Precision Medicine vs Precision Health vs Hyper Wellbeing – EP05: Don Brown (LifeOmic)

In this fifth episode, Don Brown, CEO LifeOmic, explains the nomenclature shift from precision medicine to precision health, details the firm footing his company has in precision health, how it’s now extending another foot forwards into hyper wellbeing. Lots of app, lifestyle medicine, lifespan, healthspan and biological age quantification chat.

Lee: Hi, so you’re CEO of LifeOmic, a company which I have been tracking for some time. Could you be so kind as to introduce, to give a brief introduction to LifeOmic?

Don: Yeah, I started LifeOmic almost two or so years ago. I went through a combined degree in the PhD program many years ago and ended up taking an unexpected right turn into the software industry, I was in various high tech companies for a number of years and had a good exit from a company that I had started 20 years ago and started LifeOmic with the notion of trying to bring some of the exciting things that have developed the last couple of decades in terms of cloud technologies, machine learning, and other computational techniques to medicine, to try to move the ball forward on precision medicine.

Lee: And what does LifeOmic do?

Don: Well, what we did was to create a cloud platform based on Amazon Web Services that could aggregate all types of health information. Everything from old school electronic medical records to the next gen whole genome sequences in order to try to do the sorts of BigData techniques that everybody realizes are the future of the delivery of healthcare in general.

Lee: It sounds like just wanted to have fun.

Don: Well, yeah, you know, I did. For me, it was kind of closing the loop after a long time and I really felt like I just wanted to put together some really smart people from a number of disciplines and do something cool, hopefully something that makes a contribution.

Lee: Yeah, I looked at your LinkedIn and I saw you have what four degrees and I was already envious that you’ve managed to do them and find the time because learning is great fun. You’ve got a degree in Computer Science, a master’s, a bachelor of science in Physics, a doctor of medicine and a master of Science in Biotechnology. So even before building this you’ve had a lot of fun playing with education.

Don: Yeah, I have, and I think one of the most fun things about it if you notice there were about 30 years between the last two degrees. I got my MD back in ’85 and just last year I finished up a master’s program in Biotech from John Hopkins.

Lee: Are you based over in North Carolina?

Don: Our headquarters is in Indianapolis but we have software development offices in the Research Triangle Park area in North Carolina as well as we’re close to where I am currently living out in Utah.

Lee: Okay, because when I was … Well, certainly before age 25, I used to be a freelance consultant for Cisco RTP.

Don: Yeah, it’s a great area. I was just there for the Duke Precision Medicine Conference this week.

Lee: Hey, we’re getting a little bit chatty here, I am. It’s like we’re at the pub. I guess it’s partly because we’ve not met or interacted before. Anyhow, my last guest which was guest number four was Ardy Arianpour and his company is Seqster, and he’s, to quote him, “enabling individuals to store and share longitudinal datasets.” That’s medical records, DNA, fitness, and nutrition data. I assume that appears that LifeOmic cover a different target audience and that target audience is clinicians and researchers?

Don: We’re working with Indiana University School of Medicine, that was our original collaborator on a big precision health initiative that the university launched a couple of years ago to try to assemble those sorts of various datasets for particular disease groups starting off with multiple myeloma which is a plasma cell, a white cell cancer, a pediatric sarcoma, and triple negative breast cancer.

Lee: This is a storage platform for longitudinal datasets, however, including genomics and medical records and wearable data, I believe. However, it’s not … That platform is not targeted at individuals, at consumers, to be clear?

Don: Well, we’re kind of moving in that direction. We built a mobile app. Initially it was just for fun, for the most part. During my studies at Johns Hopkins I became fascinated by intermittent fasting. We decided to build a fasting app that we call the … It’s in the Apple, the IoS app store that we call Life, the LifeOmic Intermittent Fasting Experience and to our surprise, we had tens of thousands of people around the world with no advertising, download and start to use this app.

Don: What we’re doing is building a next generation app that’s kind of a more broadly focused health maximization app that does use our platform for the storage of personal health information as well. We’re kind of pursuing both top-down, working with hospitals and clinical teams, but also bottom-up direct-to-consumer sorts of approaches and hoping that those can meet somewhere in the middle.

Lee: Okay, so your core business, up until recently or you’re saying you’re shifting towards being direct-to-the-consumer, but up until now, your core business has been putting these, matching up these large data sets so the clinicians and researchers can use them. For example, a researcher could upload their data from their university hospital and then they can start to ask questions like, “Hey, do we have enough patients with this particular gene expression between these ages coming into our facility to do a pilot study, for example, over the next 24 months?” Is that your core business at the moment?

Don: Yes, yeah, so yeah, we’re working with these academic medical centers and they’re taking people who already have a particular disease, like multiple cancer, like multiple myeloma and loading their electronic medical records so their complete histories and physicals and medications and then the sequencing information that comes from sequencing their tumors and then trying to understand why is it that some … One person with multiple myeloma will respond really well and go into remission for the 20 years with a particular type of treatment and another person will have a cancer that barely blinks and may kill them within a couple of years.

Lee: Yeah, so your platform is like beginning to let people like pharmacology work out which drugs delivered when and which dosages for whom more specifically.

Don: Exactly, it’s a whole notion of precision medicine that we’d really … I think the Holy Grail is to be able to look at each of us as individuals and tailor treatments to us and especially in terms of cancer. Because as we’re learning, cancer varies tremendously almost down to the individual.

Lee: Maybe not for this podcast, I’m not quite sure, but I want to ask anyway. Have you done any reading on the metabolic theory of cancer, you know, Thomas Seyfried?

Don: I guess, I’m familiar with the Warburg effect and some of the metabolic dimensions of cancer. I’m not familiar with that particular author.

Lee: Okay, which is something I’ve been looking at lately and plan to have a guest on much later. Anyway, you were speaking a few days ago, you mentioned it, the Precision Medicine Event and when I opened up the LifeOmic website the heading is Powering Precision Health. Could you elaborate on any differences you’ve possibly tried to make in using Precision Health as opposed to Precision Medicine?

Don: Yeah, precision, the term Precision Medicine has been around for a few years but there’s kind of a slow move to the notion of Precision Health. The connotation is that rather than what healthcare has traditionally done, which is to treat disease, to wait until people have problems, then to try to diagnose those problems and figure out how to treat them, what we really want to do is get ahead of the curve and work to keep people in good health for as long as we can. That’s the notion of Precision Health, that it’s more than just treating a disease like cancer or Alzheimer’s but also trying to prevent us from developing those diseases in the first place or at least forestalling them as long as possible.

Lee: So you’re meaning predominantly chronic diseases?

Don: Yeah, you know what we’re finding is when I went through medical school and I think this is even still true today, we look at diseases in isolation. We look at one person gets Alzheimer’s, another person gets Parkinson’s, another person develops osteoporosis and another person gets cancer.

Don: What we’re starting to realize is that these are all diseases of aging. If we live long enough, we are subject to all of these diseases and they all reflect a common set of underlying disease processes where the sort of homeostasis, the balance that we have, the resilience to different sorts of stresses when we’re younger starts to break down in mid life and starting around the age of 50 or so. If you plot the incidence of these diseases over time, you just see this exponential increase that starts in mid life and it’s the same for all of these diseases.

Don: As I say, Precision Health is an effort to try to look at the contributors to that sort of disease process and take steps to keep us in good health, hopefully, for much longer. Because we’ve been successful in medicine the last few decades in extending lifespan, but if you ask most people, they don’t want to live longer if it means living in decrepitude. What we want is to increase healthspan, more than increase lifespan.

Lee: Absolutely and you echo a lot of what Joseph Antoun, my second guest in this podcast said. I think the healthspan, longevity is where the money is going to be or where money is moving to. Would you agree with that or is that not your forte?

Don: It is and I think, you know, all of these things tie together and that really has given rise … I think Stanford was one of the early programs to actually change the label as it were from Precision Medicine to Precision Health. I mean it makes total sense that we want to start to get ahead of the curve in treating people and have them adopt the sorts of lifestyle interventions that have been proven to maximize their healthspan and hopefully, decrease that burden of chronic disease.

Lee: Well, I appreciate you focusing on Precision Health and not Precision Medicine because this podcast is about an emergent healthcare industry that I’ve dubbed Hyper Wellbeing, mainly because the backbone of it is man-machine convergence and it’s not to be confused with Health 2.0 or Digital Health, which are just the existing paradigms, digitized, i.e. disease care, but digitized. Instead Hyper Wellbeing is for the majority of the population is those who consider themselves healthy as opposed to orthodox healthcare which focuses on people who have become very sick.

Lee: I saw the other day, you had Tweeted or LifeOmic had Tweeted, “In order to collect patient data and engage the patient in their healthcare journey, via mobile apps, people want, have to want to use these apps,” and that struck me as very orthodox healthcare. I guess you were aiming at that market at that point and I guess that’s because you’re caught between two worlds at the moment.

Don: Yeah, yeah, well, we think there’s a convergence of those two worlds. We certainly have to treat people when they get sick. Now, of course, we want to try to cure cases of cancer, we want to … We’d love to find a cure to complex diseases like Alzheimer’s but even better is to prevent people from getting those diseases in the first place.

Don: I think the last 20 years, we’ve seen the emergence of a focus on aging itself and a realization that we don’t just have to accept aging and that aging isn’t the same for everybody. It isn’t this inexorable sort of process that is like a car rusting outside, but that different people age at different rates and what we do during our lives, some of the common sense interventions like exercise and nutrition can make a difference in the rate at which we age.

Lee: Absolutely and without a doubt, in fact, I know as a matter of fact, apps are coming to the market to try and slow our rate of biological aging by precisely guiding our lifestyle choices.

Don: Well, and that’s what we’re trying to do with our … We’re calling it LifeExtend that we’ll be releasing for iOS and Android before the end of the year. We are trying to merge these worlds so that people can aggregate their healthcare information up in the cloud and take advantage of machine learning, real time alerts that can let them know and there are signs that they’re falling out of homeostasis in some particular direction and maybe going down the road toward heart disease or neurodegenerative disease or something else, but also trying to guide them toward those interventions that have been proven to slow down the rate of aging.

Don: Using some of the exciting developments in assessing biological age, I think the one that really captivated me was Steve Horvath’s paper, I think in 2013 in Science that looked at just a few DNA methylation sites on a genome to be able to assess the rate at which different people were aging and finding that as we might expect people who were smokers or obese, who have terrible diets age at a faster rate than other people who do a better job of taking care of themselves.

Lee: I think it’s called Horvath Clock? Is that pronunciation correct, that you’re mentioning?

Don: Yeah, yeah, I think it was Steve Horvath, but I, regardless of the pronunciation, that’s exactly it. It’s looking at these changes that take place … You know, we all know about mutations in our DNA that can lead to cancer but there’s this whole emerging field of epigenetics where rather than mutations in the actual DNA code itself, there are on and off marks, methylation marks that happen in different tissues and with age that change the expression of genes, change the interpretation of that DNA code. We’re finding that we can analyze those methylation marks very easily to calculate a biological age for each individual.

Lee: We need to start being able to compute the interaction between the environment and our genes, that affect gene expression.

Don: Yeah, yeah, we’re finding that … and there’s a whole emerging field of analyzing what’s called the exposome, that we are all exposed to countless environmental assaults every day, bacteria, viruses, pollutants, radiation, all these things that do have an effect on our gene expression.

I think the last 20 years, we’ve seen the emergence of a focus on aging itself and a realization that we don’t just have to accept aging.Don Brown

Lee: We pretty much know what ages us faster. We know alcohol, especially, in excess, ages us faster. We know the quickly metabolized carbs, eg. bread, white flour, Et cetera, sugar, ages us faster. We know that lack of sleeping, we know that high stress, we know social caused stresses like loneliness ages us faster. Any others you can think of?

Don: I think certainly another one is lack of exercise, obesity, these are factors that do age us more quickly. I think a lot of this was kicked off by David Sinclair’s work at Harvard in discovering the sirtuin family of enzymes back in the ’90s that led to identification of resveratrol and all the publicity about that as the French Paradox, you know red wine molecule. But in the ensuing, time the focus has been more and more on metabolic rate.

Don: To over simplify a bit, it comes down to insulin being … and especially, an excess of insulin being something that’s very bad for ourselves, having a typical Western diet where we’ve got excess glucose floating around in our bloodstream all the time which results insulin knocking on the door of cells and giving them growth signals where we’re finding that that increases rates of cancer and certainly overall causes us to age more quickly. That’s why obesity is such a massive problem and also what you described, the sorts of diets rich in simple carbohydrates that cause spikes in insulin.

Don: Those are very harmful to our health and simple interventions like intermittent fasting where you just try to give your body a little bit of a break for 12, 14, 16 hours a day can make such a huge difference.

Lee: In essence, it’s evolutionary medicine.

Don: Yeah, it is. I mean, on an evolutionary level and I love thinking of it this way, we weren’t evolved to have bags of chips and cookies at our elbow and to be eating around the clock. Our ancestors would hunt and maybe bring down an antelope and feast and then might have to go for a day or two days or three days without much of any … and that is the way our bodies have evolved and we need to do, to take steps to bring our diets, our lifestyles closer in harmony to that sort of evolutionary ideal.

Lee: I agree. Here it says, LifeOmic, and I’ll quote, “Aggregate clinical genomic imaging and lifestyle data for millions of patients and use this data to make discoveries and guide Precision Health.” Just to be clear, “in the moment” is not for individuals to make discoveries, i.e. you want to go to bed before 10 PM, my post-prandial glucose the next day tends to be lower. Instead at the moment is for researchers and clinicians but you are likely or are moving in the direction of taking that to the consumer so they can make their own discoveries?

Don: Yeah, yeah, we are. We do want to kind of marry those up by allowing consumers to participate in research studies. There’s a big problem in medical research right now, there are many studies, clinical trials that are unable to reach statistical significance or maximize their effect just because they can’t find enough patients who meet the criteria for those studies.

Don: What we’re trying to do is build the cloud platform that allows those research teams to store and analyze data for thousands or millions of patients but then also to provide this mobile app that hopefully will collect information from individuals and then hook them up with the research efforts that they might benefit from and that would benefit from their participation.

Lee: I like the way you power these studies and I’m sure you can reduce the cost of studies and make certain studies possible, that wouldn’t be possible otherwise, but do you think you’ll move in the direction of letting end users have access to the platform to make their own … Well, not make their own discoveries … That the platform itself tells end user, “Hey, when you go to bed before 10, your glucose the next day tends to better.” Do you think you’ll ever go that far to offering insights based upon that BigData to end users?

Don: Yeah, that’s a very prescient question and the answer is yes. For me personally, I believe that’s the direction medicine is going. Especially in the US, our system is broken. We just have a mess with reimbursement system we have, with the way healthcare providers have to deal with dozens or hundreds of different insurance companies. I think more and more people are just disgusted with the whole system and in other facets of our lives, we’re able to take more direct control and I think that that’s where healthcare is moving as well.

Don: There are tremendous resources available online, artificial intelligence, the cloud. They are enabling people to take responsibility more for their own health and especially when it comes to prevention of disease and so absolutely, as we aggregate this information about people up in the cloud, we’re building an architecture that will allow us to send alerts to people. We have to be careful because right now, our FDA is loath to allow anybody but physicians to make actual diagnoses.

Don: We can give advice, we can give probabilities but we can’t make a definitive diagnosis and say, “Hey, you’ve developed a cardiovascular disease or Alzheimer’s,” but we can give alerts to patients indicating potential problems and especially to then refer them off to a healthcare provider.

Don: One example, I’ll give that’s pretty easy to understand, we’ve developed and will be including as part of this app, a feature that allows you if you’ve got a questionable spot on your skin to take a photo. Then we send that photo up to our cloud. We’ve got an AI engine that has trained a machine learning model to be able to identify with 94% accuracy, whether that spot on your skin is cancerous or not, whether it’s a melanoma or not. We can then give you back an assessment. We can’t say, “Hey, that’s a melanoma,” but we can say, “There’s a high probability that that spot is a melanoma and we recommend that you see a physician for confirmation.”

Lee: That last part, you’re talking about disintermediation. See, I saw disintermediation take place in the airline industry in the ’90s and then I saw it mostly after the year 2000 take place in telecommunication but I haven’t saw disintermediation take place in healthcare. For all the talk of digital health and so on, healthcare hasn’t actually changed much with the advent of the Internet and the smartphone and sensors. Would you agree that last part is a step towards disintermediation?

Don: Well, I … That’s a pretty strong word. I’m not sure I would use that specific term but I guess I view it more as democratization, that people … Rather than having healthcare providers, doctors, hospitals be the complete gate keepers that we all are going to have access to intelligent systems that provide us additional information. Especially when it comes to preventative wellness, taking as we talked about, taking steps that can keep us from developing diseases in the first place.

Don: But you’re absolutely right in that … and I’ve been part of software efforts that have brought disruption to banking, insurance, all sorts of other industries and healthcare has been a major holdout up to this point. I do think disruption is finally coming. I don’t think that a lot of people in the healthcare system really understand the rate at which that’s going to arrive but I think individuals are going to take more responsibility for their health and be less inclined to just leave it in the hands of doctors and hospital.

Lee: I think we’re in agreement that healthcare is … for want of a better word, splintering. What I’m seeing likely to emerge is a healthcare that’s focused on prediction, on prevention, and optimization. I don’t think the orthodox healthcare will take that on. You described a lot of baggage to it. I think it will stay for just acute prevention … ah, acute emergency response and injuries, but I don’t think it will take on the great prevention and prediction and optimization roles, because that’s actually belongs to data science.

Don: Well, I think you’re right. I think structurally, our healthcare networks in most countries and again, especially here in the US, aren’t set up … They don’t have any incentives to keep people healthy.

Lee: Plus you don’t have people knowledgeable in keeping people healthy, you don’t have the knowledge there and now you could train a new breed of clinicians who do have kind of knowledge, robust, in lifestyle [inaudible 00:33:38] … but the thing is it’s too late, because the machines and devices and software are coming in so fast and ever closer to the human being.

I do think disruption is finally coming. I don’t think that a lot of people in the healthcare system really understand the rate at which that’s going to arrive.Don Brown

Lee: For example, there is a speaker, I guess, I’ve got coming up and they … They ‘re injecting sensors into the body permanently. They can measure most blood chemistries and live in your body indefinitely.

Don: Everything is set for major change and you’re right. Clinicians haven’t been trained, aren’t trained … When I was in medical school, the amount of time we spent on understanding basic nutrition or wellness was pitiful. As a result doctors know precious little about these topics and I think you’re right that BigData is going to transform all of this … I gave the commencement address at the Indiana University School of Medicine graduation last year and I told the graduating physicians that within a few years, they were going to have to treat AIs as colleagues. I firmly believe that that is where things are going and it is going to be transform-

Lee: Maybe even overlords.

Don: Well, I didn’t dare say that. I think that wouldn’t have gotten me booed off the stage, but it was enough of a shock to them to think that they would be using these systems not as search engines, not as encyclopedias but rather as colleagues. Perhaps colleagues who are better trained than they are in some respects.

When I was in medical school, the amount of time we spent on understanding basic nutrition or wellness was pitiful.Don Brown

Lee: Yeah, machines took away the blue collar jobs with automation, manufacturing, et cetera. It’s clear when you look … I mean it’s abundantly clear, so much so I sort of chuckle, that when you look at where AI is going, it’s just going to remove a lot of knowledge workers and the economy. The more I study what medical doctors have studied and how they put it to use, too often for comfort, I think, “Hey, a machine could replace this now or in near future.”

Don: It’s true, doctors are kind of perversely trained to treat data as an enemy. It still boggles my mind but doctors are instructed to … kind of the classic example is don’t run a test unless you know what you would do with the results. That’s a reaction to cost pressures that because running tests, gathering data has an expense associated with it, doctors are discouraged from running those tests unless they know in advance exactly how they would use the information.

Don: This is exactly opposite to the way most other industries operate. You think of Google as the classic example, where with the Internet age the attitude is “Give me all the data you can.” I’ll collect as much data, I don’t have to know what I’m going to do with it. I’m just going to assemble as much big data as I possibly can and I’ll use machine learning, AI, because revelations will drop out of that data.

Don: Healthcare is set up in a kind of a medieval sort of way that doctors are expected to memorize thousands of different conditions and then use their expertise to look at a patient, ask a few questions, collect a few judicious points of data and then make a wise pronouncement regarding the diagnosis and the treatment. But computers are … and software systems like AI are much better situated to collect large masses of data and again, this is what we’re trying to help facilitate with our mobile app.

Don: We want people to be able to take photos of their faces, of their throats, of their hands, collect recordings of heart sounds, breathing sounds, put all this information in the cloud and have AI systems that are running continuously against this data and able to spot incipient problems before they come outright disease conditions. I think it is where things are going and will if nothing else results in a profound change in the relationship between doctors and patients.

Lee: I think the last part was an understatement. You fundamentally have to begin to have question the role of the doctor… I think that healthcare is splitting into two industries. I had to quickly name it one day and I just said, “Hey, Hyper Wellbeing,” you know because of hyper text and sort of hyper to represent machine, plus the fact of optimization is not just the staying healthy, it’s also that health is actually a continuum and I’m always surprised at the number of people who consider themselves healthy and yet I often know in talking to them that, hey, they don’t have optimal health.

Lee: I know they’ll have a nutrient deficiency, for example, magnesium or they have a small bacterial, a small intestinal bacterial overgrowth, a gut parasite, lacking vitamin D3, something of this nature. You know, it’s not like health is binary to begin with and you actually spoke of homeostasis. Yeah, we lose that capability as we age, but we can … For example, we can intentionally give ourselves a certain amount of homeostatic stress to make our cells more resilient. I mean you have to train it. You know, the whole cold shower thing, et cetera.

doctors are kind of perversely trained to treat data as an enemy… This is exactly opposite to the way most other industries operate.Don Brown

Don: Yeah, that’s a fascinating topic of hormesis.

Lee: Exactly, hormesis, that’s it.

Don: Yeah, that these small stresses … I think we all recognize this intuitively that these small stresses make us stronger. You know, the old adage that what doesn’t kill us makes us stronger, there’s a lot of truth in it. That stressing our bodies, it’s an amazing thing when you think about it … Exercising, fasting is, caloric restriction is one of those hormetic stresses, we’re finding that one of the reasons that a lot of plant chemicals are really good for us, like the phytochemicals in blueberries and other brightly colored fruit, they are minor mitochondrial toxins.

Don: They evolved as poisons for insects to keep insects away and they toxify to a minor degree our mitochondria and so this causes our cells to go, “Oh, wait, something bad might be happening. I sense a minor stress and so I’m going to start to create more antioxidants, more chaperones, more of these molecular mechanisms to prepare for a more serious assault and that process, of just periodically stressing ourselves in a minor way improves our overall health, our overall resistance to disease.

Lee: I appreciate the explanation and if you want to live longer, you’re going to need a little bit of cold shock, heat shock, a little bit of a starvation …

Don: Yeah, all these things and so that’s why it is good to … Exercise works by the same mechanism and eat a diet rich in all sorts of colors of plant foods that are these minor stresses or provide these minor stresses, being out in the cold, in the heat, [crosstalk 00:42:52] …

Lee: Yeah, don’t have a comfortable life is the key to living longer.

Don: Yeah, you can’t just sit in front of the TV and eat bags of chips. That, that isn’t what we’re evolved to do. We’re evolved to move, to think, to have to scrap for our existence. When we get closer to that, We find that we’re happier, we’re healthier, we’re less stressed, and to me it just makes total sense on [crosstalk 00:43:26] …

Lee: Hey, I don’t mean to divert off too much and become Chatty Cathy but let me share something. In my 20s I used to occasionally fast five days at a time and if I told anyone, they would get angry and say, “Oh, you’re damaging your metabolism. You need to rev your metabolism. You’re slowing it down. You could die,” and I didn’t do it because I read about it somewhere.

Lee: What happened was one day I said, “Hey, I won’t eat,” and just see how it is. I just was curious. Okay, I felt better. Okay, do two days, and then I ramped up to five days, incidentally and I do this periodically in my 20s and I was amazed by how alert I was, how good I felt, but then I had to sort of keep it as a dirty secret because I would get so much wrath for doing it, so so much has changed.

Don: Yeah, well, you were certainly ahead of the curve on that one. I wish I had known about it or even suspected that that would be a beneficial thing at that age. I’ve only been practicing intermittent fasting for the last couple of years but I have become a huge believer … I think what set me off, I read a paper by a Valter Longo at USC, who’s one of the leading researchers in intermittent fasting and I started down the Internet rabbit hole, you know, looking at other research and just became increasingly convinced that this was just … It’s a no brainer. It’s a simple thing, you don’t have to … I think doing a periodic multi day fast is a wonderful thing but that’s …

Don: Most people are unable to extend it for that long, but what we’re finding is that you don’t have to go five days to derive benefit. Go 12 hours, 14 hours, 16 hours, maybe a 24 hour fast once in a while and it … There are very specific well defined benefits that come from just putting down the fork for a few hours or maybe a day every once in a while.

Lee: Yeah, the biggest way to prevent disease in the first place is just two things, don’t eat so often, at least have a gap. I mean these gaps don’t even need to be big. I mean 12 hours is – for me just … I think it’s insane. I would find it hard to eat if I go to bed I couldn’t eat 12 hours later ’cause I would still be feeling too full but many people are just eating as long as they’re not sleeping, so don’t eat as often. Give your insulin a chance to drop. You just cannot run about with high insulin all of the time or you are going to die quicker and sicker.

Lee: The second thing is eat food which is real. It sounds kind of absurd. Don’t eat all the time and don’t food-like-products. Don’t eat the things that have barcodes. To me it seems very, very simple to eliminate many of the diseases straight out of the gate just via those two methods.

Don: You’re exactly right. The others that I would add to that, I think fairly obvious, don’t smoke. We know that’s a really bad thing and then move. Do some form of exercise. Our bodies are designed to move. We start to breakdown when we don’t move and it doesn’t mean you have to be an ultra marathon runner or anything, get out and walk. Yeah, those very simple interventions can make an unbelievable difference in our health.

Lee: Yeah, when you say exercise it doesn’t have to be knocking the shit out of yourself.

Don: [crosstalk 00:47:24]

Lee: Walking one hour a day is tremendous for wellbeing, I mean longevity.

Don: It is and if you’re able, I know many people live in urban areas, if you can walk in nature, that’s even better. We’re starting to realize there’s a mindfulness component to just being in a natural environment. Yeah, if you do those simple things you can increase your healthspan. It’s proven. You can decrease the rate at which you age and decrease the probability that you’re going to develop these diseases of aging that we’ve discussed and certainly, push them off by a few years which can make all the difference.

Lee: When it comes to smoking, I’ve been noticing more and more states are legalizing marijuana, so I see less and less people smoking tobacco. Then I see states legalizing marijuana and I’ve not looked at any material on it but I would assume that lungs don’t like any foreign objects in them. Do you how marijuana compares to tobacco?

Don: Yeah, I’ve seen some studies and you’re right, to burn any sort of material and inhale it into your lungs is not good. Your body doesn’t like it in any case. I think it does turn out that tobacco is especially harmful. Some of the tars, the nicotines are especially damaging and worse than marijuana but taking any sort of super heated product into your lungs is not [crosstalk 00:49:17].

Lee: Yeah, I kind of figured, Don. I’d gathered for some reason … I don’t know about this topic but I’d gathered that tobacco was worse but many are smoking the marijuana with tobacco and then it doesn’t have filter and inhale deeper, unless you’re Elon Musk, and hold it longer … or Bill Clinton.

You can decrease the rate at which you age and decrease the probability that you’re going to develop these diseases of aging.Don Brown

Don: That’s not a good idea. I think maybe the only difference is with cigarettes people are smoking so many times during the day, I guess, I don’t know for sure, I’m imagining the people who smoke marijuana aren’t doing it every hour, aren’t keeping a cigarette going so that may be the reason, another reason that it’s not quite-

Lee: When I had said in my 20s I would be fasting five days a week, without even calling it fasting, I just knew I felt better and I just … There was just so many benefits to it, but then as I got into my later 20s, I actually went to a nutritionist and I started paying for private gym memberships, et cetera and that’s when I began getting pushed to eat six times a day and then I was getting pushed towards “healthy” whole grains. Before I knew it, I was vegan and then before I knew it, I was type 2 diabetic [but reversed later with lifestyle intervention].

Don: Yeah, this … Unfortunately, the healthcare industry is still largely ignorant of the benefits of intermittent fasting and there’s this really bad advice people are given to eat grains. There’s this notion that you just be nibbling constantly and that somehow that’s better. I think it appeals to people intuitively that, well, if I’m nibbling all the time, I won’t have these spikes in blood glucose and spikes in insulin, but it turns out to not be … To be the opposite of what most people need to do.

Don: Now it’s different if somebody’s a type 1 diabetic, there are certain conditions where fasting is not indicated. People with eating disorders, so I want to [crosstalk 00:51:38] …

Lee: Don’t worry, we’re not giving medical advice.

Don: Yeah, it’s not for everybody, but I think for the vast preponderance of people it is far more healthy to eat two, three times a day, but especially to try to confine that eating period to around eight to 10 hours.

Lee: Absolutely, I mean eight to 10 hours is quite a lot. I’m a little bit shocked, I mean, I would say, “Of course, please don’t have a eating window greater than eight to 10 hours, please.”

Don: Well, it’s just for most people, that’s a change and if they could just make that change, which I think is relatively easy, I mean the other … The flip side of that means you’re fasting between 14 and 16 hours a day …

Lee: You call it fasting, but, geez, I wouldn’t think of that as fasting. That’s just called keeping your mouth a bit closed for some of the time, I mean …

Don: But it is, you know, it’s not many peop- You can … You know …

Lee: I guess, most people are glucose junkies.

Don: Well, they are. People are addicted to eating constantly and so …

Lee: But, yeah, they’re also not fat-adapted… so I guess, they keep needing the glucose coming in or they get hangry, et cetera.

Don: They do and so for most people, if they can just start there, take that first step of after you eat dinner, just don’t consume any calories until you have breakfast the next morning and then just try to widen that period. I think, I’ve seen some of the researchers … I can’t remember which one … describe it as just eat an early dinner and eat a late breakfast and if you prefer to think of it that way, rather than time-restricted feeding or intermittent fasting, whatever you want to call it.

Don: However you want to think of it, give your body a break from calories for at least 12 to 16 hours that you will see health benefits. You will see over time, your weight normalize and especially, if you’re doing what you’ve described, eat real food, not heavily processed foods, you will improve your health.

Lee: I’m jumping around with the personal snippets, I should get back on track here.

Lee: We’ve been speaking about what you would essentially call evolutionary medicine and then it’s kind of funny because we’re talking about the future of technology in this overlaid sensor network, cloud, BigData, et cetera, in order to guide us to live more in touch with our evolution. In fact, you had touched on our biology in the cloud and for sure, we all will have models of our biology, our unique biology running in the cloud continuously. Occasionally, what will happen is we’ll take some lab tests and that will resync the system, that could be once a year and the rest of the time, it will be running a model of our biology.

Don: Yeah, I think that, the way we see this developing, the cost of whole genome sequencing is dropping rapidly. I think Paul Allen paid a $100 million or so back in the early 2000s to have his genome sequenced. You or I could do that today for a little over a thousand dollars. Within five years that’s going to be a $100 or so. That’s something you just have to do once, right to understand what’s called your germ line genome sequence, what you were born with and then that could be stored in the cloud and that gives an AI running up in the cloud an understanding of what genetic variance each of us was born with.

Don: A great example is the ApoE gene, there are four common variants in the population that just number one through four. If one of us has two copies of one from mom, one from dad of number four, our risk of Alzheimer’s is increased somewhere 50 fold times normal. That’s a critical piece of information in just one example. You know the BRCA genes that contribute to risk for breast and ovarian cancer, and we’re finding more and more of these.

Don: A system can start off knowing what Don or Lee has as a baseline in terms of disease [crosstalk 00:56:46] …

Lee: And not just singular gene. It’s more swinging towards polygenetic.

Don: Well, yeah, I mean, I … The four genome …

Lee: The ApoE4 was just an easier example, is that why you mentioned that one on BRCA?

Don: Yeah, that’s just kind of the pro-typical example.

Lee: [crosstalk 00:57:00]

Don: Yeah, so you know, we have about 20,000 protein coding genes, at least as many or an eight coding genes and so you’re exactly right. We started off looking and understanding monogenetic disorders and now we’re starting to have the data to be able to look across sets of genes but in either case, an AI can have that information about us in the cloud and then as you described that could be combined with …

Lee: It can be combined with wearable data but you can also have models of how our … How biology works in the cloud, like a real model, a real avatar of our system in the clouds and resync parts of it again, against actual blood tests later.

Don: Yeah, I think that’s where things are going, that we are going to be able to model what’s going on in each of us, combining that whole genome sequence information with what’s going on currently, what our lipid levels are, our HDL, LDL, cholesterol, our thyroid levels. You know, all these other molecular levels that we could run periodically.

Lee: Yeah, and I also think more gut testing is going to come into it. I don’t mean just like microbiome, but I mean checking for parasites, checking for large intestinal fungal overgrowth, small intestinal bacterial overgrowth. I think our guts are going to come more into the picture, Ie. tested, quantified. I think you have to start putting the guts into it as part of that whole system.

Don: Well, yeah, at the Duke Precision Medicine Conference, the topic of the microbiome was a huge one this last week and we are realizing that the composition of the gut flora has a big impact on health and is one of those additional pieces of data that we want to have.

Lee: Yeah, I think we’re going to be in a position where we, at home, take our own blood, put the cartridge into our consumer device … There was a company speaking, at an event I put on, Know Your Cor, C-O-R is the company’s name and so what they’re planning is you take your blood at home. The device could sit in the bathroom, the whole family can use it. You take you blood into little vials and you insert into the device. It uploads it to the cloud. I also think … Don’t try and imagine this too much … That we’ll also be doing stool samples, that it will become more normal.

Lee: I mean instead of just doing it when you’re sick in an institution, I also think the … You’re not just going to be sampling blood, you need to keep taking this data as often … not as often as you can but not just when you’re sick.

Don: You’re right and what you describe is that individual personalized approach, taking personal responsibility for your health and I think that absolutely includes collecting your own blood, saliva, stool, whatever it might be and using devices either at home or that you send samples away to but again, not going through a doctor or a hospital as the gate keeper.

Lee: I agree when you say the word responsible, I don’t why I just feel a touch uncomfortable with, I would use the word proactive because the word responsible is kind of … I just kind of feel it has a tone of blame to it and I actually think the present system we have is quite harmful to people and not helping. It’s more the other way about, it’s irresponsible.

Lee: For example, we let people sail into diabetes. I mean orthodox healthcare lets people sail into diabetes as you’re way down the diabetic journey by the time you’re told you’re pre-diabetic and it could have been detected at least a decade beforehand and subverted, remedied.

Don: Yeah, maybe a better word is control, that you’re able to take control of your own health, take your own health destiny into your hands rather than leaving it up to somebody else.

Lee: Yeah, because this leaving it up to somebody else isn’t working, which is why we’ve got sky rocketing disease and obesity.

Don: That’s exactly right.

Lee: When I hear all this Health 2.0 and Digital Health, I just look at the charts of obesity and chronic disease, since these terms have been used for over a decade and I’m like, are people not noticing something here. I mean like surely this isn’t helping, it doesn’t appear to be helping so why are we having all these conferences, et cetera?

Don: Well, I think that people are casting around for ways to use technology, use data, I think we … Everybody in healthcare realizes that BigData is part of the solution but a lot of healthcare providers are loath to give up the control that they’ve had, their status as gate keepers. It’s slowly dawning on more and more people that sort of gate keeper status is going to go away and individuals are going to assert more control over the collection and analysis of information about their bodies and their health.

Lee: I find it crazy that in the United States you just can’t walk in and get your own body data, like walk in and order an insulin test.

Don: Yeah, we have this crazy HIPAA law that was probably well intended to try to provide some data protection and privacy but unfortunately institutions tend to adapt those sorts of provisions to their own ends. I went in a couple of years ago for a doctor’s visit. The nurse measured my blood pressure. I asked her what reading she got and she said, “I can’t tell you,” and I said, “Why?” and she said, “Because of HIPAA.” It’s just an insane sort of system but again, people start to use it as an excuse to not have to deal with patients.

Lee: I also think it’s an excuse to keep people in priesthood positions and also to ensure profit flow.

healthcare providers are loath to give up the control that they’ve had, their status as gate keepers.Don Brown

Don: Absolutely, I think that … and again, I don’t want to denigrate doctors. I went through medical school, there are many, many wonderful caring physicians out there but it has been treated as kind of a priesthood, as you say, and so I think it’s hard for a lot of people in the healthcare establishment to get out of that mindset.

Lee: Don, jumping slightly here, just had made a note about optimization, have you heard of Triage Theory at all from Bruce Ames?

Don: No, please.

Lee: You’ve heard of orthomolecular medicine right?

Don: Ah-huh. (affirmative)

Lee: When it comes to nutrition, we’ve traditionally only linked it to death and disease. You know, if you don’t have this, you’ll have scurvy or rickets, et cetera or you’re missing a certain nutrient, you’ll die within weeks or months. But his Triage Theory, which he has been proving, beginning with zinc is that nature will trade the long term for the short term. If you are “deficient,” I mean RDAs [Recommended Dietary Allowances] and RDIs [Reference Daily Intake] count for nothing, these are super low levels, so even if you’re getting what will prevent disease more immediately or death, you can still can be low and what nature is it doesn’t invoke processes that would increase longevity.

Lee: If you have lower levels of zinc, you don’t kick off certain processes that would let you live longer, ’cause it’s being channeled into the current, into the here and now to help you procreate. You know, procreation is key. The Triage Theory is saying, “Hey, we actually need a lot more nutrition than we currently aim for.” ‘Cause we just aim for that immediate disease prevention today or early death, not for longevity. I’ll actually put it in the show notes.

Don: Yeah, I’m not familiar with the theory applied in that way but it’s interesting. It’s consistent with something at the cellular level that’s … or the organismal level, I guess that is referred to as antagonistic pleiotropy and it’s a mouthful that just means that there are … We’ve evolved with certain genes and genetic approaches to do exactly what you described, to maximize our chance of reproducing, of passing on our DNA to … Our chromosomes to the next generation and that biology will … if it has to make a trade off between longevity and our ability to reproduce, it’s going to favor the latter.

Don: There’s no evolutionary pressure to try to make us live longer and healthier lives, and that really ties back to …

Lee: No, nature only really cares that you procreate, then you can go.

Don: That, yeah, that … you know and stick around long enough to help get those kids up to the point of being able to procreate themselves.

Lee: It’s not waiting for them to go to university.

Don: No, it’s not, sadly, that’s exactly right.

Lee: We have to look after ourselves.

Lee: I look here and I see that LifeOmic released a fasting app which you had mentioned and the company, your company put out a press release on May the 4th. That read, let me read it here, “LifeOmic released the first of its life apps to help individual to track and improve metabolic health. The app supports any type of fasting schedule, including time-restricted feeding, circadian rhythm fasting, alternative day fasting, and others. Users can securely share information to contribute to medical research and receive more personalized care from their physicians.”

Lee: I have a few questions here. It doesn’t measure metabolic health, right?

Don: Well, the current fasting app is really focused just on fasting.

Lee: Yeah, so it says, “improve metabolic health,” but you don’t know it improves metabolic health. We know fasting does, but the app doesn’t quantify that at the moment.

Don: Yeah, I mean, that’s the point. We know that regular intermittent fasting will improve your metabolic health.

Lee: Do you think you’ll ever start sending direct-to-consumer blood spot so they can prick their finger, take their blood, send it back and post and you can start attaching some quantification to them?

Don: Yeah, with our LifeExtend app, we are integrating with a whole bunch of companies that provide that individualized testing so that, maybe that you want to do a whole genome sequencing or test your gut microbiome, so from the app you will be able to order those test kits and then they will deliver their information back into our platforms so that it’s all accessible from within the app.

Lee: You’re going to build like a dashboard, which you can order DNA test kits or microbiome test kits.

Don: Exactly, yes.

Lee: What about like oxidative stress, for example, or mitochondrial function, have you thought about including them somehow in the app, because that’s where my mind has been of late?

Don: Well, what we’ve tried to do is build a platform so that we can offer integration with any sort of testing that we think would be useful, so absolutely. For some people, it’s going to be a simple matter of taking a blood sample and testing for thyroid levels or vitamin levels but I think inevitably that’s going to cover a wide range of health factors, of health quantities.

Lee: Yeah, I’ve started looking at quantifying mitochondrial health, and also oxidative stress and I see it as very useful to combine with apps and lifestyle guidance. The cheapest, easiest thing to do today is glucose ketone index.

Don: Yeah.

Lee: You obtain someone’s glucose, you obtain their ketone, you know you can get the meter, it’s quite cheap.

Don: Yup.

Lee: That do both and then, you know, you can compute the glucose keytone index, you know keep it below two, you’re going to live … You’re much more likely to live a longer, healthier life by keeping a good GKI, glucose ketone index.

Don: Yeah, yeah, I do the same thing. I’ve got a little meter in my drawer and it’s very easy to just take a prick, a pin prick and a drop of blood and measure glucose and ketones, I love doing that after different intervals of fasting to watch how my … To see how my ketone levels are changing. With our app, you can enter that information within the app, we’ll store it and graph it and use it with our AI engine as part of, one of the elements of data.

Lee: But will a consumer be able to see those graphs?

Don: Yes.

Lee: You’re saying an app which is coming …

Don: Yes.

Lee: So LifeOmic of … Oh, okay, good, so LifeOmic … Because here’s the thing, I suspected that a LifeOmic were between two worlds [orthodox healthcare and hyper wellbeing] which is why I got in contact and so you’ve clarified, you are between two worlds. As you step into the other world, you’ve produced this intermittent fasting app and then you’re going to release this app you’re calling Extend?

Don: Yes.

Lee: And you’ve created a Twitter account, I see, for each of them and the LifeExtend app has a profile. Let me read it, “LifeExtend app guides you in living longer and healthier with the power of Precision Medicine.” I like living longer and healthier, I’m a bit confused by Precision Medicine there, ’cause you know, I think that’s something you get after sick, so this app, when is it going to be available and just to clarify, it’s focused on healthspan and lifespan and how does it achieve greater healthspan and lifespan?

Don: Well, we … Okay, we try to use gamification, so we try to simplify, boil it down to what we call five pillars. When you open up the app, you see these little bar charts that allow you to quantify: first, the number of servings of fruits and vegetables you’ve had that day; second, the number of minutes of exercise; third, the number of hours of sleep; fourth, the number of minutes of mindfulness or meditation you’ve done; and fifth, the number of hours of fasting that you’ve engaged in that day.

Don: We use those to calculate a little score that we refer to as Life Points and so it becomes a game to try to maximize your score and then share that with social circles that you create, that might be friends, family, and colleagues.

Lee: It’s kind of funny you mention this because last year, I was helping a client come up with a similar concept and they were going to do an ICO in exactly the same domain, because such gamification fits a tokenized crypto system quite well, because the points are tokenized.

Don: Right, right, yeah, we don’t … We were not going down the road of creating any sort of crypto currency or anything, at least not yet.

Lee: You’re not [crosstalk 01:13:51]. Hey, can I ask you? When it comes to mindfulness, how are you quantifying that? Because I start thinking with like the MUSE headset.

Don: Ah, there are so many different approaches to mindfulness. We’re just … The first step is just to allow users to quantify if however they like so from the app, just tell us. What you count as mindfulness, whether it’s prayer, meditation, yoga, whatever it is, you tell us how many minutes of meditation you got and then we’re working with different mindfulness researchers to actually build mindfulness capabilities into the app. If you want to use ours, you can, if you’ve got some other …

Lee: Does it … so you don’t need extra hardware, somehow … How does it measure mindfulness with no extra hardware?

Don: We’re not trying to measure. We’re letting the user tell us …

Lee: Oh, so it’s a … Okay. I understand.

Don: Yeah.

Lee: You’ve got these five pillars which is fruits and vegetables, exercise, mindfulness, sleep, and fasting.

Don: Yeah.

Lee: You measure each of these and you come up with this Life Points figure.

Don: Yes.

Lee: Okay, now you saw on Twitter, I don’t know where it came from … but I saw a screen shot of an app, I guess it’s coming from the forthcoming Extend app that you’ve been speaking of and it has biological age and … Well, I was going to say, chronological age, ’cause I think it should be but it says, lifespan age. This LifeExtend app is going to show biological age as well chronological age?

Don: Biological age and then estimated lifespan. Those are …

Lee: Oh, I got confused, okay.

Don: Yeah.

Lee: Estimated lifespan so we’re talking the number of years you have left.

Don: Exactly, yeah.

Lee: Hey, this is kind of freaky, because when I put on an event in 2016, I described it to someone, “Hey, look, machines are going to know the day and time of your death,” and I just got a blank scared kind of look but it became obvious to me the last 14 months that I’ve been looking at biological age, yes, machines will fairly accurately be able to predict your date and time of death, and not only that, but there’ll be life GPS, as I called it. It’s like, “Hey, look, if you eat that, well, you’ve probably lost 30 life seconds. Hey, if you go out with that person, because of the stress level they tend to bring you, you’re probably overall going to lose two months of your life if you keep mixing with that individual.”

Lee: Machines do become our overlords and the things is machines are going to understand our lives and human beings better than we understand ourselves. We’re actually not so smart in our decision making and our foresight. We’re actually very poor, so we have these machines that … so called … What I can intimate data, but health data, wellness data, and lifestyle data, they crunch in the cloud and, you know, the machines work out the patterns of human being health and human being decision making, and hey, they know the date of your death. They know when you’re likely to marry, et cetera.

Don: Yeah, I’m not sure about the date and time of your death, but the overall idea that machines can take this data about us and make pretty accurate predictions, I think is spot on.

Lee: I think it’s only a question of time, maybe. I don’t even want to say maybe, I’m too certain because I’m that certain that I’m certain. Let me ask … I know you need to go soon, so let me just ask you a couple of more questions, if I may.

Don: Sure.

Lee: How are you calculating biological age?

Don: There’s some fairly simple algorithms, what it comes down to is the more we know about you, the more accurately we can make that calculation. We can get a rough idea of your biological age just by knowing a few simple things. First of all, what’s your chronological age, how much do you weigh? How tall are you? What sort of dietary patterns do you have? Some … With five or 10 questions, we can come up with a pretty good estimate of your biological age, but then what we also do, there are companies like myDNAge that will take a blood sample and run the Horvath methylation test and give you a much more quantified estimate.

Don: We will allow you, make it easy within the app to order a kit as we’ve described earlier, we get back the information from them regarding your biological age so that we can show that. There are a number of ways that we can show with different degrees of accuracy what our calculation is.

Lee: I was Googling that. Did you say My DNA Age?

Don: Ah, it’s myDNAge.

Lee: Ah, okay. Because when I looked into quantifying it and there’s a lot coming to the market and more and more of its going to AI, depends how much money you’re willing to spend. For example, if you can spend say, $400, you can have LifeLength.com look at your telomeres and they look at the average number of short telomeres which is very good, which is more advanced and they like Teloyears.com. Do you know the or can you … I don’t know, is it public how much this company charges to look at the methylation method?

Don: Yeah, it’s public. It’s on their website. My rough recollection was about $300 bucks.

Lee: Oh, so it’s a sort of LifeLength type figure. Because the best is if you take the blood chemistry and you take the DNA and you take the telomeres and a few other calculations, it’s that combination gives better accuracy, but the good thing is, you can then recommend lifestyle changes, an app, give people time to make them and then retest. Then you can measure if their age is accelerating or decelerating.

Don: Yeah, you know, the question we got even from one of our own developers when we started talking about intermittent fasting internally was, “Okay, if I start intermittent fasting, prove to me, show me that it’s making a difference. How do I know?” and so it’s exciting to think that with a blood sample that we can send off to somebody, one of these companies once a year or so, we can actually see that the lifestyle changes that we’re making are making a difference, are … that we can quantify their effect on our biological ages.

Lee: I think that’s key, ’cause you might do certain things that you think is good for your health, like, for example, consume a lot of protein powder and you might find that’s not the best for IGF-1 and longevity or you may be a little extreme in weight lifting and you’re eating continuously but you still see that as fitness. Yet, it’s anti-longevity and you might be recommended certain diets and I don’t think anybody should really go in the belief of other people. You need to quantify it. You need to see if it’s working and the ultimate way of seeing if these lifestyle changes is working is to measure your biological rate of aging.

Don: I think we all want that. We want some confirmation … People are really poor at responding to kind of vague, long term promises. You can tell people, that, “Look, doing this will make you live longer, you’ll not develop diseases,” but it’s just less tangible, unless we can see some quantification. I think there is a huge psychological value in getting that sort of affirmation.

Lee: Looking at those five pillars, I’m not so sure that fruits are as good for you as government advice has made them out to be. You know that whole idea of five portions, once a day, I don’t think was actually … I don’t think there was any actual science behind the number five and I don’t think that fruits and vegetables are equal. I think a lot of fruits are more sugary and are not as nutrient dense as we are led to believe, plus, I notice, people don’t even seem to know what’s in season and I … Somehow that concerns me.

Don: You know, I think there’s a trade off in trying … In coming up with something easy for people to understand. If we try to give people some complex chart with a rating system for every variant of fruit and vegetable, nobody will use it, but I think there’s ample, and not from the government, ample scientific evidence that if you maximize your intake of fruits and vegetables, you will improve your health. That’s more important … Consuming that sort of varied plant based diet is more important than trying to eliminate other things.

Lee: Oh, it definitely is a first step. I mean, if it’s a question of a real piece of food, I.e. fruit or a boxed food-like-product, certainly, it’s the former.

Don: That’s exactly right and so that’s … We’re just trying to simplify this so that it becomes something very easy for people to measure and understand and so to count the number of servings of fruit and vegetable you get every day and I totally agree, not all fruits are created equal, not all vegetables are created equal but it’s just a very easy sort of thing for people to comprehend and I think there’s ample evidence out there that getting a good number of servings of fruits and vegetables every day will improve your health.

Lee: I notice we’re coming up for the hour and a half so I’ll try and wrap this up for you. I really appreciate your time. Let me ask you just two simple things. First of all, what devices do you use to improve your health, your longevity, your wellness, if any? I assume you do use one or more and finally, what supplements do you take, if any?

Don: Sure, well, I have a FitBit, so cracked FitBit on my wrist that I use, obviously to measure, mainly, my heart rate. I do … Of course, my activity level, I try to get at least 10,000 steps a day and then periodically to measure my sleep, but that’s my favorite fitness device.

Lee: Which … Did you say which model of FitBit you’ve got?

Don: The Charge 2, that has a heart rate monitor.

Lee: Quick question from the side.

Don: Yeah.

Lee: You’re developing for the Apple Watch, are you not?

Don: Yeah, well, not specifically for the Apple Watch. We’re, with our new app, we’re interfacing both to Apple HealthKit which is kind of an API that does include the Apple Watch, as well as, Google Fit.

Lee: Okay, and is that going to be with LifeExtend on the watch? Because I believe you’re making the fasting app for the watch, I mean the fasting app is out today, the Extend app is not at all and I asked earlier but forgot to follow up, when does the Extend app come out and which platforms does it come out on first?

Don: It’ll be out before the end of this year and it’ll come out simultaneously for iOS and Android.

Lee: And the watch?

Don: We haven’t started making an Apple Watch version yet, that’s …

Lee: But you have done the fasting app or am I mistaken?

Don: No, no, no, we haven’t.

Lee: Okay, I just wondered so I derailed you there.

Don: No, it’s okay.

Lee: You were going to tell me the supplements which are going to make us all live long and healthy life, but going back to the hormesis earlier …

Don: Yeah.

Lee: You know, it’s made me be more careful of taking too many antioxidants.

Don: Yeah, that’s exactly right. There’s a good evidence that taking antioxidants will blunt that hormetic effect, so I don’t. I don’t take a whole lot. If I’m not getting sunshine, I’ll take vitamin D.

Lee: What kind of dosage and IU?

Don: I don’t even remember. I think it’s a couple of thousand IU but I much prefer …

Lee: You take it daily then? A synthetic one in the winter?

Don: Unless I can get sunshine. I try to get sunshine even in the winter so that’s far preferable, but then the other things I take … The main thing I take is and NAD precursor supplement. There’s NMN and NR so I’m convinced that that’s a good one. I take one from a company called Elysium Health.

Lee: Yeah, and I was looking at them also and then their NAD supplement I’ve been considering.

Don: Yeah, I think there’s really good science, it comes out of the research by Leonard Guarente at MIT. Our NAD levels drop as we age and NAD is a critical co-factor for the sirtuin enzymes that we mentioned in passing and so Elysium makes one that provides that provides nicotinamide riboside which is a precursor, gets turned into NAD in the body. Right, that’s the main thing I take consistently. I take fish oil sometimes and sometimes I still take resveratrol.

Lee: Do you take CoQ10?

Don: Yes, I do, periodically. I try not to take very much every day but I take CoQ10 periodically.

Lee: What about magnesium?

Don: Yes, I take magnesium supplements, oh, three or four times a week.

Lee: Anything else I’m missing out on?

Don: I take fish oil periodically.

Lee: Where do you source your fish oil, if I may ask?

Don: Zone Labs.

Lee: Okay, because fish oil was something I looked out for a couple of years and I just didn’t take any ’cause I assumed, it seemed to me it might cause inflammation because most fish oil is very badly produced. It’s rancid, et cetera, so eventually, I found two brands I was willing to go with and one in particular.

Don: Yes, I think you’re right that it’s very important to go with a quality brand. Then I periodically I take resveratrol supplement.

Lee: Do you know what kind of dosage you take of that, because it’s also on my list but I was never quite sure what dose to take?

Don: I take the supplement from a company called Longevinex and I don’t recall the exact dosage.

Lee: I’ll get off and put in a shot. What about K2?

Don: Ah, no.

Lee: Okay, I definitely … It’s definitely top of my list. My top of the list is D3, K2, and magnesium and anyhow, I should let you get going soon. I really like where you’re going with these apps and I love the way you’ve got a foot in … I don’t want to call it orthodox healthcare but you definitely have a foot in there with the whole Precision Medicine but you’re kind of seeing the big picture so you’re calling it Precision Health.

Lee: These consumer facing apps, and you’ve already got one out, aiming in a good area, the fasting. I love the way you’re stepping into this new world and this biological age measurement and app is absolutely fantastic and I’m aware a few companies who are also coming out with apps with biological age integrated. I think the next few years is going to be terribly exciting and I can’t wait to try your apps out.

Lee: I must say, though, that on my iPhone, for some reason, it’s set to the UK Store and I tried to download the fasting app but it says US Store only.

Don: In Europe, you have the GDPR privacy standard has kind of inhibited us a little bit. Our new app will be available, we’ll have GDPR support and so we’ll be available throughout Europe.

Lee: Okay, it’s either that or it takes me like 30 minutes to hack the app store via those methods to make it say US.

Lee: Hey, Don, I highly appreciate your time. I’m really glad I got in touch. I’ve enjoyed chatting with you and getting in sync and I really appreciate having you as guest number five on the Hyper Wellbeing podcast.

Don: It was an honor to be asked and I enjoyed it, too, Lee. Thanks.

Lee: Adios. Appreciate it.

Don: Bye-bye.