The Dr. Hyman Show - How And Why We Age

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Starting point is 00:02:43 Welcome to the doctor's pharmacy. I'm Dr. Mark Hyman. That's pharmacy with an F, a place for conversations that matter. And if you've ever wondered how you can reverse your biological age, listen up because I'm going to share with you some exciting tips about what we know about longevity because I just wrote a new book on it called Young Forever out February 21st, 2021. Please go pre-order right now at youngforeverbook.com. But this conversation I'm going to have with you today is going to help you understand the difference between chronological age, biological age, what the underlying mechanisms of aging are. We call the hallmarks of aging. I'm super excited to share this with you because I think about this all the time now, mostly because I'm getting older, but also because I think it's some of the most exciting research in science and it changes our

Starting point is 00:03:28 whole framework of how we need to think about aging, how we need to think about disease. So even though the focus is on longevity, the science of longevity is teaching us so much about disease in general and how the underlying causes of all the diseases of aging are really the same. And that by treating those underlying causes, we actually don't have to treat the diseases themselves. We can literally treat the process of biological aging and reverse it at any time. And that is to me so exciting. And I've done it myself, so I know it works. So let's do a little one-on-one on aging and jump right in on how and why we age first, you know, what is the difference between chronological age and biological age?

Starting point is 00:04:09 Well, your chronological age is how many years you've been on the planet. I was born in 1959. That's 63 years. That's what I got. You know, I can't change that, but my biological age is the age of my underlying biology. How healthy are my tissues? How healthy are my organs? How healthy are my tissues? How healthy are my organs? How healthy are my

Starting point is 00:04:26 biochemical processes? And that is something that we actually can change. And we have immense control over. And we can control it at any age. So it's really remarkable how powerful our interventions are now to change what we think are inevitable chronic diseases. The whole concept of chronic disease, meaning it's chronic, meaning you're always going to have it. It's something you have to live with. You have to manage your disease. I have to manage my diabetes, manage my heart disease, manage my Alzheimer's disease, which is good luck with that. But for most people, there's no roadmap for that. But what I'm going to share with you is that these conditions don't have to be a one-way street. You

Starting point is 00:05:09 can actually reverse Alzheimer's. You can reverse diabetes. You can reverse heart disease. And I've seen it over and over in my own practice and many of my colleagues in functional medicine. So our body is a system. It's a network. And it's made up of subsystems that are all interacting together. And our biological age is determined by the health of those subsystems and by whether or not they're in balance or out of balance, whether they're functional or dysfunctional. And that's really why we use the term functional medicine. We want to create optimal function. How do we create an optimally functioning immune system? How do we create optimally balanced hormones? How do we create an optimally functioning immune system? How do we create optimally balanced hormones? How do we optimize our metabolism and our ability to produce energy?

Starting point is 00:05:52 How do we optimize our detox system, our microbiome, our circulatory systems, and even our structural system, what we're made of, our biological structure, our tissues, our organs, our cells? We have the capacity to change those at any time because they're influenced by everything we do. They're not just on this set program of deterioration and disease. They are influenced by what we do. So if we don't take care of ourselves, we're going to activate all the disease programs in our body. But if we activate our longevity switches, which we now understand, I'm going to explain all the disease programs in our body. But if we activate our longevity switches, which we now understand, I'm going to explain what those are to you. But if we understand

Starting point is 00:06:29 our longevity switches, if we learn how to activate healing systems in the body, and the body has its own innate healing system that we now understand. We're so focused in medicine on treating disease and treating symptoms and medications that interfere with some pathway, instead of going, oh, the body is this amazing system that has its own intelligence, that has its own repair systems, its own rebuilding systems, its own rejuvenation systems, that we can activate those. And the most obvious one people are talking about is stem cells, right? If you cut your skin, how does it heal? If you break a bone, how does it heal? It's not because you take some drug to activate the healing system in your body. It's there.

Starting point is 00:07:16 It's innate in you. And so the question is, how do we enhance those innate healing systems? How do we stop interfering with them, which is basically what we do with how we live, right? So if we don't understand how our bodies work, and by the way, which one of you out there listening has an owner's manual that came with your body? I don't think you got it at the factory when you were born or the hospital, right? So we now understand what that owner's manual is. We understand how the body's organized and designed. And we can actually, like the laws of physics,

Starting point is 00:07:52 we can actually understand the laws of biology. So if we don't activate these healing systems intentionally, if we just go about our business as usual and eat what we want and don't exercise, of course, the diseases of aging will take over and our bodies will degrade. But if we actually learn the right way to interact with our biology, if we learn how to put in the right information and take out the wrong information, if we learn how to put in the right types of energy and the right inputs, we can literally stop this process of entropy, which is decay that happens as part of everything in life, right? Everything degrades, everything decays. And of course we will too, to some degree. I got gray

Starting point is 00:08:29 hair now. I didn't have gray hair before. Got a few more wrinkles, probably sun damage. I mean, if I, you know, wear sunblock all the time instead of the sun, which I don't, I don't really like to do. I wouldn't have so many wrinkles, but the truth is we actually can affect most of these biological processes and actually heal our bodies. We can clean up the damage. We can repair old cells and proteins. We can build new molecules and cells and tissues. We can actually enhance all these functions of life.

Starting point is 00:08:58 So what causes the degradation that causes the dysfunction that we see as what we call the hallmarks of age. The hallmarks of aging are these 10 things. Some people say nine, I see 10. Basically, we'll go through them. But basically, these are the identifying features of aging. And if we, you know, got rid of all these phenomena that happen with aging, whether it's stem cell exhaustion or inflammation or mitochondrial changes or damage to proteins or impaired nutrient sensing or zombie cells, I mean, the list goes on. If we were able to get rid of these things, then people would live to be 120, 150, 180. And they've done this in animal

Starting point is 00:09:37 models. They've seen how this works. The problem with aging is we have too much breakdown and not enough buildup, right? You buy a brand new Toyota Camry, drive it off a lot, and you can probably drive it for 100,000 miles, never change the oil, never take it in for a tune-up or anything else, it'll be fine. If you got a 1929 Mercedes Roadster, well, guess what? That's going to require a lot more care and uptake and maintenance, but it can still run and it can still go and be fine. And, you know, I think that's the key. We have to have way more positive inputs as we age and we have way less wiggle room to just goof off and do whatever we want, stay up all night partying, eat whatever we want, not exercise. You know, I could not exercise for a month when I was 25 and I could still go run five miles.

Starting point is 00:10:18 If I did that now I'd be in trouble. So the body's capable of it, but it needs a little more a little more input so what what are the things that are driving this uh and it's it's a lot of the things we talked about it's a it's it's obviously our diet which we'll talk in great length about and which i talked about in my book young forever it's our activity level it's our stress level it's our sleep it's the environmental toxins we're exposed to. It's our microbiome. And so we now actually know how to regulate these things to activate the healing, repair, and regeneration that's embedded in our biology. And I don't want you to have to manage disease. I want you to prevent them. I want you to reverse them. And I want you to get rid of them.

Starting point is 00:11:01 And I've seen this over and over. I've talked about cases on my podcast, but I've reversed so many, so many cases of diabetes. So many people with memory loss have improved. So many people with heart failure have gotten better. So many people with angina and all kinds of really what we think of our end stage diseases get better if you give the body the right conditions. And it's going to transform everything we know about healthcare. It's going to transfer everything we know about health care it's going to transfer everything we know about treating disease we're not going to have to treat all the diseases separately we're going to be able to actually create health and then diseases won't need to be treated individually and so as scientists are looking at longevity and the longevity science is really exciting because for years it's been an ignored part of medicine i mean doctors just

Starting point is 00:11:41 thought you know aging was inevitable there's nothing we could do about it Let's focus on the diseases and all the budget of the National Institute of Health is focused on diseases, but not on health. It's certainly not focused on aging and the mechanism of aging. But now there's billions of dollars flowing into it from private investment, from billionaires who care about living forever, which is, you know, okay, because they give money to research. But what they found is that there are 10 things that seem to go wrong that underlie all disease. And if you focus on these, and from my perspective, it's not enough to just focus on the hallmarks. You've got to focus on the causes of the hallmarks. And that's what's different about my book, Young Forever, is a lot of the books out there on longevity talk about the hallmarks

Starting point is 00:12:19 and interventions or drugs or mechanisms that we can interfere with these. But I think if we talk about why these hallmarks occur, we can understand how to interfere at an earlier level on the pathway to these hallmarks and not actually just focus on treating those with medication or other things, which may be needed, but it's not the whole story. So what are the things that are causing the degradation in our bodies as we get older? What are the things that are causing biological aging? Well, the first and the most important thing is controlled by what we eat. And the scientists talk about this as a disrupted nutrient signaling. So what does that mean? Well, your body is really smart and it's learned how to deal with

Starting point is 00:13:07 scarcity, with adversity. And so you have these pathways that sense the amount of food in your diet, the kind of food in your diet. And these pathways are, I call them longevity switches because they're really meta. They're almost more important than all the other sort of longevity hallmarks. They're really above everything because they help us to understand what happens to all these others. So all these other hallmarks are influenced by our diet. And so these four longevity switches that we talked about as part of the dysregulated nutrient sensing are one is insulin signaling. If you've ever listened to any of my stuff, you know, I talk a lot about blood sugar and insulin as a big driver of heart disease, cancer, diabetes, dementia, pretty much all age-related diseases, kidney disease, high blood pressure, all of it. So too much sugar and starch overloads this pathway and causes us to age. Now,

Starting point is 00:13:59 we need some insulin and we need some good insulin signaling, but when it's too much is when we get in trouble. The other pathway that's important is called mTOR, which I talk a lot in my book. It's basically means mammalian targeted rapamycin, which we may not have time to explain, but I go through in the book. But this pathway detects not only sugar, but also protein. And when you look at how the body's designed, it's designed to have alternating periods of kind of recycling and cleanup and repair and rebuilding, right? So if you want to, you don't want to say kind of remodel your house, you have to bring the demo crew in first and get rid of all that old stuff and kind of clean it up. And then you want to bring in the construction crew. So we have that built into our system.

Starting point is 00:14:44 We have the demo team in the construction crew. So we have that built into our system. We have the demo team and the construction crew. And the demo team has to be allowed to work. Now, what is the demo team in terms of the body? It's this process we call autophagy, which basically means self-cannibalism, or we eat ourselves. So we have a process where we can go up and like little Pac-Man with these cells, we kind of absorb all the old proteins and cells, we chew them up, and then we just dissolve them with different enzymes and we kind of break them down in the component part. So you can take a protein and you can break it down into amino acids so you can then use those parts to rebuild more

Starting point is 00:15:21 tissues and more organs. So it's really important that we have this process. Now mTOR is overstimulated in our culture because we overstimulate this pathway with too much food, with too much sugar, with too much protein. Not the fact that we're eating too much protein, but that we have too much food coming in on a regular basis. We need breaks. So the way to activate this autophagy is through fasting or through

Starting point is 00:15:46 not eating for a period of time. And it can just be 12 hours overnight, or it can be 14 or 16 hours, or it can be a day a week or a few days a month, whatever you want to do. But this is a very important pathway that's a survival pathway. So this is the only thing, by the way, that's been shown to extend life by a third. If you look at animals and you calorie restrict them, you inhibit mTOR and you get a third more life extension. So that means for humans, that would be going from 80 to 120 years old, which is not insignificant. So it's important to understand that we need to eat in the right way to control these pathways. The other two are AMPK and sirtuins, which have to do with DNA repair and regulating blood sugar, mitochondria, inflammation. And again, these are our nutrient switches that are affected by what we eat and the quality of the food we're eating and are also influenced by phytochemicals. And I go into great

Starting point is 00:16:35 detail about what these nutrient signaling pathways are, but they're so important because they can be modified by what do we eat, when we eat, how we eat. And it's really important to understand this part of nutrition that's so different from how we normally think about it. So how do we activate these pathways of repair and healing? And how do we build more tissue when we need to and more protein? So bringing up people, oh, we should be vegan and we should not eat protein in order to live long. Well, that doesn't make sense because if you don't eat protein, you can't build muscle. If you don't have muscle, you're going to become frail and elderly and weak and break bones, and it's not good. So you want to have times of building and a breakdown.

Starting point is 00:17:13 The other 10 hallmarks, nine hallmarks we'll talk about briefly, like DNA damage that happened because of little hits every day, but we have a whole repair system to activate. Telomere shortening, telomeres are little caps at the end of your chromosomes that keep them together from unraveling. When they get too short, you die and they are infected by our lifestyle to be modified. Proteins get damaged as a course of just normal life, like your, you know, things kind of degrade, but we can have more protein damage from various insults. So we can actually modify that. We can do things to actually improve our protein function. We have epigenetic changes. Our epigenome is the control switches on our genes determines which ones are turned on or off. And that's influenced by our lifestyle. We see zombie cells form, these aging cells that actually cause inflammation

Starting point is 00:17:59 throughout the body, which is really damaging to all of our tissues and organs. And one of the other key features of aging and longevity hallmarks are, the hallmarks of aging, I mean, is inflammation. Inflammation, we've talked a lot about on the podcast. It's one of the key features of almost all age-related diseases, even depression, autism, cancer, heart disease, diabetes, this goes on. Inflammation is such a key factor. And the senescent cells, these zombie cells tend to even create more inflammation in the body. We also see mitochondrial dysfunction, our energy factories get degraded, we don't have that much energy, our microbiome degrades, our stem cells get tired. And of course, we have this inflammation. So these are really important to understand.

Starting point is 00:18:45 They're important to understand the science of how they work, but what's more important to understand is how these things go wrong. Why do we get inflammation? Why are stem cells get more tired? Why is our mitochondria degrading? Why is your microbiome out of balance? How do our proteins get damaged? How do our telomeres shorten? How do our nutrient sensing pathways become dysregulated? This is super important. And this is really where functional medicine comes in because we can influence these hallmarks through simple lifestyle changes and behavior changes. And the science of functional medicine is basically simple. It's take out the bad stuff and putting the good stuff. And it's, I say this over and over, but functional medicine may be hard to practice, but it's simple in

Starting point is 00:19:21 concept to understand, which is the body has to be in balance. And what causes imbalance is the bad stuff, bad food, stress, toxins, sedentary lifestyle, allergens, microbes, all kinds of stuff. And what is the good stuff that we're not getting? The right nutrients, the right amount of quality of food, movement, exercise, sleep, rest, community, purpose, meaning, love. All these are the ingredients for health. So we got to take out the bad stuff, put in the good stuff. And that's really how the body works. And by understanding how to do that on an individual level, because everybody's different, we can address these hallmarks and go upstream to the hallmarks, which are upstream to the diseases. So hallmarks are better than talking about diseases, but they're not enough. We have to

Starting point is 00:20:03 get beyond that. And the good news is we can take away those negative inputs that harm our biology and drive disease, and we can add in the things that heal our bodies and activate these longevity switches. And that's really what my book, Young Forever is about. It's about teaching you in a practical way, how to activate your longevity pathways,

Starting point is 00:20:20 what causes them to become dysfunctional and how to get them working right. So it's a beautiful model and and it really is very personalized. It's very different. Right now, you know, I think, you know, these hallmarks are such an exciting area for me to think about as we start to reframe disease. In fact, the World Health Organization now considers aging a disease, that what we see as, quote, normal aging is really abnormal, and then we can start to treat these dysfunctions in a different way. So we need a very different model. And the beautiful thing is that, you know, we're understanding how this works across

Starting point is 00:20:58 the whole life spectrum, but doing more of the same type of medicine that we're doing, treating individual symptoms, individual diseases with drugs that block or interfere, inhibit some pathway, it's just a losing cause, right? Like I said, if we erase cancer and heart disease from the face of the planet, maybe we'd see an extra five to seven years of life extension, not 30 or 40 years, which we can see by addressing the hallmarks of aging. Now, for example, heart disease, Alzheimer's, diabetes, cancer, obesity, depression, even infertility, what do they have in common? Are they really all different diseases? They may manifest as different things, but at the root, they're the same problem, which is, for example, insulin resistance.

Starting point is 00:21:48 Now, this is something you've heard me talk about a lot, but when you look at longevity, it plays an outsized role. I once heard a lecture from the head of preventive cardiology at Harvard, Dr. Jorge Plutsky, and he said, you know, if you were to take a group of 100-year-old people with absolutely clean arteries, like no plaque, no heart disease, what would they have in common? He said they would be insulin sensitive, meaning they would be able to regulate their blood sugar. They wouldn't have any huge spikes in blood sugar or insulin. And it's super important. Now, what's even more frightening is that over 90% of Americans are not insulin sensitive. 93.2% are not. They have some degree of insulin resistance

Starting point is 00:22:27 and poor metabolic health, which is essentially what it means. And the beautiful thing is that most doctors don't diagnose this, but it's 100% preventable and 100% reversible. Even in type 2 diabetics who are fairly extreme, we can see complete reversal of diabetes. Type 2 diabetics who've been on insulin for decades can get off of it, can change their biology by changing everything. And what causes this phenomena of insulin resistance? Well, you've heard me talk about it. Too much starch and sugar, too much processed food, you know, things that break down into the highly absorbed, quickly absorbed starches, sugars, bread, pasta, rice, crackers, desserts, sugar-sweetened beverages,

Starting point is 00:23:06 even potatoes, make on the kind, that cause your body to release extra insulin because your sugar is going high. And it keeps your sugar low, but the insulin goes high, and that creates enormous damage to the tissues. I once asked Lenny Guarte, who was from MIT, or Guente, from MIT, who basically was one of the discoverers of sirtuins, which is this really important pathway for understanding longevity. And he said to me, when I asked him what the biggest driver of aging was, he said sugar. I was like, oh, wow. That would be some fancy, complex scientific idea. But he's like, sugar. I met with one of the top leading researchers in cancer, Siddhartha Mukherjee, who actually has been studying ketogenic diets and cancer. He wrote The Emperor of All Maladies.

Starting point is 00:23:58 I said, he said, Mark, you know, we figured out what causes most cancer. I'm like, what? He's like, sugar. I'm like, yeah, I know. I know. So insulin is essentially being produced at high levels. We can measure insulin. Most doctors don't measure it. It's one of the most important tests to measure. I co-founded a new company called Function Health, which allows you to do self-testing. And we actually check insulin on everybody. Go to functionhealth.com to learn more about it. And insulin is a fat storage hormone. Over time, your cells become resistant to the effects of insulin. You need more and more insulin to, your cells become resistant to the effects of insulin. You need more and more insulin to keep your blood sugar normal. And that creates this whole cascade of problems, including loss of muscle, extra belly fat.

Starting point is 00:24:33 You're hungrier. You have sugar cravings. You get more inflammation. You get high blood pressure. You get high triglycerides, low HDL, high bad cholesterol, too many small particles, fatty liver, low sex hormones, low sex drive, depression, memory loss, dementia, extra blood clots, diabetes, heart attack, strokes, dementia, cancer. It's a lot of stuff. So this is all caused by too much starch and sugar. And when you treat

Starting point is 00:24:57 all these diseases separately, fertility, depression, cancer, heart disease, you're kind of missing the boat. They're not separate problems. They're really linked to the same root cause. So I really never treat disease. I create health. And as a side effect, things go away. And I'll just give you a quick case example of someone who had a terrible inflammatory disease that was being treated in many different ways by many different doctors. And all of them were basically like the blind man in the elephant, treating all the symptoms, but not the cause. So she was about a 50-year-old business coach. She had terrible psoriatic arthritis, which is an autoimmune disease where you get joint pain, you get psoriasis, which, you know,

Starting point is 00:25:35 the heartbreak of psoriasis. She had also depression. She was overweight. She was pre-diabetic. She had terrible reflux, irritable bowel syndrome, insomnia, migraines, you name it. She had everything. And, you know, she was seen by the best doctors and had the best treatments. And, you know, one of the drugs she just took for her autoimmune disease was like 50 grand a year. And she was on the best antidepressant, the best stuff for her irritable bowel, the best drugs for reflux, the best drugs for her autoimmune disease, the best drugs for depression, the best drugs for prediabetes, you know, and nothing was really working that well. She was managing the diseases. So what I

Starting point is 00:26:10 did was I basically, I gave her, instead of treating all things differently, separately, I treated her core system. And I realized that her gut was a source of a lot of inflammation. She had terrible bloating, bacterial overgrowth. She'd taken lots of antibiotics and steroids, probably had yeast overgrowth we call SIFO. And I gave her an antifungal, an antibiotic to clear out the bad bugs, some probiotics, some vitamin D, some fish oil, put her on an elimination diet, got her off inflammatory foods, off of sugar and processed food. And really it was amazing. Within six weeks, she came back and all of her symptoms are gone. Her psoriasis was gone, her arthritis was gone, her depression was gone. She lost 20 pounds. Her reflux was gone. Her noval was gone. Like literally everything was gone. I wasn't managing anything. And she stopped all her

Starting point is 00:26:51 medication. I didn't tell her to, which I don't tell people to stop. I said, well, let's just see how you do. Then we'll decide. But she stopped everything and she was completely better. So, you know, I kind of joke that I'm a holistic doctor. It's that I take care of people with a whole list of problems. And she had a whole list of problems that we were treating separately. And instead of treating all those diseases separately, I got to the root cause. And that's what we can do with aging. So just to recap a little bit, we don't have to accept our current approach to aging, which sees it as an inevitable decline in function, then decrepitude.

Starting point is 00:27:22 We don't have to accept that we need a pill for every ill, for every disease in medicine. We can treat the root causes using the framework of functional medicine. We can create health from the inside out, and we can extend both our health span and our lifespan. You know, biological age, we can now measure through a test called DNA methylation. I measured mine. I'm 43, although I'm 63 chronologically. We can do that. And this is what I'm going to share with you in the book, Young Forever. We don't have to accept it as this inevitable part of our lives where we get frail and decrepit and dysfunctional. We can maintain a high level of function until very old. I plan on surfing until I'm 100 years old. So

Starting point is 00:28:01 I know I just, I don't want to stop. Why should I? And if you maintain your body and your health, you can do. And I think it's an really exciting moment in health. I want to have you all look at your biological age is a great way to look at what's going on in your body. And we can change it. It changes over time. If you want to learn more about all this, if you want to learn more about my book, go to youngforeverbook.com, order it today. I promise you won't be disappointed. I poured my heart and soul into it. I hope you love this health bite on The Doctor's Pharmacy. Be sure to share it with your friends and family on social media, and we'll see you next time on The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks

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The Dr. Hyman Show - How And Why We Age

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