The Dr. Hyman Show - Why Muscle, Our Neglected Organ, Is The Key To Healthy Aging with Dr. Chris Rinsch and Dr. Stuart Phillips

Starting point is 00:00:00 Coming up on this episode of The Doctor's Pharmacy. No cell really ever, quote unquote, goes to sleep. Even if we go to sleep, the cells are continuously regenerating themselves and renewing themselves. That's a function of mitochondria. Hey everyone, it's Dr. Hyman here. Now so many of my patients ask me how I manage to work multiple jobs, travel frequently, well not so much anymore, and spend time with my family and still focus on my health. I know it can seem hard to eat well when you got a lot going on, but the trick is to never let yourself get into a food emergency and to stay stocked up with the

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Starting point is 00:01:59 That's paleovalley.com forward slash hyman. I definitely recommend stocking up on the grass-fed beef sticks to keep in your house and 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 Hyman and that's pharmacy with an F-A-R-M-A-C-Y, a place for conversations that matter. And if you care about your muscle mass, if you care about healthy aging, if you care about finding out if you can extend your lifespan and your health span, then you should listen to this podcast because it's with two extraordinary

Starting point is 00:02:39 scientists who are at the cutting edge of research on aging and muscle and health. Dr. Chris Rinch, who is the co-founder and CEO at Amazentis, which is an extraordinary new company. It's sort of like a biotech company, but for nutraceuticals. And he oversees our operations in Switzerland. He's been working for two decades innovating in the life sciences arena. He's founded Amazentis in 2007, and he's worked in various industries. He's published in nature medicine, gene therapy, and has really been focusing on an incredible compound that we're going to talk about today called urolithin A, which is all about energy.

Starting point is 00:03:17 And if you want more energy, and if you need more energy, you should listen to this podcast, because it's all about mitochondrial health and how we can use various compounds that are found in plants to upregulate our biology. He is, you know, really doing some cutting-edge research on this incredible product that we're going to talk a little bit about. Also, we've got Stuart Phillips. We've got a doubleheader today. He's a professor in the Department of Kinesiology and a member of the School of Medicine at

Starting point is 00:03:44 McMaster University, where I tried to go to medical school, but they wouldn't let me. I went to the University of Ottawa instead. He's authored more than 220 original research papers, 90 reviews. He's a five-time nominee and three-time recipient of the McMaster Student Union's Outstanding Teacher Award, which is a great accolade because I think people really need to learn and it's hard to get great teachers and being a great teacher is a great thing. And he's also on the board, the Scientific Advisory Board of Amazentis, talking about muscle health and aging. So welcome, gentlemen. Pleasure to be here, Mark. Thanks for having us.

Starting point is 00:04:20 Okay, great. So let's talk about aging and longevity, because we have learned a lot about this in the last few decades, especially when it comes to not just living longer, but living better. And so the goal as we age is not just to add years to our life, but like to our years and live as vibrantly and energetically as possible for as long as possible, or as I like to say, to die young as late as possible. So how do we do that? Yeah, I think, you know, you hit on it in the introduction. It's not just about longevity, but it's about health span. And so it's the quality of the years that you spend. And I think when you pull back and look at the main theories of aging, one of the things that Amazentis has really achieved in is being able to influence

Starting point is 00:05:06 mitochondrial function. And so, you know, the tissue that we're interested in, which is skeletal muscle, we think that's pivotal, not only for locomotion, but metabolic health as you age, and definitely keeping your mitochondria inside that tissue is active and as long as you can, is a key to not only long life, but better life as well, better quality of life and better health span. So maybe you said a couple of important things there that I think we should loop back to. One is mitochondria, because I don't know if everybody knows what that is and why that's so important. How is it related to muscle? And why is muscle related to metabolic health? And to add on an

Starting point is 00:05:50 extra question, why is the muscle such a neglected organ? Because it seems to be the key to aging and we don't really talk about it. Yeah, it's interesting. So, you know, the answer to the first question, mitochondria are the sub portions of a cell that generate energy. And we need to have those operating at their full function. And when they do, our muscle becomes a great big sink, if you like, for controlling blood sugar, blood glucose. So it protects us against things like the development of type 2 diabetes. It also is a major contributor to burning energy. And so I think, you know, the main reason why when you talk about what, you know, why is skeletal muscle neglected, you know, to come back to your medical school example, there's really not a subspecialty in skeletal muscle. It's sort of a little part of neurology for some people. But it's not like, you know, your muscle breaks or fractures like a bone, it doesn't. There are no specific issues until you get into sort of neuromuscular or neurometabolic diseases. And then really, it's a neurologist issue. And a lot of neurologists focus on the central part

Starting point is 00:07:02 of the system, and that's the brain. So I just think there's only a few people that sort of make it their business to study skeletal muscle, to be honest. It's so important. And I think people don't realize that it's not just muscle for locomotion, but it's a metabolic organ. And it's what degrades as we age. And when your muscle function and your muscle mass declines, I know you more like you to fall and injure yourself and have trouble with just your daily activities of life as you age, but your metabolic health, your hormonal function, your levels of inflammation, your ability to regulate your blood sugar, your testosterone,

Starting point is 00:07:40 all are affected by the quality of your muscle. And what happens for most people who are listening and may not realize this, you could be 65 and the same weight that you were when you were 25, but your muscle can be completely different. You can look the same on the outside, but on the inside, your muscle has become marbleized fat, essentially turned into a ribeye from a filet mignon when you're 25. And that has enormous consequences for aging. And every single thing that we think of in terms of aging, heart disease, cancer, diabetes, dementia, in some ways they start in the muscle

Starting point is 00:08:18 and the muscle function because without optimal muscle function, we can't regulate our metabolism and we can't regulate inflammation. We can't regulate our hormones. And that all leads to these abnormal cholesterol levels, abnormal blood sugar levels, abnormal levels of inflammation, low hormone levels that we associate with aging. But often it really starts with the muscles. So it's one of the most neglected and important organs. And it starts to go downhill pretty quick, right? When we're in our 30s and 40s and it gets older. As you get older, we lose strength and muscle mass. But what I think is a little scary is that, is that, you know, while you can improve muscle mass at any age, recent studies have shown that it may not actually be able to be fully restored. So why should we focus on prevention and why,

Starting point is 00:09:02 and what can we do to help improve our muscle mass and function, especially in the mitochondria as we age? Yeah, I think you hit on a key issue about when muscle mass begins to decline and when the function of our muscles begin to really go sideways. And a lot of people debate when that starts. I think, as your example goes, we can find individuals that we pluck off the street, who are in their 60s and 70s, who metabolically look like they're in their 30s. And that's pretty much because they're physically active. They keep themselves busy. They probably exercise on a regular basis. But similarly, we can find individuals in their

Starting point is 00:09:45 30s and 40s who look pretty much like they're in their 60s and 70s because they spend a lot of time sitting behind a desk. They don't eat particularly well. They're not that physically active. And really, that's a direct reflection of the quality and maybe to some degree, the quantity of their muscles. So I don't know whether your listeners are familiar, but probably if they've heard the term sarcopenia before, that's the age-related loss of muscle mass and muscle function that I think for a long time geriatricians said, you know, that's just a normal part of aging.

Starting point is 00:10:18 And one of the things that we like to push is that it's not and it doesn't have to be and that really you should try and be as physically active which is probably one of the key things have a good diet and then as Chris's company as Amazentis has found out you can probably do a few sort of nutraceutical tricks if you like and prop up that mitochondria inside the muscle, which is another sort of just local indicator function of that tissue. Yeah, you know, but it's really key too that it's not just the muscle that there's mitochondria in. There's many, many mitochondria in heart and brain tissue in every single cell of your body because essentially it's the engine that runs every cell.

Starting point is 00:11:11 And some cells, like the brain cells, have literally tens of thousands of these mitochondria. Other cells have less, but heart and brain have the most. And that's when they tend to break down as we age. And I think most people don't understand anything about their mitochondria. They don't understand that they can actually measure its function in different ways that doctors can. Doctors don't know much about mitochondria. We learned this thing in medical school in first year called the Krebs cycle in biochemistry, and we quickly forgot it as soon as we learned it, which is the only time we really paid much attention to mitochondria.

Starting point is 00:11:39 And yet it is central to every age-related disease and the aging process itself. In fact, it's one of the most underappreciated aspects of our health, which is why we're having this conversation. I think people need to begin to understand how important their mitochondria is. A lot of the kind of healthy aging strategies, you know, low sugar diet, more good fats, quality protein, these are all about ultimately helping our mitochondria and exercise also and strength training are critical for building muscle and helping mitochondria. But the role of mitochondria is pretty interesting in aging. And there's a lot of age-related phenomena that happen that can be reversed by improving the function, the number of the mitochondria.

Starting point is 00:12:23 And this is some of the work that's being done, for example, around NAD, which is another healthy aging nutraceutical. But a lot of the intermittent fasting, time-restricted eating, the low-carbohydrate diets, ketogenic diets, these things that have sort of been experimented with all impact the mitochondria and affect their function. And so I think, can you talk about how the mitochondria affects us in terms of the aging process and why it's so important to focus on them? Yeah, so I think one of the key things, as you said, is that the metabolic processes inside cells require energy nonstop, and it doesn't have to be a muscle cell, your cardiac cells,

Starting point is 00:13:09 your heart is working all the time, digestive tissue, brain tissue. It's always metabolically active. There's always something going on. So that means that mitochondria are turning out the currency, the energy that we need to be able to function. So no cell really ever, quote unquote, goes to sleep. Even if we go to sleep, the cells are continuously regenerating themselves and renewing themselves. And that's a function of mitochondria. So once those mitochondria begin to function suboptimally, then you begin to see tissues begin to break down,

Starting point is 00:13:40 not just muscle, but as you said, brain tissue, cardiac tissue, it could even be adipose tissue. And all of these things really begin to tie together to slow cells down, they don't function as well, and they really can't then talk to each other. So this so-called what we call organ crosstalk, so between muscle and fat and liver, and in parts of our brain, it really begins to break down. And so, as I said, it's a central theory of aging, which is to say that once our mitochondria begin to decline in function, then, you know, things are really going to go poorly. You know, exercise is one way to prop it up, but not everybody can exercise or not everybody exercises to the degree that they want. And so these adjuncts that we're now seeing, you mentioned NAD, urolithin A, for example, are all of these, I think, pretty cool compounds that once we just thought, oh, you know, not a big deal, but we're now seeing are pretty important.

Starting point is 00:14:42 Absolutely true. And I think the phenomena around mitochondria in the research is pretty exciting. And there's all these genes that regulate aging that are in the mitochondria, like FOXO, DAF2, the sirtuins. These are really important regulators. And they're all, they're regulated by diet, but they're also regulated by these various compounds, these phytochemicals in plants, which we're going to talk about in a minute, because this is the work that Amazentis is doing. This is the work that they're looking at in terms of compounds that come from plant foods

Starting point is 00:15:13 that can actually regulate these biological functions in our body. So you can't obviously just take a nutraceutical and eat crappy and not exercise. It's all a package deal, but it really can accelerate the muscle improvement and function. We're going to talk about that. But one of the things that's sort of exciting, and Chris, I want to ask you about this, because we have been hearing a lot about this phenomenon called autophagy, which is this idea that we can clean up and recycle old cells and old proteins and sort of clean up the system to repair, rejuvenate, and extend life and improve health. And that's why people are doing intermittent fasting or

Starting point is 00:15:53 time-restricted eating or ketogenic diets, for example. These all improve this phenomenon called autophagy, which literally means eating yourself. But there's another thing that happens in the body called mitophagy, which is an incredible breakthrough in understanding longevity and longevity science, which is understanding this phenomenon of mitophagy. So what is mitophagy and how does it help to address the phenomenon of aging and improve our overall health and energy production? Mark, thanks for having me today. Mitophagy is really a way of renewing our mitochondria, particularly when they're damaged.

Starting point is 00:16:36 So as you get older and as you're more sedentary, your mitochondria get damaged as they work, as they're producing energy. And what you have inside of each of your cells is a process of renewing your mitochondria. And under this sort of umbrella of autophagy, as you were mentioning, we have mitophagy and sort of the self-eating of mitochondria. So basically, it takes care of recycling mitochondria as they get damaged. So the mitochondrial pool is maintained very robust, and you have basically cells that are more bioenergetically active than they would be otherwise. That's incredible. You know, one of the things that I find fascinating is this whole idea that I've talked about in some of my books called symbiotic phytoadaptation. And it's a big word I made up myself. What it means is that we have evolved, and this is just my theory, that we've evolved in conjunction with the plant world and the foods we

Starting point is 00:17:45 eat to regulate our biological functions. And that there are 25,000 plus different phytochemicals in plant foods that regulate every single biological function from our hormones to our immune system, to our gut microbiome, to our mitochondria, to pretty much everything that happens in our body. And we really have only begun to appreciate these recently. In fact, Rockefeller Foundation has funded a study, which they're calling the periodic table of phytochemicals, which is mapping these all out, identifying their function as much as we know, and talking about how do we actually use these in the promotion of health.

Starting point is 00:18:25 And so in everything, there's protein that we eat, there's protein, fat, carbohydrate, fiber, vitamins, minerals, et cetera. But there's this other class of compounds that have not been thought to be essential. And I call these the phytochemicals. And that's why I think we actually need these to stay healthy. So they're not necessarily, you're not going to get a deficiency disease, but you might get a chronic disease if you don't have these things. That's my theory anyway. And I'm so excited by the work that Amazentis is doing because it's really rigorous science that has been published in some of the top medical journals in the world that's looking at some of these compounds in plant foods that can actually regulate key biological functions, especially the mitochondrial function.

Starting point is 00:19:11 So there's this compound that you've studied, and you basically figured out how to actually extract and make, which is called urolithin A. And just for those who are listening, this is what's so interesting about biology. You eat a pomegranate, which has these elagitanids in it, which is one of these phytochemicals. So you eat a pomegranate, and that chemical interacts with your microbiome. And then if you have a healthy microbiome, it might produce a beneficial chemical called urolithin A. But if you don't, it might not.

Starting point is 00:19:45 So what you've done is sort of discovered that this molecule is so powerful in regulating mitochondrial function, and you've really done years and years of research to bring it to market. So tell us about urolithin A. How does it work? How does it affect mitochondrial function? And how did you kind of figure this out? Because there's a million plants out there and a million chemicals. So this is sort of like, you know, kind of like a needle in a haystack, right? Good question, Mark. So it all started with, for us, with the pomegranate. We were looking at the pomegranate and thinking about what type of health benefits it could bring. And we started looking at the compounds inside of the pomegranate and this led to us understanding more about compounds like elagitannins, which are a big family of compounds that are quite large inside of the pomegranate. And upon studying them,

Starting point is 00:20:37 we understood that they were transformed, as you were mentioning before, into urolithin, in fact, into a range of urolithins, which are metabolites through the gut microflora processing. And it was originally thought that this is just part of the processing and the digestion of the pomegranate. And so it wasn't sure, you know, were these urolithins actually doing anything in the body? So we started looking at them. And it was at this point when we were looking at urolithin A that we saw lo and behold that it was acting on mitochondria and improving mitochondrial function. And so it's one of these processes where, as you say,

Starting point is 00:21:18 a needle in a haystack, but it was through a very systematic dissection, if you will, of the compounds in the pomegranate and following their sort of journey as we consume the pomegranate. So you were like, oh, let's study the pomegranate and see what's in there. It wasn't like you studied every plant chemical and found out that there was this one that regulated mitochondria. No, no. We were really focused on the pomegranate at the time because there had been some general research on the pomegranate and its health benefits. And so we thought, let's take a deeper dive and try and understand what's there. And I think, as you were saying before, what's really emerged from this is the importance of not only the foods you eat, but importance of the microbiome and how they work together synergistically to create

Starting point is 00:22:14 compounds and to extract the health benefits from the food that we eat. And so, you know, it was understanding this and understanding also that very few people can actually perform this conversion. In fact, it's been estimated, and we've done some of our own studies that have shown somewhere between 30 and 40 percent of the population can actually convert these compounds, these precursor compounds found in the pomegranate, into urolithin A, and that's at even various levels. So what it makes sense is when we studied all this was, you know, we don't need to give more pomegranates to people, but we actually need to give urolithin A to people. And if we do it in the right way, if we dose it right, if we deliver it in a very precise manner, we can then get the health

Starting point is 00:23:03 benefits that we are targeting and that we've shown that work. I've been using pomegranate powder and pomegranate concentrate in smoothies for a long time because of the benefits of pomegranate. And it wasn't around particularly the mitochondrial function, it was around the microbiome effects. And so, you know, one of the things we know, for example, is that there's a microbe in the gut called acromantia, which is mucinophilia, which essentially creates a coating and a biofilm on the gut that protects it and regulates the immune system. It's necessary to fight cancer. It's necessary to regulate your metabolism. It's related to autoimmune diseases and it's very low in many people. And this bug

Starting point is 00:23:44 loves pomegranate. And so you feed it pomegranate, and it grows, and it can help cure all kinds of issues, which is fascinating. But what really is fascinating to me is the story of the microbiome and the food we eat. So could you dive a little bit more into how the microbiome interacts with these compounds that we eat, and then what happens to those compounds? How do they then get in our body and interact with everything that's going on? Because I don't think people really understand that. I think it's a very new science. And I think it's

Starting point is 00:24:12 really an important thing. Because when you're eating plant foods, it's not just for the antioxidants and the benefits that you get from the fiber and the vitamins and minerals. There's this other thing that's going on that has to do with how it interacts with your microbiome. And that is the future. So talk to us about that. Sure. So as I was mentioning before about the ablagitanins that are found in pomegranates, they're also found in a number of other foods that we eat. We find them in raspberries and we find them in walnuts and blackberries. And what happens is these compounds are then transformed after you consume them in the stomach. They're hydrolyzed into a lactic acid, and a lactic acid is then transformed by various gut microflora. So the actual identity of the bacteria have not yet been found.

Starting point is 00:25:09 But what we see is that there's a range of different metabolites, urolithin A being the most predominant one. And these are then taken up into the body, into the bloodstream, and then they go to the cells. And we found in our first clinical study, we found that we could identify urolithin A actually in the muscle tissue itself. So it actually gets right into the muscle cells. We've shown that and we've shown through biopsies of the muscle tissue that we impact the mitochondria and the gene expression level of mitochondria in the muscle tissue itself. That's incredible.

Starting point is 00:25:53 So how does it work to cause this phenomenon of mitophagy, this sort of self-cleaning service, almost like a self-cleaning oven, right? How does it work to induce this self-cleaning oven, right? How does it work to induce the cell cleaning process of your mitochondria? Well, with urolithin A in particular, it's taken into the cells. And what it does is we've shown that it can stimulate this process of mitophagy. It's not known exactly at what point it acts to stimulate the mitophagy, but it increases the clearance of the damaged mitochondria. And consequently, we see a renewing of the mitochondrial pool inside of the cells. And so you have a much more bioenergetically favorable environment inside the cells,

Starting point is 00:26:46 and the cells consequently function much better. So what you're basically saying is that when you have this pomegranate compound that basically should be made by your microbiome, but most of us don't, and you take it as a supplement, that it cleans up the mitochondria and helps to improve the energy production in your cells. Why is that important? Like, why should we care? Well, I think in particular, as Stuart was mentioning earlier, as you get older,

Starting point is 00:27:17 the activity in our muscle, basically, the ability to clear the damaged mitochondria decreases with age. And so this causes a decline in the energy levels inside of our cells and in our muscle tissue. And so then we sort of slow down as we get older and the muscle stops functioning as optimally our endurance levels drop. And this is part of a process in aging where mobility declines. And so what we're doing by stimulating mitophagy is to increase that energy level inside of our cells and basically making our muscles function at their bioenergetically optimal state, no matter how much muscle tissue you have. So this is something, it's really a new approach as opposed to what people have been doing in the past, which has been administering more protein to try and bulk up on muscle tissue. We're all about

Starting point is 00:28:23 trying to make our muscle tissue the most functional as possible as you get older. So it just sort of like accelerates the benefits of exercise, right? Yes. I mean, and as you were saying before, it's not a substitute for exercise. Basically, you want to keep this in your diet as part of your healthy routine, if you will. So you want your exercise, you want to have your right dietary supplements, and you want to eat a very balanced meal.

Starting point is 00:28:56 So it's all part of combining the three. It's sort of like a way to upgrade your biology a little bit, right? And it's so important because as we age, the mitochondria, it's not just our muscle that's the problem, although that's a big problem, it's the mitochondria in our brain and our heart that decline. And that leads to poor cardiac function and poor brain function. And a lot of the therapies that we talk about for Alzheimer's or Parkinson's, these are mitochondrial therapies that have been studied. So it's pretty exciting. So what's really exciting is that you guys have been in this sort of biotech

Starting point is 00:29:28 kind of nutraceutical company, which is a little bit of an anomaly and very brave, I would say, because I think it's a very daunting prospect to do, you know, a decade plus of research before you even come to market with a product. But you've come to market with this product called MitoPure, which is the concentrated bioactive component with urolithin A. So tell us about the development of MitoPure and why it's so important for our cellular health and our strength as we age. Thanks. So MitoPure is our proprietary urolithin A that we've developed. And what we've done with MitoPure is bring it to market in a product, actually. It's to a brand called Timeline Nutrition.

Starting point is 00:30:17 And the idea is that we put it into a powders format that you can add into various types of foods that you want to eat, particularly at breakfast. We think breakfast is a great time for everybody who's trying to sort of optimize their health with different types of supplements. So putting it into yogurt, mixing it in smoothies, even in your breakfast cereal. I put it in my smoothie every morning. Tastes great, doesn't it? Yeah, you know, I put a lot my smoothie every morning. Tastes great, doesn't it? Yeah, you know, I put a lot of stuff in there. It doesn't have a strong flavor or taste. It's sort of like little pomegranate-y, but it mixes with everything.

Starting point is 00:30:54 Yeah, no, no. So, yeah, we're excited about bringing this to market. We just launched over the summer, and now as we continue, we're going to be developing other types of products that contain the mito pure ingredient inside of it so this is a it's a very exciting time for us and this way but you know i don't know if this public knowledge but like there's there's big food companies that are interested in this because they see as a way of enhancing and upgrading their quality of their food products, right? Yes, of course. And in fact, we've formed a strategic alliance with Nestle Health Science here,

Starting point is 00:31:32 and they're a great partner, and they're putting MitoPure into a number of their products. They've even launched one product recently, in fact, with that. That's amazing. So how does it revitalize mitochondria in the sense of, you know, the research? Because this isn't just basically, oh, this is a cool thing. Let's stick it in a pill or a powder. You've actually done the hard science on this. What are the scientific studies shown about how it affects mitochondria?

Starting point is 00:32:01 Well, you know, it all started with first a very strong collaboration here with scientists here at the University of the EPFL, in particular, Professor Johan Owerks, who's a guru when it comes to mitochondrial function. And it was in his lab that they really started doing the deep dive on studying the effects on mitochondria, and we worked together on that. And they started out by looking at the effect on worms, on these C. elegans, and they started to show that they were living 40% longer. And it was after looking at these worms living longer moving more that we started to explore further and understand the mechanism of

Starting point is 00:32:51 action and that's how we we learned that we were we were stimulating mitophagy and we you know we went through the whole process of showing that this mechanism of action was conserved not only in worms, but also in mammals. We moved into mice, and then we moved into humans. So we've conducted a couple of clinical studies here, and we published one of our clinical studies in the journal Nature Metabolism. In that study, we showed that administering urolithin A or Mitopyr for a period of four weeks, we were able to show that we were increasing the

Starting point is 00:33:48 gene expression of mitochondria genes. And then when looking at the plasma, we were able to show that there was a decrease in certain biomarkers linked to mitochondrial function, acylcarnitins. And so as the acylcarnitine level drops, this is an indicator of improved mitochondrial function. And also, if you're looking at the plasma, to your point earlier about mitochondria being everywhere, this is also a sign that you're having an effect on mitochondria, not only at the level of the muscle, but something that's more systemic in general. That's incredible. So that was that study with four weeks.

Starting point is 00:34:33 But you also did clinical trials, a double-blind randomized placebo-controlled trial for healthy adults who are middle-aged. And in four months, just consuming the MitoPure every day, they had a real improvement in muscle strength in their legs. Can you talk about that study and what you guys found? Yeah, this is a very exciting study. And this was the follow-up study, which we haven't published yet. And in this study, we took a group of people who are middle-aged and overweight, as you mentioned, sedentary in lifestyle, And we provided them with mitopur.

Starting point is 00:35:08 It was taken daily for a period of four weeks, or four months, excuse me. And there at the end, we looked at the evolution of the muscle strength and we saw that we were able to improve leg muscle strength after a four-month intervention. So that was very encouraging and running parallels of the type of improvements that we saw in muscle strength in preclinical models as well. That's exciting.

Starting point is 00:35:41 So how do they measure muscle strength by how much weight they can lift or whether you can get up out of a chair sitting up? How do they measure that? Well, they use a very specialized instrument that isolates one muscle in the leg. And so you contract your leg and you can measure the specific strength of a single muscle. And that way you can be very precise in the way you assess the improvement of muscle strength. That's amazing. So, you know, will it improve athletic performance, you think? Well, you know, we plan to run additional studies in athletes and to assess the impact on athletic performance. And this is something that we, we are, um, uh,

Starting point is 00:36:29 getting ready to do this next year. So, um, you know, let's see, and we'll keep you in. Okay. It also improves, uh, you know, mitochondrial muscle function, but, but does it also help with muscle mass? If you're weightlifting, does it, for example, help you improve your muscle strength even more? Well, I would say that it's not improving muscle mass, but, you know, the idea here is really to improve the cellular function, the bioenergetics of the cell. And so no matter how much mass you have, it will basically amplify the effect of the cell and the functioning of that cell.

Starting point is 00:37:09 So if you do have more muscle mass, it should have an additive effect, if you will. More muscle mass, more cells will be impacted, and so they should function better. That's amazing. And people say, well, why can't I just drink some pomegranate juice? Why do I need to take this? It's an additional supplement, it's an additional cost. But you actually studied the comparison of MitoPure and drinking a glass of pomegranate juice every day.

Starting point is 00:37:37 So what did that show? Well, that was a very interesting study where we basically did a crossover study where we provided people either with an eight-ounce glass of pomegranate juice or 500 milligrams of MitoPure. And then we followed the evolution of the urolithin A levels in the blood of participants in this study. And what we saw over the first 24 hours under the time points that we analyzed was essentially a six-fold higher level of urolithin A in the blood after taking MitoPure when compared to pomegranate juice. So essentially meaning that you would have to take six times more or... 48 ounces of pomegranate juice should have diabetes at the end of it.

Starting point is 00:38:33 Yes, that way it's probably not the optimal approach, I would say. No. So is there anything else you want to share about the research you're doing, what's coming up, what you've seen clinically, maybe just some anecdotes of patients or people have used it and what they noticed? What's the benefit and payoff of doing this? Well, I would say this, that the one thing that's important to mention is this is not some type of miracle product, if you will, where you take it once and you see a sudden change in the effects on your muscles and on your cells.

Starting point is 00:39:11 It's something that you'll need to take for a prolonged period of time, and that's why we're selling it for a period of four months to start with. And we think that if you take it for a prolonged period of time that you get, uh, that you get more benefit, uh, from the actual product. I mean, when you go to the gym for a week, you don't improve your muscle function, although we all would like to, uh, by doing it regularly and having an impact on, uh, on your cells in a regular manner, you can slowly basically change the composition inside of your cells and improve the functioning in general at the organ level,

Starting point is 00:39:54 at the whole skeletal muscle level. So have you had friends or people taking it or patients, and what do they report after taking it for four months? Well, so we have had people who we know are taking it or patients and what do they report after taking it for four months? Well, so we have had people who we know are taking it and, and they have, you know, they, they swear that, that their performance is improving and they attribute it to that. And so, you know, we've had different people report different types of activities, but, but I would say in general, there's been for those people we know

Starting point is 00:40:27 who are athletes, they've mentioned that they had some improvement in performance and other people have felt a general improvement in walking. But it's, you know, everyone has their own, let's say, antidote, antidote, anecdote, anecdote or story to tell about's the fatigue that people have. And when they take the product, there has been a general feeling of an improvement in energy levels from a number of people that have been taking it. That's fantastic. I think energy is all we need more of. We're all overworked, overtired, and anything that's going to improve our energy is going to be helpful. Stuart, I'd love you to talk about sort of the research you're doing around muscle health and function and how we can boost mitochondrial function and muscle function as we age. Because it is probably the single biggest ignored thing in medicine that I

Starting point is 00:41:42 see is this phenomenon of sarcopenia, which is muscle loss. And every single age-related disease is a consequence of progressive metabolic poor health, which is really driven by this progressive muscle loss. And it's why, you know, at 59, I started weightlifting after resisting it for years. You know, I do biking. I play tennis. I, you know, did some yoga. I felt like, okay, but I really doubled down on the strength training, even though it's uncomfortable for me. I don't like it.

Starting point is 00:42:13 Oh, I'm learning to like it more. I mean, riding my bike through the fall and the colors and the wind and just the feeling of being free, I could do that all day. But muscle work is harder. But it's so important. So why do we need to be so focused on this? And tell us about what we can do to optimize our muscle function and health as we age. Yeah, I mean, I think one of the important points towards Chris's urolithin story is that we don't have a drug

Starting point is 00:42:46 right now that does anything for skeletal muscle in terms of that's broadly available both to men and women. I could say testosterone for men, but a large side effect profile. So things like urolithin really tell, they address a piece of the metabolic machinery that's, you know, it's hard to fix otherwise. Exercise, of course, is, you know, a key part of aging well and improving your health span. I agree that, you know, everybody can stand to be fit as they get older. And, you know, peak exercise capacity has been called by some people, and exercise physiologists are not alone in this, is saying it's a fifth vital sign. It crosses brain, heart, lung, muscle, so multiple physiological systems, and it's probably quite reflective of general overall health. I don't know when it starts, but I would urge people to think about creating the image of their future selves.

Starting point is 00:43:46 And at some point in your aging trajectory, you know, whenever that is, people say, when does aging start? I'm like, well, this year, it's about 56, you know. But I mean, my point is, and that's a personal observation, but my point would be that as you get older, some of the things that you're going to have to do on a regular daily basis are going to involve strength. And you're going to want to be able to have the strength to do probably some things that you didn't really recognize, one of which ultimately the fully functional lift is getting off of a chair. So once we can't do that, we're in trouble. But it progresses gradually and it sort of creeps up. So I applaud your effort at trying to stay stronger as you age.

Starting point is 00:44:32 Not that being fit isn't a bad goal. I think the combination of the two is best. But boil it all down and it's all still about good mitochondrial function. Funny enough. It's so true. So what other things are people exploring around mitochondrial function, funny enough. That's so true. So what other things are people exploring around mitochondrial health? Because urolithin A is important, but it's only one component. What other things should people be thinking about? Well, you mentioned NAD as a substrate. I think a

Starting point is 00:44:56 lot of people have probably sort of moved around in the antioxidant space. And it was interesting to hear you talk about the plant and vegetable, you know, phytochemical matrix. I think that this is an area where you're going to begin to see a lot of action. A lot of the things that we, you know, attributed to this is the benefit of consuming diets that are high in fruits and vegetables. If you'd have said urolithin a a decade ago people wouldn't have known what you were talking about or nitrates uh for enhancing mitochondrial function for example uh that are attributable to a something in the matrix and phytochemicals that we just don't understand in the microbiome and then you've got another layer of complexity on top of that um that again

Starting point is 00:45:47 i think we're beginning to peel back some of that uh and how that interacts with our overall health but um it's going to become interesting i think the next five or ten years you're going to see an explosion of these types of compounds and uh and how they affect cellular processes to be honest yeah absolutely well thank you guys so much. This is an incredible conversation because it underscores something I've been talking about forever, which is metabolic health. And when I say metabolic health, I mean your ability to manage your basic biological functions in a healthful way. When you have poor metabolic health, you have high cholesterol, you have high blood pressure, you have high blood sugar, you have belly fat, you lose muscle, you get marbled

Starting point is 00:46:28 muscle, which is not great. And that all has all these adverse consequences that we think of as aging, but they're actually abnormal aging. And what you guys are saying is that we have now the science to understand how that happens and what to do to intervene from what we eat, to how we exercise, to some of these nutraceutical compounds and phytochemicals that we can take advantage of to actually accelerate our repair and healing and function so that we can actually live better, healthier lives and have our health span equal our lifespan, meaning we will live fully and healthy until the day we die and then we'll drop dead, which is what we would all like, right?

Starting point is 00:47:12 You don't want to be 60 and have 30 years of disability and dysfunction and live to 90. That's no fun. So I think this is an exciting area of research. I applaud both of you for the work you're doing. I encourage you to check it out. You know, Amazentis has launched this product line, which is pretty cool. MitoPure, which is scientifically validated. You can get it through Timeline Nutrition. And there's an exclusive offer for those listeners of the Doctors Pharmacy podcast for two-month plan for $200 for subscribers.

Starting point is 00:47:35 So it's, I think, probably half off, right? Isn't it almost half off? But it's a good deal. And I encourage people to check it out and learn more about this company because I think mitochondrial health is really important. And I think it's important for us to stay focused on our muscle as we age, as well as our bellies. We don't want those to grow.

Starting point is 00:47:52 And as our bellies grow, our muscles shrink. So they kind of correlate. And thank you both for being on the podcast. It's been great to have you from Switzerland and Canada. It's great with COVID. Now we can have podcasts from all over the world. It's really awesome. It's one of the silver linings among very few, unfortunately. So thank you for listening to the Doctors Pharmacy podcast. If you love this conversation, please share with your friends and

Starting point is 00:48:15 family on social media. Leave a comment. We'd love to know about how you're taking care of your mitochondria 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.

Starting point is 00:48:44 And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to drhyman.com forward slash pics to sign up. That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter.

Starting point is 00:49:18 And I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. 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.

Starting point is 00:49:39 This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.

The Dr. Hyman Show - Why Muscle, Our Neglected Organ, Is The Key To Healthy Aging with Dr. Chris Rinsch and Dr. Stuart Phillips

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