#202 – Enhancing longevity via functional medicine | Dr. Mark Hyman & Dr. Casey Means

The hallmarks of aging are various biomarkers that indicate advancing biological age, which leads to a decline in health and eventually to death. But we can boost longevity by understanding aging biomarkers and then taking actionable steps with nutrition, physical activity, and environment. Dr. Mark Hyman and Dr. Casey Means discuss the hallmarks of aging and the factors that are within our control to not only live longer but also to thrive.

Helpful links

Connect with Mark Hyman, MD, on Instagram: https://instagram.com/drmarkhyman

Connect with Mark Hyman, MD, on Twitter: https://twitter.com/drmarkhyman

Connect with Mark Hyman, MD, on LinkedIn: https://linkedin.com/in/drhyman

Buy: Young Forever: The Secrets to Living Your Longest, Healthiest Life: https://youngforeverbook.com

The UltraWellness Center: https://www.ultrawellnesscenter.com/

Function Health: https://www.functionhealth.com

**3:57 — The current healthcare system does not address root causes of conditions**

Dr Hyman aims to empower people with actionable steps that can help them to not only feel better throughout their lives but to also thrive.

> The way we both were trained in medical school is really just suppressing symptoms and treating diseases and not understanding that we now know the science of creating health. And by creating health, we can create vitality. By creating vitality and energy, we can actually move the world forward in a better place, where people aren’t struggling. I think there’s so much needless suffering in the world that can be relieved by just really simple, simple things that people can do that they’re not even aware of that can reverse disease, that can reverse their biological age, and make them better at everything they want. Whether it’s being in a relationship, doing the work they want to do in the world, just being a good human being.
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**5:23 — We can look at aging as a pro rather than a con**

We can address aging biomarkers to reverse or prevent disease processes. Doing so can extend lifespan as well as healthspan—the years someone is in generally good health. When people are in good health in their senior years, they can enjoy life with the wisdom and experience that comes with age. And society as a whole can also benefit.

> When you think of a society of older people in most cultures, they’re revered, they’re elders. In this culture, they’re kind of shoved off in nursing homes and forgotten about. But I think that the reservoir of wisdom and intelligence and goodness that can be developed through a lifetime of struggles and learning is something we don’t want to waste. And so when you look at the economics of this, “Oh, you’re going to have a bunch of old people and it’s going to be a drain on society and a cost”—actually it’s the opposite. If you actually create healthy people who are older, you add enormous amount of value to society.
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**9:27 – Abnormal aging is a disease, not a consequence of getting older**

If we address the hallmarks of aging, several of which Dr. Hyman explains, we can prevent—or stave off—age-related diseases that lead to decline and death.

> Scientists are actually now thinking of aging as a disease—not getting older, but the phenomena breakdown and the decline we see and the diseases we see—as not just a normal consequence of getting older, but as abnormal aging as a disease that can be treated and prevented and reversed by understanding the root causes of it. So for example, if we cured all cancer and heart disease from the face of the planet—the number one and two killers—we might see five to seven years of life extension. If we address the underlying root causes of all the disease of aging—heart disease, cancer, diabetes, dementia, which by the way are driven a lot by sugar and insulin resistance and all the things that you’re working on Casey to help educate people about—if we got rid of the problems with these underlying hallmarks of aging, which I’ll describe in a minute, than we might see a life extension of 30 or 40 years, which means we might live to 120.
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**12:18 — We can influence our gene control system to counteract biological aging**

Chronological age involves the time a person has been alive and isn’t something we can change. Biological age is one’s age based on aging biomarkers, such as how well cells are functioning. It can be vastly different than chronological age. We can influence our gene control system in a positive way that helps reverse biological aging.

> The epigenome is essentially this control system that sits above your genes. “Epi” means above, and think of it like the piano player. You’ve got 88 keys on your piano that you can play jazz, classical, ragtime, rock, blues, whatever on the keyboard—the same keys. And the epigenome is like the piano player that can play all these different tunes depending on what you do. And so a lot of the things that we do to either cause rapid aging, which influence our epigenome in a negative way, or to positively influence our epigenome, we can reverse the changes on our epigenome that happen as a consequence of what we eat and stress and toxins and so forth. And we can reprogram our epigenome to a younger you. And this is really what we’re looking at with biological aging. We’re actually being able to measure the tags on our genes that determine our biological age, and then we can do interventions that will change that and reverse our biological age, which is quite amazing.
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**14:57 — The foods we eat affect longevity**

Nutrient sensing is how our body responds to our nutrient levels and needs, but our nutrient sensing can become deregulated, which is a hallmark of aging. The insulin-signaling pathway plays an important role in this deregulation that can then negatively affect longevity.

> The four longevity switches are the insulin signaling pathway, which is one of the most important determinants of aging and disease. And this is really what your work is all about, which is understanding how sugar and starch influence this insulin signaling pathway. When this pathway’s turned on all the time—which it is through our 52 pounds of sugar and our hundred 33 pounds of flour that we eat, which are the same in our bodies—that’s overstimulating this insulin pathway that is causing us to gain weight in our bellies, causing us to have more inflammation in our body and damage our mitochondria to cause DNA damage to cause epigenetic changes that make us biologically older that affect the brain and cause dementia. There’s just enormous damage that happens when this overstimulation is the insulin signaling pathway. So the key to kind of fixing that is cutting down the starch and sugar and actually eating a very low-starch and sugar diet and eating more high-quality fats and good protein, lots of fruits and vegetables, all this stuff that’s common sense, but that people don’t do.
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**21:52 — Consumption of ultra-processed food drives aging processes**

Society as a whole eats too much ultra-processed food, and such consumption is impacting health and longevity.

> Understand that ultra-processed food is deadly. For every 10% of your diet that’s ultra-processed food, your risk of death goes up by 14%. And our diet is, on average, 60% ultra-processed food. For kids it’s 67%, which is really frightening. I mean, almost 70% of their diet is this stuff that isn’t actually food. It’s these weird chemically processed, colored, extruded food-like substances that have really no resemblance to the original form. So that is the first thing you can do. The second thing is, really in terms of starch and sugar, keep it at a bare minimum. Have fun treats occasionally. There are hacks, and I have all kinds of recipes that are low-glycemic yummy treats you can have once in a while. But really understand that the amount of flour and sugar eating is deadly and is driving all the pathways.
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**33:51 — Functional medicine is a framework**

Functional medicine can be a tool for helping you determine what’s in your control for optimizing your health, counteracting disease, and enhancing longevity.

> The framework of functional medicine—which is not a specialty, it’s not an alternative therapy—it’s a way of thinking, sort of an operating system for understanding how the body works and interpreting all the data. What it really comes down to is looking at: What does your body need to function? Hence the name Functional Medicine. And what causes it to malfunction and what causes it to function at a high level? What do you need to get rid of and what do you need to get in order to be healthy, in order to operate your system properly in order to upgrade your biological software?
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**50:11 — Traditional healthcare doesn’t empower people regarding their health and longevity**

In traditional medicine, doctors test only what needs to be tested at the time, and the entirety of a “normal” range isn’t necessarily considered optimal or what will boost longevity. Dr. Hyman cofounded Function Health, a company that tests more than 100 biomarkers of health and then provides people with actionable guidance.

> I think we can really make a difference for people by identifying these imbalances and these abnormal biomarkers. And the beautiful thing about function health is we created a roadmap for people to interpret the test and to know what to do from a lifestyle perspective, from a nutritional supplement perspective, from when they need to go to the doctor, maybe do the next thing perspective. And there’s a whole AI engine behind it that’s going to help inform the patterns that we tend to see in people and guide people to much more personalized, proactive care. And the beautiful thing about is we kind of disintermediate the healthcare system and the doctor.
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**58:16 — A fasting insulin test is a helpful biomarker**

Doctors don’t routinely test fasting insulin, but it can be an informative biomarker for understanding symptoms and chronic conditions.

> I think a fasting insulin is sort of intermediate biomarker and it’s very inexpensive and it’s available and doctors just don’t order it. And it is probably the most important test because your blood sugar could be perfectly normal. And we’ve talked about this on the podcast, Casey, where you have someone who’s severely overweight, who’s got a big belly, who you think is going to be terrible on their blood sugar, but their blood sugar’s perfect even after a glucose tolerance test. But their insulin could be not 2 or 5 or 10; it could be 200 or 300. And that insulin is really driving all these horrible downstream consequences.
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**101:26 — Fixing our food systems will take time, but progress is on the horizon**

Dr. Hyman, who is an activist for better nutrition and food systems, says people are paying attention and change is occurring, albeit sometimes slowly.

> This is a long-haul job, but I do feel hopeful because I think there’s a real understanding among food corporations, among policymakers, among the public, that things are unsustainable the way they are. And I think that the levers for change are many, but it ultimately has to be both driven through business innovation and people being empowered to understand their bodies, like the work you’re doing, the work I’m doing, and other innovations in food and in agriculture that are happening that are great. And there’s big investments from large corporations and billions of dollars flowing into regenerative agriculture, into understanding how to optimize a food system. And so I think there’s a lot of things happening on the business end. On the policy end, I think it’s a little slower, but I do see change.
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Dr. Mark Hyman (00:00:06):
Ultra processed food is deadly. For every 10% of your diet, it’s ultra processed food, your risk of death goes up by 14%. And our diet is 60%, on average 60% ultra processed food. For kids is 67%, which is really frightening. It means almost 70% of their diet is this stuff that isn’t actually food.
Ben Grinnell (00:00:32):
I’m Ben Grinnell, part of the early startup team here at Levels we’re building tech that helps people to understand their metabolic health. And along the way we have conversations with thought leaders about research backed information so you can take your health into your own hands. This is A Whole New Level.
Dr. Casey Means (00:01:01):
Welcome everyone to A Whole New Level. This is Dr. Casey Means, co-founder and chief Medical officer of Levels. And I am overjoyed to welcome the legendary Dr. Mark Hyman to our episode today. We are going to talk about his new incredible book, Young Forever, out February 21st, pre-order today, and I know this episode is going to be filled with so many actionable tips about healthy aging. I cannot wait to share it. Dr. Mark Hyman is a family physician and an internationally recognized leader, company advisor, speaker, educator, advocate in the field of functional medicine. He is the founder of the Ultra Wellness Center. He’s the senior advisor for the Cleveland Clinic for Functional Medicine. He is a 14 time New York Times best selling author, soon to be 15. He is the board president for Clinical Affairs for the Institute for Functional Medicine. He’s the chairman of the Food Fix Campaign, which is fixing food in America, co-founder of Newly Started Function Health, which we’ll talk about and, of course, a Levels advisor.
(00:02:10):
I just have to say, Mark Hyman is the reason I am here today. His book, the UltraMind Solution, which I read when I was in my early twenties, was one of the first things that sent me on the path towards root cause health. So I’m very grateful to him. I consider Mark Hyman to be the premier luminary leader, really at the front of the pack, moving our planet into a transformational awakening about the way the body, food, soil and environment are connected. And if we and the government are wise enough to heed his wisdom, we may have a chance of digging ourselves out of both our mental health crisis, our chronic disease crisis, and our environmental crisis. So let’s jump right in.
(00:02:51):
I wanted to start with a question really about you and I think we’re just at this fasting time in human history where there’s this group of people like ourselves and many of the people who we know who are obsessed with longevity and really are excited about these advances and the idea of living these really long lives. But simultaneously, we’re living in a world where our youngest generation has the highest level of hopelessness that we’ve had in a long time. Suicide is the second leading cause of death for teens and young adults and life expectancy has been going down for the past few years. So I would be very curious to talk through when we think about longevity predicated in that is that we want to live a long life. We really need to love life, to want to have a long life. So I’d love to hear from you, how do you personally tap into a sense of optimism for the future, a sense of hopefulness and your sense of purpose and desire to live a long life?
Dr. Mark Hyman (00:03:59):
Well, for me, it’s a great question, Casey, because it’s not about living a long life for the sake of living a long life in some hedonistic pursuit of longevity, it’s really about understanding how we can create a better world, how we can make a difference. Common wrote in one of his songs that we should think about something, which is where are we going to leave our one grain of spiritual sand on the universal scales of humanity? And for me, that one grain of spiritual sand is trying to bring a new way of understanding the body and health that empowers people to actually feel good and do good and be good. Because the way we both were trained in medical school is about really just suppressing symptoms and treating diseases and not understanding that we now know the science of creating health. And by creating health, we can create vitality.
(00:04:55):
By creating vitality and energy, we can actually move the world forward in a better place where people aren’t struggling. And I think there’s so much needless suffering in the world that can be relieved by just really simple things that people can do that they’re not even aware of, that can reverse disease, that can reverse their age, biological age and make them better at everything they want, whether it’s being in a relationship, doing the work they want to do in the world, just being a good human being. And so I feel like we’re in this really crazy moment, like you said, where suicides are going up, the life expectancy is going down because of our processed diet. And yet, at the same time, we’re kind of reaching this frontier of understanding human biology and longevity that we’ve never had before and allowing us to unlock the secrets of what our potential is as human beings.
(00:05:47):
And I think as we get older, sometimes people don’t grow, but I think many of us become wiser and smarter and understand the ways to navigate the world and can contribute in ways that we really may be not able to when we’re younger and building our lives. So I think when you think of a society of older people in most cultures they’re revered, they’re elders and this culture, they’re kind of shoved off in nursing homes and forgotten about. But I think that the reservoir of wisdom and intelligence and goodness that can be developed through a lifetime of struggles and learning is something we don’t want to waste.
(00:06:27):
And so actually when you look at the economics of this, you’re going to have a bunch of old people and it’s going to be a drain in society and a cost, but actually it’s the opposite. If you actually create healthy people who are older, you add enormous amount of value to society. David Sinclair wrote in his macroeconomic analysis in the scientific paper that if we extended life by a year of healthy life by a year, we’d save 37 trillion a year. If we did it by 10 years would be over 360 trillion, which is an astounding amount of money.
Dr. Casey Means (00:06:56):
37 trillion if we let people for one year of healthy life.
Dr. Mark Hyman (00:07:03):
Yeah. So I think it’s kind of an interesting moment. It’s like your worst of times, best of times. So anyway, I’d see how it plays out.
Dr. Casey Means (00:07:11):
You start the book by introducing the concept of icky guy. I’d love for you to just tell people what that means and maybe share what your icky guy is.
Dr. Mark Hyman (00:07:22):
I mean, icky guy is basically when you have an alignment of who you are, what you love to do, when you can make money out in the world, sort of meaning and purpose, it’s really reason for being. And I think most of us are not really connected to our reason for being and what we’re doing. And you clearly are, I’ve gotten blessed to be able to have my own icky guy, which is being in service to healing and relieving suffering in the world where there doesn’t need to be. I think it’s through the power of functional medicine and the power of understanding community and connection as a way to change people’s behavior in life.
(00:07:54):
So for me, that’s my icky guy and it gets me up and going every day. And it’s actually so satisfying. And even though it’s hard work, I find myself pulled into it over and over again because we’re a sort of really beautiful moment where the science of medicine and our understanding of the body is really jumped to quantum leap. But traditional medicine has really not gotten there. And you talk about this all the time, but if we actually have a roadmap of how our bodies work and how to actually create healing in our bodies and create wellness and create sense of your wellbeing, we can actually make the world such a better place when people are struggling and suffering and sick, it’s hard for people to show up and contribute to the betterment of the planet and each other and our community. So that’s kind of my icky guy.
Dr. Casey Means (00:08:48):
Thank you for sharing that. I love the concept that you shared about how we’re accumulating all this wisdom throughout our life and it just keeps growing and growing and that sense of accumulation and synthesis of knowledge. And that’s right at the point in our culture when we start then getting sick and starting to be shuttled off into the sidelines. And what if we could flip that script in a more almost traditional way of at that moment in life, that’s when you are feeling amazing and can actually share that wisdom and how much we might be losing in our younger generation by the fact that the people with the most embedded wisdom are actually getting sick and devastatingly losing their mental faculties because of largely preventable illnesses like Alzheimer’s.
(00:09:31):
So I love that framing and you present a picture in the book basically saying that the way we think of aging, which is a slow gradual decline towards decrepitude and our mental faculties being lost, this is actually abnormal aging that is not really what aging is and we are think are so far from what healthy aging could look like. We don’t even know what that model of normal aging is. So I’m wondering if you could describe a vision of what is abnormal versus normal aging and what are the hallmarks of aging in the body?
Dr. Mark Hyman (00:10:08):
Well, this is what’s so exciting, Casey, is scientists are actually now thinking of aging as a disease, not getting older, but the phenomena breakdown and the decline we see and the diseases we see as not just a normal consequence of getting older, but as abnormal aging. Aging as a disease that can be treated and prevented and reversed by understanding the root causes of it. So for example, if we cured all cancer and heart disease from the face of the planet, they’d be sure the number one in two killers we might see five to seven years of life extension.
(00:10:45):
If we address the underlying root causes of all the disease of aging, heart disease, cancer, diabetes, dementia, which, by the way, are driven a lot by sugar and insulin resistance and all the things that you’re working on, Casey, to help educate people about, if we got rid of the problems with these underlying hallmarks of aging, which I’ll describe in a minute, that we might see a life extension of 30 or 40 years, which means we might live to 120. So rather than treating all the diseases like whack-a-mole, we get to understand the biology of aging and understand the different things that happen and be able to deliberately work on these things through lifestyle, through hormesis practices. We’ll talk about through sometimes nutraceuticals, maybe other innovative therapies that are coming down the pike that are really interesting, whether it’s stem cells or exosomes or plasmapheresis or hyperbaric oxygen.
(00:11:42):
These are all ways of working with these systems to create help. So functional medicine and the science of longevity is really reframing disease as an information problem, as a network problem, as a basically code that kind of goes off and how do you get the right code and the right software programming so that you actually program longevity, program health as opposed to program disease and aging as we see it now as society. And if you want, I can go through some of these hallmarks because I think it’s sort of interesting.
Dr. Casey Means (00:12:17):
I would love that. I would love that. That analogy of the software problems, it’s like are you saying that actually if we could fix that code, we’d get back to a healthy version of the software? I’d love for you to paint the picture inside the cell.
Dr. Mark Hyman (00:12:29):
Yeah, I think one of the interesting things is we often thought of genetics as a fixed thing. You have your 25,000 or 20,000 genes, you really can’t change them and that’s your destiny. But turns out that your genes may be fixed unless you do gene editing or some kind of cool SciFi stuff. But that your control of your genes is completely within your power, which genes get turned on or off, whether you’re turned on the disease genes and the aging genes or the health longevity genes. And this is done through something called the epigenome. And the epigenome is essentially this control system that sits above your genes. Epi means above, and think of it like the piano player. You’ve got 88 keys on your piano and you can play jazz, classical, ragtime, rock, blues, whatever on the keyboard, the same keys and the epigenome is the piano player that can play all these different tunes depending on what you do.
(00:13:27):
And so a lot of the things that we do to either cause rapid aging, which influence every genome in a negative way or to positively influence our epigenome, we can reverse the changes on our epigenome that happen as a consequence of what we eat and stress and toxins and so forth. And we can reprogram our epigenome to a younger you. And this is really what we’re looking at with biological aging. We’re actually being able to measure the tags on our genes that determine our biological age and then we can do interventions that will change that and reverse our biological age, which is quite amazing. We’ve seen this in study after study. So this is one of the hallmarks of aging is the epigenome and epigenetic changes, but the epigenic changes are happening because of all these other insults. So the hallmarks of aging are not all created equal in my mind.
(00:14:22):
They’re all connected, they’re all influencing each other all the time. But there’s some meta sort of frameworks around what is driving many of the dysfunctions in the hallmarks of aging, including inflammation, mitochondrial damage, damage to proteins, DNA damage, zombie cells which create inflammation, shortening telomeres. The changes in our microbiome, which I sort of added as one of the hallmarks, but one of the meta frameworks is understanding how food influences our aging process. And it does so through what it’s called these deregulated nutrient sensing. So nutrient sensing is how we sample the foods in our environment that we eat and then those nutrients affect these four longevity switches. I call them longevity switches. I made it up, I don’t know if it makes sense or not, but it’s basically there’s these four switches that are sensing our food environment and two of them sense an excess of ingredients and two of them or calories or sugar or protein and two of them sense it scarcity.
(00:15:33):
So when things are low, they get turned on and the other ones are switched on when they’re too much or something. So for example, the four longevity switches are the insulin signaling pathway, which is one of the most important determinants of aging and disease. And this is really what you work is all about, which is understanding how sugar and starch influence this insulin signaling pathway when this pathway’s turned on all the time, which it is through our 152 pounds of sugar and 133 pounds of flour that we eat, which are the same in our bodies, that’s overstimulating this insulin pathway that is causing us to gain weight in our bellies, causing us to have more inflammation in our body to damage our mitochondria, to cause DNA damage, to cause epigenetic changes that make us biologically older that affect the brain and cause dementia. I mean, they’re just enormous damage that happens when this overstimulation is the insulin signaling pathway. So the key to kind of fixing that is cutting down the starch and sugar and actually eating a very low starch and sugar diet and eating more high quality fats and good protein, lots of fruits and vegetables, all this stuff that’s common sense but that people don’t do. Mark Twain said the problem with common sense is it’s not too common.
(00:16:50):
So the insulin signaling is huge. And then the second one is mTOR. And mTOR is a pathway that is an ancient pathway that regulates protein synthesis. So building new proteins and muscle and all the things we do need to function and we need mTOR to be stimulated by the right amino acids and the right kinds of protein at the right times to build muscle and keep building all the proteins we need for our immune system and our structural system. The problem is if we’re constantly eating, which we do in this society, if we’re snacking at night and eating first thing in the morning and we’re not giving our bodies a break, otherwise known as break fast or breakfast, not eating from at least 12 hours or even 14 hours, some people like to do 16 hours, we call it time restricted eating. That gives our body a chance to not have this overstimulation of mTOR to turn on this process of autophagy, which is basically the cellular cleanup.
(00:17:45):
It’s basically like you’re recycling your system, it’s your little Pac-Man that goes around gobbling up all the old damaged proteins and cells and kind of basically recycles them and allows your body to make new stuff. So this autophagy is such a critical part of understanding longevity and so overstimulation of mTOR is not good. And so that’s why a lot of people say we should be vegan if you want to live a long time because vegetable proteins or plant proteins don’t stimulate mTOR as much as animal protein.
(00:18:15):
And it’s because animal protein has high levels of leucine, but leucine is in a really critical amino acid to build muscle. So it’s like the Goldilocks problem. You don’t want it on all the time, but you do want it on sometimes so you can build muscle. And so there’s a lot of strategies how to properly regulate mTOR, whether it’s time-restricted eating or periods of fasting or actually even certain plant compounds of phytochemicals can regulate this fatty acids like C15, which is a kind of newly understood saturated fat that’s often found in dairy, but it’s really powerful and regulating stimulate various longevity pathways and inhibiting mTOR.
(00:18:58):
There are also maybe drugs like rapamycin, which people are experimenting with to shut off mTOR at certain periods of time, cyclically to sort of induce autophagy and repair. So really important to not eat a ton of sugar and starch so you don’t over stimulate your insulin signaling pathway. And it’s important to eat protein in the right way, the right times, but not all the time. So you can properly stimulate muscle synthesis but also activate autophagy. So it’s not all or nothing, it’s like you need to understand that they’re both needed. And then the other two pathways are AMPK and sirtuins, which also are regulated by sugar. And I was at this conference years ago, it was at the Menlo Center and there was all these Tibetan doctors, Dalai Lama and all these longevity scientists and Elizabeth Blackburn. It was really quite an amazing array of Nobel prize winners and Tibetan doctors and Buddhists and I was there, Lenny Guarente, who was one of the key discoveries of sirtuins, which are this pathway that seems to be when it’s properly regulated, actually extend life by a third in animals.
(00:20:06):
So they did [inaudible 00:20:08] and they’re dealing with NMN and I said, “What is the thing that’s screwing this thing whole up? Why we have this problem with sirtuins?” He goes, “It’s sugar. Sugar is the thing that’s causing all the problems.” So it’s really comes down to the same common sense things, but now we’re understanding the biological mechanisms and how to actually modulate them through these pathways. So NMN and AD can be very helpful for stimulating sirtuins but also certain plant compounds can do this. And AMPK also is another pathway that is involved in sugar and glucose regulation that is impacted by metformin, which a lot of people are using to regulate blood sugar and longevity. But I don’t think that’s the best idea right now. I think diet and lifestyle works so much better than metformin for regulating insulin resistance and it has side effects that I worry about. So we’re going to see from certain trials, but at a mental level, your food is probably the most important regulator of biological aging in terms of what you eat, when you eat and how you eat.
Dr. Casey Means (00:21:11):
What an amazing overview and clearly, so much of it comes back to food and to quote someone I know, food is molecular information. I’ve heard this from you for years and it’s really when you talk about the switch pathways, it makes it so clear food is actually the activators or the inhibitors of these pathways. And I think when we start to think about food like this, it makes things so much more clear. It’s like, “Oh duh, that 70 metric tons of stuff we put in our body throughout our lifetime, maybe it’s doing this.” Of course, not something we learn a lot about in medical school, but what you have really helped bring to the forefront and I took a few of the pearls from there, which is like don’t eat the excess sugars and starches, make sure you’re getting quality protein at the right times. But I’m wondering if you could just give the lay of the land of what the longevity optimizing diet looks like in your mind, given how we’re trying to optimize these hallmarks of aging.
Dr. Mark Hyman (00:22:17):
Yeah, it’s so important. I think it’s really not that hard, Casey. It’s kind of embarrassing to kind of do what I do because it’s like I get paid for telling people to eat healthy and it’s pretty simple and obvious. But I think the first thing people can do is understand that ultra processed food is deadly. For every 10% of your diet, it’s ultra processed food, your risk of death goes up by 14%. And our diet is 60%, on average 60% ultra processed food. For kids at 67%, which is really frightening. It means almost 70% of their diet is this stuff that isn’t actually food. It’s this weird chemically processed colored, extruded food-like substances that have really no resemblance to the original form. So that is the first thing you can do. The second thing is really in terms of starch and sugar, keep it at a bare minimum, have it fun, treats occasionally. They’re kind of packs and I have all kinds of recipes that are low glycemic, kind of yummy treats as you can have once in a while.
(00:23:26):
But really understand that the amount of flour and sugar we’re eating is deadly and is driving all the pathways. If you look at what is the biggest driver of aging, it’s insulin resistance. If you could fix that in people, you’re going to correct most of the hallmarks of aging from mitochondrial dysfunction to inflammation to damaged proteins to DNA damage, epigenetic changes to telomere length to your microbiome. I mean, it just goes on and on. Obviously, these nutrient sensing pathways. So that is so important for people to get. The third is that you want to make sure that you increased your phytochemical intake and then these phytochemicals are plants, defense mechanisms and they work in a symbiotic way with their biology to activate longevity pathways. And there’s some things that are really helpful on there. For example like quercetin, which can be found in a lot of plant foods like onion and apples and has been shown to reverse biological age and reduce inflammation.
(00:24:28):
Curcumin, another anti-inflammatory compound, [inaudible 00:24:31] which is from strawberries that can activate this pathway that kills zombie cells. And I’m just kind of rattling off a few compounds like the catechins in green tea, which are powerful regulators of sirtuins and AMPK and all these other pathways and then glucoraphanin are from broccoli. So you want to get these compounds in your diet, so green tea, broccoli, pomegranate, curries, onions, apples that you can start to eat these foods and be conscious of, “I’m choosing these medicines and foods and I’m eating these on a regular basis.” Really important. The next thing I would say it’s really important is get an oil change. Most of us are eating the wrong oils and are not understanding that the fats that make up our body determine the level of quality of our cells because every cell is covered in fat, your brain’s made up of fat.
(00:25:20):
And so eating good levels of omega-3 fats, extra virgin olive oil, getting rid of processed oils as much as you can. There’s certain ones you can use in small amounts that are colder, expeller pressed, avocados are great, nuts are great. Really upgrade your oil in your body. And the last thing I would say is protein and understanding the role of protein in health and aging. And I think this is really where I think a lot of people go wrong with longevity. They think if you’re a vegan, it’s going to actually extend your life. And there are evidence of longevity societies like the Seventh, they have to or vegetarians that do okay, but there’s a lot of other variables. They don’t smoke, they have community, there’s like a million other things. You can’t always attribute it to that. And what happens as we age is we lose muscle. Starting in your thirties and forties and unless you are actively putting in the effort through resistance training and understanding how much protein you need, you will lose muscle and your muscle will be replaced by fat and become marbleized muscle.
(00:26:23):
We call this sarcopenia and it’s this an invisible disease that is causing so much of the metabolic dysfunction we see in our society. So how do you fix that? Well, you need to do resistance exercise, but you also need to have the right amounts and the right kinds of protein at the right time. So you don’t want protein all the time because you’re going to overstimulate mTOR. But you do want, for example, in a fasted state when you wake up in the morning, if you do for example resistance training and then you have 30, 40 grams of protein depending on your size and maybe even a little more through, for example, I use [inaudible 00:26:56] raised goat way, which I find great kind of shake in the morning after breakfast. You can do eggs or you can do … People have steak for breakfast, whatever. But that’s such an important time where then you turn on mTOR and you turn on muscle synthesis.
(00:27:09):
And the problem with plant proteins is they’re very low in leucine. This is a very important amino acid. That’s the rate limiting step in building muscle. So it’s like the starter. If you don’t turn your engine on … you can put your foot on the gas, but if you don’t turn your engine on, you’re not going to actually make your car go. And the same thing with leucine, it’s like the switch that turns on mTOR and it stimulates muscle synthesis. So if you don’t have at least two and a half grams of mTOR in a protein meal, which is very hard to get with just pure plant proteins, unless you add leucine or unless you take amino acid supplements or do some type of jacked up plant protein powder, then you really can’t stimulate mTOR. So you have to actually stimulate mTOR in the right times of the day to stimulate muscle. And if you don’t take care of muscle as you age, that’s one of the biggest drivers of problems. So that’s an important part of the diet that people get a little confused about.
Dr. Casey Means (00:28:02):
Wow. That really brilliantly, I feel like,cuts through the protein conversation so incisively. It’s nuanced and we can’t just have these one liners about it. There’s a lot of detail and nuance to it that really is fascinating about the leucine. So what I’m hearing in that amazing, the five minute Mark Hyman dietary summary is no ultra processed foods or avoid them as much as possible. Get your phytochemicals. These are plant medicines. Do an oil change. So much of the most important structures of our bodies, like our salt membranes and brains are made of fat and make sure we’re getting protein at the right times. And kickstarting muscles synthesis with leucine. Amazing. And plug for people also reading The Vegan Diet, which goes into more detail on this, which is amazing.
Dr. Mark Hyman (00:28:51):
In Young Forever, Casey, I really talk about the protein research. I mean, it was a beautiful review by the world’s protein experts who wrote a paper called the Pro-Age Study. And essentially, they reviewed all the literature on protein and aging and muscle synthesis and health and they really had very specific guidelines and we think, “We need 0.8 grams per kilo for protein.” That’s what the dietary recommendations are. That’s the RDA, but that’s the minimum amount you need to not get a protein deficiency disease. It’s not how much you need to have healthy aging. I talk about this one woman named Emma Morano who lived to be 117 years old. She was an Italian lady and when she was young, she was low anemic, her doctor told eat three eggs a day, which she did. And then when she was in her nineties, she became a little frail and her doctor said, “You need 150 grams of protein of meat every day.” And she did it. She ate 180 grams of protein every day and she died at 117 years old. So I know it’s a case study of one, but it’s interesting.
Dr. Casey Means (00:29:54):
It’s amazing. I’ve actually been on more of a protein journey since reading your book. And I’m up to point, I’m six feet tall, so I weigh a lot and I’m doing now I’m starting with 0.75 grams per pound because one gram is a lot per … and that has been a huge change for me because I was more plant-based in the past. And now of course, moving more into regenerative meats and as I’ve become a lot more aware of the regenerative farming movement and really the importance of that ecosystem around plants and animals, it’s been … but you do have to really consciously make an effort to get the right protein. And it’s kind of an interesting and fun journey honestly. And I’m noticing a difference in energy and muscle and everything. But it’s fascinating.
Dr. Mark Hyman (00:30:40):
And by the way, I just want to say this, people don’t understand. If you look at … there is no biological requirement for carbohydrates and people know your brain runs on sugar. Actually no. It runs better on fat. And if you look at the basic science of nutrition, there’s no such thing as an essential carbohydrate. There are essential amino acids, there are essential fatty acids. So carbohydrates, no essential need for. Fat, well, fat, you need it, but actually the essential fatty acids are like the omega-3s. You need in gram amounts, like a couple of grams a day. Not large amounts. The only macronutrient we need in large amounts is protein and really critical to understand. And that’s something that we can’t get away from. It’s just basic biology and science.
Dr. Casey Means (00:31:25):
When I’m reading your work and when I’m thinking about functional medicine, so much of what comes to mind is that health is really about putting in what the cells need and taking out what hurts the cells. And if you can do that and protect your cells in a dynamic way because those needs change day to day. And that’s one of the reasons I love continuous glucose monitoring so much is because you have a little bit of window of what the dynamic needs are, but it’s like put the good stuff in, take the bad stuff out. And so we’ve talked a bit about what needs to go in, in terms of the food. I’d be curious to hear you run through what are some of the normal things that are going into our bodies or our bodies are being exposed to on a daily basis in our environment, our lifestyles that we really need to take out in order to have the best chance at healthspan and longevity?
Dr. Mark Hyman (00:32:12):
That’s a great question. There’s things we need to take out. There’s things we need to put in. And I think that the framework of functional medicine, which is not a specialty, it’s not an alternative therapy, it’s a way of thinking, sort of a operating system for understanding how the body works and interpreting all the data. So what it really comes down to is looking at what does your body need to function, hence the name functional medicine and what causes it to malfunction and what causes it to function at a high level. What do you need to get rid of and what do you need to get in order to be healthy in order to operate your system properly in order to upgrade your biological software. And so we know there are certain things that we have control over what we just talked about.
(00:32:54):
Food is huge and we need the right nutrition, which is what we need to put in. We also need to get rid of the wrong nutrition, which is what we just talked about. Ultra processed food and bad oils and all the chemicals and additives and preservatives and junk we eat. I was on a TV show yesterday and I went in, they had coffee machine. I was like, “I’ll have a coffee.” And then I was looking for the creamer and I’m like, pull up this creamer, which is Coffee Mate. And I’m like, I look at it and I’m like, “Wow, okay, corn syrup, okay.” And then it had hydrogenated fat in it. And I’m thinking the FDA said eight years ago that trans fats were not safe to eat and they’re still in the food because somehow there’s loopholes that let these companies continue to add that to their food.
(00:33:42):
So you want to get rid of that stuff. I think reducing your exposure to environmental toxins is not easy. We live in a very toxin infused world, whether it’s in our skincare products or household products, our food, pesticides, herbicides, glyphosate, which is a huge one. We are exposed to toxins in also our fish from heavy metals like mercury in the air, depending where we live. It was at someone’s house in Beverly Hills the other night and they wanted to grow a garden in their backyard and they had the soil tested and it was just toxic, full of problem because imagine in LA, they had this terrible smog from all the unregulated leaded gas and everything in the years. So the leaded gas and all that has went up into the air and then came down and went in the soil. And so you think you’re growing kale in your backyard and you’re being healthy, but it could be full of heavy metals.
(00:34:35):
So we really want to minimize our exposure to toxins by being aware of where our food comes from and then just be smart about it. I’m part on the board of the environmental working group and they have really great guides called Skindeep on skincare products. I mean, other women’s lipstick has lead in it, for example, household cleaning products, your own body care products as well as what you need to get rid of in terms of your food that have toxins. So there’s a lot of ways we can really minimize those exposures. I think the stress is a bad input too. I think we really are overstressed in society, we’re stimulated and don’t actually give ourselves the body the chance to reset and calm down and get into a calm parasympathetic state. So stress can be a toxin and it does actually age us in a very particular way. So those are the big things that I think we need to get rid of. And from functional medicine perspective, it’s toxins, allergens, microbes, poor diets, stress, all of which influence us in a harmful way.
Dr. Casey Means (00:35:35):
So Mark, we’ve talked a little bit about some of the foundational stuff. So the food, the stress, a little bit about sleep and obviously building muscle and these are the foundational pillars of health. But the book also gets into some of these really advanced therapies, some of which I had never heard of before. We’re talking about plasma exchange, ozone, NMN, all these things. Could you share which of these advanced therapies is most exciting to you? And maybe a better question is which do you think actually hold the most leverage and promise that we should really keep on our radar?
Dr. Mark Hyman (00:36:16):
Yeah, I mean, I think I would say that 80% of it is what we talked about. It’s dialing in the right diet for longevity, dialing in the right type of exercise, which I detail in the book Young Forever, managing your sympathetic parasympathetic response to get your nervous system in shape and getting good sleep. These are just the four foundational, basically the legs on the table of longevity. And if you don’t get that right, you can do all the rest of the crap you want and it’s not going to make a huge difference. And then there’s these sort of really interesting things that we can do that are, some of them are really easy to do that are accessible. And my favorite are some of the Hormesis practices like cotton cold therapy or time-restricted eating or strength training. These are simple practices, stress your body that doesn’t kill it, it makes you stronger.
(00:37:07):
So that’s a really wonderful thing to think about. How do we give our body these little stresses and insults that make it rebound and come back stronger? So those are foundational that we can easily apply. And then there’s some things that are available now and things that are coming down the pike. The things that are available now that people can do that I think are really promising around longevity. And some of these are hormesis therapies like hyperbaric oxygen therapy. There’s a lot of research done on hyperbaric oxygen and longevity now and in Israel, they did some really interesting studies where they put people through a protocol over a few months where they’re able to kill zombie cells. One of the hallmarks of aging, these zombie cells that spew out inflammation and kind of kick and get other cells to become zombie cells and just like a wildfire spreading inflammation and aging, they kill these more than any other treatment that we’ve discovered.
(00:38:00):
They also increase telomere length, another one of the hallmarks of aging, which telomere’s the little caps at the end of your chromosomes that come off so you can replicate and you replicate your DNA like four quadrillion times during your lifetime. So it’s constantly doing this. So repairing that and making that better is a good thing. So hyperbaric oxygen I think is a really interesting one that’s a bit cumbersome. It’s expensive. You have to be in a tank and it requires some technology. But I think it’s exciting. I think ozone therapy is another one that’s really exciting. And I think this is another Hormetic therapy. It increases oxidative stress in your body temporarily that activates your body to respond by increasing stem cells and turning on all your anti-inflammatory systems, your antioxidant enzymes, increases your mitochondrial function, detoxifies you. There’s a lot of really interesting things around longevity and ozone that I like.
(00:38:49):
But one of the things I think is sort of most interesting, and then there’s stem cells and exosomes and kind of things that are a little bit more out of reach for people that are high cost. But one of the things that I think is really interesting is the science around parabiosis. Parabiosis is this crazy kind of concept. I don’t know who came up with it, but basically they sewed up an old mouse to a young mouse. They gave the circulation kind of … almost connected the circulation. So the old mouse was getting the young mouse’s blood and vice versa. And the old mouse became young and the young mouse became old and they’re like, “What’s going on here? What’s happening?” So there’s actually people like Mao who used to take the blood of Red Army soldiers and infuse, increase longevity, but there’s something to this idea.
(00:39:35):
And so what they found was that they didn’t have to hook up these circulations. They could take an old mouse and they could filter its blood and take out all the old stuff in the blood. And that made the old mouse younger. And this is a process called plasmapheresis. Plasma is basically the soup that all of your cells float around in your blood and you can take it out and you can filter all the plasma out and add back the cells. And in the plasma is all these inflammatory things and maybe senolytic cells and all the stuff that you want to get rid of. As we get age, you accumulate debris and crap and your blood and this essentially cleans your blood. Think of it like dialysis essentially, filtering your blood. And I’ve done this a couple of times and it’s really quite interesting. I had COVID and afterwards, I got terrible arthritis in my hand and I never get arthritis or anything like that.
(00:40:30):
I’m like, “This is really bad.” And so I had plasmapheresis and it completely fixed it in one day and I was like, went from basically not being able to use my hand and pain and swelling. It was like I had a giant broken hand to normal the next day. And I’m like, “Holy crap, this is amazing.” Because from COVID, there was all this inflammatory stuff in my blood and it got rid of it. So I think the promise of plasmapheresis is pretty exciting as a longevity therapy there. And there’s other ones, but I think those are my top ones.
Dr. Casey Means (00:41:03):
I’m going to keep my eye on plasmapheresis. That is fascinating. It makes a lot of logical sense too. It’s like clean out the mess. It reminds me of, there’s a quote on your business partner Drew Pruitt’s website about his water regimen where he says, “If you don’t filter your water, you’re becoming the filter.” There is an element that really ultimately I think thinking about your body that way is it’s like what you’re putting in, you’re either filtering it or you’re protecting yourself from it. So be careful with these inputs. But plasmapheresis might be an interesting option there for cleaning things up a little bit.
Dr. Mark Hyman (00:41:39):
And it’s interesting, there’s clinics popping around that are offering this stuff. So it’s starting to come out there.
Dr. Casey Means (00:41:44):
I wanted to dial in on something you said before in that answer, which was that potentially about 80% of this value for longevity comes from the basic pillars of food, sleep, stress, exercise, avoidance of toxins. And this is a question that I really wanted to ask you because I tend to be a fairly holistic person and I think, “Okay, I’ve really got these things dialed in and my biomarkers look amazing.” So is it going to be necessary to do some of these other things to get to 120 or is there potential to get to 120 by truly just focusing on the more basic traditional pillars? I don’t know. Do you have a feeling on the relative weight?
Dr. Mark Hyman (00:42:31):
I mean, Madam Calment lived to be 122 and was a chocaholic and drank wine. And Emma Morano would be 117 and I was in Sardinia and Korea and the [inaudible 00:42:43] Peninsula, some of the blue zones, some people looked to be well over a hundred, many, many people, well over a hundred who were still going at it. And they didn’t have exosomes, they didn’t have plasmapheresis, they didn’t have a whole bunch of supplements, they really didn’t. And so I think most of us don’t live in that world. I mean, it was so amazing to be for a moment in this world where it seemed like time had stopped where the ways that people had lived had really been unchanged for centuries. And they were eating the same foods that their ancestors ate. They were eating food was local, it was full of phytochemicals, it was from their local garden.
(00:43:21):
They were not having all these weird factory farmed animals and they were having deep sense of community and meaning and belonging. They were naturally moving their bodies through having to climb up these rocky mountains to get anywhere and herd their sheep. This is beautiful, beautiful way of living that was really a human centered as opposed to achievement centered or going to create a business and let’s go public and let’s do all the crazy stuff that we do in this society. And they just were so happy and they were so alive and they were so connected to each other. So I don’t really know if we can really totally recreate that in this world, but I think we can try to learn from those cultures and bring in those pieces and whether … I mean, we can eat great, but if you’re lonely and socially isolated, disconnected, that’s a huge risk factor for disease.
(00:44:15):
So there’s a lot of things we can do through building this. And I think in my mind, if we all follow the basic things that we know are really key to longevity, getting to a hundred and a healthy a hundred year old is not a stretch at all. And I think that’s achievable for most of us. I think I’m planning on getting to at least 120 or maybe 150. There might be some extra things we have to do for that. I think whether it’s stem cells or whether it’s plasmapheresis or whether it’s some of these interesting drugs like rapamycin, I think there’s some and man, other things that we can … and I’m experimenting and I’m experimenting on myself.
(00:44:57):
I’m making myself my own guinea pig. And I always do everything to me before I do it with my patients and we’ll see. But I do think that most of the things can be achieved through just the foundational practices. And then you added some of these Hormesis practices. For example, if you look at Finland, they have high level sauna use and that affects their life expectancy. And if you do saunas four or five times a week, your life expectancy goes up dramatically and your risk of death goes down. I think it was like 40% or something. So it’s really quite significant.
Dr. Casey Means (00:45:27):
Well, that’s a very hopeful message and I think this actually is a great springboard to switch to talking a little bit about the biomarkers that can help us track whether the things we’re doing are having an impact towards our goal of optimized health span. So you recently co-founded such a cool company, Function Health, and I am an investor and just very excited about it. I’ve also been a beta tester and I’ve gotten the 24 vials of blood taken to get my 109 biomarkers-
Dr. Mark Hyman (00:45:59):
You can thank me for that.
Dr. Casey Means (00:46:01):
Thank you. It was such a phenomenal experience. I actually have to say it’s such a great user interface and was texting back and forth with the person who was helping me get set up through your program and they said, “Drink more water than you think you need.” Everyone says drink water before your blood test. But this was actually, I drank three liters of water before my blood test because it was so many vials of blood and it literally only took about 90 seconds to get through all the vials.
(00:46:30):
So my message for people is drink way more water than you think you need to before a blood test. And it’s really easy. So it’s an amazing, amazing company that for the first time is really democratizing affordable biomarker testing of functional medicine labs and of the full spectrum of labs tell you how your body is truly functioning. So I would love for you to just tell us a little bit about the company and how you designed it, why you designed it and what it can kind of tell us about this aging process.
Dr. Mark Hyman (00:47:03):
Well, Casey, you’re a doctor. I’m a doctor and we know that we were taught in medical school to only test what you need to test. If people don’t have symptoms and don’t have a reason to test something, you shouldn’t look, that you basically keep the lab tests as your information. The doctor holds onto that in the way that it’s their data. It’s not the patient’s data. In fact, I don’t know that many doctors to actually give their patients their lab results. They just tell them, “Your labs are fine or your kidneys are good,” your whatever. They just kind of tell them your panel of goods and you’re fine. Come back next year. I mean, some doctors will actually give their patients the results but they’re often limited.
(00:47:46):
And so over the years of practicing functional medicine in the last 30 years, I really learned what are the common things that are going wrong that doctors don’t even check for and the things that need to be tracked over time to actually see whether you’re on the trajectory toward disease or whether you’re healthy. And so I design a panel of biomarkers over a hundred different tasks that normally costs $15,000 that you can now get for $500 membership because we’ve negotiated with the labs and really kind of pressured them to lower the prices because healthcare’s ready. You can go to one lab and your vitamin D is like $5 and you go to another lab and it’s $300. So it’s the whole thing’s kind of screwed up, but it democratized-
Dr. Casey Means (00:48:27):
It’s a [inaudible 00:48:27].
Dr. Mark Hyman (00:48:27):
It’s a [inaudible 00:48:28]. Totally is. So basically we look at everything that kind of matters and many things that are often missed. So we look at your nutritional status and most doctors don’t measure magnesium and vitamin D and zinc and [inaudible 00:48:42], a lot of really important nutrients that are things that we often miss. Omega-3 fatty acids, essential fatty acids don’t often get checked, almost never get checked by your doctor. And they’re such a critical component of your health.
(00:48:52):
So we look deeply at your nutritional status. We look deeply at your hormonal status, your testosterone, your estrogen, DHA and your hormonal balance. We look at metabolic health, which is so critical and things that often aren’t looked at. We look at not only your blood sugar and your hemoglobin A1C, which often doctors don’t check unless you’re diabetic. But we look at insulin levels, which are really important. If your insulin levels are high, even if your blood sugar’s normal, that’s a sign you’re heading towards pre-diabetes or you already have pre-diabetes. And we look at your cholesterol, not just in the normal way that people look at cholesterol, but actually looking at the metabolic health of your cholesterol essentially, which is influenced by air carbohydrate load and the type of fats you eat. So you’re looking at particle size and particle number and things that are really much more predictive.
(00:49:37):
We look at uric acid, which most doctors don’t check, another sign of poor metabolic health if people are insulin resistant. We also look at people’s normal things like their blood count and their kidneys and their liver, the things that you’ll get at your regular doctors. But we look also at, for example, food sensitivities. We can look at celiac, we can look at all these different biomarkers that often are abnormal, homocystine, methylmalonic acid, nutritional tests that look for B12 and folate that are often missed. So we get a really deep view. I mean, I had just a remarkable experience of so many people who are actually young and healthy and proactive about their health or think they’re doing the right thing or being a vegan. And I come back and I see all these abnormal biomarkers that are often very revealing of these imbalances that people don’t know they have.
(00:50:24):
Their thyroid’s off, their white count’s … I mean, I had a guy who was this 47 year old guy who really looks great, he is healthy, but he’s got all this stuff going on. Low vitamin D, he’s got low white count, he might have a low grade viral infections, he has a thyroid that isn’t working right. His cholesterol’s a little off. And you’ll see these things that are just a little bit off or maybe really off. We had one guy who found had a high prolactin level who ended up having a brain tumor that we discovered who just tested never were a check. So I think we can really make a difference for people by identifying these imbalances and these abnormal biomarkers. And the beautiful thing about functional health is we created a roadmap for people to interpret the test and to know what to do from a lifestyle perspective, from a nutrition supplement perspective, from when they need to go to the doctor, maybe do the next thing perspective.
(00:51:14):
And there’s a whole AI engine behind it that’s going to help inform the patterns that we tend to see in people and guide people to much more personalized proactive care. And the beautiful thing about is we kind of disintermediate the healthcare system and the doctor. It’s like you think about the real changes that happen with our society, like kind of the music industry. It wasn’t the music industry change, Apple created the iPod and that changed everything. Or you look at industries that is totally disrupted from the outside. That’s what really we’re doing. And I think empowering people to be the CEO of their own health, having their health and information, being empowered to know what to do with it, just like you’re doing with Levels and [inaudible 00:52:01] it’s just so essential. So it’s just an extension of disrupting the healthcare system by giving people data that they otherwise wouldn’t get that allows them to understand how their bodies work and to make changes and see improvements over time and adjust things.
Dr. Casey Means (00:52:16):
It’s an amazing service and I think you hit on the end on one of the reasons why it’s so valuable is that what you and your team are doing is reading the tea leaves of how all the biomarkers interact to give people a true picture of cellular function. And that’s so much of what is missing in our traditional healthcare system is not only do we not order the labs proactively, we barely interpret them as individual biomarkers, but we don’t read the full picture tea leaves, which is what gives you that really rich picture of what’s going on. So that is what is so special about-
Dr. Mark Hyman (00:52:49):
And the other-
Dr. Casey Means (00:52:50):
Yeah, please.
Dr. Mark Hyman (00:52:51):
It’s true. And the other thing is, just to kind of mention this, is when you go to a regular doctor, they’ll interpret the test one way through the lens of conventional medicine, but there’s another set of lenses that you can put on. Think of it like putting on a telescope or a microscope. You can see all this stuff that you didn’t see before. So through the lens of functional medicine, through the sort of filter of functional medicine, the information is much more comprehensive and is much more detailed because you understand the underlying things that represents in the body and what to do about it and how to fix it. And then that’s all in the guide that comes along with your test. So it’s a very different thing that you wouldn’t get, even if you’ve sort of got regular labs and you’ve got the regular interpretation and you found it all, it’s really takes it to a whole new level of understanding through the lens of functional medicine. And that doesn’t exist anywhere.
Dr. Casey Means (00:53:39):
No, it doesn’t. And you also give optimal ranges as opposed to standard ranges. And I laugh, I’m like, of course you have insulin on this lab panel. One of the most important tests, which doctors just don’t order. And even if you can twist your doctor’s arm to get an insulin and maybe pay out of pocket to do it, you get that lab report back, which is pennies and it’ll say less than 25 or less than 50 is normal. So even if you go to those lengths to get the test, the range that they’re showing you is astronomically too wide and you actually show people … yet the lab slip might say less than 25 is normal, but actually what we want you to get it under is 10 or under six.
(00:54:20):
And so two of the things that I feel like are so powerful about the biomarker testing that I really actually felt for the first time after doing the function health panel was two things. One is that it empowered me to feel even more confident about my dietary strategy because obviously we think about diet obsessively, people like you and I, but the nutrition wars are so dogmatic and so loud that it just feels like the vegan say I’m going to die, the carnivore say I’m going to die. Here I am. My life is devoted nutrition and it’s still frustrating. You see your biomarkers-
Dr. Mark Hyman (00:54:56):
Plants will kill you, meat will kill you. Okay, well then I’m just going to eat nothing.
Dr. Casey Means (00:55:00):
When you look at your 109 biomarkers and say, “Okay, my insulin is three, my triglycerides are 47, whatever,” you’re like, “This is working for me, this is working.” And that is a confidence that you cannot replace with doctor opinion, with anyone’s opinion. So cutting through the dogma, I think is one. The second is that since we know these biomarkers are linked to the diseases of aging, if you are certain that your key biomarkers are in optimal ranges, the way that lifts a weight off your shoulders around thinking about these potential inevitable diseases of aging in our culture and say, “You know what? I am pretty certain I’m not going to get heart disease.” Or you on the flip side, you might say, “Actually things are looking not great. I need to make some changes.” But to have that clarity is an existential shift inside of you about, I really don’t … I mean, looking at labs, you can be like, “Well, I’m not at risk for diabetes. I’m not at risk for heart …” So I think that’s a power that is really hard to replace.
Dr. Mark Hyman (00:56:02):
I mean, it’s really about testing, not guessing. And often people are stuck in an ideology of what they think they should do, but don’t know what their biology is doing. And I always say, don’t let your ideology trample over your biology. And I’ll give you an example of how unique and individual we are and how it’s important to see what your body is doing in response to any lifestyle or dietary change you make. I had a patient who was overweight, who struggled to lose weight, who was very inflamed, who had super high triglycerides of over 300, really high cholesterol and a very, very low HDL, which was a good cholesterol. And she wanted to try a ketogenic diet and said, “Okay, try that and see what happens.” So she was basically eating butter and coconut oil, which are saturated fat. She came back and she was so happy. She lost 20 pounds that she could never lose.
(00:56:54):
Her triglycerides dropped 200 points. Her total cholesterol and LDL dropped almost a hundred points. Her H still went up 30 points, which you should never see. And her inflammation markers went down, her blood sugar went down and she was great. Another guy who was an avid biker, he was fit. Then mid fifties, very lean guy says, “I want to try ketogenic diet because I heard it might help my performance.” I’m like, “Okay, but let’s check and see what’s going on as you do this.” And it turned out he had the complete opposite response to the same diet. His particle size number went way up, his small particles went up, his cholesterol went in a really bad direction. And I was like, “Wow, this is so fascinating. You’ve got the exact same input, two different people.” So I think it’s important to understand that we’re all different, that you shouldn’t have an ideological view of what is right or wrong. You should figure out what works for you and you can do that through testing and then rechecking and see what’s going on. It’s not that hard to do.
Dr. Casey Means (00:57:56):
Okay. Two quick final questions for you. One, top three biomarkers that everyone should be asking their doctor for to understand a snapshot of their health in terms of longevity.
Dr. Mark Hyman (00:58:08):
I mean, I think your whole company and work is devoted to understanding sort of metabolic health. And if you look at my body of work, a lot of it is really about fixing and some resistance and metabolic health. So I think the biomarkers around metabolic health are so key. And the ones that we don’t check that are so essential are this, we call a lipid lipoprotein vaccination, which means what are the, not just numbers of your cholesterol and the weight of your cholesterol, which is what we measure, but actually how many particles? What are the sizes? What’s the quality of your cholesterol panel? And that tells you so much about your risk factors. The other, I think test would be an insulin test and the insulin is super important. If I could do a glucose challenge test on everybody and measure insulin after that, that would be the gold standard.
(00:58:58):
But I think a fasting insulin is a good sort of intermediate biomarker and it’s very inexpensive and it’s available and doctors just don’t order it. And it is probably the most important test because your blood sugar could be perfectly normal. And we’ve talked to you about this on the podcast, Casey, where you have someone who’s severely overweight, who’s got a big belly, who you think is going to be terrible and their blood sugar, but their blood sugar’s perfect even after a glucose tolerance test. But their insulin could be not two or five or 10, it could be 200 or 300.
(00:59:27):
And that insulin is really driving all these horrible downstream consequences. And I think the third test, I think there’s a longevity and wellbeing I think has to do with maybe your vitamin D level. I think people’s really have very low levels of vitamin D. There’s been really good data on vitamin D and mortality on cancer, on heart health, brain health. So I think that’s important. I think there’s a few others that I would pick, but I think if you did those, you’re in good shape. And then there’s inflammation markers and all. It’s hard to pick, honestly.
Dr. Casey Means (00:59:58):
It’s hard to pick. It’s like favorite child. Yeah. Vitamin D was one of my lowest on the function panel, and I take 10,000 IUs every day with K2 and I’m actually committing now to I’m doing more sunlight. I’ve been taking so much vitamin D for years, and I think the fact that I just am always wearing long sleeve, I’m going to get a little bit more sunlight. So little controversial, but-
Dr. Mark Hyman (01:00:21):
Well, put sunblock on your face then so you don’t get wrinkles and old and then get body full body exposure. It’s fine.
Dr. Casey Means (01:00:29):
Exactly.
Dr. Mark Hyman (01:00:31):
Nude sunbathing is the thing.
Dr. Casey Means (01:00:35):
I love that. That’s a good way to end this episode. Okay, Mark, I have you on the line here, I would be remiss to not ask you this question because that’s one that’s on my mind pretty much constantly, which is really the system’s issues. And of course you’ve written a whole book about this food fix. Pretty much my favorite book of all time, everyone listening should read it immediately. Truly, Mark. I mean, it’s just incredible. But of all the people I know, you probably have the best 360 view and vantage point of what’s going on across food, agriculture, health, technology, and politics.
(01:01:12):
And we are in a really challenging time in history right now where 93% of American adults have metabolic dysfunction and chronic diseases are exploding while we spend more money on healthcare every single year. It’s the definition of an unsustainable system and people are suffering. So I’d be curious to hear in your mind, looking at the whole landscape, where is there positive movement happening? Where are the leverage points that are going to be most useful in actually having us make progress towards true reversal of this epidemic? And is there a reason to be optimistic?
Dr. Mark Hyman (01:01:48):
I mean, listen, I’m an optimist and the truth is optimists live longer even if they’re wrong. So I keep pushing the rock uphill. This is a long haul fight. I think about the abolitionists in 1700. Now, we’re still 200 years later still dealing with the effects of slavery and racism. This is a long haul job. But I do feel hopeful because I think there’s a real understanding among food corporations, among policy makers, among the public that things are unsustainable the way they are. And I think that the levers for change are many, but it ultimately has to be both driven through business innovation and people being empowered to understand their bodies, like the work you’re doing, the work I’m doing and other innovations in food and in agriculture that are happening that are actually great. And there’s big investments from large corporations and billions of dollars flowing into regenerative agriculture and to understanding how to optimize the food system.
(01:02:51):
And so I think there’s a lot of things happening on the business end. On the policy end, I think it’s a little slower, but I do see change. We had the White House conference on nutrition the first one over 50 years. We had people in Washington who are now starting to be really aware of this. And I started a nonprofit, the Food Fix campaign to educate lawmakers and the policymakers in Washington about this. And their education, their awareness is very low. I mean, it’s really quite striking to see how much they don’t know. And it’s because they really haven’t been educated by lobbyists on the other side. They’re getting educated by the food industry, which is mostly miseducation. I got a call from the new head of the Health Subcommittee and the Ways and Means Committee, which is in charge of a trillion dollars of healthcare spending, who is so doggedly focused on having hearings and creating policies and legislation that addresses this chronic disease nutrition connection.
(01:03:51):
And I’m very hopeful to see, we’re having hearings in March, we’re going to be doing a lot more work in this. I do feel hopeful. I think there’s an increasing awareness around the world that we have to fix our food system. So it’s slow. It’s plotting. There’s a lot of pushback against it for many sources. But even big food corporations are sort of getting with the program. Like Nestle is committed to 70% regenerative. I think that’s in their supply chain. They’re moving their products towards healthier products. I mean, it’s slow, but it’s happening. And I see this as a zeitgeist sort of changing. So when I started writing the book, it was pretty dark, but I feel hopeful now.
Dr. Casey Means (01:04:28):
Love that. And yes, plus one for optimism because it’s certainly not going to hurt us to be optimistic. And it’s good for our health and it’s good for the general vibrational energy, I think, of the globe. And so I love that about you and you’ve seen how bad things can be and yet are still optimistic. So I think that’s a great model for all of us.
Dr. Mark Hyman (01:04:48):
I believe in humans. I think I believe in humans. I think at the core, we are good. We are good and we want to do good. And we want to have goodness for our families and our communities and whatever your ideological beliefs are, we all have that same core of being human. I’ve traveled around the world, I’ve been in all the developing countries, I’ve been in rooms with kings and presidents and at core, we’re all just human beings looking for the same thing. And I think if we can come together in that way, I think we’re going to make some real progress. There’s a beautiful proverb, African proverb that says, “If you want to go fast, go alone. But if you want to go far, go together.” And I think we really have to do this together.
Dr. Casey Means (01:05:31):
Well, I’m grateful. You are masterful at allowing people to become a part of the community and make people feel a part of this whole journey as opposed to making health some sort of exclusive thing. You’ve democratized health for the world and I think there are millions of other people who can say with me that we are so grateful for your work. So end us on a happy high note, I’d love to hear you talk a lot about in the book about how play is such an important part of healthy aging. So I would love to hear how are you planning to play today or this weekend?
Dr. Mark Hyman (01:06:08):
Well, I am planning to go to a party tomorrow with some friends where it’s a very playful group and the theme is ’70s athleisure wear, which is basically all those weird track shoes that people used to wear in the ’70s, like Farrah Fawcett and all that. And we’re just going to have a good dive and play. There’s going to be hot and cold therapies, dancing, music, good food, and just a lot of love. And so I’m so down.
Dr. Casey Means (01:06:39):
That sounds like a dream party. Hot and cold therapy and dancing.
Dr. Mark Hyman (01:06:43):
And it’s a day party. It’s not all night and no alcohol and just having fun with each other.
Dr. Casey Means (01:06:48):
What a dream. I going to be having an EDM dance party with my seven month old goddaughter. So that is my … a little different dance party. But that’s my plan. So Mark, you are a luminary. You are such a bright light in this world. Thank you so much for being on A Whole New Level. Let people know how they can find you and where to find your book.
Dr. Mark Hyman (01:07:08):
Yeah, well you can find me pretty much everywhere. Social media is Dr. Mark Hyman. My website’s drhyman.com, my Doctors Pharmacy podcast. And of course my new book, Young Forever, is available everywhere you want to get books. You can go to youngforeverbook.com with all sorts of extra information, bonuses there. So I think it won’t be hard to find.