The Dark Side of Human Optimisation: Nicotine, Peptides, NAD+ & the Enhanced Games | Longevity Doctor Explains

36:04People are going to take performance enhancing drugs in elite sport, period. And the big pro for accepting that and saying, look, it's going to happen is a little bit like intravenous heroin addicts being allowed to get needles from the health service. it's kind of saying look you're gonna do it but let's at least let's get you to do it in a way that we can have some form of visibility on it and maybe even learn right that is the biggest single thing is is not being so patronizing to believe that by saying this is banned that people are not going to say it's just not going to happen so learn the data that you could get from studying people over time and actually seeing, is there a performance enhancement?

37:06And I'll say what I think is the most interesting type of performance enhancement because it's slightly adjunct to what the games were trying to do. And what are the harms? And really building up a registry is important. It's too small to develop a really good registry. That's the challenge. And actually, God knows if the data were really collected or offered were really what was going on. But what is fascinating to me is not whether somebody can get their personal best at the age of 45, or, as we probably pretty well failed to do in the enhanced games, win any new world records. That was what was really interesting, like the guy who thought it was going to beat Usain Bolt, and he didn't.

37:51No, he didn't. He was miserably... Nowhere near. Miserably didn't. There was only one. It was the swimmer. There was a swimmer, but they were wearing... They were wearing a swimsuit that was invented by Poseidon himself. But they're still arguing that, right? Yeah, it's a performance enhancing swimsuit. I actually did some calculations on it and it gave more of a performance advance. Many gold medals, many more gold medals would be won in normal games if people were wearing those suits. The point is not about winning a gold medal now. What is really intriguing to me is, is any of this going to help us still be skiing when we're 90?

38:36That's more important. For me, give a person a million dollars if they beat their personal best 10 years after their personal best. that that to me is intriguing because it's about maintaining the ability to still be strong fit fast balanced coordinated and hopefully independent yeah that is really intriguing people should get gold medals for for still being able to do what they did 20 years after normal nature taking its course said, no way, stop there. We don't want you to be an alpha anymore. We don't want you to be as strong. It's time to make way for the next generation. The gerodemographic situation that we've got in the world needs people to be fit, mobile, strong, have coordination, balance, and all of the good musculoskeletal and neuromuscular things that we need into our 80s now, not into our 60s anymore.

39:42And that to me is a huge opportunity. I mean, I completely agree. I was on a longevity panel and even that word I struggle with at the moment or I have for the last kind of couple of years because it feels like it's taking this whole new shape and form. And I remember Brian Johnson's doctor was sat next to me talking about these whole host of different things that people can take. And I was I kind of half of it goes over my head because it feels so advanced for where we are right now and where mainstream society is. obviously there's a very small subset of people that really want to expand and optimize and do all those things but for the most of the people were not even eating enough fiber so i feel like you know what i mean i'm like drilling it all the way back to like common sense a lot of the time sauerkraut and yeah exactly and i'm like you know just make sure that you're not eating just you know your cereal in the morning like we need to be getting more nutrition into us full stop let alone the host of things but it was really interesting one person put their hand up and said, if I only have£50 a month to spend on something that's going to help my health, what am I going to spend it on?

40:44And the irony was, even then I'm thinking for the average person, that's still so much more money than most people will spend. And obviously if you're going on a subscription for one of the multivitamins or whatever, they're really expensive. And, you know, they're great for certain amounts of people. But even in that moment, I thought, one, what a great question just generally kind of bringing the whole audience back to reality. But two, actually, if we really look at this mass market, that's still quite a lot of money. It still is. Longevity is a luxury. It shouldn't be. It shouldn't be. It should be like walking.

41:21It should be about trying to get some good sleep. It should be about trying to bring fun and enjoyment back into people's lives. Yes, I agree. If we're dialing it down to basics. Right. but we know that probably a couple of the biggest things that determine your longevity is choosing your parents well how do you do that you can't you don't have a choice you don't have a choice but your genes is one part of it and the other one is your postcode interesting so it's your wealth it's it's not to do with whether you've got so this is your point about do you have 50 quid a week to spare was it a quid a month a month 50 quid a month yeah i mean if you're not buying nicotine patches and you're doing some other things um wisely you quite a few people could probably get to spending 50 a month wisely but we but that is nothing compared to what we are being advertised i know that's what i mean if you want to go into peptides a typical motz c prescriber, even though it's not a medicine yet, will be asking you for$3 ,500 a month.

42:35I mean, who can afford that? Whether it works or it doesn't isn't the point. But 50 is wishful thinking. The amount that we are being persuaded to push into ourselves is pure marketing and no science. Or if the science is there, it is unbelievably disproportionate to the marketing push what would you say that somebody they had 50 pound a month to put something towards their health what would you what would you take personal trainer really i mean like a personal trainer is like 80 quid a month online anything that can hold you the biggest problem is the toothbrush problem it's will you do it every day ideally twice yeah it's not the substrate it's the sticking to it that is the consistency it's the consistency part of anything hyperbaric oxygen therapy do you have quarter of a million quid to spend on a four-man chamber that you've got in your home oh and you've also got it in your ski chalet and verbi as well because you know why not no but even then if you're not doing it very frequently it makes you feel great for a bit but it has there is no evidence in fact we know it probably doesn't work unless you're really doing things regularly.

43:53So regularity, again, it's the cadence as well. It's not like doing things until exhaustion and making sure you get the cadence right. We call that periodization when it comes to exercise. But why is it that almost across the entire board of health outcomes, exercise turns out to be boringly the thing that, even in Parkinson's disease, it's the only one thing that we can see that makes a difference. Look, it is the ultimate longevity drug. Exercise, what type of exercise? The different domains. So across the board, generally, it's you've got strength, you've got endurance, you've got balance, you've got mobility, like the ability to stretch and so on.

44:42And then you've got kind of strength endurance, which is like not ultimate strength, but strength, strength, endurance. And those, those compartments are all important. But what is happening in exercise? We hardly really know, but there's this kind of, there's this theory around myokines. It's like when you get your muscles moving, they release an unbelievable number of weird things. Kinds meaning movement, yeah, kinetics and things that move things. Myo meaning muscle. So they are signaling things that come out of the muscle. And they flood the system with all sorts of signals to produce hormones, growth factors, repair signals, changes in how your vessels respond to damage, inflammatory factors for healing, anti -inflammatory factors for reducing excessive damage to cells.

45:37Myokines are the most untapped and misunderstood and underappreciated factory of wellness and longevity medicine that the body produces. The other side of that, of the wave, is sleep. so I mean there are so many things that could be missing that are easy fixes if you're not seeing any sunlight vitamin d maybe um but without fail it's the the amazing stuff that comes out of moving kind of reminds the body overall that it's still useful that it's still working so it's kind of well if you're moving and you're moving well why don't we try having you hang around a bit more interesting and i think there is work now happening in uh like the work of michael levin at tufts um who are looking beyond what's happening at a genetic level or a um just a neurological level about how cells connect to each other they call those things bioelectric fields, non-neural networks, the body seems to be talking to other parts of the body in a very low frequency way, kind of signaling that this should be happening here and that should be happening there.

47:08And right from a molecular cellular mitochondrial level through to overall whether a tissue is being well used, it seems that if you move well and you continue to help yourself move well, there is the biggest single win. And the results, obviously, that you don't need to argue about the data, whether it's in cancer prevention and survival, cardiovascular disease, neurology and neurodegeneration, protection against dementia, it almost doesn't matter where you look, exercise seems to be it. So if I was going to put my money on anything, it would be on that 50 bucks being anything that would enhance my metabolic physiology which comes mostly from moving and then the number two would be investing that 50 pounds or dollars in I think the most effective regenerative medicine clinic in the world and that is the one you can visit eight hours a night called your bed.

48:22The rest is great, icing on the cake, but none of us are really optimizing. Brian, for whether you like him or you hate him, at least he keeps his exercise up and he does those things to a point of exhaustion for most people mentally and the isolation and various other sort of things. But then loads everything into himself and you know arguably does he or does he not cause himself an autoimmune gastritis i don't know as a result of all the foreign external stuff you put in but that today is as far as we know today is the biggest single thing that we're not doing right and it's affordable so i would say to that if that is what you believe to be the kind of key the key lever in longevity investment in good trainers

49:15accountability maybe accountability look let's take it to an extreme yeah if you had five grand a month to spend and you'd already easily paid for your trainers and great to organic food. You had a job or security that enabled you to not have to wake up at four o 'clock in the morning worrying about money or what was going to happen to your elderly parents who've just been diagnosed with dementia. All of these things are just out the window. You've lived in absolute fairy tale wonderland, maybe in Venice Beach. Who knows? A muscle. What is it? Arnie Schwarzenegger's. That's right. A muscle bee.

50:07And life was good. Well, maybe life. Maybe that life is good for some in that particular utopia. And you had five grand a month. What would you do with it? What would I do with that? Guys, it's taken me eight years, but I finally wrote a book. And it's called Healthy Shouldn't Be This Hard. And actually became a bestseller this May. Very exciting. now if you want more self-compassion in your life and you want to know the reasons on why that is so important I tell you all in this book and I give you a lot of tools to help you get there it's definitely been a lifesaver for me and I know many people that have read it it has for them too so if you want to check it out head to my bio or the show notes below you'll find the link to the book good I was listening to what you say then what would I do with it I would I mean I would I'd absolutely love to be in the utopia.

51:05I don't think that's ever possible. What I would do with it. I would, now living in the UK where it's a heatwave, I would invest in air conditioning because that will help my sleep. I can't sleep in this heat. Neither can I either. Let's say that was all done. Let's say it's like totally like easy to spare, totally easy to spare five grand, not 50, not 50. Do you know what I'd spend it on? What would you spend it on? Experiences with my best friends and my family. Right. Okay. So in the Harvard longevity study, what we have seen is the biggest determinants of longevity, although the others are important, that social connection seems to be the biggest single determinant.

51:54Yes, there are your genes. Okay. it's your it's the lottery that you've been the hand that you've been dealt right it is the connection with others the social cohesion that is the the biggest single determinant which you can actually change, you can't change your genes but you can change your social interaction and connection so if that is the case and even people like brian johnson are recognizing that there is something magical about that we don't quite understand the mechanisms but the theory is that a little bit like how different bits of the body remind other parts of the body that there were it's worth for the whole to stay around what if that extension was was between beings.

52:51What if we were useful to the tribe and the human connections that we felt, the oxytocinogic and other real hormonal signaling that goes on when you feel connected to others, when you feel the love and the connection to your neighbors, your family, your friends, your colleagues, people who you hold quite close and dear, who will always have your back, and who, by the way, will be there to drive you to hospital when you're unconscious, and that also saves your life and helps with longevity or whatever. But I would argue that if you've got five grand to spend, why don't you spend that on deepening your social connections with people?

53:35And it's only after you've done the basics for your body, you've done the fundamentals that you need for the close social connections. That's the foundation. Then you can start layering on the weird and the wonderful, the molecular, bizarre, beautiful things that we've invented or stolen from nature. There are obviously exceptions to that, such as I don't believe personally that any woman should be living half of their life without sufficient sex hormones. HRT was feared for a very long time. So that's an exception to the rule. But in general, the foundations are about metabolic physiology. That's like produced by fitness, eating the right stuff, sleeping the right, in the right way so that you can lay down all the good fuel into substrate in your body, like rebuild yourself.

54:42And then it's about social connection. But we don't have anything that you can buy on Amazon to do that. Maybe you should be able to buy holidays together on Amazon. Maybe that's the best way of doing it. So I think we're in a very challenging time where product is something that's in a pill. It's something visible and swallowable and injectable or smearable on your skin or whatever it might be. But maybe the real secret sauce that is indicated by the data is actually this weird, it's the force. Well, you know, when we were out, I'm going to keep bringing it back to where we met, because there was a really interesting talks and forums.

55:23So basically the whole part of what we were at was about creating different conversations on different topics. So there was like geopolitical, longevity, so on and so forth, AI. And one of them was on human friendships. which was actually yeah it's hosted by my friend jeremy app and he has done something really interesting where he's an angel investor and he's got a place in san francisco and a place in paris where it's all about with his founders he says like have my house for free and i'll host it but bring really interesting people when he's all about creating these like very interesting dynamic communities that he wouldn't ever come across and when he's in paris now it's all about trying to create like that's kind of the epicenter of culture yeah and he's like i really want to support artists i really want to support writers bringing really interesting dynamic people together so obviously when his workshop came around i was like you've you know that is just the epitome of what you've got to do one of the people and i can't remember his name he was sat in the workshop he is building just outside of lisbon somewhere in portugal a community where everyone can live and they all kind of bring up the kids together or if they're not having children, they're all kind of living in an environment and a community that is very, very supportive.

56:38I don't know how else I would describe that, but it's basically, I don't want to say it's like nomadic because they kind of all do live there, but it's all people that maybe don't fit into that streamlined society that then feel like they're maybe becoming more lonely. And he's building these subsets of kind of villages, I would say, and he said it will be ready in about five years. and then I just go back to that concept of well it takes a village to raise a child but now we've completely gone the other way yeah and then I think about the grandmother theory yes the uh the grandmother hypothesis as it's called and that came up in our in our talk and I think I'd love to dissect that with you a little bit but I think you know that is such an I don't know if we're going to go the other way because of the rise of robots and AI that now these kind of communities are going to become more I think it's going to I think it's going to flip into this kind of realization we've gone through a whole movement of your white picket fence is a sign of success yeah but actually you want to just bash that down and have houses that are not in a row but people around us fire pit yeah um i i i'm not the best at this i'm quite nomadic i'm traveling a lot i'm speaking a lot of various events i have people all over all over the world that i look after and with my team but i don't even know the names of the people who live two doors down from me.

58:13It's weird. Really? I think it's just a product of living in a very large city. Can I give you a tool to go and ask what their names are after this podcast? I'd love that. Can you message me and then tell me what they are? I will, I will. If it's a way of connecting to... I feel like you're doing an accountability buddy here. That's true. That's my 50 well spent. Does it cost 50 a month? No, no. It counts. But the... You can pay me that. It's fine. I will. I'll contribute to good causes. But the social cohesion thing I think is desperately underrated. And it would not surprise me if the fundamental secret source of blue zones turns out to be some fairly simple stuff like the social cohesion interconnection piece.

59:10like very simple things such as clean air and clean water. So like taking bad things out rather than putting more things into you. Yeah. That I call subtractive medicine rather than additive medicine. We talked about the foundational physiology,

59:31the moving, the sleeping, the good nutrition. that is probably going to end up being something that we finally realize was what gave us joy and promoted longer better lives and we will gravitate towards that just as we're gravitating now towards vinyl records and artisan coffee i think it's an inevitability and i think that with AI and the depersonalization through digitalization and this kind of like false connectivity that we have, which only floats through radio waves. We will just learn that nature and the natural things that we've been brought up by nature over however many hundreds of millions of years to appreciate and love was telling us that this feels good for a reason and we'll go back into it against a tidal wave of products trying to tell us to do otherwise.

1:00:31I mean, yeah, I mean, that's the situation that we find ourselves in the moment. I want to just touch upon the grandmother hypothesis, because I find it very interesting. And it actually kind of came up a little bit when I was doing my talk, and I can't remember why it came up. But can you explain exactly what that is? You're referring to the menopause reality. So there are a few, only a few species on earth that seem to have a menopause, meaning that the reproductive time window stops quite early on in the expected maximum life for that species. Human beings are one, pilot whales, killer whales, a lot of whales, in fact, narwhals, I think, as well.

1:01:18And the leading hypothesis for this is that it is advantageous to the species for there to be non-reproducing matriarchs in the mix. As in, stop having kids and start using your wisdom to help your kids have kids. and that is what they call the grandmother hypothesis. No one's run a trial where they've removed grandmothers and suddenly seen people live shorter or longer. So it's just a theory. But I like to think of it in a slightly adjunct way, which is that if you are choosing to have children at the age of 40, and your children are choosing to have children at the age of 40, then you've got a gap of 80 years between the grandchild and the grandparent.

1:02:29And you're probably in the middle trying to scrape around building up your career and paying the mortgage and doing all of those difficult things at the same time as having two sets of dependents. I have seen countless number of people not be able to cope with that. If you have grandparents that are mobile, capable, still earning money and absolutely have got the energy and the independence to help look after, support not only you still, but also your children. this for me is a usually is an easier kind of setup than folk who've got very very stretched out generational gaps and I this is goes into population growth and all sorts of different topics of economics and and policy that is way outside of my field of expertise but what I would say is the grandmother hypothesis is leans into that which is that having generations that are all helping each other clearly is easier than the energy cost time effort required if there's one set of stretched individuals who are looking after two extremes of of dependence so that to me is not good for your sleep, doesn't promote your ability to be going out to the gym every day.

1:04:14And you're probably stuffing food in your face, tiny little morsels that you've cooked for one person and skipped for yourself. None of that is good. So yeah, I would say the social cohesion piece is not just about proximity to individuals. It's actually proximity of generational, of generations. Right. I mean, it's interesting because I look at my family and I remember there's one family picture where there's five generations of us together. Wow. Which is quite interesting. Yeah, very rare. Very rare. I've got an older sister who's eight years older, so she had children around 30. Yeah. So my parents have been heavily involved in helping.

1:04:59I haven't yet. So that's going to be a very different dynamic for when I have children to when she has children. But I do find it really interesting that I kind of look at people are having kids much later for a variety of reasons. Like there's not just one, I think there's a variety. And I think people always try to segregate it into what must be this and it must be this and it must because there's not enough men that meet the women's standards or women want to have more career. I mean, I just think it's a whole complex multitude of things that is very dependent on the situation of everyone's life.

1:05:33But I do think that it is very interesting that even if we just dial back 50 years ago, you know, my mum had her first child at 19. 19, yeah. You know, I think like it's... That would be balked at today, wouldn't it? Wouldn't it? Yeah. You know, I kind of think about my dad's sister. You know, she again had her child again very young. And so they're all kind of 20 years apart in age. But now that's like an extreme. That's like a complete anomaly. Could you imagine that? Three generations having just 20 year gap. Yeah. 40 is the new 20. Isn't that like fascinating how much it's actually changed in such a short amount of time?

1:06:12Maybe that's from a societal survival perspective as opposed to individual longevity. Maybe that's the biggest problem that we face is the gerodemographic crisis. it's the fact that medicine is doing a very very good job of keeping us alive a lot longer than we otherwise would assisting reproduction when otherwise we wouldn't be able to have children these are not none of these things are bad these are all miracles I only have a child because of the most extreme versions of assisted fertility being here which they weren't 30 years ago I would not be a father. In fact, I wouldn't be a husband or a father if it wasn't for the miracles of modern medicine.

1:06:56So I'm not putting it down at all. I am forever grateful. But at the same time, we are pushing ourselves into surviving and stretching out our lives and stretching out the time period between our lives, the generations, and stretching out geographically how far those lives are apart from each other and all of this stretching out whether it's stretching out your individual life and all of those other elongations um that is probably one of the biggest threats that we have to all of society is this gerodemographic shift it's so interesting then i can also see like the counter argument where people are like, there's more opportunities and there's more kind of available and you can live different types of lives.

1:07:48And, you know, I think about that. I always think about like the counter argument to this stuff and actually think, you know, for instance, yes, we might be living on the other side of the world where our family are, but then you have this host of other opportunities that come your way that the previous generation wouldn't have. So like, where is the cutoff point? Where does the benefit decrease when those opportunities occur? There's no such thing as a free lunch. There's no such thing as a free lunch. I would argue that the experiment that we're running, and this comes back to should people be allowed to run experiments?

1:08:19Should you ban nicotine? Should you ban peptides? Should you ban the enhanced games? What do you think we should ban? What do you think is the most dangerous thing out there right now? The most dangerous thing is not learning and acting quickly enough off the data. The biggest challenge that we've got, if you think about how did the world really inflect in the last however many years. It's because we started connecting everyone's knowledge together. The internet really was one of the fundamental drivers of this unbelievable change that we're seeing in society, which I believe is generally for the good.

1:09:01The end result of all of this knowledge coming together, people are scared of AI. For me, it's a tool for radical transformative benevolence, for cures for diseases we never had, for many things. But what I think is clear is that whenever we've connected things and learned from those connections, big leaps have been made. Railroads, telegrams, telephony,

1:09:32the ability to move from one place to another quickly. conceptually our ability to move from one place to another in terms of our evolution of our society requires us learning from data mistruths untruths misinformation um and just the sheer lack of being able to understand what is doing what to who is the biggest thing that we should ban we should ban the not learning do you also then think i think we live in an information diet overload i think we now live in an information diet and actually we are so overloaded with data that we become paralyzed by data and that unless you understood how to read data and interpret data anyone can come out and give it to someone else this study proved x and i'm you know and you can cherry pick evidence very very quickly and you can make anything sound like something that's new and exciting.

1:10:29And actually, I think that, I think, is one of the most dangerous things out there. Yeah, but collecting data on what's working and what's not is better than just letting it happen, which it's going to happen anyway, and not knowing anything about the result except the claimed results of the marketing departments. I don't think there's anything more dangerous than selling a lot of stuff and doing a lot of stuff and not learning in as close to real time as possible of what's going on. Case in point, we changed the entire way that we ran trials during COVID. Everyone was trying everything. and it wasn't until some brilliant scientists in the UK decided to build an adaptive trial framework where every single thing that was being thrown at everyone in every intensive care department was collected and I think it was in less than a week we understood that the principal component of people not dying was a very simple drug called dexamethasone.

1:11:34It was a steroid, which you never normally give people when they've got something where you want the immune system to fight whatever it is that is causing this problem. And that became world news and global best practice overnight. And yet we are doing all this stuff so-called for longevity without learning from it. So in some ways, going back to your enhanced games piece, like what's the good bit is that maybe there's a chance to collect data and learn. what I would say is the other thing that we really need to stop doing is we need to stop absolutely stop in its tracks misinformation that is what's the thing that infuriates you online right now around this I mean you could probably read read what I write and see that I'm generally perplexed I wouldn't say infuriated but bamboozled perplexed and Bamboozled is such a great word.

1:12:33It's not bad. And I don't get angry about a lot, but there are some things that really just make me think that the world's a bit goofy. And what is that? I mean, for instance, one of the pieces is NAD infusions. I know you want to talk about this. I did want to go there. We both wrote a very similar piece. It's quite uncanny around this. There are two types of people. There's people that absolutely, really fundamentally know about biology. And there's the people that know that they will never know about biology. I'm the latter. But there's an awful lot of people that are selling an awful lot of stuff that think they know about biology.

1:13:19But what we definitely do know is that there's lots of stuff in the body that goes down. and there's lots of people selling the dream that things that go down in your body, you should put in from the top to fill it back up again. But why is it going down? And I'm just going to say, for anyone who has no idea, NAD is an energy molecule, right? And it reduces as you age. And so this is why people are basically pumping, wanting to pump more NAD. It's basically saying that it's sort of like help replenish the naturally aging levels of NAD. Just in case people think that you're talking about putting a pill and why does it go down?

1:14:02Yeah, exactly. NAD is an unbelievably important part of your energy producing cycle. If I stole all of your NAD now, you wouldn't be finishing this podcast. It's a rather important thing. And we know it's important. And we know that in people who are young, they've got high levels. In people that are old, they've got lower levels. And we also know that people who are young maybe have less disease and people who are old have more disease. So we suddenly go, low NAD is caused by aging and low NAD causes disease. Therefore, high NAD in old people means less disease. Wrong. the reality is that NAD goes down only to a point where it's really affecting cells quite late late in life the reason why it starts going down is not because your cells just get knackered it's because you have lots more accumulation of inflammatory cells and even cancerous cells that mop up NAD at an aggressive rate.

1:15:17They are scavengers of NAD. And these inflammatory processes love and need NAD 60, 70, 80 times more than normal cells. Wow. Okay? That's why they're... There's a hole in the bucket. It's not just the bucket has stopped producing NAD. There's a hole. Those holes are filled at the bottom with hungry mouths saying, please give me whatever's dripping through here. So what happens if you fill up that bucket with high pressure NAD? You're fueling the cancer cells. You're fueling the cells that are doing the job. And there is research now that's showing this, by the way. I know very well. And this is one of the fundamental things of like, okay, this is an example of people that know everything there is to know about biology.

1:16:10And the difference between the people that know everything there is to know about biology and the people that know they don't is the people that know everything there is to know about biology, when they make a mistake, people die. It's quite extreme. It is. and and also like the last thing that i think about doing if someone comes into hospital is sticking up an iv infusion in them if they don't need it why because it's a plastic bag with pfas massive amount of microplastics it's got it's plastic who on earth knows how those bags have been stored and manufactured and made before or they're filled up with whatever it is you're going to inject in somebody.

1:16:52There are forever chemicals in the linings of bags. It's not that IVs are really cool. I mean, you give somebody that cannot absorb fluids, you give them IVs, you can practically wake up the dead. It's miraculous what you can do with an intravenous infusion. Imagine days where we were not able to put in IV bags in people. Many people would die, either of hypovolemic shock, or not having enough blood volume, etc. fluid volume in their system, so they would lose their lives because of lack of blood pressure, through to not having enough of anything. Whether it's glucose, whether it's salts, whether it's sugars, it's life-saving.

1:17:30But this is the thing, NAV intravenous drips are becoming like the new thing. I mean, I would avoid an IV bag like the plague if you didn't need it. I've got an amazing infusion device. It's a huge bag with an incredible filtration system. It's called My Gut. It's an amazing bag. It contains the most incredible ways of filtering things and making sure that the right things go in and the bad stuff goes out. Popping that directly into a vein is one of the goofiest things I can imagine that you'd ever want to do. And yet the placebo effect is huge. You know, we've talked about anti-doping. The World Anti-Doping Association doesn't really care so much about some of the stuff you put in the bag.

1:18:21What does it care about? The volume. It's the amount that's in the bag that they don't like. You can put in vitamins, you can put in different stuff, not banned substances. But if you put in things that expand the volume of your blood, if you put a lot of that in, they don't like it. it is not that it is ineffective but you don't want to be doing it if you don't have to and so what you need to do is you need to do something daily like we talked about before it's like if you're doing things toothbrush level once or twice a day that is almost certainly going to be better for you than doing some uh something at the sixth senses hotel in Ibiza um in the spa That's a great spa, by the way.

1:19:08It is a great spa. It's a fantastic spa. But doing that once a year is not going to increase your longevity. What it is is blocking those inflammatory pathways and maybe, if you want, taking an NAD precursor. NMF. Yeah. That's a great rapper from the 80s. But, yeah. Because that's the precursor to NAD. But do you think, I mean, from when I wrote my article, it's not like abundant that that's going to massively like hugely boost them but there is some data that shows that's probably more effective than taking an NAD yeah if you take a precursor every day and you block the pathways that are sucking that NAD up in the wrong places I'm pretty sure that we will find better outcomes on that than massive doses of a highly potent substance that is scavenged by bad cells.

1:20:03Yeah. Well, I think the fact that one or two of us are going to get cancer in our lifetime, we don't really want to be kind of pushing anything more in there that can kind of aggravate that even further. It's not quite one and two. Is it not one and two? Is it one and three? Yeah, I mean, you are right. Half of us will die with cancer, diagnosed or undiagnosed, but one in seven to one in four of us will die of cancer. So I think it's important differentiation. It's not as scary as one or two of us will get cancer. And yes, we will, but we will only find out once they do an autopsy. It's like, oh, I had cancer.

1:20:41Yeah, and you didn't die a bit. So, but yeah, look, cancer is one of the big things. So what I really don't like is anything that could end up rapidly increasing the risk of getting cancer. It's like the biggest, scariest one. It's a little bit like the story of some of these synthetic peptides where people say they're natural. No, they're not natural. Most of the peptides that are being talked about are absolutely not anything that is associated with a gene that we have in our bodies. They're snips of molecules that our own bodies produce. and we don't know what they do long term yet. This is the whole data point.

1:21:33But if there's any sniff of those things producing cancers, that's the hardest thing to treat. Yeah, okay, cardiovascular disease, you can spot it. Yeah, maybe you can reverse it. I don't know, a bit of inflammation that's making your skin go a bit redder than you need it to or give me a bit of photophobia. when you're... I put pressure. Yeah, okay. Let's stop and let's see if we can do... You don't want to get cancer. That's not cool. It's awfully difficult to treat cancer. That sounds so blindingly obvious, but that's why people who genuinely want people to be still skiing and playing chess when they're 90 are worried about some of the things that self-experiments that people are doing, even more worried about the physicians who genuinely are of the belief that these things are net net positive yeah that said in elite sports doping in i believe it's a dutch study which has been looking at bodybuilders over a very long period of time there hasn't been with the anabolic steroids there hasn't been an increase in cancer there's been an increase in deaths from two things, cardiovascular disease and rage.

1:22:49And rage. Yep. Because the testosterone levels have become so high. Yep. Wow. People getting into fights, but not cancer. But that's the anabolic path. The other routes to enhancing human repair may also enhance, like you say, like the NAD pathway. It's kind of like, we don't yet know, is the bottom line. And trials, they stop running after short periods of time. They don't carry on for decades and decades. I think that was one of the most surprising things I had on this podcast the other day with a psychiatrist called Mark Howitz. I can't say his name, but he's incredible. We spoke about antidepressants.

1:23:35Right. And he said the longest trials on antidepressants are eight weeks. No. they're normally six to eight weeks but nobody ever goes on antidepressants for six to eight weeks people are on them for years wow and we have no long-term data of coming off them yeah and that's why when he says you're on going down from 10 20 to 10 your brain doesn't have as much of the dip but then 10 to 5 your brain goes hits the dip quite quickly and then 5 it's like you fall off a cliff yeah and so he's like you know when you're on it for that long and then actually the doctor thinks you're having a relapse so they put you back on the medication and they tout up the dose again and so you know there is no long-term data on people that have been on antidepressants for 10 years because all the studies are around six to eight weeks a brilliant peptide that we know about what do you think is the most you must know the answer yeah okay The P is peptide, right?

1:24:32So I think we probably have now near enough like 100 million life years worth of data. Oh, wow. When you think about the number of people that have been on it for a year or 10. Yeah, yeah, that's a long time. that's kind of cool because you've had a bunch of people of all sorts of ages sexes uh ethnic backgrounds social backgrounds genetics everything so like even postcodes and whatnot and so many people have now been on this for so long because bear in mind that they were discovered 40 years ago you know they weren't discovered just the other day they just become mainstream they just become mainstream do you know the story about how they were found it's a very fascinating one a long time ago in a desert called the nevada desert a venomologist was particularly interested a venomologist is someone that looks at the venom of creatures and tries to find out what they do it's a great job and um decided to try and find out what might be in the saliva of this rather ugly lizard called the Gila monster, G-I-L-A, monster that lives in the desert, in the Nevada desert, because it was able to switch its appetite off when there wasn't food for several months, interestingly, and found out by sequencing the saliva that it looked particularly like a human glucagon-like peptide, GLP, and said, oh, this is interesting.

1:26:15It lasts an awful lot longer than GLP. GLP is known for dealing with insulin sensitivity and appetite and various things, which we know about now, of course. And said, oh, this is interesting because it lasts an awful lot longer than the very, very short half-life that you get with the little pulses of GLP that the human body produces to say, hey, stop eating and now start absorbing stuff. And that became the first GLP-type drug which helped people, kids without that gene, had a gene defect who always had diabetes basically from the time they were born. And then later on it became, oh, let's take human GLP, add a sticky bit at the end of it to make it last longer in the blood.

1:27:00And that's when the big blockbuster happened, which was the famous days of a Zempick, which you might have heard of a long time ago, semaglutide and liraglutide, the earlier drugs. And it's only recently that they became well-known, but it goes back a long way. So we've actually been having safety data on this type of peptide for a very, very long time. I don't think a drug, I don't think a medicine, I don't think an anything is really properly tested for 40 to 50 years. We only really know what these things do, what anything does after a couple of generations. That's the reality. The limited randomized controlled trials that we do, which test antidepressants for eight weeks, which I find incredibly shocking.

1:27:55Oh, it's like an expose, that episode. But even psychedelic research is using much longer time frames than that for refractory depression. So this is very intriguing to me. But we are woefully bad because we don't have time to run 40, 50 year trials. All the money. I mean, who's going to run a 40 to 50 year trial? Society itself will run a 40 to 50 year trial. You'll definitely not run it if there's a pattern that's going to run out or if there's no pattern at all. so I think that's actually really fascinating that in all of this we just have to have the humility that we actually don't know what's going on do you know what one of the best lines I ever heard which was about a scientist it said you know when you've met a good scientist when they try and prove their own hypothesis wrong yeah that is science isn't it and I think we've lost our way in that where everyone's trying to prove that they know exactly what's going to happen, exactly what this molecule is going to do, exactly what the supplement means.

1:29:05And they're peddling through their own rhetoric as opposed to trying to actually say, no, what happens if we take this? Like, what are all the things I need to try and prove that this is wrong? And it stayed with me for years. So when I try and look at evidence of what things are coming out, are they marketing selling something? or is it actually that they're really trying rigorously to prove something wrong? Yeah, there's marketing and there's science. I mean, really great marketing can transform rubbish science. Massively. But amazing science seems to be unbelievably useless at reversing good marketing.

1:29:43Because a lot of it is so boring, right? Yeah. It's so boring. What are you saying, boring? I love the science. No, but you know, I think, you know, when something is, the amount of reels that get sent to me, which, oh my gosh, I'm not going to call people out because I'm not that person, but somebody very famous who wears glasses, blue blocker glasses. I don't know who you're talking about. And I get all of these reels sent from him being like, five have shreds your gut. And I think we've just got to a point now, which obviously, by the way, it does not shred your gut. It's one of the most important things for your gut microbiome.

1:30:17and overall we're not having enough fiber. Let's just make sure I get that in there. But it is terrifying. The amount of stuff that is sent online, so we've touched upon peptides very briefly, but, you know, the amount of stuff that's sent to me on, why am I not on this? I should be doing this thing because everything is sold as something that's magic. Yeah, and also everything's sold as something that works for everybody. So in general, a really good way of thinking about it is, I mean, everyone's heard of the bell-shaped curve. Okay, so, well, not everybody. Okay, there's a thing called a normal distribution.

1:30:50It's a mathematical thing. And most, excuse me. And most things that do things affect people in a bell-shaped distribution. You have a tiny bunch of people at one end that do unbelievably well. You have a bunch of people at the other tail end that have an utter disaster. and in the middle is this where most of us live, where it sometimes works, it doesn't. We don't quite know why. Was it because I was crying the night before? Was it because I had more sunlight? Is it because I was taking that combination of that thing and I had a paracetamol or is it that I've just started to take up the drinking of kombucha and that's affected my gut and my biome and my inflammatory response and therefore the drug?

1:31:38And it's like this big mess of stuff in the middle. there are very very few things in this world that don't fit that model some people do spectacularly well some people do spectacularly badly from from whatever it is you're gonna take yeah and there's a mess in the middle and the idea is to make that mess shift slightly towards the more probably going to work end and hopefully not do any harm end yeah that's um that's the ideal yeah uh and yeah i mean science is con should continually try to say how do we shift that what are we learning from it that's why trials really just take 50 years but very very few drugs are um attested on what we call phase four data phase four being it's got a marketing label you're allowed to sell it prescribe it and market it but here's actually what happened 40 years later to 100 million people or a billion people i've got a final question and i want i'm trying to think about how i would answer this what would it mean to enhance a human life rather than merely enhance the human output?

1:32:57The area under the curve. If you draw human life as a line

1:33:10and then you draw how much you've lived your life as a curve, the deeper the wells and the higher the peaks is literally the more life you lived. The length of your life is the length of the wiggly line above the timeline. And all I can say is that the folk that I've seen who've lived particularly short lives and particularly long lives, the ones that shine the most at the end are the ones that have lived a long, wiggly, spiky, wonderful life full of firsts, full of the dreams that they wanted to live, full of the love that they wanted to share, full of the experiences that, to the best of their ability and what they could afford, they experienced.

1:34:15And that is directly opposite to regret. at the end of your life. It is really, for me, not about not dying. It's about not dying dull. How about not dying dull? So what does Lipo Biwa mean to you, Jack? Well, what I've learned from this conversation is that I think your philosophy and mine are pretty similar. that there is a lot of magical mysterious metabolism mitochondria molecules chemistry drugs things you can buy things you can infuse but we know from the science that some of the simplest stuff that involve looking after ourselves and looking after the other selves that look after us are far and away the most important path to longevity.

1:35:16That's why my gift to you is Rick Rubin, the creative act. Because I cannot wait for you to divulge into his work. And it is, I mean, he is also been in his own health journey, but his philosophy of life is something that I massively connect to. He's obviously not a doctor, but, you know, he is such a creator. and I think he speaks so much sense and so that's what I want to give to you I appreciate it thank you so so much thanks Jack