Advice From the #1 Longevity Doctor: Add 10 Years to Your Life With 3 Simple Habits

Eric Topol (00:00:19):

I mean, there's all kinds of stuff going on right now. It's pretty scary. People keep talking about longevity.

 

Mel Robbins (00:00:25):

What

 

Eric Topol (00:00:25):

We want to do is improve our health span. Turns out that exercise is the only thing we know that lowers our biological age.

 

Mel Robbins (00:00:33):

What are the top three things, Dr. Topol, that most people are doing that are actually aging them faster?

 

Eric Topol (00:00:39):

The problem, Mel, is the things that they're not doing. Poor diet, not nearly enough exercise. And then of course, this is what I think most people don't understand. Ultimately, if you do all the things that we're talking about that's been studied after study, this extends healthy aging by seven to 10 years.

 

Mel Robbins (00:00:57):

Wait now, hold on. So, hey, it's your friend Mel, and welcome to the Mel Robbins Podcast. I am so excited that you're here. I'm excited that I'm here and I am really excited that our guest, Dr. Eric Topol is here today. It's always such an honor to spend time with you and to be together. And if you're a new listener, I just want to take a moment and personally welcome you to the Mel Robbins podcast family. I'm glad you're here and because you made the time to listen to this particular episode, here's what I know about you. I know that you are the kind of person who not only values your time, but you value your health and your interested in longevity. And you could not have picked a better conversation to spend your time on because this is going to be one of the most valuable things you could ever listen to on longevity on the science of aging because you're going to be learning from one of the most respected living medical researchers and scientists alive today.

 

(00:01:55):

And if you're listening right now because somebody in your life shared this with you, I want to point something out that's really cool because it means you have people in your life that care about you and that care about your health, and they wanted you to have the opportunity to learn from one of the top researchers in the world about simple things that you can do based on the evidence to live longer, to be healthier, and to have a better life because that's exactly what you and I are going to talk about today with the extraordinary Dr. Eric Topol.

(00:02:43):

Previously, Dr. Topol was the chairman of cardiovascular medicine at Cleveland Clinic, one of the top hospitals in the world, and it was ranked number one in heart care for over a decade during Dr. Topol's tenure. And if you're thinking what else could this guy possibly do? Well, he's also among the top 10 most cited researchers in medicine in the world. He's published over 1,370 peer reviewed articles, which is an enormous number, and his research is so respected that has been cited by other researchers more than 365,000 times. I mean, just to put that into perspective, that's more than 99 point 99% of all scientists globally. He's also the author of several bestselling books, including his newest mega bestseller, super Ages, an Evidence-Based Approach to Longevity, which has already been endorsed by, check This Out, five Nobel Laureates and several of the world's top medical researchers. I am absolutely honored that he chose the Mel Robbins podcast and a conversation with you and me as the very first interview that he granted for his new book, Dr. Eric Topol. Thank you so much for getting on a plane flying across the country and being here on the Mel Robbins Podcast. I'm absolutely thrilled to unpack super ages with you, your brand new book.

 

Eric Topol (00:04:00):

Oh, thanks so much, Mel. It's great to be with you.

 

Mel Robbins (00:04:02):

Well, here's where I'd like to start because you are one of the most credentialed and cited experts. The book, of course, is an evidence-based approach to longevity. I would love to have you start by talking directly to the person who's listening and tell them what they might experience that will be different about their life or the life of somebody that they care about if they take everything to heart that you're about to teach us today.

 

Eric Topol (00:04:27):

Well, there's a lot of things that we can do about our lifestyle that are more than just the diet, sleep, exercise, stuff that people have been hearing about for decades, but also the three major diseases, cancer, cardiovascular and neurodegenerative like dementia, Alzheimer's. Those three diseases take more than 20 years to take hold. So if we plan enough in advance, we can prevent those diseases from ever occurring and particularly those people who are at high risk. So it's an exciting opportunity that we're only realizing now that we have ways to prevent age related diseases.

 

Mel Robbins (00:05:04):

Well, one of the things that I loved about reading super ages is first of all, not only do I feel smarter now, but I also could feel the passion and your optimism that there are simple things that absolutely anybody can do starting today that will not only make you healthier, but more importantly based on the science of aging, it will actually extend your life

 

Eric Topol (00:05:27):

Ultimately if you do all the things that we're talking about. That's been study after study. This extends healthy aging by seven to 10 years.

 

Mel Robbins (00:05:37):

Wow.

 

Eric Topol (00:05:37):

People keep talking about longevity.

 

Mel Robbins (00:05:39):

What

 

Eric Topol (00:05:39):

We want to do is improve our health span. That is our years of healthy living. And so we can do that now if only we pay attention to the hard evidence that exists today. We don't need a magic pill or potion. We can just work with what we have right now and half, seven to 10 years more of healthy life.

 

Mel Robbins (00:06:02):

Wow. Is that true for anyone, Dr. Topol? If the person listening is one of the things that I always find when I'm listening to somebody who is as smart as you are and has done the research and you're like, here are the simple things to do, and you go, oh my God, I really screwed up and now it's too late. Does the science of aging show that even if you're starting from a baseline where you have not taken care of yourself, you're not getting sleep, you haven't been moving your body, you've basically been living out of a box or a bag of chips for most of your life, do these interventions also help you start to reclaim your health in terms of extending your life?

 

Eric Topol (00:06:41):

It's never too late. So it's also never too early. I mean, if you start doing this when you're in your twenties and you do your whole life, you get even more years. But you could start this at age 70, 80 and you still will benefit.

Mel Robbins (00:07:28):

You're basically saying there is a huge difference between what somebody like me and the person listening is seeing out in the media about anti-aging and the anti-aging craze versus what you're here to teach us about the science of aging and simple changes that you can make that not only will help you live a longer and healthier life, but these same changes also help prevent the big three diseases of cancer, heart disease and neurodegenerative issues like dementia.

 

Eric Topol (00:08:02):

Exactly. So these diseases are related to particular organs in the body, and only now do we have these things called organ clocks where these proteins in our body can tell us that a particular organ in a particular person is aging faster than it should. So not only could we tell people are they particularly higher risk, but which is the organ is the condition that is off kilter, out of whack, and that's when that prevention can really kick in to be targeted against that condition or organ that's affected. So we have from the tools of science, of aging, we have new metrics now that we never had before that's going to help us to make a huge dent in preventing age-related diseases in the future.

 

Mel Robbins (00:08:51):

One of the things that I was surprised by Dr. Topol when I was reading your bestselling book, super Ages is that literally a third of this book is dedicated to diseases. It never even occurred to me that one way to live a longer healthier life is to actually avoid having a chronic disease, and there's so much hope and science that you have in this. So how important is avoiding or not getting one of these chronic diseases to the science of aging and longevity

 

Eric Topol (00:09:25):

Now that we realize there's just the big three of cancer, cardiovascular and neurodegenerative, which is mainly Alzheimer's and Parkinson's. The exciting future, which is beginning now is that we can say you are at risk for this particular of the three and using the things that we know prevent that condition. So extraordinary right now is that we're at a cusp of being able to say this individualized or a lot of people call precision medicine that we're going to be able to say, the only thing that you're at risk for is this disease and we're going to get all over it. So you'll never really have to worry about getting it, or if you do get it, it will be 10 or 15 years beyond when you would've had it otherwise.

 

Mel Robbins (00:10:11):

First of all, when I read the statistic that for Americans age 60 and older, 95% of Americans 60 or older have some sort of chronic disease that was jaw dropping. But what I find encouraging is that all of this extensive research that you lay out in this book basically is the prescription, the lifestyle plus modifications that you're talking about when it comes to sleep and loneliness and exercise and lowering the amount of processed foods that we have, that all of these are actual interventions that help you fight these chronic diseases and may also help you never even get one. Am I stating that accurately?

 

Eric Topol (00:10:57):

Again, you really have this right, because what you're talking about is today people 65 and older are just riddled with chronic diseases.

 

(00:11:08):

If those same people had started at age 50 with what we're talking about today, they would unlikely to have those chronic diseases or seriously they might've had it when they're 75 or 80 rather than when they're 60. So that's what the data supporting, adopting lifestyle factors with these diseases. This is what I think most people don't understand. You've got 20 years to develop one of these diseases. Cancer doesn't just strike and all of a sudden you don't have a heart attack or a stroke. All of a sudden you have 20 plus years while this is working in your body, developing, incubating, if you will. And so if you started to do these things earlier in life, and again, as we reviewed earlier today is never too late, but these diseases could be avoided. The problem is most people who are 65 and have these chronic diseases have not followed these lifestyle plus factors not taking advantage of what we know today.

 

Mel Robbins (00:12:08):

And just to be clear, because I'm sure somebody will push back on that, there are all kinds of cancers and diseases that hit people when they're little or when they are in their twenties that are not determined by lifestyle. What you're saying is based on the science of aging that the big three diseases that kill people that you said over and over, heart disease, cancer and the neurodegenerative, things like dementia that people develop later in life, that by and large the research shows that these lifestyle plus interventions not only make these help you treat the diseases, but if you were to implement what you're talking about based on the research, you might never get these diseases in the first place.

 

Eric Topol (00:12:54):

There are diseases that young people get. We're not talking about that. We're talking about the ones that are clearly there are certain types of cancer, most of them in fact, and obviously the neurodegenerative and cardiovascular. These are the principle age-related diseases, and that's what I think a lot of people don't understand is aging increases the risk, but we have ways to change that whole pace, that clock, if you will. And that's what is exciting now.

 

Mel Robbins (00:13:25):

Well, you write about this on page 1 25, chapter six by 2050, the number of people dying from cancer age-related cancers projected to nearly double, but we have not yet incorporated over half a century of extraordinary breakthroughs in the understanding and use of certain biological mechanisms that can stop cancer from killing us. Now what do you want the person listening? What's the most important thing that they could do in order to put, to use these extraordinary breakthroughs in the science of aging and use biologic mechanism to stop cancer?

 

Eric Topol (00:14:05):

Yeah, this is an area that's so ripe to reboot, which is how we address cancer. So for example, the way we do cancer screening is unbelievable. It's by an age. So if you're age 50, you're supposed to have this mammograms or 40 even now, or you have colonoscopies. And these screening procedures do very little to diagnose cancer.

 

(00:14:29):

Most cancers are not diagnosed through screening. And by the way, for breast cancer, for women 88, almost 89% will never have breast cancer in their lives. So why are we putting women through frequent mammograms and other related procedures on a basis where they're never going to have the risk of breast cancer? Why don't we screen people which we can for their genetic risks so that we can say, you know what? You might have a mammogram every 10 years.

 

(00:15:00):

You might never need one, or you should have a frequent one, and maybe not only with the mammogram, but perhaps other imaging modalities. So don't particularize the person's risk and we treat everybody like we're all the same. So that's one issue. The key is finding out who is at increased risk and then putting those people under surveillance. So we have this really great test now we never had before, which is called a multi cancer early detection.

 

(00:15:27):

And so from a blood test we could say there's a microscopic cancer. The problem is we're using it completely wrong now,

 

Mel Robbins (00:15:36):

How should we be using it? Because as I was reading this book, you know what my husband did? He literally, as I was getting ready to report, he ordered a cancer screening test online. It's like $700. You probably know what it's called. The something test?

 

Eric Topol (00:15:52):

Yeah, the grail test.

 

Mel Robbins (00:15:54):

Yes, the grail test. Because we've had a couple friends that have done it that are like, oh my gosh, I'm at risk for this and so should I not be doing it?

 

Eric Topol (00:16:02):

Well, the problem is it's being marketed for people age 50 and older. That's wrong because most people age 50 are not at risk for cancer, and so they're going to get attested either a false positive or a false negative. So it has little value unless you know you're at increased risk. And so another one that's being used totally improperly is a total body MRI scan,

 

Mel Robbins (00:16:27):

Oh, I want to sign up for one of those. You're saying I shouldn't?

 

Eric Topol (00:16:29):

No, no.

 

Mel Robbins (00:16:30):

Why

 

Eric Topol (00:16:30):

Not? You don't want to do that because

 

Mel Robbins (00:16:31):

Why?

 

Eric Topol (00:16:32):

What happens with these then? It's never been validated that it helps people to get accurate diagnosis of cancer. Again, it might be okay if you're a significant increased risk. What I would say is if you had a genetic and protein and other family history and multiple dimensions of your data,

 

Mel Robbins (00:16:50):

Got it. So you have somebody that died early of pancreatic cancer and it runs in your family, so you're like, I'm at increased risk.

 

Eric Topol (00:16:58):

That

 

Mel Robbins (00:16:58):

Is something that if you can afford to do, it puts your mind at ease. Because I do have friends that have done those, which of course they find stage one pancreatic cancer and it saves their life. And then you go, I could have that too. And then you're shelling out money to go get the screening, and you're saying unless you have risk factors, it's not

 

Eric Topol (00:17:19):

Worth it. The problem with the blood tests that your husband ordered is that maybe four or five per thousand will have an abnormal reading of a microscopic cancer, and out of those half of the five per thousand will have already advanced cancer. The problem with the MRI, if it's already seen on an MRI, then it's pretty advanced. So usually the problem with the MRI is false positives. If you did the MRI after you had an abnormal blood test, that might be okay. Sure. But you don't go ahead and have a total body MRI just because you're going on a fishing expedition, you could wind up having all sorts of biopsies.

 

Mel Robbins (00:18:03):

I'm glad you said this because you hear about all these people going to concierge medicine and getting a workup done at Mayo and they go every year for all the markers and they spend all this time. And I start to think, is that what we're all supposed to do? And most people can't afford it. Are there tests that accurately show your risk for cancer?

 

Eric Topol (00:18:25):

So there's a thing called a polygenic risk score for each type of cancer,

 

Mel Robbins (00:18:29):

Breast,

 

Eric Topol (00:18:30):

Colon, prostate, lung, and these are very inexpensive. You could get these for about $50 or so

 

Mel Robbins (00:18:38):

Rare polygenic. What am I asking for?

 

Eric Topol (00:18:39):

Polygenic risk score. Yeah. They basically would tell you your risk for a particular cancer, and there's about 10 different companies that offer these now, and they can even be done through saliva. You don't even have to have a blood test. So that's a good way to know about your risk in your lifetime. But again, you don't want to just rely on one layer of data. You'd like to have other layers of data backing that up. And so that's where you can learn even more. And as you mentioned, if your family history, maybe you have a trend going on and some routine blood tests going in the wrong direction. This is where when we have AI analyze all your data and point to say, you know what? This is your risk in your life. This is the one for you to be on guard about. But right now we have some rudimentary data to help us understand who's at risk and what for.

 

(00:19:30):

And so if somebody offered me an MRI total body for free, I wouldn't have it because it's a recipe for trouble. It's a recipe for finding things that you wouldn't want to find because then you have to chase them down and you could have complications as I've had patients who then they had a liver biopsy and they bled many units. They had all sorts of things, and it was benign. Of course. Unfortunately, we have celebrities and doctors who are advocating these total body MRIs and there's nothing, there's no proof. They say they're going to do a trial, but they haven't done it and we're not going to know for years. And until then, it's just anecdotes.

 

Mel Robbins (00:20:07):

Wow, well, you just saved me 2,500 bucks. I'm not going to go do it now. I could see how I would go on literally down the rabbit hole.

 

Eric Topol (00:20:16):

Yes.

 

Mel Robbins (00:20:16):

And if though somebody is listening to you and they're like, okay, polygenic risk score. There's a test that I could do if I look back through my history and I have some things that are concerning to me, but if you are concerned, what test should you ask your doctor for or what would you ask your doctor about?

 

Eric Topol (00:20:35):

Yeah, it's interesting. Here we are in Boston and the Mass General Brigham is supplying the polygenic risk scores to their patients. They're the first health system to do that. And so they're getting a readout for their risk of the various types of cancer and heart disease. And of course soon it'll also be Alzheimer's disease too, that they will get that composite risk as part of their care, not like they get charged extra. All the health systems should be doing that. And again, they should be adding these other layers of data so that you know about yourself, what to be on guard about, and also to take action. And this is a really critical point, is that generally people might not be motivated to do all these positive things, but when they find out they have this specific risk, the chances of them going after it is so much greater. We've learned that from studies as well.

 

Mel Robbins (00:21:27):

Wait now, hold on. So basically we're not motivated when we're healthy to stay healthy.

 

Eric Topol (00:21:33):

Absolutely. And just to mention, there was a big finish study where they took people and they gave them their polygenic risk for heart disease. And the people who got a high risk, they changed their lives. I mean, they did everything we're talking about today. So it wasn't that they were going to do it when they're healthy, only when they got something to tangible evidence for them, for those individuals, that's when action was taken.

 

Mel Robbins (00:22:00):

What are the top three things, Dr. Topol that most people are doing that are actually aging them faster?

 

Eric Topol (00:22:06):

The problem, Mel, is the things that they're not doing.

 

(00:22:09):

And so what we're talking about is a poor diet with too much ultra processed foods, for example, not nearly enough exercise, and that's both aerobic as well as resistance type exercise. And then of course, getting enough sleep, particularly deep sleep. Sleep is so much bigger than we had thought years ago. And having sleep health, particularly promoting deep sleep is really important as we'll get to for brain health, that brain clock. So these are factors that not enough are paying attention to that we can do a lot today. And they're just the beginning of what I call this lifestyle plus so many dimensions. It's not just the three that we've been hearing about for so long.

 

Mel Robbins (00:22:57):

I'm bombarded with supplements, I'm bombarded with the ads about the miracle cure and slowing down aging and looking younger and all this stuff. You keep referring to this lifestyle plus what does plus mean?

 

Eric Topol (00:23:11):

Yeah, so plus means, first of all that the devil in the details about nutrition and exercise and sleep. And then beyond that, things like social isolation, the environmental factors like air pollution, microplastics, forever, chemicals being out in nature outdoors. So these factors are not just what we're eating and our exercise. Those are paramount. All these things have been associated with healthy aging. And so the woman in the book who's featured Mrs. LR here, she's she's 98 and she's the picture of health cognitively crisp. She's doing her jigsaw puzzles and oil paintings. She's amazing. And she is vibrant with her social group. Her kids have died already and her parents died in their fifties. So it isn't the genes. And that's one of the things that I think a lot of people feel they're doomed because they have bad

 

Mel Robbins (00:24:26):

Genes,

 

Eric Topol (00:24:27):

But so much of this is our lifestyle that can override or independent of any genes that we have be associated with a healthy aging process.

 

Mel Robbins (00:24:40):

Well, and what I love about the picture that you're painting and as you write about in your book is that getting older and aging is inevitable, but actually getting frail and weak is not.

 

Eric Topol (00:24:53):

Exactly,

 

Mel Robbins (00:24:54):

And lifestyle plus. I like the plus because I think when you say the word lifestyle, most of us immediately think about what are we eating, what are we drinking? Are we moving our bodies? But there are all these other factors that we're going to get into.

Eric Topol (00:26:30):

There has been nothing that's been proven in people to promote the slowing or reversing of aging, whether they're pills or compounds or infusions, transfusion, none of that is proven to have an anti-aging effect in human beings. There's a lot of that that's been looked really good in mice or rats, but not in people. So we'll start with rapamycin. A lot of people are taking this drug. It suppresses our immune system that could be very risky to do that. And unfortunately, too many people are advocating that there's nicotinamide NAD plus a supplement. There are no data to show that it improves healthy aging in people. There's this epigenetic reprogramming, very elegant. It could cause cancer. It isn't in people yet, but it's certainly a risk. There's seno litic drugs that take out our senescent cells. They're indiscriminate. They could take out bad cells out of our body. These drugs that do that, there's plasmapheresis taking young people's plasma and infusing it into old people's plasma to promote healthy aging and better cognition. There are clinics doing that. There are no data to support it. There's all kinds of infusions of multivitamins and whatnot. There's just no data to support any of it. And it's really unfortunate because people that believe this stuff are the prey. Not only are they expensive, but they are posing significant risk. It could be cancer, it could be immunosuppression. These are not things you want to play around with.

 

Mel Robbins (00:28:12):

You actually warn about the dangers and this obsession of trying to stop or reverse aging. Could you explain Dr. Topol the problem with stopping or reversing aging?

 

Eric Topol (00:28:26):

Well, so one of the most elegant approaches, which caught a lot of interest in the biomedical community was the idea of giving genes to an old animal, in this case a mouse, and now extended to other species. And these are known as yamanaka factors because they have the ability to reprogram the organism, the cells of an organism.

 

Mel Robbins (00:28:51):

So you're taking genes from a younger animal and then you're injecting them into the older animal with the presumption that the genes of the younger animal can then infiltrate and reprogram older genes, thereby making you younger

 

Eric Topol (00:29:07):

Close. But these genes don't come from a younger animal. They just are known to turn the clock backwards. And so the whole idea was, okay, we're going to inject these four into the animal and we're going to take an older animal and it's going to affect all their cells and they're going to get young. And it happened. Say, wow, this is amazing, right?

 

Mel Robbins (00:29:26):

Well, how do you tell if it looks young? When you say that to me, it's like I'm just like a normal person. So I'm like, okay, you're going to inject me with jeans. It's going to make me turn young. I feel like my wrinkles disappear. I'm not sagging in places I wish I weren't sagging. My skin's a little firm. You know what I'm saying? Is that what you mean by you look young?

 

Eric Topol (00:29:43):

It's actually pretty deep. So it wasn't just that their gray hair went away, but also the fact that at the organ level, they had, for example, their glucose regulation turned back to normal.

 

(00:29:55):

Many of their organs showed young, young look rather than having all the things that you would associate with a very old organism. So it looks great to say, wow, we just all take these yamanaka factors and we would just get young. The problem is that when they were doing this, and this is now in multiple species, tumors would develop, and that's because when you turn back these cells into younger cells, you also are potentiating the risk of cancer. And this, Mel is the problem with many of these body-wide interventions is they introduce new risk, particularly cancer, because there's a very close overlap between the hallmarks of aging and the hallmarks of cancer.

 

Mel Robbins (00:30:43):

What's the connection?

 

Eric Topol (00:30:44):

So in the case that we're just talking about, the fancy term for it is partial epigenetic reprogram. It sounds pretty

 

Mel Robbins (00:30:50):

Big, right? It's way too big for me to say.

 

Eric Topol (00:30:51):

Yeah, yeah. But the whole idea is that when you make cells younger, a group of these cells to just take off, develop a clone of cancer, and then just spread. So the problem is, is that when you're trying to rer the body's aging process, you introduce new problems.

 

Mel Robbins (00:31:11):

Well, it makes sense if you put it in the other direction, if chemo is basically killing everything to the point where you're now just going to have to rebuild all your cells if you reverse the clock, what you're saying is some of the science suggests that, holy cow, you're actually expediting the ability of bad cells to multiply.

 

Eric Topol (00:31:29):

Exactly right.

 

Mel Robbins (00:31:30):

So Dr. Topol, to you, what's the most exciting development in anti-aging technology and research that you think is going to revolutionize the way that we do age?

 

Eric Topol (00:31:42):

So I think where we're headed is that each of us will have, without added costs or very nominal costs, we will have all our data.

 

(00:31:53):

It's assembled it, analyzed by what we call multimodal ai, regenerative ai, and it'll tell us, this is your risk. This is what you need to be on the lookout for, and you're going to do these things. And also we may be treating you like for example, with an anti-inflammatory drug, or we can talk into some of the specifics, but we've had breakthroughs, Mel, for example, Alzheimer's. There's a blood test now called PTA two 17. It's as good as having a PET scan for telling us are we going to have a risk for Alzheimer's? So if you get that test again, if you have Alzheimer's in your family, it's not good enough to know, oh, I'm at risk for Alzheimer's, but I may only crop up when I'm 95. That's not really important. What we are going to have with multimodal AI is going to say you're at risk for Alzheimer's, and if you don't do anything about it at age 66 is when you're going to see mild cognitive impairment. So you can pinpoint the person and the time.

 

Mel Robbins (00:33:00):

Well, what's exciting about that too is if the research also proves that when somebody gets a diagnosis, they're very motivated to save their life. If this technology allows you to get the diagnosis 20 years early, now hopefully you have the same motivation to prevent that from happening by making the lifestyle plus or other interventions happen. Now

 

Eric Topol (00:33:23):

You got it. I mean, this is why we have the benefits of that long time to work with before the person gets the condition. And we have the layers of data which we didn't have before, or the ability to analyze that. And then the surveillance tools, whether it's scans or whether it's further blood tests, clocks like, you know what? If I have an organ clock that says that my heart is accelerated aging, and then I do these things and I prove, oh, wow, I changed it. It's now going in the other direction, and it reinforces that you're on the right track. So this is where we're headed. Now, the science of aging has given us these metrics, whether it's this body-wide aging, epigenetic clock, organ aging, this is the most amazing thing. All these years of practicing medicine, we keep talking about prevention and we have nothing that we're preventing. It's secondary prevention. Oh, you had a heart attack, now we're going to put you on this and that. We are talking now about primary prevention. That's the new thing here, that we can prevent a disease that was going to occur before it happens, and that's the real deal prevention.

(00:34:48):

22% of all deaths are linked to someone's diet. That means one in five. How can that be true, Dr. Topol

 

Eric Topol (00:34:58):

Yeah, no, it's amazing. So the global burden of disease comes out of University of Washington. They've studied this globally, and what we've learned is that overnutrition, which is really bad, having,

 

Mel Robbins (00:35:12):

That's a nice way to say what, what's overnutrition

 

Eric Topol (00:35:14):

Obese or significantly overweight, undernutrition or malnutrition. And then poor nutrition, which is as we talked about, the unprocessed foods, for example, those three categories collectively account for, they have shown in their work one in five deaths. Yes, nutrition is fundamental,

 

Mel Robbins (00:35:36):

And you write a lot about ultra processed foods. You write in particular on page 21, that eating ultra processed food likely involves the disruption of the gut brain signals that unprocessed food conveys to the brain, and that this has a direct connection to a markedly heightened risk of cardiovascular and metabolic diseases. Can you talk a little bit about ultra processed food? So I think about ultra processes, anything that's in a box or a bag and that, I can't read the ingredients on the back of the label, but you say that you believe that ultra processed foods and the big food industry, particularly here in the United States, at some point we're going to wake the hell up and realize that this is just like a modern day cigarette in terms of how it's killing us. What do you mean by that, Dr. Topol?

 

Eric Topol (00:36:35):

Yeah, I'm glad you brought that out because this is a serious matter. We have the big food industry that markets this, and basically because of the gut brain axis, you eat these ultra pre foods and you want to eat more that we've seen very careful studies that it promotes overeating, so that's bad enough in itself, but what it also does, it promotes inflammation in the body. And so when you have that, that's when have your glucose dysregulation and you can move on to type two diabetes. It also then increases the risk of atherosclerosis heart disease,

 

Mel Robbins (00:37:13):

That

 

Eric Topol (00:37:14):

That's

 

Mel Robbins (00:37:14):

A fancy word for heart disease.

 

Eric Topol (00:37:15):

What is that called? Yeah, you're basically accumulating cholesterol plaque in your arteries, which you can get heart attacks or strokes. And it also, of course has effects at the level of the brain promoting inflammation the less than we want there and the risk of cancer. And so all the data on ultra processed foods, which it's not just that you can't read because of all these ingredients, it's just that when you do read them, you don't recognize them because they're all foreign things that would never be found in your kitchen. Everything about these suggests that they're inducing a lot of harm, they're promoting aging. And one of the stories in the book I reviewed is there's a fellow named scientist physician in the uk, Chris Van Elligan, and he wrote a book called Ultrapro People. And so he actually remember that supersized me thing that the guy did that went to McDonald's every day for

 

Mel Robbins (00:38:10):

Oh, yeah, yeah, yeah. It was a documentary where he ate it for 40 days.

 

Eric Topol (00:38:13):

So this is what Chris did for 30 days, and he gained like 10 kilos, but he did brain scans before and after 30 days, and he did all these other inflammatory markers, and he showed that everything went off the track. I mean, in just 30 days of high ultra processed foods. So all of us, we can't eradicate ultra processed food, but we can bring it down. It shouldn't be as it is now, 60% or even 70% of our diet.

 

Mel Robbins (00:38:42):

I want to make sure that as you're listening to Dr. Topol, that you really took away a number of things that you said, and so please stop me, Dr. Topol, if I got this wrong, because there was a lot of life saving

 

(00:38:56):

And important information that you said. And I want to just remind us, we're talking about the science of aging and how to use that rich science to extend our lives and to live a healthier and more fulfilling life. And one of the things that we're talking about right now is ultra processed food, and we have had expert after expert medical expert scientists come on this show and talk about how ultra processed food is engineered to make you want more just like cigarettes are. And so it's super important to understand that if you're sitting there listening to Dr. Topol and 60 to 70% of your diet is fast food or it is coming out of a box or you're recognizing, I didn't realize that this was a thing, it's not your fault because the food is engineered to disrupt the way that you crave food. That's number one.

 

(00:39:47):

Number two, what was really interesting about what you just said is because there's so many chemicals and modified stuff in there that doesn't belong in your kitchen, it's also not naturally belonging in your body. So it's disrupting the way that your body and organs and everything is communicating to one another, which is also not your fault, but when it gets interrupted, you said that big word inflammation. And when inflammation and swelling and all that stuff starts to happen through no fault of your own because you're eating these ultra processed foods that are designed to be addictive, that is now speeding up the aging process, and that is impacting the quality of your life. And you're here to say that by just dialing it down, by paying attention. I call this the grandparent diet. Just eat what your grandparents ate, get one ingredient on the plate kind of situation that has a meaningful impact on not only how you age, but also how you feel as you age. Is that correct, Dr. Topol?

 

Eric Topol (00:40:53):

No question. I couldn't agree with you more.

 

Mel Robbins (00:40:55):

So you also have a section in your book where you list food groups and breakdown what the most UpToDate science says about their effects on lifespan. And I'd love to go through these rapid fire and understand what does the science say about each one of these types of things, these foods, or I don't even know if you would call it a food, but these things that we eat. First one is sugar. Dr. Topol, how does sugar impact our lifespan?

 

Eric Topol (00:41:24):

We want to cut down on refined sugar, particularly things like sugar sweetened beverages. They also promote inflammation. If you see high fructose run away, we don't want to be taking this stuff in.

 

Mel Robbins (00:41:40):

Okay, what about salt?

 

Eric Topol (00:41:41):

Yeah, salt is something that we have a very easy solution, which is a salt substitute, which is using potassium instead of sodium chloride.

 

Mel Robbins (00:41:50):

So

 

Eric Topol (00:41:50):

We should not be adding salt ideally to what we're eating.

 

Mel Robbins (00:41:55):

Wait, why I love salt. Are you telling me I can't put salt on my food? Why do I not want salt on my food?

 

Eric Topol (00:42:01):

If you're at risk for high blood pressure,

 

Mel Robbins (00:42:03):

Which

 

Eric Topol (00:42:03):

Most of us are as we get older, that's not going to help you. If you use potassium chloride, it'll taste the same.

 

Mel Robbins (00:42:10):

I don't know what potassium chloride. Do you buy this at the grocery

 

Eric Topol (00:42:13):

Store? Yeah. What? Yeah, no potassium chloride to solves substitute, and that's all. There's nothing else in it is perfectly healthy and it avoids the problem of the sodium intake and it's a lot healthier for you.

 

Mel Robbins (00:42:26):

Well, I'm going to try it, but I also just kind of had this epiphany, which is this is particularly problematic if you have 60% of your diet being ultra processed. If you're somebody that is eating from the farmer's market and eating what your grandparents did, and you're occasionally putting salt on your food, that's not what you're actually concerned about. You're concerned about all the salt that is in fast food. It's in ultra processed food, and then adding more salt makes it worse.

 

Eric Topol (00:42:56):

You're spot on with that summary. And so again, you've pointed out that in the ultra processed food category, salt is often a common culprit that is part of that reward circuit. It's part of, oh, have more a lot of fat and salt and chemicals and emulsifiers.

 

Mel Robbins (00:43:13):

Yeah. I didn't ask you about the sugar substitutes, like all of the equals and the thing, I don't know all the name brands, but all the ones that people use to not use just grain sugar. What about those?

 

Eric Topol (00:43:27):

We don't have a free pass on those. Unfortunately, as I reviewed, there's uncertainties about them. So if you can avoid the sugar substitutes, that's probably better. But unfortunately, they're not as healthy as we had been led to believe.

 

Mel Robbins (00:43:43):

What about caffeine when it comes to what the science says about how it impacts your lifespan?

 

Eric Topol (00:43:48):

Well, here's some good news for coffee law versus

 

Mel Robbins (00:43:51):

Please, Dr. Topol.

 

Eric Topol (00:43:53):

This is the one that is the rare exception where we love it and it actually is healthy,

 

Mel Robbins (00:43:59):

Really.

 

Eric Topol (00:44:00):

I mean, this is actually kind of shocking. So I reviewed all the studies and there are a lot of them, and what is striking about this, it shouldn't be that you should change your life to drink more coffee, but you shouldn't at all worry if you're having two, three, even up to four cups of coffee a day.

 

Mel Robbins (00:44:17):

Dr. Topol. What?

 

Eric Topol (00:44:19):

Yeah, it's actually pretty remarkable. It's associated with significantly less of chronic diseases, less inflammation. Everything about it points to something positive.

 

Mel Robbins (00:44:33):

On page 42 of your bestselling books, super ages, you write, despite their popularity and heavy marketing, there's little to no hard evidence for the benefit of taking any vitamins or supplements, especially in those who are following a healthy diet. Dr. Topol, what does the science say about supplements?

 

Eric Topol (00:44:53):

Yeah, this couldn't be more clear. When you really review, take a hard look at every study that is cited and they're marginal about this supplement or that or this vitamin. There's just nothing there. These are small studies with lack of meaningful endpoints. So again, it's really important to look at this hard evidence and it's void. There's just nothing to support these. And unfortunately, so many people are spending so much money and taking so many different supplements and there's no proof. And as I reviewed, there's some have potential adverse effects unknowingly. So you just want to avoid these. And I've had many patients, they come in with this long list of supplements. In fact, some of them are afraid to show the list of things they're taking. And I said, well, really, these are the only thing they're enriching is your urine. And they say, well, I really feel like they're making me feel better.

 

(00:45:48):

I can't argue with that. If they feel like they're okay, but they should know. I try to inform 'em then that there's just nothing to support why they're feeling better. It's just like the placebo, the pill, that there's nothing in it. It's inert if they feel like they're helping them. Okay. But just so you know, the science doesn't support it.

 

Mel Robbins (00:46:10):

You mentioned earlier when we were starting to talk about lifestyle plus and the impact of diet on the aging process and living a long life, you talked about protein. What do you want to say Dr. Topol to us about the importance of protein and the science of aging?

 

Eric Topol (00:46:28):

So as we get older, we lose muscle mass and the recommendations from the government, the US and abroad are 0.8 grams per kilogram now for what

 

Mel Robbins (00:46:44):

Does that mean?

 

Eric Topol (00:46:44):

Yeah, so how much protein you should have in your diet. And so let's say for a 70 kilogram person, you multiply that by 2.2 to get to pounds,

 

Mel Robbins (00:46:56):

You already

 

Eric Topol (00:46:56):

Lost it's 150

 

Mel Robbins (00:46:57):

Pounds. Dunno

 

Eric Topol (00:46:58):

What the hell's going, it's about 150

 

Mel Robbins (00:46:59):

Pounds. So 150 pounds, what am I eating?

 

Eric Topol (00:47:02):

You should be taking 70 grams of protein. And now the point is, if you start to look at how much protein, especially as you get older, you'll say, Hmm, I'm not getting 70. And by the way, as you get older, maybe you should take one per kilogram or 1.2 grams per

 

Mel Robbins (00:47:19):

Kilogram. So as you get older, you need more protein,

 

Eric Topol (00:47:21):

You need more protein.

 

Mel Robbins (00:47:21):

Why?

 

Eric Topol (00:47:22):

Because you have to counter that propensity for muscle mass loss. You don't want to waste just because of your diet. So you're talking about for the average person, 70, 80, 90 grams of protein, not 150 or 160? No.

 

Mel Robbins (00:47:38):

If you're listening to Dr. Topol, you can see him on YouTube, but I really believe you, and not just because of all of the papers that you've written and the fact that you are one of the top 10 most cited scientists and researchers in the world right now, but also because you look like Harrison Ford's younger brother. You're 70 years old. You look like you're probably late fifties. I kid you not. Has anyone ever told you that?

 

Eric Topol (00:48:09):

That's so funny. Yes. This Harrison Ford thing keeps coming up. It's so funny. Yeah, wild.

 

Mel Robbins (00:48:15):

Yeah. Well, he looks a lot like you. We should say Harrison Ford looks like Dr. Topol. So clearly the things he's recommending not only work because of the science, but you literally look like you could go run an ultra marathon right now and star in a movie.

Eric Topol (00:49:14):

Yeah, this is actually amazing and it's so much more profound than we had generally accepted. We've been hearing about it for years. But now talking about those clocks of aging and what we've learned from the science of aging, there's a thing called an epigenetic clock, which is these methyl groups on our DNA the side chains, and they can predict your biological age, so not your chronological age,

 

(00:49:38):

but instead of, let's say you're 70 and your epigenetic age is 60, like wow, you hit the jackpot. Turns out that exercise is the only thing we know that lowers our biological age. So the gap between your real age and your biological age is widened. Now, it's not just aerobic exercise. So as a cardiologist, I've been saying, you got to get on walks or treadmill, bicycle, elliptical, whatever, 30 minutes a day, five days a week. I've been pushing that. And then I didn't realize the data that's so striking regarding resistance training.

 

(00:50:17):

So you need that just as much a couple, few times a week. And that data is now become very solid, and it isn't just about getting stronger, it's having better balance. It's essential. There's nothing that we can talk about that exceeds exercise for decreasing our aging process, our body-wide aging process. And again, we wouldn't have known about this if it hadn't been all this science of aging.

 

Mel Robbins (00:50:43):

So let's just say Dr. Topol, that I'm sitting in your office and I've brought along my husband and he has not been taking good care of himself. And I have a feeling that you are often finding yourself being both a marriage therapist and a medical doctor with your patients. And I also have a feeling that there are a large number of people around the world who are going to not only be excited about what you're sharing for themselves, but they're going to share this with somebody that they care about. And so what would you prescribe as one of the most respected and cited researchers and medical doctors in the world, in the science of aging? What is your prescription for the minimum, the minimum amount that we should be doing every week? What would you say?

 

Eric Topol (00:51:32):

As long as you are getting at least 30 minutes of constant motion, getting your heart rate up, taking your body out on the highway, if you

 

Mel Robbins (00:51:41):

Will,

 

Eric Topol (00:51:42):

At least 30 minutes, five times a week, ideally every day if you can do that. But if you're getting five days a week, typically when I talk to my patients, I'll say, alright, when are we going to do this? What time of day works for you? You're not a morning person. You're not going to also, how are we going to do this? You're going to go to the gym. Do you have some equipment at home or can you go outside and walk or whatever to fit that in, figure that out. And not just the aerobic side, but then things like bands to increase resistance. They're very inexpensive and they can be so much of a plus for promoting muscle strength and things like standing on one leg for a minute, alternating your course on each foot. I mean, these are free, but work on strength, work on balance, posture. And of course this aerobic exercise is also critical. So get that as part of your life. And you'll notice quickly as you do this for weeks that, wow, I am more fit than I've been in a long time. I have better posture, I have better balance.

 

Mel Robbins (00:52:51):

Also, my golf swing is better.

 

Eric Topol (00:52:52):

Everything.

 

Mel Robbins (00:52:52):

Everything.

 

Eric Topol (00:52:53):

And so we just can't do enough of this. And of course, the byproduct of this is we get that lesser biologic age, which is going to be helpful across the board for the major age-related diseases.

 

Mel Robbins (00:53:06):

So you heard it from Dr. Topol. If somebody's been nagging you and they also sent you this episode, first of all, thank you for listening this far in and exercise. And literally 30 minutes, five times a day, just a simple walk is what Dr. Topol saying can start to lower the biological marker of your age, because exercise is the most powerful intervention that you have. Seriously?

 

Eric Topol (00:53:32):

That's right.

 

Mel Robbins (00:53:33):

That's

 

Eric Topol (00:53:33):

Incredible. And it decreases inflammation. That's another bonus factor. Oh yeah.

 

Mel Robbins (00:53:37):

And talk to us about that study related to depression and the impact that exercise had on people struggling with depression.

 

Eric Topol (00:53:45):

Yeah, this was astounding. This report kind of rocked me because the number of people are taking antidepressant drugs, these SSRIs, it's huge. And so they compared that in a large cohort with all these different activities from dancing, yoga, rowing, walking, anything. And exercise just was so much better of improving mental health than were the medications. Who would've guessed that? Because all these years we've been relying on so many people take them. That's why we had this Prozac nation and everything else. So this was a real awakening. And I think the study is quite impressive. It should reset our need for at least in some people, for SSRIs, if they're not exercising enough and substituting exercise or if they haven't been put on one of these drugs, try the route of exercise. You'll never be disappointed. And I think that's really what we're not doing enough of. If there's one thing we should be paying more attention to, this is it.