The Dr. Hyman Show - The Keys To Aging Well with Dr. Frank Lipman

Episode Date: October 28, 2020

The Keys To Aging Well | This episode is brought to you by Bioptimizers and Paleovalley When it comes to longevity, the goal isn’t just to live as long as possible. The true objective is to live as vibrantly and energetically as possible, for as long as possible. So how exactly do we do this? On this episode of The Doctor’s Farmacy, I was happy to sit down and talk with Dr. Frank Lipman about the biggest controlling factor when it comes to aging, the main longevity regulators in the body, and what we can do to activate them.  Dr. Frank Lipman is recognized as a vocal pioneer of integrative and Functional Medicine (or what he calls “good medicine”). Dr. Lipman is the founder of Eleven Eleven Wellness Center and the Chief Medical Officer at The Well. He is a sought-after international speaker and the best-selling author of six books—How to Be Well, The New Health Rules, Young & Slim for Life, Revive and Total Renewal—and his newest book, The New Rules of Aging Well: A Simple Program for Immune Resilience, Strength, and Vitality. This episode is brought to you by Bioptimizers and Paleovalley. Bioptimizers’ Magnesium Breakthrough formula contains 7 different forms which all have different functions in the body. There is truly nothing like it on the market. Right now you can try Bioptimizers Magnesium Breakthrough for 10% off, just go to bioptimizers.com/hyman and use the code HYMAN10 at checkout. Paleovalley beef sticks are gluten free, grain free, dairy free, soy free, and non-GMO. Plus, they use 100% grass-fed and grass-finished beef, which not only adds to the flavorful taste, but also means they’re free of any harmful antibiotics or hormones that you’ll find in most meat. Right now, Paleovalley is offering 15% off your entire first order. Just go to paleovalley.com/hyman to check out all their clean Paleo products and take advantage of this deal. Here are more of the details from our interview:  Combining ancient wisdom and modern research for healthy aging (8:06) The changes Dr. Lipman has made in his own life to age well (11:01) The biggest mistake people make in regards to food as it relates to aging (14:39) Getting adequate protein to prevent muscle loss as you age (17:35) How fasting supports the aging process, and the type of fasting that works best (20:15) How sugar and starch drive the aging process, and why muscle function and recovery from injury is so essential as you age (27:35) Why optimizing mitochondria, the powerhouse of the cell, is key to aging well (32:29)      Our epigenome, and why genetic predisposition is not the same as being predestined (38:06) How meaning and mindset influence aging (48:07) Is it worthwhile to take supplements? (50:09) Learn more about Dr. Frank Lipman at https://drfranklipman.com/ and his new book, The New Rules of Aging Well, at https://drfranklipman.com/new-rules-poi/ Follow Dr. Lipman on Facebook @DrFrankLipman, on Instagram @franklipmanmd, and on Twitter @drfranklipman.

Coming up on this episode of The Doctor's Pharmacy. I can't stress this enough, you know, recovering from injuries, recuperating, don't let those muscles tighten because the way our body works is to compensate and tighten somewhere else or overuse another muscle. It's really important to have those muscles working efficiently. Hey everyone, it's Dr. Hyman. Supplements are one of those things that I'm always being asked about. Is it worth spending money on them?

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and other questionable ingredients, these beef sticks are naturally fermented so you get gut friendly probiotics with every bite. How cool is that? Right now, Paleo Valley is offering my listeners 15% off your entire first order. Just go to paleovalley.com forward slash hyman to check out all their clean paleo products and take advantage of this deal. That's paleovalley.com forward slash hyman. I definitely recommend stocking up on the grass-fed beef sticks to keep in your house, in your car, and in your office. It's one of my favorite tricks to staying healthy while on the go. All right, now let's get back to this week's episode of The Doctor's Pharmacy. Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman, and that's pharmacy with an F, F-A-R-M-A-C-Y, a place for conversations that matter. If you want to learn how to age well,

if you want to learn how to avoid the ravages of diseases that we get when we age and also be vibrant and healthy and live well, you better listen to this podcast because it's with my longtime friend, functional medicine colleague, leader in the field of functional medicine, Dr. Frank Lippman. And we have been buddies for a long time. We've been running this road for a long time. And then we were just joking at how old we're getting. We used to be young whippersnappers in our 30s and 40s, and now we're 60 and 65. So we're doing okay. We're doing okay. Frank is really an incredible pioneer in the field of functional medicine, integrative medicine, and what he likes to call good medicine. It's just good medicine. He's the founder of 1111 Wellness Center and the chief medical officer at The Well

in New York City. He's a sought-after speaker and author of six best-selling books, How to Be Well, The New Health Rules, which is awesome, Young and Slim for Life, Revive, and Total Renewal. And his newest book, which we're talking about today, is called The New Rules of Aging Well, A Simple Program for Immune Resilience, Strength, and Vitality. Well, thank you, Frank, for writing that book, so I don't have to. And I really appreciate your digging into this topic of aging because it's something that's interesting me more and more every day as i get older as we all are uh so welcome to the podcast

thank you thanks for having me on yeah we are getting older but it's the thank god for functional medicine and what we've been doing it just it, it helps a lot, makes it easier. You're right. I mean, functional medicine isn't about treating disease. It's about optimizing function and creating health. And when you do that, you're learning how to turn on all the systems of the body that regulate everything that matters as we age in a positive way. And that allows disease to sort of not have a place to hang out.

And it's a very different approach to disease and to aging, and we're going to get really deep into it today because there's so much research on longevity, and there's been so much research on healthy aging lately, far more than, you know, even 10, 15 years ago. It's just astounding. So the goal really isn't necessarily to live as long as possible, although I want to live a long time. I'm going for another 60 years. The real goal is to live well, to be vibrant, energetic.

And, you know, my definition of health is basically being able to wake up in the morning and do whatever you want. If you want to go for a horseback ride, you want to climb a mountain, you want to sit and read a book in a rocking chair, whatever it is that makes you happy, that's what healthy aging is. So how do we get there, Frank? How do we do this? Well, as you said, I agree 100%. It's about getting up every day and enjoying your life and doing what you want to do and being able to do what you want to do without struggling. And the whole concept of functional medicine or optimizing function or optimizing the human condition is really how you age well. I think there are little tweaks you make.

You're 60, I'm 66 and we've been doing certain things for many years. As you get to a certain age, as you get into your 60s, I think you need to tweak a little bit more to actually affect these longevity genes or these nutrient sensors, or whatever you want to call them, which actually affect your aging and help you just increase this health span as you're talking about, or optimize your health span as you increase your lifespan. And what I find interesting, and I've always found this with functional medicine, is a lot of this ancient wisdom is there. It's how do we tap into this ancient wisdom. And now, as well as you pointed out, there's more and more research.

So it's how do we, you know, use this modern research and tap into this ancient wisdom and combine the two, and that's how you age well. That's right. It is pretty simple. I think to emphasize what you just said, there's a difference between your health span and your life span. Your life span is how many years you're alive.

Your health span is how many years of your life are healthy. So you could live to be 90 and your health span could be 60. And meaning you start to go downhill and you become decrepit and end up in a nursing home for 20 years. That is not the way we want to live. You basically want to live fully until the day you die and then drop dead of nothing. And I think that's what I'm looking forward to. Yeah, exactly. And that's, you know, I think that was the impetus of the book, especially, you know, I now have a grandchild and I want to, you know, enjoy my grandchild growing up and be healthy and vibrant and be able to play. And that was sort of the impetus of,

you know, what else can I do? I mean, yes, you know, I eat well, I exercise, I meditate, you know, sleep is very important. So I started getting into the research and what are these little tweaks that I can do as I get older. And so that was why I wrote the book, because in a way, a selfish journey. I wanted to see if it would help me. And then as I do with my books, I try and make it simple for people because I think a lot of this research is very complicated. You know, when you talk about the mTOR and the AMPK and a lot of these complicated concepts, you know, my modus operandi is always how do I make it simple for people to understand so they

can take these nuggets and make changes in their lives. They don't have to understand what mTOR is, although we can talk about it. They don't have to understand that you have these longevity genes that may be affected by certain, you know, of what you do. People just want to know what to do and how to do it. And that's sort of what I try to do in the book. You know, your books are very good because they're very clear. They're simple, but not too simple. They're very practical, and they're laid out in ways that are in digestible chunks that allow you to just absorb the information. And I'm actually a little jealous because I love those books, and I think they're laid out so beautifully. And you parse it down to just

the essential things and I like to write you know way too long books so much I want to explain but is this such a practical set of tools for living not just aging well but living well so you know it's the same thing do you want to age well or be healthy now or live well and get rid of disease it's all the same so what what do you think the biggest factor is when it comes to aging that controls our aging process? Well, I don't know if there's one biggest factor, but the things that I've changed, you know, we probably live very similar lives. We have the things that I've changed now in the last couple of years have been one, I eat less. And I do that mainly by fasting a lot.

I mainly do time-restricted eating, which in a way forces me to eat less. I have two meals a day instead of three meals a day. So I eat less. I rarely pay attention to my sleep, like more attention than ever, which I think is important. Sorry sorry just to go back to what I eat and the the big change the other big change I made in my diet as well as eating less and time-restricted eating I eat a little bit less animal protein which we can talk about which I think is important but as you get to my age, also losing muscle mass becomes

important. So as much as you need to decrease animal protein, you need to be careful about decreasing protein too much because you don't want to lose muscle mass, which is a big issue with what people suffer with as they get older. So there's all this fine tuning that needs to be done. And it's not, you've got to do X, Y, and Z. You've got to, you know, alter it according to your needs and how you're coping with the aging process. And then the last thing I think is you've got to be able to have a sense of humor. You've got to be able to laugh about it. I just can't do some of the things I used to do. And, you know, it is what it is. It's not, you can't fight it and you've got to do the best you can, but you have to have a sense of

humor about it. Otherwise, you know, that's not a good thing if you can't laugh about it. Yeah. If we take life too seriously, it definitely creates age. And, you know, it's interesting. When you look at the studies on aging, the defining characteristics of a lot of centenarians, people who are to be 100 years old, is their resilience, is their ability to bounce back from life's punches. We all get knocked to our knees by loss, by divorce, by illness, by this, by that. And the difference is how do we respond to those challenges? And are we resilient or do we end up going into a downward spiral of depression and despair and dysfunction?

And to me, that's a really interesting thing. It's your mindset. It's your belief. It's your sense of optimism. You know, optimists live longer even if they're wrong. Absolutely. Yeah, no, it's 100% correct. And that concept, you know, as I said earlier, it's about, you know, mixing this ancient wisdom with modern science. One of the first things I got taught by my Chinese medicine

teacher, Ephraim Korndall and Harriet Barnefeld, was health is about resilience. How do you build someone's resilience? You know, it's not about how well you are, but how well you respond to the knocks in life, to diseases, etc. And they always stress this concept of resilience. So I agree 100% with you. It is about being more resilient. Healthy aging well is about being resilient. You may not be, you know, I can't

run, for instance. I don't jog anymore because I got a gammy knee, but I walk and I cycle. So, you adapt. And that's with everything in life. And I think your attitude is important too. So, food is a big deal in terms of health and in terms of aging. So what is the biggest mistake people make in terms of food when they eat if they want to live a long, healthy life? Well, I think people eat too much, especially as you get older. I think people eat too frequently. I think there's more and more studies showing that time-restricted eating or fasting, whatever you want to call it, has very positive effects on our metabolism. There was a study that just came out that said it doesn't help you lose weight.

Well, that's maybe the case. But I think – and I've been monitoring this lately in our practice. We're doing more longevity stuff. We've been monitoring markers, biomarkers for health and aging with people who are doing, whether it's time-restricted eating or doing fasting, mimicking diets or fasting, whatever way they're fasting. But we've been finding that their metabolic markers change positively, which is very interesting.

Now, most people do lose a bit of weight, but for the most part, time-restricted eating or only eating in certain periods or fasting definitely has a positive effect on aging. So I think eating less is important. Low-carbohydrate diet. I mean, you came up with this brilliant term called the pegan diet, which I think is absolutely brilliant.

So thank you for that. Well, Frank, for people listening, the way I came up with that was I was on a panel with Frank and another doctor who was a vegan cardiologist. And Frank was more focused on paleo at the time. And they were arguing and fighting. And I was in the middle like a ping pong ball and back and forth I'm like if you're paleo and you're vegan then I must be pegan and I sort of sort of laughed as a joke but then I realized it really made a lot of sense because they have far more in common with each other than the traditional American diet the only difference is where you are your protein which is

animals or beans and grains that's it everything else Everything else is the same. Exactly. So I think, you know, if we want to look at a diet that was probably the best would be a variation of some type of vegan diet. I'm not against animal protein, but as you get older, I think you need to eat a little bit less animal protein. Probably, I mean, this is what the research is showing, that the amino acid composition of animal proteins, in particular meat, is such that it inhibits one of the, or stimulates one of these biomarkers that you don't, you know, these nutrient sensors or longevity genes that you don't want to stimulate as you get older. When you're young, when you're up to 40 or so, and you want to get stronger and build muscle, then eating animal protein is good.

But as you get older, it may be a problem. Hasn't this research shown that actually as you get older, that you need more protein to improve your muscle synthesis, which is really the thing that makes us age faster. We're talking about it before, but sarcopenia, this loss of muscle, results in a whole series of consequences, including inflammation and prediabetes and abnormal cholesterol and all kinds of issues that lower hormones, increase cortisol and decrease testosterone. So losing muscle is a very dangerous thing as you get older, and it's really why people end up in nursing homes.

So how do we actually have enough but not too much? Because it seems like we need more as we get older. Right. So this is probably the most complicated issue as we get older, how much, because I agree 100%. I do think we need to increase animal protein, but as you get older, you actually need to increase protein. So how do you increase plant proteins, if possible, without increasing too much carbohydrates?

Because you want to still keep your carbohydrates down. So, you know, the way I get around it, I actually use – I have a protein shake, and I use pea protein, and I put collagen in. Yeah. Because collagen actually has the amino acid profile, doesn't have as much leucine and methionine, so it's less of a problem than, you know, I won't have as much steak. It's not that I don't have steak, tonight we're having steak. It's not that I don't have animal protein, but I have cut it back a bit and maybe eat a little bit more fish and a little bit I have collagen a lot of the time I've college and almost every day so I think that is a fine balance and it's not there's no

simple answer here and I don't I think it's a big problem not having enough protein as one gets older but it also seems to be a problem of eating too much animal protein as we get older. For sure. That's a defined… And what's enough? We have these giant steaks and big hunks of meat, and what we really need is about 30 grams to stimulate muscle synthesis, which is about the size of your palm. Now, if you're Shaquille O'Neal, it's a bigger piece. If you're five years old, it's a smaller piece, right? So you can use your own body as sort of a measure of how much protein you need. But I think that's a smaller piece right so you can use your own body as a sort of a measure of how much protein

you need but i think that's a very simple right and that's why your pegan diet i think is brilliant i i love that i think that sums it up yeah exactly i actually it's funny you mentioned the pea protein because i created something called the pegan shake which is essentially pea protein pumpkin seed protein and, grass-fed collagen protein. So it's exactly what you're talking about. Right, and that's what I do. I think that's a way of getting around it, to be quite honest. So that's brilliant.

Yeah, fantastic. So let's talk about this idea of time-restricted eating, because it's a – and there are many ways to, quote, fast. There's what we call intermittent fasting which is maybe not eating for a whole day or three days or a week sometimes there's time restricted eating which is only eating with a certain time window there's fasting mimicking diets which are eating less calories for a number of days to stimulate the same pathways there's ketogenic diets they all do a very similar thing.

So what is the biology of how this works? We know that these things do work, looking at animal studies, human studies, in terms of improving metabolism and the longevity, biomarkers. But what are we seeing in how these methods actually work? And what is the most effective? What should people be doing in order to take advantage of this new science? Right. So what they're doing, I mean, the way I explain to patients is,

which I think is, I mean, they're doing a number of things, but it's triggering your body's own self-cleansing mechanisms. After you haven't been eating for a certain amount of time, 14, probably more, 16 hours, your body's self-cleansing mechanisms kick in, which is very important with the aging process because one of the factors in aging is your body, once again, it goes back to functional medicine.

The functioning of these systems don't work as well. So the fasting actually starts putting that autophagy system into play. So I think that's probably one of the most important aspects. It also will improve mitochondrial function, which also decreases as we get older so the the consequences of fasting or what happens in your body are often the opposite of what happens as you get older so that's why I think it's so important why which way of fasting is best is the way that you'll do I mean whatever works easiest for a person is what I encourage. And I think the easiest

one for most people is to eat dinner earlier and eat breakfast later, which is what I do and what I recommend. Now, if people want to do a day of just water fasting or three days or even more, that's great. That's a little bit more complicated and most people won't do that. But if you can do that, that's fine. There's also this fasting mimicking diet where you do five days a month of very low calories and no animal protein and low carbs. We've actually created some shakes or my health coach has some recipes for people.

If they want to do it themselves, you can buy the Prolon shakes as well. You should bring out some shake. I mean, it's a no-brainer to bring out a five-day program because it works. I mean, we've done it with our patients. Actually, there's no question you get the same results whether you do fasting, mimicking diet for five days, or you do intermittent fasting. We're seeing positive results across the board with biomarkers and different types of fasting. So I don't think there's one way. I think the way is to find the way that you will do and that works easiest for

your lifestyle. Yeah, you know, people say, Dr. Hyman, what do you eat for snacks? And I'm like, I don't. I think snacking is the worst invention. Snack foods are typically really unhealthy and they're a modern invention and we used to not have to be eating all the time. And that's the problem. We're eating all the time. And I think, you know, just to underscore what you said about these different approaches to time-restricted eating, intermittent fasting, fasting when we can diet, says they activate a set of mechanisms in the body that improve blood sugar control, that get rid of belly fat, that increase muscle synthesis, that build your bone density, that increase testosterone,

that increase brain function and cognitive function, that improve your stem cell function, that help your immune system, and they clean up all the debris in your cells. It's called autophagy, which we're saying sort of self-cleaning mechanisms. There's mitophagy as well that comes from the same process. So these are things that we actually can take advantage about without actually changing what we eat. Now, if you change what you eat, you get a double benefit. But these are very powerful things that we should be paying attention to in the science. And I think you just feel better. You feel more energetic rather than being sluggish from eating food all the time. Right. No, and you nailed it. Thank you. You know, all those mechanisms are what actually start, you know, their function

decreases as we get older. It becomes harder to keep your blood sugar under control, the muscle synthesis, all, you know, brain cognition and brain function. So fasting is like a magic pill or eating less and is a magic pill. So to me, that's probably the most important thing you can do. It's true. And, you know, you mentioned the meat thing. And I think it's still, to me, it's still, the science is still controversial. You know, I talked to my friend, Walter Longo, who's one of the leading longevity scientists, and he's from Italy, and he's the guy who developed the fasting mimicking diet.

He's been on the podcast. And he said, he knew this woman, Emma Marano, who lived to be 117 years old. And she was anemic when she was a young lady, and her doctor told her to eat three eggs a day, which she did for 100 years, literally. And then when she was in her 90s, I think she was getting frail and weak. And her doctor told her to eat a pound of meat a day. And she did. And she lived from 90 to 117.

So I wonder, you know how how true is this and if your other lifestyle factors are good if you're eating animal protein and getting adequate muscle benefit from it as you age you know where is that fine line in terms of animal protein well that I think this is the dilemma not really a dilemma but I think we all need to you know find what works for for our bodies but I think we all need to find what works for our bodies. But I think it also points out a factor that in Western medicine, we always try and look for the one thing that works and everything works together. We have this complicated system and the mTOR issue may be one small part of it. So I think you've got to find that balance. I agree.

I don't think – I mean, I know vegetarians who get cancer. You know, the idea of animal protein causing cancer. Vegetarians get cancer. Vegetarians don't do well. You've got to find out what works for you. And once again, I'm not trying to blow smoke up your ass here, but the pegan concept, the Pagan diet, I think, and finding your own type of Pagan diet, I think, is if we're looking for a solution, not that there's a solution, the Pagan diet in terms of eating within that content of time-restricted eating, a

pig and diet, is the way we all should be eating. Yeah. And, you know, I think the other thing that is important, I've noticed, for aging is muscle. And I think we have a neglected organ, which is our muscle, that we don't pay much attention to. And this condition that we get as we age, it's inexorable. Like if you don't do something to stop it aggressively, you will lose muscle. So you could be the same weight at 65 than you are at 25, but your body be twice as fat. And it literally looks like a ribeye

marble steak, as opposed to a filet mignon, which is what you want for your muscle with no fat rippling through it. That's all related to our diet and the lack of exercise. And so the two things I want you to talk about is the other side of the coin, because protein you need and you want to get enough, but not too much, but it's actually sugar and starch that drive this aging process. And then that combined with muscle strengthening and building as you get older seems to be some of the most important factors. So can you talk about those and how they relate to aging? Sure. Well, sugar and starches are the devil. I mean, it's not even a debate. You've got to get as much of that out of your diet as possible. So you want to eat, the protein is a harder one, how much protein you eat. And I think

as you get older, maybe decreasing animal protein, increasing a bit of plant protein, but still keeping those carbohydrates as low as possible or the sugars and the starches. I think the muscle issue is interesting. Because I've been doing acupuncture for so long and I really got into the functioning of the muscles that's not just about building muscle you want those muscles to work efficiently and what I see a lot of especially as we get older and we have injuries certain muscle groups tighten up and when certain muscles tighten up and they don't fire your body compensates and starts using other muscles so let's say you have a tight hip or you have an ankle problem your your your back muscles have to work more

and then you start getting back pains and then maybe it work goes up to your shoulders so not only do you have to improve muscle mass or watch the loss of muscle as you get older, you've got to watch that functioning because as we get older, the muscles tighten and the fascia tightens that thin layer that surrounds the muscles. When you cut open a chicken and there's this fascia around the muscles. That surrounds all our muscles in our body. And that, as an acupuncturist, and paying a lot of attention to that for the last 30 years, I've seen becomes a problem, especially as we get older and as we injure ourselves. And especially as we get older and we injure ourselves,

we don't tend to recover as well. So it's really important when you do injure yourself to get some body work, to get some acupuncture, to get those muscles working efficiently again and not just letting injuries sit there and not treat them. So I think it's not only building muscle mass or not losing muscle mass, but it's improving the muscle efficiency and that's keeping those muscles long and and and limber and and watching that the fascia doesn't tighten that's a really good point Frank because I've had

back issues my whole life from back surgery when I was 30 and recently had another back surgery and now I'm getting treated by this physical therapist who's going into the fascia and rewiring things and then giving me exercise to do that compensate for the inactive muscles. Exactly what you were talking about. And it's been only like three days of working with this person, and I feel like a different human being. My body feels limber, lighter, opener. It's pretty amazing. So, I mean, not everybody can access that, but there's ways you can do it yourself with foam rollers

and other things to really help. Okay, so let's talk about something that is… In the book, I talk about foam rolling. I think I just have to mention foam rolling because I think that is, you know, a lot of people can't afford going to some body work who does deep tissue work, but foam rolling is sort of the closest you'll get to going to someone who can do that. I can't stress this enough.

Recovering from injuries, recuperating, don't let those muscles tighten because the way our body works is to compensate and tighten somewhere else or overuse another muscle. It's really important to have those muscles working efficiently. It's one area of functional medicine that we didn't really get into in functional medicine. We talked about most of the other organs, but we didn't really talk about the functioning of the musculoskeletal system. I think that is really important.

Well, it's definitely one of the no's on the matrix, which is structural. But if we don't get into it enough, I agree. And actually, we're talking about building a whole course on structural modules. So I think that's very important. Let's talk about something that is a little abstract, but is really central to aging and that is impacted by our diet, light, by exercise, by environmental toxins. And it's something called our mitochondria. And we've talked about that on the show a little bit before, but it's really important. So what are mitochondria?

Why are they so important in aging and disease? And how do we improve them? Because it seems to be the central feature of aging is the dysfunction and the loss of mitochondria. Right. So the mitochondria are just the energy powerhouses in the cells, and you have many in all our cells. And as we get older, their number decreases and their function decreases. So optimizing their function and trying to increase their number is one of the most important things you can do for aging. And interestingly enough, most of the things we've been talking about improve mitochondrial function or increase the number.

We'll mention a couple others we haven't, but it's a low carbohydrate diet or, you know, fats are what the mitochondria thrive on. Fasting is particularly good for mitochondria. Exercise in particularly high for mitochondria. Exercise, in particularly high-intensity interval training, is really good for it. Strength training as well. So sleep. A lot of the lifestyle changes, you know, to me the mitochondria are what we in Chinese medicine talk about qi.

We talk about the energy and how do you boost qi. To me, the mitochondria are the western equivalent to qi. That's your body's energy. And all these changes we talk about actually work with the mitochondria. One of the things we haven't talked about and which actually seems to work well or stimulate the mitochondria is, um, this concept called hormesis, which is... I love that concept. What does that mean? What does that mean? I love that concept. So hormesis means sort of what doesn't kill you makes you stronger, basically. Ah, that's perfect definition. That's the best definition I've ever heard. That's a little bit of stress is actually good for the body.

You know, chronic stress we know is a problem and creates all these problems and it won't help you age well. But a little bit of stress, hormesis is good. And that's what fasting is. Fasting is physical hormesis. It's a stress. It's a mild stress on the body and your body's response to that, and we talked about resilience, but your body's response to that is a positive response which stimulates all these factors that are good for aging. So we talk about fasting.

We talk about a little bit of interval training where you push yourself a little bit more than usual. Going from hot to cold, so even just having an ice cold shower after a hot shower. You know, I love going from a sauna, I've become obsessed with my sauna, going from my sauna, jumping into some freezing cold water. So, you know, temperature extremes are another way of stimulating hormesis. What I say- I love that, I love that.

I love going from my steam or sauna right into an ice bath. And that's good for aging. I mean, that's good, that's hormesis. So anything that's a little bit of stress on the body is good. And actually what's interesting, I remember years ago Jeff Bland talking about this or someone at one of the functional medicine conferences with phytonutrients. A lot of the hormesis is really good for plants.

So plants develop more antioxidants and protective phytonutrients to protect themselves from whatever they have to deal with to survive. So spraying them with herbicides and that doesn't actually help them develop these phytonutrients to protect themselves, which actually end up being good for us too. The first time I heard about hormesis was years and years ago at one of the functional medicine conferences where someone, I think it was Jeff, who talked about the importance of hormesis on plants and developing, you know, fatty nutrients that would then benefit us. Yeah.

You know, it's really important to understand this idea because when you look at for example organic versus conventional plants or even wild plants even versus organic plants the wild plants have way more by hundreds to thousands of times more antioxidant potential phytonutrient compound and they also taste better and what's interesting is that flavor goes along with phytonutrients. So the flavor profile of a food is directly related to the nutrient density and to the phytochemical content. So if you go to a garden, which I did the other day in a friend of mine's garden, and you pick a really ripe tomato that's just ripened on the vine, you stick it in your mouth, and it's an explosion of taste and flavor and phytochemicals that is so different than these cardboard store-bought tomatoes that don't taste like anything. So that's really the power of the little stresses. And I think the strength training, the hit interval training, the fasting, the phytochemicals, these are all ways to actually improve this.

I want to get into some tweaks that you have in your book that are really, really great. But before I want to talk about this idea called our epigenome and how that plays a role in how our cells age and how we deteriorate. So what is an epigenome? What is its relevance to aging? How do we deal with it? What can we do to help fix it? Right. So this is, you know, once again, one of the basic concepts that's come out of, well, that hasn't come out of functional medicine, but what functional medicine treats that, you know, most of our genes we can change or we can manipulate in a way or upregulate or downregulate. So, for instance, you know, I actually just did a whole genetic test. I've got terrible genes. I knew I had terrible genes. I have the genes, I have the ApoE, I have the gene for Alzheimer's, I've got heart disease genes. I mean, my genetic profile

is terrible. But whether I get Alzheimer's and heart disease and all these diseases of aging is determined by how I live my life. So these lifestyle factors, how I sleep, how I think, how kind I am to other people, how optimistic I am, what I eat, how I move my body, all are going to affect most of those other genes or the genes that we can affect to up-regulate or down-regulate to affect our aging. So aging is probably less than 20% genetic. I mean, there's obviously a genetic component where you can't change those genes. I've got those genes. Oh, well, no, I don't know about those genes,

but I've got enough genes that I know that I can change. You know, just because I have the ApoE4 gene, just because I have some of these heart genes doesn't mean I'm going to get it. Yeah, I probably, I'm losing it a little bit. You seem all right. You seem all right, Frank. You're doing okay. My heart may not be as good, but that sort of makes me, you know, want to just be more careful because you can change how you age. You can change, you know, the progression of these diseases. And I think it just all comes back down to these lifestyle changes that we all have to make. And, you know, sleeping is one of those things that I think is really, really important.

And, you know, we don't talk enough about it, although more and more people are starting to realize the importance of sleep. But, you know, how you move, how you sleep, how you think, how you eat, when you eat, all these factors affect this epigenome, these malleable genes that actually can be upregulated or downregulated and affect how well we feel and how we age. I think that's really an important point, Frank, because you mentioned you have these predisposing genes, but they're not predestined. Exactly. They're not predestined to get these conditions. And what most people don't realize is that 80% to 90% of our chronic disease issues are not driven by genetics.

They're driven by what we call the exposome, what our genes are exposed to and how those genes are expressed. And so if you're exposed to environmental toxins, if your microbiome is not healthy, if your diet is crappy, if you're not exercising, if your mental set, your mindset is not optimistic and focused and positive, it literally can change the expression of your genes by all these factors. And that's the beautiful thing about functional medicine.

It teaches you how to optimize the function and the expression of your genes to improve their functioning and also to reduce the ravages of aging. And I'm very optimistic about you, Frank, because I didn't realize you were 66. I thought you were like 56. I mean, I know you're kind of older than me, but you don't look it. So something's working. And I think for two old dudes, we're doing all right. I'm 60, you're 66. It's working. And I think that people don't understand that what we see often as aging in America is abnormal aging. It's not really how we need to age, that we can age vibrantly and healthfully and be alert and focused and energetic, even right up to the end. And I've seen this in many people. I mean, I met this guy who was 95 years old the other day. He had a girlfriend that was 20 years younger than him. She was a young spring chicken at 75. And he was just running around the room. And I'm like, what's

up with you? How do you do this? He says, whatever I did yesterday, I just do it today. If I played single sentence yesterday, I do it today. And I think he just kept living his life and not mentally succumb to the idea of aging. And I think you have to be more cautious, careful, you have to be more alert to what you need to do to take care of yourself. But I think, you know, we have so much potential to stop and even reverse the ravages of aging. And I, you know, I noticed this to myself, you know, I, I, um, because of COVID, I was locked at home like everybody else. I'm like, well, I'm not going to not exercise. And I got a zoom trainer and I really never had done weights before. Cause I was, you know, I was running around on the road. I was, I didn't, I don't like it. I don't like it

hurts. It's uncomfortable. I'd rather go for a bike ride, you know, like Dennis. And, and I got, I got serious about it. And within a very short time, I noticed my body started to change. I literally put on 10 pounds of muscle. It was an incredible transformation, and it was just in a very short time. So I think we have the potential at any age to stop and even reverse these effects. And what I love about your book, Frank, is that you have very simple tweaks that have a profound impact on healthy aging. So talk about some of these tweaks, and I can sort of trigger you if you need to, but I just really yeah i'm so i mean i can't remember i mean you talk about things like physical intensity cold showers you talked about rolling out your fascia magnesium saunas mushrooms uh sunshine sleeping uh sort of various kinds of simple treat tweaks or tricks they're not really tricks they're

just you science-based interventions that if we stack them have accumulated benefit. Right. So there's so many simple things we can do. I think actually just to get back to what you said, you know, I'm also starting to do some weights now. I've always resisted weights too, you know. I love riding my bike outside and doing yoga and stretching,

but I sort of always resisted weights. I'm starting to do a little bit of weight training now, and I also find it actually quite helpful. So, you know, I concur there. I think, you know, I'm going to start back to the fascia and watching injuries because what I've seen so often in so many people, you know, because I see so many patients many times people are exercising a lot and something happens they injure themselves and then they don't recover properly and then they stop exercising or they don't exercise as much

so you know I encourage everyone when you do hurt yourself, just take care of that injury. So it doesn't limit or may change the way you exercise in the future. You know, I can't run because of my knee, but I ride a bike. So, you know, you do want to continue exercising, but don't let that injury just stick around. Don't let it fester. You need to treat injuries um so if you can't get body work a foam roller can be really helpful i think going out getting outside early in the morning again you know getting some fresh air and some natural light first thing in the morning is a really good thing um i find it helps people sleep at night. In other words, getting your body into some type of

rhythm. I'm also obsessed with rhythm, you know, maybe because I saw when I first started doing medicine in South Africa, when I worked in the bush and there was no electricity and I saw how people lived with the rhythms and cycles of life. They got up when it was light. They went to bed when it was dark. They ate whatever was local and grown locally. And they didn't seem to have a lot of the chronic diseases I was seeing in the city. So I think trying to keep a rhythm is important. If you can try to keep it with the seasons and with day and night it's important so you know if you go to bed try wake up early

and get outside and try to go to bed at the same time every night so try create some type of regular schedule I think that's really helpful you know I'm boring now me and my wife go to bed pretty early it's been great with a little grandchild because he goes to bed even earlier than us probably the only person who does but if you can get into some type of rhythm you know going to bed at the same time waking up at the same time in the morning and getting outside and getting some fresh air and some natural light that's really helpful I do think trying to incorporate some form of time-restricted eating is helpful for most people, especially as you get older than 50. It's a good idea.

Keeping active during the day. So you don't have to go to the gym. You don't have to ride your bike. But, you know, get up and move around. Move your body. I just, you know, you just want to move your body um um it's amazing how inactive we are you know when you look at an average day i've got a ring it's called an aura ring and it tells you how many hours of inactivity you have and i'm like holy

crap i'm at eight hours of doing nothing and sitting on my doing podcasts or reading a book or working on my computer. And I just, you know, it's really important to move. Right. And, you know, I found that since COVID, I've made that much more, you know, especially doing more virtual sessions with patients and not in the office, I'm actually getting up in between and going out, which is good. So I think that's important. And I think, you know, the little things we talk about, you know, don't take yourself so seriously. Have a sense of humor about aging.

Being optimistic. Being kind to others and yourself. I think kindness, compassion, I think these are all really important factors in aging. And then, finally, having a sense of purpose and some meaning. And that sense of purpose may be your job. It may be your family. Whatever it is, find something that's meaningful to you.

It could be volunteering at a nonprofit. But I think getting involved in something that's important to you is really important. And then finally, find a tribe or a community that you relate to that supports you and that you can support. So, you know, I think, yes, obviously eating. We talked about eating and sleeping and exercising, all important. But it's these non-tangible things that are important. And it's the little things we do on a daily basis, the ordinary things we do on a daily basis that have an extraordinary effect on our health and our aging.

And that's these little things we talk about, you know, having passion for life and having meaning and having a community. So, you know, don't just think it's all about diet and exercise and sleep, which is really important. It's a lot about what's going on up here. Yeah, absolutely. So, um, in your mind. Yeah. These things are, are, are key. And you know, there's so much bad stuff going on. I mean, there's so much negative,

it's so easy to get caught up in the negativity of today and yeah uh well you know frank what you were talking earlier i just reminded me of the study i read in the journal of the american medical association this year which was very amazing which showed that longevity was related to your sense of meaning and purpose yeah so even even the science is showing that just being connected to something bigger than yourself is so, so important. And having meaning and purpose is so key. So, Frank, let's talk a little bit about supplements. Is there a role for supplements?

Do they really work? There's all these longevity supplements out there. Is it a waste of money? Is it a good idea? Tell us, what's the deal on supplements? Well, I think they work. I take a shitload myself. Yeah, I do think they work. I take a shitload myself. Yeah, I do think they work.

I mean, look, I'm not going to – I think it's a bonus rather than essential because they tend to become expensive. But I do think supplements are helpful to optimize function. I really do. And, you know, I take the regular supplements that I will take with it, vitamin D, which I think is essential for everyone. You know, I'll take my fish oils. But there are supplements which I think do affect the mitochondria and do affect the aging process. Am I sure about that?

No, I'm not sure. But, you know, I'm not going to wait for the science to confirm, to make sure it's happening. I'm going to take it. The thing is with their lower risk, their low risk, there is a cost to it, but the benefit potential is there. And I think that there is good evidence that these things do affect some of the biology of aging. Yeah. I take nicoenzyme Q10. I take nicotinamide, a nucleotide, diuriboside, which is like the hot one. NAD, right. NAD, ND, and NMR. Everyone's pushing their supplements, but I actually do think,

I mean, I take it. It's hard to say if it's making a big difference because I'm doing all these other things too, but I take it. Particularly as we go older, it makes a big difference. I see people who are more nutritionally deficient as they age, their diets aren't as good, their absorption is not good, and there's really good data that shows even a multivitamin in an older patient reduces the risk of disease and hospitalizations, infections, and a whole host of things. So particularly in the time of COVID, we all need to upregulate our nutrient levels. So what about testing? Are there tests you can do in functional medicine that are different that help you determine longevity? What do you recommend?

Well, I don't know if they're different. I just do a few more biomarkers. We do like the Boston Heart or Cleveland Clinic has one too, right? I mean, we do an advanced lipid panel, which I think can be helpful. And then we do insulin growth factor. We do interleukin-6. We do a couple of other inflammatory markers. But for the most part, we're doing most of the markers we've always done. We've added maybe a couple more. We're doing more, you know, obviously hormones, measuring hormones. And then there's a wonderful genetic test that we've started doing, the 3x4 genetics, which I find by far the best genetic test, started by a woman, actually a South African woman, who is a functional medicine person. What's her name again?

But anyway, Yael. I find that we've been finding, because it's the only genetic test that I've seen that actually sort of works in a functional medicine perspective and puts a lot of how these genes work together and what you can do to help these combination of genes. So it's actually a pretty helpful test that we've been doing as well. Now, then, you know, the other tests, you know, measuring your biologic clock and telomeres. I don't know about those tests. I mean, they've been promoted and, you know, we're starting to play around with it. I don't know how important that is.

I think some people like to see these things, which is fine. But, you know, my philosophy hasn't changed from that perspective. It's more about making these lifestyle changes and, you know, my philosophy hasn't changed from that perspective. It's more about making these lifestyle changes and, you know, whether you want to do this extensive testing is fine. My experience has been that these lifestyle, these factors we're talking about have been changing people's markers. I mean, we see it being positive effects. You can measure the change over time.

So you can, and people like markers. I mean, we can measure the change over time. So you can, and people like that. So if you want to actually do a, you know, a test and then measure it three to six months later, you see the changes, which is actually, you know, that's quite encouraging for people. So from that perspective, I think it can be helpful, but these things aren't necessary. I mean, the things that are necessary are the pegan diet and then looking after your sleep and moving your body and having meaning. All the things we talked about. can be helpful because it can help you fine-tune things. Like the genetic test can say, okay, your liver function, you may need some more of these nutrients because the way you're processing hormones or toxins is not so good, or you have more propensity

for inflammation or your brain health may not be as good, so take this. So I do think the markers can be helpful in sort of taking it to the next level, but not essential. Yeah, no, I think I agree. They're supplements, not replacements for everything else. So, you know, foundationally, all the things we talked about are really important. Lifestyle, diet, sleep, exercise, maybe a little supplements. But there's new things on the horizon that are for healthy aging that people are researching,

talking about. Can you share some of the promising things that are ahead that you might be focused on? Sure. So as embarrassed I am to say is there's a drug called metformin, which is a popular you know it's used in diabetes a lot which seems to be showing positive effects for aging too which go beyond just keeping your blood sugar down it seems to affecting this m2 or one of these longevity genes or these nutrient sensors seems to have some positive effect on aging.

My concern with any drug, metformin included, is, you know, what are the side effects? Metformin seems to have a relatively, you know, low profile of side effects. It can affect absorption of some nutrients, B12 in particular can produce some gas, also can affect your response to exercise, but it's sort of relatively benign. So that's one that I find interesting. There's a drug called rapamycin, which I'm definitely not recommending yet, which some people are taking, because that rapamycin, you know. Shots down mTOR. Yeah, mTOR. But so, you know, those are the two drugs. And then some people are using peptides. I don't really know

enough about peptides to recommend them. I find them quite intriguing and interesting. I just don't know enough about them yet. And I think, you know, there's so much research going on, so there's going to be, you know, products coming out. But at this stage, you know, it's really what we've been talking about. Metformin, especially if you tend to be pre-diabetic as you get older, is something interesting. I'm going to explore it a little bit further. I'm a little bit hesitant at the moment. Yeah, I'm cautious about it. Berberine is the natural equivalent of metformin. I've been starting to take berberine now because it has similar effects to metformin. But that's as far as, you know, I don't do the crazy stuff as the biohacking. You know,

the biohacking world has been very interesting because that's a very masculine approach to aging, but I think we've got some good stuff there. I mean, some of the biohacking guys, I think, go a bit too far. I'm a little bit more on the sort of more gentle side of the pushing it. Yeah, yeah. But I think – There's a lot of – it's a wild west out there. People should be cautious. People are using stem cells, exosomes. Yeah, stem cells is – There's a lot of – it's a wild west out there. People should be cautious. People are using stem cells, exosomes.

Yeah, stem cells is – exactly. So I think there are promising things. They're not quite ready for prime time yet. Exactly. I think metformin is – I believe that if you focus on the lifestyle and the dietary things, you can probably achieve most of the same benefits. Yes. And what I worry about is like people say,

oh, I'll take a statin and I can eat a McDonald's. It'll be fine for my cholesterol. That is just a bad idea. So Frank, your book is just fantastic. I encourage everybody to get a copy. It's out. It's called The New Rules of Aging Well, a simple program for immune resilience, strength and vitality. That's what it looks like. It's a fabulous book. I just think it's also a beautiful book. It's digestible. And there's so many brilliant little snippets of wisdom that are easily applied to your life every day. And it will help you not only live longer, live better, but also even if you're not old, it's a great book for just optimizing your health, whether you're 20, 30, 40, 50, 60, it is a good manual for your life. So I encourage you, Frank, to keep doing what you're doing. You know, we've been on this road a long time, you know, and as functional medicine practitioners, we do see the power of these methods to really transform people's lives when nothing really else does. So I'm planning to be 120. I don't know where you're

going, Frank, but I'm really interested in this. You're right. We're both getting older, so we're way more interested in aging. So you're going to hear a lot more about it. And thank you so much for everything you do, Frank. And thank you, Mark. Thank you. And you can learn more about Frank's book on Dr. Frank Lipman. That's drfranklipmanwith1p.com at forward slash books and learn more about Frank and his work. It's really tremendous. And if you love this podcast, please share it with your friends and family on social media, leave a comment, tell us about how you've figured out ways to age well and push off the ravages of aging,

which we're trying to do. And subscribe wherever you get your podcasts. And we'll see you next week on The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing,

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Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding

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