Young Forever: The Secrets To Living Your Longest, Healthiest Life

Mark Hyman, MD

Dr. Mark Hyman is leading a health revolution—one focused on using food as medicine to support longevity, energy, mental clarity, happiness, and so much more. Mark Hyman, MD is a practicing family physician and an internationally recognized leader, speaker, educator, and advocate in the field of Functional Medicine. He is the founder and director of The UltraWellness Center, Founder and Senior Advisor for the Cleveland Clinic Center for Functional Medicine, a fifteen-time New York Times best-selling author, and Board President for Clinical Affairs for The Institute for Functional Medicine. He is the founder and chairman of the Food Fix Campaign, dedicated to transforming our food and agriculture system through policy.

He is a co-founder and the Chief Medical Officer of Function Health. He is the host of one of the leading health podcasts, The Dr. Hyman Show with 150+ million downloads. Dr. Hyman is a regular medical contributor to several television shows and networks, including CBS This Morning, Today, Good Morning America, The View, Fox, and CNN.

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Full Transcript

Automatically generated. Please forgive any typos or errors in the following transcript. It was generated by a third party and has not been subsequently reviewed by our team.

Intro:
Coming up on this episode of The Doctor's Farmacy.

Dr. Mark Hyman:
What are the fundamental drivers of disease, which is essentially comes down to two things. You're dying of too much of the things that cause disease and dysfunction and not enough of the things that cause you to thrive and optimize function, and it's really that simple.

Dhru Purohit:
Dr. Mark Hyman, welcome to the podcast. Pleasure to have you here. I'm going to jump right in. And your book, Young Forever is all about how to basically age backwards.

Dr. Mark Hyman:
That's right.

Dhru Purohit:
And before we unpack that and also what's going on today that is really causing so much inflammaging, abnormal aging that we see in the world, I want to talk about how do we get an accurate assessment of how old we truly are today? What are the tools, the techniques that are out there that are available today that we never really had access to before to see how actually old we are on a biological level?

Dr. Mark Hyman:
Absolutely. Dhru, it's so great to be with you on the podcast again. Most people think of their age based on their birthday. Their birthday is what it is, and their age is what it is and there's no changing that, and that's your chronological age. But the science of longevity has now helped us to unpack a very different view of aging, which is the difference between our biological age and our chronological age. And now we have tools, metrics to measure our biological age, which we never had before. Based on emerging science, looking at DNA methylation, looking at immune age, and I think other ways through the lens of functional medicine, looking at the array of biomarkers that we can collectively assess someone's state of health.
So I use all these metrics to come up with a sense of what's going on with someone's body, but the key one that's being used to assess any kind of intervention, so how do you know if you do some type of dietary change like intermittent fasting or you do some type of exercise like strength training, or you take this supplement and course a tendon, what is it doing? Is it working to affect your biological age? Well, now we have a metric based on DNA methylation, which is essentially this process that marks your DNA with little tags to determine which genes are expressed or not, so you can't change your genome. Your genome is fixed.
You've got 20,000 genes, that's it. Maybe there'll be gene editing and super fancy robotic techniques through nano robots to change your genes at some point. We not really there yet, but we can change the epigenome, which epi means above. So above your genes is this control mechanism, so your jeans are like the piano keys on a piano. The epigenome is like the piano player. And the piano player can play jazz or rock or reggae, whatever heck you want, so you can change the epigenome by how you live. So everything you do, every bite of food you take, every thought you have, every time you exercise, how your sleep is, what toxins you're exposed to, what's going on in your microbiome, everything that washes over you throughout your life, the sum total of all the experiences, what we call the exposome controls the epigenome, and you have control over all of that.
Well, most of it, you can't control the toxins in your environment as much as we'd like, but you can limit them. You can restrict access to certain foods that may have more toxins like pesticides or heavy metals. But for the most part, we can regulate our epigenome and we can reverse our biological age using the strategies that I talk about in my book Young Forever, which is about how do we take the sciences of longevity pair it with the science of functional medicine, and come up with a roadmap for how people can activate their longevity switches to reverse their biological age. So I did my epigenetic test, which is a blood test, which looks at these DNA methylation patterns, and I found my biological age was 43. Now, I'm going to turn 63 in a week, but I'm 43 biologically, which is cool. I'm trying to get to 25. I don't know if I'll get there, but I'm working on it.

Dhru Purohit:
That's great. And before we talk about your central thesis that really the whole book is about, and it sets up the book, is there one or two of those that is pretty easily available for folks? You mentioned a whole slew of different tests that are there, but if there was one test that people wanted to do to get a good sense of their biological age, would you pick from that list that you have?

Dr. Mark Hyman:
Yeah, I think the DNA methylation test is right now being used primarily to look at interventions for longevity, and it's available through various commercial labs that are combined, you get through various online programs and tests, so it's pretty easy to get. The lab that I used was true diagnostic. I don't have any affiliation with them, but they do a good job in terms of TRIM DNA methylation, there's a lot of other groups doing it from people at Elysium and Yale, and other groups are looking at how do we commercialize these tests. So there's a lot of these companies commercializing them, and I actually did all of them, and I found there was a lot of variations. So I still think this is being tweaked, but through looking at the evidence of many of the studies that have done interventions to see if they can reverse biological age, the reality is that we can track these things, so that's what I would recommend for people to track.

Dhru Purohit:
And then the example of DNA methylation, like the one you mentioned, how often might somebody want to check in on that after they've made some major changes in their lifestyle? Are they following your program and they wanted to check back in on it-

Dr. Mark Hyman:
Well, we have a number of-

Dhru Purohit:
... eight weeks, six months?

Dr. Mark Hyman:
... yeah, it's a great question. We have a number of studies that reflect the changes in biological age with certain interventions. So some of them are a year long like vitamin D, it might reverse biological age by a year. Some certain changes in diet may reverse biological age, certain interventions like quercetin, dasatinib which was done at Mayo Clinic reversed age by over a year in a intermediate term study, which is weeks. But the most impressive was the one done by Care of [inaudible 00:05:52] Group, which looked at a more aggressive dietary intervention, what I would call a functional medicine dietary intervention, which is an anti-inflammatory, detoxifying, phytochemical rich, DNA methylation supporting diet along with a number of other lifestyle interventions.
In eight weeks, they reverse biological age by three years, so it's not like you have to do this forever to get a result. You have to do interventions for a short time to see really remarkable changes in biological age. So I think we're still figuring this out, but the good news is that you can see changes relatively soon, so I wouldn't say you do this all the time, but maybe every six months, 12 months, depending on what you're doing with your lifestyle changes.

Dhru Purohit:
Amazing. All right. Let's set up the idea of the book, aging is a disease.

Dr. Mark Hyman:
Yeah.

Dhru Purohit:
Talk about that.

Dr. Mark Hyman:
In medical school, I certainly didn't learn that aging was a disease, and we don't think about treating aging as a disease. And in fact, it's considered wrong to think about aging as a bad thing. It is called ageism.

Dhru Purohit:
And people get very triggered by that?

Dr. Mark Hyman:
Yeah, be very triggered by that, but what-

Dhru Purohit:
Do you think that some of that is warranted? Because [inaudible 00:07:00]-

Dr. Mark Hyman:
... I mean, think we don't want to stigmatize people getting older, but that's different than biological aging. So you can get older and yes, you're going to change your body and things are going to happen and you're going to get wrinkles, but the reality is that we can maintain our young biological age for a long, long time, and we've seen this in study after study. So I think when we talk about biological aging and aging as a disease, we're talking about these fundamental dysfunctions that happen as we get older that are not inevitable. So getting older is inevitable, but disease is not inevitable, and most of the things we see in our culture as people get older, our phenomena that relate to underlying biological dysfunctions, we call the hallmarks of aging, and that result in the diseases of aging, heart disease, cancer, diabetes, dementia. And what was remarkable as I was researching the book, was discovering that if we completely eliminated heart disease and cancer from the face of the earth, that we would maybe extend life by three to five years, which is insane.
When you think about these are the two biggest killers on the planet, why wouldn't we then live to be 120? It's because we're not addressing the other biological mechanisms underlying aging, and so if we do that, we might see a life extension not of five to seven years, but of 20, 30, 40, 50 years. So maybe we can see us living to 120 or 130 or 150, which is not beyond the realm of possibility once we understand these mechanisms. And I see this, I see patients who are in their 30 and 40s who have a biological age of 70, and I see people who are 70 or 80 who have a biological age of 50 or 40. So we have the potential to do this if we take advantage of the science of longevity and apply the principles that are addressing the hallmarks of aging and the causes of the hallmarks of aging.

Dhru Purohit:
... so there's been a lot of books written on the topic of longevity, and it's a hot area that people want to explore. What is unique about your approach with this book is the functional medicine approach to aging. Can you chat a little bit about that?

Dr. Mark Hyman:
For sure.

Dhru Purohit:
How has that lens shaped how you look at this world of aging?

Dr. Mark Hyman:
Yeah. One of the exciting things for me as I began to research deep into the longevity research is this framework of the hallmarks of aging, which are nine, I added one, 10, which is the microbiome. We can talk about those in detail, but these are the phenomena that go wrong, damage to our DNA, change in our immune system and inflammation, nutrient sensing pathways, telomere shortening, epigenetic changes, and there's a whole list of these problems that we now have identified that go wrong in the body, that then result in the things we see as aging, all the diseases of aging. But it's like the blind men and the elephant. Everybody's talking about these things, and let's take a drug to fix our mitochondria or to suppress mTOR, or to increase telomere length or to kill zombie cells, or all these different things that could be treatments for these hallmarks of aging.
But from a functional medicine perspective, the question is always is, what's the cause? So if the hallmarks of aging cause the disease of aging, what causes the hallmarks of aging? So let's go way upstream to look at the cause of the cause of the cause, so that's where functional medicine comes in, which is looking at what are the fundamental drivers of disease, which essentially comes down to two things. You're dying of too much of something or too little of something. You're dying of too much of the bad stuff and not enough of the good stuff. You're dying of too much of the things that cause disease and dysfunction and not enough of the things that cause you to thrive and optimize function, and it's really that simple. So from the lens of functional medicine, we look at the causes of the hallmarks, which are diet, toxins, stress, physical and psychological stress, our microbiome and microbes and various kinds of allergens, and other insults that the body has as well as the deficiency of things that we need to function right.
We need the right food, and this is really important, and there's an array of phytochemicals that aren't considered essential, but that I believe are truly essential for biological health. So they may not be nutrients or vitamin or mineral, that if you get a lack of it, you get a deficiency disease like rickets or scurvy, but if you don't have these over the long time, you get what we call a long latency deficiency disease. In other words, if you don't have enough of the right phytonutrients over time, your biology can't function optimally and you age faster, so we need the right nutrients, we need the right types of exercise, sleep, rest, community, purpose, meaning, there's a whole list of these ingredients for health. So we have to remove the impediments for health and add the ingredients for health, and that allows the body to thrive. So functional medicine is the science of creating health, not treating problems. It's actually the opposite. It's actually giving the body a chance for its own innate healing system to be activated, which then will naturally create health and reverse biological age.

Dhru Purohit:
So let's just do a little quick teaser on some of those. You said functional medicine is looking at, what are we not having enough of and what is also getting in the way? What do we need to add more of and what do we potentially need to remove? So in the category of removal, what are three of the top things that you see today? There's a whole list of them, but what are three of the top things that you see today that are creating an accelerated aging for most people? In fact, it's so accelerated that you have to really go far and wide, and you talk about some stories inside of the book, which we'll chat about here. You have to really go far and wide and maybe travel to some foreign countries to really find groups and communities who are actually maybe aging in a more normal way. But what are three things you think today that are going on that are accelerating aging?

Dr. Mark Hyman:
Well, clearly far and above everything else is our diet.

Dhru Purohit:
You put that as number one?

Dr. Mark Hyman:
For sure. I mean-

Dhru Purohit:
Sometimes people talk about thoughts, sometimes people talk about toxins, but you're saying number one you really feel is diet.

Dr. Mark Hyman:
... absolutely. I mean, the single biggest input to your biology every day are the pounds of food you eat every day, and the information in that food is in real time changing your biology and regulating everything that's going on. In fact, I call them the longevity switches, which is a term I made up in the book. But essentially there's these four nutrient sensing pathways that regulate biological aging, and these pathways are one of the hallmarks of aging. So one of the hallmarks is called deregulated nutrient sensing. It's a big mumbo jumbo of medical language, but essentially it means your body and food are not working together to create health, and so these pathways, when they're not properly tuned up, will drive all the other hallmarks. So for example, the amount of starch and sugar or diet is driving increase in insulin signaling pathways, so insulin goes up, and this insulin creates this cascade that drives all the disease of aging.
So insulin resistance and poor metabolic health, which affects now over 93% of the population according to a new study, is the biggest driver of heart disease, of cancer, of diabetes and dementia, and not to mention all the other problems like depression and infertility, and so many other problems that occur from insulin resistance. So this is the biggest phenomena that's happening globally, which caused by our ultra processed diet, which is about 60% of our calories in America. And processed food could be sardines in a can or a can of tomatoes, that's not necessarily bad, but ultra processed food means that they take these raw materials from industrial agriculture, corn and soy and wheat, and they highly process them into components that you wouldn't have in your kitchen, and they recombine them into things that are food-like substances, and I've written about this. I've written I think more books than I probably should have on food and nutrition.

Dhru Purohit:
So a lot of the fast food that's out there, a lot of the grocery store in the inner aisles that are highly packaged foods?

Dr. Mark Hyman:
Yeah, all of that. All of that is so bad for you, and if you look at the label of ingredients and you can't recognize what it is with covering the front of the package, you shouldn't eat it. And whether it's a corn dog or pop tart, you may not be able to tell a difference looking at just the ingredients on the label, so that's the biggest driver of so many of these deregulated nutrients, sensing pathways. The other is just the constant influx of food. So we eat all day long, we snack, we eat before bed, and then we eat when we wake up, and this doesn't give our body a rest. And so that activates this pathway called mTOR. mTOR is really important, one of the four longevity switches versus insulin signaling, then it's mTOR. mTOR is activated by protein and also by sugar, and when it actually can drive cancer and prevent your body from repairing and healing itself.
So you need to give your body a break from eating and inhibit mTOR, which then allows this process called autophagy, which essentially means self cannibalism. So what's really exciting is our body has these innate repair mechanisms. We have the ability to clean up waste. We have the ability to rebuild new tissues. We have this... Think of it, you cut your skin and all of a sudden your body then makes new skin, which is a miracle. This is going on inside your body too, but we don't allow that to happen. Imagine if you had a cut in your skin, you kept scraping it and digging at it, it would never heal. That's exactly what we do with this constant influx of food, so we have to give our bodies a break so we can activate this process of self-cleaning, recycling, and repair, and this is called autophagy.
Now, you can't do that all the time because if you weren't eating all the time, you're going to starve your death. So you need to have this Goldilocks balance between stimulating mTOR to create protein synthesis, to build muscle, but also inhibit it at times by not eating, we call it time-restricted eating, intermittent fasting. There's a lot of ways to do it, that activates autophagy, which then creates this self-cleaning process. So think about it like it's basically this cleanup crew that comes in and cleans up all the garbage and gets rid of all proteins and old inflammatory stuff and then builds new stuff. So it's like you've got this build building construction crew and this demolition crew, and you need both to actually maintain your health and create longevity. So food is the biggest single thing, and we can talk a long time about how to use food to activate all the longevity switches properly.
And the other big thing that I think is driving our disease states is lack of exercise. I mean, most of us are not using our bodies as they are meant to be used. We don't carry and lift things anymore. We don't run anymore, chasing animals to go kill them and eat them like we used to as hunter-gatherers, so our bodies are not being used and are not fit. And that lack of exercise creates this horrible set of consequences that drives disease across the whole spectrum of illness, whether it's dementia or diabetes or heart disease or cancer and many, many other problems. So the right kind of exercise, strength training and cardiovascular fitness are medicines just like food is medicine, exercise exercise is medicine that activates also these longevity switches and pathways. And it also works through these four longevity switches, mTOR, insulin signaling, another one called sirtuins, which we can talk about and AMPK, which is regulated also by regulated by sugar and so forth.
So we have all these redundant pathways that are designed to work together to repair DNA, to shut off inflammation, to clean up old parts, to build muscle, to all these great things that our body needs to do so we can maintain our health, and what's so exciting now is we know how to turn the dials on the switches. It's like a jet plane. You go in the jet plane and it's a little overwhelming, and you see the cockpit, you go, "Man, that guy's going to fly this thing. It's got 4,000 dials and switches, I hope we can take off and land," but your body's the same way. And then the beautiful thing is though, learning a few simple principles, you can keep the thing running without a whole lot of effort if you just know what to do.

Dhru Purohit:
So you covered two. You covered food, which is eating too much and also not taking a break from food, autophagy. You covered also the category of not moving. Do you want to throw in a third bone or [inaudible 00:19:14]?

Dr. Mark Hyman:
For sure. And this is a little bit of a outside, left field thing which I added as one of the 10 hallmarks of aging, not just nine, which is the microbiome. And I add the microbiome because it is such a key part of our health and it degrades as we age, and our diet does not feed the microbiome properly with the right types of fiber and phytochemicals and polyphenols, and we do so many things to disturb our gut. And when we have a disturbed microbiome, it's a huge generator of inflammation in the body, and as we can talk about it later, inflammation is also one of the hallmarks of aging, but it's also one of the most important hallmarks of aging because it drives dysfunction in all the other hallmarks of aging. So if you were to call out one hallmark of aging, that's both the cause and the result of all the other hallmarks, it's inflammation.
And the gut is a huge source of inflammation with so many people because most of us to one degree another, have a disturbed gut microbiome and leaky gut, and that causes inflammation, obesity, and aging at rapid level, and we see this from the data. If you actually look at the data on aging, you see that as people get older, their microbiome is worse. And when they're older and sicker, their microbiome is even worse, so we can learn how to repair and heal and rebuild our microbiome through the lens of functional medicine. It's one of the greatest contributions I think of functional medicine to the field of medicine, is understanding how to fix our gut.

Dhru Purohit:
I love it. So I think it's just worthwhile to just repeat maybe, and if you don't have it in front of you, I think I have the list right over here, just the 10 hallmarks of aging. Again, you already covered one of them, which is the microbiome, right?

Dr. Mark Hyman:
Sure. I'll give you a bullet point.

Dhru Purohit:
In a little bullet point for each one. I think that'd be super helpful.

Dr. Mark Hyman:
So a lot of things go wrong and in no particular order, we have damage to our DNA. Every day we get a hundred thousand little hits death by a thousand cuts.

Dhru Purohit:
And what would be examples of things that would damage our DNA?

Dr. Mark Hyman:
So toxins, poor diet, stress, the microbiome insults, all these things create little nicks on our DNA, and we have a whole repair system that goes in and fixes it, and so that has to happen well. So problems with DNA repair, epigenetic changes, we talked a little bit about the expos on washing our DNA and marking our genes and regulating which genes get turned on or off, so there's degradation in our epigenome. There's also the development of what we call senescent cells. Senescent cells are cells that don't die, and most of the time when your cells are done doing their job, you have this process called apoptosis. They die and they get recycled and all it's good, but sometimes like zombies, they don't die, and then there's many reasons for it. Again, too much of something that we don't need and not enough of the things that we do need accelerates this process. And you get these zombie cells which produce this whole inflammatory cascade that accelerates inflammation, accelerates aging, and also causes other cells to become zombie cells, so they don't die and they just keep going.
We also have the deregulated nutrient sensing pathways that I talked about, mTOR, AMPK, sirtuins and insulin signaling. These four pathways that are really key and really are importantly regulated by food, which is why it's so important. There's mitochondrial dysfunction, so degradation of our mitochondria and how they work, which is our energy factory, so our ability to produce energy, have energy, make energy, it all gets degraded, and there's many ways to improve and enhance the function of your mitochondria, which we go through in the book. And there's telomere shortening. Telomeres are the little end caps like at the end of your shoelace, there's a little thing on your shoelace and prevents them unraveling. Every time your DNA has replicated and you have to replicate its cells all the time, the has to open up and then it has to close up, and the telomeres are part of that regulation, and as we age, our telomeres shortened. And when they get too short, you die and you can't replicate anymore, so that's bad news.
And then there's the microbiome. I added that one, so that was mine, but I think other people are also adding this too and thinking about this, but degradation of the microbiome. The dysbiosis that results in inflammation throughout the body and leaky gut, and that's a huge factor in accelerated aging. The next one is the inflammaging. Inflammaging is one of the most important ones because we have the phenomenon of inflammation as the key driver of almost all age related disease.
So if you look at heart disease, cancer, diabetes, dementia, these are all disease of inflammation, and so as depression and autism, and obviously autoimmune diseases, and so many things that go wrong are diseases of inflammation. So inflammation is both an accelerator of all the other hallmarks and is caused by dysfunction in all the other hallmarks. So for example, if you eat too much sugar, it dysregulates the nutrient sensing pathways into such a way that accelerates inflammation, but also if you have inflammation, it accelerates insulin resistance, so it's all one big web like mishmash of things, and the hallmarks are not separate. They all are dynamically interacting and affecting each other. Was that 10 or did I miss one?

Dhru Purohit:
I think that was 10.

Dr. Mark Hyman:
Okay.

Dhru Purohit:
Yeah. I think that was 10.

Dr. Mark Hyman:
I wasn't counting, but I think that's all of them.

Dhru Purohit:
I want to zoom out for a second. There's a lot of really smart people that are working in this space. Many of them are your peers, your colleagues, your friends, people that you know. And how would you contrast what you're bringing to the table with this lens and view compared to a lot of what has been talked about in the space of longevity? Just using a compare and contrast because I think it's a nice opportunity to contextualize what you're talking about because some of the things that you're saying, they feel like no-brainers to people, but in another way, when you really zoom out, there's a sense when you're reading this book that, this is actually a fundamentally different approach.

Dr. Mark Hyman:
It really is different because what I think is unique about my approach is two or three things. One is, I see the world through the lens of systems biology and zoom out to see the interconnections between everything. And I'm able to see the patterns in the emerging research based on this overarching paradigm shift in medicine called systems biology, network medicine, functional medicine. Two, I've had 30 years of experience of treating patients using functional medicine, and I've had the unique ability and a rare opportunity to have a really deep dive on people's biology because of the nature of the places I worked, at Canyon Ranch and my own practice where people came and they could do thousands of biomarkers. So I literally have thousands of biomarkers on tens of thousands of patients over decades, and that gives me a unique lens into what happens when you change different variables, diet, exercise, stress, supplements, whatever you're doing to optimize people's biology.
So I've seen remarkable things that would seem like miracles that I know work because we've done them and they're repeatable. And I think taking that experience and overlaying it with the science of longevity, it helps me to understand things a little bit differently and a little bit in more depth, and then provide a clinical roadmap of how people can take advantage of the science step by step. How they can identify what's going on in their bodies, their biological age, their imbalances, what's going on with the hallmarks, and then give very prescriptive strategies and a roadmap to correct these problems and to optimize their health, so I'm coming at it from a doctor's perspective. There are a lot of scientists who've written books who are researchers and they're great, and I've learned a lot from them, but they haven't seen a patient and they haven't treated a patient. They're treating mice or they're treating monkeys or whatever, which is helpful to understand the biology, but it really is very different than putting together a comprehensive strategy for people to assess and optimize their biology, so I think that's quite different.

Dhru Purohit:
Are there any hacks, prescriptions, supplements that you feel before we get to your list of recommendations that you have? And you've already talked about food, you've talked about some lifestyle things. We'll tease out a few others. Do you think that there's anything that you see out there right now that is getting a little bit too much weight as a solo intervention for longevity-

Dr. Mark Hyman:
For sure.

Dhru Purohit:
... and aging?

Dr. Mark Hyman:
So Dhru, everybody wants a quick fix. Everybody's looking for the magic pill to extend their life because they don't want to take on other changes. And there's a lot of people out there prescribing and taking metformin, which is a drug that was discovered in 1957 that's been most widely used for the treatment of diabetes. And it helps improve insulin sensitivity and insulin resistance, and it works on one of the key longevity pathways called AMPK, which is really important. And it can help in ways that other diabetes drugs don't, which often, in a way make it worse by increasing insulin, so this is actually a relatively good drug for diabetes. However, looking at the data from the functional medicine perspective, it's important to look at how does it work, how good does it work, and how does it compare to other interventions that may work better?
So right now, there's a lot of research going on and there's a big trial right now called the TAME Trial treating aging with metformin or targeting aging with metformin, which is important because they're doing a clinical trial to determine whether or not this really has an impact. But there's a study that was done many years ago called the Diabetes Prevention Trial, and this diabetes prevention trial was about a thousand people who were pre-diabetic, and they gave them either nothing, lifestyle changes or metformin. And the Metformin group had a reduction in the progression in diabetes by about 31%, and the lifestyle group had a reduction in the progression and performant into diabetes by 58%. And the diet and the lifestyle program was not optimized for diabetes because it was done in the days when we thought a low fat diet was the cure for diabetes.

Dhru Purohit:
1990, it was when the study was done, right?

Dr. Mark Hyman:
So if you look at the data, for example, from Sarah Hallberg and others that I talked about in the book, they use a ketogenic diet for treating not just pre-diabetes, but for advanced type two diabetes, and we're able to completely reverse type two diabetes in advanced diabetics with a ketogenic diet. And they're able to get a hundred percent of people off the main diabetes drugs and about 90 plus percent off insulin, and have a weight loss of 12% and improved all the cardiovascular biomarkers, which you would expect may got worse on a high-fat diet. So it's like, well, if you did the Diabetes Prevention Trial with a ketogenic diet and compared it to metformin, it would probably be a hundred percent versus prevention of diabetes to compare to 58% or 31%, so I'm dubious about it. I'm not prescribing metformin for longevity at this point. I think lifestyle works far better.
Now, there may be people I might use it in who have diabetes, we're working on an interim strategy, but I share a story in the book, I've shared it before, but it's just such a remarkable story of this woman, Janice, who shows the power of what food can do to reverse biological aging and to cure, not just prevent, not just treat, but to cure, and I'm saying that deliberately, many chronic diseases of aging. So this woman was 66, she came to Cleveland Clinic and joined our Functioning for Life Program. It was a group program, not even a one-on-one doctor's visit, and it was based on the 10-day detox diet, which essentially is a very low glycemic, 50% fat, not keto, but higher fat, phytochemical rich, high fiber, anti-inflammatory detoxifying diet. In three days, by the way, she had a BMI of 43, so that's huge.
Obesity's 30, severe obesity's 40, and she was very, very overweight. She had type two diabetes for 10 years on insulin. She had heart failure, her kidneys were failing, her liver was fatty, she had high blood pressure. She was on a pile of meds, $20,000 copay a year. In three days she was off of insulin. In three months, her A1C, which is your average blood sugar, going from 11, which is probably an average of 300, almost needed to be in the hospital with that number to perfectly normal at 5.5, off of all her medications and her heart failure reversed, and her kidneys normalized, and her liver normalized, and her blood pressure normalized. And then in a year she lost 116 pounds and all her diseases went away, and she reversed her biological age and she got off all her medications. Now, I could've given her all the metformin in the world and none of that would've happened, and she was already on all that stuff and it wasn't working.
Those managed diseases, I don't want to manage disease, I want to reverse them by creating health. We didn't treat any one of her diseases. I just optimized her health and created health, and as a side effect, the diseases went away, so that's the beauty of functional medicine. I don't have to know anything about the diseases that I'm treating, but I do obviously because I'm a doctor. All I have to do is use the science of creating health, AKA, functional medicine, and the diseases go away as a side effect.

Dhru Purohit:
I love it. I want to take a little quick pause and actually go through something that you've put together in your book, which is a great resource for folks, and it's your approach to the food pyramid. And I want to walk through it really quickly.

Dr. Mark Hyman:
Okay, sure.

Dhru Purohit:
Because people are so interested, you are the food is medicine doctor, and they're so interested about how you think about food and what to prioritize. And I think a thing that a lot of people don't necessarily know about your work is you really encourage people to get to a place where they have metabolic flexibility.

Dr. Mark Hyman:
Yeah, for sure.

Dhru Purohit:
Where they can enjoy a lot of different types of foods, but when their foundation is solid, that makes them able to do that. You're not the guy that's saying, "Don't ever eat sugar." You're not the guy that's saying, "Don't ever eat any particular category of things that are there." You're the guy that's like, "Hey, when we have it dialed in, then we can have a lot more flexibility, but first we've got to dial it in a little bit." So this is a little bit different than your 10-day detox diet.

Dr. Mark Hyman:
For sure.

Dhru Purohit:
This is your Pegan diet. So I have the food pyramid here, maybe Patrick, for those on YouTube, we can throw it on the screen, and for those listening on audio, we can link to it as well. So walk us through the top of this food pyramid, and we're going to start off with the top of the pyramid, the little triangle at the top, and help us understand each one of the categories as you walk through.

Dr. Mark Hyman:
Yeah. Well, first of all, I want to say that there's really a two approaches. One is, if you have a disease or a problem, then we take a slightly different approach, which is we personalize the approach. So for example, if you are in an advanced type two diabetic, there's zero tolerance for deviation from a certain type of way of eating if you want to reverse the diabetes until you are metabolically flexible or metabolically resilient. So the key is not to be restrictive, but to optimize your biology, tune your body up so it can run 200 miles an hour and not go at three miles an hour like most people's metabolic processes go. So how do we tune up your biology? That's really key, and how do we personalize it based on what's going on with you? But for the general population, you can achieve metabolic resilience without having to be too extreme.
But it really means understanding what is information in food and how to use food to upgrade your biology, so at the top of the pyramid is recreational treats, things like alcohol, sugar and so forth. And I would just say that not on the pyramid and not included in recreational treats are ultra processed food. They're just zero. I will never eat an ultra processed food no matter what. If I'm in an airport and starving, I'm not going to eat anything with high fructose corn syrup, trans fats, a thousand ingredients that are weird because they're not food. So it would be eating a rock. Why would I eat a rock? So I just don't, and I think nobody should really eat those foods because they're extremely harmful and they create all sorts of downstream consequences that drive aging and disease and also make us eat more of them because they're designed to be addictive, so that's just a no, no.

Dhru Purohit:
When you start, you can't stop.

Dr. Mark Hyman:
Yeah. So those are foods we know, all the snacks and candies and processed foods. The things that are okay are things like sugar in small amounts, they're recreational treats. So for example, I like to drink tequila. I'm not going to have it for breakfast, lunch and dinner. I'm not going to have a bottle every day, but I might have a shot a couple of times a week or maybe a couple of times a month is probably how much I actually have. Sugar, same thing. It's not you never have it. On Thanksgiving, I'm going to have a nice gathering and I'm going to have pecan pie because I love pecan pie, but I don't really eat pecan pie except on Thanksgiving. But I know I'm exercising, I'm eating well, my insulin levels are low, my lipids are good, my hormones are balanced, so I can actually tolerate more stress, more biological stress from the food because it is a stress to eat these foods. Alcohol the same thing.
So I think recreational treats are fine, but they should be seen as a special kind of thing that you don't do on a regular or daily basis. And then the next category is things that we can use that are designed to upgrade our health, and these can be mixed with all the other foods, but spices and herbs are really important because they contain so many phytochemicals. So I was in Sardinia and in Korea researching my book on longevity, and I went to Korea and they had this incredible tea they served me. That's just because they have so much of this wild sage growing there everywhere. And they don't have a lot of money, but they live in this abundant world where they harvest all these greens. They have summer greens, winter greens, all these wild herbs, and wild food has way more phytochemicals.
So they make this wild sage tea that is yummy and tasty, and it turns out has as many of the powerful phytochemicals that are in green tea, these catechins, which we know increase longevity through many of these longevity pathways. So I'm drinking this wild sage tea, and that's really helpful. Or you can use Indian food for example. It's full of spices like curcumin and pepper, and all sorts of these wonderful spices that upgrade your biology and improve inflammation and our antioxidants, and help your microbiome, so I included a lot of herbs and spices. And then I think the next is eating grains and beans. Now, grains and beans are not part of our diet from an evolutionary point of view. We really didn't have them in our diet, but I do think there are certain grains and beans that can be part of a healthy diet, and this is very personal. If you're metabolically healthy, you can tolerate more of them. If you have insulin resistance or diabetes, you have to be careful at how you're eating them, what you're eating them with and so forth, and you can now measure what's going on.
You don't have to guess anymore. There's companies like Levels that have these continuous glucose monitors and you can track what's happening in real time to your biology. So say, "I'm going to have a cup of brown rice because that seems like a healthy food." Okay, great, do it. See what happens if your blood sugar goes through the roof, it's not working for you, and it also depends on your microbiome too. We know from studies from Israel and other places that the microbiome will affect how any particular food affects your blood sugar. That's a whole nother conversation, but our microbiome plays a role as well, so you need to track your own numbers.
And I think part of the exciting thing about longevity research is these biosensors that are emerging and we have them, we wear them, or a ring or an Apple Watch or a Fitbit or a Whoop, or these implantable ones that are coming that may detect over a thousand biomarkers, the continuous glucose monitors, which are available now, which are pretty fun to track and see what's actually happening. So I think there are certain ways to eat beans and grains, and I say eat weird grains, eat weird beans, and you want the more heirloom kind. You want the kinds that are not super high in starch. So for example, we were with our friend Jeff Bland the other day, who's the father of functional medicine, and he started producing this ancient grain from a hundred-year-old seeds.

Dhru Purohit:
Which is really a fruit.

Dr. Mark Hyman:
This is really a fruit. It's a flower-

Dhru Purohit:
[inaudible 00:39:37].

Dr. Mark Hyman:
... but I think it's a flower, and it's a tartary buckwheat, and I don't know why they call it wheat because it's nothing to do with wheat, but it's basically this ancient grain like substance compound that's grown in the Himalayas that is full of 132 phytochemicals. It's very high in protein, very high in microbiome, beneficial fibers and phytochemicals. It has compounds that are found nowhere else in nature, and you can make pancakes with it or you can make noodles with it, or you can make bread with it, and that might be actually a very healthful food. So there are weird things like black rice or forbidden rice, the emperors rices like the blueberries of rice, and that's full of, again, phytochemicals or certain types of quinoa. These can be fine, and I think it's important if people want to include these, that's fine.
But again, watch what happens to your biology, look at what happens to your numbers, track your numbers. It's so important because most of us don't track what's going on inside, and that's so exciting to me for really... We look at the accelerating pace of technology and the accelerating pace of scientific advance, and what used to... My first computer had four megabytes of hard drive and one megabyte of RAM, and it cost $3,500, and now I have a supercomputer in my pocket for a couple of hundred bucks, so that's happening in terms of testing, diagnostics, we're going to get there pretty soon.

Dhru Purohit:
So one clarification, just as you're going through this list, spices and herbs is listed above beans and legumes, but you want spices and herbs to be-

Dr. Mark Hyman:
For sure.

Dhru Purohit:
... frequent in our diet. It's just that the quantity, you're not going to really eat that much spices, is that right?

Dr. Mark Hyman:
And it's based on volume too.

Dhru Purohit:
Volume, okay. Great.

Dr. Mark Hyman:
It's based on volume.

Dhru Purohit:
Awesome.

Dr. Mark Hyman:
And then down next is the fruit and starchy vegetables. So again, depending on what's going on with you, if you're a type two diabetic, you might not tolerate a lot of fruit, or you might only tolerate certain fruits like berries but not bananas. Or you might tolerate certain types of potatoes like purple Peruvian potatoes, but not Yukon, big starchy potatoes. So I encourage people to track what's going on, but I personally find that if I don't eat them, I don't function well. So I need some degree of starchy vegetables, so I have Japanese purple sweet potatoes. I have weird... I call them weird and ugly vegetables because they're, again, more heirloom, they're more richer in phytochemicals. And the beautiful thing about phytochemicals and food is medicine is that the flavor of the food comes from the phytochemicals in the food.
I mean, if you look at processed food, the flavor comes from the additives and chemicals, and sugar and starch, sugar and salt and fat that's in the food. When you look at these natural foods that are rich in phytochemicals, flavor always is resulting from the phytochemical richness of a food. So the more flavorful of food is the better it is for you. And Dan Barber figured this out as a chef, he's like, "Oh God, this butternut squash is looks good, but it's sort of tasteless, so how do we get a really yummy tasting squash?" So he created the honeynut squash, which was, in a way, kind of reverse engineering and hybridizing foods to create new varieties that actually are more like heirloom varieties to increase the flavor, but that is only because they're increasing the phytochemical richness of the food, so that's really, really important.
So I think, again, track what you're doing, watch what you're doing in terms of foods, but track your numbers. The next layer down is protein. And I think this is a very controversial subject, and it's a very confusing subject for people because many longevity researchers are saying, "Be a vegan, don't eat any animal protein."

Dhru Purohit:
Minimize animal protein.

Dr. Mark Hyman:
Minimize it or eliminate it as the solution to longevity. And I think a lot of these, just to be honest, these are very smart guys, PhDs, Nobel Prize winners. I mean, they're way smarter than I am, but they also haven't treated patients. And I think it's important to understand that, when you look at the science of protein and aging, it's really a Goldilocks problem. Too much is not good, but not enough is also not good, so all the centers around this pathway of mTOR. mTOR like I said, when it's stimulated, it builds muscle which is the currency of longevity.
What happens as we age is we lose muscle. It's called sarcopenia. Our muscle becomes like marbled fat like a rib-eye instead of a or Wagyu steak instead of [foreign language 00:43:54]. And when that happens our aging phenomena accelerate. So we become more insulin resistant, we become more inflamed. Our hormones dysregulate, our cortisol goes up, our growth hormone goes down, basically it just creates a disaster, plus all the frailty and disability and weakness that comes with it. So you have to activate mTOR in the right way at the right time to maintain your muscle mass, and that's one of the most important things you can do as you age, is maintain your muscle mass. So you need to have the right type, quantity and timing of protein to do that. And I talk about this in the book, but there was a large survey of all the scientific literature by all the world's leading protein experts... Well, maybe not all of them, but most of them called the PROT-AGE study. The PROT-AGE study really looked at, what do people need as they age in terms of protein?
And it turns out that we need a lot more and we need a lot higher quality protein than most people are getting as we age. And high quality means, it has the right amount of the muscle stimulating amino acids, which are the branch chain amino acids, particularly one called leucine, which it happens to be very low in plant proteins. Now, you can get enough of it in plant proteins, but you have to eat large volumes or you have to eat high amounts of highly processed plant protein powders, which is another way to do it if you really are committed to being a vegan, or adding branched-chain amino acid supplements or adding, for example, certain things like amino acid complex, which is a research product that came out of Europe that has high levels of leucine and all the amino acids to stimulate muscle synthesis and is used in treating sarcopenia.
There's ways to hack this, but you need to have at least 0.8 grams per kilo, which is the minimum amount to not get a protein deficiency disease. So we say, "Oh, you need 0.8, that's most people are getting more than that." You need actually, probably 1.2, 1.5, even two grams per kilo as you age, depending on your activity level and exercise level to maintain muscle mass. And part of the problem is that as you age, you get something called anabolic resistance. When you're younger, you can put on muscle a lot easier. When you're older you can't, anabolic means to build muscle, so you get resistance to building muscle because of the phenomenon of aging, but you can overcome that by the type of exercise you do and the right amounts of protein. So I would say most people need at least a palm size piece of protein, which is not that much for most people. It's like a four ounce piece of chicken or fish, or grass-fed or regenerative steaks, those can be very effective in maintaining and building muscle as we eat, so that's important to get adequate amounts of protein.
And then the bottom, which is the most abundant and the most important, I think, layer of the pyramid is the source of all the phytochemicals, and these are all the colorful fruits and vegetables which are rich in medicinal compounds that have been shown through many mechanisms to regulate so many of these hallmarks of aging and longevity pathways. And they're being studied, whether it's quercetin that reverses biological age or resveratrol, or things like fisetin, which is from strawberries that kills zombie cells, so many of these longevity pathways are regulated by these phytochemicals. So you want a richer array of phytochemicals, and the best way to do that is to eat as many wild foods as you can, which is hard for most people, and that was what I found in Korea. They actually ate a lot of wild foods. They ate wild mushrooms, they had wild tea, they had lots of greens, wild greens, summer greens, winter greens. So they had every day as part of their diet.
Even if you go to a restaurant, you get wild greens on the menu. It was amazing. And so wild foods are rich in these compounds, and they also eat animals that eat wild foods. So the animals actually take these compounds up from the food they're eating, and these phytochemicals end up in the meat and the milk of these animals. In Sardinia, they had a lot of goat cheese and sheep cheese and products, and they were very rich in these phytochemicals, which I believe helps enhance their longevity, so that's really key, and that should be probably 80% of your diet by volume.
I call this a plant rich diet as opposed to plant-based diet, or plant forward diet, whatever you want. But I think it's very different than just being a hundred percent vegan. Now, you can do it, but it's very tough. And I can say after treating thousands of patients and many vegans over long periods of time, and also looking at the scientific literature, it's very hard to build and maintain the type of muscle you need as a vegan unless you are really proactive and understand the science of it, and compliment your diet with extra amino acids and extra types of plant proteins that are jacked up proteins. So I think it's possible, but it's very hard to do.

Dhru Purohit:
That's super helpful, Mark. If we were to create almost like a pyramid for the things that are not dietary related that-

Dr. Mark Hyman:
That's a great question.

Dhru Purohit:
... you want people to be thinking about... I know number one at the top, you've already mentioned it before, exercise would be right up there.

Dr. Mark Hyman:
Yeah.

Dhru Purohit:
What would you put next in that category?

Dr. Mark Hyman:
Hormesis. What's that, you're asking?

Dhru Purohit:
I know what it is, but talk about it for the audience. And by the way, if we're thinking about it in terms of the triangle and building up from there, would you even say that exercise is, obviously all these things go together, but in terms of prioritization, when you look at the world, there's been a lot more conversation about sleep. But do you think that most of your patients that come in that you still see today, they need to dial in exercise more than they need to dial in sleep, or is it pretty similar?

Dr. Mark Hyman:
I mean, listen, we all need seven to eight hours of sleep, and if you're not getting good quality of sleep, you can't be well.

Dhru Purohit:
So let's say exercise and sleep right up there on the top.

Dr. Mark Hyman:
Exercise, sleep, and then stress reduction. The basic foundational lifestyle stuff, I think is all key. And our mindset, our thoughts, our beliefs also regulate our biological aging, so all those are key, and we could talk about that for hours, but I think something unique that people don't know about is this idea of hormesis, which is a stress that doesn't kill you that makes you stronger. So exercise is a form of hormesis we're all familiar with. You lift weights, you tear muscle, you build more muscle, you get bigger, stronger and fitter.

Dhru Purohit:
Which also creates extra mTOR in the body, but it's just a temporary situation.

Dr. Mark Hyman:
It's temporary.

Dhru Purohit:
It's like people eating protein, and the fears around that is that, "Well, it's just a temporary situation and your body re regulates."

Dr. Mark Hyman:
Exactly. Like we all say, "Oh, mTOR, you don't want to activate mTOR so you shouldn't exercise." Well, that's ridiculous, so it's really the Goldilocks problem. What's the right amount of activation of mTOR and right amount of inhibition of mTOR. But hormesis is a beautiful concept that can be applied across a broad range of therapies, and you can use some of them that are super easy and accessible and others that are maybe a little more difficult to get now, but will be part of medical care. So obviously diet can be a paramedic phenomena. If you restrict calories, it's a form of starvation, so if you don't eat for 12 or 14 or 16 hours a day, which is called restricted eating, your body sees that as a little bit of a stress, "Oh, there's no food. Let me activate all my healing systems to compensate for that."
So we have so many genes that are designed to protect us from starvation and help us live in periods of scarcity. We don't have many genes that help us deal with too much and abundance, and excess, which we have now. So different kinds of modifications of the timing we're eating, whether it's calorie restriction, which is a little harder for people, and I don't think most people can do that. Time restricted eating, intermittent fasting, which could be a 24, 36 hour fast a week, longer fasts. There's all kinds of ways they're doing it. Fasting mimicking diets, keto diets, all do the same thing, which is a mimic starvation, and that's a stress, and that is the stress we know extends life more than any other known intervention. So if you restrict calories by 30%, you'll live 30% longer. Meaning if you restrict calories by 30%, you'll live to 120 years old based on animal studies, so this is a really, a very important part of hormesis.
The second is exercise, obviously, which we talked about. A third would be phyto-hormesis, which is including these plant chemicals which are not designed for human health. They're designed to protect the plant, they're their defenses, so there can be little stresses that activate the body into a healing response. So a lot of phytochemicals is also an important phenomena. We call that phyto-hormesis. And then there's other things which we can do like I did this morning, which was take an ice-cold shower, which sounds like a horrible thing to do in the morning, but it's better than a cup of coffee, and it really works to activate longevity switches, so hot and cold therapies. And I talk a lot about hormesis in the book, but saunas, hot baths, cold plunge, cold shower, these things are very activating for many different mechanisms.
For example, a sauna will activate these things called heat shock proteins, which are designed to repair... Oh, I didn't, one of the hallmarks I didn't talk about was damaged proteins, so that's one I missed. So you have lot of damaged proteins as you age, and these misfolded, dysfunctional proteins cum up your system. So saunas actually help to repair these proteins and help to either get rid of them or repair them, and it also activates your innate immune system. And in one series of studies that was done in Finland, they found that if you took a couple of saunas a week, and by the way, their control group was once a week because everybody in Finland takes saunas once a week, so it wasn't even no saunas, it was more than once a week. It was two or three times a week, like a 24% reduction in mortality. If you did it four or five times a week, it was a 40 something percent reduction in mortality.

Dhru Purohit:
Specifically sauna, not-

Dr. Mark Hyman:
Sauna.

Dhru Purohit:
... necessarily cold.

Dr. Mark Hyman:
No, the cold plunge is different, but that activates a lot of neural pathways that enhance dopamine, that activate brown fat, that improve your mitochondrial function, that repair... I mean, I did this cryotherapy when I was at this hotel in Europe, and I had so much energy, I felt so good. I was like, "Wow, this is like taking cocaine without all the bad side effects," so I think it was pretty impressive. So cryotherapy is easy and most people can do it by taking a cold shower. I have a little steam shower at my house, and I fill up the bath with cold water. I jump in there, I go back and forth, and that's something that most people can access, whether it's a hot bath or a cold shower. Most people have that. And you can get saunas, you can get cold plunges, you can go all the way.
Then there's other hormetic therapies that are also important. One of them is, for example, hyperbaric oxygen therapy, which is a stress to the body because you're putting your body in basically a container that increases the pressure on you to two atmospheres, which is like being 66 feet underwater and then pumps in a hundred percent oxygen, which is not normal. That's a stress, and that activates all these healing pathways, and in one really interesting study in Israel, they found that more than any other intervention to date, it kills zombie cells more than any other intervention and it actually lengthens telomeres more than any other intervention, so that's cool. And then there's other therapies like ozone therapy, which is an oxidative therapy. We think, well, oxidation's bad, but a little bit of oxidation activates your body to respond stronger and turns on all these longevity pathways and it improves your mitochondrial function, stem cell production. Oh, yes. Stem cell exhaustion was another hallmark that I forgot, so our stem cells die out. Sorry, I forgot those, but now I'm remembering.
And so our stem cells kind of poop out and that activates them. It turns off inflammation and it helps you increase your antioxidant enzymes, so many things, so ozone's another one. Hypoxia, that's another one, so low oxygen states, another kind of stress. There's machines that actually you can put on your face called the Cell Gym that will take you up to Mount Everest for a little while and then bring you back down, and then give you more oxygen. And that hypoxia state is a stress to the body and it helps to clean up old mitochondria and repair mitochondria, and increase mitochondrial function, so that's another one. You can also get a $50 hypoxia mask, which restricts air, and you can sit at your desk working on your computer and be hypoxic or exercising, and a lot of athletes use these when they're training.

Dhru Purohit:
They even have these little whistles that you can get on Amazon that do the same thing. You blow out a certain amount of resistance, you breathe in a certain amount of resistance, and that, I think, is 12 bucks on Amazon.

Dr. Mark Hyman:
So also light therapy can be hormetic, so red light therapy actually activates mitochondria and repair healing and DNA repair, so there's a lot of therapies that we can start to include as part of our suite of tools. And some of these, again, like ozone therapy is a little bit hard to get, or hyperbaric oxygen therapy is hard to get, but these are things aren't going to become more part of our regular medical care.

Dhru Purohit:
In the future, do you see them as they're going to be just part of your normal gym the way that people have gym memberships?

Dr. Mark Hyman:
Absolutely. I mean, I would say it's exciting as there's a lot of companies popping up that are providing these various therapies in settings that are outside the healthcare system where people can go and pay, and join these kinds of experiences where they're getting a lot of these therapies like the ozone and the hyperbaric oxygen and mitochondrial stimulating things like Cell Gym, so it's out there. It's coming more.

Dhru Purohit:
Well, Mark, I know we only have you for a little bit more time, but what is the message around this book and the sense of hope that you want to bring to people when it comes to this area of aging, which can feel very scary, especially if people hit these milestone years, 40, 60, 80, whatever it is, there's a sense of, you look around, a lot of people don't even want to actually get older and you talk to most people. I would never want to be 120 and shriveled up in some nursing home and I'm not able to feed myself, and I don't know who anybody is. So what do you want to say to those folks who think that that's their vision of aging?

Dr. Mark Hyman:
Well, that's clearly what we see all around us. If you lived in Sardinia and Korea or Kanawa, you wouldn't think that, but if you live in Sweden and every car's a Volvo pretty much, if you live in Texas, maybe you don't see Volvos very often. It doesn't mean Volvos don't exist. It just means it's not around, and so I think we have to reframe our conception of aging and realize that if we take care of ourselves properly, just like if we have a car from 1920, that'll still run if we take care of it. It takes a little more attention, a little more love, a little more maintenance, and that's true. I can't do the same things and run myself the same way I did when I was 20, but I can still perform at a high level. I can still feel good. I can still often outperform my friends who are 30 or 40 years old because I've learned how to hack longevity, if you will.
And I think the message I want people to understand is that what we see around us is abnormal aging, nobody wants that. But by using the tools and principles in Young Forever, by taking advantage of the science of functional medicine and the emerging science of longevity, we can reimagine aging to look very different. And so my imagination takes me to a place where I'm 120 years old, I go for a hike in the mountains with my partner, my love of my life. I swim in this beautiful lake after, make a delicious dinner, have a bottle of wine, make love and just drift off into the never world, and that's how I want to go, and I think it's really quite possible. Jeff Bland, who we were just with yesterday, tells a story of, I think, his grandfather who basically was the patriarch of the family.
He was a hundred years old or something, and he had a beautiful dinner with everybody, he said his goodbyes and was having a great meal, and walked to bed and he said, "I'll see you. This is it." And he basically went to bed and he never woke up, and he was checked out. I think that sounds pretty good to me, and I think I also want to just leave people with this notion that, it's not about this narcissistic hedonism of wanting to extend your life, and it's not about doing it for the purpose of just selfish purposes, but it's really about harvesting the incredible wisdom and insights and experience that happens as we age. So at 62, I'm going to be 63 in a week, I feel like I understand life better. I understand myself better. I understand how to be a better person, to be a better friend, a better father, a better partner to give my contributions to the world, to have better impact.
And so imagine harvesting all that for our society, not having to take care of a bunch of decrepit old people, but people who are a vital part of society who are adding wisdom and value to the world as they get older, and who need less and want less from the perspective of having to climb the ladder of success. They've done it, they've got there, and now they can give back, and so that's a very different world. And just to share a quick note about the economics of this because you go, "Oh my God, what happens if we extend life and it's going to cost so much, and the planet can't take it and it's going to be such a burden?" And that there's a lot of research actually looking at this kind of concept, and David Sinclair published a paper in Nature Aging and talking about this, and I didn't understand half of it because it was this very complicated mathematical models that they used.
But essentially what they said was, if we extend life by one year because we're going to be improving health and reducing the burden on the healthcare system and we're going to be increasing productivity and value by adding one year of life, we will add about $37 trillion of value to the economy. And if we extend life by 10 years, it's over to $360 trillion. Now, that's a lot of dough. I think that's more than the GDP of the entire world annually, so that's pretty impressive. And if we see it as a value add rather than as a cost, if we see it as a way of enhancing the value to society through the wisdom and experience of elders, well, I think that's a win.

Dhru Purohit:
I love it. It's a hopeful message and it's a great place to end off. The book is out or on pre-order depending on when this podcast comes out there, Young Forever: The Secrets to Living Your Longest, Healthiest Life. Mark, what's one thing that you're going to do today? You have a whole day of press, podcast, other stuff. You already took a cold shower, so you can't answer that. Well, so one other thing that you're going to do to set your longevity up for success today?

Dr. Mark Hyman:
Well, a couple of things. One, I'm getting a green juice and a protein smoothie for breakfast, which is coming now. And then I'm going to go have dinner with my team and celebrate life and myself and my birthday, and what turns out to be almost as important as anything else is community. I mean, if you're part of a knitting group or a bowling club, you're going to live longer. And so being with people you love, you care about who see you, who value you, who you add your value to is also medicine. Community is medicine just as food and exercise are medicine.

Dhru Purohit:
I love it. Mark, thank you for coming on the podcast, for sharing your wisdom, and I'm excited to catch up with you at dinner tonight, and I have a surprise for you. We have pecan pie.

Dr. Mark Hyman:
Oh, no.

Dhru Purohit:
We have pecan pie for you. I know it's your favorite. Mark, thank you for being on.

Dr. Mark Hyman:
Thanks, Dhru.

Outro:
Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search there, find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.