What doctors know and the internet can't tell you

Introduction to the Longevity Industry and Expert Series

• The longevity industry has grown into a multi-billion dollar market, filled with various individuals, including influencers, charlatans, and scam artists, as well as some who provide good advice, with the goal of increasing health span 10s.
• A series on hacking longevity will be presented, featuring conversations with leading experts on longevity, including Dr. Zeke Emanuel, Dr. Dave Daniels, and Jason Braun, to provide accurate information and facts on the topic 2m6s.
• Dr. David Agus, an oncologist and researcher, is the founding CEO of the Ellison Medical Institute, where researchers use AI to create cancer-fighting drugs, and he played a critical role in the host's health by discovering a hole in their heart that needed to be repaired 4m30s.
• The host had a stroke many years prior, which was caused by the hole in their heart, and Dr. Agus convinced them to undergo a simple procedure to fix it, resulting in improved health and reduced risk of death 6m20s.
• The discussion with Dr. Agus will cover what works and what doesn't in terms of longevity, and will provide good advice on what to avoid, with the goal of educating listeners on the topic 8m30s.

Personal Health Journey and Medical Intervention

• The show is supported by Coler Health, which offers a product called Dakota, an attachment that fits on a toilet to help individuals interpret important health questions, such as digestion and hydration 10m0s.
• A person had a risk factor for developing clots due to a mutation that caused an overproduction of a protein called thromben, which increased the likelihood of clot formation, and in this case, a clot was able to pass through a hole in the atrium and travel to the brain, causing a stroke 10s.
• The stroke was a type that resolves itself, known as a transient ischemic attack (TIA), but the presence of risk factors made it necessary to address the underlying cause to prevent future problems, including the potential for dementia 1m42s.
• The person was initially hesitant to undergo open-heart surgery to fix the hole in the atrium, but medical technology has advanced significantly, allowing for less invasive procedures, such as fixing a valve, which can now be done with minimal recovery time 2m6s.
• A doctor's role is not only to educate patients about the risks and benefits of treatment options but also to ensure that patients make informed decisions based on their individual value systems, which can involve being persistent and advocating for the best course of action 4m10s.

Healthcare Support and Sponsorship

• The doctor acknowledges that it can be challenging to filter out misinformation on social media, where anyone can find conflicting information about medical treatments, and therefore, it is essential to rely on data-driven decision-making to ensure the best possible outcomes 6m20s.
• The doctor's approach is data-driven, and while being open to new developments, they prioritize following established protocols and waiting for long-term outcome data before adopting new treatments, as even small changes can have significant ramifications 8m30s.

Challenges in Health Decision-Making and Misinformation

• The ability to collect and analyze data has improved significantly, allowing for more informed decision-making in medicine, and the doctor emphasizes the importance of relying on evidence-based information to guide treatment choices 10m40s.
• The shingles vaccine is a simple way to prevent the recurrence of chickenpox and has been found to reduce the risk of Alzheimer's by over 50%, which is a significant discovery 10s.
• Many educated and smart individuals are taking various supplements and medications without fully understanding their effects on their health, and they often bring a bag of vials to their doctor's office to discuss their regimen 42s.
• The COVID-19 pandemic has created a problem for doctors, as science became politicized, and people's beliefs about science were influenced by their political views rather than the actual data 2m6s.
• There is a lack of equal access to healthcare across the country, and it is currently seen as a privilege rather than a right, with treatments like the shingles vaccine and GLP-1s having potential benefits for many people 4m6s.

Role of AI in Healthcare and Drug Development

• Artificial intelligence (AI) has the potential to bring significant change to the healthcare system, by taking over tasks such as data entry, allowing doctors to see more patients and spend more time with each one 6m6s.
• The key to getting the best outcomes for patients is for them to understand what is going on with their health, which can be achieved through conversations between the doctor and patient, and AI can help facilitate this by providing clues and cues for doctors 8m6s.
• A 360-system, similar to concierge medicine, can provide patients with a comprehensive approach to their health, but this is not currently accessible to everyone, and many people are scared of AI and its potential impact on healthcare 10m6s.
• The use of AI in healthcare can help standardize medical practices across the country, allowing all doctors to have access to the same information and provide similar care, which can lead to better outcomes for patients 12m6s.
• The development of drugs, such as those for breast and prostate cancers, has been significantly accelerated with the use of AI, which can predict the shape of proteins and design molecules in a much shorter timeframe, for example, six drugs were made in just five months, 10s.
• The process of creating drugs using AI involves printing proteins overnight, testing them, and then using the data to improve the model, which can lead to the development of drugs that target previously undruggable diseases, 2m6s.
• However, the production of drugs is still largely done in countries like China, which can be a concern, and there is a need for the United States to develop a strategic plan to build its own infrastructure for manufacturing drug ingredients, 2m6s.

Infrastructure and Strategic Planning in Healthcare

• The lack of chemical factories in the United States to produce drug ingredients is a significant issue, as these factories require large amounts of chemistry waste disposal, which is not desirable in local communities, 5m37s.
• There is a need for a strategic plan for healthcare in the United States, which would involve investing in critical infrastructure, such as chemical factories, and developing a long-term plan for the country's health needs, 7m15s.
• While AI can greatly assist in healthcare research, there are limitations to its capabilities, particularly when it comes to human interaction, which is essential for building trust and providing emotional support to patients, 10m45s.
• The use of large language models in healthcare also poses challenges, as these models are programmed to provide answers that are pleasing to the user, rather than necessarily accurate or unbiased, which can be problematic in a healthcare context, 12m30s.
• The medical field is a zero-fault tolerant business, and even small mistakes can cause significant concern, making it essential to develop guardrails and transparency, especially when using data sets that may not be applicable to everyone, such as a data set trained on people from Kansas being used for someone from Missouri 10s.
• The current use of powerful tools like artificial intelligence in healthcare lacks structure and leadership, and there is a need for strategic planning to effectively utilize these tools, as seen in the example of past surgeon generals, including Vick Murthy, whose platform focused on loneliness but lacked a comprehensive plan for the country's health 2m6s.

Ellison Medical Institute and Longevity Research

• The Ellison Medical Institute is a unique nonprofit organization that combines patient care, drug development, and clinical trials under one roof, with a focus on preventing disease and developing new treatments for cancer and inflammation to help people live longer 4m42s.
• The primary goal of the Ellison Medical Institute is not to develop a "secret serum" for longevity but to prevent disease and improve health span, allowing people to live quality years and enjoy life, such as playing with grandchildren in their 70s, 80s, and 90s 6m15s.
• The pursuit of life extension and longevity is often misunderstood as narcissistic, but the actual goal is to understand basic biology and translate it into ways to improve human health, such as using statins or optimizing sleep patterns to "hack" the human system and promote healthy aging 8m40s.
• The investment of resources into longevity research, including from wealthy individuals and organizations, has the potential to make significant breakthroughs and benefits available to everyone, rather than just a select few, and could lead to a better understanding of how to promote healthy aging and increase health span 12m10s.

Health Trends and Public Responsibility

• The concept of "experiment of one" is considered to be somewhat ridiculous and not data-driven, which can lead to serious negative health ramifications for those who follow it, especially when promoted by public figures, 10s.
• Public figures have an obligation to provide data-driven information and explanations, rather than promoting products or interventions without sufficient evidence, which can be a disservice to the public, 42s.
• The trend of using GLP1, a drug initially developed for diabetes, has shown promise in changing metabolism and affecting the brain's desire for food, but there is a need for more long-term data to fully understand its effects, 2m6s.
• GLP1 has been shown to be beneficial for people with an elevated body mass index, fatty liver, and certain types of heart disease, but its use should be approached with caution due to potential side effects such as sarcopenia and inflammation of the pancreas, 4m30s.
• The use of hyperbaric chambers is another trend that has been promoted for various health benefits, but its effectiveness is not fully understood, and it was originally developed to treat the bends in divers, 8m10s.
• Hyperbaric chambers can increase blood flow to certain areas of the body, but more research is needed to fully understand their effects and potential benefits, 9m20s.
• The importance of data-driven information and caution when promoting health trends is emphasized, as well as the need for public figures to be responsible and transparent when sharing health information, 10m40s.

Lifestyle and Health Optimization

• The importance of understanding that what may seem effective for one person may not be the case for another is crucial, and factors such as the environment, or "soil," can significantly impact the outcome of treatments, such as hyperbarics, which can change the environment and affect the growth of cells, including lung cancer cells 10s.
• Sleep is a critical aspect of health that often does not receive enough attention, and measures such as wearing blue light glasses, eating early, and exercising at the right time can help improve sleep quality, with the goal of getting at least an hour of deep sleep per night 42s.
• The timing of meals is also essential, as people who eat at regular schedules tend to have higher metabolism and better overall health compared to those who graze throughout the day, and even one snack can disrupt the body's rhythm for several days 42s.
• Regular movement and exercise are vital for maintaining physical and cognitive health, as the body is designed to move, and activities such as walking can help stimulate the muscles and improve overall function 42s.
• Delaying retirement can have a significant impact on cognitive decline, with studies showing that every year of delayed retirement can reduce cognitive decline by 3-4%, highlighting the importance of staying engaged and active 2m6s.
• Social connections are also critical for health, and having friends and engaging in activities can be more effective than many other methods, and having a normative body to discuss and promote healthcare leadership is essential 2m6s.
• Establishing a national infrastructure for data transmission and standardizing data terminology are necessary steps to improve healthcare, as the current system is fragmented, with different institutions having their own datasets, such as the Mayo Clinic and Harvard, and a national stripe to health data would facilitate the sharing and analysis of information 2m6s.
• The need for a structure to analyze data and improve healthcare is emphasized, with the goal of enhancing the healthcare system in the country 10s.

Funding and Innovation in Healthcare

• The role of government funding in healthcare innovation is discussed, with the National Institutes of Health (NIH) being the largest funding body for science globally, and other organizations and foundations also contributing to funding innovative healthcare projects 42s.
• A personal anecdote is shared about undergoing surgery, and the importance of demystifying medical procedures by openly discussing them is highlighted, as it can help others feel more comfortable seeking medical attention 2m6s.

Health Monitoring and Technology

• The conversation touches on the topic of health tracking and monitoring, with a product like Coler Health's Dakota being mentioned, which can provide valuable insights into a person's health by tracking biometrics and detecting irregularities 4m10s.
• A panel discussion is introduced, featuring Jason Braraw, a certified personal trainer and founder of Title Elite Performance Center, Dr. David Daniels, a cardiologist and founder of SoloPace, and Dr. Ezekiel Emanuel, an oncologist and vice provost at Penn, to delve deeper into the role of doctors in medicine 6m10s.

Expert Panel on Health and Longevity

• The importance of doing difficult and challenging things to improve cognitive health is highlighted, and having family and friends, as well as participating in activities with them, is considered crucial for a healthy life 10s.
• Zeke suggests doing "wellness trifectas," which involve activities that combine social interaction, mental stimulation, and healthy habits, such as hosting dinner parties, to achieve overall wellness 42s.
• Jay emphasizes the importance of resisted activity, such as strength training, and exercising regularly, more than two or three times a week, to load the body and maintain physical health 2m6s.
• Dave broadens the concept to include movement, food, and consistency, highlighting the need to move regularly, eat nutritious food, and maintain consistency in these habits for optimal health and longevity 2m6s.
• The conversation shifts to the importance of consulting doctors and providers, rather than relying on online research and influencers, as medical technologies and cures may not be suitable or safe for everyone, and can be expensive and pointless 4m30s.

Medical Profession and Wellness Focus

• Zeke explains that the medical profession has often neglected wellness and preventive care, focusing primarily on treating sick people, and notes that a study is being conducted to examine how often physicians discuss wellness with their patients 6m20s.
• The medical profession has a bias towards treating sick people, which can lead to neglect of those who want to engage in wellness behaviors and prevent health problems, and this bias is partly due to how doctors get paid 10s.
• People may self-medicate with supplements or drugs without consulting a doctor, and this can be dangerous, as exemplified by Donald Trump's suggestion to take a malaria drug during the COVID-19 pandemic, and doctors often have to deal with the consequences of such actions 2m6s.
• The approach to patients is often problem-based, focusing on procedures, treatments, and documentation, but when patients come to a doctor, they usually have a set of questions and concerns that require a more nuanced and contextual understanding, which is where the art of medicine comes in 4m30s.

Art of Medicine and Patient Interaction

• The art of medicine involves gauging how a patient's problem impacts their life and determining the best course of action, which requires experience and human interaction, and is something that artificial intelligence is not yet capable of reproducing 6m40s.
• Knowing a patient's health and injury history is crucial in making informed decisions, and doctors need to take this into account when guiding their patients, as illustrated by the example of Jay's industry, which is plagued by constant changes in diet, exercise, and other factors 9m20s.
• The fitness and training industry has a severe packaging issue, with many products and methods being promoted, and it can be difficult for trainers to figure out what works best for each individual, taking into account their goals, availability of resources, and tolerance for certain exercises or products 11m30s.
• The current state of the health and fitness industry is dominated by attractive individuals, with people often choosing trainers and seeking information based on physical appearance rather than expertise 10s.

Fitness Industry and Personalized Training

• This can lead to people following absurd workouts and getting varying results, with some achieving success and others requiring orthopedic surgery, and those who succeed often swearing by the workout and recommending it to others 1m5s.
• As a trainer, it can be challenging to provide evidence-based advice when people are influenced by what they want to hear, and they may ignore sound advice if they have already been told something else by someone they trust 2m6s.
• The way people choose trainers and fitness advice is often analogous to how they might choose a dentist or other professional, with physical appearance and charisma playing a significant role 2m45s.
• In contrast to general health and fitness advice, personalized analysis and tailoring are crucial in medicine, where a doctor can look at an individual's specific situation and provide customized guidance, which is something that online resources and influencers often cannot do 4m30s.
• However, there is disagreement on the importance of personalization in health and fitness, with one perspective arguing that general rules, such as avoiding ultra-processed foods and eating plenty of fruits and vegetables, apply to most people, while another perspective emphasizes the need for contextual and individualized advice, particularly when dealing with specific health issues or injuries 6m20s.
• Jay and Zeke discuss the importance of considering individual circumstances, such as a micro tear in the rotator cuff, when providing fitness advice, highlighting the limitations of one-size-fits-all approaches and the need for nuanced and personalized guidance 8m10s.

Balancing General and Personalized Health Advice

• The truth about health and wellness lies in the middle, where general rules can be applied, but professionals with experience can provide valuable insights beyond general knowledge, especially when dealing with complex issues 10s.
• When it comes to exercise, many people mistakenly believe that a great workout is measured by the amount of sweat produced, which is actually a sign of temperature regulation, not necessarily a good workout 2m6s.
• A good workout should challenge the body and require adaptation, and while walking and moving around can be enough for some people, others may need more intense exercise to see results 2m6s.
• The Coler Health Dakota Tracker is a device that can be installed on a toilet to track gut health and hydration by analyzing waste, and it can provide valuable insights into the body's health 4m42s.

Health Tracking and Gut Health

• Many people have gone crazy with health information due to bad sources, and it's essential to separate fact from fiction, especially when it comes to topics like protein intake 6m6s.
• The recommended daily protein intake is about 1.2 grams per kilogram of body weight, and most Americans already get enough protein from their diet, with exceptions for athletes and older adults who may need more 8m6s.
• A significant deficiency in the American diet is fiber, with 93% of Americans not getting enough, and this is a more pressing concern than protein intake 10m6s.

Nutrition and Dietary Misconceptions

• A variety of fiber lengths is necessary for the growth of good bacteria in the microbiome, and it also protects the colon, which is often overlooked in favor of more popular health trends 10s.
• The concept of "fiber maxing" is not as widely discussed as other health topics, and the focus on cholesterol and statins, such as Lipur, or generic tovastatin, is often driven by misinformation about the pharmaceutical industry 42s.
• Statin drugs have known side effects, including muscle soreness and potential cognitive changes, but they have been proven to decrease the risk of stroke, heart attack, or death, and not taking them can significantly increase the risk of major health problems 2m6s.

Exercise and Physical Health

• The idea that having a "great butt" is linked to longevity is a marketing tactic to encourage people to exercise, and while it may not be directly related to longevity, having strong gluteal muscles can improve posture, reduce stress on the spine, and contribute to overall health 4m10s.
• The tech industry often makes exaggerated claims about the potential of AI and other technologies to cure diseases, but when pressed for specifics, they often back down or qualify their statements, although there are still reasons to be optimistic about the potential of these technologies 8m30s.
• Zeke is impressed by the potential of AI to augment the work of doctors, particularly in helping patients manage chronic illnesses such as hypertension, high cholesterol, and diabetes, by intervening every day to help them manage better autonomously 10s.
• Dave is enthusiastic about the impact of GLPs on his patients, noting that it has helped them reduce their medication list from 10 to 3, which he believes is beneficial for their overall health and wellness 1m42s.
• Jay wishes there were more technologically beneficial tools for people, such as the V2 test, which measures how efficiently muscles can use and produce oxygenated blood, and could be helpful for creating personalized exercise plans, but notes that such tests are currently expensive 2m6s.
• The conversation touches on the topic of ineffective and junk technology being marketed and sold, with a preference for more substantial and scientifically-backed innovations, such as the V2 max test that Jay underwent, which showed improvement from excellent to superb 3m30s.

Medical Innovations and Devices

• Dave, as an entrepreneur, is working on creating medical devices and innovations, including a device to facilitate trans catheter aortic valve replacement and a company called PacNet, which aims to reduce the number of unnecessary pacemakers implanted after valve replacement, with the goal of making medical procedures simpler and more cost-effective 5m30s.
• A temporary pacemaker is being developed to allow for cheaper and less complicated implantation, with the goal of providing time-limited therapy and removing the device within 30 days to minimize complications and downstream problems for the patient 10s.
• The development of new drugs is being facilitated by AI, but the process is slowed down by two main factors: the reluctance of people to participate in clinical trials, with many Americans preferring to let others take the risks while they reap the benefits, and the slow review process of the FDA, which can take up to a year and a half to review applications 2m6s.
• The FDA's ability to review applications quickly during the COVID pandemic has shown that it is possible to speed up the process, but the agency's lack of manpower and expertise, exacerbated by the summary firing of thousands of employees, is a major obstacle to getting new drugs and devices to market faster 2m6s.
• One of the most significant health breakthroughs in the last 30 years is the development of trans catheter aortic valve replacement, which allows for the replacement of heart valves without open heart surgery, reducing the trauma and risk associated with the traditional procedure 6m38s.
• From the perspective of someone in training, the most significant health breakthrough in the last 5 years is the development of portable and electronic resistance training equipment, which allows people to work out effectively without being tied to a gym, with devices that can provide up to 100 pounds of resistance in a small and portable package 10m30s.

Challenges in Drug Development and Clinical Trials

• The development of new technologies and treatments, such as GLP1s, is critical to improving healthcare, but is often hindered by the slow pace of innovation and the reluctance of people to participate in clinical trials, which can delay the availability of new treatments and increase their cost 4m30s.
• Zeke believes that Americans need to understand that participating in clinical trials is essential to bringing new innovations to market and that the benefits of these innovations are only possible because of the people who participate in the trials 2m6s.
• Jay thinks that the ability to do effective workouts with portable equipment is a significant breakthrough, as it allows people to exercise and improve their health without being limited by access to a gym or specific equipment 10m30s.

Recent Breakthroughs and Future of Health

• Resistance training can be done with various types of equipment, making it a cost-effective and versatile way to challenge the body, and it's not just about lifting weights, but about using resistance to improve overall health 10s.
• Recent breakthroughs in biomedicine, such as gene therapy and CARTT therapy, have been remarkable, with the ability to cure diseases that were previously incurable, and these advancements are a testament to the rapid progress being made in the field 2m6s.
• Despite these advancements, the key to improving the health of the population lies in the basics, such as socialization, healthy eating, regular exercise, including aerobic exercise, strength training, balance, and flexibility, rather than relying on quick fixes or miracle cures 2m6s.
• Adopting a healthy lifestyle requires a long-term commitment and a change in mindset, rather than seeking fast solutions, such as taking a particular supplement or following a fad diet, and it's essential to focus on developing sustainable habits that can be maintained for decades 2m6s.
• The importance of basics like exercise and sleep cannot be overstated, and it's crucial to prioritize these aspects of health, rather than relying on technology or quick fixes, and companies like Coler Health are working to promote better understanding of health by providing tools like the decoded tracker, which helps individuals monitor their gut health, hydration, and other aspects of their well-being 8m30s.