What a 93-Year-Old Rowing Champion Can Teach Us About Aging Well | 10 - Longevity this Week #1

The Optispan Podcast with Matt Kaeberlein
1 Mar 202428:39

Summary

TLDRThis podcast episode discusses healthy aging, using a 93-year-old champion rower as a case study. It analyzes his fitness routine and diet as possible contributors to his vitality at an advanced age. The hosts then examine research on worsening health spans despite rising life expectancies, discussing flaws in common health span metrics and offering perspectives on potential future trends.

Takeaways

  • 🚣 Richard Morgan, à 93 ans, montre une santé et une forme physique comparables à celles d'une personne de 40 ans, remettant en question les idées reçues sur le vieillissement.
  • 🏋️‍♂️ Débuter le sport et une alimentation équilibrée à un âge avancé, comme l'a fait Richard qui a commencé l'aviron à 72 ans, peut significativement améliorer la santé et la longévité.
  • 📉 Une étude souligne un écart croissant entre l'espérance de vie en bonne santé et l'espérance de vie totale, indiquant que les Américains vivent plus longtemps mais avec plus de maladies.
  • 🔬 Les recherches sur Richard Morgan, basées sur des données physiologiques, suggèrent que l'exercice et une alimentation adéquate peuvent inverser certains aspects du vieillissement.
  • 💡 L'importance de l'entraînement en résistance et de l'exercice cardiovasculaire est soulignée pour maintenir la masse musculaire et la fonction cardiovasculaire avec l'âge.
  • 🥗 Une alimentation riche en protéines et faible en aliments transformés contribue à la santé et à la longévité, sans nécessité de recourir à de nombreux suppléments.
  • 🔎 Les études en laboratoire sur les animaux montrent des améliorations dans certains aspects de la santé grâce à l'exercice, mais n'indiquent pas nécessairement une augmentation de l'espérance de vie maximale.
  • 🧮 La mesure de l'espérance de vie ajustée en fonction de la santé (HALE) et les débats sur sa précision montrent les difficultés à quantifier le 'bien-être' à travers le temps.
  • 📚 La discussion met en lumière la nécessité de repenser les approches traditionnelles de la santé et de considérer la prévention et le traitement des causes sous-jacentes du vieillissement.
  • 🔄 La possibilité de 'renverser' l'âge à travers des interventions ciblées sur le mode de vie et peut-être dans le futur, sur la biologie du vieillissement, offre une perspective optimiste pour améliorer la qualité de vie avec l'âge.

Q & A

  • Quelle est l'histoire de Richard Morgan, le champion d'aviron de 93 ans ?

    -Richard Morgan est un champion d'aviron de 93 ans, connu pour sa condition physique exceptionnelle, comparable à celle d'une personne de 40 ans. Il a commencé l'aviron à 72 ans et a maintenu une routine d'entraînement rigoureuse, comprenant de l'exercice cardiovasculaire et de la musculation.

  • Quelles sont les caractéristiques physiologiques de Richard Morgan mentionnées dans l'article du Washington Post ?

    -L'article mentionne que Richard Morgan possède une composition corporelle impressionnante, avec un pourcentage de graisse corporelle d'environ 15%. Il pèse 131 lbs (environ 59 kg) et mesure 5 pieds 3 pouces (environ 160 cm), ce qui lui donne un IMC dans la plage normale.

  • Comment la routine d'entraînement de Richard Morgan est-elle décrite dans la discussion ?

    -Sa routine d'entraînement comprend environ 20 miles (environ 32 km) d'aviron par semaine, avec une répartition de 70% d'intensité faible, 20% d'intensité modérée et 10% d'intensité élevée. Il pratique également la musculation deux à trois fois par semaine.

  • Quel est l'impact de l'exercice sur le vieillissement selon les études de laboratoire mentionnées ?

    -Les études sur les rongeurs suggèrent que l'exercice peut améliorer certains indicateurs de la santé sans nécessairement prolonger la durée de vie. Cependant, l'impact de l'exercice sur la santé humaine est considéré comme très bénéfique, surtout en termes de fonction musculaire, densité osseuse et fonction cardiovasculaire.

  • Quels sont les aspects du régime alimentaire de Richard Morgan qui contribuent à sa santé exceptionnelle ?

    -Richard Morgan suit un régime riche en protéines, consommant environ 110 grammes de protéines par jour, et privilégie les aliments complets avec peu d'aliments hautement transformés. Il complète également son alimentation avec des shakes de protéines après ses entraînements.

  • Quelle est la différence entre l'espérance de vie en bonne santé (HLE) et l'espérance de vie, et comment cela a-t-il évolué ?

    -L'espérance de vie en bonne santé (HLE) est une mesure qui tente de quantifier le nombre d'années qu'une personne peut s'attendre à vivre en bonne santé, tandis que l'espérance de vie est simplement la durée de vie moyenne. L'écart entre ces deux mesures s'est creusé au fil du temps, passant de 10,8 ans en 1990 à 12,7 ans récemment, indiquant une augmentation de la période de vie avec des maladies chroniques.

  • Quelles sont les limites de l'utilisation de l'espérance de vie ajustée en fonction de la santé (HALE) pour mesurer la santé globale ?

    -L'utilisation de l'HALE est limitée car elle repose sur des estimations de sévérité des maladies et des handicaps qui peuvent être subjectives. De plus, cette mesure peut ne pas capturer avec précision ce que l'on considère comme une bonne santé, car elle peut ajuster les attentes de santé en fonction de l'âge et ne distingue pas clairement entre différentes qualités de santé.

  • Quelles sont les principales raisons d'optimisme concernant l'amélioration de la santé et de l'espérance de vie mentionnées ?

    -Les raisons d'optimisme incluent les avancées dans le traitement du cancer, le développement de nouveaux médicaments contre l'obésité, une meilleure compréhension de la biologie du vieillissement et un changement vers une approche plus préventive de la santé, qui pourraient tous contribuer à améliorer la santé globale et potentiellement l'espérance de vie.

  • Comment la définition de la santé et du 'six span' pourrait-elle être améliorée pour mieux refléter l'état de santé des populations ?

    -Une approche suggérée consiste à mesurer la santé de manière qualitative tout au long de la vie et à considérer le 'six span' comme la période passée avec au moins une maladie chronique significative. Cette méthode offre une mesure plus claire et plus directe de l'état de santé des individus et pourrait aider à mieux comprendre et à aborder les défis de la santé publique.

  • Quel est le potentiel d'impact des découvertes dans la science du vieillissement sur la santé et l'espérance de vie ?

    -Les découvertes dans la science du vieillissement, en ciblant la biologie du vieillissement elle-même, ont le potentiel d'avoir un impact significatif sur la santé globale en abordant simultanément les déclins fonctionnels et les maladies liées à l'âge. Cela représente une approche fondamentalement nouvelle qui pourrait améliorer la santé et potentiellement augmenter l'espérance de vie.

Outlines

00:00

🚣‍♂️ Introduction à Richard Morgan et au concept de Longévité

Ce paragraphe présente Richard Morgan, un champion d'aviron de 93 ans, comme un exemple de vieillissement extrêmement sain, défiant les attentes traditionnelles de la santé et de la fitness à son âge. Matt Cabine et Nick Arapis discutent de la santé exceptionnelle de Richard et de son impact sur les concepts de durée de vie et d'espérance de santé. Ils explorent la routine d'entraînement et le régime alimentaire de Richard, suggérant que sa discipline pourrait offrir des leçons importantes sur le vieillissement et la santé. La conversation met en lumière l'importance de l'exercice et de la nutrition adéquate, remettant en question la nécessité de compléments alimentaires pour maintenir une bonne santé en vieillissant.

05:00

🔍 Analyse de la condition physique et de l'âge biologique

Dans ce segment, l'analyse se concentre sur les mesures physiologiques de Richard Morgan, en comparant sa condition physique à celle d'un individu dans la quarantaine ou la cinquantaine. Malgré les questions sur la précision de ces comparaisons, il est admis que Richard détient des attributs de jeunesse surprenants pour son âge, grâce à son régime d'entraînement et à son alimentation. Les auteurs discutent des limites et des implications des mesures utilisées, telles que la fréquence cardiaque maximale et la composition corporelle, soulignant la différence entre inverser certains traits de vieillissement et inverser le vieillissement lui-même.

10:01

📉 Discussion sur la santé, la longévité et les tendances de l'espérance de vie

Ce paragraphe explore la distinction entre l'espérance de vie et l'espérance de santé (Health span), soulignant un écart croissant entre les deux, exacerbé par des problèmes de terminologie et de mesure. Matt et Nick évaluent les implications de cette disparité à travers l'analyse de données et de tendances, questionnant les approches traditionnelles de la santé et la longévité. Ils critiquent les méthodes de calcul actuelles et proposent de nouvelles approches pour une meilleure compréhension et évaluation de la santé globale.

15:02

🤔 Critiques et solutions pour une meilleure mesure de la santé

Ici, la conversation se tourne vers les défis inhérents à la mesure de l'espérance de santé et propose des alternatives pour mieux évaluer et comprendre la santé au fil du temps. Les intervenants critiquent les méthodes existantes, comme le HALE (health-adjusted life expectancy), pour leur manque de précision et proposent des concepts tels que 'Sick Span' pour offrir une perspective plus nuancée et applicable de la santé à travers les âges.

20:04

🌱 Optimisme et stratégies pour l'avenir de la santé

Ce paragraphe conclut sur une note optimiste, évoquant les progrès réalisés dans le domaine de la médecine, en particulier dans le traitement du cancer et de l'obésité. Les auteurs discutent de l'impact potentiel de la science gérologique et des changements d'attitude envers la santé préventive. Ils soulignent l'importance de l'adoption d'approches proactives pour améliorer la longévité et la qualité de vie, en soulignant le rôle crucial de l'empowerment individuel dans la gestion de la santé.

25:05

📚 Synthèse et perspectives sur la longévité et la santé

Dans ce dernier paragraphe, la discussion résume les principaux points abordés dans l'épisode, en mettant l'accent sur l'importance de l'initiative personnelle dans l'amélioration de la santé et de la longévité. Matt et Nick encouragent les auditeurs à rester informés et engagés dans leur propre parcours de santé, et invitent les commentaires et suggestions pour de futurs épisodes, renforçant l'objectif de sensibilisation et d'éducation autour des enjeux de santé.

Mindmap

Keywords

💡vieillissement sain

Le vieillissement sain fait référence à la capacité de maintenir une bonne santé physique et mentale à un âge avancé. Dans le script, Richard Morgan est présenté comme un exemple exceptionnel de vieillissement sain, ayant commencé l'aviron à 72 ans et devenu un champion du monde à 93 ans. Cela illustre que l'activité physique régulière et une alimentation équilibrée peuvent contribuer à un vieillissement sain, même si l'on commence tard.

💡espérance de vie

L'espérance de vie désigne la durée moyenne de vie d'une population. Dans le script, il est question de l'écart croissant entre l'espérance de vie et l'espérance de santé, soulignant que bien que les gens vivent plus longtemps, ils ne vivent pas nécessairement ces années supplémentaires en bonne santé.

💡espérance de santé

L'espérance de santé est une mesure de la période pendant laquelle les individus peuvent s'attendre à vivre sans maladies graves ou incapacités. Le script mentionne une étude du Wall Street Journal sur la divergence croissante entre l'espérance de vie et l'espérance de santé, indiquant que les gens passent plus d'années de leur vie en mauvaise santé.

💡exercice physique

L'exercice physique est souligné dans le script comme un élément clé pour un vieillissement sain. Richard Morgan, par son dévouement à l'aviron et à l'entraînement en résistance, démontre comment l'exercice peut améliorer significativement la santé et la condition physique, même à un âge avancé.

💡composition corporelle

La composition corporelle, qui fait référence à la proportion de graisse et de muscle dans le corps, est un indicateur important de la santé. Richard Morgan, avec un pourcentage de graisse corporelle de 15%, illustre comment un mode de vie actif peut maintenir une composition corporelle saine chez les personnes âgées.

💡entraînement en résistance

L'entraînement en résistance est souligné comme une composante importante de l'exercice pour le vieillissement sain, contribuant à la force musculaire et à la densité osseuse. Dans le script, l'entraînement régulier de Morgan avec des exercices de résistance est un facteur clé de son excellente condition physique.

💡alimentation équilibrée

Une alimentation équilibrée, riche en protéines et faible en aliments hautement transformés, est présentée comme un autre pilier du vieillissement sain. Richard Morgan consomme une alimentation principalement composée d'aliments entiers et riches en protéines, ce qui contribue à sa santé exceptionnelle.

💡suppléments

Le script aborde la question des suppléments, notant que Morgan n'utilise pas de suppléments à l'exception des shakes protéinés. Cela suggère que les suppléments ne sont pas essentiels pour maintenir une bonne santé et une condition physique, tant que l'on suit une alimentation équilibrée et un programme d'exercice régulier.

💡résistance au vieillissement

La résistance au vieillissement fait référence à la capacité de maintenir une fonction physiologique optimale et de réduire le déclin lié à l'âge. Le script utilise l'exemple de Morgan pour illustrer comment l'exercice et une bonne nutrition peuvent contribuer à cette résistance, même chez les personnes très âgées.

💡obésité

L'obésité est discutée comme un facteur majeur affectant négativement la santé et réduisant l'espérance de santé. Le script mentionne les progrès dans le traitement de l'obésité, tels que les nouveaux médicaments, comme une raison d'optimisme pour l'amélioration de la santé publique et la réduction de la maladie chronique.

Highlights

93-year-old Richard Morgan has exceptional fitness for his age, including 15% body fat and high VO2 max.

Morgan began rowing at age 72 and trained consistently for 20+ years, including cardio, resistance training, and a whole foods diet.

Morgan's case shows it's never too late to start exercise and good lifestyle habits to significantly improve health.

While Morgan reversed some traits of aging, he did not fully reverse the aging process to become physiologically 40 years old.

Rodent studies show exercise improves healthspan metrics more reliably than lifespan, but have limitations in modeling human scenarios.

In people, exercise likely has significant anti-aging effects on physiology and function, especially resistance training.

There is a large and growing gap between life expectancy and health-adjusted life expectancy in the US.

The health-adjusted life expectancy metric likely underestimates declines in true healthspan.

An alternative metric is "sickspan", defined as the period of life spent with a chronic disease or disability.

By this measure, sickspan starts before age 40 for the average American, suggesting a gap of 40+ years from life expectancy.

The future trajectory of this gap depends on changes in both life expectancy and healthspan.

There are reasons for optimism about future healthspan, including cancer advances, anti-obesity drugs, geroscience discoveries and a shift toward preventative healthcare.

Empowering individuals to take control of their health is crucial to narrowing the healthspan/lifespan gap.

Please subscribe and provide suggestions for future podcast episodes.

Email [email protected] with questions or feedback.

Transcripts

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the story of 93-year-old rowing Champion

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Richard Morgan at 93 he's as fit as a

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40-year-old this is a case example that

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you don't have to take a bunch of

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supplements or necessarily even any

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could this be an example of someone

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who's reversed their age it's probably

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never too late to start everybody has an

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opportunity to improve their health and

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that that we know some of the ways that

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people can accomplish that Americans are

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sick for more of their lives the problem

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being this growing gap between Health

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expectancy and and life

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expectancy my name is Matt cabine and

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welcome to the optisan YouTube

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channel hey everyone welcome to the

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optisan podcast we are going to try

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something new today uh so this is

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something we call Longevity this week

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and the idea here is that periodically

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we'll pick you know somewhere between

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two to four current stories in the field

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and do a little bit of a deeper dive on

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them and and try to distill out you know

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some of the key insights or at least

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give our our thoughts uh takeaways on

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the stories so uh so today uh we picked

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two recent stories one is about a

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93-year-old world champion rower so an

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example of what I would call extremely

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healthy aging and what are some of the

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lessons we might be able to learn from

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that and the second is a article in the

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Wall Street Journal recently that was

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looking at the growing discrepancy

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between Health expectancy and life

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expectancy and so I'm joined again today

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by Nick arapis and Nick and I are going

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to talk through both of these articles

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so hopefully you like this format and if

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you do I'd encourage you to or even if

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you don't I'd encourage you to leave

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some comments below so we can try to uh

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tweak it to uh to make it as useful as

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possible so um okay so today we're going

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to start with the story of 93-year-old

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rowing Champion Richard Morgan um this

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story actually first came across my

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radar from an article in the Washington

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Post the title of that article was at 93

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he's as fit as a 40-year-old his body

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offers lessons on aging and of course

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you know given my sort naturally

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skeptical mind the first thing I thought

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was come on is he really as fit as a

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40-year-old so did a little bit of

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deeper digging and learned that the

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Washington Post article was actually

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based on a journal paper that was

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published previously in the Journal of

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Applied physiology and the title of that

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paper uh is physiological

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characteristics of a 92-year-old

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four-time world champion Ro

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and one thing that I thought was

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interesting is the lead author on that

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article was actually Richard's grandson

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which is kind of cool um and for anybody

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who's wondering the reason why it was 92

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years old in the scientific publication

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and 93 years old in the Washington Post

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was because he actually had his 93rd

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birthday in the intervening time between

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those those two things so um anyways

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Nick I know you had a chance to take a

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look at both articles and I'm interested

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to kind of get your takeaways yeah well

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I'm impressed with his consistency to

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his workout routine his his discipline

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with his diet as well it also I to me

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may show that it's never too late to

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start an exercise and diet protocol

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routine just so just some background for

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the audience is like you said he's 92

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years old at the time of the study he

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began rowing as 72 years old and he was

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pretty sedentary up until then right he

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wasn't a lifelong athlete uh but worth

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noting 20 years is still a pretty long

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time right so he's had a a significant

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training period to sort of get to the

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point that he's at now yeah you could

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say his training age 20 years right yeah

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uh so he's won multiple group age

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related world records for rowing uh and

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his body composition is striking for

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someone his age including his uh body

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fat which I believe was 15 around there

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15% right right yeah so if I remember

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correctly he was about 131 lbs and um

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5et 3 in tall so that gives him a BMI

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you know right Square in the middle of

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the normal range about 22.6 and yeah

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body fat uh

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15.4% probably just worth noting uh the

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body fat assessment was not done by dexa

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which is the gold standard um it was

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done by electrical impedance which you

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know could be off plus or minus 10% um

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usually plus 10% so you know but even if

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it was 16 and a half 177% body fat still

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really impressive for even for somebody

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in their 50s but for somebody his age

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very impressive yeah well like you

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mentioned the article said that he has a

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fitness of a 40-year-old so is that true

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yeah I mean again I think that's a

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that's a hard thing to answer precisely

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right uh um again we talked about body

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composition from that perspective yeah I

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think you would say he's got a body

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composition that that would be

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considered pretty good for somebody in

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their 40s or 50s and if you take a

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little bit closer look at some of his

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physiological measurements so maximum

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heart rate vital capacity things like

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that um again all kind of in the range

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that we would consider uh good for

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somebody in their 40s or 50s I think he

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uh one of the Articles or an interview

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uh afterwards mentioned he had the

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highest heart maximum heart rate that

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had ever been recorded for somebody in

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his a of his age so again I sure I think

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it's I think it's fair to say that based

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on those kinds of measurements he's got

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a fitness level that we would consider

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pretty good for somebody in their 40s or

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50s I think you know it's it was kind of

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unfortunate that they did not um do a

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dexa scan I would have been interested

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to know like what does his bone density

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look like what did the positional muscle

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mass look like um that could maybe a

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little bit more information but but yeah

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I mean I think it's you know reasonable

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to say he's got pretty good Fitness

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better than a lot of 40 and 50 year olds

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yeah so uh what was his training routine

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like yeah again I think you mentioned

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consistency I think that uh plays an

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important role here so it sounded like

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um he uh didn't vary his routine very

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much but he was very consistent so he

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rode about 20 miles a week a nice

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distribution of low intensity I think

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about 70% low 20% moderate 10% High um

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uh exercise for 40 minutes a day I think

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one of the things that I took away and

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thought was probably an important

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component to his success was that in

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addition to the rowing and the cardio

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types of exercise he was very consistent

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at doing resistance training two to

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three times a week uh three sets of

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lunges curls and rows to failure um and

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so I think that combination you know as

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we've talked about before of uh

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cardiovascular training and weight

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training plays a really important role

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especially as people are getting older

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in terms of maintaining muscle function

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bone density things like that and what

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aspects of his diet adop to you yeah

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again I mean you know uh I think he had

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a diet that most people would consider

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pretty high quality so his grandson uh

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mentioned that he primarily eats Whole

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Foods so again you know very low and

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highly processed foods um protein I

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thought was interesting so he ate a diet

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that was relatively high in protein so

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again at a body weight of 130 pounds if

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you just look at the RDA recommended

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daily allowance for protein that would

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be about 60 grams of protein a day um he

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ate about 110 grams of protein a day I

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think his grandson said that he had a

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protein shake after um after his

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workouts so again pretty consistent with

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the idea that that a relatively high

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protein diet in combination with regular

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exercise including regular resistance

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training is a path to success for many

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people and and can play an important

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role in maintaining muscle mass and

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maintaining function as you get older

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the other thing I thought was

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interesting you know especially given my

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um you know somewhat skeptical stance on

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supplements was uh his grandson said

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that he really doesn't take any

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supplements other than the protein shake

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and so again regardless of where you

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kind of stand on supplements um I think

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this is a case example example that you

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don't have to take a bunch of

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supplements or necessarily even any to

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achieve what we would consider a pretty

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successful Health span trajectory okay

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yeah so we hear a lot of people talk

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about how they can reverse age you know

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reversing aging and so if he was in his

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70s when he started now he's in his 90s

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and the article says he has the fitness

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of a 40-year-old could this be an

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example of someone who's reversed their

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age yeah again I think we have to be

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really careful with the definitions that

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we use and the Precision that we use in

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our language I would say

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um we know of many examples where you

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can reverse certain traits that go along

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with aging or certain aspects of Aging

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right and so it should come as no

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surprise to people that if you take a

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sedentary person and I'm not talking

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about Richard's case necessarily but if

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you take a s sedentary say 50-year-old

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person who's been eating a poor diet

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very overweight you get them to start

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eating a healthy diet exercising

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regularly doing resistance training that

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you can improve things like muscle mass

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and V2 Max and and fitness measurements

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um so we've known that for a long time I

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would say that's not reversing Aging in

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the sense that you are not

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reversing biological aging as a whole

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and I think in Richard's case I mean all

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you have to do is look at some of the

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pictures that were in both articles of

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Richard he doesn't look like a

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40-year-old right and so clearly while

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he has improved physiological function

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in certain organs and tissues maybe

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reversed some aspects of Aging he has

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not reversed Aging in the sense that he

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went

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from looking like acting like being a

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90-year-old in every way to being a

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40-year old in every way um and so I

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would say no he has not reversed aging

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uh as a whole okay what do we know about

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exercise as an anti-aging strategy from

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laboratory studies yeah so I think the

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laboratory studies here are are somewhat

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complicated to interpret this is mostly

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going to come from work in rodents so

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mice rats there are studies that have

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looked at uh the effects of exercise on

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health span metrics and lifespan in in

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rodents um and in general the consensus

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takeaway from those studies is that

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exercise can improve some health span

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metrics doesn't really seem to

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significantly improve medium or maximum

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lifespan now there are a couple of

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outlier studies where they reported an

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extension of lifespan those generally

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are cases where the controls were

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shorter lived than you would anticipate

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so that's kind of hard to interpret but

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again I think the consensus would be

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that exercise in rodents can improve

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some aspects of healthspan really

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doesn't seem to significantly increase

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lifespan but again I think it's really

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important to appreciate that those are

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hard studies to do because really the

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only way that you can you know

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effectively do lifelong exercise studies

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in rodents is to put a running wheel in

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the cage right so the comparison really

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is is mice that don't have a running

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wheel versus mice that do have a running

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wheel um you're not controlling how much

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they exercise it's all obviously

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voluntary exercise um you can't really

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model resistance training well in

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laboratory animals there are people

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who've done some of this that's really

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hard to do over a lifespan study so I

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would say we don't really have a good

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comparison to what we might expect

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exercise impact to be on longevity in

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people the other thing that's probably

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worth mentioning is um you know the

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biggest things that exercise impacts in

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people I believe in terms of health span

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are going to be you know muscle function

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muscle mass bone density um

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cardiovascular function um those are not

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things that really limit lifespan in

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mice in general so mice typically don't

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show a lot of sarcopenia they certainly

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don't don't die from Falls and fractures

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and things like that um and

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cardiovascular disease is isn't really a

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longevity limiting factor in mice most

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mice in the laboratory are going to die

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from cancer probably and so it may also

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be a case where just the the the the

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aging process and the the things that

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exercise is is most potent and impacting

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in people are just different in

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laboratory animals so having said all of

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that this is that's all my way of saying

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I think we have to be careful not to

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extrapolate Too Much from the laboratory

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studies um and I think if you look at

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the data in people you can make an

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argument that EX exercise is probably

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the most

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effective longevity and health span

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promoting intervention in people or

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certainly right up there with healthy

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diet I mean I think you could have a

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debate about you know which could have

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the bigger impact that's going to be

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dependent on the person almost certainly

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but it's it I don't think there's any

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question that exercise positively

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impacts the biological aging process in

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people I think the question is more

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around you know which types of exercise

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are going to be most effective in

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different people or at different life

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stages things like that yeah that makes

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sense so um so my last question is

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what's sort of your big takeaway from

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this

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article yeah I mean I think you you sort

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of alluded to to one of these things

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earlier which is that it's probably

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never too late to start right so I think

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Richard's example you know certainly is

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is probably an outlier and maybe he you

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know is genetically predisposed to

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responding exceptionally well to

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exercise um but I think uh this is a

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nice example of somebody who really

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started taking control of his health in

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a meaningful way you know in his early

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70s it sounds like and has had pretty

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remarkable results and I think that's

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probably true for most people um and and

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the the um studies that have been done

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on lifestyle interventions or long

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proong longevity interventions like rap

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ay in laboratory animals I would say

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tend to back this up where unless the

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pathology of an age related disease has

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gotten to the point where um modifying

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the biology of aging isn't going to

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modify that disease so for example if

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you have metastatic cancer impacting the

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aging process might not have any impact

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on your disease progression unless a

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disease pathology has gotten to that

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point it doesn't really seem like

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there's there's a a a time where it's

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too late to have a positive impact

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that's true in mice with Rapa M you can

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start very very late in life and still

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get many of the benefits and I think

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it's um there's plenty of evidence in

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people that that's true as well uh I'm

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not I'm not suggesting that everybody go

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out and start rowing 20 mil a week but I

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think it's encouraging that that you

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know everybody has an opportunity to

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improve their health and that that we

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know some of the ways that people can

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accomplish that yeah good advice I think

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that was a great discussion for our

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first topic and leading into our next

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one so it's from The Wall Street Journal

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titled Americans are sick for more of

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their lives by Alex Jan so Matt I know

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this is something you've mentioned

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before uh so I'm interested to hear what

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you thought of the article yeah so I

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think for the for the most part the

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article got things right that really

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talks about the growing discrep y

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between Health span and lifespan um uh

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it's an important topic um I would say

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you know my one gut reaction when I

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first read the article was that if

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anything it's pretty dramatically

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underestimating the scope of the problem

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the problem being this growing gap

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between Health expectancy and and life

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expectancy um and I would say part of

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the reason why the article again in my

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opinion underestimated the problem has

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to do with sloppy terminology around

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Health span and what people mean when

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they use that word or how we go about

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measuring it and so you know I've talked

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about this before um for people who want

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a little bit more Nuance on that topic

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I'd refer viewers to our episode on

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defining Health span and its role in In

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Living longer okay so this image on

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screen right now was in the article and

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could you help explain to me and the

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audience what ihme was trying to explain

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in this graph yeah so I mean what this

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graphic is really showing is the gap

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between what they refer to as health

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adjusted life expectancy or hail um and

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life expectancy so life expectancy is

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pretty obvious that's just the the

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length of life that the average person

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is expected to live um hail is this

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little bit more complicated in fact a

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lot more complicated metric that is

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supposed to be a quantitative measure of

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healthspan and what the graphic shows is

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that uh the gap between those two

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numbers so how long we expect people to

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live and how long we expect people to

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live in a healthy state has gone from

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about 10.8 years in 1990 to 12.7 years

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today and again as I mentioned I think

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that's an underestimate but I think it

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reflects the fact that there is this

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growing gap between Health expectancy

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and life expectancy so you think the

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graph is underestimating the true scale

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of the pro problem so what would you say

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to that yeah again I think um a little

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bit has to do with the use of this

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health adjusted life expectancy

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interchangeably with health span and I

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think that's a mistake um and and as

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I've said before I would argue that

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Health span really is a qualitative term

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and what I mean by that is we don't have

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a consensus way to actually measure

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Health span um and I think part of that

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is because health is not binary it

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doesn't go from you know full health one

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day to no Health the next day if at

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least for most people it's really a

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continuous variable that changes over

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the life course it can even go up and

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down as people go through different

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experiences so hail is really an effort

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to overcome this by creating a a

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quantitative measure of health and U the

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way they do this is really complicated I

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actually wasn't able to find a single

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formula that that um that gave the exact

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calculation for Hail but basically it's

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a uh combination of waiting different

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diseases and disabilities that different

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people may have based on you know

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somewhat ambiguous severity estimation

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to get a single number of Health um and

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so one of the problems is that again I

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don't really think that this hail metric

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matches any reasonable or commonly

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accepted definition of Health span or

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really health or what we would consider

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good health so why would they use

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something like hail then yeah I mean I

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think the obvious reason is they wanted

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to have something they could measure and

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I agree with that that's important I

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think there are a couple of other

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factors here that that may have um

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complicated the way that that hail was

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developed um one could be that there is

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this expectation that older people are

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supposed to be in poor health compared

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to young people um and so this is sort

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of adjusted for instead of considering

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Health on an absolute scale in other

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words you know what we would call poor

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health in a 30-year-old might be

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considered good health in a 60-year old

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um and I I actually think that's a

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mistake if you're trying to come up with

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a calculation that's supposed to reflect

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some quantitative metric of help and I

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don't the other the other thing that I

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think about I don't know for sure if

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this is true but I do wonder if hail you

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know um is in some ways an effort to be

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a little bit politically correct and

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what I mean by that is not Define anyone

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who has a disability or a disease as

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having less than good health and again I

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get the rationale for that um but I I

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don't know that that's helpful if we

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really want to accurately measure Health

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Trends yeah so it sounds like to me that

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we don't have a great way of quantifying

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Health span so do you have a suggestion

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what we could do yeah I mean I think

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there's a couple of approaches here that

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I've thought about um one I talked about

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in an article I published a few years

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ago and the title of that article was

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how healthy is the health span concept

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and in that case I proposed that we

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develop a quantitative metric of Health

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which is kind of what hail is again I

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don't I don't agree with the way hail

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calculates Health but you could you

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could come up with something but then

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track that quantitative metric over the

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life course right so what you really get

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if you plotted that out would be a curve

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where we've got this health metric on

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the y- axis and chronological age on the

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x-axis and then you could look at

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something like the area under that curve

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as a single metric proxy for Hells span

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right so that's one approach another

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approach would be just to kind of

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reframe the discussion away from

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healthspan again the problem with

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talking about healthspan is Health

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doesn't go from one to zero right

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there's there's it's it's continuous uh

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and we could talk about something like

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six span which would which would then

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Define six span as the period of Life

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spent with at least one chronic disease

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or disability and maybe we would say

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significant chronic disease or

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disability so there's still a little bit

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of ambiguity there because we'd have to

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Define what we mean by significant but

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I'm confident that that that there that

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we could reach consensus in the field

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about you know what would fall into

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significant disease or disability and

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then six span becomes very easy to

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calculate it's just the period of Life

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spent with one or more of these chronic

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diseases or disability um the nice thing

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about this definition is it is binary so

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it's pretty easy to calculate and

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there's there's not a lot of ambiguity

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about what we mean so if we use that

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definition of six ban what does this Gap

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look like yeah right so this is where I

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think it gets interesting and this is

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why I I uh suggest that that that the 12

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years in the Wall Street Journal article

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is a pretty massive underrepresent

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presentation so you know if we just look

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at a couple of Statistics right um one

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from the CDC uh and this is a direct

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quote from their website 60% of

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Americans live with at least one chronic

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disease like heart disease and stroke

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cancer or diabetes okay so by my

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definition of six span right this would

play21:48

suggest that at least 60% of Americans

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are in that period of life where six

play21:52

span has started okay the other

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statistic here that's relevant is just

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the median age of the population in the

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United States so according to the Census

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Bureau the median age is 38.1 years so

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that means 50% of Americans are under

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38.1 years old 50% of Americans are

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older than 38.1 years old so if we just

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look at those two statistics 60% have a

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chronic disease or

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disability 50% are over 38.1

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years it's pretty clear that six span on

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average

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starts at less than 38.1 years so even

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if we use 38.1 years as the point at

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which for the average American six span

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begins that tells us that the difference

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between 38.1 and average life expectancy

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is a lot more than 12 years yeah and

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that kind of makes sense when you

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consider what up 40% of Americans are

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obese yeah I mean I think that

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statistics true so that would suggest

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that the Gap is probably closer to 40

play22:55

years than the 12.7 that they

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recommended yeah exactly so so I think

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that's exactly right um and again you

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know we could have a discussion about is

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that a good definition of how we would

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Define somebody as not being in good

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health I think

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absolutely nobody could argue with the

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statement that having a chronic disease

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or disability is less than Optimal

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Health and I would argue that it's

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probably not what we would consider good

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health so if we go with that definition

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then yeah it looks like the gap right

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now is around four decades okay so given

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the current trends where do you see this

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going in the future right so that's

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that's the big question and and I think

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it's um it's hard to know so I would

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suggest that you know where this Gap

play23:43

goes in the future really depends on two

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things uh at at the most basic sense

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what happens to life expectancy and what

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happens to six span um so if we look at

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life expectancy um I think it's kind of

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unclear uh over the last three or four

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decades there's been a pretty dramatic

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increase in life expectancy in the

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United States and other developed

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countries around the world um that kind

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of stopped about five or six years ago

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and started to plateau and then with

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covid-19 there's actually a drop in life

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expectancy in the United States um and I

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think we don't know where it's going to

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go from here you know some people

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predict that life expectancy is going to

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start going up again some people predict

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it's going to kind of plateau other

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people predict it's going to go down I

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really don't have a good guess as to

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what's going to happen um and I think

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this may be a case where you know the

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United States may go on a different

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trajectory than a lot of the rest of the

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developed worlds you know we have some

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systemic problems in our society around

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drug use and uh inequities in healthare

play24:44

that could impact life expectancy going

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forward so I think we'll just have to

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see um so the other piece here though is

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what's going to happen to six span or

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health span depending on how you want to

play24:53

think about it and again I don't know I

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mean I think there's there's positive

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and negative pressures here on uh

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population level Trends in health um I

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do think there are some reasons to be

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optimistic and so you know I'd point to

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advances in cancer in particular so both

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at the level of new screening methods

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Imaging liquid biopsies combined with uh

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immunotherapy for cancer I think there's

play25:21

real reason for optimism that uh chronic

play25:24

sickness and mortality due to cancer is

play25:27

going to decrease in the coming years um

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obesity you mentioned I think that's

play25:31

another place where there's some reason

play25:32

for optimism you know after Decades of

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seeing you know very little hope when

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you look at the Obesity Trends we now

play25:39

have these drugs the gp1 agonists that

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are pretty effective at helping people

play25:44

lose weight and I think we're seeing new

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generations of anti-obesity drugs in the

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pipeline so um we don't know yet what

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the long-term efficacy or or potential

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downsides to those drugs are but right

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now it looks pretty promising

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um and so that could have a a and a

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positive effect on not just obesity but

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all of the other diseases of Aging that

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go along with obesity um and then I

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think uh another reason why I'm somewhat

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optimistic is the science of Aging right

play26:15

the discoveries that are coming out of

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the field of geroscience um that that we

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are now understanding the biology of

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Aging in a much more sophisticated way

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starting to develop therapies that can

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actually Target that biology um and can

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potentially have an outsized impact on

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health span and potentially life

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expectancy but Health Span in particular

play26:36

and I would say this is a fundamentally

play26:38

different approach than what has been

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done before where typically biomedical

play26:43

research uh pharmaceutical Discovery has

play26:47

been focused on trying to treat

play26:48

individual diseases in isolation if we

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can Target the biology of Aging we can

play26:53

have an impact on all of the functional

play26:55

declines and diseases of Aging

play26:57

simultaneously and I talked more about

play26:58

this in the episode on um understanding

play27:01

aging and disease and then the fourth

play27:03

reason for optimism I would suggest is

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that I think we are finally starting to

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see a shift in mindset away from

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traditional reactive disease care

play27:16

towards more proactive preventative

play27:18

health care I'm not naive enough to

play27:20

think that you know that's happening

play27:23

quickly or that it's going to be easy

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but we're seeing more people talk about

play27:26

it and I think that's to start and

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clearly that's our mission at optisan is

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to hasten that transition as much as we

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can by enabling as many people as

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possible to become empowered to take

play27:38

control of their own health and so in my

play27:40

view that's really the most impactful

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way right now for us to start narrowing

play27:45

this Gap and really start to push that

play27:47

Health span curve out as far as possible

play27:49

all right well thanks Matt I think

play27:50

that's a good note to end on for our

play27:52

first episode of longevity this week

play27:54

yeah thanks Nick uh I enjoyed it hope

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everyone else did too all right thanks

play27:58

everyone for joining us for this first

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edition of longevity this week I hope

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you found it helpful and interesting uh

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if you're enjoying this podcast series

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please subscribe to our YouTube channel

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we're also available on Spotify and on

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iTunes the best place to leave comments

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and feedback is in the YouTube comment

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section but uh you can also contact us

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directly by emailing us at optisan

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gmail.com uh we of course always welcome

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your suggestions on future episodes

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guests you would like to see interviewed

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or any questions you

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have

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