Dhru Purohit Show - A Longevity Professor Shares Surprisingly Simple Everyday Habits That Extend Lifespan and Healthspan with Professor Rose Anne Kenny

Episode Date: January 11, 2024

This episode is brought to you by Birch Living, LMNT, and Sweetgreen. As the New Year starts, we may be exposed to the new trends marketed to help us kickstart our health. But we know that consistently doubling down on the fundamentals is the key to longevity.   Today on The Dhru Purohit Podcast, Dhru sits down with Professor Rose Anne Kenny to discuss the science of aging and the key factors that can help us age well. Professor Kenny shares her decades of research on aging and tests that can help us identify if we are aging optimally. She also discusses the importance of consistently focusing on resistance training, diet, exposure to nature, and community. Professor Kenny reminds us that we are not all doomed and that 80% of how we age is based on the habits and fundamentals we engage in daily. If you want motivation and inspiration to hone in on simple changes we know are tried and true, this episode is for you.  Rose Anne Kenny holds the chair of medical gerontology at Trinity College Dublin and St. James’s Hospital and is director of Mercer’s Institute for Successful Aging. Before her present appointment, Kenny held the chair of cardiovascular research at the University of Newcastle, where she was head of academic and clinical departments of medical gerontology for 12 years. She has published extensively on cardiovascular risk factors for falls and cognitive decline in aging. Her recently published book “Age Proof – The New Science of Living a Longer and Healthier Life” was shortlisted for the Royal Society Science Book Prize 2022.  In this episode, Dhru and Professor Kenny dive into (audio version / Apple Subscriber version): The importance of quality social relationships for longevity (2:55 / 2:55)  The misconceptions about aging and going back to the fundamentals (9:37 / 6:33) How do you know if you are aging well (19:33 / 16:33) Focusing on blood pressure testing and optimal ranges (26:17 / 21:47) Lipid panel and the critical tests for metabolic health (42:57 / 38:20) Grip strength and measuring V02 max as factors of aging (48:28 / 43:52) Professor Kenny’s longitudinal studies and the importance of nature, approaching life with curiosity, and healing childhood traumas (56:50 / 52:25) The importance of hormesis through cold therapy (1:06:42 / 1:02:08) 80% of aging is epigenetics (1:10:56 / 1:06:20) Roseto effect and the impact of close-knit community (1:15:04 / 1:10:30) Four factors that accelerated aging (1:23:14 / 1:18:11) The fears around aging (1:27:11 / 1:22:35) For more on Professor Kenny follow her on Twitter @RoseAnnekenny1  To get 20% off your Birch Living mattress plus two free eco-rest pillows, head over to birchliving.com/dhru today. Right now, LMNT is offering my listeners a free sample pack with any purchase. Head over to DrinkLMNT.com/dhru today. Find out more about Sweetgreen and their newest protein plates at www.sweetgreen.com. New Users of the sweet green app can use the code "Dhru5" for $5 off.  Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

There is very robust research to show that if you feel 10 years younger than your chronological age, it would appear that your attitude to how you're aging actually influences the biological pace of aging. So the dictum you are as young as you feel is actually true scientifically. So attitude matters. And having a positive attitude matters. Happy 2024. You know, right around this time of years, so many people are looking for that next pill or supplement or new magical device that can help us with our health goals.

And all those things are great. And I'll dabble in some of those here and there. But my recommendation to my audience is never forget about the basics. And when it comes to health, when it comes to wellness, when it comes to our longevity journey to hit to 100 and hopefully beyond, that's what I wish for me, what I wish for you, it truly comes down to doubling down on the basics first. That next pill, that next device, they can be all great things potentially,

and some are overblown and overhyped, but they don't matter if we don't have the basics. And today's interview, we have a top expert in this field of longevity here to remind us of those basics that are worth doubling down on. Hi, everyone, Drew Prode here. This week's guest on the podcast is Professor Rose Ann Kenney, and she's here to talk to us about the new science of living a longer and healthier life. She's a researcher in the space and has a ton of insights from her landmark research that's come out of Ireland.

Roseanne holds the chair of medical gerontology at Trinity College Dublin in St. James Hospital and is the director of Mercer Institute's successful aging program. Before her present appointment, Professor Roseanne Kenny held the chair of cardiovascular research at the University of Newcastle, where she was head of academic and clinical departments of medical gerontology for 12 years. She's published extensively on cardiovascular risk for falls and cognitive decline when they come to aging and their relationship to aging. And her recently published book, it's called Age Proof, the new science of living a longer and healthier life. By the way, this book was shortlisted by the Royal Society of Science Books Prize Award for 2022. We have a lot to cover on the topic of

aging, longevity, and doubling down on the basics that so many people forget about at this time of year, but they're so important to remind ourselves on. Stay tuned for a fantastic episode with Professor Roseanne Kenney. Welcome to the podcast. It's a pleasure to have you here. You know, in your book, you have an entire section on this topic of social relationships and friendships. What are the practical lessons from the latest science on relationships? when it comes to the people who are listening today, who want to not only age well, but live a longer life.

Okay. So first of all, it's fair to say that it's hard. If you are socially isolated and you don't have a strong friendship network, quality. It's not about numbers. It's about quality network. By its very definition, that makes it difficult to reach out. But the first thing, I would say is we need to make an effort to reach out. And I can tell you my own personal story on this, just to share that with you. COVID was particularly difficult. I'm a clinician and we were very busy during COVID, very active during COVID. So you're immediate and in some cases, particularly during COVID, your only engagement was with people at work. And then I wrote the book at that time also and it occurred to me, wow, I'm talking about this. I know the science behind all of this. I'm not really doing much for myself. And I'm not doing much for myself to afford me in latter years a comfort

blanket that I will have security in quality friendships that I have nurtured. So I made a conscious decision to reach out to people that I had known in medical school or even in school and start to engage again with those people. Now, it was by WhatsApp during COVID. And actually, that made it a lot easier because we started to have big groups and I'm on three very, very active WhatsApps at the moment and each of those three groups I have met with since COVID and I hadn't engaged in that way at all with any of those three cohorts. So that's my own personal story and I found it very worthwhile. The science is interesting and there are lots of layers to it. First of all, just to say that social isolation and loneliness, which is painful, social isolation,

isolation. It's an emotional feeling is very toxic biologically to our systems. We see this in animals, particularly gregarious and mammals who are very similar to ourselves if they're isolated. They get very marked inflammatory responses and upregulation of inflammatory genes in lymph nodes, for example, as a marker of an acute inflammatory response. That's really bad for the system. Inflammation is great if we get an infection and it kicks in. But then it's supposed to subside again, lying in wait for the next infection, not to chronically grumble in the background because that's what becomes toxic to our

biological pathways and systems. That's what we're not familiar with. And that's exactly what loneliness can do. Some people enjoy social isolation. They don't, you know, they don't particularly enjoy engaging with others. They're very happy in their own skin, in their own company. But the vast majority of us actually find social isolation at a certain threshold, painful and uncomfortable.

And that's when it's not good. Today's episode is brought to you by the Birch mattress by Helix. So we all know that getting a good night's sleep is super important, not just for our health in general, but for being a functional and thriving human being. I can tell you that when my sleep suffers, the next day is rough. That's why I'm so psyched about today's sponsor. Birch mattress by Helix. I've been sleeping on my birch mattress for three years now.

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packets free with any element order. This is a great way to try all eight of their flavors, or share element with a salty friend. Get you. yours today at drink element.com slash drew that's drink d i r nk l mn t dot com slash d hrrew drew that's me to get your offer today this deal is only available through my link so you got to make sure you go to drink element dot com slash d hr you we'll come back to this topic of friendship but i think this is a great opportunity now that we have the audience's attention to start off with some of the basics that are there. The basics that I'd love to start off with is, what do you still see today that are the most common biggest misconceptions that people have around aging

and how the aging process works? First of all, the boring but true answer is that the things that we know and have heard for a very long time with respect to slowing down the aging process, like exercise, like a good diet, those elements stand very strong still and they're really, really important. That's the first thing to say. Secondly, there is a lot of resource being pumped into a so-called cure for aging. We're nowhere near that. We're nowhere near that. at the moment. And I don't think we'll see such a thing in my lifetime. And also, I would say that there are enormous ethical questions with respect to that. So any of the work that I've personally been engaged in or my colleagues are engaged in or the general scientific community

are involved in is about not, you know, eternal life or eternal youth, but rather compressing the period of time that we all spend with some disease or disorder called morbidity or multi-morbidity at the end of life, compressing that right down to a minimum so that we can fulfill a very enjoyable, happy, independent life for as long as possible. And the reason that the compression of morbidity at the end of life, enables that is because the biggest limitation to independence and freedom from disability is physical illness or brain health illness. So that's what we're trying to understand. What are the factors which determine physical illness and morbidity and brain health illness at the end of life? How can we detect those earlier on? And what can we do about those factors?

to actually minimize any period of time we spend with those factors. Now, that's the science, and that's where the research is going for most of us at the moment. And that's what's really important. Given the global demographic shift and increase in numbers of older persons, it's very, very important that we achieve that, because otherwise there will be huge strains on our health and social care systems globally. And again, coming back to, okay, fine, it's okay for you, me, to say that. But what can I, the listener, do as an individual now, now at this stage in my life, to influence that?

And that's, they're all of the things that I've tried to touch on in the book. Physical exercise, and we'll talk about that and the importance of not just aerobic exercise, but very, very important muscle strengthening exercises and balance. exercises after the age of 45 when we start to lose muscle mass. Really important. And one study showed that less than 10% of people over 70 in the USA, population representative sample, actually engage in regular resistance exercise, muscle strengthening exercise. That's what I mean by that. So the physical exercise. Diet, and we can talk about diet, there are lots of diets. So many diets every day. knows how many new, so-called new diets are published. But actually, actually the easy rule of thumb

and what I use myself is the Mediterranean diet. There's so much evidence for it. And couple it with what we know, the new stuff about microbiome. And that's an easy rule of thumb to remember. Things like sleep, of course, is awfully important. And we can touch on that in more detail if you want later on. The important thing about sleep is to try and get as much of it as possible. And do your best to make your environment asleep friendly as possible. Start off in the morning in order to prepare for sleep that night. And if you if you have that approach with the day, it makes it easier to have a good night's sleep. The other thing, of course, that's very important is what we've just touched on. Friendship. Having purpose.

As we get older sometimes, particularly if we retire and work has been a big part of our lives, we can lose our way a little bit in the context of having purpose. And we've evolved to need purpose. It seems to sustain us biologically and extend our lifespan, slow the pace of aging. by having a purpose every day. And some of the most long-lived cohorts, for example, in the Blue Zones, have special names for having a purpose. They've recognized it's so important in life. Stress.

Stress is not good for our system. There are a couple of types of stress. It will say psychological stress, which we can be under, if we become under pressure or get bad news or whatever, but then that leads to a physical, biological stress and biological stress, which is what we talked about earlier on in the context of inflammation. Creativity, believe it or not, creativity is very good for our biological systems.

And engaging in creativity affords variety. And we know that variety feeds curiosity. And both of those elements are important for the autonomic. nervous system, which again is very closely linked to stress. There's just some of the of the aspects of healthy aging. And I think I said to you before we started the interview that I know that there's a lot of discussion around just one thing. If I was to do just one thing, what would you recommend? And I don't like that approach because it isn't just about one thing. It's do some of all of the things are as many as you can that we know works. And don't put yourself under pressure

and set impossible thresholds for yourself. Just to, you know, in moderation, the things we know work, you'll be able to continue with those behaviors much longer, hopefully for always. They'll evolve. And one will feed off the other. And in terms of biology, they will be synergistic. No, I love that advice because there's a tendency for us to go and want to, especially this time of year, new year, new you, goals, resolutions. There can be a tendency to want to do too much. But I do want to, in a healthy way, contrast it that if everybody did, you know, your book is fantastic. It's called Age Proof. We have a link to it in the show notes.

People should check it out. The new science of living longer. if people did going through all these categories, and we're going to tease these out a little bit further, friendship, sleep, you mentioned, downtime, cold water, hormesis, you know, not eating too much, you know, sex and intimacy, on and on. I'll continue back to that list. If we did a little bit of each of these, actually, I do want to acknowledge that if somebody was observing you, who is living in the standard population, they would actually consider you quite weird because your life would be very different. And I mean weird in a good way. If normal is unhealthy and unhealthy

aging and chronic disease and the last part of your life being not compressed and a lot of sickness and Alzheimer's, cardiovascular disease, cancer, the list goes on, then it actually, if that's all normal, being weird is probably a good thing, something that we should want to strive for. So yes, in moderation, but also you're going to be looking pretty weird, but that's going to be a good thing because those things are going to help you live a longer, happier, and healthier life. And they're fun. And they're fun. Yeah. I mean, even the physical exercise, we can come back to the cold water and harmonisus in a minute. I guess that's fun to believe. it or not. But but they are

fun things and I think that's that's a, that's a, that's a, that's a mind shift from where we were previously, you know, that this was hard work and it had to be hard work and if you weren't killing yourself in one aspect or another, it wasn't going

to work and you had to be fairly miserable in order for something to succeed. We know now that that's not necessarily the case at all and you have to, in order to continue being involved, it has to be fun. You have to enjoy it. Happiness is very important. Yes, absolutely. Well, we'll come back to that. Let's, again, build a building blocks on the basics. How does the audience member who's listening in today, how do they actually know if they're aging in a healthy way

versus an unhealthy way? Oh, that's a very good question. Now, there are lots of new men. measures for assessing biological aging. And in the round, we don't as yet have a measure, for example, a biological clock measure, epigenetics, which is absolutely accurate and can say, you know, I can tell you without a shadow of doubt, Drew, that you are 42 years and three months. Did I get it right? my age, yes, correct. I'm guessing.

But we don't actually have a very strong biological measure that can pinpoint exactly what our biological age is, as opposed to chronological age, which is the number of candles on our birthday cake. But we have pretty good indicators. And again, I come back, they're traditional indicators. What is your blood pressure? What are your serum lipid profiles? What is your hemoglobin A1C, which is a marker of diabetes and pre-diabetes, early diabetes? Obviously, BMI, your body mass index.

V-O-2 max is becoming more and more popular now as an indicator and appears to be a very strong correlate with biological aging. Your exercise capacity, which VO2 to some extent measures, etc. Grip strength, how strong your muscles are. So the traditional things that we've been talking about, they're all pretty good indicators of biological aging. You know, the whole biological clocks, the epigenetic clocks, the aging clocks are moving awfully fast. When we started our research, I run along Citudinal study on aging, 9,000 people who were following in great depth now for 17 years. and we see the same people every two years and do a number of measures, maybe seven hours of health assessment and social and economic assessments,

because it's an omnibus study. You know, when we started that study first, the biological clocks were very, very new, Horvall, particularly in Hannam, and their groups were the first to the table with biological clocks. But now we have clocks which measure muscle aging, clocks for measure heart aging, bone aging. But again, they're not absolutely accurate. They probably measure aging within maybe a five-year window of chronological age, etc.

But my point is we're getting there. And there's a lot of resource being put into this. A lot of very good scientists are focusing on this. And I think very soon we will be using blood tests and measuring little bits of genes, the mobile pieces of genes called epigenetics, we will be able to tell somebody's age biologically, accurately. But at the moment, it's the traditional measures. And something I really like is what age do you feel? There is very robust research to show that if you feel 10 years younger than your chronological age, say one is 60, but you know, you feel 50. I don't feel 60,

I feel 50. Actually, your pace of aging is slower than someone who is 60 and feels their 60. And that's when you adjust for all of the other things like maybe having arthritis or another disorder, which might make you feel 60. Even when you adjust for all of that, it would appear that your attitude to how you're aging actually influences the biological pace of aging. So the dictum you are as young as you feel is actually true scientifically. So attitude matters. And having a positive attitude matters. And if you kind of do, and we come back to it again,

a little bit of all the things we talked about if you can, that makes you feel better. changes your own attitude towards yourself and how you're aging, and that of itself is a positive thing. This episode is brought to you by Sweet Greens. You know, at the beginning of the year, I'm a big fan of starting off the new year by dialing in my diet and eating food that tastes good and is good for me. Everyone can relate to having a busy schedule, but still wanting to eat well, which is why I love to go to Sweet Greens to get an amazing salad, and now they have their new protein plates, which are currently my new favorite thing, since I'm

all about getting the right amount of high quality protein into my diet on a daily basis. These protein plates have at least 33 grams of protein to help keep you full and feel energized throughout the day. I've tried the miso-glazed salmon, the Southwest chicken fajita, and the hot honey chicken, my personal favorite right now, and they all taste fantastic. By the way, here's one of the coolest things about sweet greens. Their protein, their veggies, and their grains are all cooked in either extra virgin olive oil or avocado oil, not seed oils. This is huge new. news for anyone who's looking to avoid seed oils like myself. And I love Sweet Green's mission to support local communities by working with local farmers and suppliers. Honestly, I go to Sweet

Greens a few times a week. I'm very blessed to have one nearby me and often I'll order on Uber Eats or DoorDash and I love it. If you're curious about Sweet Green's new protein plates, visit your nearest sweet greens or find out more information about sweetgreens by going to Sweetgreen.com. That's Sweet S-W-E-E-T-Green.com. New users of the Sweet Green app can also use the code Drew 5, D-H-R-U-5 for $5 off today. You know, you mentioned a few biomarkers because we're not at this stage where we have one biomarker that can tell us our biological age, maybe one day that'll come. In the meantime, we have to use proxies that give us a good sense.

And I'd love to tease out a few of those that you mentioned so that our audience has a better understanding of these tests. And also, as part of things being accessible, these tests are largely, not all of them, but most of them are going to be things that most people can get through their standard healthcare. So let's start at the basics. One of the first ones you mentioned is blood pressure. As we are aging, blood pressure is a super important marker to pay attention to.

Talk about what is blood pressure and when should the audience member at whatever age they are, When should they start to really be thinking about it and how frequently and what's the optimal range that we should be targeting? So our blood pressure is measured. There are two measures of blood pressure. One is systolic pressure and the other is diastolic. So when you get the digits from your physician, the systolic is the top digit and the diastolic is the bottom digit. It's usually systolic over diastolic.

Basically, what that is, is the pressure in your system as measured by the vessel in the arm, where generally blood pressure is taken. So it's the pressure in that artery when the heart pushes blood through the system, when the heart contracts and pushes blood through. And then there's the pressure when it's almost like a wave of blood going through the system and then the wave receives. and you get a low end, and that's the diastolic. So the systolic is the top push of pressure.

The diastolic is the recession of blood flow in the vasculature and the bottom level. After the age of 20, systolic and diastolic blood pressure start to increase. Now, what's interesting, I think, is that even at the age of 20, we start to subdivided into different cohorts with respect to future blood pressure behavior. So if you look at 20-year-olds, there's a range of blood pressure, all normal, all normal for 20-year-olds, but those who are at the higher level at 20 of blood pressure, their blood pressure continues on a higher trajectory into their 60s than someone who at 20 is on the lower level of blood pressure. Their trajectory is not as high.

So we should know early on what our blood pressure is, certainly after the age of 40 annual blood pressure checks. And know your own metrics and see how your own metrics are changing year on year. When I started off as a medical student, the blood pressure threshold at which we were recommended as doctors to treat people's blood pressure was 160, that's the systolic, over 90, that's. the diastolic, or 95 it was. Now that's dropped right, right low down to 120 over 80. So our thresholds for treatment have dropped. And the drivers for that are longitudinal studies which have looked at, okay, which blood pressures make you more at risk in 20 years' time of having a stroke, which is one of the side effects of high blood pressure, of having heart failure, which is a side effect of high blood pressure, of your kidneys packing in, which is a side effect of blood pressure.

And as more and more evidence came to light with respect to those blood pressure measures, those thresholds started to drop. So currently it's around 120, you know, give or take. There's some flexibility around that at an individual level and at a specific age. But overall, it's 120 over 80. There are also people who started off at 20 with low. And in fact, might even have symptoms at age 20. So they might have a bit of dizziness because their blood pressure is overall a little bit too low and, et cetera. We call those low blood pressure phenotypes. But it appears now that actually, even though they're a bit symptomatic in their 20s and 30s because of low blood pressure,

they actually probably, that actually probably is beneficial longer term in terms of the outcomes I spoke about. Stroke, heart failure, kidney disease. So the lowest blood pressure you can tolerate without experiencing hypotensive, low blood pressure symptoms, the better. And those symptoms, just so your listeners know, one of the commonest is dizziness if you stand up very quickly. Or generally dizziness during the day, low blood pressure can also contribute to fatigue. So excessive fatigue, fatigue, which really doesn't fit with your energy level, generally speaking,

that can be a symptom of low blood pressure. Bad headaches can be a symptom of low blood pressure. So just to be aware that excessively low blood pressure can cause symptoms and issues, but actually we pretty much say now, how low can you tolerate? That's a good blood pressure. Because high blood pressure is such an epidemic out there as the world becomes more westernized, both in diet and lifestyle, I'd love to just touch on that for a second. What are the biggest culprits that lead to so many people, even individuals who are listening

today, having high blood pressure? And what are some of the things they can start to implement to dial that back? The main reason we get high blood pressure is we get thickening of arteries. And the main atherosclerosis. And the main reason, there are two reasons, principal reasons for that. One is age. With aging, we get atrochlorosis accrues and increases. And the second is excess of circulating fatty lipids, which is why your lipid profile is so important.

And also other markers of metabolic syndrome like diabetes and obesity, which is associated with inappropriate interruptions or changes in metabolic pathways, which should generally be beneficial in getting really. of lipids and getting rid of toxic compounds from the system so we don't get arthroscoposis. So atthrosclerosis is the big thing. That's what we call hardening of the arteries. You may be familiar with that. And if you have an angiogram, that's what the physician is looking for in terms of your cardiac, your heart vessels. How much hardening is there of those vessels? So that's what causes, that's the main cause of high blood pressure. And so this goes back to a lot of the key things that you've talked about, you know, primarily when it comes to the hardening of the arteries, stress, lifestyle, and in particular, making sure that we adopt a diet that regardless of what

diet you do, really highly staying away from the ultra-processed foods that typically are associated with obesity and really terrible lipid markers. Yeah. foods, actually. You know, the data from the United Kingdom, for example, and I know the states is very closely aligned with this, is that 57% of adults over the age of 50, sorry, the dietary intake in 57% of adults over the age of 50 is ultra-processed foods. And I mean, this, the next statistic is very worrying, sadly, that applies to 90% of 10-year-olds in the UK. So, I our intake of ultra-processed foods is increasing.

It's a difficult, it's really difficult because it's almost a pattern of life now, given those statistics. If I'm asked, what are ultra-processed foods? Again, a quick, quick answer to that is anything which is packaged. You know, if you fresh fruit, fresh vegetables, fresh produce, they're not ultra-processed. Ultra process generally requires something to preserve it and a packaging and something that from a commercial perspective, the commercial body can make resource from. And therefore, it has to have something that's different in terms of flavor or taste or constituents, etc. So that's more or less what ultra processed is. It's more complex than that. But I find that a very useful rule myself.

And the other quick rule about ultra processed is if it's something that you don't. normally carry in the kitchen. If you look at the at a packaging and you see things that you don't have in your kitchen cupboard, that's ultra processed. So ultra processed is a really good is a very good, is a very good point. And that that is, I think our enemy and something we're going to have to do something about the problem is that all of these factors in terms of accelerated aging and biology of aging and having more comorbidities as we get older are really closely linked to socioeconomic status. Yes.

And ultra processed foods are actually cheaper, by in the main, than natural products, than fresh produce. And that is, that is an issue. So the very cohorts, the very communities, the very groups who are most likely to have comorbidities and generally obesity are the very groups who maybe don't have an economic choice or can't see enough economic choice or aren't informed or educated to know of an economic choice that they might potentially be able to make. That is a big issue. Absolutely. And we'll touch on that a little bit more for sure. One of the components that I often see when it comes to things like

high blood pressure is that people go into the doctor's office and often, one of the lifestyle recommendations they get is let's stay away from sodium in the diet. But I think where a lot of physicians maybe undereducated is the vast majority of sodium, when you look at people's diets, are not coming from the salt that they're adding to their, you know, broccoli or, you know, grilled steak or whatever they're having. It's coming from ultra-processed foods. and in particular breads and pastries. And you don't want those.

Cereals. And cereals as well. And so there's this emphasis on salt. And there's an emphasis on often the word moderation will be kind of used in a bastardized way in the sense of, you know, just eat a good diet in moderation. But today, moderation, moderation is. is what people think of as normal. You know, I often say that if you walk to,

if you walk around Times Square here in America and you go to the average person and say, do you eat a healthy diet? You know, most people, regardless of what they eat, they're all going to say yes, because each and every one of them has a different definition of what moderation and healthy means to them. For one person, it might mean,

well, I only have two sodas, two soft drinks a day. And for another person, it's, I only smoke, you know, one pack of cigarettes. a week and they think that that's healthy because they have another friend that's smoking two pack of cigarettes a week that's there. So I think that these long format podcast with, you know, researchers like yourself are very helpful because while I do believe, and you shared it earlier, that moderation is key, I do think that we have to help remind individuals that that moderation has to be thought of in context. And nothing, nowhere is this more apparent than when it comes

to high blood pressure and some of the standard advice, because most doctors are not telling their patients, hey, cut down on bread rolls, cut down on cereals, they're saying cut down on the salt, and the patient is thinking that they're making a difference in their health by not using sea salt or table salt in their recipe anymore. And then the food doesn't taste well. And so they're not willing to stick with their, you know, healthier diet. So it's just a really good point. That's a very good point. And I mean, I think if you could, I would say to someone, right, in the context of moderation, if 50% work out how much of your diet is processed.

Like all the intake in a day, how much of it is processed, how much of it is proportionately, how much of it is natural, fresh. And then half the processed intake in the first instance. That's a reasonable threshold for you at an individual level to set as a target. Half that. personally I hate the taste of food without a little bit of salt you and everybody else me and everybody else you know but you've made a really good point

that it's the ultra processed or processed foods generally which have very high salt content in the main and sugar and sugar so have a look at what you're eating and it's very difficult for you to actually I think it's very difficult for an individual on a daily regular basis to calculate how much sodium and how much sugar they're taking in. But just look at whatever your proportion is and then half that, half whatever your normal intake is. Personally, I wouldn't have a soda if I had nothing else to drink in the world because there's nothing that's of value in them that you won't get out of water.

You know, the water content is great and the rest of it is nonsense. So have a look at that. Have a look at your intake and half it. And that's, you've done a great service to yourself. I want to say about blood pressure. There's a huge unmet need, and this applies to the USA, to the UK, and studies we've done here, something like 40% of men aged 50 to 60 in our study, who had high blood pressure when we measured it. Before measuring it, we said to them, do you have hypertension? Do you have high blood pressure?

And they said no. So they were unaware that they had high blood pressure. And then using standard metrics and guidelines, we measured blood pressure. and 40% of those who had high blood pressure were not aware. And the same level of what we're calling unmet need, unawareness of disorder or illness, was present for diabetes and pre-diabetes and for cholesterol, and for depression, low mood, but clinical depression. So there is a lack of awareness.

And it's particularly in our, study, so for men, but women were not far behind in not having awareness of having these illnesses. So regular screening is important. These are very simple screens that any general practitioner can do. And actually in Ireland, we're hoping to make them available in pharmacies because you really, the doctor needs to help you to manage thresholds if they're abnormal. But actually, to have the screen done on an annual basis, you just need someone who can do the screen. It's not rocket science. They're mostly blood tests under blood pressure measurement and height and weight if you're going to go with BMI or waist hip ratio, which is another very good measure. And I know a lot of

your listeners are female. We discussed that. And you know what? After the menopause, it's very difficult because of our hormonal change, women's abdominal girth changes. And it's really hard. And it's really hard to you will not be at 45, 50, what you wear at 20 in terms of having a size eight waist. It just won't happen. And just know that and not put too much expectation on yourself. But if your diet is good and you feel healthy and your approach is healthy and your attitude is healthy, that's good. And you keep your BMI within a reasonable range.

That's satisfactory. Well, this is all following along the thread of a question that I was asking, which is how do we know if we're actually healthy? And you gave a list of a few different markers that people generally all have access to. And because there's so much lack of education about even people who have high blood pressure that they even have it because they're not getting screened or they're just thinking that they're okay, I'd love to follow that thread and go into another category, which is our lipids and our overall metabolic health. So what are the key tests that fall into that category and why are they so important for individuals to get them done?

So we can measure a number of different components of lipid, which are pretty good indicators of our lipid health. Cholesterol is the one we all we know about. Triglycerides are the sort of fatty acids that we intake and generally have to be done fasting. Cholesterol doesn't necessarily have to be done fasting. There's total cholesterol. And then there are other measures. There are other components of lipid.

You'll hear about lipid A, etc., which come as part of a lipid screen. So if you're getting a screening test done for bats in your circulation, if you ask for a lipid screen, that will cover all of the necessary lipids, and each of them has their own threshold. And it's better if you have them done fasting, because then not all of them require fasting, then that will cover all of them. So a fasting lipid screen. Yeah. Lipid is the kind of the medical term for fats. For sure. There was another one that you mentioned that was a marker that is super important and it's hemoglobin A1C. Why was that on one of your list of things that people should

be testing to know if they're actually aging well or if they're abnormally aging, which is what most people are doing today? There are two common ways. that we apply globally to identify whether diabetes is present or pre-diabetes, which is the stage before you actually develop bullman diabetes or diagnostic diabetes. And that's a fasting blood sugar, blood glucose, glucose is the sugar, so a fasting blood sugar, or haemoglobin A1C. Now haemoglobin A1C is a measure which is different to fasting. blood glucose, but is a very good measure for diabetes.

Glucose is what your sugar is at the time in your blood that the blood was wrong. Hemoglobin A1C is a longer trajectory. So it tells you about your sugar behavior over a 8 to 12 week period. So in many ways, it gives more information to the physician about your blood pressure behavior because obviously blood sugar goes up after a meal and down after a period of fasting and then up again and down again. And that's what that's measuring. Those troughs and nadiers of blood pressure behavior over an 8 to 12 week period. Either measure is fine for diagnosing diabetes. And there have been huge studies confirming the diagnostic categories. So your physician will now, having done those blood tests,

depending on what the measures are, what your results are, whether you pre-diabetes, and if you don't do something about it now, you will become diabetic. And that's mostly lifestyle behaviours, i.e. diet and exercise and losing weight, or frank diabetes. And in the context of frank diabetes, sometimes, of course, diet works. And there have been some lovely studies started off in Newcastle in the north of England, showing that a really, really dramatic diet in people who had established diabetes, 800 calories a day on average, actually got rid of the need for these patients who had diabetes, who were on drugs and insulin for diabetes, to need the drugs or insulin. So extreme, you know, 800 calories is very little caloric intake, but it works in terms of managing diabetes in some people. So, yeah, so that's, that's with respect to diabetes. Now, it's the, that, that cluster of disorders, high blood pressure, obesity, haemoglobin A1C out with the normal threshold or pre-diabetes or diabetes and, and overweight, that constitutes a syndrome called the metabolic syndrome. We're seeing more and more

of these so that you're not seeing hypertension, for example, in isolation or overweight, in isolation, nothing else going on. You're often, often seeing that someone who's got pre-diabetes or diabetes actually also has hypertension and has excessive body weight and has high blood pressure, etc. So we now know that this metabolic syndrome is becoming more common and it's why we screen for all of the components of that syndrome, not just one. you mentioned the two other markers of seeing if we're aging well. Now, these two markers are not as widely known and not like typically tested for in your typical physician's office.

But I think they're worthwhile talking about because they're sort of a preview of what can be integrated into normal health care one day, hopefully, but also for those that have the resources and the means. one of them more straightforward, one of them a little bit more difficult, but still accessible, generally if you have some disposable income. And those were grip strength and VO2 max. Let's start off with grip strength first. And why is that an important proxy of how we age?

We've talked about it a little bit on this podcast before, but I think it's worth resharing with the audience. Okay, thank you. So grip strength is a real down and dirty and quick way of measuring your muscle strength overall. And there are tables which couple grip strength metrics with age and sex. So you know what is normal for your gender and age. And we find in clinical scenarios, we use grip strength all of the time in my clinic and I run a cardiovascular clinic. But we use grip strength as a measure of muscle strength. And as an early indicator actually of frailty or pending frailty.

And sarcopenia, which is the underlying muscle pathophysiology, which underpins frailty. It's an infiltration of muscles which causes weakness of the muscles. So a simple test like grip strength. And grip strength, the tool that's used a thing called a dynamometer, I wish I had one. But basically, it's a strain gauge technology, which the individual presses and the strain, it's fighting against you for pressure and measuring how much you're pressing on it while it tries to combat any pressure you're applying. It's been very well validated for all age groups actually. And I would recommend that you have a grip strength test done if possible. The more sophisticated

version of that is to have a physical therapist actually measure each of your muscle. groups in terms of muscle strength and also balance. So that's a more sophisticated version of that. VO2 max is a proxy for how much exercise you can sustain with your respiratory rate and your capacity for inhalation and exhalation and production and usage of oxygen. Now actually, certainly on these islands, UK and Ireland, it is not. generally easily accessible as a measurement tool. But there are some clinics which will measure, but it's much, much so far less broadly accessible as a screening tool than grip strength

or maximum exercise capacity. So you can check out your maximum exercise capacity. For example, on a treadmill, measuring blood pressure and heart rate without necessarily applying the VO2 measures and many gyms, etc. will do that. And we use a very rough rule of thumb for your maximum heart rate. And as we get older, we've much less variability in heart rate. A 20-year-old's heart rate, if you look at a 24-hour heart rate picture, will have gone up and down, up and down, up and down, up and down all day. And the more variability in heart rate, the healthier your heart system. If you think of it like the more flexible the system, the system is, the more able it is to respond by increasing and decreasing blood pressure with

minor maneuvers. As we get older, because, generally speaking, because of hardening of the archery's, tickening of the arteries, and also because our autonomic nervous system, the vagal nerve and the sympathetic nerve, are not as vibrant as previously. We don't get the same level of heart rate variability. So, coming back to the exercise. When we're doing an exercise, stress test. We accommodate for the interpretation of that test by taking 220 as a top digit, subtracting age from 220, and whatever you get, that's your target heart rate. And when you achieve that, if you achieve that target heart rate with exercise, that's pretty good exercise tolerance. If you can keep that going for a number of minutes, don't try and go about it. So there are different ways of

measuring our VO2 max surrogates without actually having that particular measure, although it's a great measure if you can access it. Yeah, we're very lucky here in America. There's a lot more clinics that have been popping up that are direct-to-consumer where you can go in. Often it might be a gym or a sports medicine clinic and you can pay out of pocket. Unfortunately, you know, insurance doesn't really cover that over here. I'm located here in L.A. and there's a bunch of clinics and I went to go get my V-O-2 max tested just as a benchmark to see. And there's a bunch of guidelines online. I've written a few articles just for my listeners and talked about my own journey of doing, you know, grip strength, ordering one of those machines from Amazon. It's not that expensive. I think it was like 30 bucks or

something. And also I did my V-O-2 max test. It was like 100 bucks, I think. And do you have any guidelines for those individuals that are going to embark those of how, what should they? be targeting in terms of the benchmark of, you know, once they get a baseline and let's say they see that they are normal for their age, but they want to improve, which goes back to this idea of can we slow down the aging process, which you've said, yes, we can by improving these things. Are there benchmarks that they should be targeting? How do they know what they should be shooting for? That's a grace. That's a great point. On a person, level, I have a personal trainer who sets my thresholds and benchmarks, because otherwise I find I don't, I don't necessarily adhere. I'm very gentle on myself. And at continuing with something, pursuing something, you know, I take myself easy. It's, I find it's nicer if you can have an external source supporting you and continuing with you. If you're at your V-O-2 max for age, I would say that's

excellent. And I would say with that, yes, to continue to increase. I mean, that's your target. You know, what the normative is for age is very, very good. But then I would say within whatever you can sustain to continue to increase. It's never too much as long as it's as long as it's not causing discomfort or pain. And also as long as you don't become disillusioned by it. and find that your change isn't mapping with your expectations. That's also very important to continue involvement. So that's what I would recommend with respect to that. Just if you are purchasing your own grip strength machine,

just so you know, because we use this all the time in the longitudinal studies every two years on 10,000 odd people, and they have to be calibrated and they have to probably be calibrated every 12 months. They go off. So if you see it, if you have it for 12 months, and you see it recording at a level that wasn't what you were, say, six months ago, and it doesn't make sense because you're doing all you should be doing, then that's just the machine has, it needs to be recalibrated.

So just be aware that's the way with all technologies. They require recalibration. It's the same with blood pressure machines. If you're measuring your own blood pressure, which is a great thing to do, by the way, I completely encourage patients, particularly if somebody has identified, you as being borderline or having a high blood pressure to measure your own blood pressure, again at different times during the day, but always be aware of the technology and you may have to renew the technology. Generally speaking, it's very difficult to get someone to constantly

recalibrate, who's a specialist in the area, these technologies for you and you almost always have to repurchase, actually. That's the corporate world, as you know, the commercial world. So that's what I would recommend for those, yeah, components. I want to move to, you know, you've talked and hinted about the studies that you've been a part of, these longitudinal studies. I'd love for you to break them down and talk about what was the hope of these studies, how long have they been going on, and what have been the key findings of them as you've now been doing them over the years. Okay, for my own, for our own study, the Tilda study, the Irish longitudinal study on aging, Tilda. We've published over 600 papers. So there are a number of different findings. And they all support what we started with in terms of the components, the elements,

which enhance biological aging. I think the purpose of these studies is they help us to understand the process of aging. What's happening biologically over a period of time at an individual level? Let me explain that in more detail. If you're 50 coming into the study and we're seeing you every two years, doing the same measurements every two years, we can see how you change over that period of time. And if after 17 years you start getting significant memory problems or problems with exercise tolerance or problems with muscle strength or a stroke, we could go back and say, okay, we've taken a whole load of biomarkers here, new ones and traditional. ones? What are the ones that actually would have given us an indication that this individual, or people in a group like this individual, were likely to develop those outcomes? And then we can

inform the field, the medical field, you should be actually probably looking at these metrics as predictors. Now, that's how all of this information, mostly, much of it from the lovely longitudinal study framing him, that's how this information came to light of the risk factors we've just talked about all of the components of the metabolic syndrome, high blood pressure, glucose, etc, etc. That's how we know that now. And it's how we know the thresholds that put you at risk. So that's the idea behind a longitudinal study. Some of the stuff that we have worked through, obviously the traditional stuff that we've talked about. Interesting things are nature, exposure to nature and inflammatory biomarkers and well-bearing. And well,

being and cognitive health and mental health, by which I mean mood, anxiety or depression. Nature and then what kind of nature? Green space or blue space. Ireland is an island. And there are similar studies to what I'm about to quote in the USA and in the UK. And they've shown that actually green space is really important. There are a number of reasons for that. first of all, of toxins in the environment, pollution, are helped with trees

because they block you from access to a degree to those air pollutants. But also, nature and green space affords variety. Curiosity. It's constantly changing.

That's really good for us. That's constantly stimulating a part of the brain that's in, we need to keep stimulated. But it's also a really, It results in relaxation through the autonomic system so that we get a dominance of vagal tone and slowing in heart rate and breathing and lowering of blood pressure. And an attenuation of sympathetic tone, which is your fight or flight response.

So rain space has been shown to do all of that. Blue space does it even more and significantly more. And it's not quite clear why blue space has the same advantages as green space, but more. But it might be because there's even more variety associated with blue space and more, more clean air and more relaxation for maybe through variety. I'll share something with you and your listeners. I have a little cottage that I go to on the west coast of Ireland, truly next stop New York. I mean, it's really at the last post in the west of Ireland. And sometimes, and I do do cold water swimming, and sometimes I can swim and I'll sit on a rock after a swim.

And I find myself almost hypnotized by the sea. So if you look at the sea for a period of time, it is almost hypnotic and very, very relaxing. So blue space is good. So that's an interesting thing that we've shown and others have shown from some of the longitudinal studies. We've particularly shown that aging is a life course science. Aging doesn't start when we're 50. Aging doesn't start when we're 60. Aging starts way back.

And actually, your childhood and your experiences, in childhood significantly influence your ageing process. Now, I'm very much aware that that's not good news to some people because, you know, you had no control over any of that. The good news is, actually, that you can attenuate, modify a number of the biological changes that unpleasant experiences or bad experiences that may have happened in childhood. You can modify those in adulthood. So, you know, that's the hopeful piece. lovely study from the New Zealand group, the Dunedin study, which actually showed that, and I cited this in the book, they have a longitudinal study, but unlike ours, which starts

at age 50, they're starting birth, a thousand babies born in one year in Dunedin and New Zealand and then followed through every four years, they're 50 now, but when they were age 38, chronological age, everybody 38. They measured biological aging using epigenetic clocks and also the other biomarkers we've discussed like cholesterol, like respiratory biomarkers, breathing, etc., like heart rate, like blood pressure, like muscle mass, etc., walking speed. And they discovered that. Even though everybody was the same age and there were only 38, that's young, young in my book now. there was a 20-year difference between biological clocks in that cohort. So some were behaving, you know, like 22-year-olds.

Some were behaving like almost 48-year-olds, 50 years. Sorry, 28-year-olds. Some were behaving like 48-year-olds. So 20-year difference. That's a huge spread. And the factors which determined the faster aiders, the older biological cohort were childhood experiences that were adverse, adverse childhood events. That was, you know, physical abuse in the home, alcohol, problems in the home,

divorce in childhood, etc. Things that go wrong when we're children, and we've no control over. So that was a real wake-up call to our whole community of how important the life course is in determining the pace of aging biologically. But then there have been more recent studies showing that that can be modified, actually. And if your socioeconomic situation changes, particularly, and stress changes, that that attenuates the childhood contribution to the pace of aging. That's so important.

You know, we've done a few episodes on that topic with different experts in this field. And one of the important sort of reminders that I've gotten from them that you've also been mentioning here is that you can score high on the ACEs question here. Let's say if you had, you know, parents that separated when you were young or you had an alcoholic parent or somebody that was dealing with substance abuse, you were born into poverty. You know, these are all the things that can have you score high on the ACEs questionnaire. And those things have an impact, but getting things like appropriate therapy, doing certain processes that are in a way, for lack of better terms, read parenting.

work where you get a chance to, with a trained professional, heal some of the influences of those things, whether it's a psychologist, psychiatrist, therapist, whatever it might be, that can at least make some buffer to these traumas that were there that are no longer in a place where they're living in our body in a maximized, unresolved way. So at least that gives us some gliver of hope that things can be done. Really important. And actually, there's another factor that I didn't mention, which you've kind of alluded to, is having a significant other makes a huge difference. So for, even for children, if there's a grandparent who takes over some of those parental responsibilities and roles, that makes a massive difference in buffering this, these

biological, the embedding of these negative biological factors. So, and I think at a societal level, we should be thinking about that and ensuring that that's the case, no matter what, that even if we've put in buffers at a societal level, that children always have a significant other who will assist them through their journey. Absolutely. I want to touch on, because you mentioned it, you know, I want to touch on this idea of cold water and the process of formisus. Now, why are you a fan of it. I'm very persuaded by the science behind it, actually, and how I feel after it. I'm laughing because I meet people and they say, I've read your book, I'm doing, I'm doing all the, you know, I'm doing what you're recommending, la la, la, la, I'm doing everything except, and I know what's

coming. I can't stand the cold water. I can't have a cold shower, cold shower, even. There's good science behind this. Hormusis is a biologic. process where we shock a cell, basically. And by shocking the cell, you actually wake up pathways and systems within the cell, which were de facto hibernating. That's very simplistically what the process is. So there are lots of ways we can do this. Radiation does it. Starving cells of oxygen do it. but cold water stimulus, changing temperatures of cells does it. And for us, as one big blob of cells, that's the best way for us to engage with harmesis.

And it does a whole load of things at a neurohumeral level. So again, neurologically, it modifies the autonomic system. So although there's an initial fight or flight response and an initial surge in sympathetic, the sympathetic nervous activity throughout the body. Then after a period of time, once that initial insult, if you like, has occurred, it's followed by a gradual parasympathetic excess

or vagal excess and a relaxation phase. Now, those neurological changes are coupled with hormonal changes. The best known are probably endorphins. And the release of endorphins and the effect of that feel good effect of endorphins can last for 48 to 72 hours after cold water exposure. Not so much after a shower as after cold water swim. Now, when I say cold water swim, I'm like in and out. At the moment in Ireland, the water is probably seven, eight degrees. It's cold.

So, I mean, if I spend five minutes in the water, I'm congratulating myself for the rest of the week. So, but it's that level of exposure. But that does cause an endorphin release, which lasts 48 to 72 hours. Another very interesting recent paper has shown that if you repeatedly expose your system to cold water, including cold water showers, It attenuates that autonomic nervous system response, that sympathetic and parasympathetic or vagal response. And that attenuation, that dampening down of those responses over time lasts, even if you don't expose yourself for many months afterwards. So that seven months later in a randomized control trial, the cohort who had exposed themselves for a number of weeks to cold water during summer months, months actually still had 50% of that attenuated response at seven months after stopping swimming.

So that translates practically into if you swim in cold water swimming in the summertime when it's not so cold. And you don't do it in the winter. You still have a hangover effect of the benefits of that when you start again the following summer. The other thing is you often do it with people. It's great fun. There's a great camaraderie associated with it. And yeah, and you're in nature. And I describe to you what I find as a hypnotic effect of just being by the sea.

So in addition to the basics that, you know, we talked about earlier when it comes to diet and lifestyle, really the larger picture that I feel like you have shared multiple times on different interviews in your books that you want to remind people of is that it used to be when we thought about aging, we thought that when you're born, however you age, is all set in stone. And really what you're bringing to the table is that through your own words, correct me if I'm wrong, but that 80% of how we age is really how we show up and express our life, our epigenetics, how we choose to eat, who we spend time with, whether or not we're mixing in some cold water therapy and bringing in some and growing our brown fat in our body.

having healthy sex, an active sex life in our in our lives and in our relationships. Another thing that you talk about in the book. And only 20% is the things that are hardwired that come back to our genetics. I'd love to just take a moment for you to just talk a little bit more about that because as much as we've known that and you're talking about it, other people have talking about Some people have been talking about this for a while now. Still, a lot of people, this comes as news to them. So, just to say that your statistics are absolutely right.

And we know about how much we're hardwired, as you say, that means our genes. We've got 20 to 30,000 genes. They're fixed. We can't do anything about them. They're only responsible for 20 or in some studies at the very most 30. of how we age when we're younger. It's different if we get into the older old age category. They contribute a bit more.

But for, you know, 40, 50, 60, 70-year-olds, you've got control over how you age by about 80%. And that's the behaviours we're talking about. We know it from twin studies, from identical twins, where their genetics are exactly the same, but their ageing process is different in many different ways. the number of diseases they accrue, their biological aging, how they look, actually, in some cases, because how you look, if you haven't had a surgeon tamper with you, actually is a pretty good metric of your biological aging. So we know from the twin studies that fixed genes, they look different, their biological aging is different, and the factors which have determined those differences,

and why one appears to be aging faster than another are the global term is environmental factors. And that's everything we've discussed. It's their diet, exercise, cigarette smoking, managing blood pressure, you know, having purpose, creativity, being happy, having a positive perception, having social networks, etc. All of those lifestyle, behavioral, environmental factors are what influence 80% of the aging process. Now, I just like the listeners to kind of just stop for a moment and take that in. That's huge. That's huge. And the clocks, the epigenetics we were talking about, which aren't really genetics. They're the dynamic pieces sticking out of genes. They're not your hardwired genes. They are influenced by those environmental factors. It's those environmental factors which change the epigenetics, change your clock. So it's within our control by and large to a very, very high extent. And yes, we've known that for a long period of time. But for some reason, it hasn't entirely saturated.

So I would just say pause and just reflect on that. That's how important the impact of all that we've discussed is in terms of how, what your pace of ageings, how you will age, how you will age, how you will accrue or get diseases and disorders towards the end of life. You can pretty much control a lot of that. There's a pretty mind-blowing story of a small town that was founded in the late 1800s here in America. And I'd love to talk about this town and some of the inadvertent secrets of longevity

that this town ended up teaching researchers. Rosetta was a town. and the story goes back to the late 1800s. There was quite a bit of poverty there. It was based in Italy, near Rome, outside Rome. And at that stage, it became apparent that there were emigration opportunities in the USA. So a number of the Rosetta and citizens did emigrate to the USA.

And they established really what was a mirror, small town, Rosetta, but in Pennsylvania. And then a physician called Stuart Wolfe had a holiday home nearby and was visiting one summer, gave a lecture, as you do, to a local community of general practitioners, etc. And the GP, the general practitioner or family practitioner who was looking after Rosetta came up to him afterwards and said, you know, you were talking about cardiac disease, heart disease, heart attacks, which at that time, in the USA was an epidemic proportions. Men were literally dropping deads in their thousands in the US in their late 40s and early 50s, which we don't really see that much now. And he said, but in the town of Rosetta, where I practice, I don't see that. Now, at this stage, it was in the 1900s. So Wolf being a very good scientist, physician scientist, took his research team the next

summer to Rosetta. And this part of the story is fab, because the local mayor gave him the community hall and the mayor's, I think, four sisters helped the students with food and with setting everything up. And they literally set up a mini health assessment laboratory in the town hall. And they assessed all of the participants. Because in advance of this, Stuart Wolfe had checked the death records and found it actually to be the case that the age of death appeared to be older by almost a decade in Rosetta than in nearby towns. And there didn't seem to be any particular reason for this. So they basically did everything that measurements that we know are associated with heart disease and healthy lifestyle. And found, yes, that people were living longer, but it wasn't what they

expected. It wasn't the diet. Actually, they were eating more pizzas than would have been expected. It wasn't the exercise levels. It didn't appear to be that. And anyway, it wasn't genetics. They looked at everything that we traditionally associate with longevity. And Wolfe himself was sitting outside the church. And the church was built in the center of this wee town with all of the houses built around it, very much in the in the same fashion as Rosetta, Italy. And he noted on Sunday as the inhabitants poured out onto the square that they spent a considerable period of time on the square after church, chatting and laughing and engaging in families. And it was then that he had the light bulb moment that the truth about Rosetta

and the secret of Rosetta was Rosetta itself. That's the inhabitants of Rosetta. And then he started to explore this more. And this was one of the first studies that actually looked in a rigorous way at is the question, is there a relationship between how we engage and social engagement, friendships, quality of friendships, et cetera, and good health? And he studied with a scientist for a number of decades called Brune and they identified that indeed there was. Now, it's worth saying that they had a job selling their findings and getting them published and eventually they did in the American Journal of Medicine. But at that time, genetics was extremely. exploding. And the medical community and indeed scientific community weren't probably prepared to

accept that something is so-called soft as having quality friendship and relationships could actually affect biology. But of course, we now know from a number of studies that that is the case. Just to pull on that thread a little bit more, what were some of the behaviors or ways that this town and the populace inside of it, what were they doing that was so different than how friendship, relationships were happening in the rest of America around the same time? So the town had, I think, 2,200 inhabitants at the time. And there were something like 22 civic societies. So for 2,000 people, if you've got 22 societies, that's a lot of activity for individuals in the town.

That's the first thing. Secondly, he noted a very egalitarian attitude in the town. There was no one-upmanship. There was a good, a lot of sharing and engagement amongst the participants. Three generations often lived in one household. So that, you know, a grandfather lived with two other generations younger than him. And the house was constantly. in flow with people, people coming and going, loads of variety.

There was never a lonely moment for older individuals. They were also respected within the family structure and within the society. So they were very much engaged with the society. So they were some of the observations that he made at that time. Now, the resettance at the time stuck very much to themselves. They spoke the dialect that they had spoken in Rosetta in Italy. They continued to speak that. They married, intermarried, et cetera.

So they were quite a closed community also. But it was the egalitarian approach and the constant variety and social engagement that particularly were attributed to their extraordinary longevity compared with nearby towns. Well, fast forwarding a little bit. and, you know, Malcolm Gladwell and others have written about this. And I think there's some documentaries about it. Unfortunately, as the years went on, things changed. Can you just share a little bit more about that? Well, except that I suppose that you could say it became polluted by our Western approaches to things, by there was more investment in the town, more external

travel by inhabitants of the town to other areas to work, etc. And, you know, I suppose the 20th and 21st century caught up with the Rosettance. Going back to the Tilda study and your group being part of this incredible body of work, were there key moments in the participants' journey? where you saw a inflection point, whether it was something that was happening in their life, whether it's something that wasn't happening, that rapidly aged them in their journey. So were there things that were key moments across the board that you found that made a significant difference, but a shorter period of time, even though we know that aging starts the moment that you're born. So it's not like you're 40 years old and then all of a sudden

now the aging process starts. But were the things that you paid attention to that were like, how when individuals went through this, they really started to go, for lack of a better terms, downhill or in a much more accelerated aging. Yeah, there's four that occurred to me top of my head just now. The most immediate one is COVID. It's absolutely remarkable. Now, I'm not sure in Los Angeles is how rigorous your social isolation programs were from a policy perspective. But the almost mandatory or strong recommendations around social isolation for people who had any sort of a chronic illness or were aged over 70 were widespread in the UK and in Ireland and of course across Europe, etc., etc.

And I know I had a researcher in China who spent 87 days in an apartment with her mother. Couldn't go out. So COVID had a huge impact because what we saw afterwards was an accelerated frailty. Wow. Particularly in older persons who had been isolated. So that's the most immediate thing. Huge. We know from the study, because we'd looked at it just before COVID, we looked at it during

COVID and we looked at it after COVID. We know that loneliness went up threefold during COVID. And after COVID didn't return to baseline levels, didn't return. turn to the levels it was before COVID. So there seems to be a lingering effect. I'm calling this, you know, a form of long COVID, this lingering loneliness. Depression likewise, threefold increase in depression and anxiety.

And again, that's a lingering effect of COVID. So COVID would be the first thing that would come to mind. Pre-COVID, say, forget COVID, loss of a spouse that you had a quality relationship with or a partner. That makes a big difference. particularly for men. Women seem to be able to come back from that sort of a hit better than men as they get older. A significant financial pressure. So a new financial hit, that makes a big difference to stress and to how and to accelerated and aging. And the other important one that I would

love to see changed is protracted hospitalization where people or illness where people or immobile for long periods of time. Even three or four days, I mean, I'm a practicing physician. I see it in hospital. If somebody's admitted to hospital on a Thursday or a Friday, and they don't get active rehabilitation, and frankly, even as we do it, you know, we walk somebody maybe up and down a corridor.

I'm talking about active rehabilitation from get-go. They become frail within a week of admission. You can see it. And we've seen this in the study. It translates into hard facts long-term in the study. So I would say protracted immobility is toxic to our biology. They're the kind of ones that I've noted particularly with the study. Yeah, and some of those are going to be life events that will all go through at some point in time.

We will all lose somebody that will be significantly close to us, you know, a spouse, hopefully knock on wood for everybody. It's a long, long way and everybody gets a chance to healthy age. but in particular, you know, how much time we have with our loved ones goes back to these core ideas of us making sure that the basics are in order. And it's not just how much time we have with our loved ones, but it's the quality of that time. In this day and age, you see it more and more that a lot of people are actually, when you ask them, hey, would you want to live to be 90 years old? Would you want to live to be 100? I've never had more people that I see that are scared because they imagine that even if they made it to their late 80s, 90s, or even 100, they're expecting that from 75 onward at least, maybe even 65, that it's a miserable life.

It's a life that they are not either in full control of their brain. maybe they have Alzheimer's or dementia, they don't have full control over their body. And your work is really helping people understand that it doesn't have to be that way. Yes, people will get chronic disease, but we can delay that onset of chronic disease if we focus on some of the basics that we covered in this podcast today. Yeah, you've mentioned fear. And one of the biggest fears, because we ask about this, is exactly, as you've said, development of dementia, loss of capacity in that context.

And I'm not sure how well known it is the significant contribution that the cardiovascular risk factors, the metabolic syndrome risk factors that we've talked about actually make to brain help to dementia. There are some of the common as modifiable, in other words, factors we can do something about that contribute or cause dementia. Now, there's a large proportion of dementia that we, you know, we just scratch our heads and say, why did that happen to that person? But these are factors that we can pinpoint and say, untreated blood pressure for that long period of time, or atrial fibrillation. Atrial fibrillation

is an irregularity of the heart, the top chamber of the heart, where the heart beats fast like this. And if it does that for, you know, a number of minutes a day or whatever, that can, significantly increased the risk of Alzheimer's disease, as well as vascular dementia, the two commonest types of dementia. In our study, in the Tilda study, of those who we found had atrial fibrillation, a third didn't know they had it at all. A third knew, and their physicians knew, but they weren't on the recommended treatments. The treatments were either not correct or not optimal. And one third only who had the irregularity were on the right treatment and the right doses. Again, this is something that we should regularly check. You can do it yourself.

If you feel your heart, you feel it palpitating for a period of time. Go and have it checked out. And heart rhythm monitors can be applied, which measure heart rate over a period of time. Easy. There are apps, as you know now, LiveCore is one of them, which, can measure heart rhythm if it's long enough and you can capture it by, you know, switching on the app and doing the measurement yourself. I get those all of the time in my cardiovascular clinic from patients and they're really good tracing. So you, an app, if you're concerned, will give you a heart tracing that you can share with a physician, but atrophibrelations and then the others that we talked about are also risk factors for dementia. Calastrol and other

lipid profiles that are abnormal, really common causes. Contributors, modifiable contributors to dementia, as is diabetes and toxic overweight, unhealthy overweight. So, yeah, dementia is one that I came. There was something else that you mentioned. Yeah, so it's very difficult. Of course, we're going to have stressful circumstances in life. And what do you do about that? First of all, I think awareness and, you know, through your podcast like this,

sharing the awareness that it can have that a negative impact on health is important. and then kind of buffering for it and preparing for it, again, by social networks and ask yourself, what if, what if I lost my partner in the morning? What would my day be like? What would my life be like? What can I do now to mitigate against some of those negative consequences associated with that? You can help yourself through that. Yeah, it's not only does meditating on that, make us more likely to want to invest in our relationships while our partner is here, right? You start to think about, wow, was I snappy with them? Was I taking them for granted?

Was I not getting a chance to maximize the time that I have with them while we're here today? But it also helps you think in advance of, do I have a robust community? You mentioned that women typically can bounce back a little bit healthier from the loss of a than men, men historically deal with higher rates of loneliness. They typically have less friendships and less strength of those friendships that are there. And it's a massive issue. So thinking about these things to be prepared for them if they happen one day, knock on wood, that happens a long time from now for those that are listening, but also to step back into, we can't let fear drive us into not taking action. And while we have as much as time as we hear, and while we have

some version of whatever health we have right now, this is the moment. This is the time to maximize that in a way. We can't let the normalcy of society, which is really abnormal aging. It's a lot of sugar. It's a lot of processed foods. It's a lot of ultra-processed foods. It's a lot of loneliness. it's a lot of isolation. It's a lot of letting the news, which is really a coverage of the worst things that are happening in the world today and a reminder of that on a regular basis

drive the priorities of our life. Instead, taking a step back and saying, let me actively take over how I age, starting with the information that I put in my body and the friendships and the people that I surround myself with. And I feel like your book is the roadmap. It's the plan of how people can do that. without going crazy. It's really just about doubling down on the basics that so many of us know,

but may not be motivated right now because we actually don't understand the science. And what I truly feel when you understand a little bit of how things work and why they work, you're more likely to want to do them in the first place. That's a great point. That was my motivation for the book, was to actually try to underpin what we know with science and good evidence base, not hearsay. There's a lot of hearsay and a lot of conjecture and a lot of wild aspirations. There's no harm in that, but they're not factually correct. And just embedded in science. And I think that becomes persuasive.

It was actually an interview I did a few years ago now, four years ago on radio. And the interviewer, we were starting a conversation like this. And the interviewer said, okay, give me your top three things. And I said, I talked about physical exercise and diet. And he interrupted me immediately. he said, oh, God, not those old chestnuts again. And it made me think, and I thought, okay, you're not wrong. I have to reframe the response so that it is interesting and engaging and factually correct

and embedded in what's happening biologically, because that's what persuades me. So that's what I need to share. Well, you not only shared in your book, again, the audience can find that. We have the link in the show notes below, but you've done it on this podcast as well. And Roseanne, I want to thank you so much. I know it's late Friday afternoon, now going into the evening for you. The sun is setting or has already set in your neck of the woods, but you stuck it out. And you were here with our audience reminding them about the power and the agency that they have to truly take their help and their pace of aging into their own hands.

So I acknowledge you for all your work, you and your team. on all the incredible research you've done, but you've done something else that I'm seeing, you know, a few more researchers starting to do. And you're that in that group, you're now taking the findings of that and you're translating it for the layperson, the person who's struggling,

the person who's listening this podcast, because you know that if the research is not met at a level that they can digest it, then ultimately humanity is doomed and we won't be able to take advantage of it. But you have made it digestible. And I acknowledge you and I thank you for that. Thank you. I've enjoyed myself. Thank you very much. Okay.

Thank you. If individuals want to get a chance to follow you and be in touch with all the latest developments and maybe one day a follow-up book that would be there, what's the best place for them to follow you? So I'm on I'm on X, as it is now, Kenny Roseanne. So and I have a... Only known as Twitter. Only known as Twitter. Yeah. That's probably the best way. And I'm on Trinity Web. website. Trinity College, Dublin is my university. Fantastic. Well, we'll have the links to your ex-profile, your Twitter profile, as well as your book. Please, everybody, pick up a copy. Roseanne, thank you again for being on the podcast. Thank you, Drew. Thank you.

Hi, everyone, Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would mean the world to me. And it The number one thing that you can do to support this podcast is share with a friend, share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter and it's called Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so much more.

If you want to get on this email list, which is, by the way, free and get my weekly step-by-step protocols for whole-body health and optimization, click the link in the show notes that's called Try This or just go to Drew Perot.com. That's D-H-R-U-P-U-R-H-I-T dot com and click on the tab that says, try this.