Episode Transcript
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Dr. Moira Gunn (00:11):
You're listening
to part two of my interview with
doctor Eric Topol, the author ofsuperagers, an evidence based
approach to longevity. Now Idon't often quote the bible. In
fact, in all these years, I maynever have quoted the bible
before, I take nation, but maybeit's the new pope. The new pope
has gotten me going here. ButJesus is quoted as saying, the
(00:36):
poor will always be with us,which says that the health
inequities will always be withus.
Do you think that's true?
Dr. Eric Topol (00:44):
Well, they don't
have to be with us to the extent
they are now, where it's justhorrible amount of inequities we
have in this country, this richcountry, especially. So, what do
we do? Well, we have to takethese powerful capabilities and
intentionally deliberately makethem available to the people who
(01:09):
need them the most, which arethe people who have suffered the
worst environmental toxins, airpollution, plastics, the
consumption of ultra processedfoods, forever chemicals,
socioeconomic status. That's allthe things that they, these are
(01:29):
underrepresented minorities.They need this stuff because
they are the ones that have themost age related diseases.
So we can't just have thismaster plan that only helps the
affluenza. We have to workreally hard at this is something
for all people. And this is verydifferent than some other books
(01:52):
on longevity, which arebasically catering to only the
very wealthy people. Thisprescription or this plan, which
is individualized has to be onethat is for any individual
independent of their, ability topay for it. Because if we
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prevent diseases and you knowthis well, that economically
could be the greatest investmentwe ever make.
Because once a person has one ofthese diseases, that's where all
our costs accrue rapidly and ofhuge magnitude. So the
investment we make to make thisavailable to all people based on
(02:35):
their data is a very prudent,you know, it's a great
investment and we should bedoing it.
Dr. Moira Gunn (02:42):
Now, more and
more diagnostics are coming into
play. How do we get that intoroutine use?
Dr. Eric Topol (02:52):
Well, first of
all, the way we do mass
screening for cancer isincredibly dumb and wasteful
because again, we treat everyonethe same. So for women, eighty
eight percent will never havebreast cancer in their lives.
Now we treat women all the sameand we tell them age 40, 45,
(03:14):
show up for your mammogram everycouple of years. This is
ridiculous because we need tofind the people who are
predisposed to breast cancer,which we can now. We can get a
polygenic risk score.
We can get, obviously the usualthings like the family history
and everything from theelectronic record. And with AI,
(03:37):
we can determine who is at risk.With the mammogram itself using
AI, even with a normalmammogram, it sees things we
don't see, and it can determinea person's risk and put off
future studies. So there's lotsof ways to establish risk and we
need to do that much better. Andpart of that is the immune
(03:58):
system because many people mightdevelop microscopic cancer in
their lifetime.
In fact, Maura, we may all bedoing that from time to time,
but if a competent immune systemjust quashes it, it just doesn't
make it. It doesn't get legs andit doesn't spread. So that's
another thing is once we get theimmune system metrics, like we
(04:22):
have an immune system organclock, which is emerging from
the great work at Stanford byTony Wiskori and colleagues.
Once we have that, that's gonnahelp us even more discriminate
who's at risk, but it's the samething for colonoscopy, for PSA
screening for prostate. I mean,you name it.
We only pick up fourteen percentof cancers through these
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wasteful, treating all thepeople the same age only
criteria. We don't partitionrisk. We have the ways to do
that now, and we're not doingit. And it's very frustrating.
Dr. Moira Gunn (04:57):
Now we've talked
about AI lifestyle plus, cells,
so we're into three. The fourthone is omics. I think a lot of
people say, what are you talkingabout, omics? You know?
Dr. Eric Topol (05:09):
Yeah. So I was
touching on that now with this
polygenic risk score, which iscommon variants, hundreds of
them that are tagged to thatparticular disease of interest,
be it a type of cancer orcardiovascular or, or
Alzheimer's. So anyway, thosepeople aren't, they're not aware
because it adds an admixturefrom your mother and father. So
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even if it's not in your familyhistory, there's a lot going on
in those common variants whenyou get that special mix that
you don't know about. And that'swhy it's really good to get a
polygenic risk score.
The one that's the mostextensively validated is the
heart disease one. But the pointis once you have that, it's just
one layer of data, which you canconfirm with other layers of
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data. So you don't want to justpinpoint this is it, because it
isn't, it's one layer of data,but the problem with the
polygenic risk score, it onlytells you yes, no risk. It
doesn't tell you when it maymean that you could get
Alzheimer's at age 98 or 68. Sowhat good is it?
(06:14):
That's why you need these otherlayers of data, but omics
includes not just genes,proteins, the organ clocks we
talked about methylation. That'sthe epigenetic clock. It
includes the gut microbiome. Itincludes the immuno. These are
the biologic layers that makeeach of us distinct.
And the genes themselves, ourDNA, it's important, but nothing
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like the, the, back in February,you know, the, the, operating
instructions for life. No, no,the DNA is important, but it's
not, you know, the master, planfor, you know, our, our lives
that as was originallytheorized, it hasn't played out
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to do that. For example, wedon't know an immune system, how
its person functions from theirDNA. We have to test that
separately. Okay.
We don't know a gut microbiomein people, which is really
important. The gut talks to thebrain and cut the, the gut talks
to a lot of other parts of thebody. You don't know the gut
microbiome from looking at aperson's DNA. So the DNA is just
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less than we had, as time goeson, RNA too, the DNA becomes
less and less prominent as toits impact.
Dr. Moira Gunn (07:32):
Well, drugs and
vaccines are your fifth
component here driving a healthspan. And, boy, we have some
real crazy things happening withvaccine discussions and actions
today. I I almost don't wannaask you about them. Holy moly.
(07:53):
What what are you gonna say?
But if you would like to makeany comments right now, I'd
appreciate it.
Dr. Eric Topol (07:58):
Yeah. Well, I do
wanna talk about drugs since we
haven't talked about that. Italked about vaccines a bit
already. The GLP one drugs,Ozempic, Mounjaro, you know,
Zepbound, these drug class areamazing. Now, as you know, I
have a history of being veryanti pharma.
Dr. Moira Gunn (08:20):
Yeah. Yeah,
Eric, you do.
Dr. Eric Topol (08:22):
I went up
against Merck during the COVID
pandemic. I went up against allthe vaccine manufacturers
because they weren't putting outtheir data or their protocols. I
mean, I took them on and, Ishould be smarter than to take
them on because it's not easy todeal with these companies. But
for once, we have a drug classthat is extraordinary,
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outperforming beyond allexpectations. Now, what we've
learned is the reason that we'reseeing so much more than
expected is because these drugsreduce inflammation in the body
and the brain.
They're potent. They may be inthe form of pills, something
(09:05):
that the vast majority of uswill take to promote healthy
aging in the future. Who knows?I speculate on that. The point
is what we've learned is our guthormones, which we never had
much respect for.
When I went to medical school,they weren't gut hormones that
we discussed like glucagon andglucagon like peptide and you
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know, what these gut hormones,and there's many more to come,
okay, that are going to be drugsand they're not gonna be just
injectables, they're gonna bepills. They talk to the brain.
They talk to the rest of thebody. They are incredibly
important to our immune system,right? No less helping to get
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rid of addiction.
Who would've thought you takethese drugs and you reduce your
alcohol, you know, tremendously.You eat healthier foods, no
less, less food. You stopgambling, you know, changes your
reward circuits in the brain. Imean, this is kind of amazing,
right? It's even changed the bigfood companies to come up with
(10:12):
healthier foods because peoplearen't eating the junk that
ultra processed foods as muchbecause so many people are
taking these drugs now.
So except for the problem thatwe've got, these are like
forever drugs. We don't know howto get people off of them
without gaining the weight back,except for that problem, which
is a problem. I acknowledgethat. I do think we'll be able
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to figure out a way to wean it.Because I don't want people
taking any drugs for the rest oftheir lives if we can avoid it.
So it's amazing. And it's justthe beginning. What you're going
to see, Maura, is a wholeexplosion of gut hormones. These
are simulating our gut hormones,right? We already have triple
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receptors with three differentthings in the GLP-one family.
It just really quite amazing.Now, the other point about this
is we need potent antiinflammatory drugs, because
we've been talking about howinflammation is the whole core
of the problem. And we haven'thad any, what do we have now?
(11:16):
Nonsteroidals and prednisone.These are not good drugs.
We need drugs that are much morespecific and potent and, know,
without big time side effects.So we're going to see that Now
back to vaccines, the measlesvaccine is- is- what's going on
right now is- is ridiculous,propaganda. It's all mis- and
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disinformation, even coming, youknow, from our government, from
our HHS leader, Bobby Kennedy,Jr. So, I think it's fair to say
that the measles vaccine isexceptionally well proven. It
has absolutely no link toautism.
It is with two shots. It hasalmost perfect protection. And
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what's impressive about it is ifyou get measles, you get immune
amnesia, most people. You don'twanna get that, and you don't
want children to get that.
Dr. Moira Gunn (12:11):
Now what's
immune amnesia?
Dr. Eric Topol (12:13):
Basically, your
immune system, which has been
built up from exposures, itforgets all of its exposure. So
you're starting all over again.You don't want that because when
your immune system gets exposedto all these different viruses
and pathogens, that's how itgets, you know, primed. That's
how we avoid future infectionsof those things. So nobody wants
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to get measles and we have a wayto protect against it.
And what's a shame is that it's,it's been under siege for years,
from a completely fabricatedstudy by Andrew Wakefield. And
now we have the MAHA moms whobelieve, unfortunately, that
their kids with autism were fromthe vaccines that they had to
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get. It's really sad becauseautism is not based from the
measles vaccine. There've beendefinitive studies to rule that
out. Now, do we still need tolearn what is the culprit for
autism?
And certainly it's gettingdiagnosed more because of the
way diagnoses are made. Andobviously, you know, I have
terrible compassion for peoplewith families that have, you
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know, significant autism, sure.But don't blame the measles
vaccine. Don't blame vaccinesthat have been tested in
millions of people and neverbeen shown to have link with
measles. So vaccines are themost important preventive thing
we ever had.
Now we don't prevent age relateddiseases, except as I mentioned,
maybe dementia, right?Partially. So we're gonna use
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vaccines more and what's notgonna help more are movements to
try to be anti vaccine. It's notgonna help because it's not
based on data. It's based onemotion.
It's based on, you know, peoplewithout, the ability to review
the data and and call the youknow, the as it is, tell the
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truth. And, it's reallyunfortunate the times we're in
right now. Someday we'll getback to truth, data, facts, and
evidence.
Dr. Moira Gunn (14:15):
One thing we
have not said, and I just wanna
wrap up with this, is we haven'ttalked about the the you
mentioned the people that youtalk the stories, your patients,
at the beginning of the book,and these people that live a
really long time. And, one ofthe things they are is upbeat.
Dr. Eric Topol (14:34):
Yeah. I mean, if
you adopt the lifestyle factors
that we discussed and, you know,we didn't get into the
importance of deep sleep, sleephealth, and exercise, the
paramount thing, you're going tokeep staving off the other
threats that we face. So, justbecause you're older and because
you've been hit by one of thesethree big three, doesn't mean
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you wanna just let down. Infact, you know, all the things
that you can do today that arebacked up by evidence that are
either free or at very low costare worthwhile because they're
gonna help promote healthy agingfor you. So, it's never too late
and there's no lost cause.
(15:17):
And, you know, the whole idea iswe wanna inspire people that
there's things they can do. Andeven just, you know, some
physical activity doesn't haveto be, you know, you're you're
training for, you know, somemarathon, half marathon, none of
that. You just, if you go forwalks every day for a half hour
and you do some strengthtraining and balance training,
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it's gonna make a bigdifference. Right? And, and
sleep, you gotta get that deepsleep.
We, we, as we get older, wewanna make sure our sleep, deep
sleep is maximal because ittends to keep going down and
down. And so there, you know,tracking it may be helpful, but
learning about the interactionsof you and your sleep,
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particularly that, that phase ofsleep, it's really important.
And so that's what people cando. You know, it's there's so
many things that we have hardevidence for that we're not
doing.
Dr. Moira Gunn (16:14):
Well, doctor
Topol, I could speak to you for
a week and still there would bethings left we haven't talked
about in your book. I wannathank you for coming in, please
come back and see us again.You're always welcome on Tech
Nation.
Dr. Eric Topol (16:26):
Thanks, Moira.
Great to be with you again.
Dr. Moira Gunn (16:29):
My guest today
is doctor Eric Topol. His book
is super agers, an evidencebased approach to longevity.
It's published by Simon andSchuster.