Alex Honnell (3:09)

Ladies and gentlemen, welcome to another exciting.

Mick Hunt (3:11)

Episode of Mick Unplugged. And today I have someone who I've.

Alex Honnell (3:15)

Been wanting to talk to for a long time.

Mick Hunt (3:17)

Somebody that has really shaped a lot of thoughts that I have around AI and discipline and health and strategies. He is none other than the amazing, the brilliant, the guy that's going to change your life today, Dr. Eric Topple. Dr. Eric, how are you doing today, sir?

Dr. Eric Topol (3:34)

Well, thank you. That's an awfully kind introduction. Very much appreciated.

Mick Hunt (3:38)

I mean, I mean every word of it. You are definitely doing some game changing things out there. I love to talk to my guests about their. Because that thing that's deeper than your why, right? That passion that drives you and you've.

Alex Honnell (3:52)

Done so much in your illustrious career. What's your because today?

Mick Hunt (3:56)

Why do you keep doing the things that you do?

Dr. Eric Topol (3:58)

I just think we can do so much better to prevent the major diseases, not just the area that I've been in for my career, cardiovascular, but also neurodegenerative, preventing Alzheimer's and also preventing cancer. We are not taking advantage of all the golden opportunities, the knowledge, the advances, the innovation, and we should be doing it. It's frustrating, but we will eventually. We'll get there.

Mick Hunt (4:23)

Yeah, yeah. I love it. And again, you're doing so much, you have done so much and you continue to do groundbreaking things in your industry. When did you know that that was going to become a passion of yours to make change and to make impact?

Dr. Eric Topol (4:37)

Well, I guess when I was training, I was at UC San Francisco and I was in the middle of really a revolution in cardiology where the beginning of angioplasty and clot dissolving therapies and all sorts of things were happening very quickly. And that gave me a sense that, well, that's not a one off. You know, why don't we do this more often? Why don't we, why don't we start to really take medicine to levels that are not the status quo, which is typical. It's a slow moving field and we need to get on the accelerator and there's too many people that are suffering, that are dying or have whatever disability and that could be as cleaning up the problems of medical errors or it could be coming up with new strategies to prevent diseases and we're just not doing that. Everything we do Essentially in medicine, you know, treat, treat, treat, where is the prevent, prevent, prevent. And so we now are empowered to go that route. And it's a lot like what I experienced in the early 80s which is, you know, when, when a field within medicine went through a radical change. We need to do that more frequently than every decade or two.

Mick Hunt (5:52)

You know, again all the things that you're doing, you have a new book coming out you the super agers and and what I love about this book and the things that you're talking about, it's evidence based, right? Like you're not just giving hyperbole, you're not giving theory, you're not doing the what ifs, you're not trying to scare people, you're talking about evidence based topics and help. Could you for the viewers and listeners talk about superagers, where the idea come from and where do you want people to get out of this?

Dr. Eric Topol (6:24)

Yeah, I think many people in your audience are like me where they have a terrible family history. When I was growing up, I think I remember the most is going to all these funerals of my relatives and my aunts and my uncles, my grandparents dying all at young ages. And I figured well I'm condemned to the same fate. So I've always been interested in genetics and you know, health span lifespan. And we did a study we called the welderly and the elderly. Basically another name for them are super agers. We, we were able to find 1400 people who were average age 89 who'd never been sick in their lives and they were on no medications. Now that's a rarefied group. And we did whole genome sequencing on these people and we found very little from their DNA sequence to account for their welderly superager status. Now there's a small genetic component but it's far less than we ever had assumed. And so that actually felt that's liberating. I might not have to, you know, succumb like my road is and I think it's an eye opening finding. And then the question is what does account for healthy aging? And we do know, as you mentioned, the evidence, the body of evidence of course supports the healthy lifestyles. You don't have to go to longevity clinics or take these anti aging supplements that have no data or other very expensive things like you know, plasmapheresis, unproven stem cells, all kinds of, you know, supplement stuff. Actually first, first off is concentrating on healthy anti inflammatory diet and lots of physical activity, not just aerobic but also strength resistance training and sleep quality really important. But the list goes on about being out in nature, having a purpose.

Alex Honnell (8:22)

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Dr. Eric Topol (11:07)

You know, having lots of social engagement. So we've learned a lot about lifestyle factors. It's not all about that. The other thing we learned that I reviewed in superagers is the immune system is really big. We need to keep our immune system healthy because as we old, this term immunosenescence is, is prone to promote inflammation. Another term, inflammaging, which is what sets off these age related diseases to occur. So we have to get on top of that and not let our immune system lose its integrity as we age. Some people, the superagers, they're just naturally got a great immune system, but most of us, we have not the ideal progression as time goes on where our immune system loses some of its protective capabilities or it gets dysregulated. We got to prevent that if we're going to get our health span extended to the max.

Mick Hunt (12:01)

Yeah. So speaking of that, with the immune system, for those that are watching or listening, what are one or two things that we can do to improve our immune system or help out our immune system so that we can become one of those superagers?

Dr. Eric Topol (12:15)

Well, one great example, I mean, you're young, but if you're over 50, you better get a shingles vaccine. It's actually pretty incredible. Now as of this week, there'll be four studies, natural experiments, large countries, us, Canada, Wales, Australia, you know, collectively millions of people. And the people who got the shingles vaccine had 20% or more reduction of dementia. Most of course is Alzheimer's, about 80%. And then today is a report about how shingles vaccine so slows the aging process in people. Now these are not related to that. It's having a big effect through the herpes zoster, which is what causes shingles. But what we've now seen is that the immune system is really amped up, it's made healthier and that's what accounts for this slowing aging and less risk of developing Alzheimer's disease. So we got one thing right now, which, if this was a drug, people would be taking this left and right. And you know, Alzheimer's is probably the most feared, dreaded disease of all people. So we have something and we're going to build on that, you know, medications, other vaccines, maybe there will ultimately be a vaccine just to prevent neurodegenerative disease. But that's a big jump in our knowledge base and it's really exciting and it goes beyond, of course, lifestyle fact.

Mick Hunt (13:45)

That's awesome. You know, one of the things that I've been passionate about as our society continues to evolve is artificial intelligence. So AI. I personally believe that in the health space, in the longevity space, AI is actually more powerful than it is in any other spaces because people forget the intelligence part of AI. Right. Like a lot of times when we're thinking AI, we're thinking of bot or we're thinking of automation, but that's not really AI. Those technologies have existed for years and years and years and years and actually decades and decades. But in the health space, AI is making huge impacts. How, how are you viewing AI for the good, for the bad or for the indifferent?

Dr. Eric Topol (14:28)

Yeah, well there's kind of three big parts to that story which you know, I agree with you. Firstly, there's the ability to improve accuracy of diagnosis. We've already seen that proven for images like mammograms and colonoscopy, picking up polyps and many other forms of imaging of scans. So that's one that is very clear cut that the AI sees things that human experts can't see, won't see, ever see. So that's one. The second is the ability to give the gift of time back to clinicians because they're very much burdened with data clerks functions and they're not even looking at patients, they're typing on a keyboard. And now we're seeing how natural language processing and all the other downstream functions of an automated synthetic note. So there's total attention being paid one to one I, I, I, and there's a presence back. But moreover we're seeing randomized studies show that it provides the gift of time, it's a big morale booster. So we're getting back that patient doctor relationship gradually and that's going to be big. But the one I think is the biggest contribution in the future is using AI to prevent diseases. That is taking all the data of a person, many, many layers of data and using that to know who's at high risk and getting all over that person so they never get a important age related disease. This, these are the three big areas. Now it doesn't mean that AI is perfect. There's liabilities of course, but I'm very sanguine about all three of these being a big deal.

Mick Hunt (16:09)

Yeah, you often emphasize the importance of, of not just lifespan, but you talk about the health span. Break that down for us. For those that are listening or watching.

Dr. Eric Topol (16:19)

Well, the average American healthspan ends at age 64 because they have a major chronic disease, mostly age related diseases, cardiovascular a cancer, beginning of a neurodegenerative disease, the lifespan as you know, in the US averages about 79, a couple years more for women than men. So that's a 15 year age gap between the end of a person's average health span to the end of their Life. Now that 15 years shouldn't be, it should be that their health span and lifespan are close. That big loss of nearly 15 years, that's what we have to start to. You know, people want to have longevity and live to 120. That's not worth anything if you're basically demented and frail. I mean, we can do that today. We could put you on a life support system and keep your life forever. But you're a functional. What, what good is that? So we have to get this maximal extension of health span and start and stop this terrible gap that exists today between healthspan and lifespan. And this longevity craze is wrong. We shouldn't be going after longevity. We should have a health span interest. That's the primary objective.

Mick Hunt (17:37)

How do we, how do we achieve this? Right, like how do we. I mean, I know you're doing your part in articulating this message, but, but how do we really just let people understand that this is a thing and steps that they can take in order to improve their health span?

Dr. Eric Topol (17:53)

Yeah. So first of all, we could accept that we're going to age. You know, that's kind of a normal process.

Mick Hunt (17:58)

Yeah.

Dr. Eric Topol (17:59)

Instead of trying to block aging and you know, reverse aging, you know, we're going to age, but let's not accept the age related diseases. So in the weeks ahead, we're starting the first prevention of Alzheimer's trial by taking all the data in high risk people and that randomizing to very intensive, continuous lifestyle improvement versus just providing some educational materials. And then in 1200, people who are at high risk for Alzheimer's will be able to tell whether we're making headway. And then we'll start with different medications that have a lot of promise on top of lifestyle. So we believe Alzheimer's ultimately will be a preventable disease, as will be most common cancers and heart disease. But it's going to take a while. You have to have the proof of concept. You have to, you have compelling evidence, but we have to get started on this. And you couldn't do this without multimodal AI because you got to take the data from all these different layers and that includes genes and proteins and biomarkers. It's not very expensive, but it relies on great analytics. And I think that's what's the, that's why I'm so excited about the new era of prevention.

Alex Honnell (19:12)

So in your estimate in the.

Mick Hunt (19:14)

This is about to be a bad question. I shouldn't even ask it the way that I'm getting at.

Alex Honnell (19:17)

But so I went to the doctor.

Mick Hunt (19:19)

For regular checkup a few weeks ago and I was asking him and the team about using AI to help with diagnosis or with symptom prevention and all this. And he said, that's not something I'm, I'm comfortable with and I don't want to experiment with that. Like, why is that mindset still there and how do we change that mindset?

Dr. Eric Topol (19:41)

Yeah, it's very hard to change anything in medicine, as I've learned over four decades. Unfortunately, it's lots of resistance among physicians to incorporate AI, especially when it's proven. I mean, there's many things that we're still waiting for, you know, the, that kind of compelling evidence. But it's sad because there are things that should definitely be part of daily routine medical practice and care. There's just a gap that time and it's just really unfortunate because it's not delivering state of the art care for patients. Oh, wow, the AI is going to take over my role. Doctors are typically control freaks. They want to control everything and hear AIs coming in and encroaching their control factor. I mean, there's lots of things here that account for this reluctance to accept or embrace AI.

Alex Honnell (20:33)

So here's something you don't know.

Mick Hunt (20:34)

And I waited till we were live together to tell you this. Ground Truths. You, your newsletter.

Alex Honnell (20:39)

My mom, who will unsubscribe to any.

Mick Hunt (20:43)

And everything in the world.

Dr. Eric Topol (20:44)

Right.

Alex Honnell (20:44)

The one thing that she subscribes to.

Mick Hunt (20:46)

That she can't wait for, the latest and greatest is Ground Truths. I love to give you the floor to talk to us about Ground Truths, your newsletter. I'm going to make sure we have links to that and obviously links to the book as well too.

Alex Honnell (20:59)

But I'd love to talk about that.

Mick Hunt (21:00)

Newsletter because my mom loves it.

Dr. Eric Topol (21:02)

Oh, well, that's, that's fantastic. Thanks so much for passing that along. Well, four years ago, I started reluctantly to do this newsletter, which is now kind of newsletter and podcast, kind of alternating weekly or if not more frequent. And what I learned was so much better than using Twitter or these other social media because you can really express yourself. It's not like, you know, 240 characters. And I started to realize that this was helping people, you know, get the latest medical advances or talk, hear from the, you know, the leading figures in the world of biomedicine and it's been fun for me. I really, I love doing it. I have one another one I'm going to work on this week is the big jump in new shingles vaccine. This happening just this week. But, but you know, I really want to have people aware most of the time it's stuff that's not covered in the media and there's big things happening and a lot of people these days are, are not very optimistic for various reasons. But I try to show, hey, you know what, we're making great progress and we're going to get to the point of preventing these dreaded diseases and you know, a whole different practice of medicines, you know, whether that's changing, how we screen for cancer, how we prevent cancer, all the things that we can do to get on top of preventing heart disease. I mean, there's something every day I have to pick the things that each week that deserve spotlighting. But it's fun. It takes some time to do it. But it's so great to get the feedback from your mother.

Mick Hunt (22:46)

No, again, my mom will unsubscribe to anything, but she loves the fact that what you send out is informative.

Alex Honnell (22:54)

And this is me and me only.

Mick Hunt (22:55)

I'll say it because it's the truth. A lot of folks that have newsletters, they're trying to show you how smart they are or getting you to click into something else where you're there, like.

Alex Honnell (23:05)

She feels like you were genuinely in.

Mick Hunt (23:07)

Your heart is to help people and to give them information that can help them. And so that's kudos to you.

Dr. Eric Topol (23:13)

Well, thanks. No, I really appreciate it. It means a lot to me because, you know, I don't have any. There's no sponsors, there's no ads. You know, it's free. It's something that is. The main purpose is to spread, you know, the word spread. What's really important going on in medicine that a lot of people might not know about. Like, for example, the breakthrough test about Alzheimer's disease that still today, you know, I go into a. Giving a. A talk and there's several hundred people. I say, anybody hear of the P Tau 217 test? Like, one person raises their hand, you know, but you know, I've written at least two newsletters about. I say, anybody heard of organ clocks? You know, two people raise their hand, you know, it's just so much stuff going on that's exciting and people don't know about it and it's not covered elsewhere. So that's what I try to do.

Mick Hunt (24:04)

Awesome stuff.

Alex Honnell (24:05)

So what else do you have going on?

Mick Hunt (24:07)

What else are you, what else are you excited about? Any projects? I know the book and like I said, we'll have links to the book. But what else is Dr. Eric working on?

Dr. Eric Topol (24:16)

Well, there are doing that, starting up that trial, Alzheimer's prevention. We just enrolled a thousand people with long Covid to try to prevent or treat long Covid, which is not. There is no treatment validated. And we're testing a glp one drug bound, four people versus placebo. So this is a direct to participant trial. All of our clinical trials are direct to participant. We don't involve any medical centers. You know, we just go right to the people. And that's what we shouldn't be doing. And we shouldn't be doing trials like the old way. They cost too much and they're very inconvenient and very slow and extremely costly. And we can cut 90% of the cost just by going direct to participant. So that's something we do. But you know, basically the AI analytics that is our main thrust is being able to take many layers of data, including sensors, variable sensors, and bring that together to extract the most meaning so that we live in a new era. Now everybody's talking about the information era for decade. Well, we're in a hyper information era. We're in a tsunami of information, but no one really is analyzing it very well. So that's one of the things that we really work on.

Mick Hunt (25:33)

That's awesome. That's awesome. So Dr. Eric, where can people find and follow you and keep up with the latest greatest of you?

Dr. Eric Topol (25:40)

Well, thanks. I mean substack, ground truth. I named it. Ground truth has a double meaning. One is it's a big term in AI, how you tell whether the AI is performing versus the truth, the ground truth. But it's also, I'm on the ground that I'm trying to tell the truth. You know, I'm trying to get out there things that people should know about. So that's one thing and you know, that's easy to find. Ground truth. Superages book is the fourth book I've written about the future of medicine. And when I'm really, you know, as I mentioned, very keen about preventing diseases and otherwise, you know, we're publishing quite a bit in the, in the main, you know, journals and you know, that's, that's kind of what we believe. You gotta have the evidence, gotta have peer review. Don't give me these influencers that are hawking supplements and other crap. You know what if you're Hawking something, then that means you're not credible. You know, you're never gonna find me selling a supplement or anything. So, you know, that's, I think, something really important. And I wish we had, you know, a lot less of that stuff because it's got people very confused out there. They don't know who to believe. Being a trusted source, that's something you, you know, you have to work hard at getting that trust and maintaining it. So that's what I try to do.

Mick Hunt (26:57)

And you do an amazing job. Again, I'm honored to, to have you on. I'm a huge supporter and follower of all the things that you do. Just, just truly blessed to, to have you here and the wisdom that you have, man. So I, I, I could talk to you forever, but I don't want to do that. But what I'm going to do is this. I want to think of the right way to do it, but I want to provide 20 copies of your book to someone. So I will make sure I purchase them. But the first 20 people that message me, whether it's LinkedIn, Instagram, my phone, whatever, the first people that message me, super agers. I'm going to send a copy of this book. How about that?

Dr. Eric Topol (27:33)

Oh, my gosh. Well, thank you.

Mick Hunt (27:35)

Yes.

Dr. Eric Topol (27:35)

And thank your mother for me because that, that's really wonderful to hear that she's, he's a reader and avid reader and Yeah, I mean, that's what it's all about is connecting with people and trying to share worthwhile information and perspective.

Mick Hunt (27:52)

You got it. Again, I'm honored to have you here. For everybody that's watching or listening, make sure you go to the show, notes in the descriptions. I'm going to have links to everything that Dr. Eric has going on. Trust me, you definitely want to subscribe to the newsletter. If you're not on Substack, go on Substack right now. Just for him, forget anyone else because he's an amazing resource writer and information share as well too.

Alex Honnell (28:15)

And for all the viewers and listeners.

Mick Hunt (28:16)

Remember your because is your superpower. Go unleash it.

Rudy Rush (28:21)

That's another powerful conversation on Mick Unplugged. If this episode moved you, and I'm sure it did, follow the show wherever you listen. Share it with someone who needs that spark and leave a review so more people can find there, because I'm Rudy Rush, and until next time, stay driven, stay focused, focused, and stay unplugged.