Our 100th Episode: How to Live to 100 and Beyond

Dr. Robert Rountree INTRO:

This is The Thorne Podcast, the show that navigates the complex world of wellness and explores the latest science behind diet, supplements, and lifestyle approaches to good health. I'm Dr. Robert Rountree, Chief Medical Advisor at Thorne and functional medicine doctor. As a reminder, the recommendations made in this podcast are the recommendations of the individuals who express them and not the recommendations of Thorne. Statements in this podcast have not been evaluated by the Food and Drug Administration. Any products mentioned are not intended to diagnose, treat, cure, or prevent any disease. 

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Hi everyone and welcome to The Thorne podcast. This is a very special episode as it marks our 100th episode released on this feed. We've covered a lot of ground in the last 100 episodes, and I'm excited to explore new health and science topics with you and future shows.

Returning to the podcast to mark this milestone with me is Dr. Nathan Price. He's the Chief Scientific Officer at Thorne, a professor currently on leave for the Institute of Systems Biology, and a researcher who was named as one of the 10 Emerging Leaders in Health and Medicine by the National Academy of Medicine. Welcome back to the show, Nathan. How are you doing today?

Dr. Nathan Price:

I'm doing great. It's wonderful to be with you, Bob, as always.

Dr. Robert Rountree:

You, too. Yeah, it sounds like a lot of fun developments going on in the anti-aging research community, so I imagine you're really enjoying that ride.

Dr. Nathan Price:

I am. I think there's been such an interest in healthy longevity. The National Academy of Medicine actually sponsored or co-sponsored a big set of awards called Catalyst Awards and Transition Awards and so forth, that they're doing to spur investment in that and research in that area. And there's just tons of excitement right now in this world of longevity.

Dr. Robert Rountree:

Well, I'm hoping that the NIH is finally starting to acknowledge that aging is a condition that we should be addressing. So who knows?

Dr. Nathan Price:

They've been moving more in that direction. We do of course have the National Institute on Aging.

Dr. Robert Rountree:

Yes.

Dr. Nathan Price:

They have traditionally been very focused around Alzheimer's disease and diseases like that. And they still are for the most part, but there is more of a push, I think, because a lot of the public is so interested in this, which translates into Congress being at least somewhat interested in this. We have our presidential candidates who are all about 80 years old now, so there’s a lot of interest in aging in general from the top down.

Dr. Robert Rountree:

From all sides.

Dr. Nathan Price:

From all sides, yeah.

Dr. Robert Rountree:

So we've had you on the show before to talk about aging. But as we celebrate our 100th episode, we thought it'd be interesting to have more of a targeted focus on that topic, which would be extreme aging, people that live to 100: centenarians. And you in particular are constantly exploring ways to push the boundaries of the human lifespan. So let's start by talking about what you've learned from those who have lived the longest. What do we gain from saying 100 year old people? And then I guess if you're 110, you're a supercentenarian?

Dr. Nathan Price:

Yes, supercentenarians are people that are over 110.

Dr. Robert Rountree:

Wow.

Dr. Nathan Price:

And there's quite a number of people, comparatively, that make it to centenarian. That's a big hurdle, but it does happen. The difference between being a centenarian and a supercentenarian is large, only a very small fraction of people that make it to centenarian will make supercentenarian. And then the world record for longevity is somewhere a little bit above 120. Some of the cases are actually a little bit hard to verify exactly where that's at. But that is at the moment sort of the limits of human lifespan. We know from animal models – and a lot of work has been done at many good places. I gave a seminar recently at the Buck Institute and was talking to them, and the world record there for extension of mice is you can get them to about double their lifespan. For a lower animal like C. elegans which is a worm, you can quintuple. Quintupling their lifespan is the best that's been done.

So for certain animal models we know that there is an effect size that you can see. There is some debate around that area, which is pretty interesting, because in a lab it's a very controlled environment. And so there is question about how does that translate into a human who's trying to live their life and in a very noncontrolled environment to some extent, but with all of our genetic differences and our lifestyle differences and all the things that we're going about. 

But there's a real question, real interest in is it possible to extend human lifespan significantly? And we have not yet shown, just to be clear to us, we don't yet have anything that we know will extend edges of longevity. And so it is important as we're going to talk about centenarians in particular today to disambiguate the notion of longevity and health span.

There's many things you can do to increase the length of time that you live healthy within this envelope of a 100, maybe 100-anda-little-bit-plus years that might be on the table for if you’ve got the right kind of genetics. Versus can we extend that end of life of humans so that you could push out to 150, 200, or is that a possible thing? That’s what really hasn’t been shown yet to any significant degree. We just know that you can do it in animals, maybe you could.

Dr. Robert Rountree:

When I bring that up to people, to my patients, one of the responses is, “Why would I want to live that long?”

Dr. Nathan Price:

Yes. And in fact, when I first got into this space, that was the most surprising result to me, is that you'd start talking a little bit about work on longevity and that exactly a big fraction of the population will immediately say that. But I think in that sense it's because we imagine those later years of life as being unhealthy, stuck in a hospital in a situation. Atul Gawande wrote a very famous, very beautiful book on this called Being Mortal about the end of life and how much of us would choose to not go through the process of ending life the way that most of us do these days. I'm actually a pretty big believer in under the right kind of constraints, like the right to die and things like that. The end of life can be quite brutal. So when we talk about extending lifespan, that's why it has to go along with expanding health span,  because what we're really talking about is how many years of life. So can you live 100, basically disease-free, healthy years of life? Is it possible to extend beyond that? We don't really know yet.

It is about trying to maintain health. In fact, one of my very favorite quotes that I am using all the time these days comes from a book I was reading. It's a 2,000-year-old book. It's written by Seneca the Younger. It's one of the stoics, so one of the Roman stoics. And it was interesting I was actually going up to RPI to give a lecture there on scientific wellness and longevity and all these things. And I've been listening to this book, the Moral Epistles. And so he's giving advice to his young learner Lucilius. And just by coincidence as I'm driving up there, the 58th letter came up and it was on longevity. So he started talking about longevity and it was very interesting like, what did people think about this 2,000 years ago? And what he said to Lucilius was, "It is very important whether you are extending your life and not your death." And I thought that was such a beautiful way, immediately in the intro to all the talk. I thought it was so beautiful. It was so much better than how I had put it. I think it's a remarkable way to think about this. 

I think for the most part, if we're having a good life, we've got people we care about, we have a purpose, we're moving forward, yeah, you'd love to extend your life. You don't really want to extend your death. And I think when people say, "Oh, I don't want longevity." It's because they're thinking, I don't want to extend my death. And I totally agree with that honestly.

Dr. Robert Rountree:

Great point. So I'm wondering then of this group of centenarians you study from people around the world, would you say most of them are in the “extending the death” category or would you say most of the centenarians by virtue of their genes or some lifestyle practice they followed, would you say at 100 they're out bike racing or are they living a robust life? When you look at them as a group, obviously a lot of them are not going to be, but what by and large do you see?

Dr. Nathan Price:

It varies, but if you look by and large, people that achieve centenarian status, mostly they stay healthy for quite a long time. On average, they really are extending their life more than their death. It's not that all the centenarians got sick at the same time as other people and they dragged on. That is the exception. The rule is that they continued on quite healthy. I think one of my grandmas is 95, so she's getting close there, still walking around, fully functional. For her, her eyesight is very bad, her eyes and her ears have really gone, the rest of her is in very good shape. That can be a fairly typical phenotype where you start losing certain things, but very metabolically healthy, very active, walks a lot, active mind, all those kinds of things.

Dr. Robert Rountree:

So those folks if they've got good genes, what are those good genes doing? Are the good genes just putting off disease? Are they doing something positive? Or in other words, are they just resistance genes or are they actually putting something into the system that's beneficial?

Dr. Nathan Price:

Yeah, I'll take that in two segments. I'll start first with the question of whether it is just around disease genes. So my lab collaborated with some really great longevity researchers that study centenarians a lot, actually run one of the largest programs of this type in the country, Paola Sebastiani and Tom Perls at Boston University, as well as Nick Schork at the University of California, San Diego. And so along with the postdoc of mine, Michael Weinberg, now a professor at University of Toronto, we embarked with them on an analysis where we took 54 polygenic risk scores of disease. So polygenic risk scores are large summations of tiny changes in your genome that predict that you have high risk for certain diseases. And we were leveraging a paper we had done there before. And the reason that we did that is to look and see if for extremely long-lived individuals, for centenarians, did they in fact have particularly low risk for diseases compared to the average in the population?

And so when we did that, what we found was that actually that was by and large not true. In fact, we only found differences in four out of the 54 that we tested. So across the board, I was very surprised by this. This was our thesis that maybe they just have more high risk for diseases, therefore they die. And that didn't turn out to be true. The only two diseases that they had lower risk on were Alzheimer's disease, a lot because of APOE, which we'll talk about in a minute, and coronary artery disease. So they had lower risk in those two, but that was it. Nothing else that we tested.

Dr. Robert Rountree:

Not for diabetes specifically?

Dr. Nathan Price:

No.

Dr. Robert Rountree:

Wow.

Dr. Nathan Price:

Which was surprising. And I'm going to talk about that in a flip side because... Well, I'll get to that in a moment. We'll get into another discussion around that, because diabetes definitely has an effect on aging. We'll get into that in a second. But at least in this study we didn't find a relationship, at least with genetic risk for diabetes. Just to be clear, here we're talking about your genetic risk for these diseases. Lifestyle is different.

Dr. Robert Rountree:

Yeah, not your intake of sticky buns. [Laughs]

Dr. Nathan Price:

That’s right. That is going to have an effect. We’ll talk about that in a minute. So this is your genetic risk. So just to be clear, that’s what we’re talking about at the moment. Now, there was two other predispositions that mattered at the genetic risk level and one was related to if your parents achieved extreme longevity. So if your parents achieved extreme longevity, so you had this genetic risk factor associated with parental extreme longevity, and there was also a polygenic risk score associated with cognitive function. So higher cognitive. So kind of the mirror side of what we said about Alzheimer's, but that was it. Those were the only disease-related or condition-related polygenic scores that correlated with extreme long life. And we were surprised that it was such a small number. Now, the flip side of that is that you can look at again, this notion of a polygenic risk score and do it for longevity.

Before I dive into that though, maybe I'll say just a little bit more about what a polygenic risk score is. I said it kind of briefly, but just to put a little more color on that, and I'll use an example that's pretty easy to get your mind wrapped around, which is height. So we know that height is heritable, tall parents tend to have tall kids, short parents tend to have short kids. Exceptions, as like in everything, but on average you see that pretty strongly. And in the early days, we couldn't predict. We could find no gene for height, there's no gene for height.

Dr. Robert Rountree:

It's not just growth hormone,

Dr. Nathan Price:

It's not just growth hormone, it's not just that. In fact, we'll talk about that a little bit more. Well, I'll just say there's certain differences in growth factor receptors associated with extreme long life. And in different studies they're associated with either being taller or shorter. So actually it's complicated, just diving into that literature recently. So I'm not super expert at it, but it's kind of fascinating. Been diving in a little bit just in the last week or so. 

But with polygenic risk score and there's no small number of genes to predict height, and so people were really confused by this for a long time. But if you fast-forward to now, it turns out that height is the single best thing we can predict off of the genome out of these complex traits. You can predict very simple things like sex of course, because it's very simple variable.

Dr. Robert Rountree:

So shorter people live longer, is that what you're saying?

Dr. Nathan Price:

No, I'm just using… 

Dr. Robert Rountree:

I've heard Valter Longo say something like that that's why I bring it up.

Dr. Nathan Price:

I've seen studies that go both ways in different populations for different reasons. It may be true on average, he probably is right on that. But for height, just to give people a sense, you can now predict height quite well from a genome, but it takes 186,000 variants across the gene to do that. So it's these tiny signals that are spread everywhere, so that's pretty interesting. 

So coming back then to longevity, you can do the same thing just on achieving an extreme age. So you get this distribution of effects across a bunch of genes. Now, the kind of genes though that pop up as being the most significant they tend to be related to things like metabolic health, so metabolic syndrome. So if you're particularly resistant to metabolic syndrome, then that's a beneficial to you living a long time. This insulin growth factor-1, that's an important factor that relates back to longevity. APOE, which is the gene that is the strongest mediator of Alzheimer's risk, that one matters.

Dr. Robert Rountree:

Both of which we can measure in our patients pretty easily,

Dr. Nathan Price:

That you can measure quite easily. And so you can in fact... I don't know if anyone sells this or makes it super easy to do it via a clinician, but technologically it's quite straightforward to take data from a genome and make a prediction off of it from using a polygenic score like this, and get a sense for the likelihood of extreme longevity from a genetic factor. So anyway, so that's kind of a bunch around the genetics of centenarians.

Dr. Robert Rountree:

So they're playing a role but it's not the total story, is what you're saying.

Dr. Nathan Price:

It's not the total story. It has a fairly strong effect I think on the extreme levels of longevity. So if you're talking about it being... It's really hard to be a super centenarian if you don't have a really good hand dealt to you. That said, I think people probably have about 20 years on the table in terms of lifestyle. That might sound like a lot, but I'm not actually talking about moving that extreme endpoint. It's more the kind of things that might lead you to die early versus being able to achieve the full potential of what's on the table for you. And that is going to get down to basically, can you avoid the major killers, is one of the big factors obviously.

Dr. Robert Rountree:

Heart disease, Alzheimer's, cancer, muscle wasting.

Dr. Nathan Price:

Diabetes.

Dr. Robert Rountree:

Falling and breaking your hip and that sort of thing,

Dr. Nathan Price:

Falling and breaking your hip, which relates to muscle wasting, balance, keeping that up. So like so many things in health, it comes back to those core issues. And then just trying to have examples of where you can really make a difference at trying to achieve your full birthright of health span, if you will. You try to do as well as you can with the hand that you've been dealt.

Dr. Robert Rountree:

So I've seen reporters that basically narrowed it down to saying, "Well, it's all genes. And here's Sally Smith celebrating her 110th birthday with a cigar and a glass of whiskey, which she has every single day of her life. And so, therefore it has nothing to do with lifestyle and live the life you want and enjoy yourself.” You've seen those kinds of headlines too, I'm sure.

Dr. Nathan Price:

For sure. And those cases definitely exist, there is the person out there. I think you don't want to extrapolate too much from those because you also don't know everything else going on in her life. OK, so she's smoking every day and she likes her glass of whiskey but maybe she really doesn't eat much processed food, and maybe she walks really well, and maybe her sociality is awesome. And there's always a totality. 

Everyone's on their personal health journey and nobody is even remotely similar to anybody else and the totality of that. The number of choices and variables and movement and everyone is incredibly unique. And so you don't know the full journey, but it is definitely true that the genes play a big role. And certain things that are a risk factor in general are not nearly as much of a risk factor for a particular individual.

Carcinogens, let's just take that case. So we know certain compounds are carcinogenic, like smoking is carcinogenic, processed meats are carcinogenic, alcohol is carcinogenic, there's all kinds of things. But if you have genes that predispose you to be particularly good at DNA repair for example, you're going to be a lot more resilient to that kind of issue. Now, if you happen to have genes to where your DNA repair is more error-prone, well, then if you have a higher mutation rate, that's going to be a big problem because you're not as well able to deal with that. So all of us have these resiliency buckets or these mechanisms and it's coded in your genome. And of course, we only partially understand this like everything in biology, we understand some things, and we don't understand a lot.

But as you start working that through, that's one of the pieces I'd really like to bring out to the forefront a lot better because like the book I wrote last year, The Age of Scientific Wellness and kind of trying this argument for trying to remake our health-care system more towards a wellness model and actually our whole biomedical enterprise, including research and how we set that up and so forth, because we do a really good job comparatively by diving into disease. That's where all the money sort of goes, where we invest research dollars, all that kind of thing it's all very disease-focused.

Dr. Robert Rountree:

What's the magic cure for Alzheimer's, for example, the latest IV drug Leqembi, right?

Dr. Nathan Price:

Yeah.

Dr. Robert Rountree:

Let's just give Leqembi and you'll be fine.

Dr. Nathan Price:

Yeah, Alzheimer's is one I would get into a lot because the evidence for the effectiveness of lifestyle and prevention in Alzheimer's is radically better than the effect that we're able to have on it via drugs. That's not true across the board in every case, but it's massively true in Alzheimer's for pretty simple reason which is that if you're trying to affect late stage Alzheimer's disease, a bunch of your neurons have already died. You've lost tons of synapses. We don't know how to bring those back. Nobody knows how to do that. There's some interesting ideas around injecting stem cells and there's some things that could be quite interesting, but today, no, we don't know how to do that. But prevention, which is stopping the neurons from dying in the first place is a way, way, way easier problem. And if people want, I did write a piece for the Los Angeles Times last year on this. If people want to look that up, it kind of goes through the whole argument of this.

Dr. Robert Rountree:

Yeah, that was a great piece,

Dr. Nathan Price:

Thank you. And it goes through and it makes the argument and gives recommendations, general recommendations for how, for the kind of things that seem to make a difference. And I gave one of the three opening keynotes at the National Institutes of Health a few months ago for combination therapies in Alzheimer's. And I'll just mention that it was kind of interesting because the two talks right before me, one was a pharma talk, and it was going through the drugs for Alzheimer's. Very well done talk, very professional, great science, everything across the board. But it's hard not to notice that the effect sizes that you're seeing are small and costs are huge.

And then the second talk was on lifestyle interventions. And it was pretty hard not to notice that the amount of benefit was not as in the drug case, slowing decline for a few months maybe with a lot of side effects. It was rather measured in the course of years to even a decade of benefit in the delay of the onset of disease for things that cost almost nothing. And these were very simple kind of things. So you're talking about exercise, improving your diet, some pretty basic supplements, just very straightforward kind of things. And these lifestyle trials, the finger study being the most famous and first of them and then there's a bunch of follow-on studies, have really shown that that has a much bigger effect. And just for your listeners, like this isn't like a radical concept or anything. This is the kind of thing we've understood all of us since we were 3 years old. It's the story of Humpty Dumpty. Once your brain is broken like the egg's broken, putting it together is crazy hard. Stopping it from falling is easier.

It's easier to think about it from the standpoint of prevention in this case. Yeah, so that is a really good example. And it is one of the ways that you can go about trying to achieve longevity is to bucket it around, getting your exercise in line, keeping your muscle intact as you get older is super important, your cardiovascular health, your metabolic health, all these things really play a big role.

Dr. Robert Rountree:

So it seems like we always keep coming back to this basic fact, which is the way you live is the most important. The natural human tendency is to go, “Well, can’t we just take rapamycin? Or can't we just wait until we get Alzheimer's and get injected with Leqembi?” So we're looking for a rescue as opposed to saying, "Well, no, it's the way you live your life that's important." It's the whole deal. So it's not just a supplement and it's not just lifting weights, which is a great thing. All these things are good. But it's all of it together.

Dr. Nathan Price:

It's definitely all of it together. And I think lifestyle obviously plays a huge role. That said, one of the things I am in favor of is in trying to build out in this area I like to call scientific wellness, what can we do to aid people in their journey? Make it so that you get a little more benefit from the effort you're putting in, because I don't think anything that's kind of entirely focused on, all right, willpower, I'm just going to change, I'm just going to brute force thing.

Dr. Robert Rountree:

You got to go to the gym five times a week, right?

Dr. Nathan Price:

Yeah, that's great. And you should do that and I should do that and it's amazingly good. But I do think some of the things you bring up, so is rapamycin looking pretty promising? Yeah, I think rapamycin looks quite promising. This isn't a session on that, so we're going to dive deep.

Dr. Robert Rountree:

Yeah, a whole other discussion.

Dr. Nathan Price:

Yeah, it's a whole other discussion, but rapamycin, metformin, these things look promising. The new GLP-I drug, that's it. I'm sure it's a whole another episode, but an assist for weight loss is an interesting thing in the toolkit. And it's what I was trying to get at before, which is we've developed all these tests for disease. Do you have cancer? Do you have ulcer? We do these things relatively late stage. We're getting better at early kind of tests, but I think it would be really good if we had a much broader sense of these reservoirs that we have of resilience, where they're at and how we could amplify them more. So for example, a trigger for dementia is that the amount of oxygenation your brain goes down. Well, how much reserve capacity do you have before that becomes a problem? I don't have a number right now that I could say, "Oh, my capacity is here and it's tricking down, therefore I'm going to have a problem at this moment."

We can kind of estimate that in some interesting ways, but you could get at that. How good is your mitochondrial health at the moment? You can kind of estimate that, a VO2 max would be somewhat related to that and so forth. But how good are you at combating oxidative stress in your body, etc. What I like to call metrics for wellness, if you could have notions of this type of resiliency, I think the more we understand these processes it comes back to your lifestyle. But if we understand the intricacies better, I think that helps us to say, "Well, if you have these particular nutrients at a certain point in time while you're trying to achieve this change, you'll get double the benefit from making that change in your life that you would otherwise." I think to me, that is a big part of our industry and trying to understand what's happening in health to the standpoint that we can just try to be aids to people. I think that's really, really a big goal.

And then if we can really understand the centenarians more deeply, what is it that makes them so protective? Can I help somebody who has not as good DNA repair be someone who at least approximates someone who has better DNA repair? Can we get to that sort of level? That's kind of the future that I think is really important to think about, so that we're trying to optimize the trajectory of a person's life or give them tools to optimize their own trajectory, however they see fit.

Dr. Robert Rountree:

So just to connect the dots, what I hear you saying is that we are taking wellness and adding science and being precise about it. So we're adding precision to the science of wellness. The science of wellness has been around as long as I've been in medicine 40 years, eat well, exercise more, have good friends, sleep. So yeah, we've known that forever. But you're saying we can get much more scientific and that allows us to be predictive and precise. Just to use words that you talked about in your book, precise, predictive, scientific wellness, which is really the future of everything we're talking about here.

Dr. Nathan Price:

Right. And that's a journey that I'm really excited about because I think it comes down to how much added benefit is there, how much is on the table for each of us if we can understand these things in a lot more detail than we do now and avoid... Because we all know the exceptions to the rule. Well anyway, I don't know how personal it gets, but we know those people that kind of live, at least on the outside, an incredibly amazing health-filled life and then suddenly die of cancer or whatever. And so it's like, can we understand the mechanisms of maintaining health in a way that we can achieve that in a much more predictable fashion? That's really what I think so much of us that are in the science side want to achieve, so that it's not so much being blindsided by things is that we can understand what's coming, what can you do, put it in your control as much as possible.

Dr. Robert Rountree:

Great. So that's been an awesome discussion. We're going to take a short break and then we'll be right back to answer some questions from our listeners. 

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Dr. Robert Rountree:

And we're back. So now it's time to answer some questions from the community. Our first question this week comes from a listener who asks, is it a good thing to push back aging? People think, well, it's more retirement, but won't it really mean more years of working at advanced age to pay for what we're doing during our retirement? Do we want 80-year-olds driving forklifts? Which seems like a separate question with its own implications. So is it a good thing to live longer?

Dr. Nathan Price:

Yeah, I think it's an interesting question. Obviously people will have their own views on that. To me like I was saying before, I think it really depends on if you've got the health that you really need so that you're enjoying your life. And for some people that will mean working longer. For others, maybe it's more about retirement. There are obviously financial implications to that length of time. We have to deal with that as a society. I actually think in some ways, we might be entering a period of quite a lot of prosperity with some of the new technologies coming on board, I guess with AIs and so forth. That's a whole other topic. That becomes an important aspect of society and how do we adjust to the notion if people really start living a lot longer. At the moment though, what we're really talking about is not so much the extension of lifespan. We are mostly talking about the extension of health span, which I think is pretty universally a good at least from my standpoint. And honestly saves a ton of money because of lowering health-care expenses.

Dr. Robert Rountree:

So living healthier longer is certainly a worthwhile goal for everybody.

Dr. Nathan Price:

Certainly, yeah, I think that's right. Whether we want 80-year-olds driving forklifts really depends on what 80-year-olds look like. If we do achieve something where health span can be significantly expanded beyond a lot of the levels that maybe we would think of now, maybe that could become a normal thing. Remember, for a lot of human history, the average lifespan was like 30 years old.

Dr. Nathan Price:

So yeah, they might be saying, "We don't want 40-year-olds doing anything."

Dr. Robert Rountree:

Yeah, exactly.

Dr. Nathan Price:

We don't think that way anymore.

Dr. Robert Rountree:

They're over the hill at 40.

Dr. Nathan Price:

Yeah, exactly. Well, for most of evolutionary history, of course, we were being killed by wild animals and so forth so there was a different standard. So things evolve and society would evolve with it. I would not expect the extension of human lifespan to happen dramatically fast. And so we will probably have some time to adjust to that, I would think.

Dr. Robert Rountree:

So again, it depends on the 80-year-old. And we could have 80-year-olds running governments or running corporations, or I read the other day that Rupert Murdoch, who's got all the news organizations, he's, what, 93 or something like that.

Dr. Nathan Price:

Wow, I can't see that.

Dr. Robert Rountree:

Yeah. So in other words there's a surprising number of what we would call elderly individuals out there in positions of power. 

Dr. Nathan Price:

Yeah, there are. Like my great partner who co-wrote the book with me on The Age of Scientific Wellness and that I've worked with a long time, Lee Hood, he's 85. He's still pushing things forward, starting new companies, building for the future. 

Dr. Robert Rountree:

And he does something like 150 push-ups a day?

Dr. Nathan Price:

He can do 100 push-ups in one sat. He likes to do two of those in the morning along with squats, and he's still very ripped, I'll say. He is a ripped, muscular, strong 85-year-old. Pretty impressive.

Dr. Robert Rountree:

Yeah, he said something about you guys riding horseback on his ranch. So I thought, well, that was pretty good.

Dr. Nathan Price:

Lee is a remarkable guy that way, there is no doubt about it.

Dr. Robert Rountree:

So next question. I've read a lot about centenarians and super centenarians eating raw egg. Is there anything to this? I have to say I've never heard that statement before, but I'm curious about your thoughts on it.

Dr. Nathan Price:

Yeah, I'm not familiar with also research that would really support the raw eggs. Two things I could think of, there are benefits to eggs certainly. One that's interesting is phosphatidylcholine, is eggs are probably the most abundant source of that. There is evidence of people that eat diets rich in phosphatidylcholine get Alzheimer's about three years later. We did some mechanistic work on Alzheimer's using something we call a digital twin model or a physiologic model of the brain. And it looks like there are mechanisms that would be explanatory for that. So I think that there could be something to that, that's something that I think about myself. And the other aspect is eggs are a very good source of protein. A high-protein diet is definitely important as you're trying to maintain muscle mass in old age. So it doesn't strike... Eggs seem to me to be probably on the whole a good thing. I don't know if the raw makes a difference or not.

Dr. Robert Rountree:

It's interesting that proteins seem to fall in and out of favor. “They're bad for you, they give you cancer, you don't want too much, they'll destroy your kidneys.” But the latest research that I'm aware of says that protein may be the single most important nutrient for people getting older, because the lack of muscle is really a major predisposing factor to falls, imbalance, et cetera. And so we really need maybe even more protein than we ever thought. Yeah, any way you can get it I think is good.

Dr. Nathan Price:

Yeah, I tend to fall into that camp too. When I've adjusted my diet to higher protein, I definitely find that to be good. I think the latest science is pushing us that way. It can be more taxing on the kidneys, but there are tests you can run to get a sense for whether or not that's happening.

Dr. Robert Rountree:

Whether it's a problem or not.

Dr. Nathan Price:

But I think there's many more people that are deficient in protein.

Dr. Robert Rountree:

Than the other way around. So can you explain what blue zones are all about? And this is the question I love, do you have to be born there to benefit or if I move in will my age go up? What I think what they mean is will there lifespan go up? So if you move to Okinawa, will you get benefits of living there? So is there something in the air or in the water or what is a blue zone?

Dr. Nathan Price:

Yeah, so blue zone is a concept that was brought out by Dan Buettner, wrote a series of great books on this, very well received, as well as some TV shows that came out after that as well popularizing this. And just the study of places where there is a higher preponderance of people that achieve extreme longevity. And I think it's a very attractive concept and the places that they live tend to be quite nice. You mentioned Okinawa, like Sardinia Italy I think is on there. I think Loma Linda is on there, or the Seventh Day Adventist group and so forth. I think my understanding of this is that it's not so much about necessarily being born there, as far as I know there's not a strong genetic signature or things of the population, but one of the things we know is that health activities are contagious. In other words, your diet's going to look a lot like your five closest friends. And your exercise that way.

And of course, there's lots of exceptions like any of these things. It's a general rule, but we tend to be influenced by the people that we're around. There's actually quite a lot of interesting activity right now on how you can try to utilize social connection or social networks as a lever to try to help improve health and populations and so forth. It's pretty interesting. So the blue zones tend to focus around areas that matter. So diet, so like the Mediterranean Diet kind of came into favor in part because of this. Physical activity. So if you're living in a community where walking, for example, is much more common. If you're in a place where you kind of have to go everywhere by car and you're just sitting in your car all day, that's much, much worse for you obviously than being in a place where you tend to walk and carry things and so forth. 

Dr. Robert Rountree:

So move to Manhattan.

Dr. Nathan Price:

Yeah, Manhattan. You have air pollution issues in that, if you could live somewhere you walk and the air is super clean all the time. But Manhattan is actually a great place for walking. I do enjoy that aspect, there're quite a lot. Social engagement, so tight-knit communities also matters. Are you connected with your neighbor? Do you have a lot of family around? Are you with your extended family? Are you managing stress? That's another aspect of walking outside is it's meditative. And as long as you don't have to dodge things, and it's peaceful and you can kind of zone out, that it's nice and meditative. And a sense of purpose to your life, that was another thing that really came out. So is there something that you feel gives meaning to your activities, a reason to stay around? And it's been pretty remarkable that social engagement, sense of purpose in life, those come up very strongly when you look at longevity.

Dr. Robert Rountree:

So the take home message is bring the blue zone home to you, right? Save the air fare.

Dr. Nathan Price:

I would say that's probably the thing. Well, with the caveat that some of the... Yeah, exactly. Can you create a community? But there are community effects. There are definitely community effects, but if you can have that with your family and so forth and your friends, you're probably on a good path.

Dr. Robert Rountree:

All right, folks, that's all the time we have this week. Dr. Price, thank you so much for coming on the podcast. Our 100th episode, wow. So if people want to follow more of your work, what's the best way to keep in touch and find out what the latest stuff is? First of all, they should read your book. I'll put in a plug, The Age of Scientific Wellness, which is a great book. Loved reading it. How else can they follow you?

Dr. Nathan Price:

So I post quite a lot on LinkedIn, so if people want to follow me there, I'll post a fair bit on science and trends and things that I'm interested in, in Twitter @isbnathanprice.

Dr. Robert Rountree:

Now X.

Dr. Nathan Price:

Now X. Yeah, I keep saying that. I keep forgetting but X. Yeah, on X @isbnathanprice. Yes, thank you for that. And yeah, those are the main ways. And then obviously Thorne.com is where any of the products or anything that we get done and ready for people, that's where that all goes.

Dr. Robert Rountree:

Terrific. All right, excellent. That was Dr. Nathan Price, the Chief Scientific Officer at Thorne on the topic of centenarians and aging. It was great to have you back. And as always, thanks everyone for listening. 

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