Health, Wellness & Performance Coaching

Big Data and Our Health: Stanford's Dr. Michael Snyder (Episode #170)

June 07, 2021 Dr. Michael Snyder Season 3 Episode 23
Health, Wellness & Performance Coaching
Big Data and Our Health: Stanford's Dr. Michael Snyder (Episode #170)
Show Notes Transcript

What if the device that you are wearing on your wrist is the key to  more effective healthcare? The opportunities as we will learn in this interview, are endless.  In todays podcast we will be talking about precision health with Stanford's  top experts in this area, Dr. Michael Snyder.  

 Dr. Michael Snyder, Chairman of the Genetics Department at Stanford Medicine, is the world’s leading expert in precision health research. He was recruited by Stanford in 2009 to chair the Genetics Department and direct the Center for Genomics and Personalized Medicine. Under his leadership, U.S. News & World Report has ranked Stanford University first or tied for first in Genetics, Genomics, and Bioinformatics every year for the last decade. As an entrepreneur, Dr. Snyder’s cofounded companies have collectively raised $242 million in venture capital and are worth more than $6 billion in value.

For more information about the Catalyst Community, earning your health & wellness coaching certification, the annual Rocky Mountain Coaching Retreat & Symposium and much more, please see https://www.catalystcoachinginstitute.com/ or reach out to us [email protected]

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 Finally, if you enjoy the Catalyst Podcast, you might also enjoy the YouTube Coaching Channel, which provides a full library of freely available videos covering health, wellness & performance: https://www.youtube.com/c/CoachingChannel

Speaker 1:

What if that device you're wearing on your wrist was the key to more effective healthcare . And now I'm not simply talking about tracking your steps. We're talking about precision health. And today you're going to hear from one of the Globe's top experts in this area, Stanford Steiker Michael Snyder . Welcome to the latest episode of the catalyst, health, wellness, and performance coaching podcast. I'm your host, Dr. Bradford Cooper of the catalyst coaching Institute. And like many of you I'm intrigued about the potential of these little computers, rather wrists from Fitbits to garments and everything in between the opportunities as we'll learn today are truly endless. Today's guest is Dr. Michael Snyder , chairman of the genetics department at Stanford medicine. He is the world's leading expert in precision health research. And you're gonna understand why after you hear him . Additionally, as an entrepreneur, Dr. Snyder's co-founding companies have collectively raised $242 million in venture capital and are worth more than $6 billion in value as always. Do you have any questions about your current or future careers, the health and wellness coach, please pop over to catalyst coaching institute.com or feel free to reach out to us anytime [email protected] We'll set up some time to talk. Now it's time for Stanford, Dr. Michael Snyder on the latest episode of the catalyst, health, wellness, and performance coaching podcast. Dr. Steiner , thanks for joining us today. This is a privilege is on short notice. Thanks for jumping on.

Speaker 2:

Great to be here.

Speaker 1:

So right out the gate, let's jump off the deep end. How did you originally become drawn to precision health research? This is a big deal. You're on the cutting edge here. Give us the scoop on this.

Speaker 2:

Yeah, well it stems from the research we do in general . We , people used to study genes and problems, one component at a time. So I are stick when I started my research career quite a while ago. It was really to look at everything at once. So rather than one , a little bit here, so a little bit there, we would try and see the whole picture basically. And so we did it initially for solving biological problems, like how to cells know where to grow and things like that. When I moved to Sanford about a dozen years ago, we really decided we need to do this for medicine . What really hit me was when the first time I arrived here, I went in new health plan. Like you normally do when you hold blood. And they gave me these 12 measurements here, we are in a modern world and they're giving us, you know, a very small number of measurements, most of which are worthless, right. We should really be doing this entirely different. And that's what, that's what triggered this.

Speaker 1:

Wow. So, so had it been something that was intriguing to you most of your life, you know, through your running or some of those kinds of things, and then you got drawn into it even more so a dozen years ago when you went through that process?

Speaker 2:

Yeah, I think it was just that we're , we're just big on, on solving problems with big databases. And I think that's really what drew me to it, that we were just, medicine was broken so many different ways and, and that is our big sick. The more I thought about the, I thought we need to transform the whole thing. We were very focused on treating people when they're ill. Uh, you know, we're very reactive. Everything though , every decision about your health will be based on population based measurement . Uh , and it's not based on individuals. And if anyone should know that it's actually probably the people you're talking to because they, they perform at an individual level. And, and, you know, especially when you're trying to reach your peak performance, you have to tighter it just right. You can't overdo it or you get injured. And if you under-do it, you underperform. So now I think it's true for just people in general. We really need to optimize our health on an individual basis. And it's obvious from everything you do from your , you know , your sleep from how you train, how your exercise , uh, we're, we're all individuals, and we need to treat people that way. So that's our general philosophy.

Speaker 1:

So you said healthcare was broken and I, I'm going to say, I think it still is though , Are these things that people can say, Hey, I heard this interview. I want this done with my blood testing, or are these things people can request now? Or is this just in the research process? And it's really not available at this point,

Speaker 2:

Small amount of it can now get out. The wearables will probably talk about that everybody can access. And I think that's going to be an important part of people's health, but the other things we're doing so Irish stick now is that we actually, we sample people. If you will, while they're healthy, we, we draw their blood and urine, actually their poop for their microbiome, many measurements as possible while they're healthy. We sample them every three months , uh, in our research project. And we'll again, make as many molecular measurements off their blood off the urine. And look at what's called the microbiome. That's, what's in your gut. And it's very important for your health so that your food very much dictates what's in your microbiome and vice versa. It , you know, your it digest your food makes essential vitamins, all that sort of stuff. So, so we think measuring all these things can be very powerful for , for us understanding better how we work at an individual level. What does it mean to be healthy? How does that change over time or some of the big questions we're getting at, but more importantly, trying to use these technologies to, to be able to see, can they be used to manage people's health better? And actually just from the group we've been profiling, it's 109 people we've been setting, believe it or not for eight years. Wow. Me , me 11 years. I'm one of the 109 . Uh , and just from the first little over three years, we had , uh , it was 49 major health discoveries by doing these deep profiles, right ? We want somebody with early lymphoma , um, two people at what are called pre-cancers , meaning they're not cancer shat, but they can't convert the aggressive cancers. And by seeing the show actually monitor more closely, I have my own ideas, what they should do, but mind you, I should point out I'm not an MD, but , um , having said that , it's probably why I look at those from very different eyes than , but we call it to me with serious heart issues. Uh , all , you know, several people with diabetes to know a lot of people with prediabetes , most people have prediabetes don't know it, and 70% of them will become diabetic. So we think it's really important to find all these things. He can again, make adjustments and why you're so healthy before you're symptomatic and actually, you know, start taking control of your health. That's really the , the mantra we do. And it seems to be working. So we have spun. Some of this offers companies. So I think academics are great at , you know , discovering things, setting up proof of principles, but those where companies can kick in and actually scale this and do it , uh , at a way that academics can't. So, so we just want companies off the one that does a deep dive on data. Uh , it's called cube bio, and they spell that for us Q bio BI . So what they'll do is they'll do , uh , what we do these deep molecular measurements on a whole body MRI. It's not cheap, it's $3,500 and they'll do it longitudinally. Uh , and they'll follow again, your health at a level nobody does. And right off the bat, same as I researched study , they found some pretty important things. They caught somebody that early pancreatic cancer, prostate cancer, ovarian cancer, to be able to heart issues. It's an older group. I should plan out for both our study and what Q bio generally studies. So it's 53.4 is the median age when people join a broad group, but mind you, again, these have been pretty important thing . Sometimes it's a genome sequence that revealed something important. Like when you saw a mutation in a gene that said, this person might have a heart defect and sure enough, they did interesting . Now they're on drugs. They caught him again before he had any issues, but he did something called a stress echo follow up , actually a , um, it's , he's got a problem. He should be on medication, which he is. And another person who had a mutation said, they're high risk for cancer. They did a whole body MRI follow-up and sure enough, they actually had early thyroid cancer that was removed when they kept most of her thyroid . So , so it's a sort of preventative medicine, if you will using big data to try and get a picture of you that you're not getting now. And see if anything's up that you might want to take corrective action on that's that's a general idea.

Speaker 1:

Yeah. It's so interesting. I know people are looking up to bile right now. All right . You have a reputation for wearing four smartwatches simultaneously. We're just curious, which [inaudible] ,

Speaker 2:

It's apple, Fitbit, Garmin, and , uh, here, I'm totally biased against , uh Sensomics. As a, as a company, I started as well with the idea again, of a lot of these watches. They're , they're great watches, but many of them, you know, they're , they'll read your email and this kind of stuff. So it's not just building a watch. It's a little more focused on. Yeah. Interestingly , I think that's powerful. It's higher resolution. So we think we can catch things again. We'll talk about that a little later. I'm sure. But we think it's going to be pretty powerful for those. Yeah. So anyway, those are the four watches. I usually wear an aura ring to that one. I lost my accident and I got to get a new one back and I have other kinds of devices to measure environmental exposures with this thing . Um , then all these sorts of things. So, so anyway, yeah, I'm uh , probably the ultimate of quantified .

Speaker 1:

So how similar is the data? It seems like, and we can, we'll talk about HRV and sleep data and, you know , resting heart rate and all that kind of stuff. But are you seeing similar results with each of the four? Or is it like this one's really good at this and this one's really bad at this, but really good at this one.

Speaker 2:

Right? So they're all good at heart rate and heart rate variability, I think. And then when it comes to other things, they simply either don't measure them. Some devices will measure skin temperature, some will measure blood oxygen. None of them are good at absolute levels of blood oxygen, but they're kind of picking up shifts. And again, some devices do that others don't. So, and this shifts by the way is important. See, we're all different. We all have different baseline measurements ensuring that you and the listeners know this already. We want different heart rate, blood oxygen, et cetera. And that's not the key part when you're looking at somebody to help. The key part is if , if you start getting yelled at , you will see a shift has changed and that's the key and people don't do that. Now that's another big part of, I was , it's not just big data. It's the fact that we collect it . What's called longitudinally over time. And even in today's health world, when you get to a doctor's office, they measure you. And they only looked at those measures moment , right ? If you're in range or not, they never looked back. And for all, you know, you're trending in a bad direction with one of your markers and they would never know because you're in range, everything's fine, but you can be trending in a bad direction and to be just, you know, below out of range. And, and that would be useful to know . So, so that's another big part. We , we try and follow people's personal trajectories so we can see if something's going off. And that turns out to be pretty powerful for following someone's health.

Speaker 1:

And it seems to , I remember the NBA was using the aura to kind of get some early possible, not, not definitive, but possible signs that somebody had COVID or had been , uh , in that circle.

Speaker 2:

Yeah. I haven't seen the results of that study yet. Uh , we actually have one rolling out now with PAC 12, you may have ran out . So we partnered with the Fitbit to be able to do similar thing with PAC 12. See these folks are getting tested quite frequently. So it's really nice if you can put a device on and see if we can pick those up. So if you'd like, I can tell you a little more about our study in that area. Definitely. Definitely. Yeah . So we're, we're very keen on wearables and we got involved in this about eight years ago before the apple watch existed and , um, Fitbit was out there and there was another watch that we use called basis. They don't exist anymore. And people were using Ms. Fitness trackers and they've put them on. They know their , you know, they know their steps when they're having something three months later to throw in a drawer. Because once you figure out your habits, you get it . And we realized these are pretty powerful, physiological monitors, right? They're measuring all kinds of important things. And , uh , even the cheapest devices make a few hundred thousand measurements per day, but some will make 2.5 million measurements on you every day. So they're just measuring you constantly 24, 7, 365 days a year if he didn't charge. So what we realized , they're pretty powerful. So, you know, we put them on air folks, these 109 people are all wearing Fitbits or whatever. And then now Fitbits and or apple watch, we let them wear whatever they like. And we , we , um, uh, I'm one of those. And so what we discovered is fun thing. Some, most people don't know this, but your blood oxygen drops on airplanes . Pilots know it, most flight attendants don't know it. So, and it turns out it makes you tired that part's not documented in the literature, but it's off it's . We did some studies to show that that when you're. Yeah. So the bottom line is you fall asleep on airplanes. Not because you've been working too hard or partying too much, what happened is cause they reduce the pressure in the cabin and your blood oxygen drops. You get tired. So in hindsight, pretty obvious, what we discovered is as wearing these is that , uh , I actually figured out my line disease of all things from this. And it was from a spinoff of what I was just telling you. I was flying to Norway through Frankfurt , Germany. That story was two weeks early . I'd been putting up fences in rural Massachusetts for one day with my brother, 55% of ticks are alive infested . And then I'm flying to Norway two weeks later and you can tell and measure me all the time and why my blood oxygen was abnormally low on this last flight. And my heart rate was running high and it's something's up. And , uh , you know, I measured it. I knew it was way low and it didn't go back to normal. When I landed. Then later, next day I got a low grade fever. It was kind of going off and on. So I went to a doctor finally. Normally I warned them might be in line because of the two weeks. You know, he drew blood say , yep , your immune cells are up. You've got a bacterial infection. You need penicillin. I said, no, I need dogs . He's like what? You feel like a little tension going on there for a few moments. He , he did give him because , uh, you know, I was persistent I guess, and it , two weeks I cleared it up right away, but you'd take him for two weeks. When I got back, I test size line positive, and I give a blood three days before I left because I do this all the time. Negative size here converted during that time, very well controlled experiment that should, we can pick up Lyme disease. So we went back and looked at all the data I had at two years of data on this watch. And it turns out there were every single time I was ill. There were four periods. One was lying to her viral infections. And the fourth time I was asymptomatic, but I know as ill because there's a, Margaret's called C-reactive protein. That was high. You get ill. It goes way up. And it was just as high as you know , at the time, all four of those times I had a high heart rate and it turns out how you had a high skin temperature too. So in retrospect, we could see this. So we wrote an algorithm, we call it change of heart. It works well. And heart rate, not so well . And skin temperature picks up when your resting heart rate jumps up over your personal baseline. And so you build a baseline measurement on you and you look for this jump up and signal and it works great. We should retrospect the way it would pick up all my viral infections on that of other blowout cohort. So , so as you might imagine, yeah, we're pretty pleased with that. We published it about four years ago. And then as you might imagine, when the pandemic hit, we just ramped us up big time. We'd been improving the algorithms that we're building an infrastructure. This is a big deal. We're trying to build an infrastructure that can follow everyone in the world. Believe it or not. Right now, we know we can handle tens of millions of people. But what it does is it's meant to follow you in real time, your health in real time. So, and the way it works is pretty similar to what I said. It'll it'll follow your baseline. Well, first of all, with COVID we had the first show at work. So we quickly enroll . We launch a study. As soon as pandemic came, got 5,000 people to join 32 Fitbit users wearing a watch when they had COVID and sure enough, 26 to 32, we could pick up this elevated resting heart rate signature. So we said, all right, it works . So then we wrote an alarming system, which we first showed retrospectively works. It can tell when you're getting ill turns out a median of four days before symptoms. So COVID has a long asymptomatic period pre-symptomatic period, and it's not specific for COVID. If you other viral infections will trigger this alarm toe . And that's about two days before illness. So similar to our previous study, then that makes sense. Again, COVID has a little bit longer pre-symptomatic period. So we can again, see this thing go up and it works about 70% of the time. So we've now launched a study. We'll have all the listeners to sign up it's innovations.stanford.edu/wearables innovations.stanford.edu/wearables. Please sign up. We have this alerting system now that we set up, we just launch it in December and it works. Basically. We tuned it in a way that alarms will go off roughly every two months. And they're not COVID alarms. Uh , most of the time it's of course it does go up when you do get COVID again, we can pick it up. 70 turns out 73% of the time. Wow. Again, before symptoms, which is good. It'll go up sometimes after those, we call missiles . But anyway, it works most of the time. We know if we can get higher resolution data, we'll do better. And other data types like heart rate variability, we talked about when to bring in these other things. And I think I I'm pretty confident we could get those much, much higher hope to 95% or better. So we think this is going to be powerful, at least , uh , hopefully for the pandemic as well as the future in general. Because if you think about the way people get tested now is usually after they get ill, right . Or, or maybe weekly screening at best the case , this pandemic, unless you're an NBA player, right . But for the rest of us , that's once a week or not at all until we're ill. But these things are following you 24 7, and they're just so much more powerful. They're cheap, right? Relatively speaking, a hundred dollar watch. We'll do the thing that we'll do the alarming. And it , it works at some level. And I know like, say, I know we can improve. That's why we want people to sign up for a study so we can perfect. The algorithm . The alarm goes off. You send us an alert again. It's not just COVID triggers other respiratory viruses drinking way too much can do it. Not just for dinner, but if you drank , if you tie went on, you'll be hung over the next day. Your heart rate will be off. And to be honest for this group, you have to watch a little bit too, because people who , uh, like if you run a marathon, it usually takes several days to recover. That will trigger the alarm to interesting overexertion will , will trigger it. And you have not normal insert exertion, but we'll we track your normal patterns. So the way it works is we're following your normal baseline pattern and you see this elevated signal. This is way off from your baseline and that's what sets the alarm off.

Speaker 1:

Okay. So let's talk accuracy on somebody saying we had an HRV expert with our , on the show probably a year ago. We talked a lot about that. It seems like the HRV , at least with the device that I use, which I won't name, you know, which one I'm talking about, it's not consistent. The HRV doesn't seem to follow any sort of pattern. Is that just me not realizing maybe some of the other things that could be affecting it or finding the HRV with the basics do tend to be pretty accurate.

Speaker 2:

I think they're pretty accurate these days and if they're authorized systematically. So I think if you were shifting, it's probably something else.

Speaker 1:

Okay . And are there

Speaker 2:

Patterns by the way, to these things, you know, I'm sure you know that already, but to see how people exercise, even in California, people have seasonal patterns. We could actually show their two biological seasons in California based on how people's molecules fluctuates kind of cool.

Speaker 1:

Now, are there certain device ? If , if people are out there going, you know what? I had a device , I haven't really used it much. Is there, is there one that you would lean towards for the fitness? Another one that you would lean more towards the health, one that, you know, are there things that you say this one's great for this piece, this one's great for that piece? Any guidance there from your expertise there?

Speaker 2:

Well, I probably shouldn't be going around promoting certain devices beyond my own that let's just say we do look for high resolution. So I would look at something called a Hertz that tells you how often you're you're sampling. And I would look for all those things, heart rate, heart rate, variability at high Hertz . And then if you came skin temperature is going up for a health. I would definitely pull in skin temperature. And we think the , the blood oxygen, again, it's the Delta that counts because the absolute values won't be that great. That's a good one to have to , some of the devices are now coming out with blood pressure. We're evaluating now . You know, again, I don't think they're super accurate, but I think I do think they are capturing differences at the end. That's going to be again, once even if it off, even that time, I told you about wine disease I was using to pulse-ox is believe it or not, one was accurate. One wasn't accurate. Even the inaccurate one. I could see that. Yeah, because the shift that counts. So that's probably the right measurement to use relevant to your audience, to , you know, people. Um, there's another pet peeve of mine about the health system. People, all doctors right now, absolutely tell you don't get a whole body MRI. Uh, and they'll say, if you do a whole body MRI, you're going to see lesions guarantee it. You'll see them in your prostate came in their ovaries. We all have them . That's not the issue. The issue is, are any of them growing, okay? And you'll never know that unless you get the baseline and most of them won't be growing . Hopefully none of them will , will be growing by given that everyone's going to get cancer in their lifetime. At least 60% of people will . It's not a bad idea to be following this stuff, right? So those are the power of longitudinal profiling, where you think that you really want to follow people while they're healthy. So you can see these shifts if I went and measured you after you got cancer right now, but I have no way of knowing which of your lesions are growing there . And so I think that's a key part is this longitudinal aspect. And again, with the wearables, of course, it's trivial, it's like that stuff. And so we build out rhythms, we'll have a paper coming out pretty soon where we can show those skills beyond infectious disease for the wearables. We can actually see if you think about makes sense, we can tell your hemoglobin, cause it's measuring that, right? Some of these devices, when they do their measurements, they're actually looking at your hemoglobin level of touch with your oxygen hemoglobin, but it uses something called spectroscopy. Anyway, it'll follow that. Uh, and it can give you a sense of how much blood you have , whether you're getting anemic, how hydrated you are. All these things can get picked up with a smartwatch. And , and there's actually some measurements that don't have a clinical correlate, like something called galvanic stress response. So it's measuring conductants on your skin. Some of the devices do that. And that actually that you don't get that majored in clinic, but it turns out that some measure of skin dryness or stress actually more stress you sweat more. If you're getting diabetic, your skin gets drier and it goes down. So there's actually signal from all these things that actually have some, you know, some signal about your health and you put them all together to get a better idea of what's going on. They're not, they're not clinical measurements, but they're kind of like giving you clues, right . Things up, just like I was telling you about the infectious disease. You see your heart rate, jump up, you know, something's up, they're real, they're real signals.

Speaker 1:

All right . So what's the next step after wearables? Do you , do you see smart tattoos or implants or those kinds of things and besides public opinion, what holds us back from seeing some of those in place now? Or are they there? And we're just not hearing about it.

Speaker 2:

Yeah. I'd say smart clothes are just coming out where people sensors on clothes , but there's no question that the rings and the watches and the most convenient , uh, they're , they're pretty easy to do. I do think the next wave will probably be implantables and, and more types of sensors. So continuous glucose monitors are a big wave. I don't know if you know much about these, but uh, yeah. So they'll measure glucose 24 7. So why is this a big deal? Uh, by the way, the devices last typically 10 days, 10 to 14 days, and that's plenty to see what's going on. So , so why is this a big deal? Well , uh , 9% of the us population is diabetic and 33% is pre-diabetic and 90% of those prediabetics don't know it . I guarantee a lot of listeners right now have no idea. They're, pre-diabetic , they're spiking right after they eat a meal. And what's, what's powerful about these as they pick that up, but they also tell you what spikes you. It turns out we're all different. And you may know this already from the plane , how we handle our food. And it turns out that different foods, bite people differently. So some people spike the bread. Some deposits are some of the berries that just depends on your micro . Your microbiome is part of this, but actually it's other things as well. We just react differently to different foods. And so you have no idea what's spiking you now. And some of this is obvious in hindsight. So we , we were very big on this because , uh , people don't realize we're in an endemic . I mean, you may have noticed the us population is getting larger, but not, not by growing taller, absolutely larger than the wrong direction , uh , bylaws . And in fact, if the numbers are staggering, something like people eat 40,000 times more sugar than they did six years ago, which is incredible. So , so people are eating badly and the net result is we're getting overweight and diabetes is probably going to be worse than actually COVID when you get right down to it. And the numbers, again, they're just going up and up and up. So , uh, people, this is one way to control this , put these monitors on their , over the counter in Europe, but in the us , you need a physician order. I mean, they're very, very powerful. So again, totally biased. But we found the company once we learned about the stuff, what we showed was a lot of normal people and , uh , for a sore spikers , meaning they spike their glucose after eating a meal. And again, it depends on the person and what they eat. And that's what these devices, teacher you'll learn that, you know, whether you have possible spiker , some people will spike the brown bread and some people spike to white bread and really assess specific. Yeah , it can be. Yeah. What's interesting is we found 80% of people's spike the corn flakes and milk and stuffs like poison corn flakes and milk

Speaker 1:

20 years ago.

Speaker 2:

But it's worse than smoking would be my guess . But anyway, it's , um, it's not good. So anyway, we , we did form a company called January that actually again , uh , once we figured out what was going on in the research lab, we spun it off and , uh, that's what they do. They teach people how to eat better just by wearing these monitors. You you'll see it's really eyeopening . And all this stuff is kind of obvious in hindsight, like pulled pork. I had no idea. He pulled 350 , you know, and it's supposed to be like 90. And , uh , I'm showing the , somebody said, well, of course, Mike, everybody knows that sugar and his idea. So you learn, learn a lot, by the way, I'm type two diabetic. I don't honestly know that interesting if it was figured out from my genome, actually I first sequence my genome. So I was high risk. And then after a nasty viral, in fact, my glucose spiked out of control and never came back. And then I had to really adjust my whole, everything. I ate my exercise regime, all those stuff. And I first got on the control, but it came back later. We think of , uh , waiting I'm genetically predisposed and then the viral infection triggered it . And now we're saying with the COVID 19 pandemic, that's happening again. A lot of people are becoming diabetic after COVID, but it's one of these lasting effects. Not all, it's a subset of people. It might be people like me were genetically predisposed, not clear. So anyway, that's a new thing that people are learning. And we're kind of the first show that said , well , guess a funny kind of way, because we shared about me after mine, I had a, what's called a respiratory syncytial virus. So it's a very different kind of a common virus, not common in adults. Anyway, I got that, got pretty sick and then became type two diabetic. So I watch yeah. So, and I can see now exactly what foods spike me, which ones don't. So, so I've learned to adjust and just simple things and Daniel , the listeners like this, but you can do very, very simple things. Like if you walk after you eat, you actually suppress your glucose spike and it has a big effect. Uh, and just little simple things that, that , you know, you can learn very, very quickly to better manage your glucose. And that's the goal. Let's keep people healthy with pretty simple solutions. Uh , let's show them what's going on and try and keep people healthy. That's again, another way we want to transform medicine,

Speaker 1:

Right? All right . Your January, 2020 study aging markers and ego types, that's going to be a big interest to listeners. Walk us through the findings. I didn't completely it, but give us the basics without taking us in too deep. And what's the application to the real world with this .

Speaker 2:

Yeah. So what we discovered is that as we're following people, again, those hundred nine people, what we discovered is that most Mo molecules don't change much over time. We're pretty robust and we're pretty different by the way. It's pretty cool . Meaning that if I do your molecular signature, look at your metabolites or your proteins or whatever in your blood, you'll have a very personal pattern. And if you get sick or do exercise, what have you, you still look more like you than me. And this is why it's so important to get your own personal baseline measurement , right ? You can't tell if you're getting sick by

Speaker 1:

Test results and say, that's

Speaker 2:

The problem and set , you compare a sick year with everybody else. It doesn't work because we're all too different from me. So, so step number one is we have a fairly stable baseline and all these molecules. But what we discovered is that as we follow people over time, some of them are changing ever so slightly, but they are shifting and about 600 molecules. And the cool thing is they're not the same in all people. So some people are aging one way and other people are aging another way. So for example, I'm a pretty typical age, or my it's called my coagulation pathway, my blood coagulation and metabolic markers and things go up. That's known to happen in general over time. But I look at the next guy over and it turns out he's a cardio ager . So his cardio hypertrophic cardiomyopathy pathways, that's his top pathway shifting. So he's a heart agent . It turns out we later learned he's stage two hypertensive kind of office . We basically took all these females said, well, how many patterns are there? And the answer we saw four major patterns. Now I know there's more than four, but they're basically kidney liver metabolic and immuno agers . So your immune system, we know they're more than that. We just were underpowered the same. We're like, there's only one of the cardio wagers . So that's why we don't have a separate category for that one just yet. But we will, as we add more people. So anyway, we can see in some people are aging in all four categories. Gory is or kidney liver, you know, metabolic, immuno agers. Um, I'm actually in three of the four metabolic kidney liver, but not too much immune, which is good. And then other people just be kidney. Others are kidney plus liver. What have you? So we can see exactly how people are aging. So why is this a big deal? But I would say for two reasons, one is everybody's bombarding you with information these days about longevity pills, blah, blah. You have no way of knowing if they're working right. If you can't measure it, how do you know if they work? Now, those group might figure it out a little bit by running time or something like that. And so that's one way to try and see if your running time, maybe isn't decreasing as much as you get older, but actually those , these molecular markers could help tell us how we're aging, which is kind of cool. So if you do take Elise him or one of these things, you can say , if it works , I think more importantly, if we see how you're aging, we can try and take corrective action . So I view it like a car. Your car gets older with time and everything gets older. Some parts are going to wear out. First could be the engine could be the transmission could be the perfect analogy and you want to know what's going on there. So , uh , what should it like the cutaways your , well, what he should do is first of all , maybe he should be on drugs if something's not quite right, or it certainly exercise more. The kidney age , you're probably wants to drink more water and do things related that a liver ager may want to not go on binge drinking as much perhaps, or, you know , uh , certainly diet will affect both the metabolic in the liver. So you want to adjust your diet. So we think all the information's actionable again. And you can measure if it's really working because we have markers and see how it's going so that we think will be very, very powerful. Well, not only follow people's health, we'll follow how it's changing with time. And if something, again, seems shifting often a bad direction, one could take corrective action.

Speaker 1:

Okay. So now the practical side, people are hearing this and they're like, this is so interesting. What do I do? Like who, how do I get this? How do I get my doctor to order this test? Or whatever, what [inaudible] .

Speaker 2:

Yeah, we haven't commercialized that . Come on, doc. Yeah. I know you told me about starting all these companies. Wouldn't , you know, they didn't start one here, partly because I'm just pretty busy guy, partly because , um , it's a harder business route to hit, but it, it , there is a lot of interest in longevity. People are now putting billions of dollars area . So I do think there is value, but you need the right business plan. Maybe it was so we'll do something. But, but yeah, so you can still get a very, very crude version of this. Um, and I'll try and find a website for your listeners. But , um, there is something a group came out, which has nine markers. It's not as good as what we were doing, but it'll give some sense of how you're you're aging. Uh, and that would be one way to start, I suppose. But I think people will get more and more involved with us . There are companies that are following changes in your DNA. It's called methylation that have formed out there, but it's not in a fashion that I , as far as I can tell is actionable. So, so I think, yeah, we need to, well , basically get the setup in a way that could become accessible to everyone. I'm pretty sure all the other stuff we're setting up, by the way, with the wearables, I didn't get into so much, but we can now, so this, this infectious disease alerting, we've built the system that again, to measure millions of people in real time, see if you get a shift in heart rate because of this cloud computing , uh, looks for a shift in high rain , pings you back on learning, do that again for millions of people. And then a key aspect is to do it all through your smartphone . So you download an app. So think this is the future. Getting back to the question you're asking, we can pull in all our health information , uh , onto this app basically. But anyway, it'll pull in all your wearable information, all your clinical information, your micro-biome leave and all that information and display it. We think this is going to be the most important tool for your help in the future. Just like your car has a dashboard that shows you the health of your car, gas and July. This is what's going to be the health of the future for people. And it's not going to replace doctors. It's just going to tip you off , uh, and show, you know, look those things not right. Maybe you better go get a checkup. Just like if you put a thermometer in your mouth and it's elevated , uh , it'll tell you that, by the way, here's another one. I'll tell you, what's your ideal .

Speaker 1:

I want to get one thing here. You mentioned there's a company that does the nine factors or a group of companies. Is that something people would go through their doctor to get, or is that something they just need to Google reach out, do the research, make sure it's legit.

Speaker 2:

Yeah. What they do. Uh , um, what I've seen is that you there's a website on, I don't remember what it is now because it's not error work, but yeah, you can take your clinical markers. There's something called a hemoglobin A1C. Uh , and liver markers. I think creatine's in there. There's about, it's about eight or nine markers that are often measured when you go get your checkup . So when you go get a check , there's a standard set of things they measure. You can take those values, that along with your weight and other habits, and you plug it into this system and after the podcasts , I can send you the

Speaker 1:

Description.

Speaker 2:

Yeah. Put it in there somewhere. Again. It's not our work. And it's kind of cool though, because it says, I have no idea how accurate it is because it's a limited number of markers. If nothing else will represent the future, meaning we'll we'll , as we collect more data around people, we will get better at doing this stuff and then get better at seeing how you age, for example. Yeah , I think it will be very prayerful , but I thought of another example of how medicine's broken along the same line, which is your heart rate, right? You go to a doctor now to get your heart rate measured . And speaking of myself, my heart rate can vary by as much as 40 beats per minute, depending on what was going on. Like whether I drove there or bike there or what's going on. And even if I sat around 15 minutes, it doesn't come back. But if you pull your heart rate off of a smartwatch, first thing in the morning is pretty consistent. And the only time it shifts the either stressed or you're ill, it's , it's much more accurate than what you'd imagine a physician's office. And the reason I brought those up as a lot of physicians say, all those wearables are not very active, blah, blah, blah. Well, they're more, they're better at measuring your heart rate health. What you mentioned, the physicians are absolutely got to change this mindset.

Speaker 1:

Blood pressure is a great example. You walk in, they've got to check it. So they have you , you know, you , you literally just walked in there. Someone walks in, some people get nervous in that setting. They popped the thing on you. Sometimes it's over your shirt and then they throw it in the chart and you're like, that's not my blood . Like why are we even measuring this number? So yeah .

Speaker 2:

Yeah. They call it the white coat syndrome. The idea when you go . Yeah , no , I've been hundreds of times, probably my measurement . So I don't get any more , but I still varied by this 40 beats per minute, just depending on what's going on. Interesting . So I think the measurements we get at home, so I think I see a world in the future where you're , you're just pulling the state all the time and then there'll be a lot of home sampling, like doing pricks, blood pricks at home and getting measurements that way sort of the Theranose system. But it works kind of idea. I just see that's where the future w we'll ahead . And if you think about, you know , uh, nobody in my family, even before the pandemic was going to store as much anymore, right. They would just order it all from Amazon. And that's how healthcare will come. Why , why would you go to a doctor to get sick for most things? Now, if you need an MRI, that's different for bigger, but for routine stuff, you'll do a lot of it. Um, just remotely, no

Speaker 1:

Shift gears here, just a little bit, another one of your 2020 studies found this fascinating potential blood test to determine fitness levels. Can you talk that through a little bit? Because a lot of our listeners are like, wait, what? You can tell my fitness level from a blood test, you can tell me more.

Speaker 2:

Yeah. That's pretty wild. So we did a study to look at the effects of exercise, like bout of exercise. So people ran to their VO, two max, the listeners probably all know that act as a sign of health. And it's actually the number one predictor of longevity. It is. Yeah. Any other value out there? All right ,

Speaker 1:

I'm going to keep doing it .

Speaker 2:

Yeah. So we had people, you know, run to their VO two max, you know , it's , it's eight to 12 minutes depending how , how your, it got set up. And , and um, so we did this way at 36 people do those and I thought, wow, you know how much he's going to change an eight minute run and the answers a lot, half your molecules do shifts . Yeah. Yeah. So we could then correlate which molecule shifted. We've pulled out 12 basically . Well , age plus 11, others actually correlate very set up a pretty good signature for your VO two max. So in the future, in principle, you can just do a blood test and know what your VO two max is without

Speaker 1:

Doing. It wouldn't hurt as much.

Speaker 2:

Well , to be honest for me, it's the whole inconvenience and taking the clothes off, putting on clothes. I did this one, the mask . Now it's just terribly. I did it in New York and I forgot my shoes. So I'm writing in my, you know, dress shoes.

Speaker 1:

I'm sure that went well.

Speaker 2:

That value came out a bit lower. I can safely say yes , but

Speaker 1:

By several , uh , standard deviations, I have a feeling , um, oh man, this is so interesting. The let's talk about the purchase in house this a little bit. Cause I interrupted John some of that stuff. And I think maybe you had something else you want to talk about. How, how do you see it being utilized in the future? And, and you've talked a little bit about that, but what are the barriers to having that as part of our future personal, personal life health journey, because it's not happening now. Everything is so generic

Speaker 2:

Right now. Everything's sick care. We don't, we don't run a house . Right . And why is that? It's because nobody pays to keep you healthy. The whole inside the model is broken. Totally. Uh, and you know, I was out of the hospital here , uh, told me it's out of here now, somebody else says he basically Mike , nobody pays me unless they walk in the door and they're not going to walk in the door unless they're ill. And so we don't have a system set up to do that. So we have to change that. So right now, everything I told you for our company is people are going to have to pay out of pocket, the cube bio, the January AI Sensomics you have to pay for that. And I think there are other systems that could be set up to crack that one is, wouldn't it be great if your provider or your insured did it because , uh , and they could incentivize you to do this. Like , uh , there's, there's a lot of talk about this, about giving you a break in your insurance. If you walk 10,000 steps a day, you have to set up systems. So people don't cheat this out, just put it on my cat or what have

Speaker 1:

You, that's the ceiling fan,

Speaker 2:

But that's where you put a GPS on it . You make sure They're probably moving pretty fast and thought of silly , but up for an hour , you know , it's yeah . You have to come up with ways to watch out for the cheating, but you get the idea. I think if , uh , I think there's two things that motivate people. One is money and the other is family. So I think if people can get breaks , uh, you know, if they do live healthier lives or, or, you know, I hate to say it, but penalize them if they don't , uh , if they don't get up off the couch and the other is your F your family, your family's pretty good about motivating you, you know, he's thinking about the time when my mother-in-law got ill with cancer, the number one person and made sure she took her pills, was her daughter, my wife, you know, you take their pills and , you know, because she's feeling run down and tired. And , but the one who was incentivized was the family. So I think we can work on those angles, that other angles, I think they're creative. How about some of these big employers? Like, isn't it in Google's best interest and Facebook to keep their employees healthy and happy because they're performing better. So if you have these wellness plans that , uh, and the stuff we said is , is some of , it's not that cheap at all. Like the CGM, the continuous glucose monitoring. I mentioned, you know, that company is running for 2 88 , uh , for the first program and that's not so expensive. And now Cuba is more expensive, 3,500, but I know the price will drop as we get better, more numbers. But yeah , but I would argue in 3,500, the cat, some of the heart problem early is huge. If they have a stroke and go on long-term disability, that's super expensive. So I think, you know, I would argue when you look at how the us spends money, we spend a ton of money on that last year of life. That's why we spend twice as much as anyone else for that money early. Yep . When people are healthy, let's keep them healthy. And I think those probably your listeners are exactly the right kind of people that probably are concerned

Speaker 1:

In their heads going, that's all we need.

Speaker 2:

They're wearing their watch. It was great. Now we just need to put health apps along with it. And probably a lot of them have some of this stuff already and we'll get better and better. Uh , as we learn more about these things. And then we're more and more sensors. I think we're heading in the right direction. We just got to get the financial models. So it's good for everybody.

Speaker 1:

So great stuff. A lot of stuff. Bring us back. Any insights that you want to share that I haven't teed up with the right question or anything that you , you know , you want to mention this app, check this app out, or this is something you definitely want to do, or, oh yeah. Brad, I, I want to make sure I mentioned this. Any of those things kind of tie a ribbon on this thing.

Speaker 2:

Yeah, well, no, I , I think this is just the future. I think we're going to be collecting a lot more data from people at home or for, you know, the sensors and things. And I just see this as the future data get ready for it . The number one concern people raise is privacy. You know , oh gosh, she was going to own my data and aren't they going to, you know, take advantage of it and what have you. And my reaction to that is, you know, if two reactions, one is privacy, get over it , uh, because you know, your credit card company, they already have it . Yep . And there's a lot of personal stuff on there yet . We don't have any problem with that. And the reason we don't is it's incredibly convenient to use a credit cards. Right . And so I would argue it should be incredibly convenient to get your health monitored and catch disease early. So we should have that same mindset. And then the other argument, I would say if, if there are going to be abuses around that, well, that's what, you know, laws or forums for. I mean , yeah . So that we can make sure they're not, it's not, privacy is not abused and is used in a way that's good. Uh , this information information's good not use against . So , so, so anyway, that that's a concern. Sometimes people raise for me. I don't think it's wrong . Believe it or not all my data. I have two petabytes of data for the geeks out there. It's all public. You can download it, you can play with it. Learn. I really

Speaker 1:

Want to get to know you

Speaker 2:

Stay with us study participants. Most of them have agreed to make the data and, and deeper now analyzing and trying to get new insights about human health. So we think it's , it's one of these systems where only, you know , trying to test the test , all this , use it, learn from it and try mat manage people's health. But we're trying to make it a research study. So other groups can learn from it too. And I think the future, we're all going to have these learning personalized trajectories, and we're going to catch disease long before it's symptomatic to me. That's Mike. Snyder's where I think we're all going to be getting our genome sequence will not ask our kids future kids before they were born, but we get using their genetic information again, get it early and , uh , yeah , better manage people's health assess risks like people's trajectories. And I just see, this is the way the fields go . And I'm sure your listeners, because they're all health conscious , probably half more doing it already. And yourselves. Now all we need is AI and algorithms to do it even better. Right .

Speaker 1:

Right. This is so interesting. I think you vote , but you've probably caused us to ask more questions than we got answers, but that's what we're here for. So love it. Thank you so much for taking the time. Really appreciate it.

Speaker 2:

Thanks for having me. Brad has been fun .

Speaker 1:

I have a feeling you will never look at your watch the same way. Thanks again for the fascinating insights from Dr. Michael Snyder , the man with four watches , thanks to you for tuning into number one podcast for health and wellness coaching. Next week's guest is Dr. Colleen Carney discussing one of your favorite topics consistently. One of your favorites sleep. However, her approach to sleep habits and how to enhance those. It's very different from everything else you've been hearing out there, which is exactly why we asked her to join us on the show. You won't sleep through this one. I can promise you if you need anything additional on the coaching front, whether considering pursuing your MBA, HWC approved certification attending this fall's Rocky mountain coaching retreat in symposium, or curious about how to integrate personalized board certified health and wellness coaching into your organization. Feel free to reach out to us anytime [email protected] or tap into more resources on the new website, catalyst coaching institute.com. Now it's time to be a catalyst on this journey of life, the chance to make a positive difference in the world while simultaneously improving our own lives, which is the essence of being a catalyst. This is Dr. Bradford Cooper of the catalyst coaching Institute. Make it a great rest of your week. And I'll speak with you soon in the next episode of the catalyst, health, wellness, and performance coaching podcast, or maybe over on the YouTube coaching .