Peter Attia (3:04)

Thank you, polly.

Audience Member / Moderator (3:06)

Thank you. Dr. Seclair, I have a quick question for those that are using GLP1s. Do you have any hypothesis in terms of how can that be used when your longevity protocols. What can we expect in terms of decelerating aging?

Dr. David Sinclair (3:27)

Well, there's a lot to say about GLP1s and I'll try to be brief because there's a few questions. More and more data is coming out showing benefits to the heart, the brain, beyond just weight loss. That's amazing. And I think GLP1s have paved the way socially for what's to come with longevity medicines. And longevity medicines will be much bigger than GLP1s, but they're great. Now, I think if you're not losing weight or you don't want to lose weight, talk to your doctor about microdosing. This all has to be doctor supervised. Of course, you can't just go out and do it yourself easily, and I don't recommend that. But, yeah, it is very interesting that these drugs, and they're getting better all the time, seem to have other benefits besides weight loss. But weight loss alone is the biggest benefit you can have for longevity. Actually, we don't say it often because it's not socially polite, but being massively overweight is a great way to accelerate your pace of aging. But, yeah, those drugs look really good. There is one downside that I need to point out besides what's known about risks. That is that there's an increasing number of people waking up blind because of it. It's still rare. It's about 20 to 30,000 people in the US a year, which is still horrible. And that's one of the conditions that, er, 100 therapy will be tested to see if we can reverse blindness caused by drugs, or it's called nyon. It can happen without the drugs. Of course that happens. We don't actually know what causes it. It might be a congenital, even.

Peter Attia (5:00)

Let's go, Andres.

Dr. David Sinclair (5:03)

So you talk a lot about eating stressed plants. Why should we eat stressed plants? And which is your favorite plant? Oh, well, so the xenohormesis hypothesis is what you're talking about, which Konrad Howitz and I published. Oh, gee, about 15, 20 years ago. The idea is that it sprung. The idea sprung from the fact that resveratrol and a whole bunch of plant polyphenols, which you probably know of, quercetin, fisetin, all these ones that now other scientists are claiming credit for, we showed back in the early 2000s, could activate SIRT1, the enzyme. So how's that possible? And why is it that aspirin is so good and most of the pharmaceuticals, at least in the 20th century, were derived from natural molecules. What is going on? It's not just coincidence. We think, and we think that we've evolved to sense stress in the plant world so that we have a heads up that we're going to run out of food and we hunker down and get ready for starvation. And. And it's a good signal. And before we could see the plants dying, we would sense them with our body. So when you eat stressed plants, what we see is that the high level of polyphenols in a stressed plant will give you that signal of adversity. And I'm all about adversity mode, as you know, versus abundance mode. And so that's the idea. So I look for xeno hermetic plants. Serena would say eat the rainbow. So when you go for colored plants, dark leafy greens, colored vegetables, it's great. My favorite one right now is broccolini, very lightly steamed and maybe olive oil and lemon. That's a good one. Yeah, or just salt and pepper. But olive oil definitely is another one on there. Olive oil is full of these polyphenols, especially if you get the really bitter ones. But it's good, it's good. A bit of olive oil every day is a prescription.

Peter Attia (6:49)

Let's go to Danny on zoom. Danny, where are you calling in from? What's your question?

Dr. David Sinclair (6:55)

Hello again.

Peter Attia (6:56)

Hello again. You're in Israel this afternoon?

Dr. David Sinclair (7:04)

Yes, I'm in Israel. It's evening and I'm here and I'm so happy to hear the presentation. Thank you. Dr. Sinclair or Professor Sinclair, I was wondering, connecting your presentation and the previous one about Lila, what's your opinion and how can you join forces? Or maybe already you joined some forces because both of them are mind blowing. So help us. Yeah, I was hoping you would ask that question. We're doing a lot with AI not with Lila yet. Haven't worked with Jeff, but backstage we hope to. We are working with companies and academics that do a lot of AI now we can't survive without it in my lab, and it's accelerating our work exponentially. We're doing now what would have taken hundreds of years before. It's amazing. And some of the things that we're doing include AI driven drug design and looking at billions and eventually trillions of molecules to see which ones might reverse aging. We've done that already, and you can imagine the excitement in the lab. Now we're using AI to tell whether a cell is old or young just by looking at it very quickly. And we can look at millions of cells within 10 minutes or so. The other area that we've actually submitted a paper on is collaborating with a group called Cadence. And they're similar in that, but not identical. They're not competing. I just checked on my phone before I came on stage. Cadence is a scientist agent that we used for longevity. We fed it a lot of transcriptomic data, and it actually made a discovery that we hadn't thought of about how to look at biological age with that data. And so we are using AI as scientists as well, to give us ideas and even be creative in that way. And if anyone tells you AI can only do what we've taught it, that is the biggest bunch of BS you'll ever hear. AI can be just as smart and creative as we are and even more so in the future.

Peter Attia (9:16)

Amazing. Okay, let's go to Guillerme.

Dr. David Sinclair (9:19)

Yes. So we hear often that your genetics are not as relevant to aging as what you do in terms of behavior.

Peter Attia (9:27)

And great question, nutrition and so on.

Dr. David Sinclair (9:30)

At the same time, we see that often longevity seems to run in families. When you have a family where somebody's a centenarian, often there are other people who are centenarians as well. How can we explain that? And why aren't we using genetics as part of. Of the tool set that we use to drive longevity? We should. We really should. And I analyze genomes for people with a longevity bias, and maybe you guys do at your clinics now. There's been a bit of a bomb thrown into the field recently with a paper just a few months ago that challenged the idea that only 10 to 15% of our lifespan is genetically determined. And they said it's closer to 50. 50. So it's somewhere between 15 and 15, 50, 50. We don't know exactly, but that's very difficult to modify. So at a minimum, I can say Science says at least half of your lifespan is up to you and the rest may be fairly determined. But we should be looking at the genome and the epigenome and blood work and beyond. Wearables, of course, are important too. Serena and I weigh ourselves down with wearables. But all of that, that's the future of health. And already companies like Peter's are allowing the pointy end of the spear to do that. But I think eventually it'll be normal to be monitored and to have something that tells you ahead of time. If you might have a heart attack next week, you could go in and get a medicine before it actually happens. That's the future. But your point on genetics is well noted and most physicians don't bother doing whole genome or even exome sequencing. And they should because it is important and we need to actually, and I'm working on this, educate doctors about what genes are important to look at and what's actionable and what's just for fun.

Peter Attia (11:29)

Yeah. There's no question that understanding your genetics in order to predict what's likely to happen to you. So when you come through Fountain, we are looking at two different things immediately. One is what's going on inside your body that you need to know about right now, very important. And secondly, what's likely to happen to you in the future so we can optimize you. And I would put genetics into two categories here. The first is your lifestyle impacts your first 70, 80 years, meaning it's dying from something stupid that you could have prevented. If you're getting from 80 to 100 or 110, genetics are going to play an outsized part of that later part. And then the therapeutics that are coming out of David's lab and others are about overcoming your genetics and going further. So that helps you understand the role there.

Dr. David Sinclair (12:26)

Right. And your genetics will tell you what to focus on and change. My father is the best example. With Ashkenazi Jewish heritage. Our genome sucks. We die typically. My ancestors die in their 70s. My grandmother had a stroke in her 30s. So the fact that my father is now living in a healthy way beyond any of his ancestors probably ever, is testament that you can really change what your genes have given you.

Peter Attia (12:49)

Avnish.

Avnish (12:51)

Yeah. Professor Sinclair, thank you for your health tips. A couple of quick things, Fountain Life I did last year and recommend it to everybody. Your tips on atherosclerosis and how to reverse that would be useful. But also, I'm from the UK. We run 22 care centers, some of the best in the UK. We have 1600 residents, wonderful older people, average age of 90. We have the oldest person in the world living with us, ethel Caterham, who's 116 and going strong. What are the tips that I can take back in terms of our wonderful residents? How they can continue to have a health span when they're in their 90s and we've got many that are living into their hundreds already.

Dr. David Sinclair (13:33)

Is that a question for Peter or for me?

Avnish (13:35)

For yourself. In terms of what can they do live in terms of living longer and also reversing atherosclerosis as well.

Dr. David Sinclair (13:43)

Yeah. So I mentioned nattokinase, which is probably the. The most natural way to do it. There is evidence that lowering LDL sufficiently can also have some reversal effects, especially if you get the inflammation down and there's a sweet spot of ldl. But it's not a fact based on science that getting rid of LDL is your goal. So if you have high ldl, try to get it really low. There are some really good medicines now that are even better than statins, like the PCSK9 inhibitors and others to come. But that's also another way that has been shown to not just slow down plaque, but can even have some reversal effects. But I haven't seen anything as powerful as nattokinase yet in the literature. Exercise.

Peter Attia (14:29)

Of course, there's one thing that is the most powerful. Your mindset. Your belief that you can live longer. Your belief that there is a revolution coming, your belief that you are needed did in society, the belief that you have purpose. Right. You've heard me quote this out the Wazir. There was a National Academy of Sciences study done that looked at those who are optimists versus pessimists, and optimists were living 15% longer than pessimists.

Dr. David Sinclair (14:59)

So you're never going to die.

Peter Attia (15:03)

So I mean, and very truly, I don't talk about immortality. I do talk about health span. I do talk about reaching longevity escape velocity. I think this is the most exciting time ever to be alive. I want to see as much of it as I possibly can, period. All right, let's go to Ipec on Zoom. Hi, Ipec.

Audience Member / Moderator (15:24)

Hi. Hi. Hi. This is Ipec from Istanbul, Turkey. And thank you. Thank you for this amazing session. So my question is, from the investment perspective, as investors entering in the longevity field, what biomarkers or clinical signals should be watched to identify companies genuinely reversing biological age?

Peter Attia (15:49)

So you're asking about investment opportunities in this area? I'm sorry, Ipec.

Audience Member / Moderator (15:55)

No, no. For the KPIs what kind of KPIs should be watch in, in a longevity company.

Dr. David Sinclair (16:02)

What kind of KPIs in a longevity company? It should be the same for all companies. In biotechnology, one of the non KPIs is who's the team? The team counts for probably 50% of my investment decisions. And then cash on hand, obviously valuation their Runway. Biotech needs to raise a lot of money to get there. So you don't want them to be struggling for cash. How far advanced are they? Are they anywhere near the clinic or is it another 10 years away? That's important.

Peter Attia (16:42)

And yeah, a lot of biotech companies run out of money. Yeah, it's their, it's their number one cause of mortality is capital deficiency.

Dr. David Sinclair (16:51)

Yeah. And if the team has a track record of raising money, that's helpful because there's ways to raise money and then there's ways not to raise money. And if they've never done it, then they can run into trouble. But the team is important because the reputation of the team, everything stems from that. They don't just do a good job. And your biotech is like a maze that you need to get through. And if you've done it before, you know the way. And there are some wormholes to go quicker. If it's an inexperienced team, let's say it's a group that just came out of academia, that's quite challenging for them unless they have really good mentors, which I've had over the years, which has been fortunate. But there are some big obstacles that you can hit. But also the reputation counts because the money can come in with the reputation of the people. And like you say, without the money, you're not going to get very far.

Peter Attia (17:42)

All right, we've got seven minutes. I'm going to get through as many questions as we can. Carl, good morning to you.

Dr. David Sinclair (17:47)

Hi, good morning.

Peter Attia (17:48)

We'll keep try to keep the questions and the answers short so we can get to some.

Dr. David Sinclair (17:51)

So David, if skeletal muscle is one of the strongest predictors of metabolic health, insulin sensitivity and survival with aging, how should longevity science think about pharmacological muscle enhancement is a long term risk of anabolic compounds greater than the systemic risk of chronic low muscle mass and sarcopenia. Well, okay, there's been a lot done on this actually. If anyone's really interested, you could dig in and look at the work of Shailender Basin B H A S I N who's run many trials, particularly on testosterone. The summary of his work, which is spanning decades, is testosterone doesn't extend lifespan so it's not anti aging, but it does prevent falls and it's good for

Peter Attia (18:38)

you overall metabolic, muscular and skeletal health.

Dr. David Sinclair (18:41)

Yeah, for sure. Which is important, right? A lot of people die from breaking bones and falling over and get frail and then the last 10 years of their life are not fun anyway. So definitely talk to your doctor about that. It's a decision between you and your doctor. If you're low on dhea, you can fix that with a supplement. But mostly it's making sure that you're moving and making sure that you're not letting your muscles waste away. That's the most important. But there's also a lot of good evidence that for women a hormone replacement is not dangerous in the way that was.

Peter Attia (19:16)

I think the evidence has come out strongly in favor of hormone replacement recently.

Dr. David Sinclair (19:19)

It is now. And if someone's told you that it might cause cancer, that was an old study that's been really disregard it now.

Peter Attia (19:27)

Let's go to sandeep and mic.

Sandeep (19:29)

Dr. Sinclair, thank you so much for being here. I have two questions. One on als, which you mentioned. Since there's so many variations of ALS and the Lugarok disease, can we expect a cure for all of them anytime soon? And secondly for retinal macular degeneration, there have been clinical trials in the uk. Is there a cure out there soon or to be expected?

Dr. David Sinclair (19:55)

Yeah. Well, I can talk about the results in the animal models because that's what we have. And I'm always driven by data, not by just by hope, although I'm very hopeful. What's been very surprising about the OSK ER100 therapy is that it's working in such broad diseases. I mentioned als and Kelly Rich is a remarkable postdoc who the friends of Sinclair lab know well. She is working on ALS in the lab and also using aging as a model for that as well because we do see degeneration of motor neurons. By the way, we're also working on sensory neurons as well in the body, hearing, eyesight, spine. To answer your question, Kelly is seeing that the regrowth of motor neurons back to the muscle is possible using OSK therapy and even with the chemical compound cocktail, which means that there is some hope that the disease isn't just going to always be progressive, that we are showing, at least in animals. I think for the first time that it is a reversible condition, which is really good news. And you mentioned macular degeneration. We have a lot of data on that both at Life Biosciences, the company, my former Student who left and went to mit, Wan Cheng Lu has a paper that he's hopefully going to publish soon and work in my lab in collaboration with the Korean lab. All three of us have shown that both wet and dry macular degeneration are reversible to some extent in gold standard animal models. So that's also on the radar of life biosciences to try ER100 in those diseases. Pending results in glaucoma.

Peter Attia (21:41)

Sorry, we have time for two more Matthias and Mike five and then we'll go to you, Perilla.

Dr. David Sinclair (21:45)

Yes.

Sandeep (21:47)

You say Matthias.

Peter Attia (21:48)

Yeah, I'm sorry, Matthias Mike 1.

Sandeep (21:50)

Sorry, David, thank you so much for your work. I read your book in 2019 and back then I amped up my belief to live until 120. Then I met my wife. She amped me up to 150 and now longevity escape velocity soon. So I believe in the power of mindset. But what I see is that the research is also what lidar science is doing. For example, it seems it's very physical and physiological and biological, measurable, empirical. And we kind of think these things are objective and measurable, but at the same time we say things that are not measurable, like mindset. They are so subjective still. And I see such a void in between there and there are people like Joe Dispenza doing these subjective things and I think it's very powerful. But I feel like there's such a gap in between and I wonder how you think. Also starting to meditate now thanks to your wife. So what's this void and how do you think also about this gap there?

Dr. David Sinclair (22:43)

Yeah, yeah, yeah. So Serena's introduced me to Joe's work. It's almost like I planted your question. I know we didn't. We are trying to bridge that. And again, Serena was the inspiration for that. She said, you know, your mind can change everything. It can make your immune system better. And I said, yeah, come on, you know, I'm driven by data. I don't believe it. She says, you know, often what we in the more metaphysical woo woo space, as I call it, turns out to be real later in science and scientists are just behind. And then a paper came out a few months later after we had this discussion that showed that manipulating the nerves in the brain of a mouse that is involved in mental thought does send signals through nerves all the way down through to the gut. And then you get more immune cells in your gut by changing the brain. So first of all I said, honey, okay, I believe it now. And then I decided to Study it. And I have a student in the lab whose name is Allegra. Again, friends know her and what she's doing is manipulating the sensory nerves in the body, rejuvenating them. And we expect to see broad effects on the body that meditation has been saying for years, potentially thousands of years, is a good thing. I believe that there will be evidence, if not proof, that how the mind overcomes matter and can do remarkable things like cure diseases that even medicines cannot.

Peter Attia (24:21)

Amazing. Perla, we're going to close with you. A short question, Dr. Sinclair.

Audience Member / Moderator (24:26)

Model longevity research focuses on genetics, molecules and lifestyle. But we spend about 10, 90% of our lives indoors. Our house, our offices. What role do you think the health of our indoor environments, air quality, materials, microbiome and light plays in human longevity?

Dr. David Sinclair (24:44)

Good question. And I've never been asked that. My indoor environment, it used to be horrible. Again, before I met Serena, I was drinking tap water, often straight out of the tap, no cup. I don't do that anymore. But what we've done with our households is air is filtered almost in every room. So HEPA filtration. I feel so much better. I was, you know, had a nasal drip for decades. So air quality is improved, water quality, plastics are out, Teflon is out. We do try to get fresh air, right? You don't want stale air. And. And we don't sit a lot if we can help it. We're always moving. But the indoor environment, what I want to use your question as a launching point for something is we've built a world that's very comfortable. Enough food, we've got chairs, even our suitcases have rollers on them. This is killing us. We are no longer in an adversity world. We're in the abundance world. No offense.

Peter Attia (25:45)

No, none taken. It's true.

Dr. David Sinclair (25:47)

But it kills us. So we need to stress our bodies. We need to make our bodies think that things are a little tough. So air conditioning, we never feel cold, we never feel hot. Change that. You know, you can get a sauna. Red light sauna is great. Dry sauna is great. We have a steam room in one of our bathrooms. These are shown especially sauna, hot sauna, to be beneficial. Why? Because then the body gets to it.

Peter Attia (26:10)

Go and try the health sauna here, right? I have one of those in my office. And I will go and do a 20, 30 minute sauna with infrared. It's amazing. It's quick. You can always squeeze that in. Plus red light. All of these different elements. Again, mold is a killer. Understanding what you're breathing, what you're drinking, what you're eating. Listen, you've got to worry about what's coming into your body, what's coming into your body physically as well as what's coming into your body mentally. What are you listening to, who you're spending time with, what's on your walls. All of these things impact your health, right? Be selfish about that for yourself.