In this second episode, Joseph Antoun, Chairman of the Board and CEO of L-Nutra Incorporated, shares his personal mission to grow the concept of biological aging. He describes his vision that by quantifying biological age and by pushing for its widespread adoption, new lucrative and transformative markets will be created.
Lee: Hello and welcome to the second episode of the Hyper Wellbeing podcast. On today’s show we have professor Joseph Antoun. Joseph is a Chairman of the Board and CEO of L-Nutra Incorporated, a nutritech company developing Fast Mimicking Diets (FMDs) aimed and preventing, intercepting, and reversing age related diseases. He’s also co-director of the Center for Health Policy at the University of Chicago, an adjunct professor of Health Policy at the Buck Institute for Research in Aging, and a Fellow at the Department of Social Policy at the London School of Economics and Political Science. Joseph is also the Co-Editor in Chief of the Journal of Health Systems and Reform. He completed his studies in public health policy in Harvard University, and public health at Johns Hopkins University, and a Doctorate in medicine and Master’s in medical and biological sciences from Saint Joseph University. Joseph and I have only met digitally so far. We were introduced through a mutual friend, Victor Chapela of Suggestic. Hello and welcome Joseph.
Joseph: Thank you very much. Happy to be here with you today.
Lee: How would you describe optimization of healthspan?
Joseph: A lot of focus today is helping us potentially live longer, but the most important notion behind that is to really live healthy and longer. Actually if you ask a lot of people, that if you ask people about whether they want to live just longer, and many of them would tell you, “Well I don’t want to be like my grandma. Sick and in pain, and live like this for a long time.” When you swap the question and tell them, “How about you stay healthier and live longer.” Then you get an overwhelming response saying that, “Yes, I would love to do that.” And we always want to better enjoy life and family, except if we’re in pain or we’re not healthy. The concept of healthspan which is they are staying healthier, longer, or the healthy part of our life, the part that doesn’t include disease is really the golden part of our ages. Should be the focus of healthcare, and the healthcare system today is more based on when we have a complaint or a symptom, diagnosing a disease and helping us get rid of this disease. The concept of healthspan is definitely the dream of us living healthy longer.
Lee: Americans spend on average 19.5 years sick, predominantly at the end of life. Is that a figure that you’re aware of?
Joseph: Yeah. It makes sense and it’s a figure that I expect it to increase not decrease with time. As you know today, close to 70 percent of American adults are obese, and among the 30 percent who are not, they still suffer from other non-lifestyle related issues. We do actually see an early onset of chronic diseases. The more we advance, healthcare is helping us today live with disease longer. We don’t die from cancer as acutely as we were dying before from diabetes. Unfortunately this relative length of being sick long is increasing, healthcare is helping prolong this a little bit and, we’re happy instead of not dying early, but I think we should do something a little bit more revolutionary to keep people healthier longer. Start early in their life. I don’t think it’s acceptable today to have 70 percent of the adult population overweight or obese, and there are a lot of health interventions that we can do to keep people healthier longer, and relatively shrink this 19 years of sick span if you want versus the healthspan.
Lee: People often muddle the distinction between biological aging and longevity because your speed of biological aging is likely to effect how long you live, IE your lifespan. If your aging goes faster, your lifespan is likely to be shorter, but actually longevity is the length of your life independent of biological aging processes, even if the two of them have a strong correlation. Do you agree with that, or is there anything else you would like to add to that distinction?
Joseph: The driver’s license might say your 60, but biologically you might be 50 or you might be 70, and it’s the most important factor. Of course one of the best correlates of how old you are biologically could be to your chronological age, but I think refining the way we do medicine today towards understanding how old my body is is the best determinant of when I’m gonna … My risk of disease, and mainly the top four age related disease, so cardiovascular disease, cancer, diabetes, and Alzheimer’s, and a good 80 to 90 percent of us will die from one of these four diseases and they’re correlated with aging. So the better you understand your biological age, and you work on even optimizing the health, the quality of your aging process, or a little bit slowing down the pace at which your aging is the most important determinant today to slow down your aging process and delay the onset of chronic diseases.
Lee: The startup of my first guest, guest number one, you’re number two, was Brad Perkins. He received funding from billionaire Jim Mellon, and Jim Mellon has been calling longevity, the greatest opportunity of all time, which I would agree. Is that also your view?
Joseph: Well yeah, the entire healthcare system is built on curing us. I mean our goal when we built the health system was to help us be well so that we’ll live a good quality of life. Some people do not want to live very long and again when you ask them it’s just because they don’t want to be sick long, but I think longevity is critically important for everyone of us. There’s always this fear of the unknown after we die. I will draw their stay, alive now, but be well at the same time, so longevity is definitely one of the top goals of, individual goals and healthcare goals, but we need to stress under longevity that healthspan, or living healthier longer is what people really want to experience rather than to be sick long.
Lee: Yeah, so you’d rather have … Deal with healthspan as number one priority, and number two would be longevity?
Joseph: I would agree with that.
Lee: And when it comes to the rate of aging, biological aging, which I think is the age metric that people care about. I would rather have a younger biological age than have a younger chronological age and an older biological age, so I believe L-Nutra is the only company with a patent on reversing biological aging, if I understood correctly. If that’s the case, are you able to tell me more about that patent?
Joseph: Yes, so I am the CEO of a company here called L-Nutra based in Los Angeles, and we’re licensed from the University of Southern California, their technology related to reversing aging through prolonged fasting. A lot of the last two decades, trials in nutrition have focused a little bit on fasting, because it was identified that if you fast for say four or five days in a row, the body gets stressed enough … It’s a heavy stress on the body that, the body takes not only weight related and metabolic related defensive action, but actually intervenes at the cellular level, inducing cellular autophagy and then stem cell regeneration in the body. It pushes the stem cells, because they’re younger biologically, they’re cost effective when they consume calories to replace old cells which are not that cost effective biologically. Under the fasting, the prolonged fasting crisis, the body actually takes cellular action to bring younger stem cells to replace elderly cells, and this process has indeed shown a reversal, a temporary at least, reversal of biological aging.
Joseph: And on July 10, 2018, practically a month ago, the U.S. Patent and Trademark Office issued for the first time in history, a patent on the fasting mimicking diet, so in order to fast for five days, which is very difficult on water, University of Southern California has developed a mimicking diet. A diet that where you can eat that mimics fasting. That fasting mimicking diet was awarded the first patent as to a product that’s pre-clinically and clinically tested for aging and now a patent on optimizing longevity and healthspan. That was critical actually. The patent title has both longevity and healthspan. It’s the first technology that’s really proven to keep people healthier longer. We’re very, very thrilled about it, and you gonna see much more about the fasting mimicking diet because the same way the body defends itself to survive, at the cellular level with fasting.
Joseph: What we’re starting to see now in the pre-clinical trial and going clinical with it, is that it uses the cells also to intercept diseases if the body is already sick, so there might be a healing factor in there that we’re actually trying to test clinically now on cancer.
Lee: What do you mean by intercept cells if already sick? How does that fit into this body, get stressed fasting, tries to make itself more efficient which is good for us – autophagy et cetera. What do you mean this interception? What’s that?
Joseph: We’re about to start our 24th human trial, and we’re looking at whether fasting could not only delay the onset of one of the top four chronic diseases, cancer, Alzheimer’s, cardiovascular disease, and diabetes, and actually autoimmune disease, there might be really beneficial effects on autoimmune disease with fasting, and I’m happy to talk more about it. But, the concept is, when you do a cycle of fasting, and specifically with the fasting mimicking diet, which again is a natural diet that you would eat over five days and it mimics the effects of fasting, it doesn’t trigger the body’s response to food, so the body stays in a fasting mode, although you’re nourishing your body.
Joseph: But the effect is that on the first two days of fast, the body would use fat as an extra source of energy, so you start breaking down fat and then using gluconeogenesis, and the more you cross day two towards day three, the body is so stressed that it starts taking cellular action, so it pushes the cells to now eat the debris inside of the cell and optimize their function, and this is a process called autophagy, so self eat, and it won the Noble Prize in medicine in 2016. Then the more you go beyond day three, closer to day four and day five, now the body says, “Okay, I’m breaking down fat to try to bring calories or ketones into the circulating blood. I ask the cells to eat their internal debris, and I still have no food, therefore I’m gonna take a bigger structural action, which is we’re gonna start getting rid of some of the cells that are inefficient because they have DNA damage or they’re very much aged, and I’m gonna push my young pool of cells. As you know the organs have younger cells and as the blood does, what we call, stem cells, and they’re very, they’re biologically younger than the average age of the body, and they’re cost effective in the way they perform their tasks.
Joseph: The body pushes the stem cells to replicate, and replace elderly cells, and replacing young with old [old with young] is a reversal, it’s a temporary reversal of aging. And what we’re seeing in diseases, at least in mice now, and again, I still caution that we’re going to human trials, we haven’t got the results in humans, but I’ll give you an example of diabetes in mice. When we have destroyed the beta cells in the pancreas, reusing [inaudible 00:13:15] and it induced Type 1 diabetes practically in mice. After doing cycles of the fasting mimicking diet, the stem cells specialize in beta cells, and the beta cells in the pancreas reproduced insulin and brought back glycemia to normal. That was the first time-
Lee: Is that full beta cell generation or just partial?
Joseph: It was partial, but advanced enough to produce enough insulin to bring back sugar to normal and for the time there’s a regeneration in the pancreas. We published this in Cell, February 2017, it was a major publication headlining for the first time ever a regeneration in pancreas, and now we also, on top of the longevity patent we have received the diabetes treatment patent as well.
Lee: I’ve never understood biologically, the explanation people give of the body starts eating debris, et cetera. I never understood why you had to fast. Any idea why the body’s programmed to do that only when extensively in the fasted state and why not to do it everyday in the not fasted state?
Joseph: Fasting lived with humanity for hundreds of thousands of years, right? When we were born on this planet Earth, we didn’t have easy supply of food, and it wasn’t easy to hunt, et cetera. For hundreds of thousands of years, fasting was part of our diet, and then that was extended even when we had food, all top five religions across the world had fasting as a common word. Even when there was food we kind of prolonged the fasting part of our diet and it was only up until the last 100 or 200 years where we started following different theories in nutrition of eating multiple times a day, everyday, and we became less religious or we tweaked a little bit the fasting, suffering within religion to make it shorter, that we lost this practice. Now we eat multiple times a day and everyday and this is how you’re getting the big epidemic in obesity and the early onset of chronic diseases.
Joseph: Fasting was, became part of our diet. It wasn’t just the negative connotation of absence of food or starvation, it became part of how our body counterbalanced the unhealthy lifestyles that you’re going through. When you’re eating a little bit unhealthy, you gain some weight, and when you fast you lose that weight. And when you fast longer, the body starts defending itself in order to keep you walking and trying to survive another day to find another fruit or vegetable and part of the body surviving the prolonged fast or fasting up to five days is to optimize cellular function, optimize the body’s function, and focus on empowering the brain and your muscular-skeletal system so that you keep walking and find the next fruit or vegetable. The longer the fast goes, the more the body takes cellular action to defend itself because of metabolic action wouldn’t be enough. That’s the concept.
Lee: Find an alternative energy source so you can hunt things down, but this cellular cleanup action, I just wondered why doesn’t the body do it daily anyway, and I guess what you’re saying is, it’s our evolutionary past, it’s our hardware programming. The body knew it would fast.
Joseph: The body doesn’t do it everyday because everyday you’re eating and this is where I tried to clarify, is when you eat, the cell is in a growth signal. The mTOR pathway says active because of the protein and the IGF secretion, and the PKA and the Ras pathways are also active because of the carbohydrates intake. The cell is in a happy growth mode. It’s not stressed enough to look for extra sources of calories. It’s only when the cell is really stressed by the absence of food that then the cell is saying, “Okay, I need to now gather myself, optimize my function, and try to eat whatever debris I have internally and use that calorie as a source of energy.”
Lee: Would you agree that healthcare today is not healthcare, it’s simply sickcare?
Joseph: It kind of became as such, although the intention might be different, but … And I’m a physician, and a lot of my training was focused on, you get a patient in with a symptom, and then out of the symptom you have some tests, and then you have a differential diagnosis, and then you try to treat that disease. I was not trained into you get a healthy person coming into your clinic, and how you keep that person healthier longer, so that they don’t get a disease. Yeah, by design … And we understand that because it’s the most urgent to intervene when there’s a problem, and the system created … We created a system that at least fixes us under firefighting which is we’re already sick. But it’s now critical to keep pushing a more public health intervention and primary care, and primordial care interventions to keep us healthier longer.
Joseph: And this is why I kind of like … Had the career shift, if you want, towards aging and what I’m doing today within fasting and the fasting mimicking diet because I and a lot of colleagues of mine who want to push the healthcare system to be true healthcare, wanted to create a market for that, a market for aging, a market for living healthier longer, and when you have a market, you have more attention to it, you have more funds coming to it, you have transactions in it, you have reimbursement and insurance coming to it. You cannot have a market if you’re not exchanging something, a product, or a service. And the fast mimicking diet, was literally the first plant based healthy intervention that had enough scientific background and enough trials, and funds from the National Institute of Health and credibility. And now a patent among 21 patents, actually, but a patent focused on longevity which is what we worked for, for years, and years, and years.
Joseph: And that would be the first product representing healthcare and true healthspan, and out of that I’m hoping really other labs come with other technologies and we start creating a full market for aging and for healthspan. That will bring more attention from policymakers, and insurance, and hopefully then would shift the focus on healthcare. Not shift, we need to do sickcare because you need to care for somebody when they are sick, but the best return on investment is definitely to keep people healthier, longer.
Lee: Do you think another healthcare needs to be constructed to sit alongside an parallel with today’s healthcare. Leave today’s healthcare for sick and injured people, and now have a secondary healthcare that’s consumer-driven, data-driven. It’s focused on longevity. It’s focused on healthspan. It’s focused on slowing the biological rate of aging, et cetera.
Joseph: Definitely there’s a mindset shift that needs to happen that empowers the consumer and that give the consumer more tools to understand what his body is about, what his body needs, and what he should do, he or she should do to live healthier longer. It’s a mindset swap and it’s a big educational and awareness campaign. Unfortunately, until we get to university, and even … I mean, imagine you completed your schooling, and now you’re going into an undergrad degree in business, say, and then you start doing work and you graduate and you go to decide your first job. You’re a 22, 23 year old person who never even had education about health and how to stay healthier longer, and how to eat, and how not to eat, and get the basics of understanding your microbiome, your routine, your family and your sensitivities, and food sensitivities. It’s a big failure of a mindset that we just left healthcare for folks that go to science schools and graduate as practitioner and take care of people when they get sick at the later stage of life.
Lee: I don’t see how the existing healthcare could transition. I can see it can go some of the way, I just don’t see it’s got the incentive structure, and that’s why I personally, I see a secondary system.
Joseph: Number one is really the policy at the high level, and we need a policy mindset, even aging and healthspan and longevity, they’re not recognized as tracks by the FDA or the government. Number two is really an educational component and building the right incentives. We, a little bit focusing the medical school education on prevention and on nutrition and on exercise and on, you know, stress and sleep and things that matter to us, and everyday it level is gonna be important. Finally, incentives. People follow financial incentives big time, whether we admit it or not, and if you pay healthcare providers for keeping people healthier, they need to do more of that. If you help people benefit more financially if they’re healthier versus not, also that creates an incentive for them to go and try to be healthier. I think when policy, education and the right mindset, plus financial incentives come together, that’s gonna move the weight.
Lee: Well I don’t want to hold you personally responsible for today’s healthcare system and it’s incentives. Jumping back a bit, I don’t think that you are a fan of taking a pharmacological approach to slowing down the aging process, I.e. drugs to target, say mTor or Rapamycin.
Joseph: The pharma industry has helped us in many different ways when it comes to infections and antibiotics. When it comes to cancer and chemotherapy and many other, and diabetes and with the insulin, so there’s definitely a major role to be played by the pharma industry. What we’re saying is they should not be the only focus or the only solution, and we should definitely, it’s clear in front of our eyes today that 70 percent of us are overweight or obese, and it’s clear in front of us that aging is driving many of the … And unhealthy aging, is a consequence of the lifestyles we’re having is driving the early onset of the main big four age related chronic diseases, again cancer, cardiovascular, diabetes, and Alzheimer’s. What we’re saying is, we have an obvious intervention to do on lifestyles and empowering the body’s own ability to heal itself and to recover, that we’re not focused enough on, and we’re betting more on a pill resolving this for us.
Joseph: This is what we’re trying to advance as an idea, and what we’re trying to say as well, is that if there’s a pill for aging, which I hope there will be, and we are collaborating with different teams and hopefully get advancing one such pill, but if there is such a pill, and this would be a pill that you’re gonna have to take for a certain period of time, when a pill focuses on one pathway or one intervention, what we’ve seen historically is there will be some side effects on different pathways or some intended goals and some unintended goals. Our only caution is that for people to consume such a pill for future longevity, it has to be really priced … Fairly priced for people to be willing spend a daily fee for it, but more importantly it should really carry minimal or no side effects.
Joseph: Everyday we’d eat three or four times, so these are three to four pills, natural pills that we eat everyday. We know we can intervene there and help the U.S. population and the global population benefit without really side effects there, and just help rematch their body and their lifestyle with natural evolution, and eating healthier, and exercising, and improving their sleep, and their stress levels, et cetera. This is where the low hanging fruit, if you want, exists. But we’re definitely are supportive of a great interventions brought by the biotech system and hopefully we’ll get to a day where there’s an antiaging pill.
Lee: Do you think that our food choices are the number one factor in terms of speeding up or slowing down biological aging and making us sick? Or put another way, do you think our food choices are the number one determinant of the obesity and the chronic disease epidemic?
Joseph: I would bet on it because again, as of the first day of life, food is what you ingest everyday, and it’s what makes your body everyday. Multiple times a day. It’s the most powerful thing. If you think about every meal as a pill, you’re basically consuming every year, 365 days multiplied by three to four times a day, it’s that same pill. So how it’s not gonna be the most powerful intervention? And we’re not saying food is gonna resolve everything, by no means. What we’re saying is that food has evolved to be readily available very cheap. The cheapest food today you can eat is the unhealthy food, it’s the burger, and the fries, and the pizza, and expensive food that you can buy today is an organic fruit and vegetable.
Joseph: In these changes, plus a lot of wrong recommendations of eating multiple times a day, and the marketing that we get pushing foods on us, has led us to over-consume food, and unhealthy food, and this is what’s flaring the levels of obesity, of diabetes, of cancer, of autoimmune disease. And a lot of autoimmune disease now are really linked to microbiome changes related to food and leaky gut and the theories of the toxins leaking more into our bodies. I would bet with a high level of confidence that food could be a main intervention we can do today to improve our healthspan, and-
Lee: You view today’s industry, healthcare industry, that treats diseases as isolated things, but your view is that most disease occurrences are pretty much an expression of aging, so healthcare should target aging itself instead of diseases which are the manifestation of aging.
Joseph: Once you have one of these diseases, you definitely want to try to break the pathway. If you already have cancer, you definitely want to try to focus on how to treat cancer, but what we are saying is that on a preventative level, genetics is important in determining what kind of disease you have, and your environment around you is important, but there’s a third factor which is as important, that’s the lifestyle and the determinants of aging. And if you’re aging biologically faster … Think of yourself driving a car, and if you’re rolling at 70 miles per hour instead of 60 miles per hour, you’re gonna reach your destination sooner, and that’s the same thing biologically. If you’re aging fast in an unhealthy way, you’re gonna reach the first disease sooner, you’re gonna reach your end of life, unfortunately, sooner, and the faster you roll forward, the sooner you’re gonna get your first diabetes diagnosis or the first cancer, or Alzheimer’s or other age related diseases. It’s not by chance that even if you have the ApoE gene, you don’t get Alzheimer’s at age 20. Childhood obesity wasn’t a thing 40, 50 years ago, and due to lifestyle changes, it is a thing today, and it’s accelerating aging, and you have the first diabetes diagnosis at very early ages now that we haven’t seen in the past.
Joseph: I would say as a prevention, definitely biological age should be the focus. Once you have one of the diseases, you definitely want to prioritize that disease and it’s own pathways and try to intervene maybe more separately on it versus on a system wide, doesn’t mean not as well in the system wide. Actually, a lot of the simulations show that even if you eradicate cancer from humanity, even if you find a cure for cancer, you can increase longevity by 3 and a half or 4 years only. It’s the same unhealthy determinants that led to cancers are going to lead to another disease, say diabetes or Alzheimer’s, or cardiovascular, and that onset of that disease happens after, say you cure cancers. Unless we work on the determinant which is healthy aging, these diseases are gonna pop up one after the other, and it’s not gonna matter much, how much we treat each one of them. It will be urgent to treat each one of them, but it’s not gonna matter from a cost effectiveness and social impact standpoint to focus on that regard.
Lee: Really what we’re going into is an age of deep personalization of lifestyle.
Joseph: Yes and no. Yes in the sense that we are all different. There are some differential determinants, whether your genetic code is different than my genetic code. Your food sensitivity is different than my food sensitivity. Your liver performance and power of catalyzation is different. We’re different individuals in so many aspects, but we also have common determinants in so many aspects. Whether you gain weight or slow, if you’re gonna late 3,500 calories every day, you’re gonna ultimately gain weight and you’re gonna develop diabetes. I would say, definitely, there’s … We do share some commonalities which we definitely need to focus on. Stress, better sleep, and the basis of nutrition, and building healthy relationship in society, and then we definitely need some level of tailoring when it comes to my body and my daily food and what I should be eating versus… not given my environment, my genetic code, and my lifestyle.
Lee: I think the economy, the global economy has been built for being measured by GDP, and I think that GDP may have tracked to wellbeing, not directly, but as a proxy for a few hundred years. But I think that in the last 30, 40 years, that measure of success of an economy is diverging away from wellbeing. I think we needed calories, we needed furniture, et cetera, but now people change their furniture every couple of years, we have excess calories, and I think that the market is often harming people by with BigFood and then selling them something to cure what the market already created. There seems to be this divergence from the economy itself and wellbeing, which I see is a large problem and many people talk about improving social determinants, but nobody seems to say, “Hang on. That would require political and economic change at a very structural level globally.”
Joseph: Yeah, I mean if you’re starting with the GDP, the GDP doesn’t definitely represent that, but we have the human developing index, the HDI index which relies … Economy is just one pillar of it, but then you have healthcare is another pillar, and education is another pillar, and I think it’s a better representation of the health, education level, and then the economy of a society. But I think what you’re alluding at is we want to add or what you’re hinting to is, societies should add this wellbeing factor to how well society is, and I would agree with that.
Lee: I agreed to have you on to speak about the fast mimicking diet or the FMD for short, which is being sold an marketed as ProLon by your company L-Nutra, and it’s a diet where you do consume nutrition, I.e., you do eat, but it doesn’t trigger the body’s nutrient detection pathway, so the body remains in a fasted state, hence the name fast mimicking diet. You’re eating, you’re getting nutrition, but somehow these nutrient pathways are not triggered, so your body does go and produce ketones. It does then go on into autophagy, et cetera, as you spoke at the beginning. And your product comes, I think it’s $250 or it’s $299, I can’t remember if the price changed, but it comes and it gets a five day box. It’s got soups, teas, bars, 60 ingredients make up the box. Correct?
Joseph: Yeah, so let me explain the concept a little bit further and thanks for bringing this up. I do believe it’s connected to everything we talked about because it’s all about keeping people healthier longer. And just to help the people listening today about why we’re talking about the fasting mimicking diet, it’s mainly because it was the very first technology that go the patent on longevity and healthspan, and has been tested at the same time for that. It’s the only product in the history of healthcare and medicine that since day one, the inventors at the University of Southern California, did the pre-clinical trial on biological aging with the fasting mimicking diet on healthspan, and that trial was published in Cell Metabolism, and the title of that article had the word healthspan in it. This is really exciting for us as experts in longevity and healthspan and will be really exciting moving forward for the healthcare system.
Joseph: Then when they conducted the clinical trial, also was focused on reversing aging and risks of chronic diseases, and the title of that paper in Science Translational Medicine clearly indicates an aging reversal and prevention of multiple diseases such as cancer and diabetes, et cetera, related to aging. Now a fully issued patent to cover this education. Really, this focus and a lot of the funds came to USC from the National Institute of Health, which we really thank in here for being more and more involved in sponsoring age related research. We do believe more and more funds should come to that field, but already the NIH was proactive enough to sponsor a dietary project which is an atypical project, on the fasting mimicking diet. It’s a nutrition project that has been going for over 15 years today, and positions from the early days on how can we keep people healthier longer by reversing their biological age.
Joseph: Let me explain a little bit the concept, which is again we hinted at a little bit in the early part of the discussion today, but mainly is we as humans fasted for hundreds of thousands, for 99 percent or even more of our existence on earth. Way more than 99 percent. We were … Fasting was part of our diet, initially because the absence of food and then prolonged by religious habits. Only in the last couple of hundreds of years, we lost the right practice of this habit, and we suddenly saw a surge of major chronic diseases. And what we’re trying to do is to bring back fasting to our diet in a healthy way, and in a practical way. We are today, so much surrounded with food and theories about eating. Everyday you hear a popup theory, and most of them, they don’t have science backing them, but what we’re saying is for sure, fasting was part of our diet, and for sure we lost that, and if we bring it back, we want to bring back the counterbalance, the checks and balances to our system. Instead of eating everyday, and overeating, and gaining weight and aging faster, and starting an early onset of diabetes, why don’t we at the intermittent level, we bring back fasting to counterbalance this fast agings overweight epidemic.
Joseph: And we started at the University of Southern California, different types of fasting. Fasting for a few hours versus fasting for a day, or two, or three, or four, or five, and six, and seven actually. And we started looking at the body and what happens to the body and a lot of us today have heard or even practice intermittent fasting which is fasting for a few hours and biologically you’re fasting when you cross a day. And it’s easy to practice, whether it’s time-restricted eating or meaning skipping a few hours and limiting food intake to 8 to 12 hours, and the fasting period 12 to 16 hours, we call it time-restricted eating. And it helps you definitely counterbalance the weight, the calorie intake that you ate the day before, and the weight gain. It’s a great weight management tool that you can practice everyday, and it has some metabolic impact when you balance your weight, you balance your cholesterol, your triglycerides, your blood pressure, et cetera, and inflammation in the blood.
Joseph: The longer you go on fasting and especially when you reach two to three consecutive days, it’s when the body is really feeling the pain now. But it’s saying, “Okay, I’m losing fat. I’m using fat as a source of calorie. I’m asking the liver to dump the extra energy it has. But still, it’s too long for me now to be two to three days without food, and I need to start asking the cells to go and find calories within them.” And this is when the cells start eating the debris within them and the organelles and we call that autophagy, self-eat. Auto is self and phagy is eat. Then more interestingly when you cross day two and three, and you fast even longer on day four and five, is when the body’s saying, “Okay, I’m declaring really bankruptcy here. I used my fat, the extra source of energy. I’ve used my intracellular energy, and now I need to do a deeper intervention to survive. I’m gonna actually push my stem cells, they’re my superstars. They’re biologically young, they don’t carry DNA damage, this is solely with age, and I want them to actually try to replace some of the inefficient cells as the last structural cellular intervention to survive and hopefully this extra defense line will help me find the next fruit or vegetable before I collapse and stay alive.” This is all part of natural selection and part of human evolution.
Joseph: We were fascinated to see cellular changes based on the absence of food and typically any diet you take, impacts the fat and the metabolism, for the first time we’re saying that the absence of food or fasting, could actually have a deeper intervention, way beyond the weight and metabolism, but on the cellular level. When we started going to human trials, and the first human trial we went on was on fasting for cancer, we tagged team with Mayo Clinic on it, it was so difficult to keep people compliant on a five days water fast. We felt the need to develop what we call today, a fasting mimicking diet, meaning a diet that you would eat, and your body would stay in a fasting mode. We did it by, basically we started studying ingredients that do not spike insulin as a response to ingestion, and that they don’t spike insulin like growth factors. Certain amino acids that do not trigger the insulin like growth factor or the protein’s pathways, what we call the protease pathways and in the cell the mTOR pathway, and carb chains that actually do not spike insulin and do not trigger the PKA and the Ras pathway in the cell.
Joseph: And by that, we’re nourishing the body actually, but we’re not at the cellular level triggering what we call the nutrient sensing pathways, the PKA, the Ras, and the TOR pathways which are the main pathways that tell the cell there is calorie coming, or there is no calorie coming. By not triggering these pathways, although you’re nourishing the body with food and our food has not only the macronutrients but the micronutrients, so vitamins and minerals so that the body operates during the five days in a safe way and you keep going to work, and you keep your lifestyle. We do not recommend you exercise heavily of course because you’re gonna lose a lot of calories, but it’s a diet that you can do while being fully functional and doing your daily activities. And the goal is to nourish the body while keeping the cells in a fasting mode and keeping the body for five days in this not only metabolic improvement, but actually cellular optimization. We call it the fasting mimicking diet, and two years ago we launched the first fasting mimicking diet on the market called ProLon for promoting longevity. It was a great name, and today after this patent, it’s actually a very well deserved name.
Lee: Is your personal aim, what’s called rectangularization of mortality, that is you live hopefully a long life, and then you have a systems failure at the end rather than breaking apart in phases, particularly early on cell diseases that we’re seeing now in younger people, it would be more typically seen in older people, and do you believe that ProLon is helping towards that goal?
Joseph: We’re helping people stay healthier longer, or delaying biological aging, are we really reaching our theoretical dream of, “Okay, you stay healthy, healthy, and then you collapse as the body, the cells are aged enough to collapse and there’s a stoppage of a system, and you don’t need to suffer for years, it’s just a short period or sudden death.” I mean, this is the theoretical dream for us in the longevity and healthspan world. We’re not sure whether when we keep healthier longer, are we delaying the onset of these diseases, but they’re still gonna happen, they’re still gonna go long or not. What we are seeing in humans, what we’re seeing in mice is yes, the mice actually are staying healthier longer, and then they’re dying on a little bit more acute level, but a lot more studies needs to happen and it’s gonna be difficult in humans, as you know. You’re gonna have to track people on that intervention, say our fasting, when we came by, they would have to do it every year for say 40 years, or 30 years, and see how they died in order to prove that.
Joseph: We are very scientifically oriented, scientifically based, so I wouldn’t give any statement or judgment today that I’m not sure about. I would say, theoretically we would expect that or we would love to expect that, but cannot definitely state this unless we prove it. There’s directionally, in mice at least, we see that directionally happening, and we hope it will happen in humans, but we don’t have the proof yet.
Lee: Joseph, how often do you suggest healthy people should use the fast mimicking diet? Did you say it’s two to three or maybe four times a year for the purposes of healthy people extending longevity and reducing biological agents?
Joseph: Probably two to three times. If you’re fit, you don’t have metabolic issues, you’re not overweight, and you live a healthy lifestyle, probably for the cellular rejuvenation reason, you want to do it and maybe two to three times, and again, in humans, our body is the result of hundreds of thousands of years of evolution and we would not expect hunger to be a monthly thing, and especially in the last few thousands of years when food became available it was cared by religion. There is two to three episodes in a year of fasting, and this is the long fasting, meaning the five days fasting mimicking diet. Intermittent fasting or allowing the body to be on 12 hours, some recommend 16 of no food, what we call the time-restricted eating, and restricting the eating time to the remaining eight or 12 hours. I think it’s a practice that should be a little bit more common as well.
Joseph: Again, before having electricity and storing food in refrigeration, our ancestors slept early, ate at 6, 7, or 8 PM and they slept, and the next day you had to wake up and find your food or have breakfast. I think it’s healthy to eat and then spend a good twelve hours of no food to counterbalance and to burn the calories you ate instead of snacking them up into fat everyday. Yeah, if you’re healthy otherwise, it would be two to three times a year. If you have metabolic reasons and you’re overweight, maybe you want to do it more towards four times, but this is the frequency we recommend. Very few people needs to do it every month or every other month, especially if you do have a major metabolic goal you want to achieve. Maybe you do it three months in a row, and then after that, you measure again if you corrected what you need to or if you reach your metabolic objectives, you can start doing it once every three or four months.
Lee: Thanks for that, and is it $250 or $299?
Joseph: No, it is a $250 if you buy one or two boxes, you pay $250. If you’re buying three boxes or more, if you’re subscribing for it, then you’re paying $225 for it.
Lee: I heard Valter Longo who we should actually mention, I heard him saying water fasting can lead to a weakened immune system. I never saw any references for that. He also said that chronic calorie restriction tends to drive down markers, whereas FMD also doesn’t do that.
Joseph: What the biosphere project showed, which was a chronic calorie restriction trial with Roy Walford, it showed a depressed immune system. When you fast, this is what many people keep asking us, “If I fast for 20 days, would I do better? If I fast for a month, is it even better?” And we don’t believe that. It’s the cyclicity that’s important. When the stem cells start it and when the regeneration happens, if you don’t refeed the body … We haven’t talked much about this today, but the five days after the five day fasting mimicking diet are really critical because when you re-feed you’re feeding a newly replicative and stimulated stem cells, and you want to feed them for them to grow. Same thing goes for new immune cells.
Joseph: When you go into a fasting regiment for a long time, say 20 days or 30 days, then it’s not enough calories even for the new regenerated cells, even for them to flourish and then you depress the entire system. What professor Longo, Valter Long is saying, and this was based on his experience with the chronic calorie restriction in the biosphere project is … What they observed is that chronic calorie restriction has depressed immunity. This is why we elected to, instead of asking people to eat less for … in the trial in chronic-restriction, the trial was 30 percent less calories a day, instead of asking them to eat a little bit less every day for a long period and deplete the system, we actually went into a more severe and acute system which was fasting for five days so we get the same positive benefits on rejuvenation because it’s a severe almost no calorie or zero calorie, when you mention the word fasting, but it’s short enough, it’s acute enough, it’s only five days, that you don’t deplete the body. This is what he was trying to explain, is a short term dip the body, let the body actually regenerate, and then re-feed to actually boost that regeneration instead of depleting the body on a long term fast or on a long term chronic calorie-restriction.
Lee: I appreciate yeah … I temporarily mixed up five day water fasting with Roy Walford’s chronic calorie restriction. Turning to yourself, I would like to just ask a few personal questions. I heard elsewhere that you’re a big believer in giving back to society. You had said elsewhere, “Move forward while thinking about the people behind you.” Is that a guiding philosophy?
Joseph: I grew up in a family, was born in a really poor family, and we were very poor economically, but we were very rich in our heart and my parents instilled in me this concept that it’s really … What’s most important in life is how much help we’re gonna provide to others, and the best memories, we’re all gonna die, and the best legacy we can leave is how many lives we save or how many lives we improve. And my father was I think a genius with a big heart, and we definitely grew the ranks and became affluent, but I think that we all kept this tradition of feeling with others and feeling other’s pain and supporting others. Part of me tag teaming with professor Valter Longo, the main inventor of the fasting mimicking diet, was because he decided to donate all his shares in this project to charities and foundations. All his shares in these fasting discoveries, the aging discoveries, and the fasting mimicking diet, even when he writes a book … Actually and he has a big book called The Longevity Diet that was last this January and became a best seller on Amazon in six days, The Longevity Diet talks about a lot of things we talk about today, and I really recommend people to go and buy it, and all the proceeds that he gets from it goes to charities and foundations.
Joseph: We believe we’re sitting on a project that’s gonna help humans live healthier, longer. We brought back fasting to society and fasting, nobody owns it, it should be for everyone. We are actually donating back a good chunk of the money to the Create Cures Foundation and other foundations and charity.
Lee: You have four C-level positions. I’d like to ask you a couple questions about them, keeping up with the tradition you spoke of. What is a Longevity Group?
Joseph: The Longevity Group is a group that we formed, I would say almost eight years ago now, or nine years ago, around that period. It was around the first time I started transitioning from my focus in health policy and health system reform, and the pharma and the biotech sectors, start understanding it’s really about aging, and it’s really about longevity and healthspan. And I started meeting people, I started traveling across the U.S. trying to see who’s working on aging, who’s working on healthspan, what are the technologies coming in that market. I’m meeting leaders in that field, and we decided to put the Longevity Group together, ask enough leaders thinking today about aging being a main driver of our healthspan, and just to empower them, to represent them, to advocate for them, and to support them with carrying the technologies into the market.
Joseph: Professor Valter Longo was one of those, and he leads the Longevity Institute at USC, and I felt he had the most practical intervention called the fasting mimicking diet. It had very robust science. It had one of the biggest footprints on aging, and I really, really wanted to start helping him and USC go to the market and grow this concept globally. Again, going back to the idea of having a product and having a market, then pushing that market of aging more for policy to do some reform and adopt it and for initial investments to come into it and hopefully for that market to be be reimbursed and have the right financial incentives to help providers and help consumers to more for their aging and their longevity.
Lee: Thank you, and L-Nutra is doing very well. I understand it’s growing 20 percent month-on-month?
Joseph: Yeah, on average I would say that’s a fair statement. Some months we grow faster, some months a little bit slower, but on average definitely, yeah. It’s still a small company. We launched a couple of years ago, ProLon, but it’s going really fast and really well. I think what helped us is the credibility and the market, it’s the research, it’s the patent, the science and they fixed the other product. The food market and the nutrition market is full of ideas. It’s full of … Every day you hear a new idea. Every day there’s a book, and I think we’re confusing consumers and we’re confusing policymakers. I think if you ask 100 policymakers about whether food is an important determinant of health, they will say yes. The same, the physicians would say yes. But when it comes to take action, they’re looking at the market driven by moneymakers, by marketing, by misconcepts, and by no science.
Joseph: And I think we have a one chance in history today with the fasting mimicking diet, with having research that is completely university based for 20 years, having the credibility of the grants coming from the National Institute of Health, having the effectiveness that we showed, having pre-clinical and clinical trials, and our patents, and now in market experience and the consumer is doing the fasting and we’re getting unbelievable results and showing very high efficacy and safety profile. We have a shot in history to present food-as-medicine, the same way the pharma industry … Our colleagues in pharma are able to convince policymakers to reimburse their product, to price them all, and to provide them, to support them to get it into patients. I think we have the same chance in history today with ProLon with L-Nutra and the fasting mimicking diet to do the same and prove that food is medicine.
Lee: And you’re also chair of the board of Global Healthspan Institute which is based in-
Joseph: Yeah the Global Healthspan Policy Institute, what we call GHPI, is an institute that’s built to advocate on behalf of even the Longevity Group or the group of pioneers in the field of aging and the folks that are trying to bring other technologies to help us live healthier longer. And a big gap into the aging market is that policy doesn’t recognize, health policy doesn’t have a recognition of aging, and we don’t want to qualify aging as a disease because it’s a normal process, but aging is the mother of diseases. It’s the biggest catalyzer of diseases. And these are interesting discussions that we start … We want to have and we want to advocate with policymakers and with funders in the country about let’s put more money into the science of aging, the science of healthspan, and keep us healthier longer, rather than talking about the crisis within Medicare which is actually directly linked to this. Medicare passively receives the elderly after a certain age. When I say passively meaning, they don’t prep them to be healthier, they just receive them, they enroll them, and they’re getting a sick pool of overweight and obese elderly with multiple conditions. This is a tragedy of healthcare system being reactive rather than proactive.
I think if you ask 100 policymakers about whether food is an important determinant of health, they will say yes. The same, the physicians would say yes. But when it comes to take action, they’re looking at the market driven by moneymakers, by marketing, by misconcepts, and by no science.Jospeh Antoun
Joseph: Again, you cannot blame the system big time for not being proactive because there was no foundation for the proactiveness. Now that science is putting together some new findings about diets and nutrition, and some proven lifestyle changes that could become the infrastructure to be funded by governments and reimbursed, I think we’re very excited about what the future is gonna bring to us. We definitely hope, we did this a long time ago, and the government has invested more and insurance into this. Now, they’re paying more attention because of the pressure, the economic pressure as well, but in anyway, we’re really excited to have on one hand technologies that are proven to improve our aging process, on the other hand bigger attention from policymaking and the Global Healthspan Policy Institute is a platform to bring them together and help make that increased awareness with policy around aging and healthspan, and creating a match and raising attention to the field.
Lee: Is L-Nutra working on quantifying biological age?
Joseph: Yeah I’m actually … Not in-house, we … Another really bright scientist at USC that now moved to Yale, her name is Morgan Levine, and has worked on the … I think it’s called the NHANES study which is a 19 year old observational study that was funded by the U.S. government looking at lifestyles of people, 9,000 I think, 300 people, and followed them over 18, 19 years until they developed chronic disease and some of them died. And we worked with Morgan to reverse correlating from death and onset of chronic diseases and the blood tests of this group of 9,000 plus individuals, and we were able to reach a formula that basically because of the number of participants and because of the length of the trial, I think for the first time even in history of biological aging, we have an observational trial based on which we were able to create a biological aging measurement, we call it the aging score, and we’re gonna announce it in October.
We have a shot in history to present food-as-medicine, the same way the pharma industry…Jospeh Antoun
Lee: It sounds exciting, the quantification of biological aging. Do you think it’s going to become as popular as … I mean, do you think biological age will achieve the scale of blood pressure one day?
Joseph: I do believe that and I hope at least, that the unit of measurement of health is going to be biological age. There is, that unit itself is gonna present so much in our body, and is gonna help us predict so much in the future, that I do hope and as part of our mission and my personal mission is to grow this concept of biological aging. As Peter Drucker says, if you cannot measure, you cannot manage. And part of our mission as the Longevity Group wasn’t only to create technologies in aging such as the fasting mimicking diet, but to measure aging. And when you measure you can see improvements or reverse direction, but at least you can then quantify, you can then put price, you can then reimburse, you can then be more proactive.
Joseph: I know a lot of companies are working on biological aging, some of them with artificial intelligence simulation, other with a little bit more simplistic simulations, and others are measuring telomerase or methylation et cetera, we’re very excited about all these projects. We hope that at some point we … The two or three most significant groups looking at aging from different ways maybe get together and averages of the biological age score would give us the best proxy to what a person’s age is. That will help healthcare focus on that. If you’re 50 and you’re showing you’re 60, you really need to do something, and then you can quantify it and then you can find really, what’s the best thing that work for you that decelerated your age and brought you back to 50 or even to 45.
Joseph: We’re extremely excited about that and about the future of health focusing on these metrics other than on other measurements that are relevant when you’re sick. You know, it’s fascinating how we did more for our cars than we did for our body. Today, you sit in a car and you have a dashboard in front of you. You know the car temperature, you know when you kick on gas, you see the RPM going up. In our case we don’t have an age accelerator or decelerator management measurement. You have different items that lit, if you don’t have water, the radiator, et cetera, et cetera. We have obligatory insurance for every car. I wish we’d do the same in our case where we measure aging. And even in a car, when you buy a car, you know, mileage determines the cost of the car because mileage is usage and usage means the best prediction of when this car will start having issues in the future. We need to find a system that also helps us quickly. We all hold iPhones today in our hands, we have computers, and we should have some easy access to some primary measurements.
Joseph: Then based on the biological aging, which I think is like a mileage of the car, is how much our body has been used and how healthy it is today. At least always know where we stand in our life and our lifespan, and try to improve it, and keep us healthier longer, and we’re gonna get sick one day, but hopefully we’ll delay that onset.
Lee: And do you think once that’s quantified, it’ll be portable? For example you can plug into dating sites and so you’ll only look for partner with a biological age within certain ranges. And do you think it’s coming to your wrist or phone quite soon to see your rate of biological aging just when you look at the time today?
Joseph: Well the dating thing is a little bit outside of my expertise. It’s a fun thing to talk about, but it’s a little bit outside of my focus. I definitely think it should be portable. I definitely, I’m not sure it’s a minute by minute something you want to track, but I definitely think that you want to, once every couple of weeks, at least directionally because there’s what’s your age now as a snapshot and there’s the direction. What I did yesterday and what I’m gonna do today are there directionally going in a healthy direction versus not so. You definitely want to have measurements that maybe you want to do every month or other months of where your biological age is, and you don’t want to do them so frequently that the difference is not statistically even significant, but you definitely want to have another measurement.
Joseph: It’s like the car, you know, you look at the dashboard, you’re rolling say at 60 miles per hour, but when you decelerate, the first thing that goes down is the RPM saying I’m decelerating or when you kick the gas pedal you have the RPM going up even before the speed goes up. You might want to have, or like the stock market and micro-trading, you want to see directionally maybe for frequently what you’re doing and then measure where you are biologically every now and then.
We’re extremely excited about that and about the future of health focusing on these metrics other than on other measurements that are relevant when you’re sick. Jospeh Antoun
Lee: I’ve used a few services to check my biological age. One is bloodcalculator.com. It said I was 20 odd years older. Another one is aging.ai. It also was quite off, but not as badly off. And I heard Valter Longo say the top five biomarkers of longevity are IGF-1, insulin, glucose, CRP, and triglycerides, oh – and high blood pressure, so I was, five main ones there, so I do measure them. Are you aware of aging.ai?
Joseph: I do actually. I am aware of, and I think this is the project of Alex and Alex is a great colleague, and I really hope his AI platform keeps growing until really refine it with very close margins where the biological age is. But what you were referring to with Dr. Longo is exactly what we talked about the aging score. When we did this … When we reverse correlated the study, done on 9,000 plus individuals, again over 18 years or 19 years now, there were five metrics that were highly correlated with aging. And it does not mean that others are not or they are, it’s just the body expresses the genes codes for proteins and the proteins call for in different streams, and then you have the genetics and the telomerase. It’s different petal stories, and the blood, what exists in the blood is in our opinion today with aging score, is the endpoint are the result of the results of all this. At least this is what the measurement that we did in the blood what these … Or the study did with the 9,300 individuals showed that these five factors are represent a summary of the story of your biological age if you will.
Lee: I’m really excited, not just by FMD because I think it can actually benefit many people, but I’m really excited about your focus on quantifying biological longevity, and I can only imagine you’re going to bring these pieces together in some package in the future. I’m not trying to ask you to relate future products and services, but I can only imagine you’re gonna start putting FMD in, you’re gonna build some software that has biological aging in it, and integrate them in some way and possibly add other products. I imagine you’ve got future products in the pipeline.
Joseph: Yeah for sure, and we would love to help every one of us understand where they biologically stand and give them recommendations about what to do, to if they’re unhealthy to become healthy or reverse part of that negative direction, and if they’re healthy to be healthier. And quantification and then recommendation intervention is really key. I think what we bring to the table, the most important is the science base. Nothing that we talked today is really my idea or someone’s else idea, this is more than two decades of work and all of it is research at universities across the world, and the science … Even if it delays us a little bit, we really want to do this a long time ago, but we’re taking the hard rod of proven science in order to bring something that shakes and moves solidly the healthcare system and be disruptive but credible enough for people and mindset to be changed.
Joseph: And yes, we’re gonna bring the aging score and make it available for people, and hopefully coupled with ProLon and many other recommendations, not only ours but a lot of bright researchers doing a lot of work on aging in different parts of the globe. We want to empower them, and this is again, you asked about Longevity Group and Global Healthspan Policy Institute is really empowering all of them to bring more credible intervention to that market and create an aging market, create a longevity market. Market not from just a financials standpoint but from an attractivist standpoint and hopefully move the needle on reimbursement and policymaking which is really what’s gonna shake that entire industry and make it big.
Lee: I appreciate your macroview coming across at the policy level. I can’t wait as a consumer to be able to sign into L-Nutra, get a biological age score, which may involve again, getting blood taken by Quest or whoever you use to pull blood, and then doing the FMD, maybe one, two, three times, however many times is required, and then retesting the biological age again via L-Nutra.
Joseph: For sure. I mean that’s … This is something that’s gonna hopefully become mainstream in the next four to five months, and we would love people to measure the before and after, and-
Lee: I can’t wait. I can’t wait. Because these serve … The market has been begging for such services and has been for a long time, and I want to say I’m surprised it’s not there in the market, but it’s not that easy so I shouldn’t be surprised, but definitely there is a lot of eagerness. Pent up eagerness out there.
Joseph: Well, it’s gonna happen.
Lee: Last question I want to ask every guest which is, what’s your top healthspan tip … You can name a diet, a device, a practice, a belief, but you can’t say FMD or fasting, something else please. Avoid sugar … I don’t know. Anything, but you can’t say fasting or FMD.
Joseph: I would say skip dinner. Or not skip dinner, or eat earlier. Eat around six or seven and then make sure you don’t eat really late at night. I think half … It might, I mean, I don’t want to put a quantification, but one of the most significant intervention we can do today to curb obesity globally is really allowing our body to be in a phase where I’m eating and then there’s another phase after that of not eating. I would say the time-restricted eating is really important to counterbalance what you ate the previous day, but if you want something non-related to food, I would say build, give more love and receive more love, and build better connections with your friends and family. There’s a lot of happiness that we lost lately and happiness is directly correlated with aging and stress and lifespan. And the work Dean Ornish did and many other labs, and are showing around the world is really rebuilding social connections, be involved with your friends, go out and love more and be loved more is something that’s gonna take you off the combination of stress and joy, moments of stress and moment of joy. It’s gonna create some level of happiness, especially within the family and I think that’s gonna help. Help our longevity and aging big time.
Lee: That was a big element of The Blue Zones, build social connections.
Joseph: Yes. Definitely.
Lee: Joseph, I see we’re out of time here, and I want to say I greatly appreciate your time, and I greatly appreciate your expertise. Thank you for rolling along with me with a few loopholes.
Joseph: No I wish you great success with your work in here. I think you’re covering really really important questions and let’s keep moving forward this, the concept of us living healthier longer. This is healthcare and it’s gonna be the most impactful investment we do in our life.
Lee: Got one request. Can I be one of your first customers in the biological age quantification?
Joseph: You will definitely.
Lee: Oh, excellent. Excellent. I’ll make you keep your word. Thank you very much Joseph. Much appreciated. Bye.