Dr. Frank Lipman (00:00):
I can’t stress this enough, recovering from injuries, recuperating, don’t let those muscles tighten because the way our body works is to compensate and tighten somewhere else or overuse another muscle. It’s really important to have those muscles working efficiently.
Dr. Mark Hyman (00:19):
Welcome to The Doctor’s Farmacy. I’m Dr. Mark Hyman and that’s pharmacy with an F, F-A-R-M-A-C-Y, place for conversations that matter. And if you want to learn how to age well, if you want to learn how to avoid the ravages of diseases that we get when we age and also be vibrant and healthy and live well, you better listen to this podcast because it’s with my longtime friend, functional medicine colleague, leader in the field of functional medicine, Dr. Frank Lipman. And we have been buddies for a long time. We’ve been running this road for a long time. And then we were just joking at how old we’re getting. We used to be young whippersnappers in our 30s and 40s and we’re 60 and 65. So we’re doing okay. We’re doing okay.
Dr. Mark Hyman (00:59):
Now, Frank is really an incredible pioneer in the field of functional medicine, integrative medicine, and what he likes to call Good Medicine. It’s just good medicine. He’s the founder of Eleven Eleven Wellness Center and the chief medical officer at The Well in New York City, he’s a sought after speaker, and author of six best-selling books, How to Be Well, The New Health Rules, which is awesome, Young and Slim for Life and Total Renewal. And his newest book, which we’re talking about today is called The New Rules of Aging Well: A Simple Program for Immune Resilience, Strength and Vitality. Well, thank you, Frank, for writing that book so I don’t have to, and I really appreciate your digging into this topic of aging, because it’s something that’s interesting me more and more every day as I get older, as we all are. So welcome to the podcast.
Dr. Frank Lipman (01:45):
Thank you. Thanks for having me on, yeah, we are getting older. But thank God for functional medicine and what we’ve been doing. It helps a lot, makes it easier.
Dr. Mark Hyman (01:56):
You’re right. I mean, functional medicine, isn’t about treating disease, it’s about optimizing function and creating health. And when you do that, you’re learning how to turn on all this systems in the body that regulate everything that matters as we age in a positive way. And that allows disease to sort of not have a place to hang out. And it’s a very different approach to disease and to aging. And we’re going to get really deep into today because there’s so much research on longevity. And there has been so much research on healthy aging lately, far more than even 10, 15 years ago, it’s just astounding.
Dr. Mark Hyman (02:29):
So the goal really isn’t necessarily to live as long as possible, though I want to live a long time. I’m going for another 60 years. The real goal is to live well, to be vibrant, energetic. And my definition of health is basically, being able to wake up in the morning and do whatever you want. If you want to go for a horseback ride, you want to climb a mountain. You want to sit and read a book in a rocking chair, whatever it is that makes you happy, that’s what a healthy aging is. So how do we get there, Frank? How do we do this?
Dr. Frank Lipman (02:58):
Well, as you said, I agree 100%. It’s about getting up every day and enjoying your life and doing what you want to do and being able to do with… being able to do what you want to do without struggling. And the whole concept of functional medicine or optimizing functional or optimizing the human condition is really how you age well, I think the, a little tweaks you make… So you’re 60, I’m 66, and we’ve been doing certain things for many years. And as you get to a certain age, as you get into your 60s, and then you need to tweak a little bit more to actually affect these longevity genes or these nutrient sensors or whatever you want to call them, which actually affect your aging and help you just increase this health span as you’re talking about or optimize your health span as you increase your lifespan.
Dr. Frank Lipman (03:51):
You know what I find interesting, and I’ve always found this with functional medicine is a lot of this ancient wisdom is there, it’s how do we tap into this ancient wisdom? And now, as well as you pointed out, there’s more and more research, it’s how do we use this modern research and tap into this ancient wisdom and combine the two? And that’s how you age well, simple.
Dr. Mark Hyman (04:16):
That’s right. And it is pretty simple, I think to emphasize what you just said, there’s a difference between your health span and your lifespan. Your life span is how many years you’re alive. Your health span is how many years of your life are healthy. So you could look to be 90 and your health span could be 60, meaning you start to go downhill and you become decrepit and ended up in a nursing home for 20 years. That is not the way we want to live. You basically want to live fully until the day you die and then dropped dead if nothing. And I think that’s what I’m looking forward to.
Dr. Frank Lipman (04:50):
Yeah, exactly. I think that was the impetus of the book, especially now I have a grandchild and I want to enjoy my grandchild growing up and be healthy and vibrant and be able to play with. And that was sort of the impetus of what else can I do? I mean, yes, I eat well, I exercise, I meditate, sleep is very important. So I started getting into the research and what are these little tweaks that I can do as I get older? And so that was why I wrote the book because in a way, a selfish journey, I wanted [inaudible 00:05:30]-
Dr. Mark Hyman (05:30):
Dr. Frank Lipman (05:30):
… to helped me. And then as I do with my books, I try and make it simple for people because I think a lot of this research is very complicated. When you talk about the M2 and AMK, PK and a lot of these complicated concepts. My modus operandi is always, how do I make it simple for people to understand so they can take these nuggets and make changes in their lives? They don’t have to understand what M2 is, although we can talk about it. They don’t have to understand that you have these longevity genes that may be affected by certain of what you do. People just want to know what to do and how to do it. And that’s sort of what I try to do in the book.
Dr. Mark Hyman (06:12):
Your books are very good because they’re very clear. They’re simple, but not too simple. They’re very practical. And they’re laid out in ways that are in digestible chunks that allow you to just absorb the information. And I’m actually a little jealous because I love those books and I think they’re laid out so beautifully and you parse it down to just the essential things. And I like to write way too long books, so much I want to explain, but it’s just such a practical set of tools for living, not just aging well, but living well. So it’s the same thing, if you want to age well or be healthy now or live well and get rid of disease? It’s all the same. So what did you think the biggest factor is when it comes to aging that controls our aging process?
Dr. Frank Lipman (06:59):
Well, I don’t know if there’s one biggest factor, but the things that I’ve changed… We’ve probably live very similar lives. We have the things that I’ve changed now in the last couple of years have been, one, I eat less and I do that mainly by fasting a lot. I mainly do time restricted eating, which in a way, forces me to eat less. I have two meals a day instead of three meals a day. So I eat less, I rarely pay attention to my sleep like more intention than ever, which I think is important. And sorry, just to go back to what I eat and the other big change I made in my diet, as well as eating less and time restricted eating, I eat a little bit less animal protein which we can talk about, which I think is important. But as you get to my age, also sarcopenia, losing muscle mass becomes important.
Dr. Frank Lipman (07:58):
So as much as you need to decrease animal protein, you need to be careful about decreasing protein too much because you don’t really lose muscle mass, which is a big issue with what people suffer with as they get older. So there’s all this fine tuning that needs to be done. And it’s not, you’ve got to do X, Y, and Z. You got to alter it according to your needs and how you’re coping with the aging process.
Dr. Frank Lipman (08:29):
And then the last thing I think is, you got to be able to have a sense of humor. You’ve got to be able to laugh about it. I just can’t do some of the things I used to do. And it is what it is, you can’t fight it. You got to do the best you can, but you have to have a sense of humor about it, otherwise that’s not a good thing if you can’t laugh about it.
Dr. Mark Hyman (08:50):
Yeah, if we take life too seriously, it definitely creates age. And it’s interesting when you look at the studies on aging, the defining characteristics of a lot of centenarians, people who live to be 100 years old, is their resilience, is their ability to bounce back from life’s punches. We all get knocked to our knees by loss, by divorce, by illness, by this, by that, the difference is, how do we respond to those challenges? And are we resilient, or do we end up going into a downward spiral of depression and despair and dysfunction? And to me, that’s a really interesting thing. It’s your mindset, it’s your belief, it’s your sense of optimism. Optimists live longer, even if they’re wrong.
Dr. Frank Lipman (09:34):
Absolutely. Yeah, no, that’s 100% correct. And that concept I said earlier, it’s about mixing this ancient wisdom with modern science. One of the first things I got taught by my Chinese medicine teacher, Efrem Korngold and Harriet Beinfield was health is about resilience. How do you build someone’s resilience? It’s not about how well you are, it’s about how well you respond to the knocks in life to diseases, especially. And they always stress this concept of resilience. So I agree 100% with you, it is about being more resilient, healthy aging well is about being resilient. I can’t run for instance, I don’t jog anymore because I got a gammy knee but I walk and I cycle. So you adapt, and that’s with everything in life. And I think your attitude is important too.
Dr. Mark Hyman (10:29):
So Food is a big deal in terms of health and in terms of aging. So what is the biggest mistake people make in terms of food when they eat, if they want to live a long, healthy life?
Dr. Frank Lipman (10:42):
Well, I think people eat too much, especially as you get older. I think people eat too frequently, I think there’s, and more and more studies showing that time restricted eating or fasting, whatever you want to call, has very positive effects on our metabolism. There was a study that just came out, said doesn’t help you lose the weight, but that’s maybe the case, but I think and I’ve been monitoring this lately in our practice, we do more longevity stuff. We’ve been monitoring biomarkers for health and aging with people who are doing, whether it’s time restricted eating or doing fasting, mimicking diets or fasting, whatever way they’re fasting. But we’ve been finding that their metabolic markers change positively which is very interesting.
Dr. Frank Lipman (11:37):
Now, most people do lose a bit of weight, but for the most part time restricted eating or only eating in certain periods or fasting definitely has a positive effect on aging. So, I think eating less is important. Low carbohydrate diet. I mean, you came up with this brilliant term called the pegan diet, which I think is absolutely brilliant. So thank you for that, because that’s sort of-
Dr. Mark Hyman (12:04):
For people listening, the way I came up with that was I was on a panel with Frank and another doctor who was a vegan cardiologist. And Frank was more focused on paleo at the time, and they were arguing and fighting, and I was in the middle, like a ping pong ball and back and forth. I’m like, “If you’re a paleo and you’re vegan then I must be pegan. And I sort of laughed as a joke, but then I realized it really made a lot of sense because they have far more in common with each other than the traditional American diet. The only difference is where you are approaching, which is animals or beans and grains, that’s it, everything else is the same.
Dr. Frank Lipman (12:34):
Exactly, so I think if we want to look at a diet that was probably the best would be a some type of pegan diet. I’m not against animal protein, but as you get older, I think you need to eat a little bit less animal protein. Probably, I mean, this is what the research is showing that the amino acid composition of animal proteins in particular meat, is such that it inhibits or stimulates one of these biomarkers that you don’t… these nutrient sensors or longevity genes that you don’t want to stimulate as you get older, when you’re young, when you’re up to 40 or seven, you want to get stronger and build muscle then eating animal protein is good, but as you get older, it may be a problem.
Dr. Mark Hyman (13:25):
Hasn’t this research shown that actually, as you get older that you need more protein to improve your muscle synthesis, which is really the thing that makes us age faster. We’re talking about it before, but sarcopenia this loss of muscle results in a whole series of consequences, including inflammation and pre-diabetes and abnormal cholesterol and all kinds of issues that lower hormones, increased cortisol, and decreased testosterone. So it’s losing muscle is a very dangerous thing as you get older and it’s really why people end up in nursing homes. So how do we actually have enough, but not too much, because it seems like we need more as we get older?
Dr. Frank Lipman (14:00):
Right. So this is probably the most complicated issue as we get older, how much? Because I agree 100%, I do think we need to increase animal protein, but as you get older, you actually need to increase protein. So how do you increase plant proteins if possible, without increasing too much carbohydrates, because you want to still keep your carbohydrates down. So the way I get around it, I actually use, I have a protein shake and I use pea protein, and I put collagen in it, because collagen actually has… the amino acid profile doesn’t have as much [inaudible 00:14:40] that’s less of a problem, then I won’t have as much steaks.
Dr. Frank Lipman (14:44):
Not that I don’t have steak to not be having steak. It’s not that I don’t have animal protein, but I have cut back a bit and maybe eat a little bit more fish and a little bit… I have collagen a lot of the time. I’ve collagen almost every day. So I think that is a fine balance. And there’s no simple answer here. I think it’s a big problem not having enough protein as one gets older, but it also seems to be a problem of eating too much animal protein as we get older. That is if it’s fine, that to me, is the trickiest part.
Dr. Mark Hyman (15:11):
For sure. And what’s enough? We have these giant steaks and big hunks of meat and what we really need is about 30 grams to stimulate muscle synthesis, which is about the size of your palm. Now, if you’re Shaquille O’Neal, it’s a bigger piece. If you’re five years old, it’s a smaller piece. So you can use your own body as a sort of a measure of how much protein you need. But I think that’s a very simple-
Dr. Frank Lipman (15:37):
Right. And that’s why your pegan diet, I think is brilliant. I love that content. I think that sums it up.
Dr. Mark Hyman (15:45):
Yeah, exactly. Actually, it’s funny, you mentioned the pea protein because I created something called the pegan shake, which is essentially pea protein, pumpkin seed protein, and grass fed collagen protein. So, exactly what you’re talking.
Dr. Frank Lipman (15:57):
Right. And that’s what I do. I think that’s a way of getting around it to be quite honest. So that’s great. That’s brilliant. Yeah, fantastic.
Dr. Mark Hyman (16:05):
So let’s talk about this idea of time restricted eating because it’s a fast… and there are many ways to quote fast. There’s what we call intermittent fasting, which is maybe not eating for a whole day or three days or a week sometimes, there’s time-restricted eating, which is only eating with a certain time window. There’s fasting, mimicking diets, which are eating less calories for number of days to stimulate the same pathways. There’s ketogenic diets. They all do a very similar thing. So what is the biology of how this works? We know that these things do work looking at animal studies, human studies in terms of improving metabolism and the longevity file markers, but what are we seeing in how these methods actually work and what is the most effective? What should people be doing in order to take advantage of this new science?
Dr. Frank Lipman (16:58):
Right. So what they’re doing, I mean, the way I explain to patients is which I think is, I mean, they’re doing a number of things, but it’s triggering your body’s own self cleansing mechanisms. After you haven’t been eating for a certain amount of time, 14, probably more 16 hours, your body’s self cleansing mechanisms kick in, which is very important with the aging process, because one of the factors in aging is your body is, once and it goes back to functional medicine. The functioning of these systems don’t work as well. So the fast thing actually starts putting the autophagy system into play.
Dr. Frank Lipman (17:44):
So I think that’s probably one of the most important aspects. It also improve mitochondrial function, which also decreases as we get older. So the consequences of fasting or what happens in your body are often the opposite of what happens as you get older. So that’s why I think it’s so important.
Dr. Frank Lipman (18:06):
Which way of fasting is best is the way that you’ll do. I mean, whatever works easiest for a person is what I encourage. And I think the easiest one for most people is to eat dinner earlier and eat breakfast later, which is what I do and what I recommend. Now, if people want to do a day of just water fasting or three days or even more, that’s great. That’s a little bit more complicated and most people won’t do that. But if you can do that, that’s fine. There’s also this fasting, mimicking diet where you do five days a month of very low calories and no animal protein and low carbs. And we’ve actually created some shakes or my health coach has some recipes for people, if they want to do it themselves, you can buy the ProLon shakes as well. You should bring out some shake. I mean, it’s a no brainer to bring a five day program because it works.
Dr. Frank Lipman (19:03):
I mean, we’ve done it on patients that actually, there’s no question you get the same results, whether you do fasting, mimicking diet for five days, you do intimate and fasting. We’re seeing positive results across the board with biomarkers and different types of fasting. So I don’t think there’s one way, I think the way is to find the way that you will do and then works easiest for your lifestyle.
Dr. Mark Hyman (19:26):
Yeah. People say, “Dr. Hyman, what do you eat for snacks?” And I’m like, “I don’t.” I think snack-eating is the worst invention. Snack foods are typically really unhealthy and they’re a modern invention. And we used to not have to be eating all the time. And that’s the problem with eating all the time. And I think just to underscore what you said about these different approaches to time restricted eating, intermittent fasting, fasting mimicking diet, is they activate a set of mechanisms in the body that improve blood sugar control, they get rid of belly fat that increase muscle synthesis, that build your bone density, that increased testosterone, that increased brain function and cognitive function that improve your stem cell function that help your immune system. And they clean up all the debris in yourselves it’s called autophagy, which we’re just saying is sort of self-cleaning mechanisms. There’s mitophagy as well, that comes from the same process.
Dr. Mark Hyman (20:20):
So these are things that we actually can take advantage about without actually changing what we eat. Now, if you change what you eat, you get a double benefit, but these are very powerful things that we should be paying attention to in the science. And I think you just feel better. You feel more energetic rather than being sluggish from eating food all the time.
Dr. Frank Lipman (20:36):
Right. And you nailed it, thank you. All those mechanisms are what actually start… their function decreases as we get older, it becomes harder to keep your blood sugar under control, the muscle synthesis, brain cognition, and brain function. So fasting is like a magic pill or eating less. And it’s a magic pill. So to me, that’s probably the most important thing you can do.
Dr. Mark Hyman (21:07):
Kaya Purohit (21:08):
Hi, everyone. Hope you’re enjoying the episode. Before we continue, we have a quick message from
Dr. Mark Hyman about his new company, Farmacy, and their first product, the 10 Day Reset.
Dr. Mark Hyman (21:17):
Hey, it’s Dr. Hyman, do you have FLC? What’s FLC? It’s when you feel like crap, it’s a problem that so many people suffer from and often have no idea that it’s not normal or that you can fix it. I mean, you know the feeling, it’s when you’re super sluggish, your digestion’s off, you can’t think clearly, or you have brain fog or you just feel run down. Can you relate? I know most people can. But the real question is, what the heck do we do about it?
Dr. Mark Hyman (21:43):
Well, I hate to break the news, but there’s no magic bullet, FLC isn’t caused by one single thing, so there’s not one single solution. However there is a systems-based approach, a way to tackle the multiple root factors that contribute to FLC. And I call that system the 10 Day Reset. The 10 Day Reset, combines food, key lifestyle habits, and targeted supplements to address FLC straight on. It’s a protocol that I’ve used with thousands of my community members to help them get their health back on track. It’s not a magic bullet, it’s not a quick fix, it’s a system that works. If you want to learn more and get your health back on track, click on the button below or visit getfarmacy.com. That’s, getfarmacy with an F, F-A-R-M-A-C-Y.com.
Kaya Purohit (22:24):
Now, back to this week’s episode.
Dr. Mark Hyman (22:26):
And you mentioned the meat thing, and I think, to me, the science is still controversial. I talked to my friend, Valter Longo who’s one of the leading longevity scientists and he’s from Italy. And he’s the guy who developed the Fasting Mimicking Diet, has been on the podcast. And he said, he knew this woman, Emma Morano, who lived to be 117 years old. And she was anemic when she was young lady and her doctor told her eat three eggs a day, which she did for 100 years, literally.
Dr. Mark Hyman (22:56):
And then when she was in her 90s, I think she was frail and weak. And her doctor told her to eat a pound of meat a day. And she did, and she lived from 90 to 117. So I wonder how true is this? And if your other lifestyle factors are good, if you’re eating animal protein and getting adequate muscle benefit from it as you age, where’s that fine line in terms of animal protein?
Dr. Frank Lipman (23:24):
Well, I think this is the dilemma, not really a dilemma, but I think we all need to find what works for our bodies. But I think it also points out, affect to that in Western medicine, we always try and look for the one thing that works and everything works together. We have this complicated system and the M2 issue, maybe one small part of it. So I think you’ve got to find that balance. I agree, I don’t think… I mean, I know vegetarians would get cancer that the idea of animal protein causing cancer, vegetarians get cancer, vegetarians [inaudible 00:24:03], you’ve got to find out what works for you. And once again, I’m not trying to blow smoke up [inaudible 00:24:09], but the pegan concept, the pegan diet, I think, and finding your own type of pegan diet, I think is, if we’re looking for a solution, not that is a solution, but pegan diet in terms of food-
Dr. Mark Hyman (24:26):
Thank you, Frank.
Dr. Frank Lipman (24:28):
Intimate fasting, eating within that content of time-restricted eating, a pegan diet is the way we all should be eating.
Dr. Mark Hyman (24:35):
Yeah. And I think the other thing that that is important and I’ve noticed for aging is muscle. And I think we have a neglected organ, which is our muscle that we don’t pay much attention to. And this condition that we get as we age, it’s an extra ball. Like if you don’t do something to stop it aggressively, you will lose muscle. So you could be the same weight at 65 than you were at 25, but your body be twice as fat. And it literally looks like a ribeye marble steak, as opposed to a filet mignon, which is what you want for your muscle with no fat rippling through it. That’s all related to our diet and the lack of exercise. And so, the two things I want you to talk about is the other side of the coin because protein you need and you want to get enough and not too much, but it’s actually sugar and starch that drive this aging process. And then that combined with muscle strengthening and building as you get older, seems to be some of the most important factors. So can you talk about those and how they relate to aging?
Dr. Frank Lipman (25:38):
Sure. Well, sugar and starches are the devil. It’s not even a debate, you’ve got to get as much of that out of your diet as possible. The protein is a harder one, how much protein you eat. And I think as you get older, maybe decreasing animal protein, increasing bit of plant protein but still, keeping those carbohydrates as low as possible or the sugars and the starches. I think the muscle issue is interesting because I’ve been doing acupuncture for so long and I really got into the functioning of the muscles. That’s not just about building muscle, you want those muscles to work efficiently.
Dr. Frank Lipman (26:22):
And what I see a lot of, especially as we get older and we have injuries, certain muscle groups tighten up and when certain muscles tighten up and they don’t fire your body compensates and starts using other muscles. So let’s say you have a tight hip, or you have an ankle problem, your back muscles have to work more and then you start getting back pains, and then maybe it goes up to your shoulder. So not only do you have to improve muscle mass or watch the loss of muscle as you get older, you’ve got to watch that functioning because as we get older, the muscles tighten and the fascia tightens, that thin layer that surrounds the muscles.
Dr. Frank Lipman (27:06):
When you cut open a chicken and there’s this fascia around the muscles, that surrounds all our muscles in our body and that as an acupuncturist and paying a lot of attention to that for the last 30 years, I’ve seen becomes a problem, especially as we get older and as we injure ourselves. And especially, as we get older and we injure ourselves, we don’t tend to recover as well. So it’s really important when you do injure yourself to get some bodywork, to get some acupuncture, to get those muscles working efficiently again and not just letting injuries sit there and not treat them. So I think it’s not only building muscle mass and not losing or not losing muscle mass, but it’s improving the muscle efficiency and that’s keeping those muscles long and lumber and watching that the fascia doesn’t tighten.
Dr. Mark Hyman (28:00):
That’s a really good point, Frank, because I’ve had back issues my whole life from back surgery when I was 30 and recently another back surgery, and now I’m getting treated by this physical therapist who’s going into the fascia and rewiring things, and then giving me exercises to do that compensate for the inactive muscles, exactly what you were talking about. And it’s been only like three days of working with this person and I feel like a different human being my body feels limber, lighter, opener. It’s pretty amazing. So, I mean, not everybody can access that, but there’s ways you can do it yourself with foam rollers and other things to really help. So let’s talk about something that is-
Dr. Frank Lipman (28:41):
And in the book I talk about foam roller. I just have to mention foam rolling because I think that is, a lot of people can’t afford going to some bodywork who does deep tissue work but foam rolling is sort of the closest you’ll get to going to someone who can do that. I really, I can’t stress this enough, recovering from injuries, recuperating, don’t let those muscles tighten because the way our body works is to compensate and tighten somewhere else or overuse another muscle. It’s really important to have those muscles working efficiently. As one area of functional medicine that we didn’t really get into in functional medicine. We talked about most of the other organs, but we didn’t really talk about the functioning of the muscular-skeletal system, I think that is really important.
Dr. Mark Hyman (29:27):
Well, it’s definitely one of the nodes on the matrix, which is structural, but we don’t get into it enough, I agree, and actually, we’re talking about building a whole course on structural module. So, I think that’s very important. Let’s talk about something that is a little abstract, but it really is central to aging and that is impacted by our diet, light, by exercise, by environmental toxins and it’s something called our mitochondria. And we’ve talked about that on the show a little bit before, but it’s really important. So what are mitochondria, why are they so important in aging and disease, and how do we improve them? Because it seems to be the central feature of aging is the dysfunction and the loss of mitochondria.
Dr. Frank Lipman (30:08):
Right. So the mitochondria, just the energy powerhouses in the cells, and you have many in all our cells. And as we get older the number decreases and their function decreases. So optimizing their function and trying to increase their number is one of the most important things you can do for aging. And interestingly enough, most of the things we’ve been talking about improve mitochondrial function or increase the number, we’ll [inaudible 00:30:39] mention this, we haven’t, but it’s a low carbohydrate diet or fats are what the mitochondria thrive on. Fasting is particularly good for mitochondria. Exercise and particularly, high-intensity interval training is really good for it. Strength training as well, also sleep, a lot of the lifestyle change.
Dr. Frank Lipman (31:05):
To me, the mitochondria or what we in Chinese medicine talk about chi, we talk about the energy and how do you boost chi. To me, the mitochondria are the Western equivalent to chi, that’s your body’s energy. And all these changes we talk about actually work with the mitochondria. One of the things we haven’t talked about, and which actually seems to work well or stimulate the mitochondria is this concept called hormesis, which is a little bit-
Dr. Mark Hyman (31:40):
I love that concept. What does that mean? I love that concept.
Dr. Frank Lipman (31:44):
So hormesis means sort of what doesn’t kill you, makes you stronger, basically.
Dr. Mark Hyman (31:48):
Ah, that’s perfect definition. That’s the best definition I’ve ever heard.
Dr. Frank Lipman (31:52):
That’s little bit of stress is actually good for the body. Chronic stress we know is a problem and creates all these problems and won’t help you age well, but a little bit of stress, hormesis is good. And that’s what fasting is. Fasting is physical hormesis. It’s a stress. It’s a mild stress on the body and your body’s response to that. And we talked about resilience, but your body’s response to that is a positive response which stimulates all these factors that are good for aging. So we talk about fasting. We talk about a little bit of interval training, where you push yourself a little bit more than usual. Going from hot to cold, so even just having an ice cold shower after a hot shower. I love going from a sauna, I’ve become obsessed with my sauna, going from a sauna, jumping into some freezing cold water. So temperature extremes are another way of stimulating hormesis.
Dr. Mark Hyman (32:59):
I love that. I love the way, from my steam or sauna right into an ice bath.
Dr. Frank Lipman (33:05):
And that’s good for aging. I mean, that’s good. That’s hormesis. So anything that’s a little bit of stress on the body is good. And actually what’s interesting, I remember years ago, Jeff Bland talking about this or someone at one of the functional medicine conferences, with phytonutrients, a lot of the hormesis is really good for plants. So plants develop more antioxidants and protective phytonutrients to protect themselves from whatever they have to deal with to survive. So spraying them with herbicides and that doesn’t actually help them develop these phytonutrients to protect themselves, which actually ended up being good for us too. The first time I heard about hormesis was years and years ago at one of the functional medicine conferences with someone, I think it was Jeff who talked about the importance of hormesis on plants and developing phytonutrients that would then benefit us.
Dr. Mark Hyman (34:08):
Yeah, it’s really important to understand this idea because when you look at for example, organic versus conventional plants, or even wild plants, even versus organic plants, the wild plants have way more by hundreds of thousands of times more antioxidant potential, phytonutrient compound, and they also tastes better. And what’s interesting, is that flavor goes along with phytonutrients. So the flavor profile of the food is directly related to the nutrient density and to the phytochemical content. So if you go to a garden which I did the other day in a friend of mine’s garden, and you pick a really ripe tomato, it’s just ripened on the vine, you stick it in your mouth. And it’s an explosion of tastes and flavor and phytochemicals that is so different than these cardboard store-bought tomatoes that don’t taste like anything.
Dr. Mark Hyman (34:57):
So that’s really the power of the little stresses. And I think that strength training, the HIIT interval training, the fasting, the phytochemicals, these are all ways to actually improve this. I want to get into some tweaks that you have in your book that are really, really great, but before, I want to talk about this idea called epigenome and how that plays a role in how our cells age and how we deteriorate. So what is an epigenome? What is its relevance to aging? How do we deal with it? What can we do to help fix it?
Dr. Frank Lipman (35:27):
Right. So this is once again, one of the basic concepts that hasn’t come out of functional medicine but what functional medicine treats that most of our genes we can change or we can manipulate in a way or up-regulate or down-regulate. So, for instance, I actually just did a whole genetic test. I’ve got terrible genes. I knew I had terrible genes. I have the APOE-e4, the gene for Alzheimer’s, I’ve got heart disease genes. I mean, my genetic profile is terrible, but whether I get Alzheimer’s and heart disease, and all these diseases of aging is determined by how I live my life.
Dr. Frank Lipman (36:09):
So these lifestyle factors, how I sleep, how I think, how kind I am to other people, how optimistic I am and what I eat, how I move my body, all are going to affect most of those other genes or the genes that we can affect or up-regulate or down-regulate to affect our aging. So aging is probably less than 20% genetic. I mean, there’s obviously a genetic component where you can’t change those genes. I’ve got those genes or I don’t know about those genes, but I’ve got enough genes that I know that I can change just. Because I have the APOE -e4 gene, just because I have some of these heart genes doesn’t mean I’m going to get it. Yeah, I probably I’m losing it a little bit and [inaudible 00:36:57].
Dr. Mark Hyman (36:58):
You seem all right, Frank, you’re doing okay.
Dr. Frank Lipman (37:00):
My heart may not be as good, but that sort of makes me want to just be more careful because you can change how you age, you can change the progression of these diseases. And I think it just all comes back down to these lifestyle changes that we all have to make. And sleeping is one of those things that I think is really, really important. And we aren’t talking enough about it, although more and more people are starting to realize the important of sleep. But how you move, how you sleep, how you think, how you eat, when you eat, all these factors affect this epigenome, these malleable genes that actually can be up-regulated or down-regulated and affect how well we feel and how we age.
Dr. Mark Hyman (37:55):
I think that’s really an important point, Frank, because you mentioned you have these predisposing genes, but they’re not predestined. We’re not predestined to get these conditions. And what most people don’t realize is that 80% to 90% of our chronic disease issues are not driven by genetics, they’re driven by what we call the exposal; what our genes are exposed to and how those genes are expressed. And so, if they are exposed to environmental toxins, if your microbiome is not healthy, if your diet’s crappy, if you’re not exercising, if your mental set, your mindset is not optimistic and focused and positive, it literally can change the expression of your genes by all these factors.
Dr. Mark Hyman (38:37):
And that’s the beautiful thing about functional medicine, it teaches you how to optimize the function and the expression of your genes to improve their functioning and also to reduce the ravages of aging. I’m very optimistic about you Frank, because I didn’t realize you were 66, I thought you were like 56. I know you’re older than me but you don’t look it, so something’s working. And I think for two old dudes, we’re doing all right. I’m 60 you’re 66, so it’s working.
Dr. Mark Hyman (39:03):
And I think that people don’t understand that what we see often as aging in America is abnormal aging. It’s not really how we need to age, that we can age vibrantly and healthfully and be alert and focused and energetic even right up to the end. And I’ve seen this in many people. I met this guy who’s 95 years old the other day, he had a girlfriend that was 20 years younger than him. She was a young spring chicken at 75. And he was just running around the room and I’m like, “What’s up with you? How do you do this?” He says, “Whatever I did yesterday, I just do it today. If I played single sentence yesterday, I do it today.” And I think he just kept living his life and not mentally succumb to the idea of aging.
Dr. Mark Hyman (39:49):
And I think you have to be more cautious, careful. You have to be more alert to what you need to do to take care of yourself, but I think we have so much potential to stop and even reverse the ravages of aging. And I noticed this to myself, because of COVID I was locked at home like everybody else. I’m like, “Well, I’m not going to not exercise,” and I got a Zoom trainer. And I really never had done weights before because I was running around on the road; I don’t like it, it hurts, it’s uncomfortable, I’d rather go for a bike ride, play tennis. And I got serious about it and within a very short time, I noticed my body started to change. I literally put on 10 mounds of muscle. It was like I was an incredible transformation and it was just in a very short time.
Dr. Mark Hyman (40:37):
So, I think we have the potential at any age to stop and even reverse these effects. And what I love about your book Frank, is that you have very simple tweaks that have a profound impact on healthy aging. So, talk about some of these tweaks. And I can trigger you if you need to, but I just think there’s some really-
Dr. Frank Lipman (40:52):
Trigger me. Yeah, I’m getting old, I’m [inaudible 00:40:56].
Dr. Mark Hyman (40:55):
You talk about things like physical intensity, cold shower as you talked about, rolling out your fascia, magnesium saunas, mushrooms, sunshine, sleeping, various kinds of simple tweaks or tricks. They’re not really tricks, they’re just science-based interventions that if we stack them have accumulated benefit.
Dr. Frank Lipman (41:17):
Right. So there’s so many simple things we can do. I think actually just to get back to what you said, I’m also starting to do some weights now, I’ve always resisted weights too. I love riding my bike outside and doing yoga and stretching, but I always resisted weights and I’m starting to do a little bit of weight training now and I also find it actually quite helpful. So, I concur there. I think I’m going to start back to the fascia and watching injuries, because what I’ve seen so often in so many people because I see so many patients. Many times, people are exercising a lot and something happens they injure themselves and then they don’t recover properly and then they stop exercising or they don’t exercise as much.
Dr. Frank Lipman (42:06):
So I encourage everyone, when you do hurt yourself, just take care of that injury so it doesn’t limit. It may change the way you exercise in future; I can’t run because of my knee, but I’ll ride a bike, so you do want to continue exercising but don’t let that injury just stick around, don’t let it fester you need to treat injuries. So, if you can’t get bodywork, a foam roller can be really helpful. I think getting outside early in the morning, again, getting some fresh air and some natural light first thing in the morning, is a really good thing. I find it helps people sleep at night.
Dr. Frank Lipman (42:52):
In other words, getting your body into some type of rhythm. I’m also obsessed with rhythm, maybe because… So when I first started doing medicine in South Africa, when I worked in the bush and there was no electricity and I saw how people lived with the rhythms and cycles of life; they got up went it was light, they went to bed when it was dark, they ate whatever was local and grown locally and they didn’t seem to have a lot of the chronic diseases I see in the city. So, I think trying to keep a rhythm is important. If you can, try keep it with the seasons and with day and night that’s important. So if you go to bed, try and wake up early and get outside and try and go to bed at the same time every night. Try and create some type of regular schedule, I think that’s really helpful.
Dr. Frank Lipman (43:46):
I’m boring now, me and my wife go to bed pretty early. It’s been great with a little grandchild, because he goes to bed even earlier than us, probably the only person who does. But if you can get into some type of rhythm; going to bed at the same time, waking up at the same time in the morning and getting outside and getting some fresh air and some natural light, that’s really helpful.
Dr. Frank Lipman (44:07):
I do think trying to incorporate some form of time-restricted eating is helpful for most people, especially as you get older than 50, it’s a good idea. Keeping active during the day, so you don’t have to go to the gym, you don’t have to ride your bike but get up and move around, move your body, you just want to move your body.
Dr. Mark Hyman (44:36):
It’s amazing how inactive we are, when you look at an average day. I’ve got a ring, it’s called an aura ring, and it tells you how many hours of inactivity you have. And I’m like, “Holy crap, I’m at eight hours of doing nothing and sitting in [inaudible 00:44:49] my doing podcasts or reading a book or working on my computer.” It’s really important to move.
Dr. Frank Lipman (44:58):
Right. And I found that since COVID made that much more of… Especially doing more virtual sessions with patients and not in the office, I’m actually getting up in between and going out which is good. So, I think that’s important. And I think the little things we talk about, don’t take yourself so seriously, have a sense of humor about aging, being optimistic, being kind to others and yourself. I think kindness, compassion, I think these are all really important factors in aging. And then finally, having a sense of purpose and some meaning. And that sense of purpose may be your job, it may be your family whatever it is, find something that’s meaningful to you. It could be volunteering at a nonprofit, but I think getting involved in something that’s important to you is really important.
Dr. Frank Lipman (45:52):
And then finally, find a tribe or a community that you relate to that supports you and that you can support. I think, yes, obviously eating, we talked about eating and sleeping and exercising all important, but it’s these non-tangible things that are important. And it’s the little things we do on a daily basis, the ordinary things we do on a daily basis, that have an extraordinary effect on our health and our aging. And that’s these little things we’ve talked about, having passion for life and having meaning and having a community. So don’t just think it’s all about diet and exercise and sleep, which is really important.
Dr. Mark Hyman (46:36):
It’s a lot about what’s going on up here-
Dr. Frank Lipman (46:38):
Dr. Mark Hyman (46:40):
… in your mind.
Dr. Frank Lipman (46:41):
Yeah. These things are key. And there’s so much bad stuff going on and there’s so much negative, it’s so easy to get caught up in the negativity of today.
Dr. Mark Hyman (46:54):
Well, Frank when you were talking earlier, it just reminded me of this study I read in the Journal of the American Medical Association this year which was very amazing. Which showed that longevity was related to your sense of meaning and purpose. So even the science is showing that just being connected to something bigger than yourself is so important and having meaning and purpose is so key. So Frank, let’s talk a little bit about supplements. Is there a role for supplements? Do they really work? There’s all these longevity supplements out there, is it a waste of money? Is it a good idea? Tell us, what’s the deal on supplements?
Dr. Frank Lipman (47:28):
Well, I think they work. I take [inaudible 00:47:31] myself. Yeah, I do think they work. I think it’s a bonus rather than essential, because they tend to become expensive. But I do think supplements are helpful to optimize function, I really do. And I take the regular supplements that I will take, whether it’s vitamin D which I think is essential for everyone, I’ll take my fish oils. But there are supplements which I think do affect the mitochondria and do affect the aging process. Am I sure about that? No, I’m not sure but I’m not going to wait for the signs to confirm to make sure it’s happening, I’m going to take it.
Dr. Mark Hyman (48:16):
The thing is when they’re low risk there is a cost to it, but the benefit potential is there. And I think that there is good evidence that these things do affect some of the biology of aging.
Dr. Frank Lipman (48:28):
Yeah, me too, I take now coenzyme Q10, I take Nicotinamide adenine dinucleotide, which is the hot one.
Dr. Mark Hyman (48:37):
NAD, you’re right.
Dr. Frank Lipman (48:40):
ND and NMR, everyone’s pushing their supplements. But I actually do think… I take it. It’s hard to say if it’s making a big difference because I’m doing all these other things too, but I take it.
Dr. Mark Hyman (48:58):
But as we got older, it makes a big difference. I see the people who are more nutritionally deficient as they age, their diets aren’t as good, their absorption’s not good. And there’s really good data that shows even multivitamin in older patients reduces the risk of disease and hospitalizations, infections, and all a host of things. So particularly in the time of COVID, we all need to up-regulate our nutrient levels. So what about testing? Are there tests you can do in functional medicine that are different that help you determine longevity? What do you recommend?
Dr. Frank Lipman (49:28):
Well, I don’t know if they’re different, I just do a few more biomarkers. We do like the Boston Heart or Cleveland clinic has one too. We do an advanced lipid panel, which I think can be helpful. And then we do insulin growth factor, we do interleukin six, we do a couple of other inflammatory markers. But for the most part, most of the markers we’ve always done we’ve added maybe a couple more, we’re doing obviously hormones, measuring hormones. And then there’s a wonderful genetic test that we’ve started doing, the 3×4 Genetics which are fine by far the best genetic tests. Started by a woman, actually a South African woman, who is a functional medicine person. What’s her name again? But anyway, Yael.
Dr. Frank Lipman (50:25):
We’ve been finding because it’s the only genetic test that I’ve seen that actually works in a functional medicine perspective and puts a lot of how these genes work together and what you can do to help these combination of gene. So it’s actually a pretty helpful test that we’ve been doing as well. Then the other tests, measuring your biologic clock and telomeres, I don’t know about those tests. They’re being promoted and we’re starting to play around with it, I don’t know how important that is. I think some people like to see these things which is fine.
Dr. Frank Lipman (51:07):
But my philosophy hasn’t changed from that perspective, it’s more about making these lifestyle changes and whether you want to do this extensive testing is fun. My experience has been that these lifestyle, these factors we’re talking about, have been changing people’s markers. We’re definitely seeing-
Dr. Mark Hyman (51:29):
Yeah, you can measure the changes over time.
Dr. Frank Lipman (51:32):
[inaudible 00:51:32] so you can and people like that. So if you want to actually do a test and then measure it three to six months later, you see the changes which is actually… that’s quite encouraging for people. So from that perspective, I think it can be helpful. But these things aren’t necessary, the things that are necessary are the pegan diet, and then looking after your sleep, moving your body, and having meaning. All the things we’ve talked about. Now, whether you want to measure all these factors can be helpful, because it can help you fine-tune things that the genetic test can say, “Okay, your liver function, you may need some more of these nutrients because the way you processing hormones or toxins is not so good,” or, “You have more propensity for inflammation, or, “Your brain health may not be as good, so take this.” So I do think the markers can be helpful in taking it to the next level, but not it’s potential.
Dr. Mark Hyman (52:38):
Yeah, I think I agree. They’re supplements not replacements for everything else. So foundationally, all the things we talked about are really important; lifestyle, diet, sleep, exercise, maybe little supplements, but there’s new things on the horizon that are for healthy aging that people are researching talking about. Can you share some of the promising things that are ahead that you might be focused on?
Dr. Frank Lipman (53:01):
Sure. So as embarrassed I am to say, there’s a drug called Metformin which is a popular… It’s used in diabetes a lot, which seems to be showing positive effects for aging too, which go beyond just keeping your blood sugar down. It seems to affecting this M2, one of these longevity genes, or these nutrients sensors, seems to have some positive effect on aging. My concern with any drug, Metformin included, is one of the side effects. Metformin seems to have a relatively low profile of side effects, it can affect absorption of some nutrients, B12 in particular, it gives you some gas, also can affect your response to exercise but it’s sort of relatively benign. So, that’s one that I find interesting. There’s a drug called rapamycin, which I’m definitely not recommending yet, anyway, which some people are taking. Rapamycin-
Dr. Mark Hyman (54:12):
Shut’s down mTOR.
Dr. Frank Lipman (54:13):
Yeah, mTOR. So those are the two drugs. And then some people are using peptides. I don’t really know enough about peptides to recommend them, I find them quite intriguing and interesting, I just don’t know enough about them yet. And I think there’s so much research going on too, there’s going to be products coming out. But at this stage, it’s really what we’ve been talking about. Metformin, especially if you tend to be pre-diabetic as you get older, it’s something interesting. I’m going to explore it a little bit further, I’m a little bit hesitant at the moment.
Dr. Mark Hyman (54:49):
Yeah, I’m cautious about it.
Dr. Frank Lipman (54:51):
[inaudible 00:54:51] that Berberine, which is the naturally equivalent of Metformin. I’ve been starting to take Berberine now, because it has similar effects to Metformin. I don’t do the crazy stuff as the biohacking. The biohacking world has been very interesting, because that’s a very masculine approach to aging but I think we’ve got some good stuff there. Some of the biohacking guys I think go a bit too far, a little bit more on the more gentle side of the pushing it.
Dr. Mark Hyman (55:30):
Yeah. There’s a lot of [inaudible 00:55:32] Wild West out there and people should be cautious. People using stem cells, Exosomes [inaudible 00:55:35].
Dr. Frank Lipman (55:35):
Yes, stem cells exactly.
Dr. Mark Hyman (55:37):
I think there are promising things that are not quite ready for prime time yet. Metformin is, I believe that if you focus on the lifestyle and the dietary things, you can probably achieve most of the same benefits. And what I worry about is people say, “Oh, I’ll take a stand and then I can eat at McDonald’s, it’ll be fine for my cholesterol.” That is just a bad idea. So Frank, your book is just fantastic. I encourage everybody to get a copy, it’s out. It’s called The New Rules of Aging Well: A Simple Program for Immune Resilience, Strength and Vitality. That’s what it looks like. It’s a fabulous book. I just think it’s also a beautiful book. It’s digestible and there’s so many brilliant little snippets of wisdom that are easily applied to your life every day and it will help you not only live longer, live better.
Dr. Mark Hyman (56:23):
But also, even if you’re not an old, it’s a great book for just optimizing your health whether you’re 20, 30, 40, 50, 60, it is a good manual for your life. So I encourage you Frank, to keep doing what you’re doing. We’ve been on this road a long time and as functional medicine practitioners, we do see the power of these methods to really transform people’s lives when nothing really else does. So I’m planning to be 120, I don’t know where you’re going Frank but I’m really interested in this. You’re right, we’re both getting old and so I’m way more interested in aging, so you’re going to hear a lot more about it. And thank you so much for everything you do Frank.
Dr. Frank Lipman (56:58):
And thank you, Mark. Thank you.
Dr. Mark Hyman (57:00):
And we can learn more about Frank’s book on drfranklipman, that’s drfranklipman with one P, .com/books. And learn more about Frank and his work, it’s really tremendous. And if you love this podcast, please share it with your friends and family on social media. Leave a comment. Tell us about how you’ve figured out ways to age well and push off the ravages of aging, which we’re trying to do. And subscribe wherever you get your podcast and we’ll see you next week, on The Doctor’s Farmacy.