I want to read to you from your book because you got some strong words about the anti-aging industry. This is a scientist and doctor whose work has been cited 365,000 times. What do you want to say about the anti-aging craze and all the marketing around it? I mean, there's all kinds of stuff going on right now. It's pretty scary. People keep talking about longevity. What we want to do is improve our health span. Turns out that exercise is the only thing we know that lowers our biological age. What are the top three things, Dr. Toppel, that most people are doing that are actually aging them faster. The problem though is the things that they're not doing. Poor diet, not nearly enough exercise, and then of course, this is what I think most people don't understand. Ultimately, if you do all the things that we're talking about that's been study after study, this extends healthy aging by seven to 10 years. Wait, now hold on. So, hey, it's your friend Mel and welcome to the Mel Robbins podcast. I am so excited that you're here. I'm excited that I'm here and I am really excited that our guest Dr. Eric Toppel is here today. It's always such an honor to spend time with you and to be together. And if you're a new listener, I just want to take a moment and personally welcome you to the Mel Robbins podcast family. I'm glad you're here. And because you made the time to listen to this particular episode, here's what I know about you. I know that you're the kind of person who not only values your time, but you value your health and you're interested in longevity. And you could not have picked a better conversation to spend your time on because this is going to be one of the most valuable things you could ever listen to on longevity, on the science of aging, because you're going to be learning from one of the most respected living medical researchers and scientists alive today. And if you're listening right now because somebody in your life shared this with you, I want to point something out. That's really cool because it means you have people in your life that care about you and that care about your health and they wanted you to have the opportunity to learn from one of the top researchers in the world about simple things that you can do based on the evidence to live longer to be healthier and to have a better life because that's exactly what you and I are going to talk about today with the extraordinary Dr. Eric Toppel. Dr. Toppel is a pioneering physician scientist. He's a cardiologist who practiced for almost four decades and is one of the most renowned researchers in the world. He is the founder and director of the worldrenowned scripts research translational institute where he currently serves as the executive vice president and professor of molecular medicine. Previously, Dr. Toppel was the chairman of cardiovascular medicine at Cleveland Clinic, one of the top hospitals in the world, and it was ranked number one in heart care for over a decade during Dr. Toppel's tenure. And if you're thinking, what else could this guy possibly do? Well, he's also among the top 10 most cited researchers in medicine in the world. He's published over 1,370 peer-reviewed articles, which is an enormous number. And his research is so respected that has been cited by other researchers more than 365,000 times. I mean, just to put that into perspective, that's more than 99.99% of all scientists globally. He's also the author of several bestselling books, including his newest mega bestseller, Super Agers: An Evidence-Based Approach to Longevity, which has already been endorsed by, check this out, five Nobel laureates, and several of the world's top medical researchers. I am absolutely honored that he chose the Mel Robbins podcast and a conversation with you and me as the very first interview that he granted for his new book. Dr. Eric Toppel, thank you so much for getting on a plane, flying across the country, and being here on the Mel Robbins podcast. I'm absolutely thrilled to unpack Super Agers with you, your brand new book. Oh, thanks so much, Mel. It's great to be with you. Well, here's where I'd like to start because you are one of the most credentialed and cited experts. The book, of course, is an evidence-based approach to longevity. I would love to have you start by talking directly to the person who's listening and tell them what they might experience that will be different about their life or the life of somebody that they care about if they take everything to heart that you're about to teach us today. Well, there's a lot of things that we can do about our lifestyle that are more than just the diet, sleep, exercise stuff that people have been hearing about for decades. Uh, but also the three major diseases, cancer, cardiovascular, and neurodeenerative like dementia, Alzheimer's, those three diseases take more than 20 years to take hold. So, if we plan enough in advance, we can prevent those diseases from ever occurring. and particularly those people who are at high risk. So, it's an exciting opportunity that we're only realizing now that we have ways to prevent age related diseases. Well, one of the things that I loved about reading Super Agers is first of all, not only do I feel smarter now, but I also could feel the passion and your optimism that there are simple things that absolutely anybody can do starting today that will not only make you healthier, but more importantly, based on the science of aging, it will actually extend your life. Ultimately, if you do all the things that we're talking about that's been study after study, this extends healthy aging by seven to 10 years. Wow. People keep talking about longevity, right? What we want to do is improve our health span. That is our years of healthy living. And so, we can do that now. Uh if only we pay attention to the the the hard evidence that exists today. We don't need a magic pill or potion. We can just work with what we have right now. and that you know to have seven to 10 years more of healthy life and is that true for anyone Dr. top like if the person listening is, you know, kind of one of the one of the things that I always find when I'm listening to somebody who is as smart as you are and who has done the research and you're like, here are the simple things to do and you go, "Oh my god, I really screwed up and now it's too late." Like does the science of aging show that even if you're starting from a baseline where you have not taken care of yourself, you're not getting sleep, you haven't been moving your body, you've basically been living out of a box or a bag of chips for most of your life. Do these interventions also help you start to reclaim your health in terms of extending your life? It's never too late. So it's it's also never too early. I mean that if you start doing this when you're in your 20s and you do it the whole your whole life you get even more years but you could start this at age 70 80 and you still will benefit. So uh the whole point here is that all of us if we had the the real um extraordinary attention to these lifestyle factors which you know are are m much more diverse and extensive than we have previously uh accepted because they involve our environment, they involve being in nature, they involve many other things um that we if we really tuned into all this no matter what age all the data supports uh promotion of healthy aging. You're basically saying there is a huge difference between what somebody like me and the person listening is seeing out in the media about anti-aging and the anti-aging craze versus what you're here to teach us about the science of aging and simple changes that you can make that not only will help you live a longer and healthier life. that these same changes also help prevent the big three diseases of cancer, heart disease and neurodeenerative issues like dementia. Exactly. So these diseases um are related to particular organs in the body. And only now do we have these things called organ clocks where these proteins in our body can tell us that a particular organ in a particular person is aging faster than it should. So not only can we tell people are they are particularly high risk but which is the organ which is the condition that is offkilter that you know out of whack and that's when that prevention can really kick in to be targeted against that condition or organ that's affected. So we have from the tools of science of aging, we have new metrics now that we never had before that's going to help us to make a huge dent in preventing age related diseases in the future. You know one of the things that I was surprised by Dr. Toppo when I was reading your best-selling book Super Agers is that literally a third of this book is dedicated to diseases. It never even occurred to me that one way to live a longer healthier life is to actually avoid having a chronic disease, right? And there's so much hope and science that you have in this. So, how important is avoiding or like not getting one of these chronic diseases to the science of aging and longevity? Now that we realize there's just the big three, you know, cancer, cardiovascular, and neurodeenerative, which is mainly Alzheimer's and Parkinson's. The exciting future, which is beginning now, is that we can say you are at risk for this particular of the three and using the things that we know prevent that condition. That's what's so extraordinary right now is that we're at a cusp of being able to say uh this individualized or a lot of people call precision medicine. Y that we're going to be able to say, you know, the only thing that you're at risk for is this disease and we're going to get all over it. So you'll never really have to worry about getting it or if you do get it, it will be 10 or 15 years beyond when you would have had it otherwise. First of all, when I read the statistic that for Americans aged 60 and older, 95% of Americans 60 or older have some sort of chronic disease. That was jaw-dropping. But what I find encouraging is that all of this extensive research that you lay out in this book basically is the prescription, the lifestyle plus modifications that you're talking about when it comes to sleep and loneliness and exercise and lowering the the amount of processed foods that we have that all of these are actual interventions that help you fight these chronic diseases and may also help you never even get one. Is that am I am I stating that accurately? Again, you really have this right because what you're talking about is today people 65 and older are just riddled with chronic diseases. Yes. If those same people had started at age 50 with what we're talking about today, they would unlikely to have those chronic diseases or seriously they might have had it when they're 75 or 80 rather than when they're 60. So that's what the data supporting adopting lifestyle factors with these diseases. This is what I think most people don't understand. You've got 20 years to develop one of these diseases. Cancer doesn't just strike and all of a sudden you don't have a heart attack or stroke all of a sudden. You have 20 plus years while this is working in your body, developing, incubating if you will. And so if you started to do these things earlier in life and again as we reviewed earlier today uh it's never too late but these dei diseases could be avoided. The problem is most people who are 65 and have these chronic diseases have not followed these lifestyle plus factors not taken advantage of what we know today. And just to be like clear because I'm sure somebody will push back on that. There are all kinds of cancers and diseases that hit people when they're little or when they are in their 20s that are not like determined by lifestyle. What you're saying is based on the science of aging, that the big three diseases that kill people that you said over and over, heart disease, cancer, and uh the neurodeenerative things like dementia that people develop later in life, that by and large, the research shows that these lifestyle plus interventions not only make these help you treat the diseases, but if you were to implement what you're talking about based on the research, you might never get these diseases in the first place. There are people diseases that young people get. We're not talking about that. We're talking about the ones that are clearly there's certain types of cancer. Most of them in fact um and obviously the neurodeenerative and and cardiovascular these are the principal age related diseases. And that's what I think a lot of people don't understand is aging increases the risk. But we have ways to change that whole pace, that clock, uh, if you will. And that's what is exciting now. Well, you write about this on page 125, chapter 6. By 2050, the number of people dying from cancer, age related cancer, is projected to nearly double. But we have not yet incorporated over half a century of extraordinary breakthroughs in the understanding and use of certain biological mechanisms that can stop cancer from killing us. Now, what do you want the person listening? What's the most important thing that they could do in order to put to use these extraordinary breakthroughs in the science of aging and use biologic mechanism to stop cancer? Yeah, this is an area that's so ripe to reboot, which is how we uh address cancer. So, for example, the way we do cancer screening is unbelievable. It's by an age. So, if you're age 50, you get you're supposed to have, you know, this mammograms and or 40 even now or you have colonoscopies. And these screening procedures do very little to diagnose cancer. Most cancers are not diagnosed through screening. And by the way, for breast cancer, for women, 88 almost 89% will never have breast cancer in their lives. So why are we putting women through frequent mammograms and other related procedures, you know, on a on a on a basis where that they're never going to have the risk of breast cancer? Why don't we screen people, which we can, for their genetic risk so that we can say, you know what, you might have a mammogram every 10 years. you might never need one or you should have a frequent one and maybe not only with the mamogram but perhaps other imaging modalities. So we don't particularize the person's risk and we treat everybody like we're all the same. So that's one issue. The key is finding out who is at increased risk and then putting those people under surveillance. So we have this really great test now we never had before which is called multicancer early detection. And so from a blood test, we could say there's a microscopic cancer. The problem is we're using it completely wrong. Now, how should we be using it? Because as I was reading this book, you know what my husband did? He literally, as I was getting ready to He ordered a cancer screening test online. It's like $700. You probably know what it's called. The something test. Yeah. And the Grail test. Yes. The Grail test. because we've had a couple friends that have done it that are like, "Oh my gosh, I'm at risk for this and so should I not be doing it?" Well, the problem is it's being marketed uh for people age 50 and older. That's wrong because most people age 50 are not at risk for cancer and so they're going to get a test that e either a false positive or false negative. So it's it has little value unless you know you're at increased risk. Okay. And so another one that's being used totally uh improperly is a total body MRI scan. Oh, I I I want to sign up for one of those. You're saying I shouldn't? No. No. Why not? You don't want to do that? Because what happens with these that it's never been validated that it helps people to get accurate diagnosis of cancer. Again, it it might be okay if you're at significant increased risk. What I would say is if you had a genetic and protein and other family history and multiple uh dimensions of your data. Got it. So you have somebody that died early of panc pancreatic cancer. You have and it runs in your family. So you're like I'm at increased risk. Yeah. That is something that if you can afford to do it puts your mind at ease. Because I I do have friends that have done those which of course they find stage one pancreatic cancer and it saves her life and then you go I could have that too and then you're shelling out money to go get the screening and you're saying unless you have risk factors it's not worth it. The problem with the blood test uh that your husband ordered is that maybe four per or five per thousand will have a abnormal reading of a a microscopic cancer. And out of those, half of the of the five per thousand will have already advanced cancer. The problem with the MRI, if it's already seen on an MRI, then it's pretty advanced. So, usually the problem with the MRI is false positives. If you did the MRI after you had an abnormal blood test, yeah, that might be okay. Sure. But you don't go ahead and have a total body MRI just because you're you're going on a fishing expedition because you could wind up having all sorts of biopsies. Well, you know, I'm glad you said this because you hear about all these people going to concierge medicine and getting a workup done at Mayo and they go every year for all the Marco markers and they spend all this time and I start to think, is that what we're all supposed to do? And you know, a most people can't afford it. Are there tests that accurately show your risk for cancer? So, there's a thing called a polygenic risk score for each type of cancer. Breast, colon, prostate, lung. And these are very inexpensive. You know, you could get these for about $50 or so. Rare polygenic. What am I asking? Polygenic risk score. Yeah. They basically will tell you your risk for a particular cancer. Uh, and there's about 10 different companies that offer these now. And they can even be done through saliva. You don't even have to have a blood test. So, that's a a good way to know about your risk in your lifetime. But again, you don't want to just rely on one layer of data. You'd like to have other layers of data backing that up. And so, that's where you can learn even more. And as you mentioned, like if your family history, maybe you have a trend going on and some routine blood tests going in the wrong direction. This is where when we have AI analyze all your data and point to say, you know what, this is your risk in your life. This is the one for you to be on guard about. But right now, we have some rudimentary data to help us understand who's at risk and what for. And so, you know, if somebody offered me an MRI, total body for free, I wouldn't have it because it's a recipe for trouble. It's a recipe for finding things that you don't you wouldn't want to find because then you have to chase them down and you could have complications as I've had patients who then they had a liver biopsy and they bled many units and they had all sorts of things and it was benign. Of course, unfortunately we have celebrities and and doctors who are advocating these total body MRIs and there's nothing there's no proof. They say they're going to do a a trial, but they haven't done it, and we're not going to know for years. And until then, it's just anecdotes. Wow. Well, you just saved me 2500 bucks cuz I'm not going to go do it now. Cuz I could see how I would go on literally down the rabbit hole. Yes. And if though somebody is listening to you and they're like, "Okay, polygenic uh risk score. There's a test that I could do if I look back through my history and I have some things that are concerning to me. But if you are concerned, what test should you ask your doctor for or what would you how would you what would you ask your doctor about? Yeah, you know, it's interesting. Here we are in Boston and the Mass General Bighgam is supplying the polygenic risk scores to their patients. They're the first uh health system to do that. And so they get they're getting a readout for their risk of the various types of cancer and heart disease. uh and of course soon it'll also be you know Alzheimer's disease too that they will get that composite risk as part of their care you know not like they get charged extra all the health systems should be doing that and again they should be adding these other layers of data so that you know about yourself what to be on guard about and also to take action and this is a really critical point is that generally people might not be motivated to do all these positive things but when they find out they have this specific ific risk, the chances of them, you know, going after it is so much greater. We've learned that from studies as well. So, wait, no, hold on. So, yeah. So, basically, we're not motivated when we're healthy to stay healthy. Absolutely. And, you know, just to mention, there was a a big Finnish study where they took people and they gave them their polygenic risk for heart disease. And the people who got the high risk, they changed their lives. I mean, they did everything we're talking about today. So it wasn't that they were going to do it when they're healthy. Only when they got something to tangible evidence in in for them for those individuals that's when action was um taken. What are the top three things Dr. Toppel that most people are doing that are actually aging them faster? The problem is the things that they're not doing. Okay. And so what we're talking about is uh a poor diet with too much ultrarocessed foods for example. uh not nearly enough exercise and that's both aerobic as well as resistance type exercise and then of course getting enough sleep particularly deep sleep. Sleep is so much bigger than we had uh thought years ago and having um sleep health particularly promoting deep sleep is really important uh as we'll get to for brain health that brain clock. So, these are factors that not enough are are paying attention to that we can do a lot today and they're just the beginning of what I call this lifestyle plus because there's so many dimensions. It's not just the the three that we've been hearing about for so long. You know, I I'm bombarded with supplements. I'm bombarded with the ads about the miracle cure and slowing down aging and looking younger and all this stuff. You keep referring to this lifestyle plus What does plus mean? Yeah. So plus means uh first of all the the devil in the details about nutrition and u exercise and sleep and then beyond that things like social isolation. Okay. Um the uh environmental factors like air pollution, microlastics, uh forever chemicals, being out in nature, outdoors. So these factors are not just um you know what we're eating and uh our exercise those are paramount all these things have been associated with uh healthy aging and so the the woman in the book who's featured uh Mrs. LR here she is. She's 98 and she's the picture of health. Cognitively crisp. She's doing her, you know, jigsaw puzzles and oil paintings and, you know, she's amazing and she is uh vibrant with her social group. Her kids have died uh you know already and her her parents died in their 50s. So, it isn't the genes. And that's one of the things that I think a lot of people feel they're doomed because they have bad genes, right? But it isn't. It's so much of this is our lifestyle that can override or independent of any genes that we have um be associated with a healthy aging uh process. Well, and what I love about the picture that you're painting and as you write about in your book is that getting older and aging is inevitable, but actually getting frail and weak is not exactly and lifestyle plus, I like the plus because I think when you say the word lifestyle, most of us immediately think about what are we eating, what are we drinking, are we moving our bodies, but there are all these other factors that we're going to get into. So, Dr. Dr. TOEFL, I want to read to you from your book because you got some strong words about the anti-aging industry. And I'm reading from chapter 12 and it is uh page 277. And I just want to remind you as you're listening, this is a scientist and doctor whose work has been cited 365,000 times. And here are his thoughts and words about anti-aging. Have you visited the longevity lifespan circus lately? There are over 800 longevity clinics in the United States. Some charge up to $50,000 per week. Fitness centers now have intravenous anti-aging drips. There are carnival barker scientists making false claims and hawking supplements. These entrepreneurial companies and investments aren't likely to settle down anytime soon because we are seeing some real progress in understanding the science of the aging process. Unfortunately though, that has led to irrational exuberance in many dimensions. I'm hoping to set the record straight on what we know, what we don't know, and how likely it is that we'll be able to modulate the aging process to some extent one day. So, Dr. Toppel, those are strong words. What do you want to say about the anti-aging craze and all the marketing around it? There is just nothing uh that's been proven in people to uh promote the slowing or reversing of aging, whether they're pills or compounds or infusions, transfusion. None of that is proven to have an anti-aging effect in human beings. There's a lot of that that's been looked really good in mice or rats uh but not in people. So we'll start with rapamy. A lot of people are taking this drug. It suppresses our immune system that could be very risky to do that and unfortunately too many people are advocating that. There's nicotine NAD+ a supplement there are no data to show that it improves healthy aging in people. Uh there's this epigenetic uh reprogramming, very elegant. Uh it could cause cancer. It isn't in people yet, but it's it's certainly a risk. There's cenolytic drugs that take out our scinesscent cells. They're indiscriminate. They could take out bad cells out of our body. These drugs that do that. Uh there's plasma feresis taking young people's plasma and infusing it into old people's plasma to promote healthy aging and better cognition. There are clinics doing that. There's no data to support it. There's all kinds of infusions of kind of multivitamins and whatnot. There's just no data to support any of it. And it's really unfortunate because people that believe this stuff are the prey. Not only are they expensive, but there are posing significant risks. Uh it could be cancer, it could be um imunosuppression. These are not things you want to play around with. You actually warn about the dangers and this obsession of trying to stop or reverse aging. Could you explain Dr. Toppel the problem with stopping or reversing aging? Well, so one of the most elegant approaches uh which caught a lot of interest in the biomedical community was the idea of giving genes to an old animal in this case a mouse and now extended to other species. And these are known as Yamanaka factors because they have the ability to reprogram the organism, the cells of an organism. Okay. So, you're taking genes from a younger animal and then you're injecting them into the older animal with the presumption that the genes of the younger animal can then infiltrate and reprogram older genes, thereby making you younger. Close. These genes don't come from a a younger animal. They just are known to turn the clock backwards. Okay. And so the whole idea was, okay, we're going to inject these four into the animal and we're going to take an older animal and it's going to affect all their cells and they're going to get young. And it happened. Say, wow, this is amazing, right? Well, how do you tell if it looks young? Like when you say that to me, like I'm just like a normal person. So I'm like, okay, you're going to inject me with jeans. It's going to make me turn young. I feel like my wrinkles disappear. You know, I'm not sagging in places I wish I weren't sagging. My skin's a little firm. You know what I'm saying? Like is that what you mean by you look young? It's actually pretty deep. So it wasn't just that their gray hair went away, you know, but also the fact that at the organ level, they had, for example, their glucose regulation turned back to normal. Their many of their organs showed young um a young look rather than having all the things that you would associate with, you know, a very old organism. So it looks great. say, "Wow, couldn't we just all take these Yamanaka factors and we would just get young?" The problem is that when they were doing this, um, and this is now in multiple species, tumors would develop. And that's because when you turn back these these cells into younger cells, you also are potentiating the risk of cancer. And this Mel is the problem with many of these anti-aging bodywide interventions is they introduce new risk particularly cancer because there's a very close overlap between the hallmarks of aging and the hallmarks of uh cancer. What's the connection? Yeah. So in the case that we're just talking about the fancy term for it is partial epigenetic reprogramming. It sounds pretty pretty way too big for me to say. Yeah. Yeah. But the whole idea is that when you um make cells younger, a group of these cells to just take off uh develop a clone of cancer and then just spread. So the problem is is that when you're kind of trying to rerigg the body's uh aging process, you introduce new problems. Well, it makes sense. It's like if you put it in the other direction, if chemo was basically killing everything to the point where you're now just going to have to rebuild all your cells, if you reverse the clock, what you're saying is some of the science suggests that holy cow, you're actually expediting the ability of bad cells to multiply. Exactly. Right. So, Dr. Tobble, to you, what's the most exciting development in anti-aging technology and research that you think is going to revolutionize the way that we do age? Yeah. So I think where we're headed is that each of us will have without added costs or very nu nominal cost we will have all our data it's assembled uh it analyzed by what we call multimodal AI generative AI and it'll tell us this is your risk this is what you need to be um on the lookout for and you're going to do these things and also um we may be treating you like for example with an anti anti-inflammatory drug or you know we can talk at some of the specifics but we've had breakthroughs Mel like for example Alzheimer's there's a blood test now called PTA 217 it's as good as having a PET scan uh for telling us are we going to have a risk for Alzheimer's so if you get that test again if you have Alzheimer's in your family uh it's not good enough to know oh I'm at risk for Alzheimer's but I may only crop up when I'm 95 five. That's not really important. What we're going to have with multimodal AI is going to say you're at risk for Alzheimer's and if you don't do anything about it, at age 66 is when you're going to see, you know, mild cognitive impairment. So, you can pinpoint the the person and the time. Well, what's exciting about that too is if the research also proves that when somebody gets a diagnosis, they are very motivated to save their life. If this technology allows you to get the diagnosis 20 years early, now hopefully you have the same motivation to prevent that from happening by making the lifestyle plus or other interventions happen. Now you got it. I mean this is why we have the benefits of that long time uh to work with before the person gets the condition and we have the layers of data which we didn't have before or the ability to analyze that and then the surveillance tools whether it's scans or whether it's further blood tests clocks like you know what if I have an organ clock that says that my heart is accelerated aging and then I do these things and I prove oh wow I changed it it's now going in the other direction. Wow. And it reinforces that you're on the right track. So, this is where we're headed now. The science of aging has given us these metrics, whether it's this bodywide aging, epigenetic clock, organ aging. This is the most amazing thing. All these years of practicing medicine. We keep talking about prevention and we have nothing that we're preventing. We It's secondary prevention. Oh, you had a heart attack. Now, we're going to do put you on this and that. We are talking now about primary prevention. That's the new thing here, that we can prevent a disease that was going to occur before it happens. And that's the real deal prevention. I want to call something out because I found it absolutely fascinating. On page 19 through 20, you talk a lot about diet and the impact that diet has on the aging process. And you write that based on the research 22% of all deaths are linked to someone's diet. That means one in five. How can that be true? Dr. To know it's it's amazing. So the global burden of disease uh comes out of University of Washington. They've studied this globally. Okay. And what we've learned is that over nutrition, which is really bad, having, you know, that's a nice way to say what what's over nutrition, obese or significantly overweight, okay? Under nutrition or malnutrition, uh, and then poor nutrition, which is, as we talked about, the unprocessed foods, for example, those three categories collectively account for they they have shown in their work, one in five deaths. Yes, nutrition is is fundamental. And you write a lot about ultrarocessed foods. And you write in particular on page 21 that eating ultrarocessed food likely involves the disruption of the gut brain signals that unprocessed food conveys to the brain. and that this has a direct connection to a marketkedly heightened risk of cardiovascular and metabolic diseases. Can you talk a little bit about ultrarocessed food? So, you know, I think about ultrarocessed as anything that's in a box or a bag and that I can't read the ingredients on the back of the label, but you say that you believe that ultrarocessed foods and the big food industry, particularly here in the United States, at some point we're going to wake the hell up and realize that this is just like a modern-day cigarette in terms of how it's killing us. What do you mean by that, Dr. Toppel? Yeah, I'm glad you brought that out because this is um a serious matter. We have the big food industry that markets this and they basically because of the gut brain access, you eat these ultrarocessed foods and you want to eat more that we we've we've seen very careful studies that it promotes overeating. So that's bad enough in itself, but what it also does, it promotes inflammation in the body. And so when you have that, that's when you have your glucose dysregulation and you can move on to type two diabetes. It also then uh increases the risk of aththeroscerosis, heart disease. That's a fancy word for heart disease. You're basically accumulating cholesterol plaque in your arteries which you can get heart attacks or strokes. And it also of course has effects um at the level of the brain promoting inflammation, the last thing we want there and the risk of cancer. And so all the data on ultrarocessed foods, which it's not just that you can't read because of all these ingredients, it's just that when you do read them, you don't recognize them because they're all foreign things that would never be found in your kitchen. Everything about these suggests that they're they're inducing a lot of harm. they're promoting aging. And one of the stories in the book I reviewed is there's a fellow named uh scientist uh physician in the UK, Chris Vanelin, and he wrote a book called Ultrarocess People. And so he actually uh remember that Superersiz me thing that a guy did went to McDonald's every day for Oh, yeah. Yeah. Yeah. It was a documentary where he ate it for 40 days. Yeah. So this is what Chris did for 30 days and he he gained like 10 kilos but he did brain scans before and after 30 days and he did all these other inflammatory markers and he showed that everything went off the track. I mean just re in just 30 days of ultra high ultrarocessed foods. So all of us we can't eradicate ultrarocessed food but we can bring it down. It shouldn't be as it is now 60% or even 70% of our diet. I want to make sure that as you're listening to Dr. Toppel that you really took away a number of things that you said and so please stop me Dr. Dr. if I got this wrong because there was a lot of life saving and important information that you said and I want to just remind us we're talking about the science of aging and how to use that rich science to extend our lives and to live a healthier and more fulfilling life. And one of the things that we're talking about right now is ultrarocessed food. And we have had expert after expert medical expert scientists come on this show and talk about how ultrarocessed food is engineered to make you want more just like cigarettes are. And so it's super important to understand that if you're kind of sitting there listening to Dr. Toppel and 60 to 70% of your diet is fast food or it is coming out of a box or you're recognizing I didn't realize that this was a thing. It's not your fault because the food is engineered to disrupt the way that you crave food. That's number one. Number two, what was really interesting about what you just said is because there's so many chemicals and modified stuff in there that doesn't belong in your kitchen, it's also not naturally belonging in your body, so it's disrupting the way that your body and organs and everything is communicating to one another, which is also not your fault. But when it gets interrupted, you said that big word inflammation. And when inflammation and swelling and all that stuff starts to happen through no fault of your own because you're eating these ultrarocessed foods that are designed to be addictive, that is now speeding up the aging process. And that is impacting the quality of your life. And you're here to say that by just dialing it down, by paying attention, I call this the grandparent diet. Just eat what your grandparents ate. you know, if you like get the get get a one ingredient on the plate kind of situation, um that that has a meaningful impact on not only how you age, but also how you feel as you age. Is that correct, Dr. Tobin? No question. I couldn't agree with you more. So, you also have a section in your book where you list food groups and break down what the most up-to-date science says about their effects on lifespan. And I'd love to go through these rapid fire and understand what does the science say about each one of these types of things, these foods or I don't I don't even know if you would call it a food but these things that we eat. First one is sugar. Dr. Toppel, how does sugar impact the our lifespan? We want to cut down on refined sugar, particularly things like sugar uh sweetened beverages. They also promote inflammation. If you see high fructose, you know, run away. We just don't want this. We don't want to be taking this stuff in. Okay. What about salt? Yeah, salt is something that, you know, we have a very easy solution, which is a salt substitute, which is using potassium instead of sodium chloride. Okay. So, we should not be, you know, adding salt ideally to what we're eating. Wait, why? I love salt. Why are you telling me I can't put salt on my food? Why do I not want salt on my food? If if you're at risk for high blood pressure, which most of us are as we get older, um, that's not going to help you. If you use potassium chloride, it'll taste the same. I don't know what potassium chloride where do you do? Do you buy this at the grocery store? What? Yeah. No, potassium chloride, the salt substitute, and that's all. There's nothing else in it. Okay. is perfectly healthy and avoids the problem of the sodium intake and it's a lot healthier for you. Well, I'm going to try it. But I also just kind of had this epiphany which is this is particularly problematic if you have 60% of your diet being ultrarocessed. If you're somebody that is eating from the farmers market and eating what your grandparents did and you're occasionally putting salt on your food, that's not what you're actually concerned about. you're concerned about all the salt that is in fast food, it's in ultrarocessed food, and then adding more salt makes it worse. You're spot on with that summary. Okay. And so again, you've pointed out that in the ultrarocessed food category, salt is often a common culprit uh that is part of that reward circuit. You know, it's part of Oh, have more a lot of fat and salt and chemicals and emulsifiers. Yeah. You know, I didn't ask you about uh the sugar substitutes like you know all of the equals and the thing I don't know all the name brands but you know all the ones that people use to not use just grain sugar. What about those? We don't have a free pass on those unfortunately as I as I reviewed. You know there's uncertainties about them. Okay. So, if you can avoid the sugar substitutes, that's probably better. But unfortunately, they're not as healthy as we had been led to believe. What about caffeine when it comes to what the science says about how it impacts your lifespan? Well, here's some good news for coffee lovers. Please, Dr. Chopel, this this is the one that is the rare exception where, you know, we we love it and it actually is healthy. Really, I mean, this is actually kind of shocking. So, you know, I reviewed all the studies and there are a lot of them. And what is striking about this, it shouldn't be that, you know, you should change your life to drink more coffee, but you shouldn't at all worry if you're having two, three, even up to four cups of coffee a day. Dr. Toppel, what? Yeah, it's actually pretty remarkable. It's associated with, you know, significantly less of chronic uh diseases, less inflammation. uh everything about it points to something positive. You know, on page 42 of your best-selling book, Super Agers, you write, "Despite their popularity and heavy marketing, there's little to no hard evidence for the benefit of taking any vitamins or supplements, especially in those who are following a healthy diet." Dr. Toppel, what does the science say about supplements? Yeah, this couldn't be more clear when you really review take a hard look at every study that is cited and they're marginal about this supplement or that or this vitamin. There's just nothing there. Um the these are small studies with lack of meaningful end points. So again, it's really important to look at this hard evidence and it's void. There's just nothing to support these. And unfortunately, so many people are spending so much money and taking so many different supplements and there's no proof. And as I I reviewed, there's some that have potential adverse effects uh unknowingly. So, you just want to avoid these. And you know, I've had many patients, they come in with this long list of supplements. In fact, some of them are afraid to to show the list of things they're taking. I said, "Well, you know, really these are the only thing they're enriching is your urine, you know." and they say, "Well, I really feel like they're making me feel better." Y I can't argue with that. You know, if they're feel like they're I Okay, but they should know. I try to inform them that there's just nothing to support why they're feeling better. It's like the placebo, you know, the pill that there's nothing in it. It's inert. If they feel like they're helping them, okay, but just so you know, the science doesn't support it. You know, you mentioned earlier when we were starting to talk about lifestyle plus and the impact of diet on the aging process and living a long life, you talked about protein. Yeah. What do you want to say Dr. Toppel to us about the importance of protein and the science of aging? So as we get older we lose muscle mass and the the recommendations uh from the um government the US and abroad are8 uh grams per kilogram. Now for that what does that mean? Yeah. So how much protein you should have in your diet and so let's say for a 70 kilogram person uh you know we multiply that by 2.2 two to get to pounds. So 150 pounds going about 150 pounds. So 150 pounds, what am I eating? You should be taking 70 grams of protein. And now the point is if you start to look at how much protein, especially as you get older, you'll say, "hm, I'm not getting 70." And by the way, as you get older, maybe you should take one per kilogram or 1.2 grams per kilogram. So as you get older, you need more protein. You need more protein. Why? because you have to counter that propensity for muscle mass loss. You don't want to waste just because of your diet. So, you're talking about for the average person, you know, 70, 80, 90 uh grams of protein, not 150, 160. If you're listening to Dr. Toppel, you know, you can see him on YouTube, but I really believe you. and not just because of all of the uh papers that you've written and the fact that you are one of the top 10 most cited scientists and researchers in the world right now, but also because you look like Harrison Ford's younger brother. You're 70 years old. You look like you're probably late 50s. Like I kid you not. Have you Has anyone ever told you that? That's so funny. Yes. This Harrison Ford thing keeps coming up. It's so funny. Yeah. Wild. Yeah. Well, he looks a lot like you. I should we should say Harrison Ford looks like Dr. Toppel. So clearly the things he's recommending not only work because of the science, but he literally you literally look like you could go run an ultramarathon right now and star in a movie. So you talk a little bit about exercise because the research that you present in this book, it's honestly astonishing. It's astonishing. You say, Dr. Toppel that the single most effective medical intervention that we know of that's even more effective than an anti-dopressant for treating depression. You write about this on page 263 in your bestselling book Super Agers. The findings are further strengthened by a metaanalysis of 41 randomized controlled trials of exercise for a major depressive disorder that marketkedly reduce symptoms of depression. Can you talk to us about exercise and the benefits when it comes to the science of aging and longevity? Yeah, this is actually amazing and it's so much more profound than we had generally accepted. We've been hearing about it for years, but now talking about those clocks of aging and what we've learned from the science of aging, there's a thing called an epigenetic clock, which is these methyl groups on our DNA, the side chains, and they can predict your biological age. So, not your chronological age, okay? But instead of, let's say you're 70 and your your epigenetic age is 60, like, wow, you hit the jackpot. Turns out that exercise is the only thing we know that lowers our biological age. Okay? So it you the gap between your real age and your biological age is widened. Now it's not just aerobic exercise. So as a cardiologist I've been saying you got to you know get on um you know walks or you know treadmill, bicycle, elliptical, whatever uh 30 minutes a day, five days a week. I've been pushing that and then I didn't realize the data that's so striking regarding resistance training. Okay, so you need that just as much a couple of few times a week and that data is now become very solid and it isn't just about getting stronger. It's having better balance. It's essential. There's nothing that we can talk about that exceeds exercise for decreasing our aging process, our bodywide aging process. And again, we wouldn't have known about this if there hadn't been all the science of aging. So, let's just say, Dr. Tobble, that I'm sitting in your office and I've brought along my husband and he has not been taking good care of himself and I I have a feeling that you are often finding yourself being both a marriage therapist and a medical doctor with your patients. And I also have a feeling that there are a large number of people around the world who are going to not only be excited about what you're sharing for themselves, but they're going to share this with somebody that they care about. And so, what would you prescribe as one of the most respected and cited researchers and medical doctors in the world in in the science of aging? What is your prescription for the minimum the minimum amount that we should be doing every week? What would you say? As long as you are getting at least 30 minutes of constant motion, getting your heart rate up, you know, get taking your body out on the highway, if you will. Yep. At least 30 minutes five times a week, ideally every day if you can do that. But if you're getting five days a week, typically when I talk to my patients, I'll say, "All right, when are we going to do this? What time of day works for you?" You know, you're not a morning person. You're not going to also um how are we going to do this? Are you going to go to the gym? Do you have some equipment at home or you know can you go outside and walk or whatever to fit that in figure that out and it not just the aerobic side but then you know things like bands to increase resistance they're very inexpensive and they can be so much uh of a a plus for promoting uh muscle strength and things like you know standing on one leg for a minute alternating your course on each foot. I mean these are free you know but work on uh strength, work on balance, uh posture and of course this aerobic exercise is is also critical. So get that as part of your life and you'll notice quickly as you do this for weeks that wow I am more fit than I've been in a long time. I have better posture. I have um you know better balance. My golf swing is better. Everything everything. And so we just can't do enough of this. And of course the byproduct of this is we get that uh lesser biologic age which is going to be helpful across the board for the major age related diseases. So you heard it from Dr. Toppel if somebody's been nagging you and they also sent you this episode. First of all, thank you for listening this far in and exercise and literally 30 minutes five times a day just a simple walk is what Dr. top saying can start to lower the biological marker of your age because exercise is the most powerful intervention that you have. Seriously. That's right. That's incredible. And it decreases inflammation. That's another another bonus factor. Oh yeah. And talk to us about that study related to depression and the impact that exercise had on people struggling with depression. Yeah. This was astounding. this report uh kind of rocked me because you know the number of people are taking anti-depressant drugs these SSRIs it's it's huge and so they compared that in a large cohort with all these different activities from dancing yoga uh rowing walking anything and exercise just was so much better of improving um mental health than were the medications who would have guessed that because all these years we've been relying on the so many people take them. Uh that's why we had this Prozac nation and everything else. So this was a a real awakening and I think the study is is quite impressive. It should reset our need for at least in some people for SSRIs if they're not exercising enough and substituting exercise or if they haven't been put on one of these drugs. Try the route of exercise. You'll never be disappointed. And I I think that's really what we're not doing enough of. If there's one thing we should be paying more attention to, this is it. You know, you say to live longer, we do need to address our mental health. Why does your mental health affect the process of aging which impacts your lifespan? Yeah. So, this is something that again a lot of physicians don't buy into this, but the data is really strong. the relationship of stress and bad health outcomes like cancer, like heart disease, heart attacks and even the neurodeenerative diseases. So what we want to do is have adaptive stress. Like for example, if stress makes you exercise more, that's really good, right? But also, you know, we we've learned things that again, I wasn't aware of all the data. Being out in nature is remarkable. Music, things that we can do more of that are good for our mental health. Uh and so um there's this interaction between our physical and mental health which is deep much more intertwined than we have accepted. And so if we're going to have a positive outlook, it's taking advantage of these things that we've learned from. And so you know being outdoors, you can't spend enough time doing that. And it is really good for mental health. These are things that add in that whole category of uh lifestyle factors, but social isolation is critical. So people that are lonely and hermits that just are living in a cave, that's having an ill effect on mental health and physical health. So it's really important that you know get together with friends, make friends, find ways to have social interactions because they're rich and they help reduce the toll of a burden of anxiety and depression. Well, you write about this in super aers, and I I'm actually looking at a graph on page 264 that is adapted from who Americans spend their time with by age. And you can see that as people get older, the amount of time that they spend alone without a partner, without family, without kids, without their co-workers spikes pretty dramatically. And I would also think we probably don't have the data, but coming out of the pandemic, I would think that you're going to see a lot of that even for younger age groups because of hybrid work. And I'd love to have you connect the dots between the aging process and longevity and time spent alone and why that is a massive stressor that ages the body. Yes. Well, I'm glad you pointed to that graph because it's it's also very striking. The more rich uh interactions we have with other people that the essentiality of being human, the more uh we see evidence that it is associated with healthy aging, health outcomes that are favorable. And unfortunately, we're going in the wrong direction. But there's something magical about the human human bond. And in this world of AI, which you know, in some of the aspects of the book, you know, we were going to rely on AI to do analytics for us to know if we're at higher risk. But here this is something a AI will never replace which is the human bond whether it's patient and doctor but more importantly in your own life seeking out and and fostering social interaction because they inevitably uh will be associated with better health outcomes and so rather than turning inward we need to turn outward. I I would love to also just for the person listening really connect the dots between mental lonely stress because I think when you hear the word mental health you tend to just think about your thoughts but there's something much deeper going on because you mentioned stress and medically speaking when you're stressed out or burnt out or on edge or just kind of feeling like when is the next shoe going to drop and I think there's recent research that shows that one of the biggest groups of people that are impacted by this right now are caregivers We think about first responders, but we don't think about caregivers and parents. And that being in a state of stress actually means that your body is running on overdrive and you're in fight or flight often times and does that state you faster if you're living in a state of stress? Yeah, this is a really big issue that you're bringing up because the stress when it's chronic and when it's accentuated, you see more body inflammation. And so what you're getting is your immune system is losing some of its integrity. It's aging faster. And if there's one system that is kind of governing our whole aging, it's our immune system, which of course, as you know, that interacts with inflammation. When your immune system gets off track, these cells start to release these proteins that rev up inflammation. So stress and our immune system and inflammation is a very tight interdependence. And so what we want to do is have adaptive responses to stress so we don't have this chronic inflammation. If we once you get chronic inflammation, you get accelerated aging. And so here again, the science of aging is teaching us about these processes. It's not teaching us about this magical pill, but it's teaching us about how do we connect the dots between what's going on in our stress in our daily lives and what's going on in the in in our body. And you know what I love is if we go back to the very beginning where you talked about the three things that age us the fastest, these are also the same three things that help us actually slow down the aging. And that would be getting better sleep, moving your body even though you got a lot of other things going on and changes to your diet so you bring down the amount of ultrarocessed food. Is there anything else that you prescribe to your patients that are going through a period of their life where maybe they're caring for aging parents or something crazy stressful is going on at work or they've had a big life change, spouse has died, divorce, some job change where they're in that state of stress. Is there something that you recommend that people do, Dr. Dr. Chobel, it still comes down to a person's lifestyle and typically a caregiver is so much um absorbed by caring that they don't care for themselves. And so being able to say, look, we got to map this out. How are we going to get you to view your body as a temple that you otherwise you're going to need a caregiver. Right. Right. So you know and this is where you have to get into the details with the person like what time of day are you not providing care for this uh elder person or you have to come up with a practical uh pathway. Well, I think the other thing that you're providing to us today is the science and the evidence and the pragmatism and the passion around this because when I understand the deeper reason why and that research bears this out, I feel more encouraged to try it. Dr. Toppel, if the person listening to this conversation takes just one action today from absolutely everything that you shared, what would be the one thing that you would want them to do? If you really do a a dedication to lifestyle um plus factors, you're going to get years more of healthy aging. And you can ignore all the false anti-aging supplements and uh drugs and interventions that exist today because they're they have no data. They're factfree, if you will. So, this is the thing is that it's right here now. We've had we have more solid evidence for the lifestyle story than we've ever had before. And it and as we have been reviewing, it's not just the big three of diet, uh, exercise, and sleep. It's a lot of details within each of them. And then several other layers of the lifestyle story that we need to be paying attention to. What are your parting words, Dr. Toppel? We are in a a time of medicine that I've been dreaming about as a practicing cardiologist now heading into a fourth decade. I've been thinking, you know, why am I seeing these people, you know, after they've had a heart attack or after they've already had a stent. Um, and to think that we are going to be able to prevent this better than we've ever had before and along with that the other two major diseases. So for me, the idea that we have capabilities we've never had before is enthralling. Um, and I think that whereas a lot of things are sobering these days uh in the world, this if you if you pay attention to what's going on in life science and medicine, it's never been more exciting as it is right now. Well, you want to know what else is enthralling? You Oh, thank you. and your incredible best-selling new book, Super Agers. Dr. Toppel, thank you. Thank you. Thank you for all the work that you do. Thank you for writing this book. Thank you for showing up, flying across the country, spending time today, not only teaching, but really infusing the message with so much passion. I just cannot tell you how much I appreciate you. Oh, you're really kind. So much appreciated, Mel. Thank you. And I also want to thank you. Thank you for taking the time to listen to something that will not only make your life better, it'll actually help you and the people that you love live longer. I can't recommend Super Agers more. And I also want to be sure to tell you in case no one else does. I love you and I believe in you and I believe in your ability to create a better life and Dr. Toppel just gave you a road map that based on science and evidence will do it. All righty. I'll see you in a few days. I'll be waiting in the very next episode to welcome you in the moment you hit play. I'll see you there. And for you sitting here watching with me on YouTube, I just want to say please share this with somebody. Don't just sit and watch. 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