Unlocking the Cellular Secrets of Aging: How NAD Fuels Longevity from the Inside Out

Welcome back to The Popkin Method! In this episode, Dr. Matthew C. Popkin takes us beyond the surface of anti-aging, exploring the science of aging from the inside out. We’re all familiar with visible signs like wrinkles and graying hair, but what really drives aging happens deep within our cells. Dr. Matthew C. Popkin uncovers the critical role of mitochondrial function and the powerful molecule NAD, revealing how their decline accelerates aging and chronic disease.

You’ll learn why energy production at the cellular level is at the heart of longevity, how lifestyle choices like diet, sleep, and exercise can naturally support NAD, and which trendy supplements may be less effective than you think. We’ll break down The Popkin Method’s sequential, practical approach to staying young, touching on gut health, muscle preservation, cognitive function, and the science behind advanced therapies. If you’re ready to understand anti-aging on a whole new level and get real, actionable strategies to improve your healthspan, tune in now!

Timestamps:

00:00 How NAD affects aging

04:17 Understanding mitochondria and energy production

07:32 Understanding nad depletion factors

10:41 Importance of muscle preservation

15:29 Importance of gut health

17:19 Gut health and diet impacts

21:49 Morning light and sleep patterns

24:33 Caloric cycling and fasting strategy

27:24 Balancing healthy living with treats

31:13 Understanding the epigenome and PARPs

33:23 The role of NAD in DNA repair

37:01 Different ways to boost NAD levels

40:15 Improving brain health naturally

44:20 Discussing plastics and hormone disruption

49:16 Stem cell and exosome therapies

51:25 Introducing the Popkin Method

You can see Dr. Popkin through his online virtual functional medicine program anywhere in the country or the world for that matter.

You can visit Dr. Popkin in his Hollywood Florida office for an in person weight loss experience.

Visit thepopkinmethod.com to send a message to schedule an appointment with Dr. Popkin or email Dr. Popkin at mcpopkinmd@yahoo.com.

Podcast Website - https://thepopkinmethod.com/

Matthew C. Popkin, M.D. - https://thepopkinmethod.com/about

Podcast Partner - TopHealth - https://tophealth.care/

“Disclaimer: Informational only. Not medical advice. Consult your doctor for guidance.”

Transcript

SPEAKER_00 0:12

Most people look at aging from the outside based on their outward appearance. They don't consider the same process that is aging them from the outside is the same process that is actually aging them from the inside. The cellular aging is what causes the chronic medical conditions that we all deal with on a daily basis. So let's dive in.

SPEAKER_01 0:31

Welcome back. I'm Dr. Matthew Popkin, and today we're going to talk about anti-aging, but not from the surface and not from the perspective most people are used to hearing, because most people think about aging from the outside in. We notice things like wrinkles, changes in skin texture, thinning or graying hairs, but those are not causes of aging. They are reflections. They're visible expressions of something much deeper happening inside the body. Because aging does not begin at the level of the skin, it begins at the level of energy production in our cells. And as we move deeper into our body, we start to see changes in things like muscle mass and strength, brain clarity and cognitive speed, gut resilience and inflammation, and hormonal balance. And underneath all of that is mitochondrial function. And underneath mitochondrial function is one of the most important molecules in human physiology, NAD plus. Now, the reduction of NAD plus and mitochondrial dysfunction is one of the major cellular mechanisms of the aging process, and the Popkin method has addressed a way of slowing this process down using lifestyle modification, diet, exercise, basic as well as some targeted supplementation, peptide therapy, hormone modulation, stem cell exosome, and secretome biologic therapies, and management of prescription medications. NAD Plus is all over social media in relation to cellular longevity and anti-aging, and I get a lot of questions about NAD Plus almost on a daily basis, which is one of the reasons why I created this podcast today. Today I'm going to walk you through exactly what NAD Plus is, how it drives mitochondrial performance, and how this relationship ultimately determines how we age, both on the outside and more importantly, on the inside.

SPEAKER_00 2:14

I love that. I'm so excited to unpack this conversation more that what we see on the outside is actually the finish line and it starts on the inside. So looking forward to hearing you explain about how that works and why that is. But let's start with what you were just speaking about NAD plus. Let's define it. Like you said, it's a hot, hot button word right now. It's everywhere. But let's actually explain what it is and why it's so important to the aging process.

SPEAKER_01 2:44

Sure. Well, NAD plus, otherwise known as nicotinamide adenide dinucleotide, it's actually a coenzyme that's present in every cell in your body. It's essential for life. It plays a crucial role in pretty much everything that your body does energy production, DNA repair, cellular signaling, mitochondrial function, and activation of longevity pathways. So if you think about metabolism as a system of energy transfer, then NAD plus is one of the key currencies that allows that system to function. Without NAD Plus, your cells cannot efficiently generate energy. In fact, without NAD plus, your cells can't survive at all. And here's the key point NAD levels decline with age. And as NAD plus declines, energy production declines, oxidative stress increases, DNA repair becomes less efficient. Essentially, our body ages. And this accelerates the aging process and leads to chronic diseases like diabetes and Alzheimer's disease, cancer, and almost every degenerative disease that we encounter. So when we talk about anti-aging at a cellular level, NAD is foundational.

SPEAKER_00 3:50

Okay, so NAD is the secret sauce, the secret ingredient in making sure our cells stay healthy. Now, if I remember one thing from science class, and I feel like there's even memes all over the internet about this, it's that the mitochondria is the powerhouse of the cell. Okay. You got that right? So tell us, tell us more about mitochondria. What does that even mean? And what role do they play? How do they relate to aging?

SPEAKER_01 4:17

Yeah, I think everyone remembers from science class that you draw a picture of a cell, and then you got the round nucleus, and you've got the like kidney bean-shaped mitochondria with all the little loops inside of it. Um, and the powerhouse of the cell meaning it uses NAD plus to produce our true energy currency, which is ATP. So mitochondria are the energy-producing structures inside your cells, and they're often referred to as, you mentioned, the powerhouse of the cell. The mitochondria converts nutrients into ATP, which is the energy our body uses to function. But the mitochondria are not just power plants. That's what's really important to understand here. The mitochondria regulate inflammation, cell survival, oxidative stress, and metabolic signaling. And as mitochondrial function declines, energy decreases, inflammation increases, and recovery slows. And we've heard mitochondria and mitochondrial health all over the internet over the past at least six to twelve months. So that's why this podcast is going to be quite important here. Um and importantly, NAD plus is required for mitochondria to function.

SPEAKER_00 5:24

So, Dr. Popkin, it sounds like NAD plus is almost like the gas that causes the mitochondrial car to move. Is that right? Is that a correct analogy?

SPEAKER_01 5:34

That's correct. NAD plus is required for the mitochondria to function. And when NAD plus declines, mitochondrial performance declines. And when mitochondrial performance declines, aging accelerates. So this is where, you know, let's say when this occurs in the skin, that's when we see the visible signs of aging. But when it occurs on the inside, like in the brain, we see cognitive decline. So regardless of the tissue or the organ involved, NAD plus and mitochondrial function decline leads to dysfunction and aging of every tissue and every organ system in the body. So you could really consider that NAD plus decline is the aging process. So yeah, NAD plus fuels the mitochondria and the mitochondria do lots of important things in the body. So without NAD plus and without mitochondrial function, we age faster. So you got it. You hit it right on the head.

SPEAKER_00 6:24

Okay, so it sounds like NAD plus is wildly important and integral for our bodies to maintain. Um, why do NAD plus levels decline as we age? Obviously, we know that our bodies don't function the same way we did they did when we were 15, you know, as as the years go by. But why does that happen?

SPEAKER_01 6:44

Yeah, so obviously NAD plus is so important that I dedicated an entire podcast to it because it is so so foundational. And you know, why do NAD plus levels decline? Just like you know, anything else in our body as we age, uh, important things decline. So this is critical because it's not just about age and time, it's about demand. And this is where your lifestyle comes in, your diet comes in, exercise and different things, because it's really on the demand side that we can really affect a change here. So NAD plus declines because chronic inflammation consumes it. And if you recall through any of our podcast episodes, we talk a lot about inflammation. And inflammation will consume NAD. Oxidative stress and pollutants can consume NAD. DNA damage increases the demand for repair, and that uses up a lot of NAD plus. Sleep deprivation accelerates depletion of NAD plus. High sugar intake, ultra-processed foods all worsen metabolic stress, which consumes NAD plus. So I was having this discussion the other day, and it's almost like chlorine in a pool. If you if you have a pool and you have a certain amount of chlorine in there and nobody swims in it, and you don't get leaves in it, and the temperature remains stable, the chlorine lasts a certain amount of time. But the more demand you put on it, the more kids that are in the pool, the more kids that are peeing in the pool, uh, the more adults that are in the pool, and some of them pee in the pool too. So the more demand you put on the chlorine, the more it consumes it. Same thing with NAD. So aging is not just about getting older, it's about cumulative demand and stress on the system that depletes NAD plus, leading to aging.

SPEAKER_00 8:27

That is such an easy, succinct, cleaving way to understand that I love it. Okay, let's talk about where we perhaps maybe see the first signs of aging as we think of aging, right? You mentioned we think of wrinkles in the skin, loss of elasticity, hair not being as shiny and long and voluminous, even having as much right hair loss. How does this affect the loss of NAD plus or the decline of NAD plus in our bodies affect hair and skin?

SPEAKER_01 8:56

Yeah, so we're gonna start from the outside in because that's how we started the podcast here. And that's typically what people notice about aging, right? They don't notice the inside, they notice the outside. So how does it affect skin and hair? Well, when NAD plus declines, the skin cells regenerate more slowly. Collagen production decreases, oxidative damage increases, which leads to wrinkles, loss of elasticity, and dull skin. Now, if we're talking about the hair, mitochondrial dysfunction affects follicle energy, oxidative stress affects pigmentation, which leads to thinning, hair loss, and graying. So what appears cosmetic is actually metabolic. And this is happening to all the cells and every tissue and every organ in our body, causing aging. We just notice it first from the outside when really it's happening on the outside and the inside. And it's the stuff that's happening on the inside that really leads to the long-term chronic illnesses that we see. So it is quite important to the skin and hair, but obviously to all the other organs, which we'll discuss moving forward.

SPEAKER_00 9:59

Sure. Yeah. So let's talk about the next place that we tend to kind of define as attractive, right? How does this affect muscle and the structures of our body?

SPEAKER_01 10:08

Sure. Well, as everyone knows, if you've listened to my podcasts, muscle is your longevity reservoir. It does so many things for you. And muscle is one of the most important anti-aging organs in the body. And I consider muscle to be the body's longevity reservoir, and it's super important to lots of different things. So when NAD plus declines, mitochondrial density decreases, energy production drops, recovery slows, and protein synthesis declines. So this leads to muscle breakdown or what we call sarcopenia. And here's the key muscle is anti-inflammatory, muscle regulates blood sugar, muscle preserves metabolic health. So preserving muscle is preserving youth. And when NED plus declines, we're directly affecting muscle performance. And this is a major principle of the Popkin method and is a common theme in all of my podcasts. Remember, I promote muscle gain and preservation as one of the most essential anti-aging activities you can do to live longer and healthier as you age. And in fact, this morning I was doing a consult on a patient and trying to get that point across. And I said, well, imagine I take this Sharpie marker and I write on one of your forearms muscle and on the other forearm protein. Would that get the point across? That's how important it is to all the different things in your body. And they got the point, and I didn't have to give them a Sharpie tattoo.

SPEAKER_00 11:33

I love that. You know, we're never too old for a good Sharpie tattoo. All right, so let's talk about we talked about the outside, the skin, the hair, talked about the muscles and structures. What about the mental heart? What about our brain, our main processing center? Is that affected?

SPEAKER_01 11:49

Yeah. So, you know, I think everyone knows somebody or a family or family member that's been affected by Alzheimer's, Parkinson's, autism, traumatic brain injury, any of the neurodegenerative diseases. So, and just just aging and age-related mental and memory decline. So to understand this is very important. The brain is extremely energy dependent and it consumes roughly 20% of the body's total energy and oxygen, despite accounting for only 2% of your body weight. So put that into perspective, the brain uses roughly 10 times more energy per gram than skeletal muscle. That's why you feel so wiped out after you have a, you know, something that really stresses your brain. After you do a detailed podcast, or you study for a test and you take your, you take your exams. Mental stress uses a lot of energy and mental function and brain function and memory requires a lot of energy. So needless to say, the brain is a very high, it has a very high metabolic demand. So when mitochondrial function decreases in the brain, we see brain fog, slower processing time, memory decline, and unfortunately increased neuroinflammatory diseases like Alzheimer's disease, Parkinson's, and other types of brain disorders. NAD Plus supports neuronal energy or the cellular energy, synaptic function, or the basically the spaces between the cells where where the neurotransmitters communicate, as well as DNA repair. So cognitive aging is largely an energy problem, which thankfully we can address and mitigate using the Popkin method techniques, which I will describe later in the podcast. Again, if you decrease inflammation, you clean up your lifestyle, you fix your diet, you do some exercise, take some basic supplements to help decrease inflammation, we can greatly affect a lot of things that are going on. And aging and NAD plus production in your body is one of them.

SPEAKER_00 13:48

So what I'm hearing you say is that it's not your state of being is not permanent. We can improve, rewind, and kind of get back to a much better and stable baseline by doing the right things, even if we've, you know, gotten a little bit off track.

SPEAKER_01 14:04

I think somebody's been listening to my podcast episodes. Absolutely right. Yes, you are not stuck in your current state. We can we can do a lot of things to fix a lot of ailments that that you're that you're having without resorting to prescription medications or any other type of therapies. You know, lifestyle, diet, exercise, and some basic supplements fix a lot of things.

SPEAKER_00 14:27

We've also talked a lot about the brain-gut connection. So let's now unpack more how NAD plus levels affect the gut.

SPEAKER_01 14:35

Well, the gut is one of the largest immune organs in the body. And I devoted episode seven, eight, and nine on diet, gut health, and the effect of inflammation on the gut and how the gut affects other body systems. So it's hugely important. And when mitochondrial function declines in the gut, barrier function weakens, which leads to leaky gut syndrome. Remember, we talked about those cells that are on the front line keeping the bad stuff out and the good and bringing the good stuff in. That's the barrier we talked about. So when that barrier becomes dysfunctional, bad stuff gets into our body, causes systemic inflammation, and then inflammation leads to cortisol and decreased NAD plus production and all those things that we know that inflammation does that is bad for you. So inflammation increases both locally in the gastrointestinal tract and systemically throughout the body. Then the microbiome shifts. So that's the bacteria in your body that in your intestinal linings that are actually creating that barrier and helping that barrier. So NAD plus supports gut lining integrity, cellular repair, and immune regulation. And it's super important to note that approximately 70 to 80% of the body's immune system resides in the gut, making it the largest immune organ in the body. So it's very, very important for our immune function. And 70 to 80% of our brain's neurotransmitters are either made or manipulated in the gut. That creates that gut-brain connection that you were talking about. So most people think of the gut as being only for digestion when in fact it's an integral part of our immune system, as well as being integral for nervous system function, neurotransmitter function, which forms that gut-brain connection. So we'll dive a little bit deeper into some of the biochemistry behind all of this. Known as the gut-associated lymphoid tissue, or GALT for short, the GI system contains a vast concentration of immune cells that monitor for pathogens, filter external toxins, and regulate immune response to maintain overall health. So here are some key facts about gut immunity, which is why it's super important to eat foods that don't damage your gut, take pre- and probiotics, things of that nature. As far as location is concerned, the immune cells live within the intestinal wall, acting as a primary barrier to harmful bacteria and viruses. So episode eight of the Popkin method, focused on gut health, can go back and listen to that and get kind of a refresher course. As for function, the gut-associated lymphoid tissue produces and stores immune cells that distinguish between food particles and harmful substances. So this is the stuff that kind of sorts through and brings the good stuff in and keeps the bad stuff out. So when that gets affected, bad stuff creeps in, systemic inflammation occurs, and then bad stuff happens. Regarding the microbiome impact, a healthy gut microbiome, which includes trillions of bacteria and fungi and viruses, all interact with this immune system to prevent overreactions and inflammation. And so what are the health implications of a disrupted gut environment? Well, imbalances in gut health due to poor diet or stress, they can weaken the immune system, leading to chronic illnesses or increased infection risk. Again, refer back to my podcast episode seven, eight, nine, and even ten regarding diet, gut health, and the effects on the systemic inflammation in the body. How can we affect this? Well, a fiber-rich diet supports this immune hub, right? Whereas the typical Western diet, or as I call it, the Americanized diet, which is high in sugar and ultra-processed foods, they can trigger inflammation, which consumes NAD plus. I mean, we have so little fiber in our diet that we literally have to put fiber as a supplement, you know, metamucil and things that put it in our on our, either in our food or drink it directly in water, because we don't have enough fiber in our diet. And this is not the way our bodies were designed. Years and years and years ago, we had lots of fiber in our diet. Now we have ultra-processed foods, sugars, inflammatory seed oils. So really, we have done a disservice to our gut over the past 50 to 100 years. So when NAD plus declines in the gut, inflammation increases and the cycle continues. So as you can see, gut health is a primary focus of the Plopkin method for many reasons. The most important of which is that we can directly fix many of these health issues by correcting dietary indiscretions by following an anti-inflammatory diet. So, to your point earlier, what I'm trying to say here is that what we do on a daily basis can directly affect our gut health. You don't need prescription medications, you don't need fancy treatments, you just need a better diet. Get rid of the bad inflammatory foods and replace them with better, healthier, non-processed, non-inflammatory foods. It's not that difficult. It's just a choice that, you know, different choices we have to make.

SPEAKER_00 19:20

Yes, the choice and the self-discipline. And, you know, I think it's it's so gradual with the improvement. Everybody wants a quick fix, but that really is. I mean, you can't you haven't said it a hundred times. Right. Okay. So we talked about how we can naturally heal the body. How do we naturally support NAD plus levels? I mean, I have my little row NAD supplement in the refrigerator. So maybe we can talk a little bit about that. But how do we naturally do this?

SPEAKER_01 19:50

Yeah. I'm gonna get to that and probably destroy that that supplement that you have depending on what it has to do.

SPEAKER_00 19:56

Okay, everybody. You you heard it here first. So I'm so glad I brought it up.

SPEAKER_01 20:00

Yeah, people well, first of all, in uh people are are really attached to their toxins, I always say, and they're attached to their ultra-processed foods, and then they get really attached to the stuff they see on social media. Um and if you notice, we haven't even really talked about supplementation of NAD plus. We're talking about natural ways that you can support your own body's production of NAD plus and and how quickly your body consumes NAD plus. So, how do we naturally support NAD plus levels? This is a great question. And at the Popkin method, we approach this in a very structured way. So we break it down into two stages. First, how do we increase our body's own NAD plus production? And second, how do we decrease NAD plus consumption, or what I like to call the NAD plus burn rate? Because both of them matter. It's an equation. You can increase production, but if you're burning through NAD plus at a higher rate, you're gonna be deficient at the cellular level. So, step one, let's discuss increasing NAD plus production. And really importantly, NAD plus production is highly dependent on circadian rhythm and metabolic signaling. And this is where we can affect it. We can affect our circadian rhythm and our metabolic signaling through the way we eat. So we start there because our circadian rhythm supports NAD plus production. Consistent morning sunlight exposure is one of the most important regulators of circadian biology. So getting light in the eyes within 30 minutes of waking helps to anchor your internal clock, which directly impacts mitochondrial signaling and NAD plus pathways. That's why I tell people as soon as you get up, make a beeline for natural light in your eyes and forward movement. So it gets your brain going and restarts your circadian clock. The next step is sleep consistency.

SPEAKER_00 21:47

Let's say if it's raining outside and there's no sun.

SPEAKER_01 22:00

Evening light and red light is a different frequency altogether. So if it is cloudy or you live in northern climates in the winter, you know, any bit of light does help. So even if it's overcast outside, you know, going outside and getting light in your eyes is super important. So red light wouldn't necessarily count there, but it does have other benefits. So I don't want to discount red light therapy. Um, but that's one of the things, you know, I try to tell people, you know, as soon as you get up, get light in your eyes, because that stimulates the clock to start melatonin 12 to 16 hours later, which helps you to sleep at night. So your sleep patterns actually start by what you do in the morning. Uh that's why when you sleep in late and and and you're kind of lazing around, it affects your internal clock. That's another reason you know the circadian rhythm is so important. And and the next part is sleep consistency. That's also integral to your circadian rhythm. Going to bed and waking up at the same time each day reinforces your circadian rhythm. Um years ago, you know, go back 500 years, right? We didn't have alarm clocks, we didn't have any technology whatsoever. The sun came up, we we woke up. Sun went down, we went to sleep, and that was pretty much your alarm clock. Now, I mean, you know, we we are so technologically advanced, our brains are not, they're not genetically wired for this type of technology. So it causes a lot of problems. And NAD plus production follows that rhythm. So if we don't have that rhythm, NAD plus production will suffer. That's why you feel tired when your sleep cycle is off due to either an altered work schedule or a zone time, a time zone changes during travel, right? People are jet lagged. And you wonder why would that be such an issue? Because your body is so adjusted to being in this cycle. So that's super important. That's why, you know, sleep is part of lifestyle modification. It's the first thing in the popkin method, right? We're not talking about sleeping pills, supplements, injections. We're talking about getting proper sleep. Everybody can adjust that, you know, based on their families and their jobs and things of that nature. So the second part of this is we talk about caloric cycling. And this is really important. This is we're talking about eating. So diet, the second part of the popcorn method, short-term metabolic stress, when applied appropriately, actually stimulates NAD plus production. So when I say short-term metabolic stress, I mean short-term fasting. This can be done through structured fasting patterns. For example, a consistent 12-hour daily fast is that kind of moderate stress on the system that leads to NAD plus production. Then you combine that with 18-hour fasts two to four times per week, which gives you a little bit more of the stress on the system, but not so much that it's going to be overly stressful, secrete cortisol, cause inflammation, and then decrease NAD plus production. So again, a consistent 12-hour daily fast on a regular basis, combined with an 18-hour fast two to four times per week, that's really good for caloric cycling that helps support NAD plus production. But this is super important. During those eating windows, you must have adequate total calories to support protein and sufficient protein intake. So during, we're not trying to restrict your calories, we're just trying to put them in your eating window because the goal is not deprivation. The goal is metabolic signaling. This fasting, intermittent type fasting is really good to stimulate NAD plus production. So when you combine circadian alignment with intelligent caloric cycling, you create an internal environment that promotes NAD production naturally. Step two, first of all, any questions on how we help to naturally increase uh NAD plus consumption.

SPEAKER_00 25:40

No, that was so enlightening. Thank you for explaining.

SPEAKER_01 25:43

Yep. And it's all free. You don't have to buy anything, you don't have to inject anything, you don't have to take anything. You just, you know, work on your diet and you work on your sleep. So then the second step would be decreasing NAD plus consumption, or more importantly, probably decreasing NAD plus overconsumption. So equally important as NAD plus production is reducing NAD plus overconsumption. And this is where most people get it wrong because the single biggest driver of NAD plus depletion is inflammation. So inflammation is bad for everything. You might as well take that Sharpie marker, you know, right on your forearm as well. Inflammation is bad. It's the enemy. So inflammation is one of the most aggressive consumers of NAD plus in the body. So if you're inflamed, you are burning through NAD plus rapidly, regardless of how much you're trying to produce. So we reduce inflammation systemically using the Popkin method principles, right? We decrease ultra-processed foods. I know people are super attached to, again, they're attached to their toxins, they're attached to their ultra-processed foods, you know, and yes, Chick-fil-A is an ultra-processed food. It's, you know, I people argue with me all the time. I don't eat fast food, but then they say they eat Chick-fil-A. And they're like, but that's they say that's that's better for you. I'm like, well, compared to what? You know, and it's compared to McDonald's or or Burger King. I mean, they're all ultra-processed foods. Um we reduce alcohol.

SPEAKER_00 27:07

Yeah, everything in moderation though, right? You know, you're doing fast food once a month, once or twice a month, right? That's not really going to tip the scales so far one way or the other. I'm not saying to make it a practice, but if it's ever an exception, like he would be like, Still not my favorite.

SPEAKER_01 27:24

But yeah, you still have to live. I mean, this is, you know, again, my my you, you know, people would hate me as a physician if I took everything fun away from them, right? And and and certainly I follow those those principles as well. You know, if you live the majority of the time, you know, 80, 90% of your life, you know, trying to be clean and doing the things that you're supposed to be eating clean, doing those things following the Popkin method principles, you are able to, you know, have, you know, you're able to have the occasional Chick-fil-A, you're able to have that birthday cake, you know, on occasion, you're able to, you know, to have the things that you like. You're just, again, like you said, in moderation. And I don't think, you know, the Americanized lifestyle knows about moderation. I mean, it's shoved in our face every day, you know, supersizing meals, you know, they judge a meal by how much they got, you know, the portion size. You know, we have these buffets. I mean, you know, go to Las Vegas and people are just gorging themselves with food. And that's people they like that and desire that. And that's just because of instinctual need for, you know, back thousand years ago, you know, you didn't have great access to food. So when you had it, you gorged on it. Well, now we don't have that problem. We have refrigeration, we have pasteurization, you know, we have an abundance of food. We don't have to over-consume. But again, you know, we talk about reducing inflammation systematically using the popkin method principle. So we decrease ultra-processed foods, we reduce alcohol intake, we stabilize blood sugar, we improve sleep quality, we reduce chronic psychological stress and physical stress. We avoid constant eating and grazing because that leads every time you eat that we generate this postprannial inflammatory response. I had this discussion this morning with a patient. Every time we eat, we create exhaust. Just like when you when your car burns gas, exhaust comes out the back. When we eat, we create exhaust, and that is in the form of free radicals and oxidative stress that affects our body. So you don't want to be eating and grazing all the time because you're constantly chronically living in that inflammatory state. That's why we talked about caloric cycling. 12-hour fasts on a regular basis, 18-hour fasts two to four days a week. And if you're eating all day, you're maintaining this low-grade inflammatory state, which continuously depletes NAD plus. So now we want to support the system nutritionally, right? So we can increase the intake of tryptophan-rich foods, particularly from high-quality animal sources, which support NAD plus pathways. Uh, we want to ensure adequate intake of B complex vitamins, especially niacin or vitamin B3, which is a direct precursor in NAD plus synthesis. We can support methylation with compounds like TMG, trimethylglycine, which helps optimize these biological biochemical pathways. I know I'm getting a little deep into the biochemistry here. I'm gonna get a little deeper. And in certain cases, we can use targeted supplementation like NMN, which is nicotinamide mononucleotide, or NR, which is nicotinamide riboside, as direct NAD plus precursors, meaning both of these are converted into NAD plus. It's not NAD plus in a bottle, which I got to check to see what you have in your cabinet there to see if it's the proper, to see if it's the proper thing or not. So NR and NMN supplements are both often touted as two of the most promising supplements to help slow down aging. So warning here, we're gonna have a geek out moment. Uh, we're gonna talk about science for a few minutes. So interestingly and importantly, NAD plus is a very important molecule that enables the proper functioning of things called sertuins in our body, which are enzymes that protect our DNA, which is quite an important job. And they regulate the epigenome, helping things called PARPs do their job, which is repairing damaged DNA. So you may ask, hey, Doc, what is the epigenome and what are PARPS? So the epigenome is responsible for marking DNA, instructing when, where, and to what extent to turn genes on and off. And unlike our permanent genome, the epigenome changes in response to environmental factors like diet and stress, modifying gene function without changing the underlying DNA. So I mentioned and described the epigenome because, again, utilizing the Popkin method, we can directly affect our environmental impact on our body by cleaning up our lifestyle and diet, adding regular exercise, adding some supplements to decrease inflammation, which can have a tremendous impact on our health. And by spending some time on lifestyle, diet, exercise, and adding a few healthful supplements, you can easily improve most of what ails you. And then after that, we can add in more advanced therapies if needed, like peptides and hormone modulation, stem cells, exosomes, secretome biologic therapies. It's becoming more and more understood that your genetics are greatly affected by your environment, hence the focus on the epigenome. That's why I'm talking about it here, because just because your genetics are patterned in a particular way, it doesn't necessarily mean that it's going to be expressed the way it's written, because you are that your genes are affected and acted on by the environment, hence the epigenome. So that's saying you can you can kind of change your biology by changing your environment. That's the whole point here. So the next thing you might ask is what are parts? Because I mentioned them, P A R P S, and these are poly ADP ribosolymerase enzymes that need NAD plus to repair the DNA damage, especially from UV exposure and oxidative stress that we encounter on a daily basis. In short, PAPs repair DNA damage and PARPs require NAD plus. So that's why this geek out moment here is important because at the cellular level, NAD plus is important because this is how the DNA repair is done in our body. And without NAD plus, we don't have DNA repair, and without DNA repair, bad things happen. So this is obviously a very important job for PARPS as damaged DNA leads to a multitude of diseases like cancer. So we want to make sure that these PARPs have enough NAD plus to do their job of repairing damaged DNA, because damaged DNA not only causes things like cancer, but pretty much everything else in our body. Any chronic illness in our body is generally caused by damaged DNA or the aging process. So NAD plus is important, parts are important, the epigenome is important. And when you take NR and NMN, what this does, those supplements increase NAD plus levels, and higher NAD plus levels protect our epigenome and therefore protect our DNA. And again, this just underscores the importance of NAD plus and the importance of our science classes from second and third grade, which leads into our science classes in high school and college. So there you go. There's a geek out moment. Wanted to emphasize from a cellular level what happens and how DNA repair is done and why NAD plus is so important. So when you look at this as a system, it becomes very clear you want to produce NAD plus efficiently. You do not want to burn through it and consume it excessively. And at the Popkin method, we address both sides of that equation, enhancing production and limiting excess consumption, because that's how you truly shift cellular energy. Not by chasing one pathway, not by taking one supplement, but by controlling the entire system.

SPEAKER_00 34:53

Okay, so we talked about what we can do to naturally increase and inhibit the massive burning of NAD plus inside of our system. So what about therapies? I guess we could call it supplementation. So I I said I went to grab my bottle. This is my little row nutrition, NAD, liposomal kind of liquid that I mix with the glutathione and the collagen in the morning.

SPEAKER_01 35:19

Yeah. So you have liposomal and NAD plus, which I'm gonna talk about.

SPEAKER_00 35:23

Okay, great. It doesn't say on here that there is NNN for the an RNA specifically, it just lists the NAD plus 100 milligrams. So Yep.

SPEAKER_01 35:36

So I'm gonna, yeah, I'll get to that because it's important. It's it's yeah, well, I I have a segment on here. Essentially supplementing with NAD plus can be achieved through various methods, with the primary distinction being between direct NAD plus delivery, which you have a bottle of it in your hand and I'll talk about it, either doing direct NAD plus delivery either through subcutaneous injections, intramuscular injections, IV injections, intranasal sprays, and other oral NAD plus either precursors, as we talked about NR and NMN, or the lifolyzed NAD plus, which we'll talk about. So let's talk about oral NAD plus supplementation first, because oral methods are the most convenient, though often considered less effective than injections due to degradation in the digestive system because of multiple factors, most of which being the acid in the stomach. So the NAD plus precursor capsules and powders, these are the most common oral methods of NAD plus supplementation. They do not contain direct NAD plus, but rather the building blocks required for the body to create it. This is because direct oral NAD plus supplementation is largely ineffective because the large charged NAD plus molecule has very poor absorption and breakdown in the acid environment of the gastrointestinal tract. Also, it's unable to cross cell membranes due to its large size and its electrical charge, hence the plus in NAD, which represents the charged nature of this molecule. Plus, it has very low bioavailability as oral NAD plus does not significantly increase NAD plus levels in the blood compared to the NAD plus precursors like NMN and NR, which I will discuss now. So NMN, which is known as nicotinamide mononucleotide, it converts directly into NAD plus in one step. NR, which is nicotinamide riboside, is a smaller molecule that efficiently enters cells and is a very well-documented way to boost NAD plus levels. Another way is with niacin or vitamin B3 that also helps to boost NAD plus levels directly. So we're getting to yours, Jamie. A second form of supplementation is the sublingual or under-the-tongue lozenges and liquids. And these are designed to bypass the digestive tract for faster, more direct absorption into the bloodstream, which bypasses what we call first-passed metabolism in the liver, which can eliminate up to 90% of the oral dose. Meaning you take it, you go in your stomach, goes to the liver, the liver basically destroys 90% of it, and then you then 10% is left to kind of float around and do what it's supposed to do. Not very effective. The third type of NAD plus supplementation is liposomal NAD plus formulations, which is what you have there, Jamie. And this is a form of oral supplementation designed to protect that NAD plus molecule from the digestive enzymes, though many studies suggest that this method may not be as effective as taking the NAD plus precursors for the reasons that I mentioned. NAD plus is a big molecule. It's charged, it has a very hard time getting into the cell. Whereas the precursors, NMN, NR, vitamin B3, they get in much easier into the cells to then be made into NAD plus. So those are the oral forms there. So I think that's your last bottle of that product, Jamie. And um but that's good. I'll save you some money and some time, and we'll go into more effective methods. There's the injection and infusion NAD plus methods. So these methods bypass the digestive system altogether for higher bioavailability. So subcutaneous injections or sub Q injections, these are usually administered into the fat or the abdomen or the thigh and are often self-administered by patients at home. Those are direct NAD plus injections. Intramuscular injections, the same thing. We're delivered, we're delivering them directly into the muscle tissue, which provides for faster absorption. Typically, these are done in a doctor's office. People are generally not giving themselves IM injections at home, but they can and sometimes do. Then there's the intravenous NAD plus therapy. Again, all these that we're talking about now, where we're injecting, are direct NAD plus molecules. And when we give it intravenously, that this is concentrated NAD plus. It's delivered right into the bloodstream, usually in a clinic setting for maximum absorption. This is costly and it's time consuming. So people do this, but it's it people tend to drop out because of the cost and the inconvenience of going to a doctor's office for these infusions. Then there's nasal sprays, which are quite interesting because they provide rapid direct absorption, which can be advantageous for reaching brain cells. So if you're doing something for, let's say, memory decline or brain fog or Alzheimer's, that's a good delivery method there. But remember, these are only adjuncts and should not take the place of natural, the natural remedies that I discussed earlier in the podcast. So the goal is to naturally increase the production and reduce the waste, the wasteful consumption of NAD plus by applying the popkin method to clean up your lifestyle and your diet, add exercise to your daily routine, which will all naturally improve NAD plus function. Then you can consider adding either the oral precursor supplements, NMN and NR, or injecting the actual NAD plus either into the muscle, the fat, uh intravenously, putting it in intranasally in those particular routes. So remember though, you cannot out-supplement poor lifestyle habits. And I'll say that again, you cannot supplement poor lifestyle habits. So you have to do a lifestyle, diet, sleep, exercise, do all the things to make your body as less inflammatory as possible. These NAD plus supplements enhance, but they do not replace the methods that we just talked about.

SPEAKER_00 41:23

I love that. Oh my gosh. Like louder for the people in the back, they enhance, but they do not replace, and nothing can circumvent actually a healthy diet, sleep, exercise routine. All right. There we go. The gospel according to Dr. Popkins. How should how should someone approach anti-aging with respect to using NAD?

SPEAKER_01 41:45

Okay, so we'll kind of wrap everything up here. Um remember that the Popkin method is sequential. So we apply all the elements of the Popkin method in sequence, including lifestyle modification, diet, exercise, basic and targeted supplementation, peptide support, hormone modulation if needed, and advanced biologics like stem cell, exosome, and secretome therapy. And finally, management of appropriate prescription medications if patients are on these or require them. So let's address each aspect of the popkin method specifically regarding lifestyle modification. And these are all things that you can do yourself. You don't have to buy anything, you don't have to take anything. You want to establish a proper circadian rhythm with a regular wake sleep cycle. You want to get early morning sunlight and forward movement to stimulate NAD plus production. You want to consider things like grounding to normalize electrical conductivity in your body. Consider meditation to decrease psychological stress. Regarding the diet aspect of the Popkin method, you want to try to incorporate daily fasting windows of 12-hour fasting windows, three to five days per week, with longer 18-hour fasting windows, let's say two to four days per week. And remember to get enough calories and protein during your non-fasting windows. This is not restriction of nutrients, just redistribution. I don't want you grazing all day. I want you taking those calories and putting it into your 12-hour eating window or in an 18-hour fast, put it into your six-hour eating window. So we're not trying to restrict the calories. We're just trying to redistribute them. We want to decrease your ultra-processed foods. I have to pry them from some people's hands, but we're going to do it, right? Decrease ultra-processed foods. Sorry, sorry, Jamie. I don't know how it tends to be. We got to do it. We got to make that commitment, right?

SPEAKER_00 43:34

We got to decrease the progress over perfection.

SPEAKER_01 43:38

That's another sharpie tattoo that I like to tell people. Just write that on there. You know, we're taking up a lot of space on your forearm, but that's all good information. Decrease the ultra processed foods, decrease the alcohol, decrease the late night eating, decrease the grazing to decrease that postprandial inflammation. Put your food eating into those eating windows that we talked about. Uh Increase your polyphenols and your antioxidants in your diet, decrease the phthalates and the BPAs and all the plastics, eliminate the microplastics in your body. And I highly recommend watching the Netflix documentary regarding the reduction and impact of microplastics. It's called the plastic detox. Have you seen this, Jamie?

SPEAKER_00 44:19

No, I haven't.

SPEAKER_01 44:20

Yeah, you should definitely, I recommend everybody watch it. It's frightening the amount of plastics that are in our life and the effect that these plastics have on our body. And they have some couples that they follow in a particular. These are couples that are having difficulty conceiving. And it it just underscores how the microplastics and all the endocrine disruptors cause inflammation and disrupt our hormones. And as we talked about through all the other episodes of the Popkin method, hormone disruption, inflammation, cortisol, glucose instability, all of these things cause really bad things to go on in your body. And in particular, we're talking today about NED plus, but there are so many other mechanisms that it causes. So the watch the plastic detox with my patients and my clients that I go, you know, that I either go to their homes and visit, or I see them in the office, I tell them, get rid of all the plastics in their home. Do not heat anything in plastics in your microwave. You should only be heating things in glass. Get rid of the Teflon nonstick pans. You should only be cooking on pans that are not coated with these substances. I use a stainless steel pan when I when I cook. So the plastic detox, highly recommend it. You'll be shocked and make some appropriate choices to help decrease inflammation and microplastics. Regarding exercise, having regular exercise program that includes zone two cardio two to four times per week. You can do a high-intensity interval training two times per week, but exercise is really important to help stimulate NAD. Regarding the use of supplements, I'm going to go back to the core five supplements. I always discuss, everyone should know these by now: creatine, omega-3 fish oils, magnesium, D3K2, and pre-improbiotics. You got those five basic things. And as an example, I'll give you a perfect example. At a consult yesterday, a woman came in, probably mid-30s, early 40s. She was she was on the GLP1 GI to P peptide, terzipatide. She was sent to me because she was plateaued at the 12.5 milligram dose. Now, this is not a woman who has diabetes. This is not a woman who's morbidly obese. So I was already shocked that she was on such a high dose of terzipatide. Anyway, first thing I did is I put her on a receptor detox and I stopped the peptide for a month. I said, stop taking it. Let's wipe the receptors clean, downregulate the receptors, and we're going to restart you at a lower level. And I recommended she start the core five, especially D3 and magnesium, which are essential to the function of the GLP1 peptides. Then the creatin will help with energy and lean muscle production. The omega-3s will help with inflammation and the pre and probiotics will help clean up the gut and make everything else function better. Then I added resistance exercise to her regimen and she's ready to go. She said, Oh, I exercise every day. I go walking two to four miles. I'm like, great, but you're not doing anything to really stimulate and strengthen your muscles. You've got to, you've got to weight train, you've got to increase muscle mass. So most clinics would have increased her dose up to 15 milligrams of the trzipatide, which is the maximum, by the way. They would have done this to make more money, and they just would have perpetuated the problem by ignoring the physiology that was staring them in the face. Receptor upregulative due to receptor resistance, for lack of a better term, I just call it receptor resistance, but she also had other inflammatory things in her body. She wasn't on a high enough protein intake. She wasn't exercising her muscles. She wasn't doing things that were effective for NAD plus production. She wasn't even doing anything that was effective for the use of GLP1, GIP1 medications. So she's spending all of this money not doing the basics, which is really a problem. So again, the Popkin method will affect and help just about everything that you're doing, whether it's trying to increase NAD plus levels, lose weight, if you're on the GLP1 peptides, if you're just trying to be healthy. So as far as other supplements, though, consider NMN and NR, niacin, or vitamin B3. Some other really good mitochondrial support is CoQ10, PQQ, ALA, magnesium, B complex vitamins. These are all targeted to increase mitochondrial support and activity. Now, regarding peptide therapy, although not a peptide direct NAD plus replacement, either sub Q, IM, IV, intranasally, those delivery methods for an added boost, these are injection techniques or intranasal techniques to directly deliver NAD plus into the body. Regarding hormone modulation, I'm going to go back to removal of plastics and other hormone disruptors that lead to systemic inflammation, which can then overconsume NAD plus, right? We consider supplement support or direct hormone replacement therapy in cases that are needed, but we want to stop those endocrine disruptors. Another thing, receipts. When you get those receipts from the gas station or these printed receipts that come out, those are horrible. They are just loaded with BPAs and other hormone disrupting toxins that are on there. Do not handle or touch these receipts. There's no need to keep them when you can get them either emailed or texted to you because these are direct hormone disruptors. So that's something else to really consider. Regarding stem cell, exosome, and secretome biologic therapies. This is a really exciting new area of advanced biologic therapies that work with your body to help decrease systemic inflammation and enhance your ability to repair and regenerate damaged tissues and organs. And the decrease in inflammation, as we spoke about, that these biologic therapies can provide will increase or can increase NAD plus in the body, which in turn can provide additional support not only for these NAD plus dependent processes like energy production, mitochondrial optimization, DNA repair, but the added NAD plus can also help the body's own exhausted stem cell function to improve. So the combination of exogenous or injected stem cells, exosomes, and secretome therapy, plus your body's own improved endogenous stem cell activity can have a significant effect on decreasing inflammation and indirectly increasing NAD plus activity, which can improve your overall health by working with your body to help prepare itself and do what it's naturally supposed to do. So to wrap things up, we want to stabilize your blood sugar, optimize sleep, build muscle, reduce inflammation, support mitochondria, and then consider some targeted therapies like supplements, peptides, hormone modulation, stem cells, exosomes, and secretome biologic therapies. But remember, anti-aging is not about your appearance. It's about energy production in every tissue and every organ in your body. And it's not just on the outside, it's on the inside as well. And when energy production improves, total body function improves. So in closing, aging is not what you see in the mirror. It's what is happening in your cells. NAD plus fuels energy production, then the mitochondria produce energy. And when you support both, you're not just slowing down aging, you're restoring function. And when you restore function, the body performs the way it was designed to. So if you found this episode helpful, I encourage you to share it with someone who may also be trying to navigate the complexity of modern healthcare because the reality is that many people today are stuck in what I call a revolving door of treatment plans, seeing multiple specialists, receiving fragmented advice, never quite developing a clear strategy that ties everything together. And the goal of the Popkin method is to change that. This podcast series is designed not only to educate, but also help people understand that there is a more structured and integrated way to approach health, one that combines the principles of internal medicine with functional medicine and regenerative medicine and a very thoughtful, coordinated care plan. So if you feel like you're ready to move beyond scattered treatment plans and start building a personalized care strategy, I invite you to start a conversation with me. And you can learn more by visiting thepopkitmethod.com. And from there you can schedule a discovery call, a virtual functional medicine consultation, or an in-person consultation at my office in Hollywood, Florida. You can also follow along with additional education and updates on my social media platforms, including Facebook, LinkedIn, Instagram, and you can find longer educational content and lectures on my YouTube channel as well. Remembering that my goal with all of this is very simple to help patients understand their physiology, organize their care, and develop a clear path toward better health. So thank you for listening to the Popkin Method podcast, and I look forward to continuing the conversation in the next episode. And Jamie, if we've uh sparked any questions, you know, now's a good time to ask or have any commentary.

SPEAKER_00 52:46

No, I think that you're so comprehensive, Dr. Pumpkin, that not a lot of questions left here besides, I guess I need to toss this guy in the trash and come up with a few new events to add to add into my repertoire. But listen, you don't need more opinions, options, or overhyped social media gimmicks. You simply need the sequence and structure that the Popkin Method provides. And that starts with one plan that's built to last. So if you're ready to explore these therapies the right way, visit thepopkinmethod.com to learn more and schedule a discovery call, an online consultation, or an in person visit with Dr. Popkin today. This is the Popkin Method, and we will see you next time.

SPEAKER_01 53:28

See you next time.