Dr. David Sinclair Transcript by Dr. Steven Gundry | Jan 10, 2020

Dr. David Sinclair Transcript by Dr. Steven Gundry | Jan 10, 2020 | Transcriptions | 1 comment Speaker 1: 00:00 Welcome to the Dr. Gundry podcast, the weekly podcast where Dr. G gives you the tools you need to boost your health and live your healthiest life. Dr. Gundry: 00:14 Welcome to the Dr. Gundry podcast. We’ve all dreamed about living longer, healthier lives, being there for our children, our grandchildren, and if we’re lucky our great grandchildren. Today’s guest has spent literally decades studying exactly what it’ll take to extend the average human lifespan to well beyond 100. While we haven’t exactly cracked the code yet, he seems to be getting closer every single year. I’m talking about my guest, Dr. David Sinclair, who has been a friend of mine for several years now. He’s a Professor of Genetics at Harvard and one of the world’s foremost experts on the science of longevity. He’s just written a brand new book called Lifespan, Why We Age and Why We Don’t Have To. Today we’re going to discuss whether aging is a disease, share our tips for living a longer healthier life, and talk about the future of antiaging medicine. David, so great to see you, and welcome to the podcast. David S.: 01:23 Steve, it’s great to see you too. Thanks for having me on. Dr. Gundry: 01:27 Yeah, I really appreciate you coming on because you’re one of the most exciting voices and researchers in longevity, and it’s just a real privilege and an honor to have you on my podcast. David S.: 01:42 Thanks. Dr. Gundry: 01:43 I want to start with the big picture question. You and I have talked about this. Come on, is aging a disease? David S.: 01:54 Well, it can be whatever the world wants to call it. It does seem strange at first when you hear aging is a disease, but when you look up the definition of what a disease is, it’s a condition that reduces function, eventually many diseases causing death. And that’s exactly what aging does. It turns out the difference between disease and aging is simply that a disease happens to less than half the population and aging happens to more than half of the population, and that’s an arbitrary cutoff. I argue in my book that because we don’t regard aging as a disease, we’ve neglected it at least for the last 200 years, and that’s led to a lot of problems in our healthcare system and in our lives where we’re spending more and more time in a state where not all of our body is kept young for longer, our brains in particular. I think with this new approach if we were to define aging at least as a medical condition it would change the way we research and develop drugs for most age-related diseases. Dr. Gundry: 03:02 Many of us hear about or know people who practice geriatric medicine for an example. Are you saying that I should have a code in my office for aging as a disease and get paid for preventing aging or modifying aging? David S.: 03:26 Yes. I’m absolutely saying that, Steve. Actually, the World Health Organization agrees with me. They have a disease code book, ICD 11, International Disease Code, and MG2A is now old age. You can now according to them report back to them how many of your citizens have old age, and it’s becoming more and more common amongst my doctor colleagues particular in Britain to write on the death certificate old age. A lot of doctors say, “Well, that doesn’t prove the actual cause of death.” True, we die from organ failure and other things. But what I also want to argue here is that we’ve been focused for the last 200 years on why people metaphorically fall off a cliff, but it’s just as important, if not more important, to understand what drove them to the cliff in the first place. Dr. Gundry: 04:28 Yeah, I think that’s a great point. I make the point in the longevity paradox, and you do too, that in years past the time that we spend in our lives in senescence in literally going downhill, going off that cliff, was remarkably short. Now, particularly in America and Western society we spend an extended period of time in senescence, in really getting old. What’s happening in your opinion? David S.: 05:05 Well, it’s what I call Whac-a-Mole medicine, that most doctors, not all, but most doctors treat diseases. If you take diabetes as an example, most people will have increased blood sugar levels the older they get, and that’s actually a very good sign of aging and how long they will live. But if you were to go to a typical doctor in most Western countries, they would say, “Well, you need to pass a certain threshold to be a diabetic, and only when you have a disease I will treat you. Go home and don’t eat so many potato chips and get off the couch, but I’m not going to help with the medicine until you actually have a disease.” Whereas we know that a drug like metformin, which is as far as drugs go relatively safe, will delay type 2 diabetes if you prescribe it earlier. It’s a very cheap drug as drugs go. I’m encouraging people, doctors, to think about prescribing metformin before diabetes actually occurs. It’s a lot easier to prevent a disease than to try to reverse it. Dr. Gundry: 06:16 Yeah. I think that’s a very good point, and I think we’ll come back and talk about metformin a little bit later because it has as you and I both know a number of pluses, and there are some people who feel it does have some minuses, particularly in mitochondrial function. You’re one of the world’s experts on how to make your mitochondrial function better, so I’m interested in that take. In fact, what the heck, I was going to talk about it later, but let’s talk about it right now. David S.: 06:46 Okay. Dr. Gundry: 06:47 You, I know, take metformin. Yes? David S.: 06:50 Yes. Dr. Gundry: 06:51 I don’t. I maybe should. Convince me. Come on, David. You and I are sitting around having a coffee. David S.: 07:00 Right. Well, I don’t want you to live a day longer than you want to, Steve, so I’m not going to try my hardest to literally convince you. But scientifically I’ll tell you what I think and why I chose to. And that is that I looked at the data in… Let’s start with animal studies. It’s not always the best, but with animal studies I was on a paper with Rafael de Cabo down at NIH, the National Institutes of Health, and we showed that metformin delays many diseases in those animals, and they do live slightly longer. That’s good. It’s obviously not doing them a lot of harm. Then when I looked at the literature of other people who did studies on… One study was over 10,000 patients, veterans, that took metformin, others, now 100,000 plus patients who have taken metformin. When they look at the risk factors and actually the incidence of diseases of aging, not just diabetes, but other diseases, cancer, heart disease, frailty, Alzheimer’s, their chance of getting those diseases went down as well, which is what you’d expect from a true longevity or what some would call an antiaging drug. And here’s the striking thing. Those patients were healthier having diabetes than people who didn’t have diabetes, and that’s remarkable. So what does that mean for people who don’t yet have diabetes? I think it should be even more effective than those people who are being studied. Now the other thing is, I’m doing a risk reward ratio always with myself. What’s the risk of not doing anything? Pretty high, right? I know what I’m going to be doing 20 years from now. It’s not going to be fun. I’m 50, I’ll be 70 in 20 years. But what’s the risk of taking metformin? Well, it does have side effects that can be severe, but for most people the most you’ll experience is an upset stomach, which I’m prepared to tolerate and mitigate with the benefit of potentially having a much healthier older age. Dr. Gundry: 09:11 You and I are probably both aware recent placebo controlled trial in older adults using metformin to see if it would actually improve exercise building more muscle mass, and I think the theory behind it was excellent. And I think it was a well designed study. Yet, metformin failed to improve muscle mass generation to exercise. Any thoughts on that subject? David S.: 09:41 Yeah, a lot. I get asked about it every day. I’ve talked to the people who ran that study, and so I’m pretty qualified now to speak about it. What the study showed… There are now two studies. If I were to summarize, it would be this. That the elderly patients that exercised whether they had a drug or not, metformin or not, all gained muscle mass and strength. There was a slight difference in the muscle mass of those who took metformin. They generally had smaller muscles. But they were just as strong as the other group that didn’t take metformin. So I jokingly said that it’s a question of vanity versus longevity. But really what I mean is that we’re trying to eek out the differences, but the benefits were still there even in the metformin group. Now, because we don’t know really what’s going on and there might be some negative effects on the muscle, even though they were just as strong, I have decided to see what happens if I don’t take metformin on the days that I exercise and recover from exercise, which is generally Sunday, Monday, Tuesday for me. That’s my little experiment. It’s not a clinical trial by any means. But I think the absence of more information, I think that’s a reasonable approach. Dr. Gundry: 11:10 That’s sounds like a fun thing to do. You and I have an N-of-One at all times. You, of course, have added your father to the N-of-One. We’ve talked about your dad, and you talk about your dad in the book. Talk about your dad and tell me the effects of some of your crazy ideas on your father. David S.: 11:36 Yeah, right. Full disclosure, full disclaimer here. This, again, is not a clinical trial, and it’s not going to be published in a journal any time soon. But my family are a bunch of scientists. My wife is a scientist from MIT, my father is a biochemist. We can read scientific papers. My father believe it or not at age 80 is an independent individual, and he has chosen to take my research seriously and has been convinced by himself, not by me, to try things because he knows what the odds are in his old age of things going wrong. By age 80, most people have at least two or three major diseases that are being treated. He started taking Resveratrol early, one of the first people in the world. This is now going back 13 years ago. And so far so good. He takes a gram or so a day. The reason I say, Steve, or so is in my family with powder we just spoon it into yogurt and mix it around. It’s important to dissolve it in something for it to be absorbed. We know that from human studies. Just to dwell on Resveratrol for a little bit, people go back and forth on Resveratrol. I can tell you in my lab we’ve definitely proven how it works. We have new results that I haven’t published, but we have had a science paper that was very positive and showed that it’s working through the sirtuin pathway that we work on. And we have new results that really nail it. I very rarely say we proved anything, but this experiment that we’ve done has proven that it works the way we said it did. But also what’s really encouraging is that there are human studies that are now showing that Resveratrol does many of the things that we saw in mice many years ago, protect people from high fat diet and reduces blood sugar levels, which is great. Part of the reason that there were negative results, I think, in people is that the researchers didn’t realize that you need to dissolve Resveratrol into something that allows it to be absorbed. When you do that, you get fivefold higher levels in the blood. So getting back to my father, he’s been on Resveratrol. He’s now on metformin. He has been on metformin for probably six years now because he had high blood sugar. Everyone in my family dies early from diabetes related complications or heart disease. He’s now the longest lived person in our family, at least on the male side. Then he started adding NMN, which is an NAD boosting molecule, the same one I take. He started that about three years ago. Those are the main things. Now, if people want to learn exactly what we do, and it’s a long list, page 304 you can skip to that in my book, but you’ll miss all the good stuff. Dr. Gundry: 14:30 It’s in here. David S.: 14:30 Yeah, yeah, thanks, Steve. Also in part two of the book, the middle section, it’s about things you can do with your daily life, about what to eat, when to eat, what to do with exercise that the science backs up. Steve, you and I have a lot in common in how we approach our daily lives and what we think will improve health. I’ll just finish to say that my father is 80. He has no illnesses. He has no aches or pains. He’s got as much energy as he did when he was in his 20s and 30s. Mentally and physically he can outpace me. So far so good. He’s a big kind of hope for all of us. Dr. Gundry: 15:11 Now, you bring up Resveratrol. I can’t leave that without talking about hormesis because one of the theories of how Resveratrol works is hormesis. What the heck is hormesis, and why is it so important? David S.: 15:29 Right. Well, hormesis is essentially what doesn’t kill you makes you stronger. You could possibly say what doesn’t kill you makes you live longer as well because what we discovered first in yeast cells that you can make beer and bread out of, and eventually in animals and now in humans, we found that these enzymes that I mentioned earlier called the sirtuins, these are protectors in the body, and they do a lot of good things. They protect cell identity. They repair DNA. They boost energy in the mitochondria, which you mentioned earlier. We discovered that, but then what we realized in the 2000s was that these genes and the enzymes that are produced from them are turned on by hormesis. And what that means is anything that puts the body in a state of perceived adversity. You don’t want to actually damage the body to be able to live longer and be healthy. You want to give the impression that times are going to be tough. So being hungry during the day, exercising, these are all things that tell the sirtuin genes to come on and to protect the body. There’s some other things that I do such as go the sauna and jump in cold water baths to try and stimulate and get my body out of its complacency. When we sit around all day… I’m at a standing desk by the way for that reason. If we sit around all day, and we don’t exercise, and we eat constantly, our defenses don’t get turned on. We don’t have hormesis. Resveratrol, which we talked about, I’ve called xenohormedic molecule, which means hormesis that you get from other species such as plants. So when plants are stressed they make Resveratrol and other molecules like it. I have this theory and some evidence that when we eat those stressed plants our body thinks that our food supply is running out, and it will also have the benefits of dieting and exercise as well. Dr. Gundry: 17:27 I love that. The more stressed plants I eat, the less exercise I have to do. Is that what I’m hearing here today? David S.: 17:37 Right. Let your food be stressed so you don’t have to be. Dr. Gundry: 17:42 Well, yeah. An interesting aside, this is not to talk about. I happen to have an olive oil that has 30 times more polyphenols of any olive oil. The person who developed it is in the moroccan desert, and he knew that great wines come from vines that are stressed. They’re planted in rocks. They’re under watered. Horrible conditions. He says, “You know, I bet you you could do that with olives.” He found a rocky part of the moroccan desert, under watered them, and planted the vines and trees right next to each other so they had to compete. When he finally made the olive oil, the French government found it had 30 times more polyphenols than any olive oil they had ever tested. You’re right. A stressed plant gives more polyphenols, and Resveratrol is certainly one of those polyphenols. I think you’re absolutely right on this. Yeah. We’re all going to go out and eat stressed plants or stressed plant byproducts, and that includes really good red wine. Is that true or is that French paradox a total myth? David S.: 18:55 I don’t think it’s a total myth, but the amounts of Resveratrol that we find we have to give people would be the equivalent of hundreds of glasses of red wine every day. Dr. Gundry: 19:07 Work, work, work, work, work. David S.: 19:09 Yeah. The new juice just keeps getting better and better. Right? But please don’t over drink. The alcohol is, of course, not helpful, and there’s a lot of calories. That said, I’m happy to entertain the possibility, and there is some evidence from looking at populations, that drinking a glass or two of red wine over 40 years can be beneficial. There’s not just Resveratrol in red wine, there’s Quercetin and other things as you know, Steve. That cocktail with a bit of alcohol may be responsible for some of those health benefits that we call the French paradox where the French can eat a lot of cheese and fat, and they don’t have high rates of heart disease. Dr. Gundry: 19:51 I think that’s very true. Like you say, and I say in all my books, look, if you don’t drink, don’t start. It’s rule number one, I think. What’s one thing that my listeners can do to stimulate hormesis for themselves? You mentioned several of them. Come on, give us an easy one. David S.: 20:14 All right. Well, having read tens of thousands of papers and read your books and studied this my whole life, if there’s one thing that I could say that everybody needs to do, it’s eat less often. That’s not malnutrition, not starvation. Please nobody become underweight. But what this means is the three big meals a day with snacks in between in my view is ludicrous and has led us into a world of obesity. So I’ve recently… Well, actually most of my life I’ve skipped breakfast but more recently tried to even skip lunch and then have a normal dinner. It’s been great for me. We know in mice… Here’s something that I’ll leave everyone with if we take the break. I mentioned Rafael de Cabo down at NIH, my good colleague down in Bethesda. He did a study that I think is a landmark. He mixed different types of… different amounts of protein, fat, carbohydrate, and gave 10,000 mice different versions of a diet. They all lived the same lifespan. The group that lived the longest was the group that had access to the food only two hours a day, which argues that it’s not just what you eat, but when you eat that’s important. Dr. Gundry: 21:33 Yeah. I think that’s so important. Whether we call it intermittent fasting or I like time restricted feeding, which is kind of what you and I do, you’re an expert in this field. Would you please tell people why breakfast is not the most important meal of the day? David S.: 21:55 Well, I found at least for myself, and I assume I’m an average person, when I measured my blood sugars… Steve, I started measuring my blood sugar with a patch you can buy. It’s prescription only, but still I managed to convince one of my friends to let me try it. What I found is that I, and I’ve heard many others, their blood sugar goes up in the morning. People like me are not hungry at all when we wake up. It’s really force feeding for many of us. I can do quite well without breakfast, and I don’t need it. Actually, I do much better physically and psychologically mentally without breakfast. I think for many people having a breakfast is not just a waste of money, it’s actually dangerous because it adds up… The calories add up fast. Dr. Gundry: 22:49 Yeah, that’s a really good point. Both our cortisol and our adrenaline levels rise in the morning, and that, of course, both kick up blood sugar. I take care of a large number of diabetics many of whom have been on insulin, and one of the things they don’t quite get is they always wake up with an elevated blood sugar, and they think it’s because of what they ate the night before. Most of them unfortunately then say, “Oh, my gosh. I’ve got to eat some food, and that will bring my blood sugar down.” Well, in fact, when they measure it again at 11:00, their blood sugar is down, and they make this connection that the food brought it down. Well, it didn’t. Their cortisol and adrenaline fell normally. As you know for the last… Now, this will be my 18th year from January through June I not only don’t eat breakfast but I don’t eat lunch. I’m a mouse at the NIH. I eat all my calories in a two hour window. So far so good. As I say, I’ll let you know when I’m 150 if the experiment worked. David S.: 24:03 Right. Dr. Gundry: 24:03 But I got to catch Dave Asprey who we both know and respect. He’s going to be 180. We got to do something to catch him. All right. Let’s take a break. We’re going to go to break, and we’ll be back with Dr. David Sinclair, one of the greatest experts on longevity that I’ve had the pleasure of knowing in the world. So stay tuned. Is eating lectin free safe for my children? How about during pregnancy? Dr. G., how on earth can I afford to feed my entire family on the plant paradox eating program? In my latest book, The Plant Paradox Family Cookbook, 80 One Pot Recipes to Nourish Your Family Using Your Instant Pot, Slow Cooker or Sheet Pan. These questions and more will be answered. Plus, there’s delicious recipes of comfort food you love like cheesecake and mac and cheese made with ingredients that actually love you back. The book comes out on November 19th, but why wait? Preorder your copy today wherever you buy books online. And we’re back. Welcome to the Dr. Gundry podcast. And my great pleasure to have back with us, Dr. David Sinclair, who’s recently released his book Lifespan, and it’s a must read. He’s going to tell you more about how living well for a very long time than just about anybody else maybe besides myself. I have taken so much advice through the years from Dr. David Sinclair, and that’s why I’m so excited to have him on the podcast. All right. We talked about hormesis. We talked about daily practices that hopefully and by evidence will extend not only lifespan but I think more importantly to both you and I and all of our listeners is health span. Talk to me about the benefit of a low protein diet as part of this. Any thoughts on that subject? David S.: 26:21 Yeah, I have a lot of thoughts. It’s controversial because there are a lot of people who… Some of our friends, Steve, are carnivores. But I’ve looked at the data, and I’ve chosen to become mostly vegetarian, and what I’m trying to do is to not overload my body with excess protein. We all need protein to live and make the acids that are essential. There’s no doubt. But overloading it by eating huge amounts of steak I think is a mistake. One of the reasons for that is there’s a longevity mechanism in all of ourselves that responds to how many amino acids we eat particularly the branched-chain amino acids, leucine, isoleucine and valine. If we eat a lot of those, what happens is this longevity mechanism in the body called mTOR doesn’t do its job. It becomes lazy. It says, “We’ve got enough food. Let’s not worry about surviving any longer. We’re going to put our effort into actually growing muscle rather than surviving.” That’s why it’s good for bodybuilders to bulk up on this amino acids because it puts the body in a state of growth. But it’s probably at the long-term expense of health and longevity, I imagine. There are a lot of studies that show that lowering the activity of this pathway is beneficial both in animals and in people. There are even drugs that are being developed right now to mimic low amounts of amino acids without actually having to avoid a lot of meat. Until those drugs are available… And there’s one on the market that’s kind of dangerous. It’s used as an immunosuppressant, so I’m not taking that one. Long story short- Dr. Gundry: 28:13 Me neither. David S.: 28:14 … I have low amounts of amino acids and not overload my body. I’ll eat a bit of fish occasionally, but I’m not a big steak guy anyway. Dr. Gundry: 28:23 Yeah. I coined the term to describe my diet of “veg-Aquarian.” My wife and I eat mostly vegan during the week, and then on the weekends we’ll either have some wild shellfish or some wild fish for the meal, but that’s about it. I enjoy talking with the carnivores. I’ve even had one on my podcast. First of all, you and I have studied longevity for most of our lives. I’m not aware of a long lived society that is a carnivore based diet, and I’m sure you’re not aware of one. David S.: 29:07 Right. That’s true. Look at the Okinawans in Japan on that island. They eat a little bit of fish but mostly it’s plant based, and they don’t eat a lot of food either. Yeah, I think that’s right. You’ve got to look to where people live the longest and try to mimic their diets. Dr. Gundry: 29:25 I think a lot of the carnivores that I know of or who write on Twitter, most of these people are definitely time restricted feeding. They don’t talk about that, but it’s very clear from their physique that they are. What about the argument that if we use a lot of bone broth or we have a lot of the cartilaginous parts, tail, the nose, eating that will have so much glycine that we will block mTOR from being turned on. Can you go down that pathway for a second? David S.: 30:08 Yeah, there’s a school of thought that glycine has a number of benefits. We haven’t studied that in my lab, so I can’t say that I can speak with any authority. I think it’s possible that that’s true. The one downside of eating a lot of branched-chain amino acids from meat, which just came out in a publication a few days ago by studying animals, it was a study from Sydney, Australia, was that these branched-chain amino acids unfortunately stimulate the hunger response in your brain or at least in the animal’s brain. So it actually caused those animals to eat too much, and they became obese and died prematurely. Maybe what our friends are doing, the carnivores, by restricting their feeding is actually counteracting the negative effects of their high branched-chained amino acid diet. That would be something that we’d need to really study to say for sure. Dr. Gundry: 31:13 All right. We’ll leave them alone for now. The Atkins diet resurfaces every 50 years. I actually do think it’s a useful elimination diet because it does get rid of every plant compound known to mankind at least for a while. As you know, some plants hate us. I get back to agree with you that xenohormesis is probably a really good thing in the long run. But let’s move on. Tell me about vitamin D. As you know, I’m a huge fan for vitamin D in longevity. What say you? David S.: 31:57 I agree. Actually, I co-developed a blood test that predicts your biological age, the best that we had until recently. Vitamin D was one of five things we measured that correlated very nicely with longevity. So I’m a big fan. I take vitamin D every day along with vitamin K2 for my blood vessels. I give it to my kids too. Especially in a place like Boston, you can become deficient. I don’t want to go anywhere near being deficient. The vitamin D receptor is very important. My wife who I mentioned earlier, the scientist, she studied vitamin D for the skin and the health benefits of activating these receptors. And it’s critical for bone and for skin health. Yeah, I totally agree with you, Steve. You’ve got to keep those levels up. Dr. Gundry: 32:52 Yeah, I’m glad to see that actually there’s several labs in the country now that have raised their safe limit of vitamin D to 120 ng/mL. I actually think it’s probably safe to be higher than that. For the last 18 years I’ve been running my vitamin D levels greater than 120 to prove I’m not dead. So far it’s working well. I’ll tell you a funny story that I think I’ve said before. Many, many years ago in my clinic I met a husband and wife in their late 70s. At that time, we were actually measuring the actual number of vitamin D. Most labs kind of cut off after about 150 and say, “greater than 150.” These people both had vitamin D levels of about 280. I was flabbergasted because here were two quite healthy looking individuals. I thought, “Why aren’t they dead?” number one. Number two, have they had kidney stones? No. Do they have neuropathy? No. I said, “You guys take a lot of vitamin D, don’t you?” They said, “Oh, yeah, it’s a longevity hormone, and we’ve been taking… ” It was actually the first time a traditional MD saying, “These people aren’t dead, and they have this humongous high vitamin D level.” That’s when I actually started experimenting on myself with these two individuals because it was like… I’ve talked about it in my books. I owe most of what I’ve learned from an individual or patient going, “Look at this. I’ve got a vitamin D level of 280.” Now that’s not to say that everybody should have a vitamin D level of 280, and I don’t think you’d say that either, but I think we’re woefully under vitamin D’d in this country. David S.: 34:53 Yeah. Absolutely. Dr. Gundry: 34:57 Tell me about NMN. Everybody thinks we’re talking about M&Ms, the candy. What is that and why is that so important in your opinion? David S.: 35:09 Yeah. Well, I think most people would agree with me these days, NMN is a molecule that we also refer to as an NAD booster. This is one of the things that my father and my wife and I and our dogs take actually. I brought a vial here to show you. I take them in pill form. What is NAD? NAD, everybody learned about it in high school biology and then promptly forgot about it. It may have been the reason why people left science or became disinterested because it is the most boring molecule in biology. It’s used for about 500 chemical reactions. It’s essential for life. Without NAD we’d all be dead in about 30 seconds. But we were forced to learn these chemical pathways. It’s not that interesting. Things got really interesting when we realized that the body was sensing the levels of NAD to determine how it was doing and what the environment was like. So we now know when you exercise and when you are hungry your NAD levels go up. It turns out that as you get older your NAD levels go down. That’s just a correlation. But what we’ve shown from numerous animal studies, room studies and increasing number of studies in people is that what’s going on is the NAD is turning on the body’s defenses against aging through a group of enzymes that we worked on and have essentially spent 25 years figuring out, they require NAD as well. The hormesis mediators, the enzymes that we think provide the health benefits of diet and exercise, are responsible for the longevity that you get when you lead a healthy lifestyle. Now, it’s interesting to pause on this because we used to think that just running would make your blood flow better and being hungry you lost weight, and that’s why you lived longer. But, actually, what I believe, and more and more people also believe, is that NAD and these other things that raise NAD are working… and also raise virtual, are working because they’re actively turning on the body’s defenses against aging. It’s not a passive effect. It’s not a coincidence. It’s really just telling your body times are going to be tough, fight against this onslaught. NAD is one of the best things that I know of to turn on these sirtuin defenses. Dr. Gundry: 37:58 You and I take the approach that supplementation is a very important component of successful aging, and that’s controversial. Believe me, I was the original anti-supplement guy. When I got into this, I did think they made expensive urine. Are you saying that you could take these NAD boosters and achieve all the effects that you would need without fasting, without exercising, without doing any other trick? Is it a genie in a bottle? David S.: 38:39 No. There’s no magic bullet here. Dr. Gundry: 38:42 Darn. Oh, come on. Help me here. David S.: 38:44 There’s no easy way out of this. First of all, I don’t know if these pills are going to make me live a lot longer. So far like you say my father and I are not dead, so that’s good. Right? Our blood biochemistry looks great. We do this under doctor supervision. It’s not just random stuff, and I wouldn’t ever talk about it unless I knew a lot more about it than the average person. It’s not a substitute for a healthy lifestyle by any means. That’s the reason I do these other healthy things. One of the best bits of evidence I can give you is that we treat a lot of mice in my lab to make them live longer or healthier or stronger or fitter. What we see is that if we combine Resveratrol with restricted feeding or if we combine NMN with exercise we get a greater benefit than either of those things alone. Dr. Gundry: 39:48 I think that’s a great takeaway to kind of finish this up. I’ll tell you what. You and I have both been on Dave Asprey’s podcast, so we’ve both known Dave for a long time as well. Give me your take. Are we going to make it to 180? Is that Dave’s pipe dream? What do you see coming down the pipeline? David S.: 40:10 I think diet and exercise can get us beyond 80 for sure on average. Most people I know that have looked after their bodies live into their 90s in a healthy way unless they’ve got really bad genes or they’re unlucky. That’s the minimum I think we can expect. Can we reach 150? I think that’s not going to be for everybody certainly. We’re going to need some major breakthrough in science to get there. But there are major breakthroughs being made in the field all the time. The one that gives me a lot of excitement and hope is our ability now in my lab to reprogram cells to be young again. We have what’s now a gene therapy, but eventually will presumably be a pill that literally turns back the age of cells, what we call epigenetic reprogramming. That could be a treatment one day that literally turns the clock back. Dr. Gundry: 41:16 Wow. On that note, I think that’s a great place to end. Where can people find the book? Where can they learn more about you? Of course they can type anywhere in PubMed and find you all over the place. Tell us about Lifespan. David S.: 41:36 Yeah, sure. So Lifespan has tips on how to live longer and what I do. But it also talks about the future. Like I talked about, we got just into this reprogramming, but it’s all in there. You can buy the book at where all good books are sold around the world. It became a New York Times bestseller, so thank you everyone. Dr. Gundry: 41:36 Congratulations. David S.: 41:59 You can get it…You can also learn more at lifespanbook.com and even sign up for a newsletter that I put out every month on the latest musings and what’s going on in my brain. Other than that- Dr. Gundry: 42:13 Oh, man. I don’t get your newsletter. Well, of course, I can call you up any time I want. David S.: 42:17 That is true. You have me on speed dial. The book is cutting edge, but there’s always new stuff coming out. I’m on social media wherever good social media is to be found. Also, publications. So those of you who are doctors or scientists or just very curious, we have a number of papers, three in fact, that are now put online that will be published, but you can read them before they’re even published. If you Google myself either at Cell Press or what’s called bioRxiv, B-I-O-R-X-I-V, B-I-O-R-X-I-V, you can read this research that is written about in the book. Dr. Gundry: 43:01 Oh, that’s fantastic. All right. So thanks again, Dr. David Sinclair. Always a pleasure for learning your knowledge and sharing it with my listeners. We’ll see you soon I hope. David S.: 43:13 Sounds good. Thanks again, Steve. Dr. Gundry: 43:15 Okay, it’s time for the audience question. Erica Frantz on Instagram asks, “How can I do a fast and not have it backfire by releasing too many toxins, heavy metals, into my bloodstream?” This is a great question, and I’m so glad you asked that. Our problem in Western society is our fat cells is where we store heavy metals and toxins, all the pesticides, all the herbicides. All the heavy metals are stored in fat. When we fast we release all of those from fat cells because obviously we’re using our fat. So the idea of fasting as a healthy technique would’ve been a brilliant idea in a third world country or with all great religions, but currently it’s a very dangerous technique, and Dr. Joseph Mercola and I discussed this in detail. So what do you do? There’s certain things that you have to do. Number one, we have a horrible detoxification system in our liver. You should take liver boosting enzymes that are phase one and phase two detoxification pathways. That includes milk thistle, dandelion, artichoke extract, just to name a few. D-limonene is another one. Next, the liver does not detoxify heavy metals. It has no ability to detoxify heavy metals. So what it does in its brilliance is says, “Well, I’m just going to put these heavy metals like mercury, like lead, like cadmium, into the bile, and I’m going to excrete it into the intestine, and good news, I’ll just poop it out.” Nope, doesn’t work that way. Once it’s in our intestines we actually reabsorb the heavy metals. So they don’t get pooped out. That’s the biggest mistake I see in people who are detoxing. They’re actually retoxing. So what do you do? You have to take Broken Cell Chlorella and you have to take activated charcoal. Both of these agents will bind heavy metals. In fact, I’ve gotten mercury levels down in all my patients with Chlorella and activated charcoal. So those are the tricks, and please, please, please do not do a fast without these agents. You’re going to regret it. I see that all the time. Great question. Now, it’s time for the review of the week. Susie from Oklahoma says, “Thank you for your podcast. So informative and helpful. You are a wealth of information. Thank you for sharing it. I really enjoy when you interview people about their experiences eating plant paradox and examples of their healing.” Well, thanks a lot, Susie. This is why we do this. Thank you again. That’s all for the Dr. Gundry podcast today. We’ll see you soon. Thanks for joining me on this episode of the Dr. Gundry podcast. Before you go, I just wanted to remind you that you can find the show on iTunes, Google Play, Stitcher, or wherever you get your podcasts. If you want to watch each episode of the Dr. Gundry podcast, you can always find me on YouTube at youtube.com/drgundry, because I’m Dr. Gundry, and I’m always looking out for you.