October 1, 2024 • 39 mins
Heart disease, heart attack, and stroke are the nation’s #1 killers of men and women. But these chronic disorders of aging are easily detected and cost effective to prevent. If you want to not only live longer, but live a healthy, active, happy life to 100 and beyond, you’ll want to listen to heart surgeon David Luu, M.D. He’s founder of The Heart Fund, dedicated to democratizing access to cardiovascular care in low-income countries, and the startup Hearty.com, a service designed to detect heart disease and other age-related conditions early.
You’ll learn…
· Why checking your blood pressure should be as routine as brushing your teeth.
· The cholesterol blood test that everyone should undergo but few people do.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
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christopher quindes (00:00)
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Hello and welcome back.
to the Healthy Longevity podcast. I'm Dr. Florence Comite your host. And today's podcast is very exciting. We're gonna discuss how to improve our heart health and longevity.
and excited to welcome in today's discussion, my friend, Dr. David Luu a pediatric cardiothoracic surgeon, entrepreneur and philanthropist. Dr. Luu is president and founder of the Heart Fund, an international non -profit organization dedicated to democratizing access to cardiovascular care and health education and advancing cardiology research and practice in low and middle income countries.
He's also a phenomenal entrepreneur who recently launched Hearty .com, an online service designed to detect heart diseases, cancers, and age -related conditions early to add healthy years to your life.
I met David for the first time when we were both on a healthy living panel discussion in New York City last year. We're also part of a group that David created called Longevity Docs,
physicians around the world who share ideas, research and methods for combating chronic diseases of aging. Welcome, David. And I'm delighted to spend time with you talking about your work and topics you're passionate about. Thank you. Thank you. I'm super excited to spend this time with you, Florence. And thank you for this invitation on the Healthy Longevity Podcast.
For starters, we'd love to hear more about your background and what prompted your interest in medicine. for our listeners, we detect a slight accent. Did you grow up in France? Can I hide this accent? No, it's beautiful. so. That's going to be forever. So I'm trying to make myself understandable, but yes, I'm coming from France and...
from someone coming from the south of France. You have to add south of France because we're really proud coming from the Mediterranean. So I'm coming from Nîmes. It's a really small, know, roman city. And I did my medical school in Montpellier. So Montpellier is one of the first official medical school in the world, Starting in 15th century. So.
When you go to this medical school, it's super inspirational because it's kind of in the castle, you get into the labs and you see all those, you know, those antics. And, you know, I think it really inspired me to, to become a, you know, a better doctor, seeing all this, you know, legacy coming from all those doctors who, you know, who started there centuries ago. So yes, I'm coming from France.
This is a small country in Europe. don't know if you heard of that. I did. I even visited. I can see where, you know, I know Europeans feel like America is still a baby because we've only been around, you know, a very short time compared to Europe. But I had the same impression as you because at Yale, there's this big entryway where they always take pictures there.
And it has a a nice saying above the top. And it always made me feel that I'm in a long line of people who must have come through there. So I can't imagine the 15th century But you see exactly what you're saying. I think what is important is we search a small, you know, part of this, this lineage of
people trying to help others feeling better and treat disease or prevent disease. And so I think, we are still learning, right? Imagine what we knew like centuries ago and what we think we know today and what's gonna happen in the next 100 years. So we have to have this community of saying, yes, we do our best, but yet, mean, who knows, right?
It's inspiring, right? I say that all the time, you know, there's inspiration and hope, but then there are days we struggle with, you know, what we don't know. we don't have answers for questions that we don't even have. And the learning curve is so steep and yet we want to help humans live better lives.
We're using this word, mean, longevity has been here forever. Everyone wants to live a longer, healthier and happier life in a way. And so, yes, I mean, past few years have been really pushing this world on the top of the headlines, on the media and social media, But I think, you
if you think about it, good medicine is looking for longevity, That's what is medicine for, we're preventing people to die from diseases by treating them. And then at some point, every doctor should be a longevity doctor in that way, Absolutely.
You know, so that's it. It was like, where are we, all of us? And so why don't we do a small group where we can meet all together and then discuss what's the future and present? Totally agree.
And yet if we could just roll the clock to an earliest stage in life and give people the tools to survive and live life to the fullest till 100, 120, because they're healthy and they feel good. Who wants to live a longer life if you're not healthy and in good shape? That's really the question to me. And that's where I started, you know, looking at the fact that we begin to decline in our thirties, but if we could just stop aging, which to me is the biggest impact on diseases.
that we get in the future, we can sustain who we were at 25 or 30. Life would be fun at 100. We'd have the je de vie of life. So practically only my only French statement, but I did study French David. well, I'd to hear more about the heart surgery procedures and particularly in low resource countries and what you're continuing to do.
What's the genesis of that and what's the heart fund that you've established? I think it all started with a personal story, I lost my dear friend and girlfriend at that time, Emily, when I was 20 years old. And so it drove me to, know, a few months later to Africa.
And so I spent a few months in Africa and broke in Afa. So at the time, think in 2001, was the beginning of the war with Ivory Coast. And so I was looking to help children. I think it was always a mission for me. My mom is a pediatric nurse. My dad is a professor of acupuncture. So treating children and then preventing disease was probably
of my DNA. was so patient coming to my home on the Sunday, getting the care from my dad. They bring some food and clothes to Cambodian refugees in churches with my mom. I was not even 10. I think I was always in this environment of understanding that life is precious.
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and your health is even more, Especially when you don't have resources. So coming back to where I was in Africa, I saw a lot of children with hydrocephaly, You know, on those big heads, coming from meningitis complication. And I realized that it was possible to help them. So I started to reach out to a lot of different surgeons in Montpellier.
and say, would you fly over and try to treat those children? I was 21 years old. was just starting medicine, and so I didn't know anything. So I started to bring some intern and fellow, and I was raising fund to do that.
And then obviously we, you know, we started to operate children for congenital malformation in a different place of the world. And especially in Cambodia where
We're going into the jungle and looking at all those children with some information. What sparked really my interest is I did a lot of rotation and executive elective clerkship in Boston and Harvard, MGH, UCLA, USC, And one day I went to the operating room and I saw an open heart surgery. A surgeon putting a valve into a heart, changing that. was like, wow.
that's what I want to do. And so when I came back, started to really being focused on becoming a cardiac surgeon. then I started the Heart Fund. was one of, I was 30 years old starting my residency in cardiac surgery. And so we went to Haiti where after the earthquake, a lot of people couldn't access to any cardiovascular care. And so
with a lot of different help and organization and people around us. We started to have this cardiovascular program. We were bringing surgeons. I was helping those professors operating on the other part of the world. And so again, I'm super grateful that I got the trust from all those mentors, but especially, I think, from the local population. And so we operated on kids.
that had absolutely no resources. So what I realized is we were the only solution at some point, which was amazing for them, but that was so limiting in a way because if you're the only solution, if you don't come back anymore, what's happening? There's nothing else. And so starting to think how can we really help people on a more sustainable way? And that's why I think preventative care and training
you know, training people, understanding, you know, how can we leverage tools. So 2014, we started to build the first mobile clinic to go to villages and then screen people with portable EKG, portable, you know, cardio echograph. And we built an electronic medical record. We use satellite communication to send, you know, images to other doctors around the world. And so that's basically, you know, the beginning of the heart one.
So it's still going on. We do lot of public -private partnership with governments and large organizations to fund those efforts. it sounds like you made a real difference and it's that kind of knowledge you can't, you know.
unless you experience it, you can transfer what you've done to help everybody. I think it's amazing to start from scratch like that and create something so magnificent out of a tragedy that you experienced with the loss of your girlfriend at the time. And then had compassionate parents who taught you from the beginning what it meant to help and make a difference. I still remember my mom.
making food and going to visit people in nursing homes and wanting to spend time with them to make them feel good and compassionate, really. it makes a difference. It really does. And when you think about it from your experience, how do you see the states? Because I have a point of view that we get a lot of care, but there's big groups of people
if you cut out the coast, you're looking at the whole vast middle and south and north and the kind of attention to the care they need to understand what they can do both for themselves and in partnership with medicine. Many of them don't have appropriate access to preventing disease.
And so that kind of need, think even in a country that people feel and it's not always true that we have wealth in this country, but we don't necessarily have health in this country. So what can you transfer to that? Cause I think that in part, must've what led you to thinking about creating a new startup where you could help people, you know, at all stages capture their health and stay.
in front of it instead of allowing disease to invade. what is really interesting is when you're a doctor, right. And I always say that you're a doctor forever. Right. Whatever you start, whenever you start medicine, I think is you have a mission is to help people. The tool that you use, you know, they don't really matter. Right. And so the tools, you know, it could be a nonprofit organization. It could be a startup. It could be, you know,
becoming a policymaker. I think it's really understanding what is the root cause of those systemic problems. if you look at it, I can really address those problems in three parts. There is the policy parts. When you live in a country like America, you have to understand what are the causes of those chronic diseases. And I think they are really simple to understand. Chronic disease is the number one cause of death in the world.
and obviously in the US as well. This is blood pressure, obesity. high cholesterol, diabetes, inflammation, stress, lack of sleep, all those components are part of the cause. And then you have, the policies in place and that's probably harder to change, And so the root you can take
to control tobacco, improve the management of cardiovascular disease, working with Department of Health, It's a long, long term root. And so I figured out what is the easiest way you can help people. I think the easiest way saying, those are the tools you can use today to diagnose the disease that you can prevent tomorrow. Those are the tools that you can use today to avoid
to age in a really unearthly way. And you start with the heart, you can add the cognition decline, like early dementia, and then cancer, all those, diabetes, are chronic diseases that are easily detectable today in a cost -effective manner.
Those are the same too, it doesn't change. So I realized that at Hearty, the name is a little bit misleading, everyone's like, you're only treating the heart. think, yeah, it starts with the heart because that's the first cause of death. But then when you look at something, when you look at one disease, then you can look at all the other ones that are related. If you only look at the cardiometabolic disease, can we detect pre -diabetes and diabetes?
today easily? Yes. Can we treat it? Obviously, we can treat it. Heart attack, stroke, hypertension, all of those are really easy disease to detect. Now, I think the whole mission right now, Hearty is saying, how can we avoid those diseases to appear? And to do that, you have to diagnose them. You have to detect them. And so what we do is we have a program. We have a membership program which is totally virtual.
It's a lot of things that obviously, instance, you've seen from the beginning. But we look at, for instance, the CT scan of the heart, Measure the calcium score, which is the calcium you get in the coronary arteries.
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The arteries that brings the oxygen blood to the muscle of your heart. And then you can tell if they're healthy or not. And so there is even AI right now with a CLEARly test that can really measure before it's too late the health of those arteries. And because of that you can act earlier. You can act before the heart attack.
Exactly. And so that's the thing. Can we do that for a lot of disease? Can we do that earlier than, you know, the 76 years old gentleman? I think we can. And then we can start really early. Even for kids, Number one prevention is education.
for everybody. When you show them the results deep inside, like the CT calcium score or CT angiogram, they can't see that on the outside. They feel well. They don't know there's blockages building up or calcium deposits. And it's like unveiling what's going on at a deeper level in the body, which is a wake up call for people that you can see pretty early. So I completely concur that that gives them and adults and children alike.
the education they need to make wiser decisions, to own responsibility for how they wanna live life. It doesn't mean suffering and not having fun and not eating some of the time, the ice cream or a glass of wine, you know, here and there, but it means they have the tools to think about what are the next steps they could do to prevent a sudden heart attack.
so it's very insightful, I think, if we can offer the kind of services you're talking about right at their home. It's amazing. think, yeah, I think it's first of all, mean, every doctor should understand. that's what longevity docs is pretty interesting because we learn from so many interesting doctors, right? We've been there on the front line every single day. So I think there's like a few things are really simple.
Right. Your blood pressure, first of all, right. Testing your blood pressure as and I'm saying that for the audience, Blood pressure is number one is it's really cost effective tool and it's easy to do. Everyone can do it. There's even some tools right now. Not not all of them are validated, but you you can get some tools and measure your blood pressure and then store everything on your phone. Right. You're resting. Yeah. Your body composition, understanding that, you know,
you have to get some muscle and less fat, right? This ratio is important. And you can even have visceral fat within your body that you don't see. So you can look skinny outside, but fat inside, right? And I know you. Well, even, even skinny fat, but also I've seen people who are ripped, who have fat invading their liver and that you can reverse, but blood pressure, there's so many different ways you could go into a pharmacy that has machines.
You have apps on your phone, the camera on some of the phones, and you just have to make sure it's reproducible.
And then you can even go a little bit further, right? You can do like advanced, advanced lipid pattern, for instance, right? Understanding not only the regular cholesterol, which, you know, it's already great to have your LDL and HDL. But I mean, going a little bit deeper. So for instance, lipoprotein A is something that, you know, everyone eventually should test to understand if you have
genetic risk of having high cholesterol, hypercholesterolemia. And look, that's not something that's really costly. I don't think it's reinforced by insurance. anyway, ApoB, know, hypolypropyten B, or triglyceride. I think everyone should know their number, but that's one like for metabolism, right? You have HyH1 and, you know, imoglobin A1C, fasting glucose, fasting insulin, understanding your uric acid.
And like you said, inflammation is the trigger, right? You can have cholesterol in your blood, but without inflammation, it doesn't really impact the vessel. You need inflammation to damage the vessel. So the triad is inflammation, cholesterol, and hypertension, because now it pushes it right into your blood vessel. creates this plaque. And that's where the danger is, right? Especially when the plaque is soft and unstable.
And so when we tell you like three times a day, brush your teeth, brush your teeth, brush your teeth, it's like, you should as well protect your heart, protect your heart, protect your heart, right? No alcohol. maybe twice a day, brush your teeth and once a day, check your blood pressure. Actually, even in my family, we all had high blood pressure and it started with no other diseases starting quite young.
And my dad who was very conscious of health, he started me on my journey. he was probably one of the first self quantifiers. He made his own brand muffins. He would go for long walks. He would do races. He would race himself in the ocean, cause he'd walk along the ocean. He worked out in the gym. couldn't even keep up with him in his nineties, by the way. He would go with firemen and policemen and test himself. And I would take pictures and he'd laugh at me.
And then afterwards saying to me, let's go for a swim. And I was like, no, I'm wiped. You can go for a swim. But his brain was protected up into the last moment. And yet his brother, who I knew well too, but was less vigilant and didn't really want to take the same kind of care of himself in his eighties, he already appeared to have dementia because the high blood pressure stopped.
blood flow in his brain. And so it looked dementia, it wasn't dementia, was due to high blood pressure that wasn't proactively managed. And so I completely appreciate how important that is from a cardiometabolic point of view. And you're right, it's low hanging fruit and everybody can do something about it. The minute you know, your pressure goes up and down, you talk to your clinician, you talk to your physician.
There's so many things, you know, and I can go into my journey as well, but there's so many things that are accessible and are simple to implement. we don't have to go to all those, you know, I would say a crazy biohacking formula to get better. There's like 90 % of things that are accessible. almost, you know, they were super cost effective. So it doesn't have to be, you know, all those solutions for the Uber rich of the world.
And there is a lot of free content and education that can be distributed around that, that's for sure. Absolutely. And that's where I think even as a wealthy nation, we don't do a good job of pulling everybody in and saying, well, these are the basics. And that's scary because I think it's pervasive in the medical community too, that you don't see a doctor or bother or spend money unless you're really sick or you have symptoms when underneath,
It's brewing without symptoms. So to take a little turn, but I know it's connected to your, you know, you're creating Hearty .com. I understand a few years back, you had a skateboarding incident, which also changed, you know, the way you decided to go forward in life. Can you tell us something about it? And what were you thinking? Skateboarding?
We moved outside of New York because they're starting to build the hospital in central parks. Wow, we have to protect our son. So we move outside and then we're in Long Island. What happened is I said, wow, I'm going to start and I'm going to go into the water. want to surf.
That was on my vision board and he still is. surfing was on my vision board. So I started and I mean, obviously it was super cold February. So, my God, you started surfing in February. No, what I did is I said, it's, it is freezing in February. So what are you going to do? I going to go and buy a skateboard so I can train in the neighborhood. Got it. Lasted two days. So I saw another at the bike. I was following him with the skateboard and then
for some reason it was a stiff rod, couldn't break and I felt on my shoulder, we compressed my clavicle and broke it in four pieces. It was on a Sunday, I waited, went back home, my wife was pissed. And the next day I went out, I'm going to the hospital, to the ER to take my blood, et cetera, et cetera. say, hey, doc, you are due for surgery. So I see the surgeon and I say, hey, you know,
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I haven't done a blood work for a long time. Can I see my result?" I yeah, don't worry, it's fine, fine. It's just for the anesthesiologist before the OR. said, yeah, still, send me the result. I look at the result and my cholesterol was a little bit high, really like upper limit. And I think it was even over limit. It was not normal. And so I was like, wow, that's interesting. And that wasn't interesting, that was bad.
That's what I thought. But I was surprised. Yeah, bad, interesting surprise, you know, because, you know, I was look again, I was skateboarding. I was always, you know, active playing tennis, running, not withstanding the injury. You were skateboarding. Right. But what I didn't realize is I was being whatever I wanted because I was exercising because I thought I was healthy because I, you know, I looked, I wasn't overweight, but you know, still a little bit of abdominal fat and
And so at age 41, I met Dr. Frank Lippman, And Frank said, look, you have to do all those blood tests, more advanced, et cetera, et cetera. Long story short, I discovered I had lipoproteinolol -A, which is this marker, cholesterol marker, which basically tells you that your cholesterol is something from your family.
I did as well a genetic test, an epigenetic test. my God. was like, wow, I'm aging too fast. What's happening? have cardiovascular risk on my genetics, in my blood. I'm looking at, you know, I have 20 % of body fat. So I wasn't shaming myself. was like, man, that's not really good for a cardiac surgeon. And so I started this journey of understanding that if I wanted to live longer and taking care of my son and my grandchildren and enjoying life,
to the fullest, right? Maybe not living to 120 or 150, that wasn't the point, but living to, let's say 90 or 100, but fully in great shape like your dad, like bicycling and fishing and enjoying and traveling carrying suitcase with my grandchildren at 90, and you need to act now at 40 to build the next 50 years.
And so I started really this incredible journey to reverse my aging. And at some point, believe it or not, on biological age, we measure, for your audience, we measure some epigenetic, we have epigenetic tests that measure the methylation of the DNA. I reversed it a little bit.
One interesting question that I think our viewers would love to hear is, what about your parents? Did any of these diseases show up in your mom, dad, grandparents? Because that's what we encourage people to tell us. I used to think of family history as a poor man's genetic test.
But over the years, as genetics became better and better, I actually realized that it's actually even better than genetics in some ways, because of where the field is today, because it actually shows disease that emerges. And as you mentioned, Lp little a is a genetic factor. And sometimes your cholesterol can look perfect. Maybe you're good stuff. The HDL is super high. Your bad stuff is super low. You have the right number of particles. But if that Lp little a is present, you're at high risk and it's a hard thing to tap.
So parents, history, family history, are those things that struck you? Yeah. I think my mom has a little bit of hyper pressure. know my grandparents died from heart attacks or strokes. So it's there, right? And my dad is Chinese. So we have those Southeast Asian genes.
And so, you know, I totally believe that there is not only the genes, you know, like 10, 20 % of what makes us in terms of impact in, you know, age related diseases. But I think, you know, our lifestyle, know, is a marriage. It is a marriage, right? It's marriage of the way, because as you said, you felt pretty healthy. You realize maybe you put on a couple of pounds around the middle, but
knowing what was going on inside, which is what makes it so important, I think, to do the work that we're doing with the rest of the doctors in the world, with the focus on health. Longevity, we're not, for me, I'm not God. I don't know people's length of life. I'd like to live beyond, because I want to be with my great -great grandchildren. I want to dance at their weddings. want to... But the age isn't the critical part of it. It's how do you keep your health?
from going downhill and you got a wake up call. So that was really in a way the shoulder is something that's going to protect your life now because you've fully started investing in what you need to do. Exactly. And I think, we have micro stressors, micro trauma, micro whatever every day, but then sometimes you have big ones,
And so death, Death of someone you love, injuries, I think they have tell you something, to inspire you to change something. And I think that's what I always use. I want to help other people to say, yeah, I'm sure you're all going through something really hard today. I know that. There's a lot of people. But if you use that, to...
be better, to help more people, then that's really a fantastic lever. That's an opportunity to grow another person, To be kind, to have more compassion, to impact more people, to impact yourself. actually, totally. I can't help myself. Like I'm in the gym this morning doing strength training and workout with a trainer. And there's a guy
I can tell from his body, he's probably around 50, that maybe wine, a little too much wine at night, he works out to beat the band. and I gave him one of my continuous glucose monitors. And he said, my God, he had just came back from India because he's Indian too. And he, said, I can't believe it. It's really helping me make decisions about
Is it tequila or is it wine or is it? And he said, the sugar goes up and down. And cause I kept telling him, you you can work out as hard as you want. You're not going to lose your little tummy there. And, and he was very grateful. And so I think just advice, cause I can't help it, you know, to me, it's so important, as you pointed out, low hanging fruit with blood pressure, really low hanging fruit. And we need to take the weight off the.
the medical system because doctors can't do that. You have to know thyself. And I still remember my dad telling me that probably 40 years ago, we were together and he said, you know, I go to my cardiologist because I need to spend five minutes with him, but how does he know me? I have to watch myself. And then I can report to him the things that might be different. Yes, I might need a prescription, but we live in our own bodies. We need to make sure that we take care of them because we have no other place to live.
And so that struck a chord in me as well. But I've heard your journey now to healthspan. So I'm excited to see what you've attained and I'm happy to look at those numbers, David, with you. to see how well it's going. totally. I think healthspan is something amazing. have really lifespan, healthspan, number of years you live healthy. But now, you know, I'm even coming up with something interesting that I call peak longevity. Right.
You know, the investment of health spending is for the next 20 years, right? 30 years, making sure you don't have cancer, Alzheimer's, or heart attack in the next 20 years. years. Maybe 50 years, right? But then what happened tomorrow, right? What is the peak performance? need tomorrow, right, to get to those 50 years. And so I think it's really looking at, can we shorten this outcome in 50 years and see the outcome tomorrow? And I think there's all those intangible, I mean, now we can measure it a little bit better, but you see stress.
sleep, loneliness, community, All those kind of intangible, think that's going to be the future,
what would you pick as the one, if if anybody stopped you in the street and they said, what is the most important thing I can do to protect my health? What would you pick out of all of
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Good friends. That's fascinating. And they will tell you the truth. They will be here when, you know, when, when you get into the deepest moment, the saddest moment of your life. That's what is the most important, right? You can have, you know, there's this broken heart syndrome in Japanese named Kotaku Tsuru. You can die from a heart attack because you're sad. Right. And so I think there was an epidemic of loneliness starting in the U S from social media.
you know, like we're doing everything virtual right now. So I think at the public health level, would say good friends is number one, right? At the personal level, I would say as well that a good friend was, you know, and I say good friend, you have to define good friend, but someone I can tell you the truth. It will be here to hear from you. That will bring you the soup or the food if you're sick, right? That will show up when you have Alzheimer,
I think those are good friends. That's a wise answer. I'm very impressed. And I think you're absolutely right. In fact, there's data, David, that goes way back that has shown that people who have a heart attack and go home to a human being, a spouse, a partner, a friend, live longer than people who go home to a lonely empty house. if you have a dog,
or a cat with unconditional love, you actually live even longer. And with metastatic cancer, there are studies out of Stanford, David Spiegel, who showed that women with metastatic breast cancer, when they were part of a support group, lived 18 months longer than women who were not. I think I recognized coming to New York from Yale and New Haven, Connecticut.
because people are lonely even in a city that's so crowded. In fact, of the parts of what I thought was my job and I was so excited introducing people to one another. Like I had patients who I knew, because patients reveal themselves in their heart and soul, were lonely.
and one of my questions when I talk to new people who want to come and see me I ask them how close they are to their relatives. Do they see their brother? What about the children? it's very telling when people.
say, no, we really don't have a relationship, things fell apart. And a lot of times in the process, if they become my clients, my patients, I will encourage them to lend a hand, that it affects their health and their stress in their body and the way they will age because it does.
It's an investment to keep good friends. But think about that. If you have this, you know, this small group of friends, they are the one who you're going to exercise with. who going to you joy and reduce your stress. And I hope one day we're going to put like, you know, social connection and purposeful social connection as a biomarker of health.
Because right now we're looking at the proteomics, multibolomics and epigenetic change, which I love, which we measure. But we measure as well, know, social connection and your purpose. What are you driven? A lot people say, why are you doing that? I say, I don't know. I think this is really who I am. This is in my DNA. Probably my parents send me those genes. It's who I am. I'm a doctor. I like to do it. I, know, obviously I want to be successful doing it because I think that has more impact.
But at end of the day, this is just who I am. It's not work. Like helping people, bringing health to the world. health is only a tool.
You have health to live longer and to enjoy your friends, right? Otherwise, if you have the health, you need to have the other pieces. So that's great. What I want to turn to now is here at the Comite Center and also our virtual app, Grok Health.
we focus on a lot of biomarkers as you rattled off and it's the interpretation, connecting the dots as I think about it and really interpreting what's going on at a deeper level. That's why sometimes that would be hard even for self quantifiers, getting the fullness of life as you mentioned is where I think the best of life comes.
but there are a few questions that I'd love to bring up because we have a cardiothoracic surgeon on the line. Listeners always like to ask us, you know, specific questions that disturb them. And I'd love to have your help in answering some of the questions from listeners.
I'm a 63 year old male with no heart disease in the family, but I was prescribed Crestor for high cholesterol. I've been on it for a decade. Should I have a cardiac CT scan? And what's the difference between that
and calcium score, Yeah. So, I mean, look, first of all, it's always really important to understand the whole, life of this person, yes. To answer the question is yes, but not only, I think it is really important to do, you know, everything that includes, this calcium score.
A lot of people look at really the diagnostic because that's easy to understand, But again, the blood pressure is really important. Like measuring the inflammation is super important. Understanding why they have this high cholesterol. What's the level of the plaque? Is it calcified plaque? Is it unstable plaque? So maybe it will benefit you have something that's, you know, it's a clearly and measure the soft plaque,
when you say the calcified plaque, that's the CT calcium, which is a predictor of the future risk of heart disease compared to other people. Then the CT angio gives you the unstable plaque and then you want to take it once beyond it using AI to look at the depth of the plaque and to compare it over time. And I think that that would serve.
besides all the rest of it that would serve this gentleman really well. Moving on to another one, you can relate. I'm 41 and
think I'm in pretty good shape. I take a spin class, I run half marathons, I eat a healthy diet. My father had a heart attack at 60. What should I do to protect my heart health? I mean, look, obviously you're doing everything right, because you're running marathon, et cetera, but that's a risk because now you don't know how healthy is your heart, And yet you're running marathon. And so we see a lot of sudden
death happening Marathon. I think first of all, especially if the dad died from a heart attack or had a heart attack, is understanding, measuring why he had a heart attack. The only thing that you could do today, I would say, is lipoproteinolol -A. Measuring Lp -A and then inflammation. Understanding that your A -po -B, so really having something that's extremely,
specific for the metabolic health, right? Cholesterol, Now, What was the heart attack linked to? And so that's that's really interesting,
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He also needs to look at his whole life. How much sleep is he getting? Is it six to eight hours? Is it quality sleep? What is the kind of food he's eating? He may be not living on great food for his body, despite being a half marathon. We have people who run marathons who have stress fractures of their bones. Taking a look at what's going on there might be important too, as you pointed out. Let me give you one more.
I'm a woman who's 35 and my father is alive and well. He had angioplasty, he's 80 and he's in great shape, doing well. But my mom, she died of a massive heart attack at 60. And when she went to her doctor, remember this was probably about 20 years ago or more, the doctor labeled her as emptiness syndrome and gave her some Librium or Valium. What should I do now at 35?
I think I take pretty good care of myself. I try to intermittent fast. You know, I don't eat much in the way of ice cream. I do have a glass of wine every night. What would you recommend that we tell this 35 year young woman who wants to protect her health?
So I think the most important is really understanding the whole pillars of health, right? It doesn't mean because your family had a problem that, you know, it will happen to you, but you have to be conscious. And so I would say sleep, like you said, is super important.
understanding that you need to measure and understand your sleep. Is it seven hours minimum of quality sleep? The type of food, understanding the type, the food that can impact your inflammation, your cholesterol, mean, sugar, refined, you know, carbohydrate. I mean, even one glass of alcohol is bad. And so people should know that alcohol is not good.
smoking, even vaping, cannabis has an impact on your cardiovascular health. Exercise, a lot of people do not exercise enough. You should at least get 30 minutes of exercise per day, including strength training to maintain muscle mass, testosterone level, even for women. And what I think is really important is measuring your stress and managing it, because that's what creates a lot of inflammation.
as well, know, the food you eat and then the microbiome, think gut health is related with brain health and heart health at some point as well. it's all interrelated. is, is. And have her take steps to one at a time, maybe to be able to explore. There's a lot of great apps out there like Oura Ring, for example, that can give you a sense of your sleep. There's even scales at home like InBodyScale that looks at your body composition, fat and muscle distribution.
That was a great answer. really appreciate it. And I know our many listeners really loved hearing your expertise and how your takeaway on what you're doing as well as what they could do to improve their life. I wanna thank you for being on Healthy Longevity. And I look forward to more lively discussions with you and the rest of the Longevity Docs.
Thank you so much, Laurence. Thank you for everything you're doing. You're pioneer in the space. You you inspired me and you're many others. Keep pushing. Kim, being an innovator, I think we need more people like you. And I hope, you know, we're going to not only democratize this movement of longevity medicine, but we can really help people tomorrow, you know, if they have any question, happy to answer on any social as well.
Well, thank you all for listening to the podcast. I'm Dr. Florence Cometé and until next time, I'm wishing everyone a health span to match your lifespan and keep it up. Thank you. Thank you.
christopher quindes (00:00)
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Hello and welcome back.
to the Healthy Longevity podcast. I'm Dr. Florence Comite your host. And today's podcast is very exciting. We're gonna discuss how to improve our heart health and longevity.
and excited to welcome in today's discussion, my friend, Dr. David Luu a pediatric cardiothoracic surgeon, entrepreneur and philanthropist. Dr. Luu is president and founder of the Heart Fund, an international non -profit organization dedicated to democratizing access to cardiovascular care and health education and advancing cardiology research and practice in low and middle income countries.
He's also a phenomenal entrepreneur who recently launched Hearty .com, an online service designed to detect heart diseases, cancers, and age -related conditions early to add healthy years to your life.
I met David for the first time when we were both on a healthy living panel discussion in New York City last year. We're also part of a group that David created called Longevity Docs,
physicians around the world who share ideas, research and methods for combating chronic diseases of aging. Welcome, David. And I'm delighted to spend time with you talking about your work and topics you're passionate about. Thank you. Thank you. I'm super excited to spend this time with you, Florence. And thank you for this invitation on the Healthy Longevity Podcast.
For starters, we'd love to hear more about your background and what prompted your interest in medicine. for our listeners, we detect a slight accent. Did you grow up in France? Can I hide this accent? No, it's beautiful. so. That's going to be forever. So I'm trying to make myself understandable, but yes, I'm coming from France and...
from someone coming from the south of France. You have to add south of France because we're really proud coming from the Mediterranean. So I'm coming from Nîmes. It's a really small, know, roman city. And I did my medical school in Montpellier. So Montpellier is one of the first official medical school in the world, Starting in 15th century. So.
When you go to this medical school, it's super inspirational because it's kind of in the castle, you get into the labs and you see all those, you know, those antics. And, you know, I think it really inspired me to, to become a, you know, a better doctor, seeing all this, you know, legacy coming from all those doctors who, you know, who started there centuries ago. So yes, I'm coming from France.
This is a small country in Europe. don't know if you heard of that. I did. I even visited. I can see where, you know, I know Europeans feel like America is still a baby because we've only been around, you know, a very short time compared to Europe. But I had the same impression as you because at Yale, there's this big entryway where they always take pictures there.
And it has a a nice saying above the top. And it always made me feel that I'm in a long line of people who must have come through there. So I can't imagine the 15th century But you see exactly what you're saying. I think what is important is we search a small, you know, part of this, this lineage of
people trying to help others feeling better and treat disease or prevent disease. And so I think, we are still learning, right? Imagine what we knew like centuries ago and what we think we know today and what's gonna happen in the next 100 years. So we have to have this community of saying, yes, we do our best, but yet, mean, who knows, right?
It's inspiring, right? I say that all the time, you know, there's inspiration and hope, but then there are days we struggle with, you know, what we don't know. we don't have answers for questions that we don't even have. And the learning curve is so steep and yet we want to help humans live better lives.
We're using this word, mean, longevity has been here forever. Everyone wants to live a longer, healthier and happier life in a way. And so, yes, I mean, past few years have been really pushing this world on the top of the headlines, on the media and social media, But I think, you
if you think about it, good medicine is looking for longevity, That's what is medicine for, we're preventing people to die from diseases by treating them. And then at some point, every doctor should be a longevity doctor in that way, Absolutely.
You know, so that's it. It was like, where are we, all of us? And so why don't we do a small group where we can meet all together and then discuss what's the future and present? Totally agree.
And yet if we could just roll the clock to an earliest stage in life and give people the tools to survive and live life to the fullest till 100, 120, because they're healthy and they feel good. Who wants to live a longer life if you're not healthy and in good shape? That's really the question to me. And that's where I started, you know, looking at the fact that we begin to decline in our thirties, but if we could just stop aging, which to me is the biggest impact on diseases.
that we get in the future, we can sustain who we were at 25 or 30. Life would be fun at 100. We'd have the je de vie of life. So practically only my only French statement, but I did study French David. well, I'd to hear more about the heart surgery procedures and particularly in low resource countries and what you're continuing to do.
What's the genesis of that and what's the heart fund that you've established? I think it all started with a personal story, I lost my dear friend and girlfriend at that time, Emily, when I was 20 years old. And so it drove me to, know, a few months later to Africa.
And so I spent a few months in Africa and broke in Afa. So at the time, think in 2001, was the beginning of the war with Ivory Coast. And so I was looking to help children. I think it was always a mission for me. My mom is a pediatric nurse. My dad is a professor of acupuncture. So treating children and then preventing disease was probably
of my DNA. was so patient coming to my home on the Sunday, getting the care from my dad. They bring some food and clothes to Cambodian refugees in churches with my mom. I was not even 10. I think I was always in this environment of understanding that life is precious.
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and your health is even more, Especially when you don't have resources. So coming back to where I was in Africa, I saw a lot of children with hydrocephaly, You know, on those big heads, coming from meningitis complication. And I realized that it was possible to help them. So I started to reach out to a lot of different surgeons in Montpellier.
and say, would you fly over and try to treat those children? I was 21 years old. was just starting medicine, and so I didn't know anything. So I started to bring some intern and fellow, and I was raising fund to do that.
And then obviously we, you know, we started to operate children for congenital malformation in a different place of the world. And especially in Cambodia where
We're going into the jungle and looking at all those children with some information. What sparked really my interest is I did a lot of rotation and executive elective clerkship in Boston and Harvard, MGH, UCLA, USC, And one day I went to the operating room and I saw an open heart surgery. A surgeon putting a valve into a heart, changing that. was like, wow.
that's what I want to do. And so when I came back, started to really being focused on becoming a cardiac surgeon. then I started the Heart Fund. was one of, I was 30 years old starting my residency in cardiac surgery. And so we went to Haiti where after the earthquake, a lot of people couldn't access to any cardiovascular care. And so
with a lot of different help and organization and people around us. We started to have this cardiovascular program. We were bringing surgeons. I was helping those professors operating on the other part of the world. And so again, I'm super grateful that I got the trust from all those mentors, but especially, I think, from the local population. And so we operated on kids.
that had absolutely no resources. So what I realized is we were the only solution at some point, which was amazing for them, but that was so limiting in a way because if you're the only solution, if you don't come back anymore, what's happening? There's nothing else. And so starting to think how can we really help people on a more sustainable way? And that's why I think preventative care and training
you know, training people, understanding, you know, how can we leverage tools. So 2014, we started to build the first mobile clinic to go to villages and then screen people with portable EKG, portable, you know, cardio echograph. And we built an electronic medical record. We use satellite communication to send, you know, images to other doctors around the world. And so that's basically, you know, the beginning of the heart one.
So it's still going on. We do lot of public -private partnership with governments and large organizations to fund those efforts. it sounds like you made a real difference and it's that kind of knowledge you can't, you know.
unless you experience it, you can transfer what you've done to help everybody. I think it's amazing to start from scratch like that and create something so magnificent out of a tragedy that you experienced with the loss of your girlfriend at the time. And then had compassionate parents who taught you from the beginning what it meant to help and make a difference. I still remember my mom.
making food and going to visit people in nursing homes and wanting to spend time with them to make them feel good and compassionate, really. it makes a difference. It really does. And when you think about it from your experience, how do you see the states? Because I have a point of view that we get a lot of care, but there's big groups of people
if you cut out the coast, you're looking at the whole vast middle and south and north and the kind of attention to the care they need to understand what they can do both for themselves and in partnership with medicine. Many of them don't have appropriate access to preventing disease.
And so that kind of need, think even in a country that people feel and it's not always true that we have wealth in this country, but we don't necessarily have health in this country. So what can you transfer to that? Cause I think that in part, must've what led you to thinking about creating a new startup where you could help people, you know, at all stages capture their health and stay.
in front of it instead of allowing disease to invade. what is really interesting is when you're a doctor, right. And I always say that you're a doctor forever. Right. Whatever you start, whenever you start medicine, I think is you have a mission is to help people. The tool that you use, you know, they don't really matter. Right. And so the tools, you know, it could be a nonprofit organization. It could be a startup. It could be, you know,
becoming a policymaker. I think it's really understanding what is the root cause of those systemic problems. if you look at it, I can really address those problems in three parts. There is the policy parts. When you live in a country like America, you have to understand what are the causes of those chronic diseases. And I think they are really simple to understand. Chronic disease is the number one cause of death in the world.
and obviously in the US as well. This is blood pressure, obesity. high cholesterol, diabetes, inflammation, stress, lack of sleep, all those components are part of the cause. And then you have, the policies in place and that's probably harder to change, And so the root you can take
to control tobacco, improve the management of cardiovascular disease, working with Department of Health, It's a long, long term root. And so I figured out what is the easiest way you can help people. I think the easiest way saying, those are the tools you can use today to diagnose the disease that you can prevent tomorrow. Those are the tools that you can use today to avoid
to age in a really unearthly way. And you start with the heart, you can add the cognition decline, like early dementia, and then cancer, all those, diabetes, are chronic diseases that are easily detectable today in a cost -effective manner.
Those are the same too, it doesn't change. So I realized that at Hearty, the name is a little bit misleading, everyone's like, you're only treating the heart. think, yeah, it starts with the heart because that's the first cause of death. But then when you look at something, when you look at one disease, then you can look at all the other ones that are related. If you only look at the cardiometabolic disease, can we detect pre -diabetes and diabetes?
today easily? Yes. Can we treat it? Obviously, we can treat it. Heart attack, stroke, hypertension, all of those are really easy disease to detect. Now, I think the whole mission right now, Hearty is saying, how can we avoid those diseases to appear? And to do that, you have to diagnose them. You have to detect them. And so what we do is we have a program. We have a membership program which is totally virtual.
It's a lot of things that obviously, instance, you've seen from the beginning. But we look at, for instance, the CT scan of the heart, Measure the calcium score, which is the calcium you get in the coronary arteries.
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The arteries that brings the oxygen blood to the muscle of your heart. And then you can tell if they're healthy or not. And so there is even AI right now with a CLEARly test that can really measure before it's too late the health of those arteries. And because of that you can act earlier. You can act before the heart attack.
Exactly. And so that's the thing. Can we do that for a lot of disease? Can we do that earlier than, you know, the 76 years old gentleman? I think we can. And then we can start really early. Even for kids, Number one prevention is education.
for everybody. When you show them the results deep inside, like the CT calcium score or CT angiogram, they can't see that on the outside. They feel well. They don't know there's blockages building up or calcium deposits. And it's like unveiling what's going on at a deeper level in the body, which is a wake up call for people that you can see pretty early. So I completely concur that that gives them and adults and children alike.
the education they need to make wiser decisions, to own responsibility for how they wanna live life. It doesn't mean suffering and not having fun and not eating some of the time, the ice cream or a glass of wine, you know, here and there, but it means they have the tools to think about what are the next steps they could do to prevent a sudden heart attack.
so it's very insightful, I think, if we can offer the kind of services you're talking about right at their home. It's amazing. think, yeah, I think it's first of all, mean, every doctor should understand. that's what longevity docs is pretty interesting because we learn from so many interesting doctors, right? We've been there on the front line every single day. So I think there's like a few things are really simple.
Right. Your blood pressure, first of all, right. Testing your blood pressure as and I'm saying that for the audience, Blood pressure is number one is it's really cost effective tool and it's easy to do. Everyone can do it. There's even some tools right now. Not not all of them are validated, but you you can get some tools and measure your blood pressure and then store everything on your phone. Right. You're resting. Yeah. Your body composition, understanding that, you know,
you have to get some muscle and less fat, right? This ratio is important. And you can even have visceral fat within your body that you don't see. So you can look skinny outside, but fat inside, right? And I know you. Well, even, even skinny fat, but also I've seen people who are ripped, who have fat invading their liver and that you can reverse, but blood pressure, there's so many different ways you could go into a pharmacy that has machines.
You have apps on your phone, the camera on some of the phones, and you just have to make sure it's reproducible.
And then you can even go a little bit further, right? You can do like advanced, advanced lipid pattern, for instance, right? Understanding not only the regular cholesterol, which, you know, it's already great to have your LDL and HDL. But I mean, going a little bit deeper. So for instance, lipoprotein A is something that, you know, everyone eventually should test to understand if you have
genetic risk of having high cholesterol, hypercholesterolemia. And look, that's not something that's really costly. I don't think it's reinforced by insurance. anyway, ApoB, know, hypolypropyten B, or triglyceride. I think everyone should know their number, but that's one like for metabolism, right? You have HyH1 and, you know, imoglobin A1C, fasting glucose, fasting insulin, understanding your uric acid.
And like you said, inflammation is the trigger, right? You can have cholesterol in your blood, but without inflammation, it doesn't really impact the vessel. You need inflammation to damage the vessel. So the triad is inflammation, cholesterol, and hypertension, because now it pushes it right into your blood vessel. creates this plaque. And that's where the danger is, right? Especially when the plaque is soft and unstable.
And so when we tell you like three times a day, brush your teeth, brush your teeth, brush your teeth, it's like, you should as well protect your heart, protect your heart, protect your heart, right? No alcohol. maybe twice a day, brush your teeth and once a day, check your blood pressure. Actually, even in my family, we all had high blood pressure and it started with no other diseases starting quite young.
And my dad who was very conscious of health, he started me on my journey. he was probably one of the first self quantifiers. He made his own brand muffins. He would go for long walks. He would do races. He would race himself in the ocean, cause he'd walk along the ocean. He worked out in the gym. couldn't even keep up with him in his nineties, by the way. He would go with firemen and policemen and test himself. And I would take pictures and he'd laugh at me.
And then afterwards saying to me, let's go for a swim. And I was like, no, I'm wiped. You can go for a swim. But his brain was protected up into the last moment. And yet his brother, who I knew well too, but was less vigilant and didn't really want to take the same kind of care of himself in his eighties, he already appeared to have dementia because the high blood pressure stopped.
blood flow in his brain. And so it looked dementia, it wasn't dementia, was due to high blood pressure that wasn't proactively managed. And so I completely appreciate how important that is from a cardiometabolic point of view. And you're right, it's low hanging fruit and everybody can do something about it. The minute you know, your pressure goes up and down, you talk to your clinician, you talk to your physician.
There's so many things, you know, and I can go into my journey as well, but there's so many things that are accessible and are simple to implement. we don't have to go to all those, you know, I would say a crazy biohacking formula to get better. There's like 90 % of things that are accessible. almost, you know, they were super cost effective. So it doesn't have to be, you know, all those solutions for the Uber rich of the world.
And there is a lot of free content and education that can be distributed around that, that's for sure. Absolutely. And that's where I think even as a wealthy nation, we don't do a good job of pulling everybody in and saying, well, these are the basics. And that's scary because I think it's pervasive in the medical community too, that you don't see a doctor or bother or spend money unless you're really sick or you have symptoms when underneath,
It's brewing without symptoms. So to take a little turn, but I know it's connected to your, you know, you're creating Hearty .com. I understand a few years back, you had a skateboarding incident, which also changed, you know, the way you decided to go forward in life. Can you tell us something about it? And what were you thinking? Skateboarding?
We moved outside of New York because they're starting to build the hospital in central parks. Wow, we have to protect our son. So we move outside and then we're in Long Island. What happened is I said, wow, I'm going to start and I'm going to go into the water. want to surf.
That was on my vision board and he still is. surfing was on my vision board. So I started and I mean, obviously it was super cold February. So, my God, you started surfing in February. No, what I did is I said, it's, it is freezing in February. So what are you going to do? I going to go and buy a skateboard so I can train in the neighborhood. Got it. Lasted two days. So I saw another at the bike. I was following him with the skateboard and then
for some reason it was a stiff rod, couldn't break and I felt on my shoulder, we compressed my clavicle and broke it in four pieces. It was on a Sunday, I waited, went back home, my wife was pissed. And the next day I went out, I'm going to the hospital, to the ER to take my blood, et cetera, et cetera. say, hey, doc, you are due for surgery. So I see the surgeon and I say, hey, you know,
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I haven't done a blood work for a long time. Can I see my result?" I yeah, don't worry, it's fine, fine. It's just for the anesthesiologist before the OR. said, yeah, still, send me the result. I look at the result and my cholesterol was a little bit high, really like upper limit. And I think it was even over limit. It was not normal. And so I was like, wow, that's interesting. And that wasn't interesting, that was bad.
That's what I thought. But I was surprised. Yeah, bad, interesting surprise, you know, because, you know, I was look again, I was skateboarding. I was always, you know, active playing tennis, running, not withstanding the injury. You were skateboarding. Right. But what I didn't realize is I was being whatever I wanted because I was exercising because I thought I was healthy because I, you know, I looked, I wasn't overweight, but you know, still a little bit of abdominal fat and
And so at age 41, I met Dr. Frank Lippman, And Frank said, look, you have to do all those blood tests, more advanced, et cetera, et cetera. Long story short, I discovered I had lipoproteinolol -A, which is this marker, cholesterol marker, which basically tells you that your cholesterol is something from your family.
I did as well a genetic test, an epigenetic test. my God. was like, wow, I'm aging too fast. What's happening? have cardiovascular risk on my genetics, in my blood. I'm looking at, you know, I have 20 % of body fat. So I wasn't shaming myself. was like, man, that's not really good for a cardiac surgeon. And so I started this journey of understanding that if I wanted to live longer and taking care of my son and my grandchildren and enjoying life,
to the fullest, right? Maybe not living to 120 or 150, that wasn't the point, but living to, let's say 90 or 100, but fully in great shape like your dad, like bicycling and fishing and enjoying and traveling carrying suitcase with my grandchildren at 90, and you need to act now at 40 to build the next 50 years.
And so I started really this incredible journey to reverse my aging. And at some point, believe it or not, on biological age, we measure, for your audience, we measure some epigenetic, we have epigenetic tests that measure the methylation of the DNA. I reversed it a little bit.
One interesting question that I think our viewers would love to hear is, what about your parents? Did any of these diseases show up in your mom, dad, grandparents? Because that's what we encourage people to tell us. I used to think of family history as a poor man's genetic test.
But over the years, as genetics became better and better, I actually realized that it's actually even better than genetics in some ways, because of where the field is today, because it actually shows disease that emerges. And as you mentioned, Lp little a is a genetic factor. And sometimes your cholesterol can look perfect. Maybe you're good stuff. The HDL is super high. Your bad stuff is super low. You have the right number of particles. But if that Lp little a is present, you're at high risk and it's a hard thing to tap.
So parents, history, family history, are those things that struck you? Yeah. I think my mom has a little bit of hyper pressure. know my grandparents died from heart attacks or strokes. So it's there, right? And my dad is Chinese. So we have those Southeast Asian genes.
And so, you know, I totally believe that there is not only the genes, you know, like 10, 20 % of what makes us in terms of impact in, you know, age related diseases. But I think, you know, our lifestyle, know, is a marriage. It is a marriage, right? It's marriage of the way, because as you said, you felt pretty healthy. You realize maybe you put on a couple of pounds around the middle, but
knowing what was going on inside, which is what makes it so important, I think, to do the work that we're doing with the rest of the doctors in the world, with the focus on health. Longevity, we're not, for me, I'm not God. I don't know people's length of life. I'd like to live beyond, because I want to be with my great -great grandchildren. I want to dance at their weddings. want to... But the age isn't the critical part of it. It's how do you keep your health?
from going downhill and you got a wake up call. So that was really in a way the shoulder is something that's going to protect your life now because you've fully started investing in what you need to do. Exactly. And I think, we have micro stressors, micro trauma, micro whatever every day, but then sometimes you have big ones,
And so death, Death of someone you love, injuries, I think they have tell you something, to inspire you to change something. And I think that's what I always use. I want to help other people to say, yeah, I'm sure you're all going through something really hard today. I know that. There's a lot of people. But if you use that, to...
be better, to help more people, then that's really a fantastic lever. That's an opportunity to grow another person, To be kind, to have more compassion, to impact more people, to impact yourself. actually, totally. I can't help myself. Like I'm in the gym this morning doing strength training and workout with a trainer. And there's a guy
I can tell from his body, he's probably around 50, that maybe wine, a little too much wine at night, he works out to beat the band. and I gave him one of my continuous glucose monitors. And he said, my God, he had just came back from India because he's Indian too. And he, said, I can't believe it. It's really helping me make decisions about
Is it tequila or is it wine or is it? And he said, the sugar goes up and down. And cause I kept telling him, you you can work out as hard as you want. You're not going to lose your little tummy there. And, and he was very grateful. And so I think just advice, cause I can't help it, you know, to me, it's so important, as you pointed out, low hanging fruit with blood pressure, really low hanging fruit. And we need to take the weight off the.
the medical system because doctors can't do that. You have to know thyself. And I still remember my dad telling me that probably 40 years ago, we were together and he said, you know, I go to my cardiologist because I need to spend five minutes with him, but how does he know me? I have to watch myself. And then I can report to him the things that might be different. Yes, I might need a prescription, but we live in our own bodies. We need to make sure that we take care of them because we have no other place to live.
And so that struck a chord in me as well. But I've heard your journey now to healthspan. So I'm excited to see what you've attained and I'm happy to look at those numbers, David, with you. to see how well it's going. totally. I think healthspan is something amazing. have really lifespan, healthspan, number of years you live healthy. But now, you know, I'm even coming up with something interesting that I call peak longevity. Right.
You know, the investment of health spending is for the next 20 years, right? 30 years, making sure you don't have cancer, Alzheimer's, or heart attack in the next 20 years. years. Maybe 50 years, right? But then what happened tomorrow, right? What is the peak performance? need tomorrow, right, to get to those 50 years. And so I think it's really looking at, can we shorten this outcome in 50 years and see the outcome tomorrow? And I think there's all those intangible, I mean, now we can measure it a little bit better, but you see stress.
sleep, loneliness, community, All those kind of intangible, think that's going to be the future,
what would you pick as the one, if if anybody stopped you in the street and they said, what is the most important thing I can do to protect my health? What would you pick out of all of
(01:25):
Good friends. That's fascinating. And they will tell you the truth. They will be here when, you know, when, when you get into the deepest moment, the saddest moment of your life. That's what is the most important, right? You can have, you know, there's this broken heart syndrome in Japanese named Kotaku Tsuru. You can die from a heart attack because you're sad. Right. And so I think there was an epidemic of loneliness starting in the U S from social media.
you know, like we're doing everything virtual right now. So I think at the public health level, would say good friends is number one, right? At the personal level, I would say as well that a good friend was, you know, and I say good friend, you have to define good friend, but someone I can tell you the truth. It will be here to hear from you. That will bring you the soup or the food if you're sick, right? That will show up when you have Alzheimer,
I think those are good friends. That's a wise answer. I'm very impressed. And I think you're absolutely right. In fact, there's data, David, that goes way back that has shown that people who have a heart attack and go home to a human being, a spouse, a partner, a friend, live longer than people who go home to a lonely empty house. if you have a dog,
or a cat with unconditional love, you actually live even longer. And with metastatic cancer, there are studies out of Stanford, David Spiegel, who showed that women with metastatic breast cancer, when they were part of a support group, lived 18 months longer than women who were not. I think I recognized coming to New York from Yale and New Haven, Connecticut.
because people are lonely even in a city that's so crowded. In fact, of the parts of what I thought was my job and I was so excited introducing people to one another. Like I had patients who I knew, because patients reveal themselves in their heart and soul, were lonely.
and one of my questions when I talk to new people who want to come and see me I ask them how close they are to their relatives. Do they see their brother? What about the children? it's very telling when people.
say, no, we really don't have a relationship, things fell apart. And a lot of times in the process, if they become my clients, my patients, I will encourage them to lend a hand, that it affects their health and their stress in their body and the way they will age because it does.
It's an investment to keep good friends. But think about that. If you have this, you know, this small group of friends, they are the one who you're going to exercise with. who going to you joy and reduce your stress. And I hope one day we're going to put like, you know, social connection and purposeful social connection as a biomarker of health.
Because right now we're looking at the proteomics, multibolomics and epigenetic change, which I love, which we measure. But we measure as well, know, social connection and your purpose. What are you driven? A lot people say, why are you doing that? I say, I don't know. I think this is really who I am. This is in my DNA. Probably my parents send me those genes. It's who I am. I'm a doctor. I like to do it. I, know, obviously I want to be successful doing it because I think that has more impact.
But at end of the day, this is just who I am. It's not work. Like helping people, bringing health to the world. health is only a tool.
You have health to live longer and to enjoy your friends, right? Otherwise, if you have the health, you need to have the other pieces. So that's great. What I want to turn to now is here at the Comite Center and also our virtual app, Grok Health.
we focus on a lot of biomarkers as you rattled off and it's the interpretation, connecting the dots as I think about it and really interpreting what's going on at a deeper level. That's why sometimes that would be hard even for self quantifiers, getting the fullness of life as you mentioned is where I think the best of life comes.
but there are a few questions that I'd love to bring up because we have a cardiothoracic surgeon on the line. Listeners always like to ask us, you know, specific questions that disturb them. And I'd love to have your help in answering some of the questions from listeners.
I'm a 63 year old male with no heart disease in the family, but I was prescribed Crestor for high cholesterol. I've been on it for a decade. Should I have a cardiac CT scan? And what's the difference between that
and calcium score, Yeah. So, I mean, look, first of all, it's always really important to understand the whole, life of this person, yes. To answer the question is yes, but not only, I think it is really important to do, you know, everything that includes, this calcium score.
A lot of people look at really the diagnostic because that's easy to understand, But again, the blood pressure is really important. Like measuring the inflammation is super important. Understanding why they have this high cholesterol. What's the level of the plaque? Is it calcified plaque? Is it unstable plaque? So maybe it will benefit you have something that's, you know, it's a clearly and measure the soft plaque,
when you say the calcified plaque, that's the CT calcium, which is a predictor of the future risk of heart disease compared to other people. Then the CT angio gives you the unstable plaque and then you want to take it once beyond it using AI to look at the depth of the plaque and to compare it over time. And I think that that would serve.
besides all the rest of it that would serve this gentleman really well. Moving on to another one, you can relate. I'm 41 and
think I'm in pretty good shape. I take a spin class, I run half marathons, I eat a healthy diet. My father had a heart attack at 60. What should I do to protect my heart health? I mean, look, obviously you're doing everything right, because you're running marathon, et cetera, but that's a risk because now you don't know how healthy is your heart, And yet you're running marathon. And so we see a lot of sudden
death happening Marathon. I think first of all, especially if the dad died from a heart attack or had a heart attack, is understanding, measuring why he had a heart attack. The only thing that you could do today, I would say, is lipoproteinolol -A. Measuring Lp -A and then inflammation. Understanding that your A -po -B, so really having something that's extremely,
specific for the metabolic health, right? Cholesterol, Now, What was the heart attack linked to? And so that's that's really interesting,
(01:46):
He also needs to look at his whole life. How much sleep is he getting? Is it six to eight hours? Is it quality sleep? What is the kind of food he's eating? He may be not living on great food for his body, despite being a half marathon. We have people who run marathons who have stress fractures of their bones. Taking a look at what's going on there might be important too, as you pointed out. Let me give you one more.
I'm a woman who's 35 and my father is alive and well. He had angioplasty, he's 80 and he's in great shape, doing well. But my mom, she died of a massive heart attack at 60. And when she went to her doctor, remember this was probably about 20 years ago or more, the doctor labeled her as emptiness syndrome and gave her some Librium or Valium. What should I do now at 35?
I think I take pretty good care of myself. I try to intermittent fast. You know, I don't eat much in the way of ice cream. I do have a glass of wine every night. What would you recommend that we tell this 35 year young woman who wants to protect her health?
So I think the most important is really understanding the whole pillars of health, right? It doesn't mean because your family had a problem that, you know, it will happen to you, but you have to be conscious. And so I would say sleep, like you said, is super important.
understanding that you need to measure and understand your sleep. Is it seven hours minimum of quality sleep? The type of food, understanding the type, the food that can impact your inflammation, your cholesterol, mean, sugar, refined, you know, carbohydrate. I mean, even one glass of alcohol is bad. And so people should know that alcohol is not good.
smoking, even vaping, cannabis has an impact on your cardiovascular health. Exercise, a lot of people do not exercise enough. You should at least get 30 minutes of exercise per day, including strength training to maintain muscle mass, testosterone level, even for women. And what I think is really important is measuring your stress and managing it, because that's what creates a lot of inflammation.
as well, know, the food you eat and then the microbiome, think gut health is related with brain health and heart health at some point as well. it's all interrelated. is, is. And have her take steps to one at a time, maybe to be able to explore. There's a lot of great apps out there like Oura Ring, for example, that can give you a sense of your sleep. There's even scales at home like InBodyScale that looks at your body composition, fat and muscle distribution.
That was a great answer. really appreciate it. And I know our many listeners really loved hearing your expertise and how your takeaway on what you're doing as well as what they could do to improve their life. I wanna thank you for being on Healthy Longevity. And I look forward to more lively discussions with you and the rest of the Longevity Docs.
Thank you so much, Laurence. Thank you for everything you're doing. You're pioneer in the space. You you inspired me and you're many others. Keep pushing. Kim, being an innovator, I think we need more people like you. And I hope, you know, we're going to not only democratize this movement of longevity medicine, but we can really help people tomorrow, you know, if they have any question, happy to answer on any social as well.
Well, thank you all for listening to the podcast. I'm Dr. Florence Cometé and until next time, I'm wishing everyone a health span to match your lifespan and keep it up. Thank you. Thank you.
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