how you make energy in your cells, your detoxification system, your circulation, blood vessel health, your hormones and communication systems, and our transmitters, your structural system, what you're made of all these things are influenced by food and they regulate so many different functions of your body. So when we see chronic illness so I'll just tell you a quick story about you know, the power of food, the.

Speaker 3:

This is in my book Young Forever. I share this story there of a patient who came to Cleveland Clinic at 66 years old with a body mass index of 43. And that's really really obese. She, you know, basically normal, is 25 or less 30 is obese, 40 is severely obese. She had type 2 diabetes for 10 years on insulin. She had heart failure. She had kidneys were failing.

Speaker 3:

Her liver was failing, blood pressure was high and she had multiple stents put in her heart and was on a pile of medications and was not doing well, even though she was having her disease managed by the best doctors in the world that were doing the right thing according to our current paradigm and rather than try to tweak her medications or adjust her dosages, I said why don't we try a different approach? And she joined a group we have at Cleveland Clinic called Functioning for Life and was able to actually transform her health very quickly using food. And she radically changed her diet from eating all through processed food diets that was high in starch and sugar to whole foods, low glycemic, anti-inflammatory, low sugar, starch, higher fat diet, and within three days she was off her insulin. In three months she reversed her heart failure, her diabetes, her A1C both you know you're a doctor or you know it was 11. It went to five and a half, which is unheard of. If you have a medication that drops it by one point, it's like a blockbuster drug and we're talking here about six and they're a point and it's algorithmic, so it's not linear point.

Speaker 3:

And she reversed her heart failure again, something we never see in traditional medicine reversed her kidney failure again never something we see in traditional medicine or liver fatty liver resolved, her blood pressure normalized. She got all her medications. Her copay was $20,000 a year. She got off everything, lost 43 pounds in three months and ended up losing 116 pounds a year and completely reversed everything at 63 years old or 66 years old. That's the power of food. There's no drug that works as well as that. It's just there isn't. If there was, I would prescribe it. I have no kind of righteousness about medication or pharmaceuticals. I use them all the time. The question is what's the right?

Speaker 1:

drug for this problem and 90% of the time it's food. Yeah, that's such a powerful story, mark. I wonder and I've heard that in other settings as well how these chronic diseases, which we're treating the symptoms of with drugs and surgery the root cause can be reversed with lifestyle changes, and particularly food is arguably the most powerful one. I always wonder and I'm still involved at a medical school now teaching people, and I see what's going on, I see what's being taught why aren't people shouting this from the, from the Raptors that you know we've got a cure, or not even we've got a cure?

Speaker 3:

No one gets rich selling broccoli.

Speaker 3:

I mean, I think, Pfizer just announced that it increased the price of COVID vaccines 10,000%. Now this just doesn't make any sense, right? And I think we're in a profit-driven healthcare system that often ignores the simplest, most effective and inexpensive treatments in favor of things that actually don't work that well and that cost a lot and have downstream negative consequences. So I think, you know, we have an antiquated healthcare system. We have an antiquated medical education system. My daughter's in medical school right now and it's staggering to me what she's not learning. I mean, you know, it's like by the time a textbook's written, it's outdated. But the truth is that most of our textbooks are not just outdated, it's like we're learning about the world that's flat and the world is round world, and I think that's really, you know, it's really criminal.

Speaker 3:

Given the level of understanding we have now about biology. The entrenchment of our healthcare system and the old medical paradigm is really frightening. It sort of reminds me of Semmelweis, who discovered that washing hands could prevent childbirth fever and the death of his patients in labor and delivery. You know, he was ridiculed for thinking that and was banished from medicine and ended up dying, you know, in disgrace. And it took 50 years for doctors to go. Oh yeah, I guess we should wash our hands before doing surgery. You know, that's kind of where we're at now.

Speaker 1:

You know, that's kind of where we're at now. Well, I mean, yeah, I certainly understand the pernicious incentives and the financial motivations from the drug companies and all the factors that are lining up, but I mean, what about the young medical students that are idealistic? They're just not being taught. I mean, are they maybe not exposed to this?

Speaker 3:

No, I mean, they're trying themselves. My daughter's like hey, dad, there's a food is medicine study group at my medical school. The students put together. I'm like yeah, okay, great, and that should be part of your curriculum. It shouldn't be something they have to do on the side, right right, yeah, I mean, I love your.

Speaker 1:

I love your quote that every bite of food you take is like instructions that control the operating system of your biology. I think it's sort of like somebody else said is the way we program our epigenome is with each piece of food we take is programming our epigenetics for better or worse you know, depending on the food we take.

Speaker 3:

Yeah, absolutely, absolutely.

Speaker 2:

Yeah, so you talk about hormesis. Can you explain what it is and how it can be activated?

Speaker 3:

Yeah, so you know, one of the exciting things about our understanding of biology is that we have an innate immune and healing system. We have an innate system that is designed to rejuvenate, repair and fix our biology and it's activated by stress. And historically we lived in a world where we were constantly exposed to different kinds of stresses heat, stress, cold stress, hunger, stress, exercise stress and it turns out that these kinds of stresses are actually help us. If you are in extreme stress for too long, it will kill you, right? If your body is immersed in a 40 degree Fahrenheit water for too long, you will get hypothermia and die. But if you do it for three or four minutes, it activates your body into a response that creates healing and builds your immune system, activates your brown fat, increases dopamine, increases focus, energy, helps your metabolism in many ways. So there's so many benefits to these different kinds of little stresses that we have insulated ourselves from. So hormesis is the idea that we should practice little stresses every day to activate our body's own healing system. So what are those kinds of stresses? Well, first one is diet and what you're eating and how you're eating and when you're eating and what you're eating.

Speaker 3:

The easiest form of a poor meat is just taking a break from eating for a little bit. And I'm not talking about fasting for a week, I'm talking about 12 hours, which most of us don't do. We go to bed and we even wake up. So taking a 12, 14 hour, even 16 hour fast every day, overnight fast, which means eight of those hours you're sleeping, it's not so hard. So if you eat dinner at six at night, you can eat eight in the morning. That's a 14 hour fast, right? That creates a little bit of stress and starvation in the body. That then activates a body's own repair systems called autophagy, which means self-eating or cannibalism. That helps your body recycle and repair old parts and cleans up old waste, and that's really important for longevity and for healing the body. And then what we eat is really important.

Speaker 3:

There's a whole world of science around phytohormones, which are the plant compounds, the phytochemicals in plants that actually bind to different receptors and pathways, that create a little bit of a stress, like a little bit of a toxin, that activate these ancient and built-in systems that enhance longevity and reverse biological aging and then there's other stresses that we we can easily do, like take a cold shower for two minutes in the morning, get a cold plunge, which may be a little more expensive, but or you just get nice like a some guy got a trough that you buy for next to nothing at the animal feed store filled with water and ice cubes and, you know, sits in that for three minutes. Saunas, again another powerful way to increase our stress to our body from heat stress that creates heat shock. Proteins that help repair damaged proteins, that helps activate our innate immune system, that help our bodies reduce inflammation and improve our heart rate variability, reduce stress in our systems and have a really powerful effect. And sauna users, for example in Finland live, you know, have a 40% reduction in death rates because of using saunas, for example. Or we can do, you know, other forms of hormesis, like exercise. That's a great form of hormesis where we stress our bodies. When you weight lift, you tear muscles and that's a form of injury or stress to the system, but then you back stronger.

Speaker 3:

Same thing with with interval training, when you do high intensity interval training, when you run really fast for like a minute and then you're like you're gonna run from a tiger, but then you rest for three minutes slowly walking, that you do that for half an hour and repeat, and that activates something called improvements in your vo2 max, which is really critical for longevity and is again another beneficial stress. And then there's, you know, other kinds of stress, like hypoxia. You can get the breathing mask for 50 bucks online that you can use while you're sitting at your desk. That limits your flow of oxygen and you can use that for periods of time to create hypoxia, which causes an um, you know, inducible hypoxia factors which are again reparative.

Speaker 3:

We can also use other forms, like hyperbaric oxygen, which has been shown to kill zombie cells, which are part of the aging process, that spew out inflammation and that increase your telomere length, by using hyperbaric oxygen, which is basically a pressure chamber where you are basically under the water, equivalent of two atmospheres of pressure and 100% oxygen, which is a stress to the body and that creates a healing response. Ozone is another therapy. So there's many of these kinds of therapies that are available to us. Some are easy to get to and some are a little bit more challenging or expensive, but they're around and those are the kinds of things that really activate their body's healing system. So I make sure I activate some type of hormesis every day.

Speaker 1:

What is it about the stress or the exercise or the event? Um, that that takes it from beneficial to harmful, like a little bit of stress is beneficial but chronic stress is harmful. A little bit of exercise, I mean, or moderate exercise, is good, but too much is harmful.

Speaker 3:

What what's the?

Speaker 3:

difference I mean. Well, to paraphrase the parasol, the dose makes the poison right. So I think you know you've got to find that Goldilocks version of the stress. If you again stay in the sauna too long, you'll die of heat stroke. If you stay in a cold plunge too long, you'll die of hypothermia. If you have oxygen hypoxia too long, you'll, you know, run out of oxygen. If you're in a hyperbaric chamber too long, you'll get oxygen toxicity from being in too high oxygen state. So I mean, it's just really about finding that perfect dose of use. Don't eat for 16 hours or 24, 36 hours, you're fine. If you don't eat for a month, you're dead.

Speaker 2:

So it's really about finding that Goldilocks version it's, it's, um, what we call the inverted u-shaped curve, which is a very common relationship, uh, where you need a certain amount of whatever the stimulus is to activate, but then if you go too far past it, then you bring that curve back down. So, stress and performance, the challenges that you're talking about, you want to challenge the body is what I'm hearing but you want to do it within a certain framework where you're not overloading the body.

Speaker 3:

Exactly.

Speaker 1:

Yeah, Part of the one of the emphasis of this program is on inflammation and inflammation. Could you talk about how inflammation drives aging or how the hallmarks of aging are affected by inflammation?

Speaker 3:

Yeah, well, I mean, first of all, you know inflammation is something we're all familiar with. It's this process where there's pain and inflammation, through which leads to swelling and heat, and you know, it's the classic signs of inflammation. But what's really going on is more sterile, chronic inflammation in the body that's influencing all the diseases that we see today in the world, from depression to cancer, to obesity, to diabetes, to heart disease, autoimmune diseases, obviously, and more, and these are all driven by these underlying factors that are driving inflammation Our diet, our inflammatory diet, our processed foods, our sedentary lifestyle, our chronic stress levels, environmental toxins, our sedentary lifestyle, our chronic stress levels, environmental toxins, changes to our microbiome all these things are driving inflammation, and so that has a massive effect throughout the body. And as we begin to understand the process of aging, scientists talk about the hallmarks of aging.

Speaker 3:

Some say there's nine, I say there's 10, I include the microbiome, but essentially these are all things that go wrong as a result of various insults in the body or insults to the body, or lack of certain things we need to thrive, like good food and sleep and the right nutrients, et cetera, and so inflammation is kind of a common unifying theory around a lot of this and all the hallmarks of aging are both caused by and can cause inflammation, so they're really insufferable. And the hallmarks of aging are both caused by and can cause inflammation, so they're really insufferable. And the hallmarks of aging are, I think you might or may not be familiar with. There are things like damage to our dna problems, their epigenome mitochondrial injury, proteins that are messed up and not folded properly, or injured um problems with our nutrient sensing system. This is one of the essential features and it also drives a lot of inflammation, which is how we regulate our our responses to proteins and sugars and things in our diet that regulate the aging process.

Speaker 3:

So too much sugar and starch, which is the predominant source of our calories in our diet today, drives these inflammation pathways and that makes this process of inflammation, inflammation worse. And so you know, we have all these ways and even the microbiome you know is a huge source of inflammation because of our toxic diet and that affects our microbiome and that creates changes in the rest of our biology. That drives inflammation. So inflammation is this common unifying theory, but it's both the cause and the and the effect. It's both causes a lot of the other hallmarks of aging, but it's caused by a lot of the other hallmarks of aging, so it's really one. I mean, it's not really good to call them all separate. They're really one interlocking set of problems that if you deal with the root causes upstream to the hallmarks of aging, you deal with all of them.

Speaker 3:

So a lot of the science now around longevity is focused on treating the hallmarks of aging, which I think is a big improvement, and seeing aging as a disease, which I think is a big improvement. But it doesn't really address the underlying phenomena that the hallmarks of aging have a cause, right, what is the cause of the cause of aging. And that's where functional medicine comes in and the framework of understanding what you're basically dying too much with, too much of or too little of your diet, too much bad food, too much stress, too much toxins, too much you know, allergens, microbes, etc. And you're dying of too little of the right things, too little of the right nutrients and the right high quality, phytochemically rich diet and the right amount of sleep and movement and etc. So it really, functional medicine helps us get to the root causes of the causes, and that's what's so important.

Speaker 1:

That's why it's such a radically different approach to aging you mentioned how, how important and powerful nutrition can be in decreasing inflammation, and certainly the role of avoiding sugars and refined carbohydrates, starches, all those things to decrease inflammation. Do you think following a diet that lowers those, is there any additional value for being in ketosis, where you've actually switched your metabolic switch to fat burning?

Speaker 3:

yeah, so there's a lot of ways to activate hormesis, right, which is this idea that that you know it sort of mimics starvation. So we know from from the research that the only thing that really extends life in animal models is calorie restriction, which is if you eat a third less calories, you live a third longer. So that's like 120 years old. But no one's going to want to do that because they're going to be hungry and irritable and have no sex drive and be frail and like. It's not a good thing. So the question is you know, how do we, how do we activate or mimic calorie restriction? And that's where we talk about time-restricted eating or intermittent fasting or fasting-mimicking diets and ketogenic diets are another form, because historically, when we ran out of food, we have about 2,500 calories, which is basically a day's worth of calories in our muscles stored as glycogen, carbohydrate. We probably have 50, I don't know, maybe, depending on who you are 100,000 or more calories stored as fat in our body and when our body can start to break down that fat, it can use that as fuel. The body is like a hybrid car it can run on gas or electric. Gas is like dirty burning fuel, carbohydrates and fat is clean burning fuel like electric. And so when you eat a ketogenic diet which historically we didn't eat a ketogenic diet, we just didn't eat. So we'd go into ketosis and we were kind of hunting and gathering. We didn't find something to eat.

Speaker 3:

We shift into this state of hormesis which activates our body in the same ways as these other forms of starvation. So we end up activating our anti-inflammatory systems, dna repair systems, we silence mTOR, we increase autophagy, we fix our mitochondria, increase mitochondrial biogenesis. We do all these things that basically create health as a consequence to make us stay alive. So we kick in all of our repair and healing mechanisms when we do that. Now the question is do we stay in ketosis all the time? Is it good to be on all the time? And I think, from an evolutionary point of view, we never were. We would eat and then we would starve, and then we'd eat and we starve. So I think it probably cyclical ketosis is not a bad idea, or any of these other techniques, and we're still trying to thread the needle on what that is. And there are drugs which are making that, like rapamycin being studied for longevity. But I think we're still in the early stages of trying to figure all that out.

Speaker 1:

Yeah, I want to talk more about rapamycin and mTOR in a bit. But before we leave the nutrition part, I think, yeah, the consensus is pretty strong about sugars and refined carbohydrates, you know, avoiding those to drive inflammation. There are a couple other things I wanted to get your take on. Is some people also, in addition to avoiding refined sugars and refined carbohydrates and sugars, they also avoid what are called seed oils or industrial oils canola? Oil, you know rapeseed all those things as drivers of inflammation. How do you feel?

Speaker 2:

about that.

Speaker 3:

Is that?

Speaker 1:

important to do or.

Speaker 3:

Yeah, I mean, I think, know. The problem is, you know, we, we always consume these oils, but in their original state, right, we eat the beans or the seeds or the nuts or sources of these oils that were were found in in whole foods. What we've done, you know, in the last hundred plus years we've we've invented this refining process where we've pressed and extracted the heat and solvents, these oils from various plants that are really unknown to our biology, in the sense, for example, soybean oil has increased a thousandfold in its consumption in the last hundred years. So when you see something like that, I'm like, is that really good for us? And I think in general know, in general a little bit, it's not going to be bad and many of the observational studies show that it's good for you.

Speaker 3:

I think there's a real challenge with nutrition science. It's hard to do good experiments with people. It's hard to do good experiments because you can't, you know, lock 10,000 people up for 30 years in a room and another 30, another. Lock 10,000 people up for 30 years in a room and another 30, another 10,000 people another room and feed them two different diets and see what happens, which would be the best thing to do, which is never going to happen. So we kind of have to extrapolate and that's why there's so much nutritional confusion in the literature. Personally I think that you know the main oils we should be consuming are olive oil, extra virgin olive oil, avocado oil, which is an oil that's more monounsaturated, it's a higher temperature heat, some coconut oil. Depending on your health and lipids and your genetics, you know, some people tolerate more saturated fat and I don't think it's the boogeyman that it was thought to be. So coconut oil can be helpful. Animal fats typically are fine for most people. I think you know the whole idea of cholesterol and animal fat. That's been really well debunked from the literature in terms of cardiovascular effects. In fact there are trials from Sarah Hallberg and others where they put type 2 diabetics on ketogenic diets basically butter and you know, and coconut oil and other fats and super high fat, 70% fat diets, and every single one of the cardiovascular biomarkers got better or more neutral. So I think there's really good evidence that in interventional trials that there's really little harm, especially in metabolic and healthy people.

Speaker 3:

So my personal opinion is I don't consume those oils. I avoid them. They're ubiquitous in processed foods. We don't actually even think we're consuming them. We may not use them in our kitchen of foods. We don't actually even think we're consuming them. We may not use them in our kitchen, but people do. Vegetable oil, corn oil, soybean oil, canola oils all these oils I typically stay away from them and I think I consume them in their whole food forms. I think we do need them and the people I've seen have extremely high imbalances in omega-3s and omega-6. When you have too much omega-6, it can create problems with the function of the omega-3 fats, so you kind of, in a way, invalidate the omega-3 fats. So it's not bad to have omega-6, as we need them. They're essential fatty acids but it's just really the right ratio and balance.

Speaker 1:

And one last food question. One other area people talk about is grains, and you know even people who don't have full blown gluten intolerance or celiac disease. Do you recommend avoiding grains themselves, whole grains or any kind of grains, as drivers of inflammation?

Speaker 3:

Well, I mean, there's two questions there. If you have celiac disease, you should definitely avoid gluten. There's no question about that from anybody in medicine. Grains as a whole are not all gluten grains. You can eat black rice, you can eat buckwheat, you can eat amaranth quinoa these are all ancient grains that can be healthful. However, when you are metabolically very unhealthy which is about 93% of Americans the more even of these quote healthful grains that you consume, they can be problematic.

Speaker 3:

So one of the things that's emerging that I really think is fabulous is the ability to monitor our own biomarkers in real time. So now we have continuous glucose monitors. You can measure your blood sugar, and so you can stick a little thing on your arm the patch and have this continuous read of your blood sugar and you can see. If I eat a cup of rice, what does that do. If I eat a cup of quinoa, what does that do? So some people can tolerate it, but other people it is a problem, and for people who are in the extreme ends, like type two diabetes, I don't think they should have any grains or beans until they're able to reverse their type of diabetes and then they can broaden their diet. So I'm not extremist. I do think in certain situations you need a more aggressive approach, and that may include limiting grains and beans.

Speaker 2:

Yeah, thank you. Thank you. We're talking about what can impact our biology. We're talking about hermesis and different challenges, but you've also talked about the power of community and love to actually change our biology. Can you expand on that?

Speaker 3:

Sure, there's a whole new field emerging that it's called sociogenomics, which is understanding of how our social connections and interactions influence our gene expression. And we know from these data points that if you're lonely or isolated or disconnected, don't have physical touch or community, that you age faster, that you die sooner. That is an extreme high risk factor for all kinds of diseases and death, and that if you have community and you have connection and you have meaning and purpose, that you live longer. And so it really. We understand not only just this from a population-based study perspective, but actually from the mechanistic perspective.

Speaker 3:

And I traveled to Sardinia and Korea as part of the Blue Zones. My friend Dan Buechner introduced me to people there. I got to really see inside these people's lives and there's this deep sense of meaning and purpose and connection and community. They're not stressed all the time and busy all the time and they just want to sit and chat and hang out and enjoy each other, enjoy life. And it's like we kind of miss that in this culture. We're always like driving, going, doing, being productive, rather than just being and enjoying life. So I feel like you know, we're in a very interesting moment where we need to kind of rethink our values as a society and start to bring back some of those values of community and love and connection.

Speaker 2:

Yeah, yeah, so it sort of resonates with my model of resilience, where relationship is a very important component, as well as having purpose in your life. So it fits with what you're saying.

Speaker 1:

For sure. Yeah, that's so important. Well, maybe I can go from love and community and kind of go back to another question what are the most promising longevity compounds? And from a functional medicine doctor, yeah, yeah, what do you want?

Speaker 3:

I mean? I mean, honestly, food, but, um, I think, I think within food, um, there's a whole, a framework of understanding these phytochemicals, um, and this whole emerging field of phytohormesis, which is the idea that within the plant world and even within animals who eat those plants when you eat those animals or their milk or cheese actually contain these very powerful compounds from nature that we've co-evolved with, that regulate our biology and can have really remarkable effects. For example, phycetin in strawberries, which is a compound that seems to activate many of the positive nutrient-sensing pathways that we want to activate properly when we want to think about longevity, for example, like senolytic processes, which we kill, these zombie cells, or we increase autophagy, or we decrease inflammation through inhibiting.

Speaker 3:

NF-kappa B, or we increase mitochondrial biogenesis and function, meaning we use our energy system function. These compounds really do that, and they're. They can come from green tea, from red grape skin or taro skill bean, which is another compound. Curcumin, you know, one of my favorite compounds is something called quercetin and some of the bioflavonoids that are found in Himalayan tartary buckwheat as a plant, which you can eat as pancakes, believe it or not, or as a supplement, but in that there's something called tuahoba, which is an immunorejuvenating compound that's down nowhere else in nature. Big Boat Health makes this. Jeffrey Bland, my mentor, is the founder of that company, and so there are all kinds of these magical compounds in food that we can use, from green tea, catechins, curcumin and a real promise, and I tend to consume these foods as much as I can. I tend to take supplements with them in them. But then there's a whole class of pharmaceuticals that are being explored, and two of the most promising ones have to do with regulating two of the nutrient-sensing pathways that are part of one of the hallmarks of aging mTOR and MPK, and so one of them is called rapamycin. It's a compound that was discovered in Rapa Nui in the 60s. Rapa Nui is Easter Island, where they have these weird statues that I think aliens brought down or something. They got there but they found that on the back of the statues there was this compound that we thought maybe was an antifungal or had other properties. But it wasn't so good. It kind of maybe was helpful in transplant medicine for immune modulation, but then we discovered it regulates this ancient survival pathway called mTOR, which is needed to build muscle, for protein synthesis, but also it needs to be silenced at moments to increase autophagy, which is the recycling repair system we talked about. And so this drug, rapamycin, which is named after epineuie. It binds this receptor called mTOR, which is named after the drug called mammalian targeted rapamycin. It actually seems to extend life in animals and reverse a lot of the biological signs of aging and hallmarks of aging. Probably not, I think there's still a lot of research needs to be done. There's a lot of questions about the dosage and safety, the frequency, the timing. There's a lot of companies I just talked to the CEO of one of them today who are creating rapamycin analogs that may be better with side effects. So that's a really exciting compound, I think.

Speaker 3:

Another one is metformin. I'm a little dubious about it. It works on a pathway called AMPK which regulates insulin resistance and use for diabetes. But all the studies I've seen on metformin is that it actually works, but it doesn't work as well as lifestyle. So it's like people are like, oh, I'm going to take this drug and I'm going to change my diet.

Speaker 3:

Well, no, I mean in the large diabetes prevention trial for a thousand people, they found that people who lived a healthy lifestyle and it was actually a really crappy diet for diabetes. It was a low fat diet but they had other supports and exercise and group meetings and healthier food, but it was low fat, which is not the right diet for the diabetics. It still was far better than metformin and nothing. So you know there was a 58% reduction in progression of diabetes with people doing that, versus a 31% reduction with metformin. So you know, even if you, for example, would do a study on like Sarah Halberg's work, and you know you look at maybe a 60% reversal of diabetes, not just prevention a. You know you look at maybe a 60% reversal of diabetes, not just prevention. A. You know 100% reduction in some of the main medications and 12% weight loss. I mean just staggering numbers If you were to use that kind of diet with these people. You'd see, probably you know metformin would look like it barely had a blip on the graph in terms of efficacy.

Speaker 3:

So I kind of I'm a little dubious. There's a big trial going on now, the DEPAIN trial, which is coming out. It doesn't. It's not without side effects. It does have some adverse effects on mitochondria. So I kind of don't like the idea. That that's what I said I'm more optimistic about. But again, I think there needs to be more research and maybe the use of some derivative compounds that don't have the side effects. But I mean the longevity research is just accelerating at a rapid pace. Yeah.

Speaker 2:

You mentioned mTOR, and how do you reconcile the need, as we grow older, to silence mTOR with also the need to maintain grow muscle?

Speaker 3:

Yeah. So this is the thing you know. You've got this pathway. That's essential for building muscle, which is the currency of aging, and sarcopenia, which means loss of muscle, is really what people die from like, from frailty and weakness, and the metabolic consequences of replacing muscle with fat, even if you're normal weight as you get older. So keeping your muscle mass is critical as you get older. But it's also important to increase autophagy, which is the ability of the body to recycle and repair and clean up old parts. So we both need the demo team and the construction team, right, and it's got to be a balance.

Speaker 3:

So a lot of people say, oh, you should be vegan because you want to silence mTOR and you want to fast all the time. So a lot of people say, oh, you should be vegan because you want to silence mTOR and you want to fast all the time. I'm like well, no, I mean, you need times where you're actually building muscle and you need times where you're not. And so within the course of a day, it's not that hard to do. You just do a 12, 14, 16-hour fast, right overnight fast, and then you work out and then you have a load of good quality protein that activates mTOR for muscle synthesis, and it's the surest way to maintain and keep your muscle. And then having adequate amounts of protein throughout the day at each meal, with the right amounts of leucine.

Speaker 3:

Now, leucine is an amino acid that's not more an animal protein, lower in plant proteins and you know you have to eat a ton of plant protein to eat the equivalent in terms of its leucine and branched amino acids, which are critical for protein synthesis. So, people who just don't understand this well, you can get all your protein from animal plants, well, yes, but you, you know, you have to have six cups of brown rice to get the equivalent of a four ounce of chicken. Nobody's going to eat six cups of brown rice, so, or two cups of beans. So I think you just have to be realistic about the dose and the quality of the protein, and you need to modify your diet as you get older. And even studies that may suggest that having lower protein when you're younger is better, they all show that when you get older it's not.

Speaker 3:

It's really important to have high quality protein, and the Protege Study, which is a big survey of all the science on protein and aging and muscle mass and sarcopenia by leading aging researchers, leading protein experts in the world, all came to the same conclusion we need not just 0.8 grams per kilo, but we probably need 1.2 to 2 grams per kilo, depending on our activity level, to build and maintain muscle as we get older. And yet we have to, again, also give breaks and activate autophagy, and there may be compounds like rapamycin that we can begin to take that actually even accelerate the autophagy and kind of thread the needle a little bit. So it's kind of an exciting time but I think people need to understand that it's you can't go extreme one way or the other are you using rapamycin with your patients or in your group?

Speaker 1:

uh currently not not.

Speaker 3:

No, I think it's still too experimental. I mean, there are biohackers who are using it. There are leading aging researchers who are taking it. I think it's definitely very fascinating, but I think it also has side effects. I think it's a drug. It's not like. It's like I say eat lots of strawberries, from wild strawberries, which are high concentrations of quercetin. You're not going to get in trouble doing that, right?

Speaker 1:

Yeah Well, we're almost out of time. Is there anything we haven't talked about that you're particularly excited about? That we need to need to cover here?

Speaker 3:

I mean, I think I think the message I would love people to take home is that is that you know, we're at this really exciting transitional point in medicine where, for the first time, we understand the laws of biology and how to activate our body's own healing system. And it's not by treating disease, it's by creating health, and functional medicine is the framework for doing that, packed with the science of how this works and what's at the root cause of aging and the root cause of the hallmarks of aging, and give you a very practical sense of tools and a pathway and roadmap to follow that actually will help activate all these healing systems and reverse the biological age.

Speaker 2:

Yeah, yeah Now, you know we usually end by asking you one or two things that people can do to improve their longevity, but I'm so pleased that you've been giving us a whole menu of things throughout our talk, so that's really great. I really appreciate that. How can people reach you if they wanted to learn more about your work?

Speaker 3:

Well, they can find me on my podcast, the Doctor's Pharmacy with an F. My website is Dr Mark Hyman I'm sorry, Dr Hymancom and on social media it's just Dr Mark Hyman, Dr Mark Hyman, and they'll have more than enough of me.

Speaker 1:

Great Well, thanks. Thanks so much, mark, for taking an hour to spend with us and our audience here, and thanks also for the great work you're doing in this field. It's really been a pleasure.

Speaker 3:

Thank you so much, thank you.