Full Transcript Introduction to Longevity and Measurement 0:00 Welcome everyone again to this new episode, part of the Longevity Summit. 0:04 I hope you're as excited as I am. 0:06 Longevity is the new big thing. 0:09 Longevity is what a health care system should aim for us living healthy and long. 0:14 Not just longevity, but the concept of health spending healthy and long. 0:18 And how do we know if we're healthy or not? 0:20 This is why this specific episode I have the pleasure to welcome Doctor 0:25 D’Agostino Who really specializes in measurement 0:29 as a way to manage your health and longevity. 0:31 Doctor Dom, I'm going to call you. 0:33 Dom is a professor at GSF College of Medicine and super 0:38 well known in the field of measurement and how to use that to improve actions 0:43 and in supporting people with onboarding on the longevity lifestyle. 0:49 Welcome, doctor. 0:51 D’Agostino .Great to be here. 0:52 Great. 0:54 Yeah, I want to hit it right away. 0:55 I know you're working on testing and longevity. 0:58 What is the most interesting thing at the moment that you're working on? 1:02 Yeah. 1:03 Well, I mean, over the years we've been moving the preclinical 1:06 animal model research to like, human clinical trials. 1:09 So we have an R 21 grant, you know, doing a metabolic intervention 1:14 for cancer patients and metabolic interventions that improve metabolic 1:18 profiles like fasting, mimicking diets and, you know, restricted ketogenic diets. 1:22 They can augment the standard of care for cancer. 1:25 So we're working on that. 1:27 And also working on an R one grant that is mostly proposing to look at, 1:33 you know, it's evaluating and testing different products that are on the market, 1:37 different supplements, metabolic supplements, and 1:40 for rigor and reproducibility in the work that has already been done. So. 1:44 So we have that in the pipeline. 1:46 And I'm working with Choose Health on a white paper. 1:49 And that white paper really comes from testing a wide variety of biomarkers 1:54 repeatedly within with a very innovative at home testing kit. 1:58 The white paper has the data and it has over 200 000 tests 2:02 and across the full population. 2:05 So we kind of discovered that the values drift 2:08 toward optimal ranges as people test more often. 2:11 So, you know, a single, you know, test can only tell you so much. 2:15 But among the people whose tests were like out of range in the beginning, 2:20 when they started testing more often that the benefits were 4 to 5 2:24 times, you know, more beneficial shifts in biomarkers. 2:27 And that's an important, 2:29 you know, discovery that we're excited to get out there as we're working on it. 2:32 And so the measurement itself appears to be part of the intervention. 2:37 So when we talked about that before jumping on, and that's an important 2:41 sort of take home message here, is that the measurement really important itself. 2:45 You know, it's a concept that applies everywhere, right. 2:48 I remember from Peter Ducker, for those who don't know, Peter is like 2:51 the grandfather of the, you know, business education, especially in grad school. 2:56 And one of his famous saying is if you don't measure, he cannot manage. 3:00 And it makes sense. 3:02 But the concept you're advancing is like it's not measuring once. 3:06 It's like the more you measure it seems, the more people kind of 3:10 get that repository reminder feedback and they're on board on a,
Research on Metabolic Interventions and Biomarker Tracking 3:14 you know, what, I'll get to do better or you know what, I'm doing great. 3:17 That's a positive feedback. 3:18 Let me continue doing what I've been doing. 3:21 You know, I'm interested in longevity and also in weight management. 3:24 Part of that, and I remember a couple of experts in weight management, 3:28 they always said the only proven long term 3:31 intervention to lose weight sustainably and in a healthy way 3:36 is just having a weight scale at home and measuring you weight every morning. 3:40 So that's kind of the extreme case. 3:42 We're not going to measure your blood markers every morning. 3:44 But just to show, I think the concept that you're 3:47 trying to advance to us today is it's not just a baseline. 3:51 And then wait 3:51 until whatever you're doing, or wait until a year and see what happens. 3:56 It seems there's a correlation and a positive feedback loop between 4:00 the more you measure and the better you actually achieve your goals. 4:04 Exactly. Yeah. 4:06 I mean, Drucker's quote, 4:07 what's gets measured, gets managed, and more so longitudinally like over time. 4:12 So it becomes really important to do that and scale. 4:16 The scale of analogy is really good. 4:18 And that's a great example of it. 4:19 You know, kind of the low tech way for people out there. 4:22 So what do we measure? 4:23 I bet everyone listening here is like, okay, I'm interested in 4:26 longevity is why I'm in this, you know, summit. 4:29 But what would I measure for longevity? 4:31 What do you recommend today to consumers, to patients, to longevity aficionados? 4:36 What should they measure and track as they get older? 4:41 Yeah, that's a good question. 4:42 And I think it could be personalized for each individual. 4:45 But we kind of think about it in like four domains. 4:48 So like glucose regulation is one, not just fasting, 4:52 you know, morning glucose but glucose management in the body. 4:56 So that would be insulin. 4:57 So you're fasting insulin is really important 4:59 because insulin can rise over time without a rise in glucose. 5:04 Right. 5:04 So we could predict type two diabetes years before it happens by just looking 5:08 looking at an insulin levels hemoglobin A1. 5:11 See the insulin. 5:12 So that would be the glucose regulation would be the first one. 5:15 And then lipoproteins really important especially depending upon your genetics 5:21 and also other biomarkers that we can talk about. 5:24 But something like ApoE B is really important to know it. 5:27 And we have drugs that can reduce it. 5:30 Lifestyle things can reduce it. 5:32 Triglycerides obviously really important. 5:35 So glucose regulation lipoprotein and then the liver to the liver. 5:39 You know we think about it as kind of like a detoxifying organ. 5:42 But the liver is really like the master metabolic regulator. 5:47 So like the blood in your bloodstream right now 5:50 is basically titrated and finely tuned by the liver. 5:54 And the liver does 5:55 a lot of the heavy lifting when it comes to sort of metabolic regulation. 6:00 And so it's really important to keep it healthy. 6:02 And there's biomarkers. 6:03 We have AST alt GGT not utilize as often as it should be. 6:08 It should be included. 6:10 So glucose lipoprotein liver and then inflammation. 6:14 Inflammation is really important to measure. 6:17 Something easy to measure is high sensitivity C reactive protein 6:22 is actually a stronger predictor 6:25 of cardiovascular disease events then LDL. 6:28 And we have interventions out there. 6:31 I mean, we're talking about, 6:32 you know, a fasting mimicking diets, probably the most powerful intervention 6:35 that I know of that can kind of suppress your, 6:39 you know, systemic inflammation better than anything. 6:41 So and then there's and that's the for ones. 6:44 But there's also like deficiencies like if you're deficient in vitamin D 6:47 or vitamin B and you know, drugs on the market 6:50 like GLP ones and things like that, because you're not eating as much food 6:54 you could be deficient in, you know, vitamin D, vitamin B12, things like that. 6:59 So, so they should be measured too. 7:01 But it's really glucose lipoprotein levels. 7:03 Liver and inflammation are areas that you want to track. 7:08 Fantastic. 7:08 And obviously we ought to be big believers as you are. 7:11 You know, I didn't know you were at an FMD fasting when we can buy that as well. 7:16 First time we meet and we talk for as a disclaimer. 7:19 So I appreciate that a lot. 7:20 And of course we love the FMD. 7:22 Again. 7:22 The first thing we we can die as a first healthy alternative. 7:25 But a lot of people are going from are doing the GLP right. 7:29 There are three acronyms the FMD and the LP. 7:32 Yeah. So the Zen pigs and they will go with etc.. 7:34 What what kind of testing you do for those as well for GLP ones yeah I do. 7:39 It's really important because GLP ones produce a very rapid weight loss. 7:45 They are highly efficacious drugs. 7:46 The you know liraglutide was actually worked on in the 1990s 7:50 by our course director, Doctor Barbara Hansen back in the 1990s. 7:54 So these drugs have been around for quite some time 7:56 originally for type two diabetes. 7:58 And they found out the weight loss effects. 7:59 But because of, you know, the weight loss could be rapid. 8:03 And then the context of rapid weight loss, you can have lean body mass loss. 8:08 So I do think in the context of using a GLP one, it's important to do
What to Measure for Longevity 8:13 like for example, a Dexa scan or you know the equivalent is the in body. 8:17 I like the Dexa because it does the bone, 8:19 you know, bone density, resting metabolic rate. 8:21 You want to make sure that you're losing weight in a way 8:25 that's not suppressing your resting metabolic rate, metabolic cart. 8:28 But from a blood marker perspective, you want to look at liver 8:32 enzymes are going to be important ApoE B, vitamin D and vitamin B12. 8:36 Because, you know, these drugs drop total nutrient intake. 8:41 And if you drop total intake. 8:43 You're inadvertently dropping the intake of potentially vital nutrients. 8:49 And these things we don't fully know, they could be impacting the absorption 8:52 utilization of some of the things, these markers that we could be tracking. 8:56 But yeah, off the top of my head, I think those things need to be kind of 9:00 monitored and measured. 9:01 And when you lose weight very rapidly, a lot of unexpected 9:06 things can show up in the blood work. 9:07 So and we've seen that. 9:09 So it's important to, you know, monitor just a comprehensive metabolic panel CBC. 9:15 But also some of those other biomarkers I mentioned you mentioned vitamin D, 9:19 which is, you know, very essential for longevity and healthy aging. 9:23 And and a lot of people, especially when they go, I mean, 9:27 when they see their doctor, they go on medication, they do some testing. 9:30 But a lot of people on supplements today, and they don't measure 9:33 why they take the daily, you know, multi supplements or a couple 9:37 other supplements they heard about or they got recommended to take, 9:41 but they don't measure. And this is very important. 9:43 You know supplements also send big signals to the body. 9:46 And we have to track and measure 9:48 I know you advise choose health right which is an at home testing. 9:52 But it's not about choose health and about panels that people can be doing, 9:56 whether they're, you know, taking their supplements, 10:00 whether they are uncertain medications, whether they want to onboard 10:03 the longevity lifestyle or even on GLP or on the fasting mimicking diet. 10:07 Like how this choose health approach this. 10:11 And I know they have a special technology for at home measurement called task. 10:15 So that I was familiar with and I supported, I think 12, 13 years ago. 10:20 It was a surprise to see you there and a positive one. 10:23 But can you explain a little bit about it? 10:25 Talk about choose health and explain like the offerings there? 10:28 Sure. 10:29 Yeah, I'm an advisor for them 10:31 from the perspective of analyzing data that they've been collecting. 10:35 And I think, you know, 10:36 they're one of the few companies that actually has, 10:38 you know, they're very interested in publishing the results 10:41 and digging into the results so they understand 10:44 and can even, you know, perhaps iterate kind of what they're doing. 10:47 But but the constraint, you know, that in practice is really 10:51 has never been sort of what to measure so much 10:54 as the friction involved in, in measuring and having the patient 10:58 actually go to and get their blood drawn from a phlebotomist so that the 11:03 the Tasso device and the ease of at home testing with an idealized panel. 11:08 And they have a lot of different panels, you know, a long panel for, you know, 11:12 if you're on hormone optimization, you know, a specialized panel for that. 11:17 And you can adjust and titrate or adjust the panels and personalize them. 11:21 And the importance is that, you know, the removing the friction 11:25 of having to go to a center to get blood draw that you can test, 11:29 you know, get the initial test on the baseline and retest. 11:32 It's that retesting that's actually really important because that, 11:37 you know, over time, those trends that you see when you do an intervention 11:42 or even if you're not doing an intervention of everything stable 11:45 and you get tested over time, you can start to see trends and then, 11:49 you know, choose an intervention from there. 11:51 But if we're talking about fasting, mimicking diet or a drug 11:55 therapy or supplement therapy, it's the ability to retest. 11:59 And that retesting is going to differ depending upon the intervention. 12:02 Something like looking at 12:03 triglyceride to HDL ratio that can move in like four weeks. 12:08 But if you're supplementing vitamin D, 12:10 you know that's going to take about 3 to 4 months to really show up, 12:14 you know, measurably and significantly on a blood test. 12:17 So so the measured outcome is going to be really important. 12:21 As you do more retesting, you want to look at those longitudinal trends, 12:26 you know under different and also use the same assay. 12:29 Sometimes people jump from lab to lab 12:31 and they're just trying to get a better price or whatever, 12:34 and the price is going to choose how they're very competitive. 12:36 But I'd also say that, you know, we put a lot of weight into 12:39 randomized controlled trials, and they're absolutely needed, 12:42 but a very well designed, well thought out and of one, 12:46 if you will, the object measuring their own biomarkers with enough 12:51 data is probably more informative for that person 12:54 than a randomized controlled trial. 12:56 So for that individual like over time. 12:59 So and the dried blood spot cars they use that and the Tasso device 13:03 and you know these it's validated. 13:05 The assay is validated across the the sea certified labs. 13:09 And it got the Cap accredited processing and also a physician review of the panels.
Monitoring GLP-1 Therapy and Nutrient Status 13:14 So these are all like incorporated and part of the Choose Health program. 13:18 So the ease of testing, the biomarkers you can choose from personalizing it 13:23 and the ease of retesting I think are all major. 13:26 And I think choose health. 13:28 There's not too quite a phlebotomist. 13:30 Why they send you a kid. Yeah. 13:32 And then this the device called it has a device. Right. 13:34 They can help you just you're taking the sample at home, and there's 13:38 no need for any, anyone to visit or any human interaction with that. 13:43 Right. Exactly. 13:44 Yeah. It's like, you know, next level testing. 13:46 And I think, 13:48 you know, they're early into this market and probably things will go that way. 13:52 And I just think it just makes it so much more appealing 13:56 for individuals to be able to test on their time frame and to have that ease, 14:00 and also just the ability to the level of testing 14:03 that's offered, and also the oversight and the validation that they have 14:07 on all their testing measurements are kind of unparalleled. 14:10 So you have a lot of advantage there. 14:12 And and also the data that the data itself and the data platform, the analytics 14:16 of what they can give you insight into what I wanted to ask you about. 14:19 So you're sending back the results plus the interpretation of the results. 14:23 Yeah, to some extent. 14:24 I mean, there's a team of physicians that look over it and then, you know, 14:27 using various processes, it can personalize it to the patient 14:31 and then they can follow up. 14:32 And ideally you want to, you know, continue 14:35 with the same testing protocol that you did at baseline 14:38 and then and adjust it depending upon what other intervention you're doing. 14:43 And that could be a pharma intervention, you know, 14:46 hormone, a supplement, a diet, exercise. 14:49 And these things are all kind of taken into account, 14:52 you know, when you're working with them and there's somebody need the prescription 14:55 to like a doctor prescription 14:57 intervention to, to access the testing or they just can order it online. 15:01 Yeah. 15:01 I think, 15:02 you know, it's part of the process that when you kind of register 15:05 and get online, that process with the doctor, 15:08 getting that prescription is sort of handled and expedited very quickly. 15:12 So that's another benefit of doing it. 15:14 So it's just as easy as, you know, signing up clicking on what you want. 15:18 And then you get the kit and then you measure and and it's that easy. 15:23 And so you 15:24 talked about that cycle of testing acting and then retesting. 15:29 And when should we retest. 15:30 Can you talk a little bit about, 15:32 you know, the different panels or when a person should reorder their test again. 15:36 Yeah, that's a really important consideration. 15:38 I think it could vary 15:39 depending upon the test that you're doing and the intervention that you're doing. 15:43 If you are sort of the view of the cheap, 15:45 your health goals, and you just want to maintain, 15:47 you know, just like for longevity and you feel like you're kind of 15:50 optimized, you know, maybe as little as two times 15:54 a year, maybe appropriate, you know, if you're not doing an intervention. 15:57 But if you are, you know, doing any kind of change 16:02 and that could be a dietary change, you know, a lifestyle change, 16:05 a supplement, a drug, it really would pay to do at least every three months. 16:11 So say four times per year. 16:13 3 to 4 times a year is going to be really important to capture 16:17 sort of the granularity in the data longitudinally 16:21 over time, because things could change if you space it out too far. 16:24 But ideally in an ideal world, and it makes it easy with something like 16:28 choose health, to do it like four times a year would be a good starting point. 16:32 And that's what I do personally. 16:33 Four times a year I think is good. Okay, great. 16:36 This is what I wanted to channel to is personally, what do you test on you now 16:41 and what do you drive for your own health and longevity? 16:45 Yeah, I think, you know, every person is different 16:47 and I'm in my 50s now, so I and when I got maybe a 45 or towards the 50 range, 16:53 I started testing from once a year, once or twice a year to 3 or 4 times a year. 16:59 Now is pretty much I've settled in on that. 17:01 And I do, you know, your standard comprehensive metabolic panel, 17:05 CDC, CMP and I also think it's really important to do
Choose Health, At-Home Testing, and Retesting 17:11 the cardiometabolic biomarkers that are not part of standard testing. 17:14 So that would be fasting insulin. 17:16 That would be like triglycerides. 17:18 That would be HSC hemoglobin A1. 17:21 See these I also wear a continuous glucose monitor and a continuous ketone monitor. 17:27 And it also tests various, you know, multi analyte sensing technologies on that. 17:32 So things that are kind of 17:33 in the pipeline that come out later like real time metabolomics. 17:36 So you know we do a lot of these tests and and having that data 17:40 is also interesting to kind of compare to the blood work data. 17:44 But I think, you know, 17:45 as someone gets older they want to track their hormone profile, 17:49 whether that be testosterone, thyroid, estrogen hormone panel. 17:52 And, you know, as you get older to males, prostate specific antigen, 17:57 you know, are things that you want to kind of measure over time. 18:00 But it's not you know, I think the message here is that testing is important, 18:04 you know, comprehensive metabolic panel, CBC, but also to add the cardiometabolic 18:08 biomarkers that I mentioned that correlate with longevity. 18:12 So we have very good peer reviewed data 18:16 over time that unambiguously show that these cardiometabolic 18:21 biomarkers will predict, you know, your longevity. 18:24 And on top of that, I mean, 18:25 obviously things like blood pressure and to get a Dexa scan 18:28 and to know your body composition every year I do a Dexa and I try to 18:33 I try to not lose lean body mass, and I try to beat 18:36 my Dexa from the previous year. 18:37 It's like a little kind of game that I play. 18:39 So I plan out a week of, you know, a year in advance 18:43 for that next Dexa scan and try to 18:45 and I think that's important, especially as we age, we lose a lot of muscle 18:48 and bone density, and we need to do things like that. 18:52 Going to ask a theoretical but but fun question 18:55 if you can measure only three markers that you want to know about yourself, 18:59 what will be the three that that you will pick to 19:02 measure only three three markers? 19:05 Yeah, only be personalized to me. 19:08 So I would do SCRP. 19:12 I knew that would be the number one. Yeah, yeah. 19:15 And a lot of people don't even like consider that one HSC or P 19:18 would be one of probably two people. 19:21 Why HSC or an HS for those 19:24 listening to us is the high sensitive CR and inflammatory marker. 19:28 And just to help people understand how important that is, right. 19:31 Inflammation in the body is like the the heat of the engine of the car. 19:36 Right. The more the higher. 19:39 And even there's this you don't need to have a disease 19:42 even, you know, there's the concept of inflammation, right. 19:45 And it's a process. 19:46 Part of it is a response to health conditions. 19:49 But part of it is really how the body, how fast your aging. 19:53 And, and it's important to control it because you know, it, 19:57 it goes a little bit linear. 19:58 But then there's a point in time when you have enough senescent cells 20:01 and you have your more you have a lot of tired, 20:05 tired immunity, but a lot of pro-inflammatory old cells. 20:09 This is when actually it starts, you know, aging the body even a faster, 20:13 faster pace. 20:14 It's also behind a lot of the acute, life threatening events. 20:18 Right. 20:18 The heart attacks happen when you're you have young players 20:22 in the coronary and there's high inflammatory setting. 20:25 And this is how the plaque, you know, breaks and you get a, 20:28 you know, a cloth and you get a heart attack. 20:30 So it's a such an important marker. 20:33 And like it, it's like on the dashboard of a car, you know, 20:37 you have the speed and you have always that heat that he begins. 20:40 They somehow they define that you can learn 60 things 20:43 about your car, but that important temperature of the car was so important. 20:48 And this is how Jesse is presented. 20:50 It's very important to first measure it to understand how fast or what's 20:56 the heat of our engine in number two, how to take action. 21:01 You know, measure, act and then retest. 21:04 And such an important, I think, metric for again, acute events 21:08 for short term, you know, issues but also long term aging. 21:13 Absolutely I agree with everything. 21:14 And I think, you know, even maybe the root word of inflammation is something 21:18 like fire, right. 21:19 Like fire. And so it's yeah. 21:21 And that's I think it's a good barometer, litmus test to basically tell you 21:25 like what's happening in the body. 21:27 You know, when I see chronically elevated crp 21:30 like in the ten, you know, 12 range of people, I get concerned. 21:34 And I do see that 21:35 in patients that, for example, have cancer like different disease states. 21:39 That's and I'll tell you just from working with Mavic Cancer Center, 21:43 that's why they're interested in the fasting mimicking diet. 21:45 They basically unambiguously they say the lower the HSC aap 21:49 that they can bring that down the patient, the much more responsive 21:52 they'll be to immune based therapies like checkpoint inhibitors or Car-T 21:56 therapies like, you know, if they're HSC or is really elevated, they tend to be
Personal Testing Routine and Key Biomarkers 22:01 kind of refractory to or not very the therapies don't work very well. 22:05 So so I think, you know, 22:07 giving that that can further augment, you know, therapies in that way. 22:11 But here I think I used to kind of not think much of it. 22:15 It's a, you know, systemic inflammation could be triggered 22:19 by this or that, and it's very nonspecific. 22:21 But the more I, the more you dig into the data. 22:24 You realize, even for things like mental health, like anxiety, depression, 22:29 you know, gut permeability, that would be 22:33 you improve your gut that HSC, AAP is going to come down. 22:36 And if you have systemic inflammation that leads to neuroinflammation, 22:39 and that's going to affect your mood and your mental state, 22:42 and also probably amyloid and platinum development over time. 22:46 So we and now I think about it in that way. 22:49 Yeah. Yours ago I did not. 22:50 But now I do. It's a systemic indication right. 22:53 And we can spend hours on it. 22:54 But something here very important 22:56 because you know I, I come from medicine as well in MDP, PhD. 23:00 And what we learned is, you know, medicine has to tell you are you healthy or sick. 23:04 And it's always a cut off, right? 23:06 If your CRP is below this, you're fine. 23:09 If it's above and it's just a one one. 23:12 If your blood fasting blood sugar is above 140, you know you have a disease. 23:16 If it's 139, you're not sick yet. But watch out. 23:19 You know I'll see you in six months, right? 23:20 That's not the practice of new medicine and longevity. 23:24 So looking. 23:25 I'm saying this because an help level, you have to take it in a gradual first. 23:30 How is it evolving. 23:31 And this is the importance of retesting. 23:33 And then every level of P means something. 23:37 There's no there's no cutoff 23:39 where you're at risk or you're high and and then you're lower. 23:43 And we need it always in relevance to the age of the person. 23:47 And the other kind of, you know, symptoms that they're presenting with. 23:50 But very important. So that's number one. 23:52 What are the two other things you would measure yourself 23:54 if you want to just pick three for your health and longevity? 23:57 Yeah I think insulin your fast your insulin level is really 24:01 an important predictor. 24:02 So insulin 24:03 you know 24:04 as we age and we have chronic inflammation 24:06 that's going to make you more insulin resistant. 24:07 But it gives you a window into your metabolic physiology your fasting insulin. 24:13 And and when that starts to creep up over time, 24:15 you know, that's something to get concerned about. 24:17 And insulin resistance is a really, really big problem right now. 24:21 Yeah. 24:21 Another super important 24:23 you know, I'm going to simplify what you said a little bit to the audience. 24:26 You know, today in medicine we measure blood sugar 24:29 and we tell you if you're diabetic or pre-diabetic. 24:31 But the process to get there, this is where prevention 24:34 and longevity medicine comes in is you kind of, 24:37 you know, build some fat and you increase insulin resistance gradually. 24:41 And then blood sugar starts increasing. 24:43 And then but insulin resistance goes way beyond that. 24:46 It's linked to aging. 24:48 It's linked to cardiovascular disease. 24:49 It's linked to ALS, Hymers. 24:51 So again it's a process of accelerated aging 24:55 insulin resistance IGF spikes HSC. 24:58 These are three symptoms that hey you're going fast towards your end. 25:02 You get a little bit. 25:03 Take your foot off the off the gas and slow down on calorie intake. 25:08 And this is what's leading 25:09 to the insulin resistance on high inflammatory status etc.. 25:13 So thank you for mentioning that. 25:15 What would be the third one? 25:16 Yeah, the third one is kind of a tough one. 25:19 I was going to say triglycerides, but maybe because that will improve 25:22 with the other ones. 25:23 But I think maybe ApoE b could be a b, especially if you have 25:28 I mean we have like cardiovascular disease in the family and things like that. 25:31 So if you are have a genetic predisposition for cardiovascular disease, 25:36 it's also a modifiable, you know, whether it be 25:39 with diet, lifestyle or pharmacological agents. 25:43 We can move the needle on that and actually do people what is a B. 25:47 Yeah oppo B is a big lipoprotein B and it's a component 25:52 so that it gives you like the total amount of lipoproteins. 25:56 And it doesn't necessarily it doesn't reflect what it's carrying per se. 26:00 It's just a total amount of protein. 26:01 So you'll find a Bob and LDL and other lipoproteins. 26:05 But the total count of a Bob has is a better 26:09 predictor of cardiovascular disease than LDL cholesterol. 26:13 So ApoE b is really kind of like the number if you're measuring LDL 26:17 would be more informative to measure apolipoprotein B, Apple B, 26:21 and and that test is usually, you know, you can add that on in a most tests 26:25 and choose has that. 26:26 So it's probably the best. 26:28 You know maybe you can argue triglycerides could be. 26:32 But most people that are healthy if you're already healthy, 26:34 if you have insulin resistance and your Triggs are high, 26:36 you might want to measure that. 26:37 But my triggers have always been really low.
Top Three Markers and Final Takeaways 26:39 But ApoE B has climbed up over time, and I've been able to reduce 26:43 that with a drug, not a statin. 26:45 But I use a Z. 26:46 So as Z blocks the MPC one L1 receptor. 26:50 So I do hyper absorbed cholesterol. 26:52 And I've been able to knock that down about 30 or 40% 26:55 without taking like a statin. 26:57 Not I mean statins have their place and everything, but the amide 27:01 kind of works at the intestinal lining and a little bit maybe in the liver. 27:05 And it can block that cholesterol absorption which could lower, lower a bob. 27:09 And that's something I found through genetic testing, but also that I monitor 27:13 with tests like choose over time longitudinally and be able to titrate, 27:19 you know, the dosage of that in my diet to improve that number. 27:22 And that's like, well, I this was a great, 27:25 I think, very practical discussion for folks listening in here. 27:28 And I want to appreciate your time today. 27:30 Any final any conclusive words or anything you want to add? 27:34 I think we cover a lot of ground. Yeah. 27:36 I just want to say, you know, I'm a fan of what you're doing. 27:39 I'm a fan of, you know, fasting, mimicking diets, 27:42 fan of Doctor Valter Longo body of work, which is incredible. 27:45 And I do think that, you know, 27:46 my bias experience is that metabolic based therapies like, 27:50 you know, these dietary therapies can move the needle more, more than drugs. 27:54 And I think that a lot of people need to be testing because there are ways 27:58 to optimize, you know, nutrition therapies through measurement and testing. 28:02 And I think that becomes a priority 28:03 to get that baseline and to do, you know, predetermined tests after that. 28:08 So you can titrate and adjust as you go. 28:11 Fantastic. Doctor Dom, thank you very much. 28:13 My pleasure. Thank you.
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