Shoshana's Summer Playlist (3/5): The secrets to aging well with Zeke Emanuel

0:02Zeke Emanuel: Hi, it's Shoshana and welcome to my summer playlist. This summer we're spending time with an idea that I keep coming back to in health. The mind and body are always in conversation. And sometimes that conversation is quiet. Sometimes we notice it right away in our stress, our sleep, our digestion, our attention, or the way that loneliness can settle into the body. So I pulled five talks from the Ted Health Archive that helped me think about that connection a little differently. You'll hear from Alexandra Crosswell on deep rest, Dr. Vivek Murthy on loneliness, Dr. Zika Manuel on quality of life, Megan Rossi on the gut-brain connection, and Dr.

0:43Zeke Emanuel: Sasha Hamdani on attention. These are conversations that I really loved having and ones that I found myself thinking about long after they ended. And I hope they stay with you, too. This is TED Health, a podcast from TED, and I'm your host, Dr. Shoshana Ungerleiter. Lately, I've been thinking about how complicated health advice has become. I've talked about it on this show, too. It's interesting because at the end of the day, most of us just want to feel good in our bodies. We want to have good health as we age. We want to stay mentally sharp and enjoy our lives along the way. It's a pretty clear goal.

1:23Zeke Emanuel: But every day there seems to be a new headline telling us to eat this, avoid that, track more data, optimize harder. And it can start to feel like staying healthy is a full-time job, one that requires discipline, money, and constant vigilance. But what if the biggest drivers of long-term well-being were not extreme routines or expensive tools? What if, instead, the answer is a lot more doable? A handful of simple habits done consistently over time, with room for pleasure built in. To help us sort out the facts, I invited Dr. Zika Manuel to join me on the show. Dr. Manuel is an oncologist and bioethicist, a best-selling author, and one of the most influential voices in American health policy.

2:08Zeke Emanuel: He's currently Vice Provost for Global Initiatives at the University of Pennsylvania, and that's just one of the many impressive entries on his resume. He's helped shape everything from research ethics to national health care reform, advised multiple presidential administrations, and spent decades studying how health systems and individual choices affect how long and how well we live. His new book is called Eat Your Ice Cream, and its message cuts through a lot of modern wellness noise. In our conversation, Dr. Manuel explains why longevity should not be about chasing the longest possible life at all costs.

2:49Zeke Emanuel: Instead, he makes the case for maximizing years of good function, connection, and enjoyment. Because pleasures like ice cream sundaes can be part of a healthy life too. Things like movement, sleep, food, social ties, and mental engagement are key to a long and happy future, and none of them require perfection to make a meaningful difference. Then after the interview, stick around for a TED Ed lesson that takes us inside the science of aging itself. If we can't see age written clearly on the human body the way we can in trees or mileage on a car, how do scientists measure it? And what can those measurements really tell us about what healthy aging looks like?

3:31Zeke Emanuel: That's all ahead, but first my conversation with Dr. Zeke Emanuel. And before we dive in, a quick break to hear from our sponsors.

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6:07Zeke Emanuel: Now I want to welcome Dr. Zeke Emanuel to the show. It's a real privilege to have you here. Your work has truly shaped how so many of us think about medicine, ethics, and really what it means to live well.

6:20Shoshana Zuboff: Well, thank you. Thank you.

6:21Zeke Emanuel: So you've spent your life moving between medicine, ethics, policy, and teaching. And when you step back and look at that whole arc, what question about how we live and care for one another has stayed with you the longest?

6:37Shoshana Zuboff: When I was a freshman, there was a bird sanctuary with lots of trees down the hill from my college. And one winter day, I walked in to the bird sanctuary and found a log. I sat down on the log and I was thinking. And I spent a lot of time there. And a kind of epiphany, I think is what others would call it, came to me. It's like, look, I'm on this planet for a very short time. I want to make a difference. And the difference I want to make is how can I make the world a better place for people to live in so that more people can have more fulfilling lives? And it seems to me that upon reflection all these many years later, that's a very common motivation for a lot of people who we greatly admire.

7:28Shoshana Zuboff: Here at the University of Pennsylvania, our founder is Ben Franklin, and I have a course on Ben Franklin on Coursera because he's just a remarkable, brilliant person. But mostly what makes Ben Franklin so amazing is that the key to his life is he always was wondering how he could be useful in his community, in his larger city, in the country of the United States. How you can make the world better for other people, I think, is one of the most important motivations for wellness.

8:02Zeke Emanuel: This is something I think about a lot. And that sense of a through line, something persistent beneath all those roles feels really essential to understanding your work. And you've certainly changed and helped shape national conversations about health policy, yet you've also sat at bedsides with patients near the end of life. What do patients consistently understand about health and aging that our healthcare system still misunderstands?

8:30Shoshana Zuboff: Well, our healthcare system doesn't do a great job about wellness. When we were passing the Affordable Care Act, politicians would say, you know, we've got a sick care system, not a health care system. And the answer to that is, yes, we do. And the main reason we do is because we pay for sick care. We don't pay for wellness and health. One of the big complaints of a lot of people is doctors almost never ask, well, how many friends do you have? How frequently do you talk to them? One of the most important things for wellness, they don't actually think is that important. Yes, they might talk about smoking.

9:04Shoshana Zuboff: They might talk about alcohol, but lots of other stuff they don't even scratch the surface of.

9:10Zeke Emanuel: Yeah. And I want to stay with the bedside for a moment just because this is certainly an area that I care a lot about. And so as an oncologist, I suspect you've spent years listening to people talk about what matters most when time feels limited. What do patients say that surprises you or clinicians? And how might our lives change if we were to normalize those conversations much earlier?

9:33Shoshana Zuboff: Well, I think for a lot of patients, they know there's a family event that looms very large for them, whether it's a wedding or the birth of a first grandchild. And you see a lot of people struggling to figure out, can they go and have those events? And it's very important. But you also see people at the other end. They don't want to fight it. They've had a good life, and they often put it in this language, being tortured by chemotherapy is not how they want to end their life. And my father is a great example of that. He was 92 when he was diagnosed with a very large brain tumor. He said, nope, not going to get additional treatment.

10:17Shoshana Zuboff: Everyone came in and he had 10 pretty good days visiting with everyone and died peacefully in his sleep. And so I think you see both of those elements where people are clear about what is important to them. And part of the role of a doctor is to figure out how to make what you've deemed important happen. My job is to make the best of the time they have. Some of them I can offer a cure. Some of them you're just not going to be able to cure. And so the issue is to try to make it as good as possible.

10:53Zeke Emanuel: It's been interesting to me to see how for people facing a life-limiting illness, how clarifying that can be about your goals and your values.

11:02Shoshana Zuboff: You know, people often ask me, why'd you go into oncology? And I said, well, it's so raw because people's values come to the surface. And it's a privilege to have that conversation. You get to know patients intimately in a way you can't in almost any other aspect of medicine. And it is a privilege to be there. But it's also, if you do it well, very helpful. one of the things you see, even in the patients who are cured of cancer, is they put away a lot of stuff that gummed up the works in life. Those meetings, not necessary. I'm not doing it more. And then they focus on the things which are really, really important to them and they think important to the world.

11:42Zeke Emanuel: Yeah. Zeke, one of the things that we touch on on this show and is certainly coming up quite a lot is this idea about longevity. And much of your work challenges the idea that longer life expectancy automatically means progress. So what should we be measuring instead if we truly cared about living well?

12:03Shoshana Zuboff: That's a very sophisticated question. And let me just put it in perspective. The first thing to recognize is at the upper limit, you know, the people who are centenarians and supercentenarians, we're getting more centenarians, but the amount of time people are living at the top end hasn't increased. So all these advances are not increasing the top end, which is why a lot of us think there's a sort of biological limit to the life expectancy. We are getting more people into the late 80s and 90s. What I think we should really focus on is getting past 75. And the fact of the matter is that we still have a lot of people in America who are dying, and not just America, by the way.

12:46Shoshana Zuboff: Every developed country has a 20 to 30 or 40 percent of the population dies before 75. And our big challenge, very big challenge, is to get all those people up to live a full life. And we can stop worrying so much. And it's really the people who are dying at 50 or 45. And almost everyone these days knows someone like that because the cancer rate of people under 45 is going way up. So I think those are the conditions we really need to focus our attention on. Because someone dying at 40, that's a tragedy. They're probably half the age they should be. And we've got to do a better job of preventing those deaths, especially kids' deaths.

13:27Shoshana Zuboff: I mean, preventing kids' deaths and preventing illness that disrupts the normal development, that's what really motivated my father as a pediatrician.

13:36Zeke Emanuel: So when we start talking about the sort of longevity movement and biohacking, I think that filters out into everyday folks and social media and the pressure shows up as this constant self-monitoring and optimization, many people, including myself, right, as a physician, feel overwhelmed by conflicting health advice and this idea of constant optimizing my health. Based on decades of research and clinical experience, what truly deserves our daily attention and what are we dramatically overcomplicating?

14:11Shoshana Zuboff: Well, my book is all about don't obsess about this. Here are the simple things you can do and you don't have to worry about the latest fad. And I say this to people all the time when they ask me, well, you know, should I take this supplement or what about peptides or what about what's the diet you would recommend? And I said, listen, if something's going to be a home run, really make a difference to your life, like GLP-1s, you'll hear about it. Everyone will be talking about it. It'll become standard of care. If not everyone's talking about it, if it's just floating around on the ether of the internet, you know, it's probably unsupported and not very valid.

14:53Shoshana Zuboff: Or there may be a study that suggests it with a small number of people, and I wouldn't give it much stock, and I wouldn't really spend a lot of mental capacity focusing on it. So what I like to say is the first important thing is, first chapter of my book is don't be a schmuck. Don't do stupid things that are high risk with not a lot of high reward. We know some of them like don't smoke, don't vape. We also know that, you know, take your vaccines, get your cancer screening tests. I have a long discussion of the PSA, which I actually don't recommend. And then there are some things which are really stupid.

15:32Shoshana Zuboff: Base jumping, climbing Mount Everest, where the risks are mind-boggling high. I mean, climbing Mount Everest, most people think, well, you know, you can go there as a tourist, pay$150 ,000. You know what? The risks of dying on Mount Everest are one in a hundred for all comers, including mountaineers and Sherpas. And if you're over 59 years of age, they're one in 25. What could be more stupid, okay? Just dumb. Don't do it. That's the first thing. We should all be aware that the most dangerous thing we regularly do is turn on the ignition of our car. The chance of dying over a lifetime are under 1 in 100 from driving.

16:14Shoshana Zuboff: Okay? That's really high. So you have to balance things. And none of us are stopping to drive. So we have to balance against that risk everything else. The other thing that I would put front and center is the second chapter, which is socialization. As I said at the start, one of the things that we don't think about is social interaction as a wellness activity. It is a wellness activity. There is literally a mountain of data. More than 3 million people have been followed assessing their social activities and their longevity. And it turns out that it's really, really important. And I'll just give one study, the Health and Retirement Study, which is a big study of the U.S.

17:00Shoshana Zuboff: government funds that tracks people over time, 20 ,000 people over 50, did a study where they looked at people's number of friends, number of close friends, how much time they spent together, the quality of the relationship. and then they followed people for eight years. And it turns out people who had more close friends compared to people who didn't actually had 25 % lower risk of mortality in the next eight years. That is huge, huge decline. At the other end, there are these things called weak social interactions, people you might not know, people where you have some overlap but not a lot. Those turn out to be really important for daily life, happiness.

17:40Shoshana Zuboff: And we think, oh, well, it's all in your head. you know, that's good psychologically. No, it's good physiologically, your body. Researchers have looked at genes in the UK biobank and, you know, it turns out that loneliness is associated with genes that actually regulate the immune response, overreaction of the immune response. More social interaction decreases your cortisol level. So it decreases your heart rate, your fight or flight stressors. So they have physiological impacts and we tend to ignore that. So both deep relationships cultivate your family, your close friends, but also cultivate casual relationships, whether it's with a barista, a cab driver, someone, your waitress, waiter.

18:23Shoshana Zuboff: It helps you and it helps them.

18:25Zeke Emanuel: Yeah. Yeah, it's interesting. I'm a pretty extreme introvert, even though I'm talking to people all day long. So I've had to reframe this in my mind as this is a wellness practice, just like the two hours of walking or running I'm going to do this afternoon. I have to force myself to interact with other people for my help.

18:43Shoshana Zuboff: Yeah, so Shoshana, it turns out that a professor at the University of Chicago, Nick Epley, has done great studies on this. And introverts, and about 25 to 30 % of the population is introverted, when they force themselves to be extroverted, actually are happier. And yes, they may be hesitant, more hesitant than extroverts, but it turns out it has this positive impact even on an introvert. So your experience is exactly the experience that people should do. Force yourself to be extroverted. It turns out to be good for you.

19:20Zeke Emanuel: We'll be right back with more of my interview after this quick break. Today's episode is sponsored by Kashi. Say hi to new Kashi Gut Health Granola, a straightforward, delicious way to fuel your gut, made with prebiotics, fiber, and cultures. My favorite flavor, blueberry almond, has perfectly crispy clusters, delicious almonds, and bursts of whole blueberries. It's an easy fit for a daily routine, whether that's for breakfast or a snack. In a world of overwhelm, it's a straightforward, delicious choice. Try new Kashi Gut Health Granola.

19:59Zeke Emanuel: This episode is sponsored by Toyota. One of the most interesting parts of being human is that we're all a little different. Different preferences, different priorities, different ways of seeing the world. And ideally, the things we use should reflect that. Toyota's new all-electric lineup is built as a family, but not a uniform one.

20:17Shoshana Zuboff: Each vehicle has its own personality, from the sleek, expressive design of the CHR to the more rugged feel of the BZ woodland. It's not about standing out for the sake of it. It's about finding something that actually feels like you. Learn more at Toyota.com, the new all-electric family. Toyota. Let's go places.

20:49Zeke Emanuel: so I love the title of your new book, Eat Your Ice Cream, and congratulations on the New York Times bestseller list. I saw that.

20:57Shoshana Zuboff: Thank you. Thank you.

20:58Zeke Emanuel: Why did you choose that phrase? And And what does it capture about how you think people should balance their health and pleasure and probably responsibility and meaning over a lifetime?

21:10Shoshana Zuboff: You point to the fact that it's unexpected for someone in wellness to say, eat your ice cream, indulge yourself a little bit. But part of the book is, look, we're here only for 75, 85, 90 years, right? You can't make wellness a lot of self-deprivation, self-denial. You're just not going to continue if that is it. You have to do these wellness practices for decades, and they have to be integrated into your life, and you actually have to find them pleasurable. A scoop of ice cream is not going to mean you die five years earlier. It just isn't. And you should enjoy it. Everyone enjoys ice cream. You should enjoy that ice cream.

21:50Shoshana Zuboff: I have a friend who his 9 p.m. nightcap is not whiskey or alcohol beverage, but it's a scoop of ice cream. That's great. Look, the wellness should be pleasurable. It should not be something that's onerous to you because you won't continue it. We all know that willpower fatigues. It's limiting. You can't do things by willpower over and over again, which is why the vast, vast majority of New Year's resolutions go out the window because people are just trying to force themselves. And most people can't adhere to the diets because they're mostly about self-denial. You have to make it more about pleasure.

22:25Shoshana Zuboff: And I think that's a message people want to hear. They want to understand that life can be pleasurable and healthy. A healthy life does not, should not, better not be one of continuous self-punishment. It's just not going to work.

22:40Zeke Emanuel: So sleep and movement and food and connection and curiosity, they sound simple-ish, but they're not equally accessible. And from an ethics and a policy standpoint, where should responsibility fall between individuals and society when it comes to making healthy lives possible.

22:59Shoshana Zuboff: So I wrote this book first to make it very affordable for people to say, look, these are things you can cut out and you're not going to sacrifice, right? Supplements, you don't need to spend money on them. Sleeping pills, don't spend money on that melatonin or whatever. Buying a Fitbit or an Apple Watch or whatever, whoop. You don't need to do that to be well. Probably the place where cost is a big issue is in food. And that is an area where we can do better, but also society has to do better because our food ecosystem actually is a major part of the reason that we have such overweight and obesity-related illnesses like heart disease and stroke, kidney disease, wearing out of joints, hips, and knees requiring replacement.

23:51Shoshana Zuboff: So we can do things like stop drinking sodas because they're 140 calories with absolutely no nutrition. We can do things like stop eating packaged cakes and cookies and pretzels and potato chips because, again, they're not nutritious and the proportion of calories has gone way up. So we can actually save ourselves money by eating better now. The problem is that eating better is expensive. fruits and vegetables, are minimally subsidized by the government, but largely not compared to ultra-processed foods that we've made, you know, corn and soybean and wheat and rice cheap, so that the big manufacturers like Cargill can turn them into ultra-processed foods or sell them to Kraft and other ultra-processed food makers.

24:40Shoshana Zuboff: And that's the disconnect. So the system needs to improve thing. I also think the system needs to improve. We probably need to bring back home economics in school so that people know how to cook for themselves. We also need better school lunches for kids. A lot of that school lunch is simply a dumping ground for ultra processed food. Yeah.

25:00Zeke Emanuel: Well, I want to switch gears a little bit and ask you about a statement you made. You once said that you would be ready to die at age 75. And I think that made many people uncomfortable. What conversation were you actually hoping to start at that time?

25:16Shoshana Zuboff: Oh, Shoshana, your questions are very sophisticated because you realize I didn't say I wanted to die. I said I would be ready to die and I wouldn't take life prolonging treatments. And that's a very important distinction. So, look, I know what hell looks like to me. hell to me is if my body's working great good physical shape the heart's still pumping great you know the blood vessels are good the kidneys good liver's great but my brain isn't great and I've got cognitive impairment and dementia that is hell I don't want to be remembered like that I'm not there if that is true and so when you look at the data and what's clear is the rate of dementia is sort of relatively low.

26:03Shoshana Zuboff: There are some people who get early dementia and then shoots up at 75. And a lot more people have cognitive impairment where they're not fully demented, but their brain isn't working as they want or normally. And that's what I am going to try to avoid because I know that what makes my life meaningful really has to do with how my brain is functioning and how well it functions. Being alive and demented is my view of hell. I don't want to be in that condition. And the essay was really, here's my philosophy. Now, what's your philosophy? I was challenging the reader not to adopt my philosophy. There are a lot of people.

26:44Shoshana Zuboff: So a third of people, they just read the title, you know, Why I Want to Die at 75, which I didn't give it, but the editor did. A third of people say, oh, Dr. Emanuel, you finally gave voice to what I have been thinking in my philosophy of life. Thank you so much. And to this day, get a lot of those responses. And then a third of people are like, wow, that's a challenging question. And it's making me think. And they're very uncomfortable with that. And I think those are the people I was trying to get to. You really have to think about the point of your life. and when the physical deterioration, which is inevitable for all of us, overwhelms your reason for living.

27:22Shoshana Zuboff: And we try to avoid thinking that way. I happen to be one of those people who, that's the most important question in your life. You better focus on it. And that was the point of the essay.

27:34Zeke Emanuel: Yeah, thank you for that. That certainly makes sense to me and is a really provocative way to bring it up. And so for our listeners who tend to skew a little younger, but maybe feel behind or overwhelmed or convinced it's too late to build healthier habits in their lives, what does the evidence actually say about starting later in life or starting now? And what small changes still meaningfully will improve your health and your mood and your quality of life?

28:03Shoshana Zuboff: First of all, it's never too late. And the data are pretty good on that. You know, if you start, for example, exercising at 55. Yeah. Very, very important to make these changes early. But middle age is not too late. Even 65 is not too late to do these things. But remember, one of the reasons to start earlier today is that you will have longer. My wife likes to tell me, if you don't do it today, you're not going to be doing it at 85. If you don't do your yoga today, you're not going to stay flexible at 85. If you don't ride the bicycle, do your 30 miles on Saturday, you are not going to be doing that at 85.

28:50Shoshana Zuboff: And if you want to be doing that at 85, okay, I got to do it today. It's not the gada. I enjoy it, right? I ride with my wife. We have time together. We ride through nature and we're getting physically fit and the endorphins are happening. It's a lovely, lovely experience.

29:08Zeke Emanuel: We've touched on this a little bit, but if you're now speaking directly to the person listening who's super busy and tired and just trying to do their best, what single principle of healthy living would you want them to focus on tomorrow or in the next few years? And then how might their life feel different if they did that?

29:28Shoshana Zuboff: So you have to make wellness a habit. And again, the place I would start is your social relations because it's virtually costless. The great thing about social relations is it's good for you today and it's good in the long term. And third, it's also good for the person you're talking to. You're being generous and virtuous by helping someone else as well. And that should make you feel good. So I would start with social relationships. You know, if you haven't called a sibling or you haven't called a dear friend, pick up the phone and talk to them, right? You're going to buy a coffee, talk to your barista.

30:04Ask him or her, you know, how was your weekend?

30:07Shoshana Zuboff: Or that's a beautiful heart you made on my coffee. How long did it take you to learn that? You know, simple things like that. I would like, frankly, I would like to learn. And it looks complicated. I'm not a very artistic person. So do that. And then I would do a few things in the eating category. And again, don't try to do it all at once. Don't boil the ocean. Again, the data suggests doing one at a time is way better. And get it to be a habit. So if you want to think about exercise, think about, all right, what are you going to do for 20 minutes three or four times a week? Go out for a walk after dinner.

30:42Shoshana Zuboff: or walk a few stairs at work before lunch or just after lunch. Eating, I like to say to people, all right, you got 21 meals a week. Make one new meal every week, one out of 21. Focus on making it healthy and doing something new that will make a difference to you. And by the end of a year, you'll have 50 meals that you can make. You can have an easy, have a dinner party, and then you've got a wellness trifecta. You've got great food, right? You're learning something, and you're socializing. What could be better?

31:20Zeke Emanuel: I love it. Dr. Zeke Emanuel, thank you for the rigor, the honesty, the reminder that a good life is a daily practice.

31:30Shoshana Zuboff: Yes. Thank you, Shoshana.

31:31Zeke Emanuel: Thank you.

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33:11Zeke Emanuel: My conversation with Dr. Emanuel asks us to rethink what it really means to age well. Not just how long we live, but how we live, what we value, how intentionally we use the time we have. he reminds us that health is not about chasing immortality or optimizing every metric, but about function, meaning, and connection with others. But that raises an important question. If aging is not just about the number of years we've lived, how do we actually measure what's happening inside our bodies over time? What does aging look like at the cellular level, long before we feel it? And how might that knowledge change how we care for ourselves and each other.

33:54Zeke Emanuel: In today's TED-Ed lesson, scientist Yulia Yulhava walks us through the hidden clocks inside the human body. From telomeres to epigenetic changes to chronic inflammation, she explains how scientists are learning how to measure biological age. And it's more nuanced than just counting the number of birthdays we've had. This lesson is a fascinating look at what aging really means under the surface, and why understanding the biology of aging may help us live longer and better, too. And now, your TED-Ed lesson of the day. If you want to learn a fish's age, simply take one of its scales and count the number of bands radiating from its center.

34:35Zeke Emanuel: For trees, you can count their rings. For narwhals, their tusk layers. And for blue whales, their layers of earwax. When it comes to humans, scientists have yet to find any visible traits that mark our age with anywhere near the same specificity. But in the past few decades, they've discovered small, invisible markers hidden within the body that do change over time. And they may hold even more information about our health, history, and future. The first of these markers was discovered in the 1990s. Telomeres are repetitive sequences at the ends of DNA strands that protect chromosomes from fusing together.

35:15Zeke Emanuel: However, each time a cell divides, part of the telomere is cut off. These small losses can add up over time, and once telomeres get too short, cells lose their ability to replicate and eventually die. This gradual shrinking process led scientists to identify telomere length as a promising, albeit imperfect, marker of aging. As technology has advanced, scientists learned how to detect even more discrete changes to DNA, like the addition of individual molecular tags called methyl groups. This DNA methylation can control gene expression, including switching genes on and off. It can occur rapidly and frequently, allowing cells to respond to different situations and perform normal functions.

36:03Zeke Emanuel: Yet researchers notice that at certain sites in the genome, methylation levels tend to change more gradually and predictably as we age. The reason for this is still unknown, but these changes may be associated with stress or caused by random errors during DNA replication. By measuring DNA methylation patterns from hundreds or thousands of these sites, scientists have developed what they call epigenetic clocks as another way to measure aging. A third way our bodies change over time is through inflammation. Proteins that are important components of the immune system generally increase when we get sick, then decrease again once our body has recovered.

36:42Zeke Emanuel: But as we get older, their baseline levels rise, resulting in chronic, low-level inflammation. This process is called inflammaging. Scientists are still unsure why it occurs, but it could be due to repeated encounters with pathogens and other stresses. Another explanation could be the process of cellular senescence. When cells get old and stop dividing, they secrete inflammatory proteins. And by measuring the level of these proteins, scientists have developed yet another clock that can accurately measure ageing. While all three of these markers are great additions to the age estimation toolbox, they don't perfectly correlate with chronological age.

37:22Zeke Emanuel: Instead, they're best at estimating something called biological age. Biological age is a measure of how well your body is functioning, how much damage your cells and organs have accumulated, and your overall risk for certain health problems. Unlike chronological clocks, biological clocks tick at different rates for different people due to genetic differences as well as health, stress and many other environmental factors. And different tissues and organs within the body may even biologically age at different speeds. In many ways, these clocks are still a work in progress. For example, most experts recommend against personalised biological age testing.

38:03Zeke Emanuel: While these tests are commercially available, the value and accuracy of these measurements remain unclear. Currently, these tools work best at the population level when data from many individuals are analysed. However, many scientists hope to change this in the future as accurately tracking this information could revolutionise personalised healthcare. For example, one day, a person's accelerated biological age might help doctors detect an unknown health condition much earlier. And other researchers are searching for ways to slow down or even turn back these biological clocks. Though so far, most attempts at this have been largely unsuccessful.

38:44Zeke Emanuel: Besides, researchers still don't know if telomeres, inflammation or epigenetics are actually to blame for aging, or if they are simply neutral markers of other processes happening in the body. We may be learning to read the language of aging, but we still have a way to go in understanding its grammar. That was a TEDx lesson by Yulia Yulhava.

39:11Zeke Emanuel: And that's it for today's episode. Thank you so much for listening. TEDx Health is a podcast from TED, and I'd love to hear your thoughts about this episode. send me a message on Instagram at ShoshanaMD. This episode was produced by me, Shoshana Ungerleiter, and Jess Shane. Edited by Alejandra Salazar and fact-checked by Vanessa Garcia-Woodworth. Special thanks to Maria Lages, Farrah Degrunge, Daniela Balarezo, Constanza Gallardo, Tansika Sangmarniwang, and Roxanne Highlash.

39:59Zeke Emanuel: This episode is sponsored by Toyota. There's something powerful about momentum, that feeling when things are moving forward, when you're not stuck, you're not waiting, you're just going. That's true in life, and it's true in how we move through the world. Toyota's new all-electric vehicles are built to support that kind of momentum,

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