Episode 665: Dr. Michael Roizen on The Great Age Reboot

Published Feb 18, 2024, 10:00 AM

Dr. Michael Roizen, Emeritus Chief Wellness Officer at the Cleveland Clinic and author of The Great Age Reboot, discusses the potential for humans to live longer, healthier lives. He explains that the key to longevity is avoiding chronic disease and maintaining a healthy lifestyle, including stress management, physical activity, and a healthy diet. He also discusses the impact of scientific advancements, such as gene editing and cellular regeneration, on increasing life expectancy. Dr. Roizen believes that the next decade will see significant breakthroughs in longevity research, potentially allowing people to live to 115 while maintaining the health and vitality of a 40-year-old

On this episode of news World. Doctor Michael Roysen is the emeritus Chief Wellness Officer at the Cleveland Clinic, a professor at the Cleveland Clinic, Learner College of Medicine at Case Western Reserve University, and author of four number one New York Times bestselling books. He has written more than one hundred and ninety peer reviewed scientific articles and has been recognized with an ELI, an Emmy, and the Paul G. Rodgers Award for the National Library of Medicine for Best Medical Communicator. He's joining me today to discuss his latest book, which I recommend very highly, The Great Age Reboot, Cracking the Longevity Code for a Younger Tomorrow. Michael, welcome and thank you for joining me on neut World.

My privilege.

We've talked a fair bit together in the early two thousands about real age, so this is a reunion and you are clearly a leader in this area, So thank you.

My admiration for your research is very deep. But I'm curious you took the leap into anti aging research.

What led you there?

Why did you begin to focus on that?

Well, believe it or not, this started in nineteen seventy eight. I wanted to run an ICU, and I got to do that. I had done both intromedicine and anesthesia training because in that era they weren't ICU training programs, and I didn't think the domain of either one was enough. So I was doing this at UC San Francisco when they asked me to take over cardiovask anesthesia wasn't because I was so great. It was because the surgeons were difficult to work with. But all they cared about was, in fact, the outcome of their patients. And what we found was that it wasn't cardiac functional, lung function, of liver, function of brain function. What determined outcome, complication rate, and return to function was their age. It was a threefold difference between someone is seventy five and sixty five and ninefold difference. That is, someone who was seventy five undergoing the same operation had a ninefold increase in risk compared to someone who's fifty five. So my job, I thought, was how do we get people to be physiologically twenty years younger in that two week surrounding their operation. So that's what started it. As we learned that you could sow aging physiologically. You know, we used to think that exercise was good for the brain because it increased bloodfloil. But we learned after the Human Genome Project, you know, it was three billion dollars in NIH money, three billion dollars on the private side to get the same thing now, which shows how fast science is advancing since then is one hundred dollars. But what we learned was that it wasn't exercise wasn't just good because it increased blood flow, but it changed which of your genes was on or not. That is, it changes the functioning of your genes. We have switches. That's what we learned from the Human Genome Project, and we control at least eighty percent, maybe ninety three percent of the switches that turn our genes on or off, and which ones.

Are on or off or under your control.

So when you exercise and stress a muscle, you turn on a gene that makes a small protein called ARISM that goes to the brain and increases it turns on brain derived neurotropic growth factor, which is like miracle growth for your hippocampus your memory center, and does much better. Similarly, when you do that, you turn on a gene in the liver. We have no idea why that fixes the blood brain barrier to prevent inflammation from going to the brain.

So what we've.

Learned is that maybe we can in fact turn back the mechanism of aging by correcting the defects that we've developed since age sixteen or eighteen. And they are now fourteen areas of research into the mechanism of aging that we detail, and each one has changed the rate of aging from about a ninety year old person back to a forty year old person equivalent in at least two animal species. So now we have this incredible opportunity that's going to occur in the next decade or so.

One a typical forty year old comes here and says, I want to live longer. What do you say to them.

We know of at least one hundred and eighty things that have been shown in two studies in humans that help you avoid chronic disease, help you avoid structural damage, and let you live healthier, much longer. In nineteen nine, when we came out with real Age, we said sixty could be the new forty. That's actually happened. Sixty can be the new forty. We now believe ninety can be the new forty. But each of us has enormous power over our genes. Let me give you an example. You say, well, what does stress management do? Just meditating for six minutes a day, which is what is required on strength to get stress management. Well, it turns off or on over two hundred and fifty six genes. Some of those genes produce inflammatory proteins, and you get to turn those off just by meditating, something as simple as meditating or deep breathing, or they're twelve different techniques for stress management, including having friends you talk to. But doing that decreases inflammation. Now what does information do. It's the major cause of kidney damage. We worry a lot about developing kidney damage, especially if you get type two diabetes.

Well, guess what.

You can turn off inflammation by a number of techniques. Yes, walking helps do it, but so does stress management, so to food choices. But just something as simple as that six minutes a day will let you live a lot longer without chronic disease. That means enjoying disability. Longevity or what we call making yourself younger, making your real age or actual age younger than your calendar age. It's doable, and there are more just for your brain. There are forty things that have been shown in more than two studies. A simple one taking four smells a day, coffee, alcohol, whatever, four smells you want to smell, but do it deeply to function, to cause your olfactory nerve to function younger, and that clears up a lot of brain disease. We don't know why, but it does. It's just like we didn't know why exercise was so good for the brain, but now we know it turns on some genes. We didn't know why stress management was so good for the kidney. Now we know it decreases inflammation that makes the kidney older. So we have enormous power, and so to the average forty year old, we say one, we educate as to why they have so much power, and then we start them on things they want to do. People aren't going to do one hundred and eighty things, but they will do one, two or three, and then they'll build habits as they go along and get much younger. Most important habit is friends, a posse, and a purpose in life. Those are the two things, and then you add play to it, and that's the most important things for decreasing age.

Well, I'm very curious because you make a distinction. I hadn't thought about it, and that is you asked the question, you know what's better than having cells younger, having them actually be younger, and you talk about cellular regeneration. Now, is that really happening.

In animal species? It is really happening. That is what determines how old or young we are our cells are is the proteins that our genes produce. And what we learn is that the switches that control our genes to be on or off. We have twenty two five hundred genes, but we have many more switches. And what determines whether those switches are on or off a our actions to a great degree. As we age, we change some of those settings, the original factory settings on their switches. What we've learned is you can reset those or you can get rid of old cells and have the majority of your cells be younger. Those are two different theories. One is an epigenetic resetting. Yamanaka won the Nobel Prize for it in mice, and what he showed was if you turned four genes on, you actually corrected the errors in your epigenes and the animal, the mice instead of functioning as a ninety year old mouse and being a ninety week old mouse, functioned as the equivalent of a forty year old human and being a forty week old mouse, and they lived as though they were forty weeks that is, they lived about fifty percent longer. The problem was that when you turned all four of those genes on, that twenty percent of the mice developed cancer within the equivalent of two human years. Well now six groups, the latest one being coal Eco which is the Google Moonshot group, have shown that if you turn on only three of those genes, you actually reset your switches without the development of t answer. And so that's one of the areas. It's now done it in dogs, and we understand in George Church's lab at Harvard MIT, and we understand this is going to go into human trials pretty soon. Another one of these is just what we call therapeutic plasma exchange. You donate plasma and you get paid for it, so it's not very expensive. But in this case, it washes the red cells, it gives you fresh plasma, You get rid of your old proteins, forcing your body to make new proteins, and it gets yoursells and body to function as if it's much younger. That's a second technique that has worked in more than two animal species and we're now seeing it in humans. It's the young bod to old blood. The convoys did a hook up, a pair biosis, where they hooked a old rat and a young ratation up. The old rat became younger, the young rat became older. For fifty five years, they were looking what was it in the young rats blood that made the old rat young? It wasn't that. It was that the old rat got rid of his old proteins. Only in the last three years has that been recognized, and so we can reset that and the cells actually function with young proteins as if they're young cells.

At Osaki University they're actually now having a transplant of a special kind of cardiac stem cell, and that seems to be having a really profound impact.

Right, there are fourteen areas, and you've hit on another one, which is can we give you stem cells if you're injured and get it to function as if younger? And let me go over how this was first developed in humans. At the Cleveland Cornic they did a male heart transplant into a female person and This female was living fine, but then she developed a heart attack. She developed afterosclerosis. Again, this was before statins, in before a lot of them, stints, et cetera. So she rushed back to the hospital when she was having chest pain, got her blood flow opened, and initially her ejection fraction, the amount of blood squeezed out of her heart every beat, went from fifty five percent where it had been after the transplant, down to thirty percent when she had the heart attack. But over six weeks it got back to fifty five percent. They did a biopsy of her heart and her stem cells were repairing the male if you will heart so, if you get to the hospital fast enough after a heart attack or stroke and get the blood flow opened, it isn't just a marginal tissue that improves. It's that you have exces zones. You sell factors that call for stem cells and they come and repair it. Well, what do we do we run out of stem cells. We only have so many duplications of our stem cells, So the question is can we get ourselves to manufacture more. Well, in this experiment in Japan, what they found is they can take stem cells from you, grow them in culture, and give them back to you, and it takes about forty million stem cells. You hear about stem cell things in the United States, that's eight hundred to one thousand.

It's useless.

You need twenty million to forty million at least, so you need to grow them. Well, you grow them externally. Well, what's the limit on that. It's very expensive on a one on one basis. So in Japan what they did is they found out again it was actually a American scientist, Mike West, who figured out how to knock out the immunogenicity the way of our stem cells being attacked by our body if they're grown outside. If we take someone else's stem cells, he knocks out the imogenicity of the stem cells. They grow four trillion, and they can give these to one hundred different people in a relatively inexpensive fashion. So that experiment is going on to say can we repair an injured heart that way? The early results are very promising. That's one of the things. Another company, a Hopkins offshoot company, has figured out how to grow the stem cells by giving you a pill that helps you elongate what we call your telomeres, so you can grow your own stem cells much more. Another company, a viv from Israel is learned how to use again an expensive technique, hormetic hyperbaric oxygen to stimulate as if you're hypoxic, which helps.

Grow stem cells.

So there are three different approaches all to tell me your lengthening to get us to have stem cell replacement. Stem cells are the original matriarchs. They're the mothers of the human body from which everything comes. So when you have your stem cells, you can repair things.

One of the things I was striking in your new book, you suggest that all of these different breakthroughs combined mean that today's twenty year old is likely to live much longer on average, and to be dramatically healthier. Can you walk through just a little bit of the scale of change that you and vision coming.

Well.

In the book, we were pretty conservative, so I'm going to be that conservative if you will. Imagine you live thirty more years, so you live to one hundred and fifteen or one hundred and ten, but you're a.

Forty to sixty year old.

So instead of drawing Social Security at age sixty one or sixty two, or instead of having Medicare at sixty five, you'd stop working at maybe seventy five or eighty five. In addition, you'd be vigorous and be able to enjoy a family much longer. Now that's with one reboot in mice. We are now seeing the second reboots where you can take a ninety week old mouse, make him forty. When he gets to ninety week old, make him forty again. Imagine that none of this is in humans, and mice aren't humans. But imagine you being productive for thirty more years. And I'm looking forward to it. I hope you are too.

What I'm struck by and all of this work on longevity, it was described to me by somebody who said, if you think of longevity as a tree, as you gradually get older, there are branches that come off the tree diabetes or heart disease or whatever, and we'd focus enormous amounts of resources on the branches, very intensely, focused on each of these specific disease centers. But they said, you know what, if you grew the tree longer so that you didn't get to those branches until much much later in life. First of all, if the change would by itself save medicare for the rest of our lives, because you would be moving all of the cost structures way out of where they are. And second, people would be so much healthier and so much more active that it would change all of the equations we have about what we expect out of people, and we would change the propensity to remain active both financially and politically and socially in ways that would be literally a different society. Do you think that's pie in the sky or is that actually a reasonable analysis?

I think that's very reasonable. But I think part of it is we're going to have to keep what I would call preventing unforced theirrors. That is, there are still things that will cause bathosclerosis or plaque in your arteries, and we know how to prevent that now to a large degree, and so you're going to have to be willing to do that. Exercise is important for keeping your functions young. I think that tree analogy is a wonderful analogy, and we're try and steal that.

You know. One of the things that is fascinating to me is I get older, is the number of people over one hundred, for example, is now is stunning. What are we learning by studying the people who have successfully lived in a healthy way well beyond one hundred years?

Of age well in what it's called the Blue Zones, which studied the seven areas in the world where this is very common. It is the avoidance of chronic disease, usually by the four biggest things. One is stress management, and they do it by having a posse and purpose in life, and that is friends and a community. Second is doing physical activity. Third is eating largely a much healthier diet than the American diet. And fourth is avoiding unforced errors such as texting while driving or something as simple as that. And what we've learned is that it is the tree that you talked about. It is growing older without developing chronic disease. That is the key for these communities, and they've done it by a posse and purpose, physical activity, food choices and portion size, and avoiding unforced errors.

I'm very curious, you are very sophisticated research doctor. I keep hearing about the use of metforman that it actually has a positive effect in general, and it's currently so inexpensive in your sense. I mean, do these kind of things actually help at the margins as we try to go through this kind of change.

I don't want to talk about met foreman, because there are some side effects of met forman. If you exercise, for example, it may inhibit that Neil Besseau who is doing the tame trial, And we debate whether met foreman is good or bad at this time. What metforman does is lower your blood sugar level, and sugar is a precursor of both feeding cancer and feeding atherosclerosis in the diabetic world, causing your muscles to develop insulin resistance and not use calories as efficiently. But there are many other things we may be able to do that are relatively inexpensive that will keep us from having as much chronic disease for much longer. And let me give you one that was done at the Gladstone in San Francisco where they looked using quantum computing, so fourth degree structure of proteins, and they said, is there any drug that has been approved by the FDA and is now generic that blocks the attachment of amoid and tao to brain cells. Amoid and tao are the gunk that attaches to brain cells that are associated with the development of Alzheimer's dementia and are associated with inflammation of the brain that wipes out neurons. Well, they found that a four dollars a month waterpill Vieumex largely replaced by hydrocorrethiside and furosimito LASiS blocked it almost totally in the computer models. They then used it in a mouse model of Alzheimer's disease and it blocked the mice from developing dementia. They have then looked at two large databases one point eight and three point eight million people and it blocks seventy and seventy two percent of the development of all dementias compared to people who were taking other water pills or taking no diuretic, no water pill at all. That has now led to a randomized control trial. So this is a four hour month waterpill. The side effects are lowers your blood pressure. Doesn't have serious side effects in that regard as safe as any of the other diuretics and looks like it at least in the early studies, prevent seventy percent and maybe more dementia. So that's something that we're beginning to see the combination of this technology, the quantum computing and inexpensive molecules. There's another one in phase three and the company has promised that it will be less than forty dollars a month.

That is what we call.

CETP cholesterol esterraise transfer protein that would transfer normally. What CETP does is transfer LDL cholesterol into your arteries. Will you block that and you stop coineriaortery disease and most of the causes of stroke and a lot of causes of dementia. And its side effect is it lowers blood pressure too, So that's in some phase three testing. It's a small molecule, so it's very cheap. You've seen semagutide and zeppetite or lagovia or zepeic and munjar borrow now wiping out obesity and probably wiping out the craving from alcohol, maybe even from opioids. But clearly we know that it does that for food craving and alcohol craving. Well, just imagine if we can wipe that out and semaglutide I understand comes off patent in about a year, so it's going to get much cheaper and be available. It will save about we think someplace around one sixth of the Medicare and medicaid budget by wiping out obesity if we did it, meaning it's two or three percent of GDP that we will be saving in our budgets that we could use for other things or for decreasing our debt load. So amazing things that are happening.

I remember one center Bob Carry and I co chaired a task force on Alzheimer's for three years that if you can postpone Alzheimer's, the effect on both human happiness and on the budget, and the effect on the caregivers, because if you are a family caregiver, you're twice as likely to have an illness as people who are not in an Alzheimer's family. So the kind of secondary and tertiary effects we're talking about become huge as these breakthroughs begin to occur. And I think that if you look back and you think, what if we had the health structure of say, nineteen fifty, you'd have people dying younger, you'd have people much more debilitated, you'd have a totally different economy. And we've already profited from longer lives and healthier lives. And now I take it from your book and others that we are really on the verge of a breakout that could, in the next five or ten years dramatically change our expectations about how long we live and about how well we live. I mean, is that a reasonable summary.

I think that's that's exactly right. I think we're on that step of breakthrough kind of the way I would say the Internet was in two thousand and six to eight, where it's getting fast enough and speedy enough that we're going to take off, and it's almost irrepressible, meaning this is occurring so fast.

I'll use how much.

Reading I had to do when I was in nineteen seventy eight. I had to read one article every six months. I can't keep up now because it's one every six minutes. That's how fast the articles are that are meaningful in this field.

We're beginning to be during a period where we may be able to actually grow organs for transplants in a way that would have seemed possible thirty years ago.

So just imagine right now we're at a point where you can, in fact insert a gene just one letter, one base pair into a gene and you no longer have that deficiency that enzyme, and people don't have to suffer at all from it. So it's really remarkable the progress that, in fact, your work early on to invest in Aniah and invest in the National Science Foundation that has yielded everything is much less expensive because of that.

Well, and I think you have to have these examples to explain to the average citizen why investing in basic research over time is the most powerful single investment because it liberates things that you couldn't have imagined and that you can't achieve without the basic research breakthroughs. I think it justifies almost everything that Aniah the National Science Foundation do. I have to ask you about one big story, which is that Altos Labs raised three billion dollars for its launch, making it the best funded startup biotech company of all time, and it's trying to take on the agent challenge head on. What is your sense of those kind of large systems? And it's going to change the economics of being a biology professor just by the kind of salaries are now paying.

What Altos has done is they've taken some of this animal research the fourteen areas we write about in the Great Age Reboot book. One of their areas is this epigenetic reprogramming. This will advance the transformation from the animal models into humans. So a lot of what they're doing is not only basic science, but is in fact the translational research to speed the process of it coming to you and me and all of society. I'm strongly in favor of what they're doing. Let me get you the idea of how fast this is moving. The total amount invested in aging research, including the National Institute of Aging was around three hundred million in two thousand and six.

This is three billion. This is ten times.

Alone for one firm, and the estimate is it's probably closer to six billion got invested last year into aging.

Yeah. I think what's happened is we've passed the critical mass of believing it's possible, and it's now moving into a commercial world, which has a capacity both to attract entrepreneurs who break through and who forced things to happen, and to attract scales of resources that you could never get through a public bureaucracy. We're a little bit like Henry Ford and Thomas Edison and the degree to which they just privately revolutionized everything because they went out and did it. And I think we may begin to see that and part of the point you make in your book, which is really I think exciting, and if people can and integrate this into their heads and realize how real it is that over the last one hundred and twenty years, life expectancy has actually increased by over thirty six years. So when we project forward, we're not projecting a fantasy. We're projecting an acceleration of a process which has actually been underway for over a century. Can you talk about that degree to which scientific and other breakthroughs really changed. We've already gained thirty six years, so when you start talking about gaining the next thirty or forty or fifty years, it's not science fiction. It is science progress. And somehow we have to get that across to people.

Yeah, it really is. So you're right.

Obviously the Human Genome Project did a great thing. But do you know what Elvis's major contribution to.

The world was.

I'll take your word for what.

He actually got vaccinated against polio on TV when he went into the army. And when he went into the army, he got vaccinated live on ABC, NBCCBS, And at that time, zero point three percent of Americans had gotten vaccinated, less than one percent. Within two years of him getting vaccinated, those eligible went up to eighty three percent. He saved America just in treatment of folio over one hundred billion a year. So Elvis's largest contribution through his music was in fact a health change, And so the science is getting there, and we have to get people to understand what this will do, just like Elvis did with a folio vaccine.

That is a perfect example of what we're talking about and of what our challenge is, because we have to somehow find a way for everyday folks to realize that they're about to benefit from changes of such extraordinary magnitude that it's going to affect their personal lives, it's going to affect their economy, it's going to affect the structure of their government in ways that increase the potential for human happiness beyond anything we've ever dreamed of.

And that's the key point. This is an opportunity. When you say people you're going to live longer, it isn't extending the end years. It's extending your most productive, most fun years, if you will. So it is extending those productive years from instead of being forty to sixty or forty to seventy, even forty to eighty, it's going to be forty two, one hundred, So you're going to get to extend those happy years You're right, those most productive years.

I'm very curious, because we've known each other so long, how has all of this knowledge and research affected you in terms of your own life.

I used to exercise a great deal.

I captained the US team and squashing the Pan American Games in nineteen eighty three.

I think so.

I used to be physically active, but I never did stress management. I didn't eat the right foods, And in fact, I've adopted gradually and progressively as I've seen the data almost all of the things. I still have too much stress, and I still sometimes sacrifice sleep for the rest of life. But in general, I've said I want to have no structural damage in my body, to keep structural damage out of my body as long as possible, so that when the reboot comes, when we learn what it is to take ourselves back, I'm going to be available and going to not have so much structural damage. That is, to have a little bit of structural damage, so I can reboot back to be a younger tree, if you will, and grow old without the branches falling off. As your great analogy is, so, if you will, yes, do I call people every Sunday to increase my posse and nurture.

It.

Yes, to have a purpose in life, Thank you. It is teaching longevity others do. I do deep breathing and double breathing and do inspiratory resistance training for my diaphragm.

Never did that because I didn't know about it. Now I do it do.

I avoid red meat and process red meat and fried food and added sugers, added syrups and simple carbjet. So I do all of the darn things, plus a lot of simple little ones, one of which is speed of processing games. It's been shown to decrease dementia. So just thirty hours and ten years decreases dementia by over thirty five percent. So there's some simple things all of us can do, and I've adopted almost all of them because the data are there.

I want to thank you. I think the work you are doing and the conversations we've had now for almost a lifetime, we really are at the edge, and you are one of the pioneers helping us get there. And your book, The Great Age Reboot, Cracking the Longevity Code for a Younger Tomorrow, I think should be mandatory reading for every citizen and certainly for every political leader to understand how exciting and positive the future is going to be, and to break through all of the gloom and doom and recognize that in fact, for most people, it's going to be a dramatically better world with dramatically more opportunities. And you're both one of the people creating it and one of the people explaining it. And Michael, that makes you a real national treasure.

Well, thank you. Let me return the favor.

You are one of my heroes for getting the budget balance, So thank you for doing that.

We need you again.

Well we're going to go back into it one more time, I think, and I think we'll probably get it balanced in the next decade. But I really appreciate you spending the time with us today.

Thank you, my privilege.

Thank you to my guest doctor Michael Roysen. You can get a link to buy his book, The Great Age Reboot on our show page at newtsworld dot com. Newsworld is produced by Gingers three sixty and iHeartMedia. Our executive producer is Guernsey Sloan. Our researcher is Rachel Peterson. The artwork for the show was created by Steve Penley. Special thanks to the team at Gingerish three to sixty. If you've been enjoying Newsworld, I hope you'll go to Apple Podcasts and both rate us with five stars and give us a review so others can learn what it's all about. Right now, listeners of Newtsworld consign up for my three free weekly columns at gingrishtree sixty dot com slash newsletter. I'm Newt Gingrich. This is news World

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