Dr. Peter Linneman & Dr. Michael Roizen
Leading Economist, Former Wharton Professor & Chief Wellness Officer at Cleveland Clinic
Chief Wellness Officer at the Cleveland Clinic, Dr. Michael Roizen and renowned economist, Dr. Peter Linneman discuss the secret to longevity.
On a groundbreaking episode of the Walker Webcast, we were joined by Dr. Michael Roizen, Chief Wellness Officer at the Cleveland Clinic, and renowned economist, Dr. Peter Linneman. They joined Willy to discuss the most jaw-dropping medical, technological, and scientific advances that will significantly extend lives, all of which are covered in their new book, The Great Age Reboot.
Discover the critical factors to maintaining health, the greatest detriment to our immune system, the far-reaching benefits of exercise, incredible medical trials being studied today, and so much more.
Michael starts off the episode by explaining the concept of “real age.” It’s the “net present value of the choices we make” based on disability and mortality data—and the most accurate predictor of cardiovascular-caused mortality that we know of.
Unlike calendar age, real age is a part of our destiny that’s largely under our control. In fact, we can use self-engineering to impact up to 80% of our DNA settings and “reboot,” which Peter found to be his most interesting discovery while writing the book. He says “real aging” is something we simply can’t afford to ignore as a society.
So, how exactly does one turn back the clock? Michael details six key factors: managing stress, making healthy food choices, staying active, avoiding bad habits, getting enough sleep, and taking supplements.
For healthy food choices, Michael noted five food types that increase blood sugar levels and therefore aging: simple sugars, added syrup, simple carbohydrates, red meat and egg yolks. When you eat matters as well. People who eat earlier in the day are proven to eat better, sleep more, and are less hungry, according to Michael. He recommends eating only when the sun is up.
In the heated debate between resistance training vs. cardio for exercise benefits, which does Michael suggest? Jumping—specifically jumping on a hard surface 40 times per day. It’s an effective exercise to prevent mobility and hip fractures as we age, he says, as it keeps the disks in the back lubricated and increases bone strength, he says.
Peter weighs in from an economist’s perspective. He rejects the belief that our society can’t afford people to live longer. Longer lives indicate greater health, and less need for care and resources.
The impact of stress is not to be minimized, according to Peter and Michael. In fact, it is the strongest thing which diminishes our immune system as we age. Fortunately, there’s a powerful way to counteract stress: through friends and purpose. It can be difficult to do as we get older, particularly as sensory losses impact the ability to interact. But losing engagement with other people has massive implications for overall health. Peter shares personal experiences and practical tips, including how he strives to keep in touch with seven people on a regular basis.
Webcast transcript
Willy Walker: Good morning and welcome to another Walker Webcast. It's a true joy to have two incredible men and good friends joining me this morning to discuss their new book, The Great Age Reboot and a topic that is dear to my heart. Before I introduce my two guests who need a little introduction, a couple of quick points.
The markets continue to adjust to yesterday's higher than expected inflation report and the ten-year spiked to 3.4%. It's hard to imagine the Fed doing anything less than a 75-basis point increase next week. The more dramatic shift is that the market prior to yesterday expected a 50-basis point hike in November, followed by a 25-basis point hike in December, so a total of 75 basis points after next week's hike. And that has now been revised over the last 24 hours or the majority now expect another 75-basis points in November and then a following 50 basis points in December. So that's another 200 basis points, including next week's increase of 75 that will come into the markets if what the market projects actually happens.
I want to get Peter's take on inflation rates prior to us jumping into health and wellness. But one other note before I go to Peter, as it relates to single-family housing, Zelman published their monthly homebuilding survey yesterday showing that while single-family orders decreased by 24% year over year, they increased 11% sequentially above normal seasonality, spurred by a significant increase in incentives showing that while demand for single-family housing is down, it is a bit more elastic than expected. A final little plug for Zelman. As many of you know, Walker & Dunlop owns Zelman, and they're holding their annual housing conference next week, which is consistently regarded as one of the best housing conferences in the country. If you have any interest in attending the Zelman Housing Conference, just go to ZelmanAssociates.com and you can register.
So, Peter, real quick before we start off and I do introduction of Mike and the book, your take on yesterday's inflation print and the market's reaction?
Dr. Peter Linneman: This is like going to a Simon & Garfunkel concert and shouting out, “Freebird,” “Freebird” right?
Willy Walker: (Laughs) I have you here. I got to get 30 seconds.
Dr. Peter Linneman: So, look, never have ten basis points caused so much confusion. I think people are overreacting to the phenomena. It's largely a rounding error. People are trying to read into. It's just like old Soviet analysis. You're trying to read into things that may or may not be there. I'm not saying there is nothing there, but there's also a very high chance that it's just noise. Having said that, I do think what it does is what you said – the Fed will raise the rates next week, probably 75-basis points. I think they'll pause a little from there to see what job numbers are in the subsequent month. You know, when we get the monthly data three weeks from now, they'll see what that looks like. I would remind people, there's a very good article in the Wall Street Journal today or yesterday. There is no Phillips curve and there is no tradeoff between inflation and non-employment. There is none. I can't say this, I've written about this, the empirical evidence is voluminous on this. Mike, this is a little like saying “cigarette smoking has no correlation with health.” There is no correlation between inflation and employment and unemployment. I don't know why people believe it. Believing in virgin birth is easier. So, I think that's a good transition point.
Willy Walker: That is a great transition point.
Dr. Peter Linneman: There's overwhelming evidence there's no tradeoff between inflation and unemployment. Mike, do we know DNA evidence on whether there was virgin birth or not? I don't know.
Willy Walker: We're going to go to The Great Age Reboot. So let me do a quick intro now, and everyone on the webcast today knows who Dr. Peter Linneman is. Renowned University of Pennsylvania and Wharton School professor, founder and CEO of Linneman Associates, savvy real estate investor and habitual Walker Webcast guest and quarterly review of The Linneman Letter.
Dr. Michael Roizen is a graduate of Williams College. (Mike, I will tell you, last night I mentioned at dinner with my great friend Jonathan Coleman that you were on today and he said, “Oh, Williams College grad!” And I said, “Yup.” Then I went on to talk about all the great work that you and Toby Cosgrove did at Cleveland Clinic, and Jonathan then plugged back in and goes, “Another Williams grad!” So, Williams College is getting a good plug here.
An Alpha Omega Alpha graduate of the University of California, San Francisco, School of Medicine, he performed his residency in internal medicine at Harvard's Beth Israel Hospital and completed Public Health Service at the National Institutes of Health in the laboratory of Irv Kopin and Nobel Prize winner Julius Axelrod. Dr. Roizen is the Cofounder of RealAge Inc, which was sold in 2006, yet he still Chairs its Scientific Advisory Board. Dr. Roizen was on the Faculty University of California, San Francisco and shared their Department of Anesthesia and Critical Care at the University of Chicago and then became the Dean of the School of Medicine and Vice President for Biomedical Sciences at SUNY Upstate. And then he became the chair of the Anesthesiology Institute of the Cleveland Clinic in 2007 and was later named Chief Wellness Officer of the Cleveland Clinic, the first such position in a major health care institution in the United States.
Dr. Roizen has authored or coauthored four #1 New York Times bestsellers and nine top ten bestsellers. He and Dr. Mehmet Oz, who is no longer writing with Mike due to Dr. Oz's Senate bid, write a daily newspaper column syndicated to over 100 newspapers across the country. His newest book, coauthored with Peter Linneman and Albert Ratner, The Great Age Reboot hit bookshelves this week.
So, Mike and Peter first, thank you both for joining me. Mike, we've discussed your book, What They Eat and When and which caused me to stop eating dinner for a while. And then I read The Great Age Reboot and looked into canceling my life insurance policy. Before we dive into both of those books. You're now 76, yet your real age is closer to 55. Can you explain what real age is? And the real age questionnaire, which I believe about 70 million people have completed?
Dr. Michael Roizen: Right. The real age is the actual age of your body as opposed to your calendar age. I was lucky enough to be at the University of Chicago, and since he acknowledged it, I had a patient named Gary Becker.
Dr. Peter Linneman: Who was on my thesis committee.
Dr. Michael Roizen: So, Gary had won the Nobel Prize for the net present value of investments. And so, I was trying to get people to understand how important health choices are. And so, we did the net present value of medical choices. What real age is, is really the net present value of the choices you make based on disability and mortality data. It had to be in at least four studies in humans. And so only one thing out of the 151 in real age has even come in question. I'm very proud of that, if you will. An independent study shows it is the most accurate predictor of cardiovascular and all-cause mortality that we know of, independent of us. They looked at 10 million of the first people who had done it. So, it's still available free at www.sharecare.com.
Dr. Peter Linneman: What's your real age, Willy? You certainly took it.
Willy Walker: It's funny, I wanted to do my real age this morning and I ran out of time before doing this. So, my calendar age is 55, but I'm quite certain my real age is significantly below that. What's yours, Peter?
Dr. Peter Linneman: I'm 71 calendar age and 54 is my real age.
Willy Walker: Yeah. So, Mike, you kiss your wife, Nancy, every morning, which helps keep the stress levels down. You eat your final meal before 4 p.m. in the afternoon.
Dr. Michael Roizen: No, I eat before 7:30 in the evening.
Willy Walker: All right. I know that when you go to Cavaliers games, you every once in a while eat a little bit later. But anyway, and you do 10,000 steps a day on the treadmill, and you drink lots of coffee. So, I've had numerous conversations with Peter where he puts on his earpods and is out walking and huffing and puffing as the two of us are trying to talk about economic data and things of that nature. So, both of you walk a lot. Both of you watch your diet. Obviously, it's a combination of all. But, Mike, as you sit there and say it's diet, it's sleep, it's exercise, what are the critical factors to maintaining health and having a calendar age in the mid-70s and a real age in the low 50s?
Dr. Michael Roizen: The key is managing stress. Stress is the greatest ager of all, and it is friends – a posse and a purpose. So, my purpose in life is actually spreading the message that we get to control our genes to a large degree, and it's not that hard. We call it self-engineering, but apparently as you get older when you're young, it's pretty easy to have friends through school and sports. As you get older, you've got to work at that posse. And that's especially true as we've moved out of the office. So, getting back to the office holds a great chance of reducing stress, actually, and managing it.
So, there's six real big things. One is stress management. The second most important is food choices, portion size and time you eat it. The third is the four components of physical activity that have been shown to affect disability and death rates. The fourth is unforced errors, avoiding tobacco, texting while driving, vaping, etc. The fifth is sleep and brain health, and the sixth is what we call supplements or small molecules, things you can take that make a difference in how long and well you live. I'll give you an example of that sixth one. We have a scientific advisory board on The Great Age Reboot and ten excellent people in longevity. None of us knew, for example, that creatine, which is a muscle building supplement that kids use, 15- to 35-year-olds…
Willy Walker: I got big vats of it in my house because my two football playing teenagers love eating it. So anyway, I got lots of it.
Dr. Michael Roizen: So, it's inexpensive. But in the randomized studies of people over the age of 65, it decreased muscle mass loss. It helped you stay strong, so you didn't develop frailty. And incredibly enough, they looked in two of these studies, randomized controlled trials. They looked at brain health and it improved cognitive function in each one of those. So, 4000 milligrams at four grams a day, a teaspoon of that stuff is what you want, Willy when you get old, as old as Peter and I are routinely. But the earlier you start, the better, presumably. That's one of the small molecules, there about 18 that we have on the website and in the app that goes with the book that you can go through that the greatagereboot.com website and that helps people gradually increase things. We've been suggested since the original webcast we did with you through questions we've gotten from your audience and others, there have been over 50 small molecules or supplements suggested, about 18 of which actually have really good data. That's a benefit. This was one of those suggested by one of your listeners that none of us in the scientific advisory board were taking. So, you've got vats of it at home. Go to it.
Dr. Peter Linneman: You know, I came into this because Albert Ratner is a dear friend and they asked me to join them and I figured, “well, I'll humor him.” But I learned and I had a great time, and I learned a lot. The most interesting thing I learned was just how much of our destiny we control. What is it Mike? We have 22,500 DNA cells?
Dr. Michael Roizen: That's genes. Let me divert for just a minute and then you continue.
Willy Walker: You can talk about interest rates in a second and Peter can correct you, Mike, so it's all good.
Dr. Michael Roizen: I'm not talking interest rates. (Laughs) So when the Human Genome Project started in 1992 and three, both the Venter group, the private group and the Collins group at NIH expected to find 300,000 genes. They only found 22,500 genes and what they called the rest of the DNA? They call it “junk DNA.” But eight years later, it was found out it's really switches that control our genes. And we control it, I'm going to let Peter finish this. Go ahead, Peter.
Dr. Peter Linneman: What I was stunned to find – I'd always heard genetics, genetics you're born with and it's true you are born with. But basically, we control 80% of our DNA settings by the type of stuff Mike was talking about and what the geneticists are working on is how to either make it easier for us to control those settings or deal with the ones we can't control. But 80% of our DNA settings we control by what we've called self-engineering. You may not be at MIT or Caltech, but you're a great genetic engineer for better and worse. That was the single most important thing for me personally to learn. I used to think I felt better. I thought I just felt better. And it's more that I felt better, I was better. Healthy cells create healthy cells and unhealthy cells create unhealthy cells. And so anyway, that's an aside.
Dr. Michael Roizen: I will give you an example Willy, if I can do another diversion, is when you exercise –we always thought that it was because you improve blood flow to your brain that you prevented dementia. It is that. But in addition, this was discovered or tried to be patented the same day by Harvard and by University of California. You turn on a gene that produces a small protein. All genes are protein factories. You turn on that gene that produces a risen, goes across the blood brain barrier, and increases your hippocampal size, your memory center. So, there's only one organ in the body where size really matters, and that's your hippocampus, and it gets bigger, so you're much less likely to get dementia. Why did they patent it? Because they hope to be able to give you arisen by itself and have the same effects. But that's one of the effects of doing exercise, whether it's gardening or whatever you like doing. Albert likes playing ping pong, whatever you like doing. If you stress a muscle, you turn on that gene that produces arisen.
Willy Walker: So, Mike, on that, just two quick things in that I listen to a webcast and I and I'm forgetting her name, I'll go look it up. But a researcher from New Zealand who was on the WHOOP podcast talking about the fact that exactly what you're talking about as it relates to mental capability in the restoration and maintaining of the white matter inside of your brain that staves off both Alzheimer's and also keeps you more mentally fit. That cardio doesn't do it as well as resistance training, and her comment was not only resistance training, but resistance training at 70% of your max or more. I can pull it up and I should have done a little bit more on this. But does that sound right to you in the sense you put forth on exercise that there are four things you ought to do. You ought to do any exercise. Second, you ought to do resistance training. Third, you ought to do cardio. And fourth, you ought to do jumping. The jumping one got me. But go to this about resistance versus cardio and the benefits not only for your physical well-being, but for your mental well-being.
Dr. Michael Roizen: The interesting thing is the data on resistance training being stronger than cardio is controversial, meaning in different animal species, you can imagine you can get rats to do pull ups in some ways which is resistance training for the rat. But in different animal species, different things are more important at turning on arisen-producing gene. So, we don't really know whether it's different in different human ethnic groups or not. All we know is that no matter what exercise, if you stress the muscle enough, it will produce. It will turn on the gene that produces arisen. But there is initial data, at least in humans from New Zealand and from Australia, that resistance training turns on that gene at a lower level than does cardio. But this week we learned that walking does it, turns on the gene that produces arisen to.
Willy Walker: Talk for a moment about jumping because as I was doing my research yesterday and listening to one of your previous talks, I heard you talk about jumping and lo and behold, I have a routine that has all my step things and the next thing you knew, I was jumping at the beginning and jumping at the end. So, talk about jumping for a second.
Dr. Michael Roizen: So, this is really interesting because one of the things we worry about most is mobility as we get older, and we worry also about hip fracture. So, this study was saying: Could we increase bone accretion that is putting bone into your hip? We know that resistance exercise and certain things such as vitamin D and calcium together help slow the decrease in it, but we have never known how to increase it predictably. It turns out jumping, and when you look at it, you max out at 40 jumps – 20 in the morning, 20 in the evening. Only two studies on it, but that's the max benefit. Not only does it do that, but it keeps your disks in your back lubricated. The reason we get this disease is our discs dry out and at least this data and they use sophisticated MRIs that can look at hydration of your disks. The disks stay lubricated better if you jump 20 times morning and night and if you're doing it at the right time, that is, before you lose mobility and you lose disk power, you want to do disks. Now, I should put a caveat in here before all the people are listening. None of these things you should do on your own without talking to your practitioner, because there are some people who shouldn't do resistance training and there are some people who shouldn't do cardio and some who shouldn't do jumping. So please, this is not medical advice. This is, if you will, information.
Willy Walker: The one final piece on that, Peter, before we move off of jumping also jumping on a hard surface. So not jumping on a mat but coming down on a hard surface.
Dr. Michael Roizen: Right. Because apparently what happens is just like when you do resistance training, you get a little tear in the muscle. And it's almost like the muscle says, “you can tear me today, but I'm going to build back stronger for tomorrow.” And you turn on those cells, those genes that build muscle. Well in the bone, what you're turning on is osteoblasts. So, you have both osteoblasts and osteoclasts. The osteoblasts build bone, the osteoclasts reabsorb bone. And apparently what you do is you get a little break in the bone when you jump in, that little break gets built back stronger. And that's why jumping increases bone accretion or bone strength in your hips and back.
Dr. Peter Linneman: By the way Willy, what I was going to say is, many of these major research institutes have switched to using real estate developers as the targets because they are much more flexible in their thinking that they're willing to do because they'll do anything for money. And the researchers don't get attached to them nearly as much as they do the rats. (Laughter)
Willy Walker: Mike, talk for a moment about diet because you started on what we eat and how we eat. An easy rule of thumb that you talk about is “Eat only when the sun is up” and “Eat dinner for breakfast and breakfast for dinner.” Can you expand upon that a little bit? And I think going to the science as it relates to blood sugar levels and why our metabolism is so capable of dealing with food during the day and not at night, and how that can have a big impact on overall weight would be very insightful.
Dr. Michael Roizen: You know, Willy, you do so much research and you understand these things so well. You could do the podcast right now. But that's right. There are five foods that have been shown to increase aging. Everything else is fine to eat and you want to eat food you love and that loves you back. The five foods are simple sugars, added syrups, and simple carbohydrates. Why? Because they raise your blood sugar level and it's the raised blood sugar level that sugar attaches to proteins and makes the protein less dysfunctional. So many people know that we measure hemoglobin A1C for type two diabetes. What that is, is just a hemoglobin molecule with a sugar attached to the A1C position and that keeps it from releasing oxygen normally. That's why we think that diabetes causes leg ulcers and some of the other problems such as cardiovascular disease and dementia. So, you want to keep your blood sugar lower. The other two foods are red meat and processed red meat and egg yolks, and, if you will, one class of foods – fried foods. And the reason is that red meat, processed red meat and egg yolks, we a lot of people thought it was cholesterol. It isn't, it is the combination of carnitine or lecithin and choline and saturated fat. So, people take lecithin, pills, or carnitine pills. There's no problem with those when they take them alone and not with saturated fat. But when you take the two together, it changes the bacteria inside your gut to produce inflammation. So essentially having two six-ounce porterhouse steaks a week increases your risk of, if you will, heart attack more than an LDL cholesterol or a lipoprotein B of 250 because of the inflammation it causes and it moves in a shorter period of two weeks. So, one 4-ounce steak is no problem as long as you don't have the egg yolks or other things with carnitine less than choline and saturated fat with it because it doesn't change the bacteria enough. So, the reason to eat earlier in the day is part of that glucose thing. We become insulin resistant during the day. So, a calorie is a calorie is a calorie in the test tube. But in your body, a calorie in the morning is less of a calorie than a calorie in the evening. And so that's why we say eat more early, less later. In addition, people who do that in the study sleep better, have more energy, and are not as hungry at night. So, three big things from a weight control standpoint.
Willy Walker: Peter, as you hear Mike talk about that and back to sort of your comment about what turned on the light bulb for you about controlling 80% of the outcomes – what have you changed as it relates to what you eat as you read the research and listen to Mike talk exactly as he just has. What's something that's a practical thing? Mike lives this stuff every day. He knows more about this stuff than any of us ever will. You are on this topic, a commoner. What have you changed in your way you eat or live?
Dr. Peter Linneman: I'd given up red meat in 1983. I mean, if I go to somebody's house and they serve it at dinner, but I gave up red meat in ‘83 and I had gone to a reasonably healthy diet. So, the main thing my interaction with Mike has done is make me feel guilty when I eat ice cream, which I try not to do, but I had figured out a reasonably healthy diet. My wife is on a very healthy diet. I hadn't figured out that it was working at more than just a calorie level until this. That it was really working at a fundamental DNA level. Not only do you feel better, but you’re going to live better. You're going to live longer and healthier. And that's the real thing on RealAge. A lot of the things that are happening in medicine and they're stunning and we can talk about them. The second thing is, you've got to stay healthy until the cavalry gets there. It doesn't do you any good if you don't take care of yourself. It takes nine years for some breakthrough to occur. And meanwhile, you allowed yourself to wither away before then. So, we have a lot in the book about that. If you reboot either through genetic engineering from external sources or from yourself, we estimate that somebody who's 25 today has 100 years of additional life, and somebody who is 45 today has 75 years of additional life. Somebody who is 65 today has expected 45 years of life, and somebody 75. So, think of the two of us, Mike and myself, we have an additional 25 years. Now, obviously, if the breakthroughs don't occur in our lifestyle, that is, we don't self-engineer or come external. Those numbers adjust, but we feel very strong, about 80% chance that those are achievable. And the last part of the book, and you've read it, I think the last part is Albert and I kind of pushed Mike and Mike pushed us. We cannot afford as a society not to reboot. Otherwise, we won't be able to afford health care. Otherwise, we won't be able to have all sorts of issues. But if you think about getting those numbers an extra 25 years of productive life, imagine what this does is create some number like an additional 110-115 million healthy 40 and 50-year-olds. You say? Well, yeah, but they look like they chronologically are celebrating their 90th birthday. Yeah, but if 90 is the new 40 or 45, what we did, what we're going to do over the next 30 years is to truly create a vast population of 40 and 50-year-olds by standards of today in terms of productivity. They're going to be unleashed in a highly productive economy. They're the solution to problems. And you can look at it as what happens to GDP. If you're going to live 25 more years, you're going to work ten of them either because you want to or you have to afford them. Ten years is a 25% increase in your productive output of your life. I mean, just pause, and think about that.
Willy Walker: And you and I, on our quarterly discussion are going to talk about the labor force participation rate, because COVID obviously changed that a lot and a lot of people exited the labor force. But if I can pause for a moment on the economic side and go back to the health care side, Mike, you talk a bunch in the book about both boosting your immune system. The second is stress and getting stress out of your life there. As it relates to immune systems, we've all been dealing with vaccines for the last two years and we get boosted and all that great stuff. So, everyone's sort of more than ever in our lifetimes really thinking about our immune system and about immunity. Talk for a moment about how we ought to think about that as it relates to sleep, exercise and diet and then take that into stress. Because coming out of the pandemic, one of the big things for any of us who go to an airport and hop on an airplane is that everyone still seems to be pretty darn stressed out from the pandemic. And we haven't gotten the great reboot, if you will, as it relates to our attitudes about just taking a deep breath and not letting the Uber driver scream at you, or the Uber driver shouldn't scream at you to begin with, or whatever the case may be. What can we be thinking about as it relates to stress management? Because those two things are so closely linked in your immune system and then also stress.
Dr. Michael Roizen: Yeah, let me go back just 1 second. So, Peter talked about how we self-engineer our own DNA. Whether our genes are on or not, well, our food does that to the bacteria inside us. So, we are actually changing which of the genes are on in the bacteria inside us and they produce a whole mess of different things. Even exercise changes the bacteria inside you. So, it's amazing, we're just going to be learning that and how to and that will be an area that's one of the 14 areas of aging research that is changing our rate of aging substantially and being able to make us 40 when our calendar strikes 90.
As far as immune aging, my favorite story, which I relate in the book, is of Jim Allison, who had the idea: “Why doesn't our immune system attack cancer?” When he was a graduate student at University of California, San Francisco, in about 1978-1979, he did animal experiments until the late 80s, showing you could inhibit what he called the “checkpoint”. You could knock out that thing that the cancer cells send out that says “immune system, I'm a normal cell” and the mice with cancer would get cured. He then, big pharma did seven studies over I think $4 billion invested in this and found no success through 2001. He was, in fact, in a Berkeley coffeehouse in 2001 after he formed his own company because the data monitoring committee at one year had taken metastatic malignant melanoma and said, “That's what I want to work on.” And because it's the worst disease, it has a five-year survival rate of under 3%. And he started at one year. The survival rate in the chemotherapy along group with his drug was chemotherapy alone, 12.6%. Chemotherapy in immunotherapy, 12.3%. He was told by his data monitoring committee; we always have data monitoring committees that are independent of the investigators and company. And they said, “Stop, you're never going to find a result.” But he said, “I'm going to continue on. I've got enough money in the company to do the three-year study.” And they said, “You're going to lose all credibility. They'll never let you work in this area again. They'll never let you do an FDA study again.” He said, “I don't care. I really believe in this.” He was right. At three years, the survival rate in chemotherapy and immunotherapy was 11.3%. The survival rate, I believe, in chemotherapy alone was 3.1%. The drug KEYTRUDA was born, and that has led to clinical care for metastatic malignant melanoma, one of the worst cancers. It's 63% five-year cure rate not survival rate, but cure rate. And it's gone on to he believes that within five years it'll be an 85% cure rate. What that means is that we've learned and by the way, Dana-Farber is the other group that did it. You shouldn't feel bad for Jim Allison, who got the Nobel Prize, and he sold his company for well over $1,000,000,000. So, you don't feel bad for him. But in fact, he was really the father of this whole field of immunotherapies and immunotherapy being stronger. So now with COVID, you're hearing about T-killer cells. Well, what T- killer cells are in our bodies is when we get a vaccine, we not only make B-cells that make antibodies to the virus, but we make killer T-cells. We never knew that. But those killer T-cells are programmed to kill that specific virus as well. And that's what's being used in chemotherapy. And some of the chemotherapies where you're taking out a person's T-cells, you're finding a specific protein on the cancer and you're re-injecting those cancer cells. Now, that's very expensive, those T-cells to kill that cancer, it's very expensive right now, but it's going to get cheaper as we get to mass produce the T-cells against specific things. So, one of the T-cell mass productions is against what we call senolytic cells, old senile cells. So, you've got in your body, you start producing senile cells right from the beginning. And we can find them if you do it in any one day in people under the age of 30, but you can't find them accumulating under the age of 30. But over the age of 30, you find them accumulating and they make the cells around them, they send out a hormonal signal through this protein that makes the cells around them function older. Well, imagine if we either had killer T-cells mass produced that would knock out those old cells based on that protein or a vaccine that helps us build killer T-cells that does it. And that's one of the things that's advancing now that we've learned with the mRNA vaccines.
So why is stress important? Let me come back to your question, sorry I gave everybody more of an education on the immune system than they probably wanted. But that's one of the great hopes of doing things in aging mechanisms as well. But your immune system starts to dysfunction as you get older. And that's why we get more cancers and more of some other things that kill us as we get older. One of the great areas of research is that the strongest thing at knocking out our immune system is stress. And by the way, for marathon runners, a marathon is stressful, and it knocks out your immune system for 2 to 3 weeks. So, you're much more likely to get a respiratory infection, maybe a lot more likely to get other things. So, when you do exercise, you want to do it in a way that doesn't knock out your immune system or that you're prepared for that stress. The greatest stress, of course, is relationship stress and mental stress. And the greatest way of solving stress is posse and purpose. So, it is having those things that help you with friends. It's one of the reasons to come back to the office. You get a lot of friends and it's also having a purpose in life, what you're doing in life and having a mission in that. Like you do, like both of you do. There are other things you can do. There are 12 other things you can do for managing stress – guided imagery, deep breathing, progressive muscle relaxation, meditation, etc. All of those help you manage it, but the best way is actually posse and purpose.
Now for the immune system, there are some other things that we need that we've learned about. And so it is that we learned this in crazy ways. When you get a vaccination, if you sleep 6 to 8 hours for three days beforehand, the vaccination has a much better antibody response. Similarly, if you take a multivitamin for three weeks beforehand, if you weren't taking one before, that also improves it. We think a bunch of that improvement is related to vitamin D levels, but no one segregated out what it is in the multivitamin, multimineral that is so beneficial to immune response. But those are some of the things. But again, it is posse and purpose that are most important.
Willy Walker: So, Peter a) do you take multivitamins and b) how do you curate your posse? And I know your purpose, you got a thousand things going on. How do you curate your posse?
Dr. Peter Linneman: So, I do. I've done vitamins sort of forever. But one of the other things I got out of doing the book with Mike, which we realized we started in January 2018, he's now my free part of my posse. About the most recent things that come out, I send him little emails “should I do this, or should I not?”
Willy Walker: I was going to say he said, “Don't go jump without checking your doctor or your trainer.” I was about to text Mike yesterday and say, “Can I actually start jumping?” But I did it. I did it on my own on my own behalf. But go ahead. Keep on going.
Dr. Peter Linneman: Posse? I've always been blessed to have some amazing people around me, not least someone like Albert Ratner. And I think Albert and I have been good friends for 32 years. I have a lot of really good relationships with people of different ages. One of the things this work taught me is they were much closer to my age than I knew. In a real age sense, we were much more akin than we were in a chronological age sense. These were people who had. Take somebody like Alfred Taubman, and he was hardly a picture of health, but he was a picture of energy, purpose, vitality. And we were much closer to real age in that sense. And so, what I do is I try every week to reach out to about seven people on a regular basis. Some of those are easy, right? You have a daughter who calls you every day or I call her. Some of those you got to work out a little bit.
Willy Walker: Do you miss the classroom? And do you think that the classroom made you younger?
Dr. Peter Linneman: The classroom made be younger, right, until it made be older. And I'm not joking. I realized about 20 some years ago that while I may not be successful, I was successful enough that I didn't have to work with a$$holes anymore. If somebody were to call me up and say, “I want you to do some advisory work for us or be a partner with me on an investment.” If I didn't want to do it with them, I would just say, “Well, my schedules too busy. I'm sorry,” and so forth. The real reason was it was just too wearing to deal with that. But when you're young, you don't have that luxury, right? When you're young, you deal with whoever. I'm not joking when I say it about the university. So, I cut out working with a$$holes out of my life when I was 50. And it worked really well on the non-university side. But if you work for a big university, you cannot cut them out of your life. It's impossible, right? I don't control the students who walk into the classroom. And by the way, they're a big population and some of them are amazing, but some of them are a$$holes. And what I found is they were making me miserable. And by the way, the same on the faculty and the administrators, some amazingly wonderful and some are a$$holes. I realized the only way I could cut a$$holes out of my life kind of completely was to retire from the university. And I'm not joking. And by the way, my level of happiness, stress, if you will, went up enormously because I had curated them out of my life. To your question, though, Willy, there's about, I don't know, 100-150 students, former students of mine, that in a random month I'll have contact with eight to ten times each.
Willy Walker: Yeah. And I know many of them and they all cherish their friendships with you. Mike when I hear the talk about the cutting edge technology and yet at the same time also the need for all of us to extend our own age to get to the point where some of these very innovative technologies you just outlined as it relates to cancer research, it makes me think a little bit about global warming and the fact that we're sitting here sort of hoping that technology comes and solves our problems with increasing temperature of the globe. At the same time, we all know we need to do certain things every day to try and slow the rising temperatures of the globe so that global warming doesn't hit us even faster than we're all predicting it will. And I think about it in the health space as it relates to what you said in the book about me, if I can make it to 80, I'm going to go to 115. So, I'm in my mind saying, I got to keep my health, go to 80. And by the way, we're talking about stress. I have to say, I read the front page today about Ken Starr. And I'm not talking politics here, but I can't imagine Ken Starr in his job didn't deal with a tremendous amount of stress as he was prosecuting his case against former President Clinton. Not making a judgment about whether it was a just case, not case, whatever. But I thought Ken Starr died at 76 years old and I said too young. And so, are people who are listening to this webcast or sitting there and saying, how do I keep stress down? How do I keep my immune system up? How do I do more exercise? How do I eat well? What's the bridge? When are technologies going to come, sort of says, okay, if I can get to that, it gets me there. Or your cautionary note, which is if you don't take care of yourself, all the technology in the world isn't going to save you.
Dr. Michael Roizen: Let me go and do a couple of the 14 areas we put in. The first third of the book is on the 14 areas of these, what we call “Breakthrough Technologies” that have been shown on aging mechanisms in animals and at least two animal species to be able to reboot animals from the equivalent of a 90-year-old human to a 40-year-old human.
Dr. Peter Linneman: Now, let me interject what Albert and I did was make Mike describe these in the book in a way that everyone could understand.
Dr. Michael Roizen: So, let me just talk about one of them. We knew from the Conboys work in the 1960s at the University of California, San Francisco, that if you took a young rat, and gave that young rat blood to an old rat, the old rat would become younger. Biopsy their organs, they looked much younger. We thought it was something in the blood and the medical and scientific communities have spent 50 years trying to find that something in the blood. What it turns out in the Conboys did it themselves is it was getting rid of old plasma. So, it was doing a plasma exchange or what we call donating a unit of plasma, that now in animals reverses skin aging, reverses muscle aging, reverses cardiovascular aging. We're in biopsies of kidney and liver and pancreas. They look much younger. Now in human trials, the Anbar studies have shown that it also reverses. So, the only thing we know is randomized controlled trials, donating a unit of plasma every week for five weeks. And then every month for the next four months of nine donations over five months at 15 months these people had reversed the cognitive dysfunction, not slowed it but reversed the cognitive dysfunction of Alzheimer's and early dementia. That was 280 some patients study, two centers in Spain, two in Chili, the University of Pittsburgh and Cleveland Clinic in the United States. It's now going to a hundred center study 3000 patients because we think this will reverse it. And guess what? In animals, it reverses all the other signs of aging. So, at some point, you may go into a car wash at one end of 90 and come out at 40 at the other end. But that's not probably for 30 or 40 years. What we think now is it's going to be organ by organ, brain or heart or one organ at a time, which means you've got to preserve as much function as you can. And that's why the third part of the book is done organ system by organ system, such as the immune system and cardiovascular system more. There are 33 things that are in there relating to brain functioning. That is, there are 33 things that have been shown in at least two studies in humans. They change the rate of aging of the brain, speed of processing games. We've already talked about physical activity, a tablespoon and a half of extra virgin olive oil a day, an ounce of blueberries a day, and four cups of coffee if you're fast metabolizing, smelling for things, etc.. And we put them all, by the way, on the website at The Great Age Reboot, they're there or in the app, Reboot Your Age, they're available so that you can gradually institute them and keep each of the organ systems younger. That's the whole point that these things are moving very quickly and so within ten years we expect them to be available and maybe by 2050 you will get one treatment to get you younger like the rats and mice are getting now.
Dr. Peter Linneman: I was going to say when we said these things to friends and when we talked about these issues with friends, they would all say, “But we can't afford to have all these old people.” And we’d say, well, first of all, they're not going to be old. They're going to be productive wise be more like the 30-, 40- and 50-year-olds you know. So that's the first. And they’d say, “But, you know, we can't afford all these people.” And if they were Mike’s age, I'd say to them, “So should we start with you and just get rid of you?” And they said, “Well, I don't mean me.” And if they were your age, Willy, I'd say, “Well, should we start with your dad?” And you go, “Well, no, I don't mean that.” And if they were your kids' age, I say, “Should we start with Grandma?” “Well, I don't mean grandma.” I'm joking, but I'm not. What it underscores is we know we can afford it. We go through mathematics of economics that show stunning numbers that we can afford - 20% increases in our lifetime output for people, cutting medical outlays by half just because we're healthier, living more productive and happier. But the little example I give of why don't we start with you, or your father, or your grandmother respectively, shows that people know deep down we can afford it. They really understand that at a fundamental level. And while, yes, we do the math, and the math is very impressive, we hope readers, listeners and readers don't go away saying, “Oh, my God, what a disaster. We've only got the globe warming, but we've got all these old people and we can't afford them.” And by the way, to Mike's point about stress, probably at the current state of global warming, the biggest negative it raises for health is the people who are stressed out about it, as opposed to anything else.
Dr. Michael Roizen: Yeah, let me let me take one thing. So, the Human Genome Project not only is helping with human life but will help with biomanufacturing. And Willy, although I watch most of your podcast, I don't know if I've seen one or if you've had one on biomanufacturing, but beer is bio-manufactured in a bioreactor. And why is it there? Because they've saved yeast over the decades that turned sugar into alcohol. Well, we now can edit the genes of yeast to produce anything. You want to produce corn? We can have yeast to produce corn. You want to produce the meat of salmon? You can do that with yeast in a bioreactor. And in fact, we can take a city the size of Cleveland, if you just did bioreactors in the whole city, you could produce the amount of food the entire world uses. Maybe one of these days, I don't know if you've already had someone on biomanufacturing on, but you can literally manufacture the entire world's food supply and cut down on a lot of climate change by just doing bioreactors in a city the size of Cleveland. It will occur. How fast it will occur, I don't know. But that's how fast we do this human genome project by learning how to edit genes. We can do that in the genes of yeast just as we can do it in the genes of humans.
Willy Walker: You mentioned in the book, Mike, and Peter, that it cost $4 billion to sequence the genome and now we can do it for $100 at WalMart. And so, it's just unbelievable. A lot of these things you talk about that plasma technology, and by the way, the plasma technology work makes me think about the Tour de France cyclists who all were doping and we're taking blood. The bottom line on it all, it was it worked? Bottom line, which is also illegal. But I mean, it makes me think about how that regeneration and how important it is. I mean, one of the things that a lot of people miss on the whole steroid use and I'm going to go off on a quick tangent for two seconds, but the issue with it is, it was not so much that it made them more powerful. It made them recover quicker. And I think that this is the recovery quickly in your comments as it relates to taking vitamins before getting a vaccine, all of these things done over time have these long-term implications. One of the other things in the book, Mike, that you mentioned that I think is so interesting as it relates to our general health, is you talked about the Hopkins study of the people who lost their hearing loss between age 45 and 65 and that the incidence of dementia spiked because they're pulled out of society because of their lack of being able to hear and sensory perception. And I thought that was so interesting because it sort of says you can, but if you lose that interaction, if you lose that posse, if you lose that engagement with other people, it has massive implications to your overall general health.
Dr. Michael Roizen: Not only that, but one of the great things this year that happened is the FDA approved over-the-counter hearing aids. So, they've gone from $5,000 to under $500 now. And that's a tremendous boon to aging, because people will be able to interact with society and have, if you will, a posse.
Dr. Peter Linneman: Willy you asked, did I learn anything? I have an amazing friend, Albert Noser, she's almost 101.
Willy Walker: And by the way, Mike's mother-in-law is 101. Is she still with us, Mike?
Dr. Michael Roizen: No, actually this is a crazy thing. She was holding an elevator for a friend. The elevator goes fast. She fell down and ended up not surviving that fall.
Willy Walker: 101 years, though. That's a full life. Anyway, Peter, I jumped in, sorry go ahead.
Dr. Peter Linneman: I got to tell you that one of the things that this posse idea did stimulate is I would speak to this friend over the last couple of years that kind of once a week, once every ten days, as in the last two or three years, because she is losing her hearing and she is in assisted living and she's isolated. I call her every day and every day I ask her something about her past life. Tell me about your wedding. Tell me about the board you were on in 1975 so that she'll answer. She's terrific. I'll tell her one or two pieces of news like yesterday, the inflation number and the market was down and then I'll usually do something that we did not long ago, the last time I saw her to make her connected and to help her be connected. And yes, she's 100, but I don't think she's going to live to 150, although who knows? But it's the posse effect. Sometimes you have to be purposeful in that posse effort. You don't just call up and say, how are you? If all I do is call and say, how is she? That doesn't help her much. I find if I give these cues, she connects and I think that's true of a lot of people, not just somebody who's 100. If all you do is call up your kid who's 22 and say, how are you? That's going to be you know, if you say, what did you do in whatever? I think it goes a long way to connect with your posse. Mike alluded to it is your posse has to evolve over time because you move. They move. They get sick. They get divorced. They do this. They do that. You do this. You can't do a posse as a static phenomenon. You have to view it as a dynamic, ever-changing phenomenon.
Willy Walker: So, a couple quick things. First, Susan Webber sent me a DM on the side and said, two minutes till the end. And that's the first time I've done 115 or 120 of these things. It's the first time she's actually said to me, “You're almost at the end”, which I said, and I wrote back, and I said, “You think I'm having fun or something?” So, I think that this topic is so great. Your book right here is so great. To anyone who doesn't have it, please go out and get it because it's got so much good stuff in it.
And the final thing I would just say on all this as it relates to something that is, I think Mike, you started the whole conversation on this. The office and work and engagement with people has a huge component to our overall health. And I think that that's been a missing thing. I think a lot of people have thought back to the office, and I would say one quick thing, which is just that we've changed it from “back to the office” to “go forward to work” at Walker & Dunlop. I stole that from Keith Ferrazzi, who was on the Walker Webcast a couple of weeks ago. And I think the reframing of let's not go back to 2019 and what work was like then, let's go forward to the office in 2023 and using virtual and using in-person and having those chemical reactions is such an important reframing.
But Mike, I have to say that your comment about seeing people daily in the office and interacting with people, whether it's at the mall, at the church, at the school, or in the office, that the policy and the social interaction is so important to our health.
And the final thing I'd say is I wear a WHOOP strap; we have at Walker & Dunlop a wellness program. It's not nearly as successful. We didn't get into it today, Mike, but it's not nearly as successful as yours at the Cleveland Clinic. But it's been great, and we've got well over 50% participation in our wellness program. But when you get to over almost 800 people in our wellness program, it's hard to feel connectivity to drive results. There are a ton of people in it. There's a big leaderboard, but only a few people are at the top leaderboard. And so, one of the things we're trying to do is break up and have smaller groups so that people inside of our wellness program can have a cohort of ten or 20 people to keep track of one another and to see who's who had a big weekend of work out who's eating well, who's sleeping well. And the WHOOP strap obviously allows you to do all that great stuff. And so, I just thought a couple of the points you've made today are so helpful of practical things we can all do as it relates to getting stress out of our lives, staying engaged with other people, cultivating our posse and taking care of ourselves.
Dr. Peter Linneman: And reading the great age reboot will reduce your stress levels.
Willy Walker: There you go. Mike, the final word to you.
Dr. Michael Roizen: Let me come back and talk to you about a wellness program and how to design it, because I've learned a lot in doing it for our 110,000 employees and dependents.
Willy Walker: I know that. One quick stat on that was Mike, during his tenure, he started the smoking rate at the Cleveland Clinic was 15.2%. And during his tenure running wellness, it got down to 5%.
Dr. Michael Roizen: That is actually 0.2% now.
Willy Walker: Oh, it is? Well, okay. It's just unbelievable. Thank you both. Great to see you. A real pleasure, as you can tell. I'll see you both soon and good luck on the book. I know you don't need it. It's a wonderful read. And everyone today, we'll see you again next week.
Dr. Michael Roizen: Thank you.
Dr. Peter Linneman: Thank you.
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