Cleveland Clinic’s Dr. Michael Roizen on slowing the aging process
When it comes to health, wellness, and longevity, dr. Michael Roizen has all the answers. In Walker’s latest webcast, she joins Willy to discuss how to determine her real age, why it matters when she eats, how to boost her immune system and reduce stress, and much more.
dr. Roizen, director of wellness at the cleveland clinic and former chief of anesthesiology and pain management at the university of chicago and the cleveland clinic practices internal medicine with a “real age” approach. he counsels patients on lifestyle changes, placing great importance on the role of diet and other habits that can help reverse the disease process. As an award-winning author, Roizen is the author or co-author of five New York Times #1 bestsellers, including The Real Age: Are You As Young As You Can Be?, due for release in September 2022.
for starters, willy asks dr. roizen to help explain the difference between his actual body age and his calendar age. then she discusses why we should care about what we eat but also when we eat. Melatonin, insulin, and the sensitivity of various receptors in your body play important roles in your health. dr. roizen discusses what it means to have a sun-adjusted lifestyle, why you should eat in a shorter window of time, and how changing circadian genes can alter aging. he says that people have the ability to change their rate of aging and weight with simple lifestyle adjustments. He also briefly addresses the role of alcohol and its impact in this area.
turning the conversation to the immune system, willy asks dr. Find out what can be done to help boost it, which is especially important while we’re in the middle of a pandemic. While exercise is an essential player in immune health, it can become an added stress on your body if not incorporated in the proper ratio. they also address how to think about sleep, diet, daily habits, and the influence of sugar on the immune system.
what position is best for sleeping and what role does stress play? dr. Roizen dives into all of this, including why pain and stiffness in the mornings may be a sign of inflammation, rather than injury. then we learn about record stress levels around the world and the importance of stress reduction. dr. Roizen talks about his journey to help establish the stress free now program.
willy asks dr. roizen about his role as chief of anesthesiology and pain management at the university of chicago and cleveland clinic. Could the opioid pandemic have been prevented? dr. Roizen tells of the training he conducted for his employees and how he discovered that this problem could be prevented among staff with proper training.
the two then take a look at the great age reset and how life expectancy has changed over the years. they close by discussing the human genome project and the fourteen areas of advancement that are proving to be the most influential, all of which are keys to improving life longevity.
0:51 willy welcomes dr. michael roizen 1:16 greeting the next two guests in the pipeline 4:22 dr. the incredible biography of michael roizen 7:47 real age versus calendar age 11:10 daily habits that can change your dna 16:34 the role of alcohol 18:23 the immune system and how to stimulate it 20:50 the best sleeping positions 23: 05 the role of stress and the need to reduce stress 27:24 position as chief of anesthesiology and pain management, and the opioid pandemic
learn more about dr. michael roizen and connect with him on instagram. pre-order his newest book, the reboot of the great age on amazon. check out walter & Dunlop’s website.
willy walker: good morning everyone. welcome to our first walker webcast of 2022. having crossed the threshold of three million total listeners by the end of 2021, i am very excited about what’s to come in 2022 for the walker webcast. what better way to start the new year than with such a fantastic guest at dr. Miguel Roizen
before diving into dr. roizen’s impressive bio, a couple of quick programming notes: Next week we’ll have our quarterly discussion on macroeconomics and commercial real estate with dr. peter linneman (a mutual friend of dr. roizen and mine). my conversation with peter continues to draw a large audience, and after reading his quarterly letter, he won’t want to miss next week’s webcast. The following week, Jim Courier, former Grand Slam tennis champion and world number one tennis player, joins me from the Australian Open. Given that Australia has just changed his country’s Covid policy to allow Novak Djokovic to play in the Australian Open, it will be fascinating to discuss with Jim not only his run to become the world’s number one tennis player but also what’s going on in the tennis community around the world. And after Peter and Jim, we’ve got an incredible guest list to discuss everything from where to invest in 2022, how AI is changing our world by the minute, and how to lead a major financial services organization.
I wrote an email this morning to several people at walker and dunlop, highlighting three articles in today’s wall street journal. the first, that opec has just increased its daily production by 400,000 barrels, which clearly indicates that they do not believe that omicron will slow down the global economy. second, that investors are piling on distressed senior care facility debt, reinforcing the sentiment that we may be nearing the end of the pandemic when senior care facilities can return to something closer to The normality. and finally, the waiver by australia and the nba to allow novak djokovic and kyrie irving, respectively, to return to play. While the omicron variant is very clearly here and impacting all of our lives every day, there seem to be clear signs from the market that we are nearing the end. I really want to hear the opinions of my guests on that topic.
I would also add from a general macroeconomic standpoint that we ended 2021 with a goldilocks economy. the dow jones industrial average, which ends the year around 36,500 and the 10-year treasury around 150, is something that if you were to rewind the tape a year and ask the smartest investors in the world to give you what they would say, it would be an incredible result of the year. I doubt they would have come close to those numbers. Inflation is clearly prevalent throughout the economy, but inflationary pressures in December played a big role in stopping wasteful spending and new bills pouring out of Washington. I’ll take 6% inflation any day, over $3 trillion in spending, and a tax increase. And while rates have hovered between 15 and 20 basis points since the start of the year, we have to keep in mind that a 10-year 167 is still dramatically low. for most of the 2000s before the great financial crisis, 10-year cash was in the 4-5% range.
so, my guest? This is one of the most amazing biographies I have ever had the pleasure of reading. I’m going to try to move as quickly as possible, but there’s so much good stuff here that gives my guest context that I want to make sure you don’t miss it.
dr. michael roizen graduated from williams college and is an alpha omega alpha graduate of the university of california san francisco school of medicine. he completed his residency in internal medicine at harvard beth israel hospital and completed the public health service at the national institutes of health in the lab of irv kopin and nobel laureate julius axelrod.
dr. Roizen is a co-founder of Realage Inc., which he sold in 2006 but still chairs its scientific advisory board. dr. Roizen is a former chairman of the advisory committee for the food and drug administration and a former editor of six medical journals. he has published more than 185 peer-reviewed scientific articles, 100 textbook chapters, 30 editorials, four medical books and received US$13. and many foreign patents.
he was first a faculty member at the university of california, san francisco, then chaired the department of anesthesia and critical care at the university of chicago, and later became dean of the school of medicine and vice president of biomedical sciences at the state university of upstate new york. he later became president of the institute of anesthesiology at the cleveland clinic and, in 2007, was appointed director of wellness at the cleveland clinic. the first position of its kind at a major healthcare institution in the united states.
dr. Roizen’s first book for the general public, Real Age: Are You As Young As You Can Be?, became a #1 New York Times Bestseller. Other books include the New York Times bestseller The Royal Age Diet, The Royal Age Makeover, The Owner’s Manual, written with Health Corps founder Dr. Mehmet Oz, (also a New York Times Best Seller) and is the author or co-author of four New York Times Best Sellers and nine Top 10 Books.
he and dr. oz writes a daily column syndicated to over 100 newspapers by king syndication. His most recent book, The Great Age Reboot, with co-authors Peter Linneman and Albert Ratner, which we’ll be talking about today, will be available on shelves and on Amazon in September 2022.
finally, dr. Roizen still practices internal medicine using the realage metric to motivate his patients. She routinely sees patients at the Cleveland Clinic Wellness Center who are struggling with smoking, heart, diabetic or arthritis problems. she coaches them with simple but persistent lifestyle changes to live, feel, look and be younger. she really enjoys getting them to throw away their medications when they are no longer needed and teaching them the role of food and other simple steps to reverse the disease process.
mike, first of all, thank you so much for joining me. I’ll tell you, just reading your books and researching this discussion has changed my life. Since I read what to eat and when, I haven’t had dinner. and ever since i read the great age reset i called my insurance broker and thought i would cancel my life insurance policy. So, we’re going to dive into those two things in a moment. but the day after tomorrow, mike is your 76th birthday, but your actual age is closer to 55. Can you tell us what your real age is?
dr. michael roizen: his actual age is the actual age of his body as opposed to his calendar age from which he may be many years old or so. So, now we say 60 is the new 40. So, for most people who want to, you’ll live like the average 40-year-old in 1980 at age 60. but it’s not that hard to do. . very soon and that’s the only reason I write books is because of compelling new science. so what to eat and when was written when the science of intermittent fasting came to be enough human studies for us to say that that was a really appropriate strategy to try to slow aging. the great age reset now is science saying we are going to be 40 while our calendar age is 90 and a lot of that will change everything else which is why peter linneman and albert ratner are a part of this because the economic and political changes that occur with it are substantial and can be planned.
willy walker: so, we’ll get to all of that in a moment. But before I get to that, I think there are just under 70 million people who have taken the actual age quiz. when someone completes that, what does it tell them? So, you’re talking about someone who is 90 who actually acts like they’re 40 or feels like they’re 40. How do you determine what your actual age is?
dr. michael roizen: so, you can go and have that. i had the privilege of being at the university of chicago when charlie becker was there, who did net present value investing and won the nobel prize in economics for it. So when we started this, I contacted him, we worked together, and we did the net present value of changes in health. For example, if you walk 10,000 steps a day compared to the typical American, you’re about 4.6 years younger. it’s a little different for men and women, but that’s what the computer does, and it does it in covariance. but essentially, what is the net present value of your health options? and reviews 157 things for men and 158 for women that influence your rate of aging.
willy walker: and i assume the delta gets bigger as you get older.
dr. michael roizen: that’s exactly right.
willy walker: so, is it complicated?
dr. michael roizen: as new science begins, the composition becomes much larger. and maybe you’ll talk to peter linneman next week about what that capitalization means. he really convinced us that starting early is a change of policy in the usa. uu. You need to do what Australia, Singapore and the Netherlands have done to reduce wealth and equality.
willy walker: so, in your book, what to eat and when, the central question is, why should we care when we eat?
dr. michael roizen: so, we always thought the sun controlled sleep, and that was it. But the hormones that the sun affects are not just melatonin, but also our insulin and the sensitivity of various receptors. For centuries, we’ve always had our lifestyles sun-adjusted, so eating earlier, less late, and eating within eight hours of getting into ketosis every day does two things: it changes your circadian genes, and it changes your genes. that work related to metabolism and aging. now i have said a lot of things there so let me tell you that you are a genetic engineer. even if you don’t know what dna is, you change the way your dna works by your habits every day. So, for example, when you hit ketosis, your body thinks you’re in survival mode. I mean, you’re going to die. and thus, it begins to preserve and recycle its proteins and other structures. when you eat, so let’s say you have a fasting window of 14 or 16 hours every day. once you get past 14 hours, you start to be in ketosis and your body goes into survival mode. turns on the genes that recycle your old cells. then when you eat again, hopefully the right food, that means food your body and brain will love back. when you eat again, you start to grow new cells, so it slows down your rate of aging considerably.
We used to think it was caloric restriction, but the way caloric restriction worked was that people ate in a reduced amount of time, so they got this benefit. animals too. So, you are a genetic engineer. The whole point of “what to eat and when” is that as you change the time period, you change your rate of aging and you change your weight. So one of the things that happens is that you’re more sensitive to insulin in the morning and more resistant at night. So a calorie is a calorie in the test tube. but in your body, a calorie eaten early is less calorie than when eaten later. the less is 15% less. therefore, eating the same number of calories earlier in the day than at the end of the day makes you less likely to be obese.
willy walker: so, in your book, there is a study that showed that if you eat 70% of your calories at breakfast, you lose weight versus 70% at dinner, you gain weight . So it’s really only fair that your body can absorb those calories much more effectively throughout the day. and if you’re having a big dinner and you go to bed, your system basically shuts down. therefore, those glucose stores are converted to fat and metabolized as fat rather than used for energy throughout the day. is that what it means to a layman like me trying to figure out the science behind it? is that enough?
dr. michael roizen: that’s pretty close. I don’t know if everyone knows how much work you put into putting together these podcasts or webcasts, but I am in awe. I’ve been on many webcasts and many television shows. nobody does the amount of work that you do, so you should know that. so essentially: that’s correct. you get a switch that changes from using the calories and getting rid of them to storing the calories later in the day when you eat them. if you eat later in the day or closer to sleep, you’re more likely to store those calories.
willy walker: so one of the challenges i’ve had since i started doing this, mike, is i haven’t had a family dinner so i was just curious, what’s your life like Social?
dr. michael roizen: well, you know, i’m a science nerd, so a lot of my time at night is spent reading medicine. But the rest of the time, I’m also a Cavalier Browns and Indians (they’re keepers now) season ticket holders, so a lot of my social life is going to sporting events with people. Hopefully, I’m involved enough in the sporting event that all I have is a glass of wine. So, I try not to eat before 11-11:30 in the morning and finish eating at 7:00 or 7:30 in the evening. so, i have 16 hours of getting into ketosis every day.
willy walker: so, i understand that your co-author, dr. Michael Crupain has a salad for dinner and a glass of wine. and he was curious about the glass of wine because a lot of books that you read about diets and things of that nature say, leave the alcohol behind. I was very surprised that Mike, and I think you too, will have a glass of wine along with that light dinner. tell me a moment about alcohol and its impact.
dr. michael roizen: we’ve always thought, and this was based on a number of studies on what we call a j-shaped curve and all-cause mortality from alcohol. if you’re a teetotaler, you’re at higher risk from all causes than if you drink half to two drinks a day, and while you drink four or five, your mortality risk becomes substantial. that has been disputed, but it appears there is still a j-shaped curve with the lowest risk of mortality from all causes, especially from cardiovascular disease being between one half and one drink per night for women. now we think it’s maybe three or four nights a week and one or two drinks a night for the men, again three or four nights a week. we make sure everyone understands that one drink a night is not seven drinks on Friday night. must be spaced. so the j-shaped curve appears to be holding still. there are some questions about it, but if you haven’t started drinking, don’t start for this reason. if so, that’s a reason to make sure you space it out.
willy walker: so, let’s go back to the immune system for a moment, particularly given the prevalence of covid and the omicron variant found around the world and in our country. When you talk about boosting your immune system, what can we do to help you during these times? one of the interesting things I read when I was doing research for you was exercise, and I’m someone who does a lot of exercise. and one of the things you say is get your normal amount of exercise but don’t push yourself because going beyond your normal amount of exercise actually weakens your immune system. what are the things we should all be thinking about, be it exercise, sleep, and diet right now to help us boost our immune systems?
dr. michael roizen: well, the data that we have is somewhat limited, but let me tell you what you can conclude from the data. One is, if you were to get a vaccine, having three days of good sleep and a week or two of a multivitamin beforehand increases the rate of application of that vaccine. So the data we have is on common colds. we have some with the other coronaviruses but not the covid 19 viruses. and it seems like 1) sleep before six and a half to eight hours, 2) multivitamin for three weeks before, 3) and exercise at your usual pace. doing more than two hours at a time, meaning marathon runners are at higher risk of common colds and susceptibility to infections beforehand. sugar decreases the ability of white blood cells to kill and absorb bacteria and viruses. therefore, it is a healthy diet with little sugar. so what you’re doing with intermittent fasting is absolutely perfect for sticking with it. now where is the conflict between what i am saying now and your earlier question about alcohol? because alcohol affects your immune system, and we think some of that is due to the sugar in the alcohol. and so one of the commitments I make is that glass of wine at night. willy walker: so you also talk about how we should sleep, not how long we should sleep, but how we should sleep on our backs, on our sides, which fascinated me.
dr. michael roizen: yeah, this is one of the coolest things: if you can and you don’t have sleep apnea, then the best position for your musculoskeletal system is on your back with a pillow under your knees. if you’re going to sleep on your side and you’re concerned about sleep apnea or have some trouble sleeping on your back then it’s on your side but not in the fetal position, rather stretched out with a pillow again between your knees the point of this is that many of us wake up with pain when getting out of bed or stiffness. that is actually an inflammatory process. so pain in the morning is inflammation. pain at night is an injury. so pain in the morning is when you want to do things that will decrease inflammation and stretch you out at night instead of contracting you.
willy walker: and also as far as covid and where covid sits with sars, it was more embedded in the lungs and therefore not as transmissible as the covid variant 19, while now this is sitting in our nostrils, therefore being on the side is better than being on the back. I am right?
dr. Michael Roizen: Yeah. So, in other words, the reason stomach sleeping is now used in the ICU is exactly that. 1) you get better aeration, but 2) but it prevents the infection from getting worse, from getting from the nose to the lungs. so if you got infected, sleeping on your back is not the thing to do, you should sleep with your head slightly down so that your nasal secretions drain out instead of into your lungs or intestine.
willy walker: stress is a huge inhibitor of the proper functioning of your immune system. I know that you wake up every morning and kiss your wife, Nancy, which greatly reduces your stress level. but let’s talk for a moment about our current society and the fact that we seem to have more stress than we ever have at a time when we should de-stress and not increase stress. we read these stories about flight rage and people getting on planes and accosting flight attendants and all the kinds of anger and animosity building up in our society today and what that’s doing to stress levels of people. from what i have read of what you have written we should all relax and try to get along because stress is affecting our immune system.
dr. michael roizen: yes, you’re absolutely right. stress and toxins like tobacco are some of the worst things for our immune systems, so to speak. stress management is one of the best. so we developed a program called stress free now at the cleveland clinic. if we had known how to market it, we would have beaten calm and everyone else by a long shot because it’s actually a much better show. It is part of our application reset your age. But what it is, now we’ve done studies using the Pittsburgh Perceived Stress Scale (PSS) developed at Carnegie Mellon University in 1979-83. So that’s when we have the standards. In the United States, the standard is higher, which means more stress, but in 1979 to 1983, it was 12:1 for men, 13:7 for women. women were thought to have higher levels of stress due to their caregiving responsibilities. We tested that in about 10 different cities in the United States, Canada, France, Saudi Arabia, Abu Dhabi, India, China, and 14 different countries. in any case, the average stress level worldwide was 19.1. no country had a level below 18.5. that’s five standard deviations above the mean in 1979 to 1983 and was associated with the development of chronic disease.
if you do this stress free now program and we publish it, then it’s a randomized controlled trial, we use nurses at different hospitals and the cleveland clinic. you can reduce simply by doing one of the 12 techniques. And so, we go through 12 techniques, such as deep breathing and guided imagery, progressive muscle relaxation, meditation, and so on. if you perform one of those techniques regularly, you can bring the stress level of that population down to the normal range or even below the normal range. so, we’ve done this at many different health care institutions. the world is at a much higher level of stress now than it was in ’79 to ’83 and is at a level now than it was in ’79 to ’83 that would have been associated with the development of a chronic disease like type 2 diabetes or osteoarthritis.
I practice in executive health at the cleveland clinic and wellness, and almost every executive will say that i give them stress. everyone has stress. therefore, stress reduction is something we should all practice.
willy walker: before we move on to what you did on the wellness front at the cleveland clinic because the data is so compelling. I think it’s very eye-opening for both individuals and corporate leaders on how they can make a difference in the well-being and health of their population base. prior to taking that job, you were the chief of anesthesiology at cleveland clinic and also of pain management, which included 180 operating units and 28 pain therapy intervention units. i just read patrick radden keefe’s empire of pain all about the opioid crisis in america and the sackler family’s role in it. and there’s a tv show my wife and i are watching right now that talks about that pandemic quite a bit, if you will. I guess my question to you, dr. roizen is this: Could the opioid pandemic have been prevented?
dr. michael roizen: well, i don’t know if it was totally preventable because the drug developed by paul janssen, who sold his company to johnson and johnson, fentanyl is very good. when i accepted the job as department head of anesthesia, critical care and pain management at the university of chicago, the first thing i did was call a friend through squash named doug talbert. doug ran the largest treatment center for doctors in 1985 for drug addicted doctors. and I told him how we prevent it? and he said, you have to close the o’s for three days at the beginning of your residency and teach people how dangerous these drugs are, and scare the hell out of them, and teach them how to do interventions. they’re going to have to if they don’t have all their friends controlled like this. so what we did was close half the operating rooms, which was kind of expensive, and we did this three-day program at the university of chicago. we trained over a thousand trainees in all that time and had a great staff, nurses in icu etc. we had a total of two people get addicted, and they got addicted to propofol and avoided the training program, but fentanyl is so good. you can’t try it once without getting addicted. if you look at heroin, demerol, and morphine, they all cause a little bit of dysphoria, a little bit of disgust, nausea, and vomiting. fentanyl often does not cause any of these side effects. so one dose and you can become addicted. when i came to the cleveland clinic as chair of anesthesia, critical care and pain management the hardest negotiation was with toby cosgrove about that three day reduction because it’s so expensive to downsize operating rooms and intervene on each other. and that was so powerful that in the time at the cleveland clinic and we did random drug testing, we had zero in my time at the cleveland clinic when we did that. Is it preventable between doctors and nurses? i think if you have enough education and understanding then don’t try it once because these medicines are too good. likewise with purdue pharma drugs, they are very good. there are very low side effects; constipation is one of its main side effects until reaching respiratory depression, which is, of course, a narcotic effect. So the point is, I don’t know if it could have been prevented with the development of these good drugs. one of the things that kept it down from ’85 until recently was that fentanyl was much more difficult to synthesize and no one knew the formula, which is why johnson and johnson was able to preserve that drug so well. they also make carfentanil.
one of the experiments we did just to show you how powerful carfentanil is. remember, there were kidnappings in the late 80s and 90s. using the university of chicago economics department and math department, we did a study to spray some kind of carfentanil and then run narcan and save all the people that were regular passengers, pilots and flight attendants, but not hijackers. and we couldn’t. I mean, the problem is that you would lose some of the passengers that way. but that’s how strong carfentanil is. you get a little on your skin and you can die from it. so that’s one of the things that’s now being synthesized. It’s a horse anesthetic or a large animal anesthetic, that’s why it was developed, but it’s so powerful.
willy walker: you mentioned toby cosgrove when he ran the cleveland clinic, and you give him a lot of credit for putting you in the role of wellness director. and then the results you’ve achieved, mike, are amazing in regards to the well-being of the 100,000+ employees within the cleveland clinic system. reduces smoking from 15.4% of the employee base to 2%.
dr. michael roizen: this just shows what a leader does. So, there were a couple of high-profile surgeons, big producers, and excellent nationally recognized surgeons who were smokers. And they refused to quit when Toby banned smoking on campus. they said, “let’s smoke in our offices”. Toby said, “You’re going to have to find new offices because I’m going to fire you.” and they kept smoking, and toby sent them away. if he was willing to fire them, he’s willing to fire anyone else, right? so that changed everything. and people understood that he was serious and that we were serious as a health care organization, we should stand up and help our employees be healthier.
willy walker: so, you used meaningful incentives, and i read that there was a study by rand that said incentives don’t work to get people into wellness programs unless the incentives are really big. . so what does great really mean because you clearly have the incentives to work at the cleveland clinic?
dr. michael roizen: so everyone understands, the average age of our workforce was 47 years old. it was a little skewed, more feminine. when you look at it nationally, 6% have “normal six plus two”. six normal means normal blood pressure, normal body mass index, no cotinine tobacco end products, etc., in your urine. so i can go over why we chose normal six plus two, which show up in the medicare database. we went up to about 44% from 6%, which was the national average for the age of 47, with our demographic at 44%. And we did it by giving people at least a third of what we save, we don’t spend on health care. and he complied with that, so we ended up at the maximum limits allowed by law, which is $1,540 in our premium for getting six normals plus 2. the plus 2 is seeing a primary care doctor every year and getting shots at the day. that was even before covid. covid is not included yet. but in any case, we exceed 44%. we are spending 38% less than our competitors or our trend line. plus, our employees spend about $250 million or less on copays and premiums. we have saved just over $1.4 billion over the 11 years for our one hundred and one thousand employees and dependents.
willy walker: then his CFO said it wasn’t savings, he didn’t have to spend the money. and you’re going to have to explain to me how the financial director of the cleveland clinic says that’s not real savings if you’re not actually going to spend the money. that number mike, it’s just amazing. And by his calculation, he just said over $1.4 billion in total savings.
dr. michael roizen: right.
willy walker: last time i heard you talk about what went into the savings account, the cleveland clinic employee retirement accounts, it was a calculation on your behalf almost $200 million of additional funds, if you will, in those retirement accounts of the cleveland clinic employees who participated in this. Is that correct?
dr. michael roizen: that’s right. If they had put the savings into their HSA, their retirement account, their account could roll over to retirement at age 65. they were about $250 million in savings. now that was two years ago. there’s an additional probably close to 50, maybe even $100 million since you’d have to do the math.
willy walker: what I find so interesting is that the incentives are there, and they are real and definite. and then the second thing is that the normal six, they don’t even go as far as making people do something they don’t want to do. it’s just putting those six, if you will, biomarkers online. and if you can get those in line to pay rewards for it, the result has been amazing.
dr. michael roizen: yes. so what we did is when toby named me, i said, “what can we do to help our employees?” everyone was doing process. ie he gets paid if he measured your variables or if he measured your ldl or whatever. they paid you if you did 10,000 steps a day or whatever, it was for three months. but those are processes. what mattered for health outcomes, whether people stayed healthy, whether they needed hospitalization or needed medical care, was from medicare. It was actually the Chicago Public Employees Unions in 1946; the gas, electric and water companies agreed to have their lives followed until they died: their medical costs. and if they had six normal values: normal blood pressure, which is probably the most important thing, normal ldl cholesterol, and normal body mass index. It doesn’t have to be normal, it’s not going to enter the range of obesity due to being overweight, normal fasting, but your hemoglobin a1c, there’s no cotinine in your urine. and then all we used the process for was completing the stress program. when we started as i couldn’t stress at the cleveland clinic. like toby said, i cause stress like a lot of executives do, and people have to cheer up when i do. So, I don’t want that as a measure. but in any case, seek to see a primary care physician and get the values each year. by the way, primary care doctors love this because suddenly people were taking their blood pressure pills and doing things instead of ignoring them. So what happened is in the Chicago Public Employees Union, a 70% reduction in developing chronic diseases, they live 30% longer, so their total medical costs for the rest of their lives were about 50% less. that’s why we made that policy. And what’s happened is, Toby said, we’ll continue to increase the incentive as we save more money and pay them back. and we will do it as the base of the length. and we carried out an active lobbying campaign during the construction of aca, ppa to try that prevention can be paid for up to 30%. and if the hhs secretary says tobacco can be included, she can get up to a 50% difference in health care premiums. so, we did it. we are at 30%, now the highest allowed by law. and so now it’s about a reduction from $1,500 to $1,540 per year for employees for that. and this is how we do it. where was the crossing point? when you give a small amount, you actually see employees stopping other employees from doing it because they say: they will make it mandatory. when you get big enough, everyone starts doing it. so it was big enough in 2015, $680, we started to see all the barriers being broken down for people not to do it. and as you keep going up, you break more of those inhibitory barriers.
willy walker: so, i want to shift gears towards the great era reset and just talk about longevity and what your next book is about in relation to the economics of it all. So if I was born in 1800, my average life expectancy would be 36 years. if i was born in 1928 i would be 55 so i would be dying next year. if he had been born in 2000, he would be 78 years old. and right now, if I was born in 2016, I would have a half-life of 80 years. but his work and his research basically says, throw those numbers out the window because technology and innovation will allow all of us to live much longer. reading your book made me very, very excited because on page 27 of your book (and you can move between now and when it’s actually published) it shows that my age in 2021 at 55, that a woman born in 1967, which is the same year that I had a life expectancy of 74 years and that by 2030, my life expectancy will have increased by 60 years to 115 years. So I need you to explain to me, Mike, how I just found 60 years of life expectancy.
dr. michael roizen: well, you didn’t find around 36 or 40. but let me go through that. I told you that you are a genetic engineer because each of your choices changes which of your genes are turned on or not. When the human genome project started, we expected that there would be enough base pairs of DNA in its core to find three hundred thousand genes, but only about 22,500 were found in both human genome projects and what they call the rest of the dna. initially they called it junk dna. then, seven years later, it was discovered that they were actually switches, little rheostats, like a rheostat in the wall that governs which of your genes are turned on or not. and you have an incredible amount of rheostat material. that is, you have 280,000 equivalents in genes such as rheostats, switches.
so when you manage stress, for example, you change, and you do it successfully. you down about 150 genes that make inflammatory proteins and turn them off. That is why stress management is so important. you can turn off your inflammation-producing protein genes. well, what we now know about this is that we know a lot, because of the human genome project, about how to edit genes and how to look for genes associated with aging. yamanaka got the nobel prize, i think, in 2012 for four genes that he found to be capable of. when he did this on mice, he reset the mouse from an old mouse to a young mouse. So, imagine you have all the genes you did when you had eight cells and no brain or heart. and then maybe we could, the idea was, develop a new brain and a new heart by turning on the right genes.
well, there are 14 of these areas. editing of the crispr-cas9 gene is one, and reproduction of stem cells is another, harvesting of old cells is another. anyway, 14 of these areas have been made on at least two species of animals. So they don’t fly at night. and what that means is that there is a very good chance with more than 80% chance that the group of these can make you feel 40 when you are 90 and have a life expectancy. and we’re very conservative when I say 115, because in animal species they’ve now done it a second time by resetting mice and rats that were literally 107 years old, back to 40, and they did it a second time. so now there are 170 year old rats reset to 40, the equivalent human age. so if any of these will work in humans, we’re not sure. but the derivatives, just imagine that one of the derivatives is heart failure. an abnormal protein causes approximately 30% of heart failure with crispr/cas9. they’ve knocked out that gene in six Australians who had it and changed their life expectancy from six to eight months to 18 years. well, with these people with heart failure. they are also doing it with sickle cell anemia. So spin-offs are changing our life expectancy and quality of life right now. peter linneman and albert ratner go into economic changes and why this is a solution to our economic problems, rather than longevity being a causation.
willy walker: your projections in the book are that by 2050, we will have a united usa. population of 450 million people, while the census bureau is currently projecting a us. population in 2050 of 390 million. So just think of the additional 60 million people in your table, you’re projecting that by 2050, there will be half a million Americans who will be over the age of 120. by the way, when I pulled out my insurance policy to take a look at this thing, it’s only 100 years old, and my insurance policy yield is 4.23%. If I live to be 100, which is the only reason I’m sitting there, why would I continue with an investment? if I die tomorrow, it’s obviously a great return for those who benefit from my life insurance policy. But if I live past 100, the return on the life insurance policy is ridiculously low, right?
dr. michael roizen: and, in fact, a lot of policies until recently gave zero to the beneficiaries of it. if he lived past 104, they have now adjusted it to a hundred and twenty many of the insurance companies. but if you look at the fine print, it’s really amazing. So if you owned a life insurance company, you want to sell life insurance and not annuities, so to speak. and people often ask, “well, what about covid-19? we have heard that it shortens life expectancy.” that is what we call periodic life expectancy. would you die of covid-19? Would covid-19 death rates persist every year into the future? that didn’t happen in any pandemic, and we don’t expect it to happen with this. but cohort life expectancy, how long is your cohort going to live? we believe that he will still live much longer. in fact, much of the science developed because of covid-19 will help you live longer.
willy walker: so let’s talk about cohorts because i think it’s very interesting. you mention in the book mike, a study at johns hopkins university that talks about people who were hearing impaired between the ages of 40 and 50, or maybe 45 and 55. and those people who were hearing impaired during that period of their lives they ended up developing dementia at twice the rate of those who did not. and all of that sensory piece related to our longevity and interacting with cohorts and participating in society is such an important component of all of this. it is not?
dr. michael roizen: people have to understand how well you read the book because it’s a little sidebar. that’s right, our senses of hearing, smell and sight we have done a lot to reset them, that is, to be able to do them. So, on your cell phone now, thanks to Walmart; Instead of being a $5,000 device to get a good hearing aid, there’s now $500 at Walmart for things that can really change the rate of hearing. and that’s one of the things about medicare, i think they were trying to get in, and i don’t know if they got it or not on the old bill where hearing and devices would be paid to some degree. but in any case, you’re listening and saying, yes, I can get a device and hearing aid that you can’t even see that I can adjust with my cell phone that is inexpensive and will keep me busy with my cohort. and that’s one of the most important things. when you look at studies of british civil servants or alameda county, which are excellent studies, it was the number of people you related to as friends, to whom you were vulnerable, including your spouse or others, in one month. when it reaches six, you live much longer than when it reaches zero, one or two. therefore, interact with other people. and one of the things that we think hearing is so important is that engagement and that socialization. a couple of things is having a purpose in life, having a goal in life and having friends are absolutely key to longevity.
willy walker: you mentioned earlier a number of emerging technologies, senolytics. you mentioned in the book hyperbaric chambers, lengthening telomeres, you mentioned plasma exchange research being done at uc berkeley that slows down the aging process.
dr. michael roizen: plasma exchange is now a randomized controlled study at 2b/3, which for people who follow the fda when you get two-three three studies, then it gets approved. Therapeutic plasma exchange removes half your blood volume and returns your cells, fresh albumin, and saline. It used to be that you had to make a trade. people would get young blood. In Silicon Valley, there was a young blood company where blood was taken from a young person and transfused into an older man. now it looks like you don’t have to do that. all you have to do is do a plasma exchange. you can be paid in the same way. if you want to do it now by donating plasma, they pay you to do the same. but in any case, your cells are returned to you. What was done in this ambar randomized controlled trial, four countries involving the cleveland clinic and the university of pittsburgh in the united states. Randomized controlled trial showed plasma exchange once a week for eight weeks and then once a month for six months. It not only reduced the rate of dementia, but reversed it in people with mild Alzheimer’s disease. now that is a study that has been completed. they are now enrolling a second study of three. but this is amazing. and this is essentially what they’re harvesting is old cells. So, it is a senolytic drug without plasma exchange, which removes old plasma. the old proteins in your plasma kill off some of the senolytic cells, which are old cells that cause other cells around them to age. So, one of the techniques is therapeutic plasma exchange. and if you want to follow him, you can follow ambar on google. but the other point is if you have someone in your family with early dementia this is something to discuss with your doctor about the amber study and if you should start donating plasma.
willy walker: so when i hear you talk about that specific example and in your book, you talk about many others, you talk about the crispr technology used to edit the cells of a young man i think of you, you used the name johnny. I’m assuming that’s not his real name, that he had pancreatic cancer and how successful gene editing and a grape study on glioblastoma has been and some amazing results they’ve had. and as i read about all these dr. roizen, i was thinking about a presentation i saw from andreessen horowitz about two months ago, where they put all these fintech companies and they put paypal and they put square, and all this and they were trying to impress us all, that fintech was going to take over the world and, in particular, of the financial services industry. and they said that all these fintech companies added together are worth $500 billion, and they said that to try to impress everyone in the room. And I raised my hand and said, “but do you realize that the market capitalization of JPMorgan Chase, a company, is $500 billion.” and my question to you is that all these one-time investments or changes can be like fintech to help a specific thing. our eyes, our ears, what do you have. but what is jpmorgan? which one is going to really push the needle in and take over so we can get to these numbers that you’re talking about in the book?
dr. michael roizen: well, they’re all contributing. all 14 areas are helping with specific problems and making progress. So, for example, one of those and epigenetic reset: Giving an adenovirus with an epigenetic reset protein reverses retinitis, reverses the retinal cell loss that goes along with macular degeneration. so each of these is developing an area to help. now what you’re saying is, is there a reset where I go into the car wash at one end as an old car and come out as a new car at the other end? and the answer is, if you want to bet on it, we don’t know if that will happen. but that’s really tissue induced pluripotent tissue regeneration or epigenetic reset. calico the google spinoff looking at aging is for the early years they started in a different sphere but now they’ve shifted to this and they’re really moving the field a long way in this induced pluripotent regeneration that started with the yamanaka factors of getting the rat now from one 170 to 40 twice. so that would be the bet. but I believe that each of the 14 areas will contribute to extending our lives a decade from now. but by 2050, if you hit 20-30, you’ll be much younger. but if it gets to 2050, there may be a car wash reset, but we don’t know yet.
willy walker: and isn’t the bottom line all the work you’ve done in your career to get people into the normal six levels you have for basic health? to be able to have all this help you? that if you let the normal six values get out of line, if you don’t take care of yourself every day by eating enough and getting enough sleep and just doing the normal thing, you’re likely to catch some disease that takes you down before the disease really develops. car wash.
dr. michael roizen: we are concerned that this is the case. That’s right, and the key point is that you can do things healthy now, and we can change things from a rule base like Australia has to help decrease wealth inequality and health inequality as we go forward. . but it’s your choice now. I mean, you are a genetic engineer. And so, every day it’s your choice to engineer your genes in a way that helps you live younger, longer.
willy walker: well, with that, i will say that it was his choice to join me today, and it was my great pleasure. I have, as I usually do, a couple more pages of notes to go over with you, but I’m out of time, but I look forward to, if you’ll let me, the second part of this once the big era reset is available and others they can read it and you and I can review it in more detail and ask you more specific questions about it. dr. roizen and thank you so much for joining me today. It has really been a pleasure.
dr. michael roizen: for those who want more information, go to greatagereboot.com. and when the book comes out, they will be notified. but also, we have an application that will help you, and your doctor will help you stay as young as you want to be.
willy walker: i would go to the great age reboot website and also google dr. roizen, and you will be led to many other things that can be very useful for your life.
again, mike, thank you very much. it was an absolute delight and everyone who joined us today thank you and see you next week.
dr. michael roizen: thank you.