August 31, 2020

How to improve your wellness and age later – Dr. Nir Barzilai

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Dr. Nir Barzilai has always been fascinated by the aging process. Most of us know if we don't treat our body well, we will likely succumb to one or more chronic diseases like heart disease, cancer, diabetes, or neurodegenerative disease. 

Dr. Barzilai has been studying the genes of SuperAgers, the people who have no just a longer life span, but a healthy lifespan. We're beginning to identify the longevity genes and crack the code on human aging. 

We get into the science during this discussion, but Dr. Barzilai also shares some practical tips so you can Age Later.


[00:04:17.010] – Allan
Dr. Barzilai, welcome to 40+ Fitness.

[00:04:20.060] – Dr. Barzilai
Nice being with you.

[00:04:21.740] – Allan
Now your book, Age Later: Healthspan, Life Span and the New Science of Longevity is obviously a topic that I think more and more as I age it just kind of one of those things that just sticks out like, you know, I see people living to their 90s to one hundred. And plus, I was watching a show on Netflix the other day called Old Guard, and they were effectively immortal until for some reason they weren't. But you're talking about people in this book that are almost immortal.

[00:04:52.910] – Allan
I mean, they're living 40 percent longer than the average. And that's that's incredible. And if we're going to live that long, obviously, we also want to have the health span to go along with that. So a lot of good stuff. I want to pull out of your book, and I really appreciate the opportunity to review it with you.

[00:05:09.080] – Dr. Barzilai

[00:05:10.260] – Allan
OK, so you got interested in aging. You're talking about meeting up with your father. You're walking with your father.

[00:05:18.200] – Dr. Barzilai

[00:05:19.980] – Allan
Grandfather. And he got really he got really tired walking up a hill and that kind of got you at an early age thinking about aging. And in your study, as you got older, you know, you're actually studying this topic. You identified a term you call super agers. Can you can you define super agers and some of the traits that you found in people that live for a really long time?

[00:05:41.390] – Dr. Barzilai
Well, let me just go back and say that in the field of aging, we call it Gero science. We made really great strides because we kind of ignored the fact that it's really very complicated when you look at the components. But it's less complicated when you look at models that seems to age longer, to age slower, I mean. And to have an increased health span. And there are models like that in nature. And once they were discovered, once you could do it, imitate some of the findings in genetic ways, it became much, much more achievable.

[00:06:27.680] – Dr. Barzilai
And we understand now that aging is flexible and we can target it. And the reason I went to the centenarians at the same time where those genetic component have been discovered and very exciting models, was because I thought, you know, let's go to humans who live 100 years old because they lived, as you say, they lived 40 percent longer than their cohort. You know, now people are living longer anyhow, but we're not living to age of 100 and ask, what are the reasons for their slow aging, and that's why we got them. And in order to be in my study, basically you have to be healthy at age 95. Now, if you're one hundred and twelve and in coma, you still make it because it's the genetics that we were after. OK, and we wanted to find the genetics component of exceptional longevity, but being healthy and living independently at 95 showed that no matter what, they've exceeded their health span by a lot compared to other people. And that that's our definition of the super agers.

[00:07:49.530] – Allan
OK, now you found a few traits that are fairly common amongst the super agers dealing with cholesterol, growth hormone. And I'll be honest with you, the last part of that, you got a little over my head in the science.

[00:08:06.810] – Dr. Barzilai

[00:08:07.350] – Allan
But can you talk about those traits, what they are and what they mean?

[00:08:11.400] – Dr. Barzilai
Yeah. So, for example, when we started looking at the centenarians and doing just kind of routine tests, initially routine tests, one thing that was really remarkable is that they had a high level of the good cholesterol of HDL cholesterol. It actually ran in the family. It's kind of complicated because the good cholesterol goes down when you look at this certain individual longitudinally, OK, you take the same person. The HDL every year, every eight years will go by five fold by five points.

[00:08:46.890] – Dr. Barzilai
So basically 100 years old, their HDL should be like 20. But it wasn't it was normal. When you, when you look at those data cross-sectional, when you look at population, it doesn't change with age. It's forty five for men. Fifty five for women. So how can you explain that in individual it goes down and as it's the same. Well if this is a longevity factor, if this protects you against dying, then the people where it goes low, they die and the people with high level maintain the high level up.

[00:09:22.410] – Dr. Barzilai
And this is kind of what we've discovered in our centenarians. So they did have high level of HDL, which made us ask, well, what is the genetics of that? What are the changes in genes that they have and others do not have that explain this high level of HDL in their families. And we found a couple of them that proved to be not only interesting, but they're, it was kind of realizing the promise because in each case, a drug was created for them. One by Merck and one by another pharmaceutical called Ionis. So it really was a proof of concept that was really interesting and important.

[00:10:12.420] – Allan
OK, and now the second trait you talked about was human growth factor.

[00:10:17.530] – Dr. Barzilai

[00:10:18.310] – Allan
Particularly the IGF one.

[00:10:20.410] – Dr. Barzilai
So, again, one of the first thing that was discovered in nature, in genetics is that the animal models that the animal dwarfs in many models, they live long. Even the nematode, when you take out the nematode warm, when you take out the growth gene, they live much longer than the little dogs live longer, the ponies live longer. And when you mutate many of those growth genes, you get an extension of health span and lifespan.

[00:10:59.320] – Dr. Barzilai
And I actually thought that that's probably not going to be the case in humans. But, you know, when you write a grant, you come up with hypotheses. You don't care if it's true or not. And my belief had nothing to do here. I was convincing that I should get the money to do it then. And we found out that it is very important. In fact, more than 60 percent of our subjects have mutations or changes in the growth hormone pathway, the growth hormone pathway.

[00:11:31.930] – Dr. Barzilai
There's more than one gene. There's about growth hormone, but there's another gene that's very important. That's called IGF1. And that's what growth hormone does when it binds to the liver, it increased growth IGF1 and then IGF1 has this receptor and growth hormone as receptors, there's a whole pathway. And this pathway is impaired in our centenarians. And so we think that actually look, it's to explain simply the theory here is that at a certain point you have to change your energy from growth to defense.

[00:12:13.900] – Dr. Barzilai
OK, now you're playing defense. You have to stop this growing and you stop you have to start like pointing the energy to do something else, like stop the genetic breakdown, stop the breakdown, basically. And so people who are already tuned like that are aging just just later.

[00:12:39.340] – Allan
OK, so the big anti aging movement has people taking testosterone and in some cases they're also taking growth hormone, but in fact, that might actually be shortening their lives.

[00:12:53.950] – Allan
Right. And I would add estrogen for women in this case. Look, we were rushing and by the way, I was there at this camp initially, when I came to aging, there was no aging, not much of aging. There are several people who had apostasies, but there is no really big signs of aging. And I thought, well, I should be an endocrinologist because one thing is clear, all those hormones are going down, which means let's just replace them. And that's how we'll do aging.

[00:13:35.780] – Dr. Barzilai
And it turns out that it's almost the opposite, because, look, when you have the breakdown of aging and you're seeing lots of things, some of them can cause aging. There's no doubt some of them maybe don't play any role, at least in our lifespan. But some of them may be protective. After all, when you start to have this break down, just like you have an infection, you have inflammatory response. When you have a breakdown of aging, you have a response. By the way, some of this is inflammation too.

[00:14:12.860] – Dr. Barzilai
So it's it's not as simple as to say, oh, it's high, we lower that or it's low and will increase it. It's not like that. And I think the best, and all the examples that you gave are really good. But, you know, the estrogen was such a controversy. I mean, some people say why the Women's Health Initiative even went to estrogen. We knew it's going to be good.

And now that it's bad, people are saying, well, maybe, you know, maybe no, it's not what it is. Maybe there's other explanation. And they basically focusing on the fact that if you give estrogen between 50 and 60, maybe at that point you get some benefits. But still, the women who are older than 60 didn't do well in estrogen. So it's going to it's going to get to them, OK? And it's kind of the same with testosterone.

[00:15:09.360] – Dr. Barzilai
And I mean, no matter how we looked at testosterone, the risks outweigh the benefits. And growth hormone is a really open area because there is a lot of business in growth hormone and lots of elderly people are getting growth hormone.

[00:15:29.930] – Dr. Barzilai
And in the meanwhile, I'm discovering by totally unbiased way that probably this is not a good idea to give growth hormone OK, because it's the opposite. If you have low growth hormone, you're much more protected. You can live healthier and longer.

[00:15:47.180] – Dr. Barzilai
I would say just one thing to be aware of, this effect of growth hormone is huge in females and not as much in males, both in animals and humans. In other words, growth hormone injections might not be as risky for men as they are for women, but we are not sure of how risky it is. What is the magnitude of this effect? So there's a little openness here, but be careful.

[00:16:22.240] – Allan
Yes, and then when you get into the mitochondria, I think you did lose me a little bit there only because it got pretty, pretty detailed. But can you kind of go into, you know, the mitochondria does a little bit more than just provide energy in the cell. And the things you're finding is that that's part of what's causing the aging or the slower aging.

[00:16:44.080] – Dr. Barzilai
Right, so yet so let me let me describe the evolution of that, OK? Once upon a time, many hundreds of million years ago, there was the initial cell. And the cell had a real problem, the cell had a lack of energy could do only glycolysis. There's not that many calories from glycolysis. And the cell was also exposed to oxygen, which is very toxic. So there was the cell, but next by the mitochondria was walking. And the mitochondria is really a bacteria that can do two things, can harness the oxygen and also make energy out of that.

[00:17:38.180] – Dr. Barzilai
So that's how the cell got the mitochondria. OK, so these mitochondria is a collaboration of bacteria and and the cell to make it better. And it was felt that in this marriage the cell really was calling the shots because a lot of the messages came from the nuclear genome, OK, for the from the nucleus of the cell. Right. And what we kind of discovered is a new biology that really showed that this mitochondria has hundreds of its own messages.

[00:18:20.480] – Dr. Barzilai
And so there's a crosstalk not only between the nucleus and the mitochondria, but those peptides that are being manufactured by the mitochondria are exiting and they're influencing other effects across the body. And they are known as mitochondrial derived peptides. So, yeah, you know, about the mitochondria and the powerhouse and the fact that mitochondria declines with aging and that is associated with lots of diseases. And we really need to make sure our mitochondria is OK.

[00:18:54.890] – Dr. Barzilai
But there's another aspect of the mitochondria, which is the messages they have. And I have a company that I founded with my co-founder, Hossy Cohen, who is the dean of USC School of Gerontology. It's CohBar where we are actually making therapy out of those peptides that are basically offering resiliency against many of the diseases of aging.

[00:19:25.940] – Allan
OK, so so these are traits that we would have. You know, if we're looking at our own aging, there's seven what they call, I guess, Hallmark's. You didn't identify these, but you mentioned them in the book. So kind of like the areas where your field looks, a couple of them that I was really I was obviously familiar with and you've gotten into already is the epigenetics, but also inflammation and a few others. Can you kind of go through those and why looking at all seven of those is important.

[00:19:57.380] – Dr. Barzilai
By the way, I have eight there, but, you know, we had seven initially, the Europeans had nine, then Brexit happened, you know. You know, those those hallmarks we we initially thought to call them the pillars of aging. And then we said, you know what, we still are gathering data. It's going to change. And if you all of a sudden take a pillar, the whole building would collapse. So let's not call them pillar, let's call them Hallmark. But in fact, I'm using much more another term, which is knob's, because what makes a hallmark hallmark is the fact that there's a good research that shows that if you intervene then you change health span and lifespan.

[00:20:47.930] – Dr. Barzilai
OK, that's really the evidence. Another thing interesting, those hallmarks are interconnected in the sense that you can target one of the knobs and it's going to influence the others. So I'll give you an example. One of those hallmarks is called Purtill Stars. What is Protostar? We are manufacturing and with aging, we're manufacturing in increase amounts of proteins that are just wrong. They're not folding right, they're not accumulating. They're doing traffic jams and they're causing lots of problems.

[00:21:33.120] – Dr. Barzilai
Now, there is a way to deal with it. There are several ways to deal with it. But one is called autophagy. Autophagy is the garbage disposal of the cells. OK, there is the ability to garbage disposal that is decrease with aging. But by the way, it's a green energy garbage disposal because it gets those proteins or whatever garbage takes them to little components that are, that can be recirculated for energy again. And autophagy, by the way, is eating yourself, but it's not really eating yourself, it's cleaning yourself and making available better, better body.

[00:22:11.430] – Dr. Barzilai
So when you turn on autophagy, which you can do genetically or by drug, you get the effect on the mitochondria. You get the effect on the metabolism and you get the effect on immunity. OK, and other things. Another thing, two of the hallmarks are decline in immunology, in immune function and also inflammation or as we call it, inflam-aging. Those are the really two things that are relevant now to COVID. And let me make a point out of here, COVID.

[00:22:51.840] – Dr. Barzilai
So I'm telling you how we went from Hope to promise. Right. And we're going to realize the promise. And then COVID landed on us. And it's it must be an opportunity to but COVID landed on us and really showed ages. It showed that if you're 80 years old, you're two hundred times more likely to die if you're 20 years old. OK, it's really the major risk for dying.

[00:23:16.800] – Dr. Barzilai
And by the way, multi morbidity, lots of diseases for me they're just how old. But you are biologically, you know, at age 65, half of the people in Europe have less than two diseases and the other half have more than two diseases. So they're they're not super agers. They're aging really quicker. Aging is the major risk factor for COVID. And this is because of something that happened to those Hallmark's the immunity declines so the virus is more likely to attack you.

[00:23:50.550] – Dr. Barzilai
And second, what the people die from within few days of the infection, they get a very big inflammatory response uncontrol that is destructive, that is destroying the lung, and that is really causing the death. Those are two of the hallmarks of aging that can be targeted. Actually, both of them can be targeted. And we're trying to find a way for the public to know that, know what to do about it. But this is just, I think, important insights on the hallmark. If you want something more specific, you can ask.

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[00:25:58.080] – Allan
That was wonderful because, you know, I think that really when I when I saw that picture, because you had a graphic in the book, you could see that interrelation, you know, and you did an excellent job there with Covid as an example of, you know, you've got two things. You've got the immune response and then you've got the inflammation in the body and how they're interrelated. So now that's really good.

[00:26:19.380] – Allan
You got into one topic that I thought I thought was a little interesting. You know, being in the health space, I have a lot of friends that are in the health space. And I have one friend that was on metformin while he was he was diabetic. He reversed his diabetes and he got off of metformin. But he decided for personal reasons, longevity reasons, to start taking metformin again. Now, he exercised he rides his bike. He does a lot of different things. So he was already exercising, which was a benefit. But then when he started talking about metformin, I was like, OK, well, until I saw it in your book. So can you kind of talk about the benefits we get from something like metformin or exercise?

[00:27:00.810] – Dr. Barzilai
Sure, really interesting topic. And in fact, let me say, I have many interest in metformin, but it's all because of overwhelming interest. We're trying to do a study that will demonstrate to the FDA that aging can be targeted and then variety of age related diseases, not only one, but few can be delayed substantially. OK, that aging is a preventable condition from age related disease perspective. To thread this needle, we had to find a drug that does it, a drug that is available, a drug that doesn't have pharmaceutical about it because we were just scientists and a drug that really will serve as a tool to pave the road.

[00:28:00.780] – Dr. Barzilai
Because because the point is, if the FDA doesn't have indication to target aging, then health care providers don't have to pay for it. If health care providers are not paying for that, the pharmaceuticals are not going to jump in because they need a business plan. I realize that. So we needed to break that. And that's the Gero-science effort and American Federation of Aging Research. And the NIH now are all partners in the study.

[00:28:29.850] – Dr. Barzilai
That's called TAM, targeting aging with metformin in order to show that aging can be targeted. OK, so that's the big picture. OK, of course you have to understand that because of that I'm not selling metformin to anyone. OK, that's not the purpose. But I need to do the study in order to show that. But why why metformin? Well, first of all, if you give metformin to almost all animals. Most recently a fish, one of the fish that is in the lab now investigated. It's called killing fish, killing fish, all other animals. You give them metformin, they live healthier and longer.

[00:29:11.000] – Dr. Barzilai
OK, but in in people, because and by the way, metformin, just from historical perspective, it's a drug that initially in the forties of last century. OK, so 80 years ago was used to prevent flu and malaria. In other words, somebody discovered the fact that it has some strong effects. While doing that, people also demonstrated that people who got metformin and in high glucose level, their glucose level normalized. And in fact, then it all became about diabetes. And it's the first drug of choice to treat Type two diabetes, which is the major form of diabetes.

[00:30:02.160] – Dr. Barzilai
So metformin is out there for more than 60 years. So everything you want to do, you know about metformin, we know about metformin, OK? It's been around there currently almost two hundred million people around the world that are on metformin. So it's generic. There's no pharmaceutical beyond it. It's cheap. It's safe.

[00:30:26.230] – Dr. Barzilai
Perfect tool for us. What is the evidence from humans, Will? If you take non diabetic and give them metformin, you'll prevent diabetes in them. OK, a big clinical study, it's called the DPP. Another big clinical studies were to look at the effects of metformin versus other drugs on prevention of cardiovascular disease and diabetes, metformin prevented cardiovascular disease and diabetes.

[00:30:57.820] – Dr. Barzilai
There's many association studies, hundreds of association studies, all showing that people in metformin have less cancers, all all kinds of cancers. There's both clinical studies and association studies that there is less cognitive impairment and less Alzheimer's in people with metformin. And maybe the most fascinating to me is a huge study that was done in the UK, where in the UK you can go into the pharmacies and get data, you know, not the name of the person, but other medical information on those on those subjects.

[00:31:43.070] – Dr. Barzilai
So they took like 170,000 people and took this 78,000 that are on metformin data control with age match people, you know, in the treated by the same doctors getting subscriptions from from the same pharmacies. And basically they showed that compared to non diabetic people with diabetes and metformin had much less mortality, 17 percent less mortality over five years of follow up. Now, the people with more mortality had no diabetes and the people on metformin had diabetes, they had they were more obese and more sick to start with, and yet they live longer.

[00:32:36.000] – Dr. Barzilai
So take everything I told you about metformin and you see that it's a real drug that has real effect on many diseases in a composite of diseases. And that's why we use it as a tool to get permission from the FDA to target aging with it.

[00:32:58.840] – Allan
OK, now we can get we can get a similar effect with exercise, but in the book you kind of talked about using both of them together.

[00:33:06.260] – Dr. Barzilai
So, you know, so one of our challenges is we have all those hallmarks. Let's say we have a drug for all the hallmarks. Can we use all the combination together?Will it be additive? And the answer is it's specific. So we collaborated with a group that done the following study. They took elderly and they exercise them. A half of them were exercise with metformin and half of them without. And they actually that was an NIH grant. And they predicted that metformin will be editive to the effect of exercise. But to their surprise and by the way, there are other groups that showed the same.

[00:33:58.750] – Dr. Barzilai
All the people that exercised did better, but the muscle of the ones that exercised was bigger than the muscle of those that exercised and were on metformin. So it looked like metformin was actually inhibiting the growth of the muscle. OK, we were interested in that because in one of the supplements that you don't read, they also show something fascinating that although the muscle was a smaller, the strength was the same between two groups.

[00:34:37.820] – Dr. Barzilai
OK, so for me it means per gram of muscle. The one on metformin is better. OK, why is that? And what we did with this group we got, they did biopsies before and after treatment of the people. And we looked at the transcript of those biopsies and we showed exactly the mechanism by which muscle growth with exercise and why and how it wasn't growing as much with mitochondria, it was totally fitting. But metformin increased 516 other transcripts that are more of the aging protected transcripts.

[00:35:23.080] – Dr. Barzilai
OK, so they affected autophagy, as I said before, some other things they decrease and or some other things. And so at the end, you can choose if you want to exercise because you want big muscle, don't take metformin. But what the metformin did is it didn't affect the force but affected the aging of the muscles. So at the end it had the similar functional effect but you can choose what you want to do.

[00:35:58.890] – Allan
Yeah. And that kind of falls in line if you think about it. When we first started this conversation and we were we were talking about the growth factor in the hormones and people will often take those hormones because they want to get a little bit more muscular even as they age. And then here we are saying, you know, if you can build the quality strength of muscle without building that extra size, metformin will help you do that. And I guess the final one is…

[00:36:26.270] – Dr. Barzilai
Can I just say something about that. Look, a lot of what growth hormone is doing and for which you say it is quite expensive. Right. So how people, why people are buying it. Because they see something. What they see growth hormone melts fat under the skin. OK, that's why people seeing that something is happening when it melts fat around your muscle, your muscles look bulgier, OK? There's very few studies that shows any effect on strength. OK, maybe there's a little bit, but it's not much at all.

[00:37:08.370] – Allan
Yeah, that's going to come with the testosterone where you're recovering a little faster, therefore you're working out more often and that's typically where, you know, bodybuilders, they use either testosterone or steroid. That's where they see the size come from is they're just able to train harder and longer and more often. And that's what they get.

[00:37:26.820] – Dr. Barzilai
But, you know, what you said is very important. So I want I want to use this opportunity. We're talking about 70 years old. We're not talking about bodybuilders below 40. OK, so what I'm telling you is true for aging, OK? I'm not saying it's untrue for the others, but I'm not saying it's true either. OK, so let's say let's just build a Chinese wall.

[00:37:56.810] – Allan
Yeah. And I think that's where I was going with this is to say, you know, a lot of the things that we would be doing to build muscle and look more aesthetically pleasing are not necessarily going to be good for aging.

[00:38:16.310] – Dr. Barzilai

[00:38:16.950] – Allan
OK, and one that I wanted to get into is I saw this on this show. It's been years ago. And you name them you call them chronies. But they're basically people that significantly under eat. And there's some science behind how under eating can and calorie restriction can allow you to to live longer. We see that. We've seen a lot of that. But you talked about in the book ways that we can use things like intermittent fasting and ketosis to mimic that effect.

[00:38:46.680] – Dr. Barzilai
Right. So I want to say something about this paradigm. When we started caloric restriction, we knew another fact that if you give zero calories they all die in a few days, right, so we know that there are limits. OK. The question is how much how much calories, right?

[00:39:10.520] – Allan

[00:39:10.770] – Dr. Barzilai
And I'm not sure that the chronies took the right amount of calories. I think they took less calories than what they should have. But for me, one of the things that I, that we've done that always has to go back to the science. Yeah, we did those caloric restriction everywhere all the time, and it was always successful. OK, and whenever I test a drug that might affect aging, one of the control groups is the caloric restricted animal. Right. But what we did with the caloric restricted animal is the following. We would come in the morning. They were hungry. We would put all the food in the morning so they would eat all the food in the morning and will fast for twenty three hours more. OK, we really OK, because we said, oh, you know what caloric restriction means, it means that less for breakfast, less for lunch, less for dinner.

[00:40:07.490] – Dr. Barzilai
But that's not what we did to the animal. When we started actually doing the caloric restriction throughout the day, they were thinner, but they didn't live longer, which means something is in these. Fasting is important for the benefits of caloric restriction.

[00:40:26.160] – Allan
Do you think that has something to do with, you know, with cell death and the bodies reusing of materials a bit a bit more efficiently?

[00:40:35.750] – Dr. Barzilai
Well, we are looking we're looking now and it really we're looking at it what happens in this time course of fasting. So we're taking young and old people, men and women, and we're trying to look what happens to the biology of aging. We're going to take their cells and see at which time they become younger. Right. We are going to see in the plasma, when are the ketones starting to go up? When is the insulin going down and all that and and really determine. Because, look, first of all, if all it takes is 12 hours, then more people will be able to do 12 hours.

[00:41:13.820] – Dr. Barzilai
They'll they'll just skip lunch right? The 16, eight hours, which is what I'm doing is just surprisingly easy. All you do is skip breakfast. And you know that in 16 hours you can have whatever you want and you're not limited, although you find out that you eat less, but you're not limited. And I think this is a big advantage. If you gave me a diet for three months, I could fail any day. I could break any day. But I'm not going to break if I have two hours to go. I'm just not going to break. OK, so that's easy. And another thing, you lose weight quite rapidly initially, then it's stabilized, but you lose weight, so good diet.

[00:42:00.230] – Allan
And I think that's kind of the point. You know, when I get into ketosis, which I'm approaching right now, I naturally stop wanting to eat breakfast. I just when I wake up I'm not hungry. That's a very productive period of time for me. So even stopping the eating because it's quiet. You know I get up about four or five o'clock in the morning. And so I have about four hours before any emails are coming in or anything else is going on.

[00:42:25.610] – Allan
And those are the most productive hours of my day. So I don't want to stop and eat. Then I want to wait till the email start coming and then I can eat my breakfast while I'm reading email. But, you know, I think there's a lot to this and I appreciate that you're taking the time to to study how all these different protocols and in some cases now we're going to say medications can target aging because again, we don't want to just get older. We want to we want to have a long health, healthy life, too. So try to get that biological age lower than our chronological age.

[00:43:01.970] – Allan
Doctor, I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get and stay well?

[00:43:11.700] – Dr. Barzilai
Well, first of all, I agree with this definition and, you know, with my book, I'm not trying to sell any medication, although I have a lot of comments on many of those and not on medication, on stress, on society on interaction.

[00:43:33.480] – Dr. Barzilai
I mean, boy, the older people are so lonely with this covid-19. They are just so lonely. There's so many things that are part of health span. And it's not only medical, it's emotional, it's everything. What I'm what I'm trying to do is really to say something else. So I'm sorry. I'm not you can ask me specifically, but I'm trying to do something else in my book. I'm trying to say there's a lot of information out there. OK, here, we're going to have information out there.

[00:44:11.250] – Dr. Barzilai
How how do you know what's real, what's marketing, what was proven, what was hope, what is totally fake? OK, it's very difficult. And I'm saying, look. I'm going, I'm basically I'm impressed only when I see a clinical study, a clinical study means we take a population. Half of them are on a drug, half of them are in placebo. They don't know. The doctors don't know. And we have an outcome that we calculated. We know how many people we need and how much time we need. And this is a clinical study. And that's the only way that you can be sure that you're doing the right thing.

[00:44:56.470] – Dr. Barzilai
And unfortunately, there are not that many of them. I brought as an example, vitamin D. Vitamin D is associated with every disaster in the world. OK, but just the same, except women with osteoporosis. Every time you give vitamin D to people in risk, almost nothing happens or very little happens that the effect of vitamin D seems huge and when you give vitamin D, almost nothing happens or very little happens.

[00:45:30.020] – Dr. Barzilai
So there's no compelling reason. By the way, I have low vitamin D level. My doctor wanted me to take the vitamin D and I said show me to me. And he said, well, maybe if you have osteoporosis, said, let's do a scan. I did a scan. I actually have bones that are five sizes thicker than the average. And I'm thinking, you know what, maybe that's why I have low vitamin D level, because we might not know all the direction. Maybe the fact that my bone is like that, it decreases the conversion of vitamin D because it needs protection. So I don't need to be all bone. OK, so so for me, vitamin D is not a is not an issue because the clinical studies have not supported it.

[00:46:24.340] – Dr. Barzilai
There is another part of vitamin D, though, that I would give us an example. If you want to take vitamins, at least vitamin D didn't show to be harmful. So that's also good. So, you know, we can go one by one. And so but then there's another category. There's a category of drugs that have promise, OK, based on lots of data, maybe animals data. But there is no clinical study and maybe there won't be clinical study, you know, there are nutraceuticals. OK, so in that play, in one of the examples, anime and ad supplements and a man. So I don't have anything against taking in a man.

[00:47:13.130] – Dr. Barzilai
I think I don't understand everything. We don't understand everything we need to know about any men, but it probably has strong anti-aging properties. And I don't see really that it's doing harm, although I'm not in absolute way sure of that either. OK, are they good people who have cancer? Maybe it's not good in people with cancer. OK, there are lots of safety issues that we could deal. But the point really that I'm trying to stress is we have to do better than just reading something in the Internet and taking it much better than that. And there's a way to make progress in that.

[00:47:52.510] – Allan
Yes. Well, Doctor, thank you so much. If someone wanted to learn more about you, learn more about the book Age Later, where would you like for me to send them.

[00:48:00.650] – Dr. Barzilai
So Age Later can be bought on Amazon. And if you want to have more information about the book and about health, the American Federation of Aging Research, AFAR.org is where you can find more about the book.

[00:48:21.810] – Allan
You can go to 40PlusFitnesspodcast.Com/449 and I'll be sure to have the links there. Dr. Barzilai, thank you so much for being a part of 40+ Fitness.

[00:48:33.950] – Dr. Barzilai
A pleasure. Good luck to you and and nice mission to have.

[00:48:38.150] – Allan
Thank you.


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