LIFTS Episode 134 – Everything You Know About Longevity Is Probably Wrong | Oliver Patrick

0:00The rise of direct consumer labs will be a real inflection in the longevity space and I think you've talked there brilliantly Mo about the sort of rise of this longevity sector. I think just in the last three months alone I've seen three or four businesses in both the availability of lab work so biochemistry and hematology and bloods and then of course we've seen the big operators or a whoop and other start to integrate those labs into the wearable picture. So that is a big inflection in the last three months. And I think it's another example of technology clinicians and operators moving at a speed that is far above and beyond the consumer's understanding.

0:41Lifestyle will still be the determining feature of not only our length of life, which will be determined as lifespan, but more importantly, our quality of life, which will be more determinable by this concept of healthspan.

0:57Matthew Januszek:Welcome to this week's episode of Lyfts. I'm Matthew Januszek and I'm very excited about our conversation and our guest today. I'm here with my co-host Mohamed Iqbal. Mo, how are you doing today? I'm doing good. I'm still out on the eastern end of Long Island and spending a few more days here and it's just really nice. DC is steaming hot right now to over 100 degrees. I'm not sure what that converts to in Celsius, but I think it's about 40. So out here, it's been great. I've been running along the beach, having a lot of lobster and seafood and seeing friends. In fact, this week - I thought you could invite us over there, Mo.

1:35Matthew Januszek:Like I'm waiting for my invite, actually. You're welcome anytime. In fact, I've got to stop by and see Kevin Yates because he's in Southampton right now. But I don't know if you saw my LinkedIn post this week, Matthew, but I stopped, it looked very great, but it was great because it was raining Monday and Tuesday, but I stopped by Jack Bailey's house and he put me through a workout. I was with Douglas from High Rocks. And it was a lot of fun. We were on the beach throwing a 30 pound ball around and had a really good time. So enjoying my time out here. How about you? I mean, have you come up with any new wellness hacks?

2:14We're going to be talking about it, but typically I feel like every six months you're trying something new. But we haven't talked about that in a while.

2:22Matthew Januszek:No, we haven't. And I'm not prepared. There are a few things that I've been working on, actually. They're kind of like partly figured out. And I'm hoping I'm going to use this conversation today with Oliver just to really sort of check if I'm going in the right direction. So maybe that's one for a future episode demo so I don't kind of embarrass myself in front of Mr. Oliver Patrick. Well, let's get right to it. But I'm really excited to talk about our episode today. It's a topic that, Matthew, we've covered over the last three years quite a bit, and that is longevity. And it's interesting because that word longevity, I've heard that it's become overused a lot.

2:59People don't like using it, but I'm still using it and we can let our guests speak to whether that term is correct or not. But I think it's a fascinating moment for us to have this conversation because whether you call it longevity or wellness, we've all seen it in the last six months. It's really moved from something that was in the fringes done by biohackers to something that is very much mainstream. In fact, I have a group of eight dads in my neighborhood in Arlington, and they're talking about different peptides and should we take BCP-157 or they are on GLP. So red light is something else which I'm hearing more and more about.

3:36And a few years ago, this topic was mostly reserved for academic researchers. You talk about it at medical conferences, elite concierge-based health clinics, and maybe a relatively small group of high-intent biohackers. Today's everywhere. We've had guests from gyms who are talking about adding wellness services to their portfolio. Obviously, recovery spaces, boutique wellness clubs. I was at a Pilates studio in New York the the day, and they had a red light therapy and a sauna at a boutique fitness studio. That wasn't something that you saw even a year ago. It's coming into wearables. It is in supplements.

4:16I'll put another personal note there. I started taking creatine with HMB, and I've actually seen an improvement on my sleep and recovery scores. And of course, there's blood testing in this whole world here. So from an industry perspective, we mostly talk about the fitness industry, not enough about wellness, but it's really created this immense opportunity that a lot of operators are really trying to capitalize on and figure out, okay, how do we, number one, help serve our members better that, you know, moving from just tracking how often they come to the gym into being more outcome focused. And number two, isn't there an opportunity for them to participate in a larger share of wallet?

4:53And we've had some great conversations there. The market is responding well, and there's a lot of innovation that's happening. Here's the paradox that we keep on seeing. And I know we've talked about this with Ali before. We have more health information than ever before. There's more experts. There's more podcasts. There's more ways to measure yourself. But more broadly speaking, the population as a whole, they're still moving in the wrong direction. So even though we have more data and more supplements as a whole, we're not moving in the right direction. So while we have the wellness economy that's booming, the longevity area is exploding, We have more technology and more wearables.

5:33But I wouldn't say that the average person is necessarily becoming healthier. And I think that's the tension which we want to unpack a bit today. So to cover all this, we've got, I think, the perfect guest, someone who we've had on the podcast before, Ollie Patrick, hailing from the UK. I don't know specifically where in the UK you're in, but I know in the UK, I think you're in London, but we'll let you cover that in your intro. In your career, you've sat at the intersection of physiology, nutrition, high-performance, preventative health, and behavioral change. You have co-founded one of the world's most advanced health evaluation and personalized health management services.

6:14You also co-founded Future Practice, where you have served as clinical director at Pillar Wellbeing. You have consulted for some of the best brands in the industry. And I've heard you, Ali, speak at a ton of conferences. You've got a podcast and you're definitely someone who I follow and I'm always keen to listen to. And you've always bring so much valuable insight. So I want to first start with a question. In the last three months, is there something that you've either personally experienced or you've personally seen that you think is going to be impactful in this wellness economy that we're in?

6:52It's such a great intro and you've started with an absolute belter of a question. Last three months, I think the rise of direct-to-consumer labs will be a real inflection in the longevity space. And I think you've talked there brilliantly, Mo, about the sort of rise of this longevity sector. I think just in the last three months alone, I've seen three or four businesses in both the availability of lab work, so biochemistry and hematology and bloods. And then, of course, we've seen the big operators or a whoop and others start to integrate those labs into the wearable picture. So that is a big inflection in the last three months.

7:34And I think it's another example of technology clinicians and operators moving at a speed that is far above and beyond the consumer's understanding. and if you're putting me on the spot with that one I'd say that's probably it I haven't seen anything that says salvation lies ahead I've seen probably a greater fragmentation of longevity as people have seen this sort of global demand rise and I'm not sure it's a consumer-led demand either I'm not sure much of the longevity demand is coming from people I think it's coming from a better understanding of the science and a better opportunity, as you say, to commercialize offerings.

8:15But I think the race for longevity is an interesting space. Is it owned by medicine? Is it owned by aesthetics? Is it owned by biohacking technologies? Is it owned by fitness and nutrition? And when we talk about longevity, that critical piece, what do we mean by it? And how would we ever determine it if it's only measurable at the point of my death?

8:35Matthew Januszek:One of the reasons, Oliver, we exchanged some conversations or some messages on LinkedIn. And just to give everyone a little bit of background, the reason this conversation kicked off was that Mo and I were talking about this report that came up. And the report really was related to a previous episode that we did with you, Oliver, where I guess one of the biggest takeaways from that previous conversation was that the, you know, while genetics matter, we're not prisoners of them. And for decades, this accepted thinking, which I understand was based on this Danish twin studies from the 1990s, was that genetics account for around about 20 to 25 percent of how long we live, with lifestyle environment accounted for the remaining sort of 75 to 80 percent.

9:27Matthew Januszek:So that seemed to be putting the control back into our hands of, all right, well, look, no matter what we're born with, we can really have a big impact on it. But what seems to have happened recently is that this recent update, which seemed to sort of slightly change the way that that was being explained, seemed as though that genetics were a lot more responsible. And one of the researches involved warned that people might become fatalistic, thinking that if genes matter, then why bother? So I wanted to speak to you because we had a little bit of backwards and forwards. And I thought, because it's such an important study with such quite large implications, even with me, I'm almost like, well, sod it, you know, just enjoy life and not worry about too much.

10:17Matthew Januszek:Can you give us a little bit of an overview and maybe sort of start again from probably, you know, give us a little bit of an overview of this study, the recent update, and then where your position is after reviewing, you know, reviewing some of the recent press releases that have, you know, been in the media quite a lot recently. I think it's a brilliant pickup, Matthew, because it's an important thing. But, you know, my position, I'll start at the end, is that lifestyle will still be the determining feature of not only our length of life, which will be determined as lifespan, but more importantly, our quality of life, which will be more determinable by this concept of health span.

10:53So the statistics have changed for sure. that figure that you mentioned was this sort of general idea if I develop a disease particularly a lifestyle disease if we think of the traditional big four where you've got neurocognitive decline like Alzheimer's cardiovascular disease metabolic disease and cancer and each each of those would be a term that includes multiple sort of subdivisions the general theme is when people first decoded you know the genetic material there wasn't a gene for a heart attack. There wasn't a gene for cancer. There wasn't a gene for Alzheimer's. There were genes that increased your predisposition, but they didn't cause.

11:31And actually then using identical twins who have the same genetic material, it's always a really fascinating trivia question. So if you've got identical twins, genetically they are the same. So when the health outcomes of genetic twins was sort of mapped over time, we saw quite large variance in both the incidence of lifestyle disease and then actually the the you know their mortality how long they lived and this narrative was building and building say actually your heritability so what i got from my mother and father genetically isn't going to determine whether i get these big diseases it's down to my lifestyle and then we had this fascinating moment where that was that was again was getting down sort of five percent ten percent so we're really saying actually genes contribute very little and then someone said oh isn't this sort of a statistical anomaly here that we haven't discounted other causes of death.

12:18Like we've got this big variance between identical twins, but one of them died in a car accident and one of them died because they contracted a viral disease on holiday. So they hadn't really absorbed into the statistical modeling death not caused by lifestyle disease. And so they then re-looked at all the data and said, do you know what, when we sit down and look at this, the contribution of our DNA, our genetics to health looks closer to 50%. So instead of it being a diminishing contribution it suddenly swelled back up to a sort of toy you know a coin toss saying actually the contribution of these diseases seems to have a greater heritability than we thought five years ago two years ago what does that mean it means yeah i think there'll be some people go right yeah sod it then i'll just you know go and get boozed up and and you know miss the gym and i won't bother going to sleep properly but broadly that that isn't the way we look at the data the data actually doesn't say 50 of your of your disease is caused by your genes it says um we can explain 50 of the difference in mortality through genes and that subtle difference comes back to the central premise the biggest thing that will affect your length of life and quality of life will still be the actions you take across your lifespan the actions you take not in one domain of of lifestyle movement not in one domain like nutrition but in a holistic lens of all the ways in which your environment interfaces with your genes.

13:44And we sit in this really important intersection now where we say, yes, genes matter, but the turning on and off of genes, the process which we call epigenetics, which is driven by lifestyle and behavior mostly, will still be the biggest thing that influences health and is critically the only thing that we can currently control. And I say the only thing we can control because we've got an incredible gene editing experiment going on on a young boy in mexico at the moment who's got a a muscle wasting disorder and they're trying to use the crisper methodology to insert a virus that edits the gene that is faulty for him to develop that disease so that that disease so we are sitting on the the landscape of being able being able to alter our genetic material in human trials and that that is costing 2.8 million uh for that single boy to receive that treatment so we need to watch that really closely and see how that pans out.

14:37So Duchenne's disease, I believe, which is a sort of progressively difficult muscle wasting disorder. And so two things, can we change our DNA? Well, peptides, gene editing, that's all starting to influence that element. In the real time, what we must be clear on is people should be galvanized into controlling lifestyle, should be, again, given clear guidance that this is the key to living long and living well. And I separate those two things, but they're intertwined, but they are separate. And therefore, we've got to be careful that this gene study doesn't cast shade onto the lifestyle industry and put people into passive healthcare solutions, which would be a big misstep, I think.

15:17So I sit in the same position, Matthew, that our lifestyle is our biggest key to unlock health, well-being, performance, longevity. There's nuance to that, of course. We can't at the moment influence our genes that we should focus on what we can control rather than get too caught up in what we can't. So I think that's incredibly interesting because I agree, I hear this a lot. And it is challenging because it's also a very complicated question. And just as humans, we want to have a simple answer to it. So it seems, I think that we are trying to oversimplify something to say that genetics either matter and they carry an over-indexed amount of weight towards your longevity and your health, or that it does not matter and lifestyle actually plays a bigger role.

16:03I think the reality here, though, is that genetics do matter and influence your lifestyle decisions such that, you know, Ali, there are things that you might do versus what I would do to impact our overall health and to extend our health span, right, based off our genetics. And that's the part that I think needs to be unpacked a little bit further. We're starting to see that. In fact, I recently visited our good friend, Jeff Zuiful, who just became president of 10xHealth and understood how they go through their own gene process, identify what genes you have and how environmental factors could help impact your longevity outcomes.

16:48But I have a couple of questions for you. I think the first one is there are so many therapies and supplements and lifestyle changes that you can do. And it's very easy to get overwhelmed and ironically to get overstressed and increase your cortisol because you're so worried about the data that you're collecting, the supplements that you have to take and all the things that you potentially can do. But at the end of the day, I believe, and from the research that I've read, the highest impactful items still come down to the fundamentals, such as starting with sleep. Could you improve your sleep quality without any sleep?

17:29And the answer is yes. Can you get better sleep? Are you engaging in movement? Is your nutrition sound of avoiding ultra processed foods, avoiding sugars, and are you hydrating enough? I mean, to me, those still are the main pillars. And of course, you can go deeper in any one of those pillars, but we'd love to get your thought. Is that still how you view the world that you've got to get these fundamentals right? Are those pillars the right ones? Would you add or remove anything?

18:06Matthew Januszek:ecosystem combines intelligent equipment, AI-powered software, and the WellPass corporate wellness platform to help operators grow their business and deliver measurable health outcomes to exercises of all shapes and sizes. From powering gym floors to supporting employee wellness, eGym is redefining the workout one rep at a time. Learn more at eGym.com. I love that, Mo. And I think, you know, when I was involved in setting up the world's most advanced health assessment clinic, you know, which was my old business, so I don't do that anymore. You would spend an awful lot of money to identify the absence of one of those behaviors.

18:46And then your strategic recommendation would be one of those behaviors. So someone might come in and pay 30 ,000 pounds and be told, well, you need to do 8 ,000 steps, or you need to go to bed at a consistent sleep time, or you need to, you know, reduce the percentage of your diet that's ultra processed food and increase the percentage that's nourishment you know and what you got for the money was that the absolute personalized dosage of that behavior but the behavior itself was still the same behavior as you might read on a government you know government website we the pillars are for me you know absolutely where everything must start and most things should should end you know the idea of biohacks giving you know a marginal gain when someone has overlooked a foundational behavior is really something that in most of the businesses I'm involved in, I'm trying to sex up the basics, try and bring a hyper-personalized rationale to which behavior will be the biggest one to focus on because there's lots of foundational behaviors and targeting the one you're already okay at won't be as effective as targeting the one you're really poor at.

19:49Movement is the bedrock of all of this, which is why I firmly believe the movement profession has the best opportunity to be a holistic wellness professional because I think movement is the most complicated of the basic lifestyle requirements you know sets and reps for resistance training and zone two versus zone five and you know mobility plyometrics you know quality stretching daily activity that's more confusing than eating food that looks like something that came out the earth going to bed and waking up with the light and the dark you know the the foundations in sleep the foundations in nutrition I think are much simpler beast um they require as much behavioral support and the behavioral economics of convincing people to do them are there but i i would again say if someone said ollie you know which health assessment should i do i'd say well do you meet government guidelines for movement 150 minutes cardio two weight training two mobility sessions do you eat five portions of fruit and veg 1.6 grams of protein per kilogram body weight 30 grams of fiber a day 30 different plants a week do you get seven to nine hours with consistent sleep and wait times free from caffeine free from alcohol i would add to those basics social connection do you engage in tribal activities are you part of a group is there a dependency on you or are you dependent on on some kind of ecosystem and i'd add to that sort of some of the cognitive behaviors around self-compassion and grit resilience so what i'd call psychological fitness if those foundations aren't met what do you expect to find in the test you know if if you don't move what do you expect me to find in your lipid profile or your inflammatory markers if you don't nourish what do you expect me to find in your gut microbiome if you don't sleep what do you expect me to find on your cognitive test if you do not socially connect what do you expect me to find in all your key sort of biological markers of success and i think somehow people got distracted that the biology sits separate to behavior biology is an extension of behavior if my biology and physiology is just adapting to the behaviors it's meeting on a consistent regular basis if those foundational behaviors are not there I will sooner or later measure dysfunction and genes will play a role in how much dysfunction I measure so someone might get away with something and another might not at all and here's that idea again genes don't of course in most cases cause disease if we think of the gene for producing melanin three different levels of tanning capability on this call.

22:14And I see it very much at the lower end of that spectrum. So do my genes give me a risk of cancer? No, they mean I need to adhere to sun protection more virulently than you both do. That's the behavior. So just a quick part on sun protection. You might've seen this, but recently there's been a movement towards no sunscreen. Read. Yeah. Which seems scary. I'd love for you to comment on that. Yeah. So, and again, it's that great idea again, that because of the critical role of vitamin D, which is fundamentally a hormone with, you know, over 100 biological benefits, we're seeing such a mass vitamin D deficiency, we're seeing massive circadian biology, our 24 hour clock dysregulation, that we've made the sun the enemy and the sun isn't the enemy, excessive UVA, UVB rays are.

22:58And I think what we're really looking at is we don't want to avoid the sun, we want to avoid the midday sun, that middle spectrum light, which is the one that's got the highest propensity for skin damage but we need that morning light we need that evening light you know i always if you follow my instagram you know most of my photos are taken in the last hour of the day because the golden hour you know you get this on the west coast in particular you know matthew will be you know lots of photos of him looking magnificent as the sun goes down because all of that red light that brings in that beautiful sort of aesthetic is a critical part of regulating our sleep cycle so i think again it's it's when we try and simplify things to is sun cream good or bad for you it's it's probably not ideal first thing in the morning it's probably not needed in the evening but it's definitely needed in the midday sun and then what sun cream is it is it full of forever chemicals and and toxins or is it relatively clean so there's nuance upon nuance but i think the general theme on all these things are i i spend my life using technology to reinvigorate the basics and find both a hyper personalized dose of the basic and then critically use that data to reward the behavior that gives the individual that self-efficacy that i started dropping caffeine that solved my that you know my low immune system that revealed itself through a change in my heart rate variability and that relationship between me getting a goal through adhering to a behavior and having that evidenced in the metrics i think is is the bit that that we can use modern science to galvanize the old the old foundational habits you mentioned um making

24:31Matthew Januszek:the basics sexy and I do agree there's a there's a lot to be said around that because it's like you know the basics have been around for a long time you know we've we've known about fitness for a long time so that's kind of a little bit boring and we've known about sleep again for quite a while and that's boring okay Oliver you know what tell me the new sexy thing that I need to be telling you know to be using you know tell me about that new pill that I need to be trying or those new injectables and and I think as as Mo mentioned at the opening of the conversation This word longevity is being pasted around everything.

25:05Matthew Januszek:And as an industry, we kind of like to latch onto these words and put them into, pump them into everything that we can. One of the other words that kind of I get to see attached a lot to it certainly gets a lot of clicks and buzz, buzzing, you know, buzz is the biohacking word as well. and going through a lot of events and seeing a lot of products that are coming out from the hardware to nutrition and supplements are really tapping into this. And the consumer is clearly influenced by a lot of the big social media people out there that are doing particularly well at the moment. So I wanted to get your view about this because a lot of people that are listening to this are in the fitness business.

25:55Matthew Januszek:They're operators, investors in the space. And if you walk into many gyms today, you'll see certainly it will be difficult to get away from seeing some sort of promotion for things like red light, saunas, cold plunges, compression, IV therapy. and particularly in the US now that, you know, everywhere and everybody and almost like every teenager is talking about peptides. So what I wanted to get your thoughts on really as an advisor to some of the professionals in the industry is if you were sitting down with operators with, you know, a relatively limited budget, what would you be advising them to to invest in first, particularly if they are a business that is selling fitness.

26:43Matthew Januszek:And going back to the answer you just given, there is a lot that we could be doing around fundamentals. So should we be worrying and investing in getting some red light therapy and hyperbaric chambers and that kind of stuff? Or should we be just doubling down on the basics or a combination of two? What is your position on this? and what should we be thinking in some kind of like ranking order? Great question. I'm a bit Walter White on this. If you're fans of Breaking Bad, and I say to operators and I say, you know, tread carefully because there's a very quick opportunity to discredit your high integrity on your core offering by choosing the wrong intervention for the wrong reason.

27:22I think longevity itself is an interesting space. You know, someone has decided that's a consumer demand. I don't know many people who are engaging in challenging habits and behaviors so they may not get a disease in 30 years time that they don't really understand what that disease is. So we've got to just be clear if you're positioning longevity, the longevity marketplace has got, you know, gyms which are talking about retention of biological capabilities are retaining cardiorespiratory fitness, retaining muscle mass and strength, retaining bone mass. And really, it's a very clear outcome metric for good quality exercise and training.

27:56The medical communities realized it can sell longevity as a preventative word. So rather than just selling services to people with existing chronic disease, it can sell longevity and repurpose the MRI scan that was, you know, measuring the size of tumors. And now it can measure whether there is a tumor. It's the CT scan that did do, you know, CT angiograms, and now it's doing a full chest CT. And so longevity is also preventative medicine's new vehicle. We've also seen anti-aging disappear and rebrand as longevity. So hotels, spa and luxury have moved into longevity with the the idea of sort of visual aesthetic longevity.

28:29And it doesn't matter how long you live, as long as you're beautiful when you die, which is totally valid. You know, and then you've got the cellular longevity crew, which would be, well, I've got less NAD in my cells at 20 than I had at birth and less at 40 than 20. So I'll infuse this molecule that works in my mitochondria to help with the production of energy. And I will hack my cells with more oxygen through hyperbaric oxygen therapy or through using red light modalities like photobiomodulation. And again, I think that the first piece again is lots of companies ask me what they should do. And I say, have you asked your people what they want?

29:03And have you asked them whether they trust you to extend that relationship further? And I think those two bits are really important that you, depending what relationship you have with them, and have you built a brand based on high efficacy exercise, high efficacy nutrition? Have you nailed the basics so that you have the right to play in a heightened space? Because if you don't train people well, please don't put a hyperbaric in the corner of your room and think that that's going to be a particularly effective, you know, broader strategy. So I think the foundations play a part in that what's next piece, because there's a lot of, again, the idea that I would put someone into red light therapy who didn't sleep seven hours a night is mathematically so illogical, it's hard to conceive.