S1: Welcome in San Diego , it's Jade Hindman. On today's show , The Science of Being a super Ager , hear from Doctor Eric Topol on his new book. This is KPBS Midday Edition. Connecting our communities through conversation. There's a few Midday Edition regulars that our listeners know quite well. One of them , without a doubt , is Doctor Eric Topol. He's given us real practical information about Covid 19 since the onset of the pandemic five years ago. Well , now Doctor Topol , who is a scientist , cardiologist and geneticist , is out with a new book. It's called Super Agers an evidence based Approach to Longevity. Doctor Topol is the founder and director of the Scripps Research Translational Institute. Doctor Topol , it's always great to have you on.
S2: Oh , thanks so much , Jade. I always enjoy our conversations.
S1: Well , I'm excited to dig into this book.
S2: We launched a study called The Elderly. It took seven years to bring together 1400 people who qualified for that status , and that meant they didn't have any diseases , chronic diseases , age related diseases. They were over 85 years old , all the way up to age 102. And once we had those 1400 people , we then did whole genome sequencing , and we were stunned about the results because we expect that we're going to find all these genes that accounted for their resilience and their remarkable health span. Uh , but in fact , we found very little. So that led us to this concept that , you know , being healthy The aged is not so much a function of your genes. There were some people , of course , that had a lineage of that in their families , but most did not. And so that is something that I think I've been working on in a while. Our team has. And then I saw a patient more recently who's in the book , who's from here in San Diego , Lee Russel , who 98 years old , was just like the people in the elderly group. And she was prototypical because her her parents and her brothers , they all died in their 50s and 60s. And here she is , 98 , completely intact.
S1: And of course , we all age.
S2: These account for the vast majority of of ways that either we are having fatal events or also these days that we're living with these serious conditions. So in order to promote Healthspan and get to that super ager status for most people , we need to prevent those three conditions. And the excitement is we can do this , we can do this now. So even though there's so much work being done to slow the body wide process of aging , reverse aging , that's a much more difficult and risky and will likely be very expensive. On the other hand , we've got new inroads to be able to prevent age related disease that use some of the great advances that have been made in recent years. in the science of aging. So it's it's so alluring and exciting. We just got to get on it. Well.
S1: Well. So let's dig into that.
S2: So in the diet nutrition side , we've got to get the ultra processed foods down to the lowest quantity as possible because they're very pro-inflammatory. And here in the US we have the highest consumption 70% of our diet is ultra processed foods. And then the other thing in the diet side is people are in a protein craze right now , and they need to know it's fine to increase their protein intake a bit. But and certainly as we're getting older , but getting too high on that can be actually dangerous. Pro-inflammatory promote atherosclerosis. The last thing we want to do. And then on the sleep side , you know , deep sleep is what we're after. And if there's a question about a person's sleep health , that's how you clear your toxic metabolic waste from your brain each night. And so we got to promote that , especially as we get older. And tracking that and and getting those numbers of deep sleep up as much as possible is really important. And then exercise is the biggest of all. We've got to get more people physically active , even if it's not that strenuous. But as as close to daily as possible. Not just aerobic , but also including , uh , strength and resistance training and balance training. So those things we've known about. But now we know even more the mechanisms of how they help. And beyond that , we have to understand each person's risk story. You know , are they at risk for one of these three diseases ? And now we can pinpoint when they are at risk and and whether we're able to change the arc of that , uh , if we intervene with these lifestyle factors and many other ways we can intervene in these conditions going forward. Mm.
S1: Mm. Uh , something that you mentioned , you mentioned pro-inflammatory foods like those that are highly processed and meat. How do you know if you're inflamed ? Uh.
S2: Great question. We don't have the best blood markers right now. We have things like C-reactive protein and cytoskeleton. And , you know , we don't have that and we don't. As I really emphasize in the book , we don't have a good immune system , uh , test , uh , in the clinic that we would routinely get , because as we get older , uh , some of us have a real letdown of our immune system. It's our guardian. And and others are incredibly resilient. Like the super agers , uh , appear to be. So we need better inflammation markers. The reason I say the the ultra processed foods is one example. Another would be the microplastics and nano plastics or air pollution or. Forever chemicals. All these things raise the inflammation in the body and in the brain. And that's been determined through research grade studies , not the kinds of things that we can get through , uh , commercially available lab tests that are easily obtained. So we need to have those kind of tests to know about a person's inflammation and immune status. Uh , that that should be part of an annual checkup of the future. Hmm.
S1: Hmm. Well , in your book , you also talk about the importance of everyday diet.
S2: And what did they eat ? They ate a mediterranean diet , and they eat lots of fruits and vegetables. Low amount of of red meat. Um , it was mainly plant based. Uh , and , you know , that's what we've seen throughout all the studies previously that I review in the book. So that's the right diet for folks. Uh , generally , uh , because it's actually anti-inflammatory. It brings the inflammation level in our bodies to a lower level. And just to point out , these three age related diseases have a common thread , which is untoward inflammation. That's what drives them , uh , the immune system , which is tied into inflammation , the cells that are our basis of our immunity secrete proteins , chemokines and cytokines that drive inflammation. So that's why diet can make a real be a real help by mitigating and in fact , reducing the body's inflammation. And another thing related to that these GLP one drugs like Ozempic and Monero , they reduce inflammation long before they A reduced weight loss in the brain as well as in the body , and that appears to be a fundamental mechanism by which they're working. And they're being tested right now in big trials of Alzheimer's disease to prevent it. So that there's a common thread , as you can see , Jay , which is we got to get this immune system and it's , uh , triggering of inflammation , uh , in a much better state to promote the whole healthy aging , uh , opportunity. Mhm.
S1: Mhm. I mean , how do you get past the fact that there just aren't very many blood markers or tests out there to let people know ahead of time before they get cancer or other chronic diseases and illnesses that there's a lot of inflammation in their body. Yeah.
S2: Yeah. So even though we don't have the great inflammation test , we've got a lot of the really other new great tests. So for Alzheimer's is a test called Tau 217 I wrote about in the book and also in the Ground Truth Substack that I do. And it's a breakthrough because it tells people more than 20 years ahead if they're going to be at risk for Alzheimer's and gives a temporal , that is the timing for when it might appear. That is the mild cognitive impairment. Now , I wouldn't recommend people going and get that test , but if they have a family history of Alzheimer's , if they have an APO for a gene that they carry , which 2,025% of us have , uh , that's a reason to check that. And so the whole point is you have all these layers of data , including our electronic health record , our lab tests , the three I just mentioned , the brain clock that's going to be available soon , along with eight other clocks of the body , uh , the total body clock methylation that you can get. Anyway , you have all these layers of data. You use multimodal AI , um , to establish What's the weather ? You're at high risk and then you go into high gear prevention mode. Uh , surveillance and prevention. So there's a breakthrough test adding to the brain clock , which itself is a breakthrough test. Um , adding to the immune status clock. These clocks are just an incredible outgrowth of the science of aging. And soon we're going to have these. And that's really exciting. And they work the same way for cancer. Uh , and they worked the same way for cardiovascular disease. Once you have a heart clock or , you know , the clock of interest , along with some basic genetics called polygenic risk score , very inexpensive. Um , you know , if you are at high risk for one of these three diseases , and we have never in the history of medicine prevented these diseases at any scale , in any substantive way. But this has been a fantasy , you know , for millennia in medicine. But now we have an opportunity to do this. That's what's so exciting.
S1: So and in terms of preventative measures , you mentioned GLP ones being used in the reduction of inflammation. That's very interesting. Tell me a bit more about that. Yeah.
S2: Yeah. So when these drugs , you know got this whole chapter on that in the book. But you know , as you know they were initially 20 years ago uh , being used for uh , diabetes , type two diabetes. And the people there who took it didn't lose much weight , just a few pounds. And so there was no impetus to study that in obesity. But thanks to a scientist in Denmark named Lata Knutson , she kept pushing , pushing , pushing. You got to study obesity. And eventually it was done. And as you know , it's been extraordinary. And it isn't just obesity. It's been related to heart and liver and kidney , all sorts of benefits unrelated to diabetes. But what's interesting is that people with obesity , without diabetes. Lost 40 , 50 , 60 , £80. Right. So now we understand what's going on. Um , before the weight loss occurs , there's this reduction of inflammation in the brain and throughout the body. And of course , the weight loss adds to that. But it's happening just from these drugs. And so that's why the Alzheimer's trials are ongoing right now. And there'll be a lot more work to capitalize on this blocking of inflammation. It's the most potent inflammation blocker we've seen. And , you know , I've had patients who with rheumatoid arthritis that took these drugs that didn't have any drug that was really helping them. And they're on , you know , one of these and their rheumatoid arthritis symptoms all went away. It's all because of the anti-inflammatory action. And so in the book and many others have speculated I'm not the first. This now is in pill form coming out in the next year or so. And it's as potent as the injectables , which a lot of people don't want to take , and they're much more expensive. Anyway , when it's in pill form , it might wind up being used pretty broadly for various things like the ones we're talking about. Moreover , this whole explosion of the gut hormone that talked to the brain and talked to our immune system , that's what these are. These are basically taking gut hormone memetics. And so we're seeing an entire field of new medications based on gut hormones , which is revolutionizing the future of health care of of how we can achieve super agers. And that's all part of the story as well. It's not just the lifestyle , it's the other tools that we have to to get there. Wow.
S1: Wow. All right. So bottom line all this for me super agers are super agers because why.
S2: Well we don't know you know absolute terms. There may not be just one thing , right ? Some people are just darn lucky. Random so-called stochastic. But for the most part , everything comes together is that it's the immune system of people. To get to 85 , 90 , 95 without these three chronic diseases , they have to have a really fine tuned , highly functional immune system. Not too much , not too little. Right now the lifestyle is affecting that. That is what they eat , how they sleep , how much they exercise , their kind of optimistic personality and you know , their time. That socially interactive , which correlates very well with healthy aging being out in nature. That's something we were lucky about here in San Diego. These are all lifestyle factors. So what you have is we know the lifestyle factors that help. We know the immune system is critical and uh , we know ways to get to that point of , you know , 80s and 90s without these three major age related diseases. So the answer to your question , we don't know everything. We'll never know everything about it. But we know ways to deal with it. We know there's ways to take advantage of the advances in the science of aging. Uh , and so that's why we are at a unique , propitious time , uh , in medicine , where we can finally achieve the mission. Uh , it's so much better than to try to treat someone than it is to prevent the condition in the first place. We really didn't have the ways to do that. But now this convergence of all the things we've learned in recent years , and the necessity of using AI to assemble billions of data points on any given person , which is beyond human capacity , that's what's all making this possible. Wow.
S1: Wow.
S2: Right now , as you know , when people get well into their 60s and 70s , they're not the elderly , they're the elderly. We've got to change that , right ? We know some of the ways to do that , that people are not necessarily bought into in lifestyle. But soon we're going to pivot and have many more. The highest proportion of people will be able to avoid these three age related diseases. So I'm hoping the book gets the medical community on it. I'm hoping that we stop seeing gutting of our medical resources , when the whole idea was that we want to get healthier , not again , just healthier. Right. And , you know , I'm really excited that we'll build on this , that it may take some time to see the difference. But , you know , over the many years going forward , the hope is that we'll see the elderly be the ones that are more common than the elderly.
S1: I've been speaking with Doctor Eric Topol. He's founder and director of the Scripps Research Translational Institute. And his new book is called Super Agers An Evidence based Approach to Longevity. Doctor Topol , thank you so much.
S2: Thank you , I enjoyed it.
S1: That's our show for today. I'm your host , Jade Hindman. Thanks for tuning in to Midday Edition. Be sure to have a great day on purpose , everyone.
