I listened to an interesting podcast featuring the guru of Functional Medicine, Dr. Mark Hyman.  He’s written numerous NY Times bestseller books (UltraMind Solution, UltraMetabolism Solution, What the Heck Should I Eat?) and runs UltraWellness Centers across the country. He just released his new book called “Young Forever: Secrets to Living your Longest and Healthiest Life”.

This podcast was a teaser of what’s in the book – here are some highlights:

• Hyman has tested his biological age using the DNA methylation test which also measures your telomere length (offered by True Diagnostics) and he is 20 years younger than his chronological age! There are other tests out there but the key is to get a baseline of where you are now and then track how you age over time. You cannot track what you don’t measure.
• Aging is not a disease! Functional medicine offers a paradigm shift and he doesn’t want the healthcare system to manage chronic disease – he wants them to eradicate it.
• The book features 10 pillars of aging and how to activate them for optimal health.
• Why do the hallmarks of health become dysfunctional in the first place? Do the hallmarks cause disease? Ultimately, what is the root cause? For example, inflammation is a hallmark of health dysfunction and it can cause a myriad of diseases (rheumatoid arthritis, diabetes, heart disease, etc.) But what created inflammation in the first place? That’s what you need to find out. Simply treating inflammation with an anti-inflammatory drug is not the answer!
• Hyman highlights several pathways that promote aging:
  • Insulin signaling. High insulin is a key marker of aging and is one of the most important tests to get done. Doctors don’t generally run fasting insulin so you’ll have to ask but it’s an inexpensive test. You can buy it yourself if your doctor won’t order it for you. Consider that many of us consume pharmacological doses of carbs and sugar. Your fasting insulin is an indicator of your metabolic health. If you want to get your insulin levels down, you need to eat a low glycemic, low starch and low sugar diet.
  • MTOR (Mammalian Target of Rapamycin) pathway. MTOR is important because when activated, it builds muscle and when inhibited, it activates the process of cell repair and clean-up. So over-stimulation is not good. We need cyclical inhibition of MTOR. When you go through periods of starvation, your body kicks in to repair, clean up and build new proteins.
  • Eating one third fewer calories can extend your life span by a third and there are calorie restriction societies out there that promote this. But it’s not sustainable – who wants to be hungry for the rest of their lives? Then, what mimics calorie restriction? Time restricted eating/intermittent fasting, and a ketogenic diet. Also the drug Rapamycin inhibits MTOR, increases DNA repair, and activates sirtuin activity. Dr. Hyman is a fan of rapamycin and includes it in his regimen.
  • Meat has gotten a bad rap because it is known to activate MTOR. Meat is not bad for you! You should stay away from feed lot (CAFO) meats. But you need MTOR to build protein AND you also need its inhibition to clean up.
  • To activate MTOR for protein synthesis, the quality of protein is important. You need 2.5g of the amino acid leucine to activate MTOR as you won’t turn on muscle synthesis without it. So, you have to eat meat, chicken or fish. A serving of 30g of protein has about 2.5g of leucine in it. To get the same amount of leucine from a vegetarian source, you need 2 cups of beans or 6 cups of brown rice (vs. 4 oz of chicken) – that’s a lot of carbs and gas!
  • To maximize muscle synthesis, load up on protein in the fasted state. If you eat a typical American breakfast of biscuits, cereal and orange juice, you are slowly killing yourself. You need to load up on protein to activate MTOR after fasting. The Recommended Daily Allowance (RDA) is 0.8g of protein/kilo of weight but that is too low.  To build muscle, you need ~1.6g/kilo to 2.0g/kilo (depending on your level of physical and fitness activity).
  • The surprising fact is that sugar raises MTOR more than animal protein! What is a well-known bodybuilder trick? They take maltodextrin to spike sugar along with protein to maximize the MTOR effect to build muscles.
  • MTOR inhibition promotes autophagy which is the process of cellular self-cleanup and recycling. We need autophagy for optimal health. Did you know that people that survived concentration camps lived a long time? Their systems shut down from starvation which activated the longevity pathways. Not a recommended strategy but another benefit of calorie restriction. If you love to eat, there is a product called fatty15 – it’s a long-chain (C15) fatty acid that has been shown to stimulate inhibition of MTOR. I started taking this product recently – it’s one tiny capsule/day and easier to take than Omega-3 fatty acids.
  • The sirtuin pathway is important for longevity as it activates DNA repair, improves mitochondrial function, improves insulin sensitivity and delays cellular senescence. Compounds like NAD, metformin and rapamycin all work to support the sirtuin pathway. However, Dr. Hyman is not a fan of metformin due to mitochondrial side-effects and digestive upset.
• Hyman advocates that lifestyle is an order of magnitude more powerful than any drugs. For example, Ozempic is a popular GLP-1 agonist (a class of medications utilized in the treatment of type 2 diabetes and obesity) for improving insulin sensitivity. But did you know that 40% of the weight loss from Ozempic use is the loss of muscle? You essentially have to do aggressive strength training with the drug use. Because the minute you get off the drug, your metabolism will have slowed due to muscle loss and 65% of the weight lost is regained. Drugs like Ozempic are promoted as a lifelong drug. According to the New England Journal of Medicine, the current budget for Medicare Part D (drug benefit) is $145B.  But if all obese Americans took Ozempic, the entire bill will be $268B which is 85% more than we currently spend on all drugs for all Medicare patients! An intervention that has orders of magnitude benefit more than medication is lifestyle.
• Hyman is NOT for anti-aging as he is not against chronologically getting older. He’s advocating healthy aging and understanding how to optimize health, prevent and reverse disease, and extend one’s health and lifespan.
• As a functional medicine doctor, Dr. Hyman calls himself an inflammalogist. And inflammation leads to aging and disease. Heart disease, cancer, autoimmune conditions, and diabetes are all inflammatory diseases. Inflammation is a common route to aging (inflammaging) that accelerates as we get older.
• One accelerator of inflammation is the formation of zombie and senescent cells. These cells are not killed off by apoptosis (cellular self-death) but live forever and spread inflammatory stuff while infecting other zombie cells. So you need to treat zombie cells with senolytics (compounds/drugs that eliminate zombie cells) – Fisetin, quercetin, and hyperbaric oxygen therapy are some therapies to try.
• Another promoter of inflammation is mast cell activation. Mast cells release histamine when activated but those with mast cell activation syndrome release excessive amounts of histamines and other chemicals that lead to allergy-like symptoms. In that case, you may need a low histamine diet.
• Knowing how to reset immunity is important for a healthy lifespan. In treating people with environmental allergies, chemical and food sensitivities, rather than just avoiding the culprit, Dr. Hyman will look for the cause of their sensitivity. When he focuses on fixing their gut microbiome and immune system, these allergies/sensitivities will often be eliminated.

In a nutshell, you don’t have to go to Dr. Hyman’s UltraWellness Center or spend a fortune on the latest anti-aging therapies. Read his Young Forever book that is filled with practical tips. I’ll be downloading a copy of it to have as a reference guide.