June 29, 2025 • 25 mins
Expanding Your Health Span with Dr. Benjamin Miller
In this episode of Peaceful Life Radio, host Don Drew interviews Dr. Benjamin Miller, an expert in aging research from the Oklahoma Medical Research Foundation. Dr. Miller discusses the importance of extending the health span—the period of life spent in good health—as opposed to merely extending lifespan. He explores the biological fundamentals of aging, the role of mitochondria, and his research on the benefits of exercise and potential anti-aging therapeutics like metformin and rapamycin. The episode also details ongoing studies and offers practical advice on maintaining health through physical activity, nutrition, sleep, and social engagement.
00:00 Introduction to Peaceful Life Radio
00:42 Meet Dr. Benjamin Miller
01:27 Dr. Miller's Journey into Aging Research
02:27 Understanding Aging and Health Span
04:03 The Role of Mitochondria and Muscle in Aging
06:52 Health Span vs. Lifespan
09:08 Current Anti-Aging Studies
11:21 Exercise and Molecular Health
14:14 Participating in Aging Research
16:10 Practical Tips for Expanding Health Span
19:24 Future Directions in Aging Research
23:43 Conclusion and Final Thoughts
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Benjamin Miller (00:00):
So think about later in life, you get a
higher incidence of diabetes,heart disease, stroke, cancer.
Age is actually the number onerisk factor for all of those
things more than smoking whatyou eat, whatever.
How old you are is the riskfactor for all those diseases.
We've prolonged the period thatwe can live with those things.
What we're trying to do in thefield now is extend the period
(00:23):
spent in good health rather thanperiods spent with disease that
we're managing.
Don Drew (00:28):
Welcome all to Peaceful Life Radio.
That was Dr.
Benjamin Miller, and today we'reexploring current research on
increasing your health span.
I'm Don Drew and my co-host,David Lowry, is taking the week
off to enjoy sunny Florida.
So let's jump right in.
Dr.
Benjamin Miller received his PhDin integrative biology from the
University of CaliforniaBerkeley and is currently the GT
(00:49):
Blankenship Chair in AgingResearch and Program Chair of
the Aging and MetabolismResearch Program at the Oklahoma
Medical Research Foundation.
Dr.
Miller's dedication to researchallows us to get a better
understanding of the changesthat occur in our bodies as we
age.
Particularly the role thatprotein plays in these changes.
By advancing our understandingof aging, he is contributing to
(01:11):
the broader goal of improvingour health span, the period of
life spent in good health.
Through his research, Dr.
Miller is helping to pave theway for a future where we can
all enjoy prolonged periods ofvitality and wellbeing.
Dr.
Miller, welcome to Peaceful LifeRadio.
Dr. Benjamin Miller (01:26):
Thank you for having me.
Don Drew (01:27):
Dr.
Miller, can you give us someideas about what got you
interested in aging in the firstplace?
I mean, we all have to face itat some point in our lives if we
live long enough.
But why did you pick that as anarea to investigate?
Dr. Benjamin Miller (01:40):
Good question.
My research originally startedin muscle, specifically how to
make muscle grow.
But I found the preventing ofmuscle shrinking, which is the
opposite of growth, and they'renot just the reverse of each
other, really interestingproblem.
How do we maintain what we havewith age?
That led to other questions ofaging, not directly related to
(02:03):
muscle, what is basicallyhappening within a cell that
causes this breakdown over time.
And I find aging a fascinatingquestion because like you said,
it happens to everybody.
We don't know how to prevent itfrom happening yet.
So it's an unanswered question,which is always a more
interesting question to me.
(02:24):
And it's just become afascinating area.
I think we're also on the cuspright now, the aging field of
doing some truly fantasticthings.
Aging used to be this sort ofcultish fringe type science with
fountains of youth and potionsand whatever that will reverse
the aging process.
And it's really emerged out ofthat to become a real hardcore
(02:47):
science that we actually callgero-science now.
So, the word gerontology isderive from age, so
gero-science.
And this extension of healthspan has become a really
tangible goal that I think we'regonna make some really big
differences in the upcomingyears.
And I'll go a little bit furtheron that and tell you why that's
(03:10):
so important.
So you've probably noticed thatas people get older, the number
of people with diabetes, cancer,Alzheimer's, heart disease, and
so on, all the things that killus, those things accumulate with
age.
Age is actually the number onerisk factor for all of those
(03:30):
things.
By far more than smoking whatyou eat, whatever, it's how old
you are is the risk factor forall those diseases, the most
important risk factor.
So if we could slow that agingprocess, we're simultaneously
slowing the onset of all ofthose diseases.
So that's why I think studyingaging is super important and a
(03:51):
super interesting question is tobe able to not just whack-a-mole
and treat one condition at atime, but to simultaneously
prevent the onset or treat allof those diseases at the same
time.
Don Drew (04:02):
Dr.
Miller.
I've been reading about yourwork and it involves
mitochondria in cells, variousproteins, and a better
understanding of how centralthey are to the aging process.
Can you provide an overview ofthe biological fundamentals of
your work?
Dr. Benjamin Miller (04:15):
Sure.
So we have two main areas in thelab.
One is just the basic biology ofaging what fundamentally causes
us to age and deteriorate withage.
It seems like we should havesystems in place for keeping the
cells and tissues from breakingdown, but eventually that occurs
and it occurs in everybody.
(04:36):
So we study why that happens andhow it happens.
The second areas we focusparticularly on muscle.
We know that muscle's importantto keep us mobile and
independent, but it also is animportant metabolic contributor
to health and wellbeing becauseit uses a lot of energy.
It's a sink for certain energysources, by sync, I mean it uses
(04:58):
them or it stores them.
So it has a lot of importantfunctions for keeping us
independent.
So those are the two main areas.
But if I go a little morespecific, we study mitochondria.
As you mentioned, most peopleare taught in grade school or
high school, that these are thepowerhouses of the cell.
They're what produce energy.
(05:19):
The way I like to provide ananalogy here is that we're
familiar with a car engine orinternal combustion engine where
you have oxygen.
You have a fuel in the form ofgasoline and the engine makes
work out of that.
And it generates work and italso dissipates some excess as
heat.
(05:39):
Okay.
So that's an inefficienttransfer.
So I think cars are somethinglike 30 to 40% efficient of
harnessing all energy that ispresent in petroleum.
But in our body, what we do iswe take in foods and those foods
have chemical bonds that haveenergy in them.
And when we get to the point ofthe mitochondria, we essentially
combust it.
(06:00):
It's not exact perfect analogy,but we use those things derived
from foods to make energy.
And just like an engine, we losesome of that as waste, as heat.
That's part of what keeps ourbody warm.
But that energy we generatekeeps all cells, keep all
tissues, keep the whole bodyfunctioning in a normal way.
And if you think about all thethings that UV light or all
(06:22):
these things that could causedamage to us during a day long
process every day, we have torepair those things that all
cost energy.
We have to move things aroundour body that cost energy.
And we don't have an infiniteamount of energy.
So we have to make decisions onwhere to use that energy and
where not to use that energy.
And we sort of study all of thatto find out why there's a
(06:45):
failure in the ability to repairover time.
That might come from a lack ofhaving enough energy.
Don Drew (06:52):
Very good.
So most of us have probablyheard that Americans possess a
life expectancy of around 78years at birth, and your
research aims to increase whatyou term the health span.
Will your research allow me tolive longer?
Dr. Benjamin Miller (07:04):
The term health span is this concept that
people that are interested inthe science of aging did not see
a huge value in increasinglifespan without increasing the
period of good health.
Okay, so in the 20th century wewere very good at extending the
maximal expected lifespan.
But what we've done is managediseases better so that we are
(07:26):
actually extending the periodspent with disease.
So think about later in life,you get a higher incidence of
diabetes, heart disease, stroke,cancer.
We've prolonged the period thatwe can live with those things.
What we're trying to do in thefield now is extend the period
spent in good health rather thanperiods spent with disease that
(07:48):
we're managing.
So that term for that is healthspan.
I would say that we've madesignificant progress in that
area.
But what you may note is thatthere's not a drug out there for
health span yet.
And that's something the fieldis working towards.
We know of some things that dopromote longer health span,
things like exercise.
(08:09):
But as we have found over andover getting a hundred percent
of people to be physicallyactive in exercises hasn't
worked very well.
Don Drew (08:17):
Is it fair to say that this is a two-pronged approach
that you're taking looking atboth biology and the value of
exercise?
Dr. Benjamin Miller (08:25):
Yeah.
in the case of exercise, it'ssomething that we know works and
we don't completely understandhow it works or why it works.
So we study how it works but wealso use exercise as a benchmark
for other sort of therapeuticsand drugs and stuff that we're
trying to develop to increasehealth span.
My catchphrase for this is thatall the drugs that we're working
(08:49):
with are trying to be as good asexercise.
We know exercise works, but wedon't exactly know how, so we
can't just turn that into apill.
Anybody that tells you that theyhave exercise in a pill that's
false advertising.
It just, it's not possible yet.
So we're trying to find multipledifferent ways to approach this
question of health span andextending it.
Don Drew (09:08):
You're presently conducting an anti-aging study,
if I can use that term.
What is that about?
Dr. Benjamin Miller (09:13):
We have two studies and let me cover both of
those real quickly.
So the one that is wrapping up.
We had 101 subjects come throughthis study and it was testing
the effects of metformin.
Many of your listeners will knowmetformin and a lot of'em may be
on it'cause it's one of the mostprescribed drugs in America for
type two diabetes.
So there was some evidence thatmetformin might actually trigger
(09:38):
processes in the cells globallythroughout your body that may
slow that aging process.
Okay?
So there was some evidence forthat.
We had evidence that it mightwork for some people and it
might not work for others.
So that study was about testingwhat we say, the context
specificity of metformin.
Who is it good for and who is itnot good for?
Turns out we don't think it'sthe right thing for everybody.
(10:00):
If you're metabolicallyunhealthy, I think it's a very
good thing.
But if you're already healthy,it's probably not the right
treatment for you.
So that's one study and we're insort of the analysis phase of
that study.
The one we're starting up now isa funded study looking at
exercise in a different way.
So if you put a hundred peopleon an exercise training program,
(10:24):
say 40 of'em will have reallypositive benefits for it and 40
might not have much of a benefitfrom the exercise and maybe 20
fall somewhere in the middlethere.
So not everybody responds toexercise the same, and some
people don't seem to get much ofa benefit at all.
So we're testing in oldersubjects, what is it that causes
(10:47):
that heterogeneity of responseto exercise?
Could we predict who's not gonnarespond?
And if we could predict who'snot gonna respond, what could we
do to make sure that they dorespond?
So there's two goals for thatstudy.
Be able to predict who's gonnarespond and who won't respond.
And the second goal for thosethat don't respond, how can we
(11:08):
make it or tailor things so thatthey do respond?
And this is a very simplisticversion of that study.
I mean, we're getting into thecellular pathways, molecular
pathways, and so on.
But that's the general idea.
Don Drew (11:21):
Okay.
Help us understand, a littlebetter this link between
exercise and improvement at themolecular level.
Dr. Benjamin Miller (11:27):
Yeah, so a simple analogy here would be if
you had a house that you didregular maintenance on, kept it
up, painted it every coupleyears, replaced gutters, do
things as you go, that house 20years from now is gonna look
largely like it did when youbuilt the house.
If you ignore the house anddon't put any maintenance into
(11:48):
it, then it falls apart overtime.
And that's the same thing in ourbody.
When you do things likeexercise, you trigger pathways
and cells that rebuild and breakdown proteins.
Proteins just accumulate damageover time, just like something
exposed to the elements is gonnaaccumulate damage over time.
One of the main things in cellsand we talk about mitochondria,
(12:10):
are these things called reactiveoxygen species.
They're a natural byproduct orfree radical, some people know
'em as, that can cause damageand they're just a natural
byproduct of our mitochondrialworking.
But by doing things likeexercise we can trigger those
repair processes that keep thecells looking young.
It's triggers the cellularpathways that are like regular
(12:34):
maintenance to a house.
That's a very simplified versionof these biochemical pathways.
Don Drew (12:40):
So you're recruiting people now for this study,
correct?
Dr. Benjamin Miller (12:43):
We are.
So, this is a two site studyfunded by the National
Institutes on Aging, which is inthe National Institutes of
Health, NIH.
We have two sites, one here, andone at a Research institute in
Florida.
We are seeking to recruit 70people here at OMRF.
And these people undergo 15weeks of supervised exercise
(13:05):
training.
So it's like having a personaltrainer.
'cause we have controlledexercise programs that people
will go through.
And then at the end of that 16weeks, if we find that people
are fall into this category ofthat they respond to exercise,
or they don't respond toexercise will determine what
happens then for a second phaseof the study.
If they don't respond, then wedo some things that hopefully
(13:28):
will make them respond.
Don Drew (13:29):
The participants have to meet certain qualifications,
correct?
Dr. Benjamin Miller (13:32):
Yeah, we're looking for people over 60 and
we're looking for people thatdon't have major health
conditions currently ongoing.
There's some people that mayhave treated a health condition
in the past and would stillqualify.
There are certain drugs that weexclude, such as Metformin, the
one I mentioned before.
And we watch out for things likedosing of statins.
(13:55):
Some people on statins willqualify, some will not.
If we didn't allow anybody inwith statins, then we might not
have anybody in our study.
So we have to be practical, butalso screen out some things that
could cause major differences bythemselves.
Don Drew (14:09):
So if somebody's on Metformin, then they would not
qualify.
Dr. Benjamin Miller (14:13):
Correct.
Yeah.
Don Drew (14:14):
If our listeners was interested in participating in
this study, what specificallywould they need to do?
Where do they go to connect?
Dr. Benjamin Miller (14:21):
They would go to the OMRF webpage, Oklahoma
Medical Research Foundation, andthere's a link on the page for
participants interested instudies or they can directly
contact me if you're able toleave some information in the
notes for the show, but we couldleave some contact information
there for any listenerinterested in being involved in
(14:42):
the study.
And it starts with a simpleonline screening.
And then maybe half our peoplewill screen out just from that.
But then you go to the next stepof screening, which is, in
person.
And then we walk you throughthis process.
Don Drew (14:54):
Many of our listeners may be outside Oklahoma area and
may not meet the criteria foryour particular study, but are
interested in participating inaging studies like yours.
How might they go about findingmedically overseen research
studies in their area of thecountry?
Dr. Benjamin Miller (15:08):
So there's a central database called
clinical trials.gov.
That's clinical trials, oneword.gov.
And for any sort of researchstudy that you might be
interested in, you can do searchterms, area terms whatever else,
and it'll bring up all fundedclinical trials on that topic in
your area where you live.
For example, my father hadpancreatic cancer or has a
(15:32):
pancreatic cancer.
So I immediately went to thatwebsite to see what ongoing
clinical trials there were fortreatments for pancreatic
cancer.
It's a nice resource.
Don Drew (15:39):
It's a resource anybody could use really to look
up clinical trials no matterwhat medical condition you're
looking at.
Dr. Benjamin Miller (15:46):
Absolutely.
But also I encourage people tobe active and seek out what
their local communities have.
As far as information about, myarea of interest aging.
There's a lot of aging resourcecenters within most cities as
well.
But the research, the actualresearch you wanna seek out
through these, clinicaltrials.gov.
Don Drew (16:05):
We've talked about the science here and about exercise
and a number of issues relatedto your studies.
But what are some of the thingsthat people can do right now
that could help expand their ownhealth span?
Okay, that could help us livehealthier during our life
besides do more exercise, eatbetter, and that sort of thing,
is there anything that you canthink of that would be useful?
Dr. Benjamin Miller (16:27):
So that's, that's funny.
Because what we've narrowed onare things that are kind of
obvious.
Okay.
So there's exercise, nutrition,and we're not, when we say
nutrition, we're not saying likea fancy diet of some sort.
It's just the absence of eatinga bad diet.
Eating a whole nutritionistfoods and things like that.
Sleep has emerged as another keyfactor.
(16:48):
That's not my area ex expertise,but it's an important one.
And social engagement hasemerged as an important factor
too.
These are the basics.
What we're doing as scientistsfor the people that cannot
exercise, is there somethingthat we can substitute that has
some of those same effects?
And this is where we get intotherapeutics or drugs and we
(17:10):
talked a little already aboutMetformin.
Everybody knows someone that'son a GLP one agonist right now,
so that's getting some tractionin the aging space.
There's a drug called rapamycin,and for anybody in your audience
who really pays attention toaging research, this one will be
top on their list.
This is a drug that wasoriginally used as if someone
(17:33):
was getting a liver transplantor something, they would get
this drug because it suppressesthe immune system so you don't
reject that organ.
But it's turned out to be a verypowerful reproducible treatment
to slow the aging process.
In mice, for example, we canmake'em live 30% longer in
better health.
Rapamycin is one that's startingto be taken into humans in some
(17:56):
forms of dosing trials.
Some might have heard ofSenolytics.
Senescent cells are what we,people refer to as zombie cells.
They're a somewhat dead,somewhat alive cell that
functions like a rotten appleand spoils everything around it.
And then there's a class ofdrugs that will go in and
selectively kill those cells tokeep them from spoiling the runs
(18:19):
around them.
So there's clinical trials forSenolytics right now, too.
The important thing with allthese drugs is that right now
we're getting closer to this,but as of right now, if you go
to the FDA to try to get a drugapproved.
So if I brought a drug to theFDA to say, treat blood
pressure, we measure bloodpressure and we know if it
(18:40):
brings blood pressure down, it'sworking.
We don't have a measurement ofslowing the aging process.
That's something that's reallyhard.
I mean, you have a calendar toshow someone's age, but that's
not necessarily their biologicalage.
So what do we measure for that?
So if we go to the FDA topropose a drug for aging, right
(19:00):
now, we don't have the frameworkto be able to say, yes, this
drug is working for slowing theaging process.
And that's a main hindrance forbringing a drug to market for
aging.
But many in the field are in theprocess of changing that, and I
don't think we're that far offfrom bringing clinical trials of
(19:21):
different drug treatments toslow the aging process.
Don Drew (19:24):
Dr.
Miller, I happen to know thatyou're a cyclist.
You love to exercise in that wayand I'm sure you probably do
other things as well.
I've been reading a lot aboutthe importance of strength
training lately, and totallyanecdotal, but in my own case,
I've been doing more strengthtraining lately and it's
improved balance and it's helpedme in a lot of positive ways.
When we use the term exercise,are there some exercises that
(19:46):
you suspect might be reallyexcellent exercises for people
that are in the second half oflife?
Dr. Benjamin Miller (19:53):
So I'll start with a lot less exciting
answer probably than you'rehoping for.
The thing is, the majority ofbenefits from exercise comes
from not doing anything to justdoing something.
Okay.
To get people physically active.
We don't even have to call itexercise.
Just physically active can havea lot of the major benefits of
(20:16):
so-called exercise.
And as you have people thatexercise frequently or
regularly, adding more exerciseon top of that has diminishing
benefits.
It's just going from doingnothing to doing something.
And that's not glamorous, butit's effective.
Okay.
Then once you get to that point,you do wanna have a mix of what
(20:36):
we call both strength trainingand aerobic exercise training.
So the cycling and running andwalking are all aerobic
exercises they're endurance typeexercises.
But it's a nice to have abalance of both strength and
endurance training'cause theyhave different benefits.
So strength obviously is gonnawork on things like muscle size
and balance and other thingswhere endurance actually targets
(20:59):
the mitochondria that I'm sointerested in.
Either one of them can bebeneficial.
Doing both of'em is recommendedto have well-balanced benefits.
I don't wanna go too long onthis, but if you do strength
training or you do aerobicexercise training, it's not just
about what it's doing, say tothat particular muscle.
When your muscle gets stimulatedby exercise, it releases all
(21:22):
kinds of things into the blood.
And those things that itreleases into the blood travel
to other places in your body.
One of the places that travelsis the brain.
So exercise is not reallydirectly stimulating your brain
in a way like solving a puzzlewould, but it has benefits
there.
It's no mystery that physicalactivity leads to brain health
(21:45):
'cause these things are allconnected.
So it's not just the directbenefit it has, it has all kinds
of peripheral tangentialbenefits when you do exercise,
no matter what kind of exerciseyou're doing.
Don Drew (21:57):
What else are you working on and what's the next
big thing for you?
Dr. Benjamin Miller (22:01):
Another area of the lab that I think it
might be interesting to somepeople is that, if you've ever
watched someone go into thehospital and they're in a bed
for five, seven days, youngpeople come out of the hospital
and rebound pretty quickly fromthat.
But the older person comes outof that never quite the same
again.
Okay.
Never quite back to fullstrength.
(22:23):
And that's something that westudy'cause it's a significant
health problem.
How to recover from this periodof disuse like hospitalization
to regain strength and functionto what you were before you went
in.
That's a significant healthconcern.
And we get funding from the VA,the Veterans Association, to
study that'cause it's a problemfor veterans too.
(22:43):
And that's an area that's takenup a lot of focus in our lab
right now.
So this isn't a question ofhealth span directly, but it's a
question of muscular healthafter a period of insult of some
sort.
Don Drew (22:55):
I know you're the immediate past president of the
American Association on Aging.
So I'm sure you've heard about alot of really interesting
studies that are happening.
So is there anything that justreally like tickles your own
imagination?
Dr. Benjamin Miller (23:06):
Well.
There's so much going on in theaging area right now, and it was
nice to be president of thesociety for a year and we just
got done with our annual meetingand you see what's going on in
the area and, you see all theyoung scientists with their new
ideas.
I guess the one thing, aboutscience that's so important
right now, including the work wedo, is how do we continue to do
(23:26):
this work in a productive way?
Science in the United States isunder threat right now.
It's threatened.
There's large scale cuts to theability to do this kind of
science.
I actually worry most about theyoung scientists coming up.
Don Drew (23:43):
Dr.
Benjamin Miller, Chair of theAging and Metabolism Research
Program at the Oklahoma MedicalResearch Foundation, past
President of the AmericanAssociation on Aging and so much
more.
Dr.
Miller, thank you for educatingus on your work and for
providing our listeners withhope that they can achieve a
longer health span for theirlives.
Thank you for being on PeacefulLife Radio.
Dr. Benjamin Miller (24:02):
Thank you.
I enjoyed it.
So think about later in life, you get a
higher incidence of diabetes,heart disease, stroke, cancer.
Age is actually the number onerisk factor for all of those
things more than smoking whatyou eat, whatever.
How old you are is the riskfactor for all those diseases.
We've prolonged the period thatwe can live with those things.
What we're trying to do in thefield now is extend the period
(00:23):
spent in good health rather thanperiods spent with disease that
we're managing.
Don Drew (00:28):
Welcome all to Peaceful Life Radio.
That was Dr.
Benjamin Miller, and today we'reexploring current research on
increasing your health span.
I'm Don Drew and my co-host,David Lowry, is taking the week
off to enjoy sunny Florida.
So let's jump right in.
Dr.
Benjamin Miller received his PhDin integrative biology from the
University of CaliforniaBerkeley and is currently the GT
(00:49):
Blankenship Chair in AgingResearch and Program Chair of
the Aging and MetabolismResearch Program at the Oklahoma
Medical Research Foundation.
Dr.
Miller's dedication to researchallows us to get a better
understanding of the changesthat occur in our bodies as we
age.
Particularly the role thatprotein plays in these changes.
By advancing our understandingof aging, he is contributing to
(01:11):
the broader goal of improvingour health span, the period of
life spent in good health.
Through his research, Dr.
Miller is helping to pave theway for a future where we can
all enjoy prolonged periods ofvitality and wellbeing.
Dr.
Miller, welcome to Peaceful LifeRadio.
Dr. Benjamin Miller (01:26):
Thank you for having me.
Don Drew (01:27):
Dr.
Miller, can you give us someideas about what got you
interested in aging in the firstplace?
I mean, we all have to face itat some point in our lives if we
live long enough.
But why did you pick that as anarea to investigate?
Dr. Benjamin Miller (01:40):
Good question.
My research originally startedin muscle, specifically how to
make muscle grow.
But I found the preventing ofmuscle shrinking, which is the
opposite of growth, and they'renot just the reverse of each
other, really interestingproblem.
How do we maintain what we havewith age?
That led to other questions ofaging, not directly related to
(02:03):
muscle, what is basicallyhappening within a cell that
causes this breakdown over time.
And I find aging a fascinatingquestion because like you said,
it happens to everybody.
We don't know how to prevent itfrom happening yet.
So it's an unanswered question,which is always a more
interesting question to me.
(02:24):
And it's just become afascinating area.
I think we're also on the cuspright now, the aging field of
doing some truly fantasticthings.
Aging used to be this sort ofcultish fringe type science with
fountains of youth and potionsand whatever that will reverse
the aging process.
And it's really emerged out ofthat to become a real hardcore
(02:47):
science that we actually callgero-science now.
So, the word gerontology isderive from age, so
gero-science.
And this extension of healthspan has become a really
tangible goal that I think we'regonna make some really big
differences in the upcomingyears.
And I'll go a little bit furtheron that and tell you why that's
(03:10):
so important.
So you've probably noticed thatas people get older, the number
of people with diabetes, cancer,Alzheimer's, heart disease, and
so on, all the things that killus, those things accumulate with
age.
Age is actually the number onerisk factor for all of those
(03:30):
things.
By far more than smoking whatyou eat, whatever, it's how old
you are is the risk factor forall those diseases, the most
important risk factor.
So if we could slow that agingprocess, we're simultaneously
slowing the onset of all ofthose diseases.
So that's why I think studyingaging is super important and a
(03:51):
super interesting question is tobe able to not just whack-a-mole
and treat one condition at atime, but to simultaneously
prevent the onset or treat allof those diseases at the same
time.
Don Drew (04:02):
Dr.
Miller.
I've been reading about yourwork and it involves
mitochondria in cells, variousproteins, and a better
understanding of how centralthey are to the aging process.
Can you provide an overview ofthe biological fundamentals of
your work?
Dr. Benjamin Miller (04:15):
Sure.
So we have two main areas in thelab.
One is just the basic biology ofaging what fundamentally causes
us to age and deteriorate withage.
It seems like we should havesystems in place for keeping the
cells and tissues from breakingdown, but eventually that occurs
and it occurs in everybody.
(04:36):
So we study why that happens andhow it happens.
The second areas we focusparticularly on muscle.
We know that muscle's importantto keep us mobile and
independent, but it also is animportant metabolic contributor
to health and wellbeing becauseit uses a lot of energy.
It's a sink for certain energysources, by sync, I mean it uses
(04:58):
them or it stores them.
So it has a lot of importantfunctions for keeping us
independent.
So those are the two main areas.
But if I go a little morespecific, we study mitochondria.
As you mentioned, most peopleare taught in grade school or
high school, that these are thepowerhouses of the cell.
They're what produce energy.
(05:19):
The way I like to provide ananalogy here is that we're
familiar with a car engine orinternal combustion engine where
you have oxygen.
You have a fuel in the form ofgasoline and the engine makes
work out of that.
And it generates work and italso dissipates some excess as
heat.
(05:39):
Okay.
So that's an inefficienttransfer.
So I think cars are somethinglike 30 to 40% efficient of
harnessing all energy that ispresent in petroleum.
But in our body, what we do iswe take in foods and those foods
have chemical bonds that haveenergy in them.
And when we get to the point ofthe mitochondria, we essentially
combust it.
(06:00):
It's not exact perfect analogy,but we use those things derived
from foods to make energy.
And just like an engine, we losesome of that as waste, as heat.
That's part of what keeps ourbody warm.
But that energy we generatekeeps all cells, keep all
tissues, keep the whole bodyfunctioning in a normal way.
And if you think about all thethings that UV light or all
(06:22):
these things that could causedamage to us during a day long
process every day, we have torepair those things that all
cost energy.
We have to move things aroundour body that cost energy.
And we don't have an infiniteamount of energy.
So we have to make decisions onwhere to use that energy and
where not to use that energy.
And we sort of study all of thatto find out why there's a
(06:45):
failure in the ability to repairover time.
That might come from a lack ofhaving enough energy.
Don Drew (06:52):
Very good.
So most of us have probablyheard that Americans possess a
life expectancy of around 78years at birth, and your
research aims to increase whatyou term the health span.
Will your research allow me tolive longer?
Dr. Benjamin Miller (07:04):
The term health span is this concept that
people that are interested inthe science of aging did not see
a huge value in increasinglifespan without increasing the
period of good health.
Okay, so in the 20th century wewere very good at extending the
maximal expected lifespan.
But what we've done is managediseases better so that we are
(07:26):
actually extending the periodspent with disease.
So think about later in life,you get a higher incidence of
diabetes, heart disease, stroke,cancer.
We've prolonged the period thatwe can live with those things.
What we're trying to do in thefield now is extend the period
spent in good health rather thanperiods spent with disease that
(07:48):
we're managing.
So that term for that is healthspan.
I would say that we've madesignificant progress in that
area.
But what you may note is thatthere's not a drug out there for
health span yet.
And that's something the fieldis working towards.
We know of some things that dopromote longer health span,
things like exercise.
(08:09):
But as we have found over andover getting a hundred percent
of people to be physicallyactive in exercises hasn't
worked very well.
Don Drew (08:17):
Is it fair to say that this is a two-pronged approach
that you're taking looking atboth biology and the value of
exercise?
Dr. Benjamin Miller (08:25):
Yeah.
in the case of exercise, it'ssomething that we know works and
we don't completely understandhow it works or why it works.
So we study how it works but wealso use exercise as a benchmark
for other sort of therapeuticsand drugs and stuff that we're
trying to develop to increasehealth span.
My catchphrase for this is thatall the drugs that we're working
(08:49):
with are trying to be as good asexercise.
We know exercise works, but wedon't exactly know how, so we
can't just turn that into apill.
Anybody that tells you that theyhave exercise in a pill that's
false advertising.
It just, it's not possible yet.
So we're trying to find multipledifferent ways to approach this
question of health span andextending it.
Don Drew (09:08):
You're presently conducting an anti-aging study,
if I can use that term.
What is that about?
Dr. Benjamin Miller (09:13):
We have two studies and let me cover both of
those real quickly.
So the one that is wrapping up.
We had 101 subjects come throughthis study and it was testing
the effects of metformin.
Many of your listeners will knowmetformin and a lot of'em may be
on it'cause it's one of the mostprescribed drugs in America for
type two diabetes.
So there was some evidence thatmetformin might actually trigger
(09:38):
processes in the cells globallythroughout your body that may
slow that aging process.
Okay?
So there was some evidence forthat.
We had evidence that it mightwork for some people and it
might not work for others.
So that study was about testingwhat we say, the context
specificity of metformin.
Who is it good for and who is itnot good for?
Turns out we don't think it'sthe right thing for everybody.
(10:00):
If you're metabolicallyunhealthy, I think it's a very
good thing.
But if you're already healthy,it's probably not the right
treatment for you.
So that's one study and we're insort of the analysis phase of
that study.
The one we're starting up now isa funded study looking at
exercise in a different way.
So if you put a hundred peopleon an exercise training program,
(10:24):
say 40 of'em will have reallypositive benefits for it and 40
might not have much of a benefitfrom the exercise and maybe 20
fall somewhere in the middlethere.
So not everybody responds toexercise the same, and some
people don't seem to get much ofa benefit at all.
So we're testing in oldersubjects, what is it that causes
(10:47):
that heterogeneity of responseto exercise?
Could we predict who's not gonnarespond?
And if we could predict who'snot gonna respond, what could we
do to make sure that they dorespond?
So there's two goals for thatstudy.
Be able to predict who's gonnarespond and who won't respond.
And the second goal for thosethat don't respond, how can we
(11:08):
make it or tailor things so thatthey do respond?
And this is a very simplisticversion of that study.
I mean, we're getting into thecellular pathways, molecular
pathways, and so on.
But that's the general idea.
Don Drew (11:21):
Okay.
Help us understand, a littlebetter this link between
exercise and improvement at themolecular level.
Dr. Benjamin Miller (11:27):
Yeah, so a simple analogy here would be if
you had a house that you didregular maintenance on, kept it
up, painted it every coupleyears, replaced gutters, do
things as you go, that house 20years from now is gonna look
largely like it did when youbuilt the house.
If you ignore the house anddon't put any maintenance into
(11:48):
it, then it falls apart overtime.
And that's the same thing in ourbody.
When you do things likeexercise, you trigger pathways
and cells that rebuild and breakdown proteins.
Proteins just accumulate damageover time, just like something
exposed to the elements is gonnaaccumulate damage over time.
One of the main things in cellsand we talk about mitochondria,
(12:10):
are these things called reactiveoxygen species.
They're a natural byproduct orfree radical, some people know
'em as, that can cause damageand they're just a natural
byproduct of our mitochondrialworking.
But by doing things likeexercise we can trigger those
repair processes that keep thecells looking young.
It's triggers the cellularpathways that are like regular
(12:34):
maintenance to a house.
That's a very simplified versionof these biochemical pathways.
Don Drew (12:40):
So you're recruiting people now for this study,
correct?
Dr. Benjamin Miller (12:43):
We are.
So, this is a two site studyfunded by the National
Institutes on Aging, which is inthe National Institutes of
Health, NIH.
We have two sites, one here, andone at a Research institute in
Florida.
We are seeking to recruit 70people here at OMRF.
And these people undergo 15weeks of supervised exercise
(13:05):
training.
So it's like having a personaltrainer.
'cause we have controlledexercise programs that people
will go through.
And then at the end of that 16weeks, if we find that people
are fall into this category ofthat they respond to exercise,
or they don't respond toexercise will determine what
happens then for a second phaseof the study.
If they don't respond, then wedo some things that hopefully
(13:28):
will make them respond.
Don Drew (13:29):
The participants have to meet certain qualifications,
correct?
Dr. Benjamin Miller (13:32):
Yeah, we're looking for people over 60 and
we're looking for people thatdon't have major health
conditions currently ongoing.
There's some people that mayhave treated a health condition
in the past and would stillqualify.
There are certain drugs that weexclude, such as Metformin, the
one I mentioned before.
And we watch out for things likedosing of statins.
(13:55):
Some people on statins willqualify, some will not.
If we didn't allow anybody inwith statins, then we might not
have anybody in our study.
So we have to be practical, butalso screen out some things that
could cause major differences bythemselves.
Don Drew (14:09):
So if somebody's on Metformin, then they would not
qualify.
Dr. Benjamin Miller (14:13):
Correct.
Yeah.
Don Drew (14:14):
If our listeners was interested in participating in
this study, what specificallywould they need to do?
Where do they go to connect?
Dr. Benjamin Miller (14:21):
They would go to the OMRF webpage, Oklahoma
Medical Research Foundation, andthere's a link on the page for
participants interested instudies or they can directly
contact me if you're able toleave some information in the
notes for the show, but we couldleave some contact information
there for any listenerinterested in being involved in
(14:42):
the study.
And it starts with a simpleonline screening.
And then maybe half our peoplewill screen out just from that.
But then you go to the next stepof screening, which is, in
person.
And then we walk you throughthis process.
Don Drew (14:54):
Many of our listeners may be outside Oklahoma area and
may not meet the criteria foryour particular study, but are
interested in participating inaging studies like yours.
How might they go about findingmedically overseen research
studies in their area of thecountry?
Dr. Benjamin Miller (15:08):
So there's a central database called
clinical trials.gov.
That's clinical trials, oneword.gov.
And for any sort of researchstudy that you might be
interested in, you can do searchterms, area terms whatever else,
and it'll bring up all fundedclinical trials on that topic in
your area where you live.
For example, my father hadpancreatic cancer or has a
(15:32):
pancreatic cancer.
So I immediately went to thatwebsite to see what ongoing
clinical trials there were fortreatments for pancreatic
cancer.
It's a nice resource.
Don Drew (15:39):
It's a resource anybody could use really to look
up clinical trials no matterwhat medical condition you're
looking at.
Dr. Benjamin Miller (15:46):
Absolutely.
But also I encourage people tobe active and seek out what
their local communities have.
As far as information about, myarea of interest aging.
There's a lot of aging resourcecenters within most cities as
well.
But the research, the actualresearch you wanna seek out
through these, clinicaltrials.gov.
Don Drew (16:05):
We've talked about the science here and about exercise
and a number of issues relatedto your studies.
But what are some of the thingsthat people can do right now
that could help expand their ownhealth span?
Okay, that could help us livehealthier during our life
besides do more exercise, eatbetter, and that sort of thing,
is there anything that you canthink of that would be useful?
Dr. Benjamin Miller (16:27):
So that's, that's funny.
Because what we've narrowed onare things that are kind of
obvious.
Okay.
So there's exercise, nutrition,and we're not, when we say
nutrition, we're not saying likea fancy diet of some sort.
It's just the absence of eatinga bad diet.
Eating a whole nutritionistfoods and things like that.
Sleep has emerged as another keyfactor.
(16:48):
That's not my area ex expertise,but it's an important one.
And social engagement hasemerged as an important factor
too.
These are the basics.
What we're doing as scientistsfor the people that cannot
exercise, is there somethingthat we can substitute that has
some of those same effects?
And this is where we get intotherapeutics or drugs and we
(17:10):
talked a little already aboutMetformin.
Everybody knows someone that'son a GLP one agonist right now,
so that's getting some tractionin the aging space.
There's a drug called rapamycin,and for anybody in your audience
who really pays attention toaging research, this one will be
top on their list.
This is a drug that wasoriginally used as if someone
(17:33):
was getting a liver transplantor something, they would get
this drug because it suppressesthe immune system so you don't
reject that organ.
But it's turned out to be a verypowerful reproducible treatment
to slow the aging process.
In mice, for example, we canmake'em live 30% longer in
better health.
Rapamycin is one that's startingto be taken into humans in some
(17:56):
forms of dosing trials.
Some might have heard ofSenolytics.
Senescent cells are what we,people refer to as zombie cells.
They're a somewhat dead,somewhat alive cell that
functions like a rotten appleand spoils everything around it.
And then there's a class ofdrugs that will go in and
selectively kill those cells tokeep them from spoiling the runs
(18:19):
around them.
So there's clinical trials forSenolytics right now, too.
The important thing with allthese drugs is that right now
we're getting closer to this,but as of right now, if you go
to the FDA to try to get a drugapproved.
So if I brought a drug to theFDA to say, treat blood
pressure, we measure bloodpressure and we know if it
(18:40):
brings blood pressure down, it'sworking.
We don't have a measurement ofslowing the aging process.
That's something that's reallyhard.
I mean, you have a calendar toshow someone's age, but that's
not necessarily their biologicalage.
So what do we measure for that?
So if we go to the FDA topropose a drug for aging, right
(19:00):
now, we don't have the frameworkto be able to say, yes, this
drug is working for slowing theaging process.
And that's a main hindrance forbringing a drug to market for
aging.
But many in the field are in theprocess of changing that, and I
don't think we're that far offfrom bringing clinical trials of
(19:21):
different drug treatments toslow the aging process.
Don Drew (19:24):
Dr.
Miller, I happen to know thatyou're a cyclist.
You love to exercise in that wayand I'm sure you probably do
other things as well.
I've been reading a lot aboutthe importance of strength
training lately, and totallyanecdotal, but in my own case,
I've been doing more strengthtraining lately and it's
improved balance and it's helpedme in a lot of positive ways.
When we use the term exercise,are there some exercises that
(19:46):
you suspect might be reallyexcellent exercises for people
that are in the second half oflife?
Dr. Benjamin Miller (19:53):
So I'll start with a lot less exciting
answer probably than you'rehoping for.
The thing is, the majority ofbenefits from exercise comes
from not doing anything to justdoing something.
Okay.
To get people physically active.
We don't even have to call itexercise.
Just physically active can havea lot of the major benefits of
(20:16):
so-called exercise.
And as you have people thatexercise frequently or
regularly, adding more exerciseon top of that has diminishing
benefits.
It's just going from doingnothing to doing something.
And that's not glamorous, butit's effective.
Okay.
Then once you get to that point,you do wanna have a mix of what
(20:36):
we call both strength trainingand aerobic exercise training.
So the cycling and running andwalking are all aerobic
exercises they're endurance typeexercises.
But it's a nice to have abalance of both strength and
endurance training'cause theyhave different benefits.
So strength obviously is gonnawork on things like muscle size
and balance and other thingswhere endurance actually targets
(20:59):
the mitochondria that I'm sointerested in.
Either one of them can bebeneficial.
Doing both of'em is recommendedto have well-balanced benefits.
I don't wanna go too long onthis, but if you do strength
training or you do aerobicexercise training, it's not just
about what it's doing, say tothat particular muscle.
When your muscle gets stimulatedby exercise, it releases all
(21:22):
kinds of things into the blood.
And those things that itreleases into the blood travel
to other places in your body.
One of the places that travelsis the brain.
So exercise is not reallydirectly stimulating your brain
in a way like solving a puzzlewould, but it has benefits
there.
It's no mystery that physicalactivity leads to brain health
(21:45):
'cause these things are allconnected.
So it's not just the directbenefit it has, it has all kinds
of peripheral tangentialbenefits when you do exercise,
no matter what kind of exerciseyou're doing.
Don Drew (21:57):
What else are you working on and what's the next
big thing for you?
Dr. Benjamin Miller (22:01):
Another area of the lab that I think it
might be interesting to somepeople is that, if you've ever
watched someone go into thehospital and they're in a bed
for five, seven days, youngpeople come out of the hospital
and rebound pretty quickly fromthat.
But the older person comes outof that never quite the same
again.
Okay.
Never quite back to fullstrength.
(22:23):
And that's something that westudy'cause it's a significant
health problem.
How to recover from this periodof disuse like hospitalization
to regain strength and functionto what you were before you went
in.
That's a significant healthconcern.
And we get funding from the VA,the Veterans Association, to
study that'cause it's a problemfor veterans too.
(22:43):
And that's an area that's takenup a lot of focus in our lab
right now.
So this isn't a question ofhealth span directly, but it's a
question of muscular healthafter a period of insult of some
sort.
Don Drew (22:55):
I know you're the immediate past president of the
American Association on Aging.
So I'm sure you've heard about alot of really interesting
studies that are happening.
So is there anything that justreally like tickles your own
imagination?
Dr. Benjamin Miller (23:06):
Well.
There's so much going on in theaging area right now, and it was
nice to be president of thesociety for a year and we just
got done with our annual meetingand you see what's going on in
the area and, you see all theyoung scientists with their new
ideas.
I guess the one thing, aboutscience that's so important
right now, including the work wedo, is how do we continue to do
(23:26):
this work in a productive way?
Science in the United States isunder threat right now.
It's threatened.
There's large scale cuts to theability to do this kind of
science.
I actually worry most about theyoung scientists coming up.
Don Drew (23:43):
Dr.
Benjamin Miller, Chair of theAging and Metabolism Research
Program at the Oklahoma MedicalResearch Foundation, past
President of the AmericanAssociation on Aging and so much
more.
Dr.
Miller, thank you for educatingus on your work and for
providing our listeners withhope that they can achieve a
longer health span for theirlives.
Thank you for being on PeacefulLife Radio.
Dr. Benjamin Miller (24:02):
Thank you.
I enjoyed it.
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