Part II: "Super Agers … An Evidenced-Based Approach to Longevity".... Dr. Eric Topol, Author, Prof., and EVP, Scripps Ranch
You're listening to part two of my interview with doctor Eric Topol, the author of superagers, an evidence based approach to longevity. Now I don't often quote the bible. In fact, in all these years, I may never have quoted the bible before, I take nation, but maybe it's the new pope. The new pope has gotten me going here. But Jesus is quoted as saying, the poor will always be with us, which says that the health inequities will always be with us.
Dr. Moira Gunn:Do you think that's true?
Dr. Eric Topol:Well, they don't have to be with us to the extent they are now, where it's just horrible amount of inequities we have in this country, this rich country, especially. So, what do we do? Well, we have to take these powerful capabilities and intentionally deliberately make them available to the people who need them the most, which are the people who have suffered the worst environmental toxins, air pollution, plastics, the consumption of ultra processed foods, forever chemicals, socioeconomic status. That's all the things that they, these are underrepresented minorities. They need this stuff because they are the ones that have the most age related diseases.
Dr. Eric Topol:So we can't just have this master plan that only helps the affluenza. We have to work really hard at this is something for all people. And this is very different than some other books on longevity, which are basically catering to only the very wealthy people. This prescription or this plan, which is individualized has to be one that is for any individual independent of their, ability to pay for it. Because if we prevent diseases and you know this well, that economically could be the greatest investment we ever make.
Dr. Eric Topol:Because once a person has one of these diseases, that's where all our costs accrue rapidly and of huge magnitude. So the investment we make to make this available to all people based on their data is a very prudent, you know, it's a great investment and we should be doing it.
Dr. Moira Gunn:Now, more and more diagnostics are coming into play. How do we get that into routine use?
Dr. Eric Topol:Well, first of all, the way we do mass screening for cancer is incredibly dumb and wasteful because again, we treat everyone the same. So for women, eighty eight percent will never have breast cancer in their lives. Now we treat women all the same and we tell them age 40, 45, show up for your mammogram every couple of years. This is ridiculous because we need to find the people who are predisposed to breast cancer, which we can now. We can get a polygenic risk score.
Dr. Eric Topol:We can get, obviously the usual things like the family history and everything from the electronic record. And with AI, we can determine who is at risk. With the mammogram itself using AI, even with a normal mammogram, it sees things we don't see, and it can determine a person's risk and put off future studies. So there's lots of ways to establish risk and we need to do that much better. And part of that is the immune system because many people might develop microscopic cancer in their lifetime.
Dr. Eric Topol:In fact, Maura, we may all be doing that from time to time, but if a competent immune system just quashes it, it just doesn't make it. It doesn't get legs and it doesn't spread. So that's another thing is once we get the immune system metrics, like we have an immune system organ clock, which is emerging from the great work at Stanford by Tony Wiskori and colleagues. Once we have that, that's gonna help us even more discriminate who's at risk, but it's the same thing for colonoscopy, for PSA screening for prostate. I mean, you name it.
Dr. Eric Topol:We only pick up fourteen percent of cancers through these wasteful, treating all the people the same age only criteria. We don't partition risk. We have the ways to do that now, and we're not doing it. And it's very frustrating.
Dr. Moira Gunn:Now we've talked about AI lifestyle plus, cells, so we're into three. The fourth one is omics. I think a lot of people say, what are you talking about, omics? You know?
Dr. Eric Topol:Yeah. So I was touching on that now with this polygenic risk score, which is common variants, hundreds of them that are tagged to that particular disease of interest, be it a type of cancer or cardiovascular or, or Alzheimer's. So anyway, those people aren't, they're not aware because it adds an admixture from your mother and father. So even if it's not in your family history, there's a lot going on in those common variants when you get that special mix that you don't know about. And that's why it's really good to get a polygenic risk score.
Dr. Eric Topol:The one that's the most extensively validated is the heart disease one. But the point is once you have that, it's just one layer of data, which you can confirm with other layers of data. So you don't want to just pinpoint this is it, because it isn't, it's one layer of data, but the problem with the polygenic risk score, it only tells you yes, no risk. It doesn't tell you when it may mean that you could get Alzheimer's at age 98 or 68. So what good is it?
Dr. Eric Topol:That's why you need these other layers of data, but omics includes not just genes, proteins, the organ clocks we talked about methylation. That's the epigenetic clock. It includes the gut microbiome. It includes the immuno. These are the biologic layers that make each of us distinct.
Dr. Eric Topol:And the genes themselves, our DNA, it's important, but nothing like the, the, back in February, you know, the, the, operating instructions for life. No, no, the DNA is important, but it's not, you know, the master, plan for, you know, our, our lives that as was originally theorized, it hasn't played out to do that. For example, we don't know an immune system, how its person functions from their DNA. We have to test that separately. Okay.
Dr. Eric Topol:We don't know a gut microbiome in people, which is really important. The gut talks to the brain and cut the, the gut talks to a lot of other parts of the body. You don't know the gut microbiome from looking at a person's DNA. So the DNA is just less than we had, as time goes on, RNA too, the DNA becomes less and less prominent as to its impact.
Dr. Moira Gunn:Well, drugs and vaccines are your fifth component here driving a health span. And, boy, we have some real crazy things happening with vaccine discussions and actions today. I I almost don't wanna ask you about them. Holy moly. What what are you gonna say?
Dr. Moira Gunn:But if you would like to make any comments right now, I'd appreciate it.
Dr. Eric Topol:Yeah. Well, I do wanna talk about drugs since we haven't talked about that. I talked about vaccines a bit already. The GLP one drugs, Ozempic, Mounjaro, you know, Zepbound, these drug class are amazing. Now, as you know, I have a history of being very anti pharma.
Dr. Moira Gunn:Yeah. Yeah, Eric, you do.
Dr. Eric Topol:I went up against Merck during the COVID pandemic. I went up against all the vaccine manufacturers because they weren't putting out their data or their protocols. I mean, I took them on and, I should be smarter than to take them on because it's not easy to deal with these companies. But for once, we have a drug class that is extraordinary, outperforming beyond all expectations. Now, what we've learned is the reason that we're seeing so much more than expected is because these drugs reduce inflammation in the body and the brain.
Dr. Eric Topol:They're potent. They may be in the form of pills, something that the vast majority of us will take to promote healthy aging in the future. Who knows? I speculate on that. The point is what we've learned is our gut hormones, which we never had much respect for.
Dr. Eric Topol:When I went to medical school, they weren't gut hormones that we discussed like glucagon and glucagon like peptide and you know, what these gut hormones, and there's many more to come, okay, that are going to be drugs and they're not gonna be just injectables, they're gonna be pills. They talk to the brain. They talk to the rest of the body. They are incredibly important to our immune system, right? No less helping to get rid of addiction.
Dr. Eric Topol:Who would've thought you take these drugs and you reduce your alcohol, you know, tremendously. You eat healthier foods, no less, less food. You stop gambling, you know, changes your reward circuits in the brain. I mean, this is kind of amazing, right? It's even changed the big food companies to come up with healthier foods because people aren't eating the junk that ultra processed foods as much because so many people are taking these drugs now.
Dr. Eric Topol:So except for the problem that we've got, these are like forever drugs. We don't know how to get people off of them without gaining the weight back, except for that problem, which is a problem. I acknowledge that. I do think we'll be able to figure out a way to wean it. Because I don't want people taking any drugs for the rest of their lives if we can avoid it.
Dr. Eric Topol:So it's amazing. And it's just the beginning. What you're going to see, Maura, is a whole explosion of gut hormones. These are simulating our gut hormones, right? We already have triple receptors with three different things in the GLP-one family.
Dr. Eric Topol:It just really quite amazing. Now, the other point about this is we need potent anti inflammatory drugs, because we've been talking about how inflammation is the whole core of the problem. And we haven't had any, what do we have now? Nonsteroidals and prednisone. These are not good drugs.
Dr. Eric Topol:We need drugs that are much more specific and potent and, know, without big time side effects. So we're going to see that Now back to vaccines, the measles vaccine is- is- what's going on right now is- is ridiculous, propaganda. It's all mis- and disinformation, even coming, you know, from our government, from our HHS leader, Bobby Kennedy, Jr. So, I think it's fair to say that the measles vaccine is exceptionally well proven. It has absolutely no link to autism.
Dr. Eric Topol:It is with two shots. It has almost perfect protection. And what's impressive about it is if you get measles, you get immune amnesia, most people. You don't wanna get that, and you don't want children to get that.
Dr. Moira Gunn:Now what's immune amnesia?
Dr. Eric Topol:Basically, your immune system, which has been built up from exposures, it forgets all of its exposure. So you're starting all over again. You don't want that because when your immune system gets exposed to all these different viruses and pathogens, that's how it gets, you know, primed. That's how we avoid future infections of those things. So nobody wants to get measles and we have a way to protect against it.
Dr. Eric Topol:And what's a shame is that it's, it's been under siege for years, from a completely fabricated study by Andrew Wakefield. And now we have the MAHA moms who believe, unfortunately, that their kids with autism were from the vaccines that they had to get. It's really sad because autism is not based from the measles vaccine. There've been definitive studies to rule that out. Now, do we still need to learn what is the culprit for autism?
Dr. Eric Topol:And certainly it's getting diagnosed more because of the way diagnoses are made. And obviously, you know, I have terrible compassion for people with families that have, you know, significant autism, sure. But don't blame the measles vaccine. Don't blame vaccines that have been tested in millions of people and never been shown to have link with measles. So vaccines are the most important preventive thing we ever had.
Dr. Eric Topol:Now we don't prevent age related diseases, except as I mentioned, maybe dementia, right? Partially. So we're gonna use vaccines more and what's not gonna help more are movements to try to be anti vaccine. It's not gonna help because it's not based on data. It's based on emotion.
Dr. Eric Topol:It's based on, you know, people without, the ability to review the data and and call the you know, the as it is, tell the truth. And, it's really unfortunate the times we're in right now. Someday we'll get back to truth, data, facts, and evidence.
Dr. Moira Gunn:One thing we have not said, and I just wanna wrap up with this, is we haven't talked about the the you mentioned the people that you talk the stories, your patients, at the beginning of the book, and these people that live a really long time. And, one of the things they are is upbeat.
Dr. Eric Topol:Yeah. I mean, if you adopt the lifestyle factors that we discussed and, you know, we didn't get into the importance of deep sleep, sleep health, and exercise, the paramount thing, you're going to keep staving off the other threats that we face. So, just because you're older and because you've been hit by one of these three big three, doesn't mean you wanna just let down. In fact, you know, all the things that you can do today that are backed up by evidence that are either free or at very low cost are worthwhile because they're gonna help promote healthy aging for you. So, it's never too late and there's no lost cause.
Dr. Eric Topol:And, you know, the whole idea is we wanna inspire people that there's things they can do. And even just, you know, some physical activity doesn't have to be, you know, you're you're training for, you know, some marathon, half marathon, none of that. You just, if you go for walks every day for a half hour and you do some strength training and balance training, it's gonna make a big difference. Right? And, and sleep, you gotta get that deep sleep.
Dr. Eric Topol:We, we, as we get older, we wanna make sure our sleep, deep sleep is maximal because it tends to keep going down and down. And so there, you know, tracking it may be helpful, but learning about the interactions of you and your sleep, particularly that, that phase of sleep, it's really important. And so that's what people can do. You know, it's there's so many things that we have hard evidence for that we're not doing.
Dr. Moira Gunn:Well, doctor Topol, I could speak to you for a week and still there would be things left we haven't talked about in your book. I wanna thank you for coming in, please come back and see us again. You're always welcome on Tech Nation.
Dr. Eric Topol:Thanks, Moira. Great to be with you again.
Dr. Moira Gunn:My guest today is doctor Eric Topol. His book is super agers, an evidence based approach to longevity. It's published by Simon and Schuster.
