← The Dan Buettner Podcast
The Dan Buettner Podcast
The 8 Root Causes of Disease You’ve Never Been Taught with Dr. Darshan Shah
01:07:36
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- [00:01]
A
I've spent decades studying the world's longest of people and written several New York Times best selling cookbooks about how they eat. But here's the truth. Even I don't always have time to cook from scratch. That's the gap Blue Zone Kitchen meals fill. We now have served over 3 million of these meals built on the same principles. Whole foods, nothing processed, maniacally delicious. When you have the time, cook from scratch by all means. But when you got only five minutes, grab a Blue Zones Kitchen meal from the freezer aisle or go to bluezoneskitchen.com Same principles, real life conveniences. That's how to set up your life for longevity. See you when you're 100.
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B
Even though I was highly trained in western medicine, I could save people's lives in the intensive care unit and in trauma surgery. I could reconstruct you from cancer. I did not have the knowledge to get myself healthy. I really believe the top 10 causes of death can become orphan diseases. Orphan diseases are diseases that rarely we ever see.
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A
You talk about kind of the five general rules to greater health and longevity.
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B
Sure.
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A
Yeah, yeah, knock them out, Darshan Shah. You know, it's amazing. About a week ago we were in Dubai together at one of the more extraordinary health conferences I do with ypo. We love YPO that you help curate or at least uber curated it.
- [01:36]
B
Yeah. And now here we are back in Los Angeles, the miracle of modern times and flying around the world.
- [01:43]
A
Still a little jet lag, but here. But you know, you're really a guy at the center of innovation when it comes to longevity and proactive health. And not just in your professional life, but you're in a very unique position that your job is to find the best health expert, the best longevity experts, bring them together for your YPO audience. But you also have the benefit of being, you know, the conductor of the symphony here. So you're. I'm really excited about our conversation. You know, Blue Zones takes a point of view on health and longevity. And that point of view is that much of it comes from, first of all, paying attention to the wisdom of our grandparents, but also this notion that our environment governs most of our unconscious decisions. And it's the unconscious decisions that last long enough so we don't develop these diseases that foreshorten our lives, these non infectious diseases. But I have to admit there are a number of other modalities that are emerging that perhaps some new supplements or new genetic interventions. Certainly data is increasingly important in our ability to take charge of our own health And I'm really curious to find out what you're excited about and to get your to your advice on longevity. But first, tell us a little bit about your journey. You were a surgeon and then you saw a need and fulfilled the need need. What led up to becoming a surgeon and what are you doing now?
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B
Yeah, so I became a doctor very early in my life. I was 21 years old when I did my first surgery.
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A
Did you skip medical school?
- [03:31]
B
Unfortunately, that was not the one I skipped. So I skipped a couple years of high school, grade school, and I went to this accelerator program. I grew up in New Jersey. Yeah. And then there is program back when I was graduating from high school, which I did early, that allowed me to do medical school and undergrad together in six years versus aids. So, you know, luckily I just had a series of fortunate events and found the right schools and I was able to become a doctor very early in my life. And that's what that really did for me was allowed me to have multiple kind of careers in medicine. So I started off in surgery and trauma surgery. Then I moved on to like cancer reconstruction and I did some cosmetic work as well. And then now I'm doing what I call health optimization and longevity medicine. And so, you know, this kind of journey I've had through the western medical system into where I am now is because I've had so much time and so much experience talking to patients and I've seen basically everything in medicine. And kind of the pivotal moment in that journey was 10 years ago when my son was being born and I was in the hospital. They also did surgery and I just finished a reconstructive surgery. My wife is like, my water broke. Let's go. Meet me upstairs in labor and delivery. So I just went right upstairs to labor and delivery. A few hours later, my son was born. As we all know, like, that's just such a life changing moment, right? And for me, I realized I was a little bit older. Dad, I'm 42 years old. And I took a really good hard look at that moment of my current status of my health. I was on 10 different prescription medications. I had diabetes, hypertension, that was uncontrolled, heart disease, high cholesterol, all the bad stuff. And the worst thing was I had an autoimmune disease developing. And this autoimmune disease was eating away at the skin of my scalp, but also my skull tissue. My skull is now just like paper thin on one side of my body. And this was an autoimmune disease that had developed what's it called? It's super rare. It's called Coupe de Sabre.
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A
Jesus.
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B
Yeah. Basically, it means injury from a saber.
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A
Yeah. Saber blow.
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B
Right, exactly. And so people that have Coupe de Sabre, if they let it progress, what happens is it looks like half your skull got cut off with a saber. And I was 42 years old, and, you know, this was just enigmatic of all the stuff going on with me. And the solution western medicine had for me was just keep adding more pills. And I had just started this new pill that was an immune suppressant, a really strong immune suppressant. And, and we all know that even though that slowed the progression of this Coupe de Sabre, what it really did was weaken me.
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A
Yeah. Open the doors for other diseases.
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B
Exactly, exactly. And I was like, you know what? I'm 42 years old, I'm on 10 different prescription medications, a strong immune suppressant, and I just had a son. And the way if you look at the mortality rates of these diseases together, there's probably a 50, 50 chance I lived long enough to see him graduate from college and get married and meet my grandchildren. And so I had to make a change. But the sad news was, even though I was highly trained in western medicine, I could save people's lives in the intensive care unit and in trauma surgery. I could reconstruct you from cancer. I did not have the knowledge to get myself healthy. Amazing, almost zero knowledge in how to get myself healthy. And I mean, that was like a really stark realization for me. I trained at the Mayo Clinic, one of the foremost institutions in the world.
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A
Minnesota.
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B
Yeah. Where I'm from. Yeah, I know, I know. Yeah. And it was just mind blowing that we have this multi trillion dollar system that we've built that can. Thank God we have it like if you get a heart attack, you get into a car accident, you get diagnosed with stage four cancer. Thank God we have this multi trillion dollar industry that I was deeply invested into with my whole life, but I had no idea how to get healthy. Because the realization is that system was never built to reverse chronic disease or to keep us healthy in the first place. Yeah, exactly.
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A
It's. It's built to profit off of making sick people less sick.
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B
No.
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A
Which isn't a bad thing. It's, you know, it's what, what people do. But there's very little money in health maintenance of. And you know, these, these statistics. We spend about $5 trillion a year on healthcare. 85% of it is on fixing avoidable diseases. Well, why the hell aren't we spending one of those Trillion on keeping those 85% diseases that we don't have to have. We don't have to have type 2 diabetes, do we?
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B
Right.
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A
What percentage.
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B
We absolutely do not have to have type 2 diabetes. That was a human created problem. We created that problem.
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A
We've had on this podcast Dr. Michael Gervin, who found a population in Bolivia that has no heart disease. Human beings, their per capita income's probably $200. No heart disease. What percent of us of us have to have heart disease, do you think?
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B
I mean, it's the number one cause of death. If you go to the CDC's website, heart disease is the number one cause of death by at least double of the next cause of death, which is cancer. Heart disease is the number one reason most people will die. It's just a massive problem right now. And you don't have to have heart disease. I really believe that, that the top 10 causes of death can become orphan diseases. Orphan diseases are diseases that rarely we ever see. If people, to your point, went back to the roots, went back to what we knew, that our grandparents knew, that our ancestors knew. Right. I think a lot of these diseases on that list are created by humans.
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A
So you were a train wreck, or you were train headed for a wreck with type 2 diabetes and heart disease and an autoimmune disease. How did you make a U turn here? Cause, you know, here you look good. You're healthy and strong and sharp and 50 pounds lighter, and your scalp's intact.
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B
What I'll tell you is that it came from re educating myself. So I took some time off to go learn the science of nutrition. I knew there had to be something there. Even though I had learned none of this in medical school, I knew there was one key lie to nutrition. And I found that nutrition was definitely a major solve for me. And so I got really excited and I was like, let me learn about movement and exercise. So I got a nutrition degree, a degree in personal training, learned how to exercise. Right. I moved the needle even more. And through learning about nutrition and also exercise, a lot of the people in those rooms where I was being educated was talking about functional medicine and root cause medicine. And then I was like, well, let me look up what functional medicine is. And I googled it, and I found that, you know, this is something that some doctors are teaching now. So I went to one of the first classes in functional medicine in the Institute of Functional Medicine, which was created by Dr. Mark Hyman and Dr. Jeffrey Bland.
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A
Yeah, we know them.
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B
You know them. I know we're all good friends. And it blew my mind. It completely changed my life. And what I learned basically in functional medicine, that this list of diseases that I had, the list of diseases that humans have, like, you know, we're given a book called an ICD9 code manual to put a code next to every disease so we can bill insurance for it. There's thousands of codes. But what you learn in functional medicine is there's eight root causes of all of those diseases. And when I looked at those eight root causes, eight items I had never really addressed or even evaluated in myself, I started checking each one of them off. I just got immediately and instantly healthier.
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A
Wait, can you tell us what those eight root causes of disease are? This is interesting.
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B
Yeah, it's really interesting. A lot of these terms are very sciency and so we'd have to dive
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A
in a little bit deeper, make them simple for us.
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B
Yeah, for sure. So one of them is, for example, inflammation.
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A
Inflammation, okay.
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B
Inflammation I think a lot of people already know about is an over activation of your immune system. Another one is hormone deficiencies or dysregulation. Okay. So you know, as we age, we have less and less testosterone, estrogen, et cetera. And this is happening much younger and younger. And so people are going through menopause and menopause younger and more severely. Okay. Another one is gut dysbiosis. So that's the trillions of bacteria and viruses that live synergistically within our gut are getting killed by ultra processed food. They are getting dysregulated by antibiotics and you know, non choidal anti inflammatory drugs.
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A
Or we don't feed them enough fiber
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B
and we don't feed them enough fiber. Exactly. And so we're doing a lot of damage there. Another one is disruption of your mitochondria. Mitochondria are the powerhouses of our cells and if those aren't working well, we just have not enough power in our system. Another one is a toxic exposure. Okay, so being exposed to the 155,000 toxins in our environment that we've never ever been exposed to before. Right. Circadian disruption. Not living in rhythm with the, with the sun and the moon and the planets.
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A
Really, that's that disruptive?
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B
Oh, it's massively disruptive.
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A
So that, I mean staying up after dark is. Everybody does that.
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B
You're right. And humans did that since the dawn of humanity. We did stay up after dark, but the reality is we're staying up a lot lot longer and we're getting up a lot sooner. And what's happening in between is severely dysregulated as well. You know, I see hundreds of patients right now and ask all of them, how do you sleep? And many of them say, you know, I sleep fine, seven, eight hours, I'm good, you know, and then we have them just wear a sleep monitoring device for six weeks. We find that they have less than 30 minutes of deep sleep, almost 85, 90% of the time. A very small amount of deep sleep, small amounts of REM sleep. And this is when your body's clearing itself of toxins, especially in the brain. There's a system in our brain called the glymphatic system. It only works well at nighttime during deep sleep. And if you don't get enough deep sleep, these toxins accumulate in your brain. And it's a real reason why so many people are suffering from neurodegenerative diseases like Alzheimer's disease right now.
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A
Well, just to take one of them, I mean, there's so much here. How do you get more deep sleep?
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B
So, number one, we talked about circadian rhythms, right? So living with the rhythm that you are meant to live with. I always say your sleep routine starts the moment you wake up. And what I mean by that is you have this crossover of where in the morning, your cortisol is supposed to be really high and. And then it's supposed to go really low by the end of the day, and your melatonin is really low at the beginning of the day, and then it goes higher and higher towards the end of the day, and then at nighttime, it's what makes you sleep. Unfortunately, when we don't live with circadian rhythm and the rhythm of the day and the night, this system is completely thrown off. So first thing in the morning, the way to get your cortisol level to rise is move your body, do some sort of physical activity, go outside in the sunlight, and expose your body to the outside environment and also the light of the sun. Right. And if you can't do that, there are like these 10,000 lux panels that you can buy, and you can use those or just wait until the sun comes out and go outside.
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A
Or get exposed to the sun.
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B
Get exposed to the sun. Right, exactly. And move. Those are the kind of the main things you want to do first thing in the morning. And then in the evening, your sleep routine needs to start about two hours before you go to bed. When you start winding down, disconnecting from electronic devices, lowering the lights in the house, all of those things are important. And then your sleep environment, which Is your bedroom that you're sleeping in needs to replicate a cold, dark cave like our ancestors slept in as much as possible. Cooling the environment, making it as dark as possible, making sure it's as quiet as possible is really important.
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A
But what is the main thing that robs us from deep sleep?
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B
The number one thing is the cell phone. Really? Yeah, it's the number one thing. People go to sleep with their cell phone next to them and use it as their alarm clock. Right. And I'm making air quotes for people listening. You don't need your phone to be your alarm clock. You can get an alarm clock to be an alarm clock. There's studies that show just having the phone next to you in your bed turned off is disruptive to your deep sleep. Even if it's turned off. Okay.
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A
Why? Because you subconsciously know it's there or
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B
emits something or your phone trains you all day long to cause elevations of your cortisol levels. Right. Because every time it gets a bing or a text message comes in.
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A
That's so interesting.
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B
Yeah. You get a dose of cortisol. Right. I mean, there's a lot of stress that's tied into what's happening in the world. And your portal to the world is through the phone. And so that's your. It trains your brain, it trains your hormones, it trains your sympathetic and parasympathetic nervous system to always be on high alert. So the more distance you can put between your phone and you at nighttime, both physically and also time wise, it's going to be a huge benefit. So what we do at our house, our phone charger is by the coffee machine and the kitchen, which is the farthest point in the house for me, where I sleep.
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A
So you have a double incentive when you wake up to go to the coffee machine.
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B
Exactly.
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A
You know, I happen to know this, that, that the ideal amount of sleep for maximum life expectancy for most people is between seven and eight hours. If you're getting less than six, it's shaving about three years off your life expectancy. And paradoxically, if you're getting more than 10 hours of, of sleep, it's shaving two years off your life expectancy. So it's really important to get that sleep part right. I didn't, I didn't know this. Deep sleep, the importance of deep sleep. I have, by the way, I have almost no deep sleep. I like eight minutes a night of deep sleep.
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B
We got to take care of that. We don't talk about that.
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A
My dementia.
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B
Yeah, Deep sleep is super important. And that's why knowing that number, how much you're getting, it can change how you think about your sleep. Because people unfortunately live decades with getting very little deep sleep and they just don't know it.
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A
What's your favorite sleep monitoring device?
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B
You know, I think my favorite one is the one that works for you.
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A
So I all kind of give different readings.
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B
Yeah, yeah they do. And it's really following the trends more than anything. So we always tell people, don't focus on the night to night number, focus on the trends. And you know what we, when a patient comes to us, whatever device have, whether it's a whoop band, an oura ring, an ultra human ring, or some watch, Apple watch, which just now started doing sleep. But also like, there's also like mattress pads, you can put a pad under your mattress that monitors your sleep. What we look at is the one month average of how much deep sleep you're getting. And then if it's, you know, less than 30 minutes, we obviously want to aim higher. So we put some interventions in place and we have people come back and we look at the one month average after they come back. And it's going to take some time to get your deep sleep right. But I would say usually about eight to months to a year, we can fix it.
- [18:46]
A
I put you on kind of the spot. Of these eight root causes of disease, I think we got to about six. Do you remember?
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B
I think the ones that we might have skipped might have been inadequate nutrients maybe. Did I say that one? Nope. Okay, so that, that's another one. And oh, obviously the biggest one is metabolic disease. Okay, so that's dysregulated insulin response to sugars. Basically.
- [19:14]
A
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B
The base of the pyramid. Right. Of how to improve your health span and your longevity. Sure. Yeah. Yeah.
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A
Knock them out.
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B
Okay, so obviously you know there's nutrition, we talked a lot about sleep, those exercises.
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A
Let's talk what's the in your view, what's the optimal diet? You're a doctor and you study nutrition, which most doctors don't. So your experience and and education tells you what, what, what's the optimal diet in your mind.
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B
Great question. Okay, so I'm going to give you my answer cutting through all the BS because there's so much out there that is really, it just really confuses people. People get paralysis by over analysis of too much competing information. Well, people need to know the reason there's competing information. Why some people thrive on the vegan diet versus the carnivore diet is because everyone's biology is an n of 1. Meaning your biology functions differently than my biology, than his biology, than her biology. And we gotta find what's Working for your biology at that moment in time. Okay. But there's certain truths that work well for everybody. Number one is avoiding ultra processed food. You're probably familiar with the Pareto principle, right? There's a 20% of actions that give you 80% of the result. Well, the Pareto principle of diet is getting rid of ultra processed food. Number two is I like to really get people focused on three critical components of their diet versus giving anyone like a named diet. Okay, People love. You know, a lot of times named diets are out there because they lead to buying more products or whatever. But there's certain principles that you and I both know work, right? That's a diet full of fiber and phytonutrients. So a lot of vegetables that are non starchy. Secondly is getting enough protein in your diet from good sources of protein. And lastly is getting essential fatty acids and essential fats and from olive oils, fatty fish, et cetera, nuts. And if you focus on those things, you're going to have 80% of the problem taken care of. And then you can dive into things like around timing, you can dive into certain micronutrients that might be missing from your diet. But that's kind of like the next step.
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A
Do you know, We've talked to Dr. Valter Longo. That's a very clear sort of opinions on, on how much fat, carbohydrates and protein do you have? Does your training tell you what sort of percentages we should be shooting for?
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B
So I'll tell you, my training makes me believe that it's super individualized for every single person. I've had Valter Longo on my podcast a couple times and you know, we've debated this and we've talked about this, but I really believe it's really different from individual to individual. But what I will tell you is that as far as macronutrient content goes, I really get people to try to focus on protein, then high fiber vegetables of a variety of vegetables, and then carbohydrates last. Because unfortunately there's a high percentage of our carbohydrate diet that comes from ultra processed food. And if you save that as your last component of your diet, you're naturally going to eat less of it. Carbohydrates cause the most amount of hunger. Non fiber carbohydrates cause the most amount of hunger. And unfortunately we are kind of programmed to eat carbohydrates first in our meals. You know, you get the bread basket.
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A
Yeah, yeah, yeah. Chips, the tortilla chips.
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B
Yeah, and you end up hungrier and you get more food. That's kind of the restaurant trick to getting to buy more food. It makes you hungrier, actually.
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A
So if they serve you bread at the front end, you're more likely to buy just at the back end type of thing.
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B
Exactly, exactly.
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A
Note to self, guy, you've heard it here. The bread industry is going to hate us.
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B
But, oh, they hate me for sure. I'm a very.
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A
You know, we have these blue zone projects we work for with entire cities and we try to change the defaults so people eat less, they eat better, they move more, they socialize more, and we, and we certify restaurants. And one of the things restaurants can do to earn certification is to agree to change the defaults around bread, bread baskets. It turns out that if you don't serve people bread, your Italian restaurant, for example, if you don't serve people bread, they don't even miss it.
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B
Exactly.
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A
So when you flip the default to automatically giving them a bread basket too, they have to ask for it. Some small proportion does. And as a result, two things happen. Number one, the customer consumes fewer mindless calories and these calories that aren't so good for us, bread and butter. And secondly, the restaurateur saves money. So everybody wins.
- [26:39]
B
It's a win win situation. What are we doing here?
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A
Right?
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B
Exactly. And I like to start every meal just like a crudite or a vegetable from the menu. And that usually is going to be additive as far as the benefit goes, because when you start with a crudite or vegetable, the fiber actually slows the glucose absorption for the rest of the meal. And that's a critical tool that you need because 90% of Americans right now suffer from metabolic disease because of too much glucose in their blood sugar.
- [27:08]
A
I learned a trick from a Yale researcher getting kids to eat vegetables. Kids always complain, oh, I don't want to eat vegetables. The way to do it, very similar to the way you do it around your house. You wait until dinner time and they're hungry. And then you put a variety of vegetables in tiny little cups. Peas in one, carrots in the other, peppers in the other, cucumber, celery, whatever. And you put it in front of them and they're hungry, they're going to gravitate to one or more of those vegetables. And you pay attention to what vegetable they gravitate. My kids like the carrots and the peas. So then, you know, you can start adding carrots and peas in their diet because, you know, as opposed to Eat your broccoli. Well, the kid doesn't like broccoli. And you keep jackhammering them to eat the broccoli and it's never going to happen. Instead of helping them identify the vegetables they like and then give it to them after, you know, they like them. So.
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B
Yeah. Anyway, that was such a great tip.
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A
Riffing off your crudite appetizer.
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B
Can I give you one more trick for. Because I think, you know, if we can get our kids to change what they eat for breakfast, it's going to be a game changer just for society in general, because go from Fruit Loops
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A
to Lucky Charms or something.
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B
I know, seriously, it's like cereals, like Froot Loops, Lucky Charms.
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A
It's candy.
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B
It's candy for breakfast every morning. If it's not that, it's a waffle with, you know, that's like an Eggo that you put in the microwave. That's.
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A
And then Mrs. Butterworth, which is sugar syrup.
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B
Yeah, it's high fructose corn syrup. Right, exactly. So what we did with our kids was we. It took us a while, but what we did was we gave them a menu to choose from every morning. And the menu didn't have any of that stuff on it, but it had six different kinds of healthy things on it, including vegetables, including different ways of preparing the eggs. And they thought it was fun to order from a menu now after, you know, we did this years ago, but it only took us like a month or so where they're eating eggs, vegetables, and basically fruit every morning for breakfast. And we don't have any carbohydrate or any sugar for breakfast anymore. And we're saving money. Cereal's expensive now.
- [29:20]
A
That's right. Yeah. And you just want to keep eating it.
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B
Yeah.
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A
Do you believe eggs are net positive or net negative in a diet? Obviously net positive.
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B
I think it's absolutely net positive.
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A
So good tips. What about what, what other sort of rules or, or lessons have you learned about healthy living?
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B
And you know, one of the things I wanted to talk to you about specifically on this podcast, is that there's a lot of truth in what happens in the blue zones. Right. As far as rules of healthy living, you taught me that you've taught the world this. Right. But one of the things that I think that we can really accelerate people's journey to healthy living and understanding how these rules are working for them is by empowering them with modern day technology. So what I mean by this is we use sleep as an example. Right. We know sleep is important. Everyone knows sleep is important. I think now. Right.
- [30:18]
A
I think more and more we're learning it. I don't think we knew how important it was, say, five years ago.
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B
Yeah, I agree with that.
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A
Yeah. But to your point about using tools to help us assess our own sleep and realize, holy crap, right. I'm getting nine minutes of deep sleep, but you're right, I violently agree with you.
- [30:38]
B
Good, good. So we have those same tools available for nutrition. For example, there are blood tests that you can do to see the quality of your nutrition and how it's working for you. And there's newer tools like the continuous glucose monitor that I'm a huge fan of that. You know, with 90% of Americans being having some level of metabolic disease, I like to put a continuous glucose monitor on all my patients for six weeks just so they can learn these rules on their diet and what's causing their glucose to shoot up. Things like eating fiber first and getting rid of the bed basket. It's just that feedback that really helps.
- [31:15]
A
Our friend, our mutual friend, Mark Pariski, he wore one of those glucose monitors and he discovered that a banana spiked his glucose more than a Snickers bar. And who would have known? He could have gone through his whole life thinking, all these bananas are good for me. But little did they know he was on his way to diabetes by eating bananas. So that's a really good point.
- [31:38]
B
Yeah. People are surprised all the time with what spikes their sugar. And the biggest sugar spike that creates the most problems for you is the one that happens at the beginning of the day. And that sugar spike, if you start your day with a big spike of sugar, which a lot of us do, it throws off your glucose regulation for the rest of the day.
- [31:57]
A
So what do you think is one of the more common mistakes we make first thing in the morning to sugar in our coffee?
- [32:03]
B
I suppose I was just going to say that. One sugar in the coffee, a piece. Two pieces of toast for breakfast.
- [32:08]
A
Oh, shit.
- [32:09]
B
Yeah. A glass of orange juice.
- [32:12]
A
Oh, yeah, that's like a Coke.
- [32:14]
B
Yep, exactly. So those are the mistakes people are making first thing in the day, that throws off the rest.
- [32:19]
A
How about cream in your coffee?
- [32:21]
B
Cream is probably okay as long as there's no sugar in the cream. Oh, yeah.
- [32:25]
A
Those creamers tend to be full.
- [32:26]
B
They're full of sugar. Yeah. And they're full of, you know, a lot of them are made with seed oils as well. So you got to be careful for the pre packaged creamers and, you know, usually just regular dairy. Milk is better.
- [32:38]
A
All right. Keep Going, yeah.
- [32:40]
B
So empowering your kind of knowledge about how are the basic.
- [32:44]
A
We have a sleep monitor, we have a glucose monitor. What else should we be monitoring?
- [32:47]
B
A blood test. So every. I really encourage all our patients every quarter to get some basic biomarkers done through blood tests. And these are blood tests that are available to every person in the Western world. Now you can ask your doctor for them. Our friend Mark Hyman started a company, Function Health, that also provides these. If you can't get your doctor to get them, we do them at NexHealth as part of our membership programs. There's like 10 or 15 of them that you have to know just so that you can become more in tune with what's really going on with your biology. The problem is right now, you know, our biology is extremely resilient. We don't show signs of disease until we've been living with it for 10 to 20 years and it's too late now. You're talking about reversing chronic disease instead. Why not just avoid it in the first place?
- [33:36]
A
Can you talk about some of these without trying to get too technical? Okay, I get a blood test. What are the numbers I should be paying the most attention to?
- [33:46]
B
I'll give you my three top ones and then there's more that I can give your listeners a resource that I put together that they can download in your show notes. But the three top ones that I would say that are most important to me are hemoglobin A1C. That's a three month average of blood sugar. Okay. You want this as close to 5.2 or below as possible. At 5.7 you get diagnosed with pre diabetes. At 6.5 you have diabetes. It takes two decades to go from 5.2 to 5.7 and then diabetes. So you want to know as soon as possible is when it's going up to like 5.3, 5.4, 5.5.
- [34:20]
A
That's a really good start.
- [34:22]
B
Yeah, it's a really good thing to know. And I would say you want to know that every four to five, six
- [34:27]
A
months for sure this goes back to your glucose monitor because you want to know what's spiking your glucose so you can stop eating that food or at least eating that food in that way. So you're that number that a hemoglobin A1C. Yeah, A1C doesn't keep going up.
- [34:42]
B
Right, Exactly.
- [34:43]
A
That's a really good point.
- [34:44]
B
Yeah. So kind of the pathway on this is, you know, you're trying to modify your diet. We know that we want to make sure you never get metabolic disease because it is the root cause of many of the other diseases that will kill you. You get a hemoglobin A1C done. If it's anything like 5.4, 5.5 or above, wear a glucose monitor for six weeks. There's companies that provide these online, like Levels Health.
- [35:07]
A
Zoe does.
- [35:08]
B
I think Zoe does, too. And it's super easy to do this yourself and you learn about your own biology. You want another biomarker?
- [35:16]
A
Yep. I want the top three.
- [35:17]
B
Okay. Hscrp. Highly sensitive C reactive protein. This is a marker of overall inflammation in your body. Inflammation, I said earlier, is an overactivation of your immune system. When your immune system is overactive, it's because it's being assaulted by something. And when you have your immune system overactive, what it does is not only fight the foreign material that's causing you to become sick, but it's also having a lot of collateral damage to your normal tissues, including your liver, your brain, and your heart. So you don't want inflammation to last a long time. Obviously, inflammation is good. If you get an infection, for example, the flu, you need some level of inflammation. But people are living with inflammation 24 hours a day, seven days a week, 30 days a month, and for years. And you need. And they don't know this until we get this blood test. HSCRP is another for most people.
- [36:12]
A
Darshan, where does our stress. Where does our. Maybe I give it away. Where does our inflammation come from?
- [36:19]
B
You said stress, but actually most people, it comes from poor gut health. And number two is stress. So, okay, poor gut health, it's there because crappy food. Yeah, eating crappy food. And 90% of our immune system lives in our gut because that's where most of the toxins come in. And so our immune system stays overactive because it's dealing with all these toxins in our food.
- [36:40]
A
Oh, interesting.
- [36:41]
B
Yeah. And so you want this HSCRP number as close to zero as possible.
- [36:46]
A
Okay, that's two. And the third.
- [36:48]
B
Okay, the third one I would say is apob. APOB is a. Is a protein that wraps around all the harmful forms of cholesterol in our bloodstream. Okay. Now, I said earlier that just because you have high cholesterol doesn't mean you're going to get heart disease. But high cholesterol combined with inflammation combined with poor metabolic disease. So high HSCRP, high hemoglobin A1C, now that cholesterol matters. And APOB is a great marker because you don't have to worry about all the other markers. You don't have to worry about ldl, hdl, all these other markers anymore. You just look at the apob. If the apob is high, you got a problem, especially if those other two are problem. And so then you need to start working on changing your lifestyle to reduce that number as well.
- [37:32]
A
And for a lot of people out there, they're saying, well, I don't know if I can afford that. Can people afford to get these three tests?
- [37:39]
B
It should be free. If you, I have a guide. If you go to drshaw.com biomarkers you can print it out, it's free. And you can bring it to your doctor and say I want these biomarkers. And it has the reasons in there why you want them. And so your doctor should order them for you. Because every insurance is covered by insurance. Covered by insurance. Yes.
- [37:58]
A
I think this is really important for people. Could you repeat the website?
- [38:02]
B
Yep. DrShaw D R-A H.com/ biomarkers.
- [38:07]
A
Biomarkers. I'm going to download that myself.
- [38:08]
B
Yeah. And I've also put in other biomarkers in there that are not blood tests. Things like blood pressure and skeletal muscle mass, grip strength. These are so important for people to monitor, especially as we age, because as we age we tend to lose skeletal muscle, we tend to lose strength, we tend to develop more fat, and then we also tend to get high blood pressure. All of these are silent killers in our life because they're silent, because they don't raise an alarm and give you symptoms until it's too late. And so by knowing what these few numbers are and tracking them yourself every quarter or every six months, you're going to be avoiding all these chronic diseases.
- [38:47]
A
When you talk about this, I can see that. Well, I know I'm not getting enough deep sleep. I can fix that or I can start to fix that. The glucose monitor. I can see these certain foods are spiking my glucose. I can kind of avoid those. The apo.
- [39:05]
B
Apob.
- [39:05]
A
Apob that seems to be a little bit harder to do something about or what do you do about that?
- [39:11]
B
I don't think it's that hard. I think what you do about that is just stop eating ultra processed food. That's gonna make a massive difference in your APOB. Get more fiber. Fiber lowers your APOB by in some people up to 20% for example. And then, yeah, stay away from fatty cuts of meat especially, you know, limited down to like one or two days a week if you can, or even less. And Then you know, once you stay away from kind of the more saturated, then you might want to stay away from saturated fats as well.
- [39:43]
A
All right, let's say I'm, I'm a single mom and I want to bring my family out to eat. Where do I go so I can actually keep these biomarkers in check and keep me and my family healthy. Where do I go and what do I eat?
- [40:02]
B
Yeah, you know, so I think that you need to go to a place where they are focused on serving healthy food.
- [40:09]
A
And so that's not America, Middle America. I hate to interject here, but I work in Iowa where, you know, there's a Godfather's Pizza Hut, a McDonald's, a Burger King. And where do you, where do you go?
- [40:23]
B
Well, you're gonna have to go to the grocery store.
- [40:25]
A
There we go.
- [40:25]
B
You know, that's where you go. You go to the grocery store, you learn what's going to keep your family healthy and then you pick those items and then that's what you cook at home. And you've got to invest the time to make that happen.
- [40:37]
A
Do you have a no brainer? This is from a doctor who's been unhealthy, got healthy himself. So he put his money where his mouth is. What's a one or two? Go to meals that you would endorse for all three of those markers. All three for the pre diabetes, for the pre heart disease and the pre inflammation. What is a meal that'll keep all those in check?
- [41:00]
B
Simple is king. Right. As food gets more complicated, it gets more expensive and is probably going to have be more problematic. So if you can go to the grocery store and just get a vegetable. Okay. A lot of vegetables, they come in the frozen section of the. Yeah.
- [41:18]
A
Cheaper there.
- [41:18]
B
They're cheaper. And they're also. They've locked in the nutrients at that point in time. So get a vegetable, one vegetable that you like. Learn some spices that you and your family like. Right. Buy a few spice combinations and try those on the vegetables. And then some form of protein, whether it be a salmon or a piece of chicken, you can find good protein that you can learn to cook up.
- [41:44]
A
How about just a grain and a
- [41:46]
B
bean and a grain and a bean. Right, exactly.
- [41:48]
A
That's a protein.
- [41:49]
B
You can do those as well. Yeah. Cheaper. And they're probably cheaper too. Absolutely.
- [41:55]
A
You hear my bias coming up, by the way, that book in the background there. Yeah.
- [41:59]
B
And then make sure that you are getting to like olive oil and you're getting to like nuts like a lot of families don't have any olive oil in their home, they don't have any avocado oil, they don't have any nuts in their home. And just kind of slowly introducing the food. I'm seeing your Blue Zones kitchen book right there, which is a great tool. We have one of those.
- [42:18]
A
Thank you very much.
- [42:20]
B
I love the Blue Zone kitchens. But you know, and I think unfortunately in America we've gotten away from this concept of actually buying your food and cooking it and serving the family at dinner. It's like very unheard of almost nowadays in some urban environments. And we just got to get back to that.
- [42:36]
A
You know, I'm just going to put in a self plug about. Earlier this year I started a program in downtown Miami with the oyc and this is a youth organization, but a lot of inner city families go there and I invited 20 inner city moms and they had to commit to 10 weeks. They committed to the 10 weeks. I gave them a free instapot. Why an instapot? Because a lot of people don't have a lot of money, don't have pots and pans, they don't have ovens, they don't know how to use them. Instant pot, simple. Then brought the 20 together, I connected them, I had them answering questions about what they're proud of and answering questions about what are their fears and what are their hopes. So they got to connect. And then I gave them my books. The Blue Zone kitchen. They got to pick whatever recipe they wanted. Then I bought all the food, hired a chef and we cooked it together. They had to do the chopping, they had to weigh things out. They put in the instant pot, they put the top on, they hit the button. 20 minutes later, bam. There's a maniacally delicious whole food, largely plant based. Actually it's 100% plant based meal, but I make sure it's delicious. They ate it together and then they took that instapot home so that their kids could eat it. And the thing is, I'm a big believer that we are not going to get a healthier America until we start cooking at home.
- [44:03]
B
Yeah, agreed.
- [44:04]
A
Taking control of the own ingredients, getting the software that is the right recipes, the hardware, the right equipment, the know how to, how to cook them. And the most important thing is the experience of tasting it and saying, oh, I know that tastes good. Because I think most people think healthy food tastes like crap or tastes like rabbit food. And not until you realize that you can actually make beans and grains and vegetables and fiber, which fuels our microbiome. We can make it taste good. And not until it tastes good. Are we going to compete against the, you know, meaty, cheesy, fatty, ultra processed world of food profit out there.
- [44:42]
B
Absolutely. I'm so glad you mentioned the instant pot. We still use an instant pot in our house two or three times a week. It is a game changer as far as creating good, nutritious and good tasting meals. If anyone listening to this podcast does not have an instant pot, I mean, I think that's one of the first things you need to get in your kitchen.
- [45:02]
A
I love it.
- [45:02]
B
And it's fast. Yeah.
- [45:03]
A
I think the number one objection. I don't have time to cook healthy. You don't have time not to cook healthy. By the way, the average, average 20 year old American could gain between 10 and 12 extra years of life expectancy if they move from a standard American Western diet to a whole food plant based diet. You take that extra 10 or 12 years and you average it out through the rest of your life. That's three, few, three more hours a day of life that you can cook. And with an instant pot, you cook a great meal in less than 20 minutes. So the reality is you do not have time to not cook healthy.
- [45:39]
B
Yes, that is so true. And you know, to further enable that for people that are listening, if you have a cell phone, which everybody does, you can download any one of the AI apps now and just talk to it and say, I have some broccoli, some, you know, parsley, some whatever have you in my fridge right now. Give me an instant pot.
- [46:01]
A
Great idea.
- [46:02]
B
Yeah, that's a great idea.
- [46:03]
A
To make it taste good.
- [46:04]
B
Yeah.
- [46:05]
A
So let's move on to simple, effective and inexpensive things to make us healthier that nobody makes any money off of. To, to the longevity hacks, which.
- [46:15]
B
All right.
- [46:15]
A
Which I'm generally not a fan of, but I think you, you know, of some pills and supplements and what do you think really works out there in the world of longevity hacks or, or anti aging products?
- [46:30]
B
Great question. So first of all, let me just frame this piece of the conversation with. If you don't have the basics down, don't go to the longevity.
- [46:38]
A
I love it. There you go. And that's what most people do.
- [46:41]
B
They go right to the. Yeah, they go right to the. Give me the pill. That's going to solve all my problems.
- [46:46]
A
Steak and martini for dinner and egg bagel for breakfast. And now give me a pillow.
- [46:51]
B
Absolutely. If you're not living, you know, 80, 85% of your life with some of these simple Rules in place.
- [46:56]
A
By the way, I really admire you for saying that because you are in the business of having patients come see you and making them healthier. And the fact that you can say, don't come see me if you're not doing these basic things, I think that's real integrity.
- [47:11]
B
Yeah. I mean, and people come see us all the time and they want to go right to the, you know, what's the most fancy, expensive thing that I could do? And we always start off with the things we talked about.
- [47:22]
A
Before we get into that, I do want to talk about. Let's hear more about your clinics.
- [47:26]
B
Oh, okay.
- [47:27]
A
I want people to understand what you're building here, why you're building it, and how it can figure into their health journey.
- [47:35]
B
Yeah. So I built these clinics because of my own.
- [47:38]
A
They're called Next.
- [47:38]
B
Yeah. Next Health. Next Health. Yep. So I think it's a Next version of healthcare, basically. And because I, I was a doctor and I didn't know where to go to get healthy, all I found was disease care. Right. And I hired concierge doctors. I went to four or five doctors in Los Angeles and hired some of the best concierge doctors in town. And I just kept getting more pills. Very little advice on how to get healthy. So when I got healthy, I was like, we gotta practice medicine completely differently in the country, this country. And there's two ways to do that. One way is to try to fix the current system and try to get everyone to do what they need to be doing. Preventative care, also lifestyle medicine. But you and I both know that that's kind of almost a fool's errand. That's just very difficult to change this trillion dollar system that, to your point, no one's going to make money off that. In fact, it's put less money in everyone's pocket. So I said, we just need to build a brand new system. And so I started my first clinic of this new system 10 years ago in West Hollywood. And turned out people got healthier. And turned out people really liked being healthy because they felt great and they got off their prescription medications. And so I then opened another one and then another one. And then I decided to put one in New York and one in Hawaii
- [48:53]
A
and then one in Miami too, right?
- [48:55]
B
Well, yeah. And then the pandemic happened and everyone had a renewed focus on health because they saw like, the people that were most susceptible to the COVID virus were people that were unhealthy. And then we, now we're opening clinics all over the world. We have we have 14 clinics right now, including Miami, Chicago, Nashville, Santa Barbara, Dubai, and we're opening another 25 clinics in the next year. So we're basically, the way I look at it is a new way to practice medicine, which is focused on preventative and lifestyle medicine and functional medicine first.
- [49:29]
A
So if I become a client, I guess I probably pay a annual fee or something like that. And then what happens?
- [49:37]
B
Yeah, so we have multiple levels of membership. Our least Expensive one is $99 a month, which is pretty affordable, I think, in my view. And for that.
- [49:46]
A
Yes, for your health.
- [49:48]
B
Yeah, exactly.
- [49:49]
A
What better to spend money on?
- [49:50]
B
Right. And now you get a medical team that's gonna talk to you about all the things you wish you could talk to your doctor about. Right. And so that's what we do. We give you access to our medical team. We check all the blood tests I talked to you about and all the other tests like skeletal muscle mass and grip strength every quarter. And we help you get things directionally going in the right direction again. Our goal is to reverse chronic disease and get you off your chronic med. Our goal is to get you to, you know, build skeletal muscle and lose fat mass. Our goal is to protect your brain. And we do that, but it takes time. And so we built our centers to be beautiful. They look like. People call us the apple store of health because when you come in, you feel inspired to do these things. And then we also have some of this cool kind of, you know, biohackery technology that biohackery helps to move the needle a little bit. Things like, you know, sauna. We know sauna has a lot of benefits. So we have sauna. We also have cold therapy. We have hyperbaric oxygen chambers and LED light beds. All these things that people are looking for when they kind of go out there and look at what the biohackers are doing. But stuff that we believe does move the needle, if you keep it as a routine.
- [50:57]
A
One of the most important lessons we learn from the Blue Zone is how to eat to 100. We know exactly what people there have been eating most of their lives. And it's whole food and mostly plant based. But it's not just what they eat, it's how they eat. They cook at home and they cook together. Cooking is never rushed. Someone is chopping vegetables, someone else is stirring a pot and someone's telling a story you've already heard and nobody seems to mind. That's simple ritual that turns food into connection and connection into longevity. At my lake house in Wisconsin, the kitchen is always the center of the house. Friends gather, we cook simple meals. We linger at the table, maybe play a few rounds of cards after dinner. Those evenings do more for my health than any supplement ever could. When I'm traveling, I like knowing my home can still host those moments and give the gift of connection to other families. Hosting my home on Airbnb means other people get a space where cooking isn't an afterthought. It's a reason you come together. Hosting fits naturally into my life. It keeps the heart of the home alive even when I'm away. Your home might be worth more than you think. Find out how much@airbnb.com host very quick rapid fire here scale one to ten. Ten being you're for sure it's going to help you live longer. And one being like eh, a red light therapy one to 10, I would
- [52:35]
B
give that about a six or a seven.
- [52:36]
A
Cold plunges, I think cold plunges are
- [52:39]
B
more of like a 4 or 5. They make you feel, I think give you an incredible sense of an endorphin rush. You feel great as kind of a reset. Also, if you use cold plunges as a way to regulate your nervous system. So going into it pre regulated and we can talk about that a little bit, is where you see the most massive benefit is using it as a tool to regulate your parasympathetic and sympathetic nervous system.
- [53:03]
A
Saunas.
- [53:04]
B
Saunas are a nine. Yeah. This great research around them being preventative for cardiovascular disease and even neurodegenerative diseases. Hyperbaric chambers, I think those are also like an 8 or a 9. Lots of great data around it. We use them at the Mayo Clinic to help people heal wounds from surgery. But also after strokes and after, you know, sadly when people almost drown, it really helped to protect their brain.
- [53:27]
A
A multivitamin.
- [53:29]
B
Multivitamins are definitely. They can be an 8 or a 9 for some people and a 1 or 2 for others, just depending on if you need them. Beans are a 10.
- [53:40]
A
I love you.
- [53:42]
B
Beans are a 10.
- [53:43]
A
Creatine.
- [53:44]
B
Creatine. About seven or eight. Yeah.
- [53:46]
A
Testosterone.
- [53:47]
B
Definitely an eight or a nine depending on what your levels are. Vitamin E. Oh. I mean that's much lower on the scale of three to four.
- [53:56]
A
Omega 3 fatty acid supplements.
- [53:58]
B
Eight or nine. Wow. Yeah.
- [54:00]
A
So there's a lot of tools in the toolbox.
- [54:01]
B
A lot of tools in the toolbox.
- [54:02]
A
But you got to remember to do them. You have to remember to keep doing them. There are very few of them you can do once, right?
- [54:08]
B
Absolutely. Health is a habit. Real True health comes from your routines and your daily habits. And so I emphasize the word daily because it is really stuff you got to do every day. You know, what are some of the
- [54:21]
A
other more sophisticated or emerging longevity interventions or pills that you, that you believe in?
- [54:30]
B
So there's some supplements, I have a lot of research around them now that are showing a lot of promise. One of them is Urolithin A. It is a supplement that improves mitochondrial health. And we're seeing more and more studies come out showing how it can help your immune system. It can help, you know, just every system that requires energy in your body, which is every system. So I like urolithin A. I'm liking also NAD supplements, specifically in a supplement called Tru Niagen, which is a well absorbed form of nad, which also helps your mitochondria make energy. And then I would say on the kind of Gut health piece, there's certain probiotics that work really well, like Akkermansia, which is made by a company called Pendulum. I would say those are some of my favorites. And then on the multivitamin side, I would say, unfortunately, we live in an environment where people are not getting all of their nutrients that they need. You should get them from food. And we do testing to see if you're not getting enough nutrients from your food. A lot of people try really hard, and just because of years and years of poor diet and poor gut out, they just don't absorb the nutrients that they need from food. So to your point, multivitamin may be helpful in some of those people. And you have to just make sure you're getting a high quality multivitamin. And then I would say, you know, like getting off the supplement track there. One of the kind of the darlings, I think, of the longevity industry right now is a therapeutic plasma exchange, which is something that we do at Next Health, which is kind of a reset or an oil change for your body, where we basically use a really modern piece of technology that was actually FDA approved in 1970s to remove your plasma, which is where a lot of the toxic burden lives and the inflammation lives in our plasma.
- [56:16]
A
Don't our liver and kidneys do the filtering for us? Do we really need a.
- [56:21]
B
They do, but they're overwhelmed. I mean, the number of toxins that we live in in society right now is just our kidneys and liver just can't catch up. And that's why, you know, when you measure plasma levels of toxins, they're high. A lot of people have high levels of mercury for Example, high levels of PFAS and bpa. And all these chemicals that are our kidneys and liver are working as hard as possible to the point where they're getting fatty and fibrous. Right. They're overworked and they're suffering, and people are getting fatty liver disease and fibrotic liver disease because of it. Just can't catch up.
- [56:59]
A
So the plasma exchange, you take your plasma out and you clean it or something.
- [57:03]
B
Yeah. So you take your plasma out and
- [57:05]
A
you basically put it through a coffee
- [57:06]
B
filter and you reverse it. No, you replace it with. With fresh albumin. And so your plasma is actually completely removed, actually discarded. So you get brand new fresh albumin, which is a protein combined with fluid. And so you basically get fresh, new plasma put in.
- [57:23]
A
I see. And do patients say, I feel better?
- [57:26]
B
What we really see is in your blood test and your biomarkers. So we measure biomarkers before and after plasma exchange on all of our patients, and we can see a massive reversal of inflammation, mass reversal of toxins, massive reversal, even, like what we call malformed proteins. There's a lot of research around plasma exchange using to slow Alzheimer's disease, to reverse autoimmune conditions, et cetera. So. And, you know, it takes time, and it takes sometimes multiple treatments. But we can. We can really help with some disease states as well.
- [57:59]
A
About stem cells. It seems stem cells help with sore knees and backs and shoulders and so forth. But where do you land on stem cells?
- [58:08]
B
Yeah, so stem cells, the reason everyone knows about knees and backs is because people have been using them for years now to create healing in those tissues by injecting them directly into your tissues. And, you know, you feel. You feel it in your joints when you get it done, because they don't hurt as bad, and you can move around better. But we also use stem cells intravenously to create healing throughout the body. And so I think stem cells, unfortunately, because of regulations around them in the United States, they have not been used or studied effectively. Those regulations came from a lot of pharma influence over FDA that basically made them treat stem cells as drugs. Now we're coming into a new time in regulation where many states now are allowing stem cells to be used, like Florida and Utah and Montana, because they realize there's tremendous benefits with potentially a lot less side effects than drugs. And I say potentially because it really depends on where you're sourcing your cells from and how they're being cared for before they get injected.
- [59:15]
A
Can you tell me how Simplified. How stem cells systematically heal us when we get them iv.
- [59:23]
B
So stem cells have a really good ability to hone in on areas that need healing. They do this because in areas of our body that are crying for healing, those cells are secreting what are called cytokines. Cytokines are messenger molecules that travel through your bloodstream, and stem cells kind of find where the highest concentration of these cytokines, and they go there. Once they go there, they release packets of information that tell all the cells in the surrounding area how to heal. Okay. And so these packets of information are called exosomes, and this is a signal to create more healing. And then they also bring mitochondria to the area as well. Mitochondria are the energy producers, and they move those mitochondria into the cells that need to heal as well.
- [60:12]
A
Are they some mitochondria inside cells?
- [60:14]
B
Yes. And so they go from inside the stem cells to your own cells.
- [60:18]
A
What is a situation where you'd say stem cell. This is. This is going to. I'm 90% sure this is going to help you.
- [60:26]
B
So, unfortunately, the FDA kind of puts a zipper on our lips about this kind of stuff, so we can't say it cures or can potentially help any disease. But I can point people to the research around stem cells, specifically in strokes, for example. There's a lot of research going on in Florida at the university, where they're injecting stem cells into areas where people have had a stroke showing actually regeneration of neuronal tissue and connections joints. We know there's a lot of research showing joints healing that are degenerative. Right. There's also research going on in Florida as well, around stem cells being injected into areas where people have had a heart attack and creating regeneration of myocardial tissue in the heart as well. In the heart, and even in using IV stem cells as well. So there's a lot of great research going on out there. I think we're gonna see a huge surge of stem cells being used therapeutically once some of this research goes over the finish line.
- [61:32]
A
What else do you really believe in? What are the. Some emerging tools that we ought to be paying attention to or things you're using at Next Health with Success?
- [61:41]
B
I mean, a lot of people have heard of peptides. I think peptides are very powerful as well. Peptides are signaling molecules that our body has made since the dawn of humanity. The same signaling molecules our bodies use right now. A lot of people have heard of the most famous peptide out there called insulin. Insulin is actually a peptide. And so diabetics get insulin because it signals our body to absorb glucose into our cells. The next famous One is called GLP1 and a lot of people are using that right now as well. And there's probably hundreds of other peptides that you can use. And, you know, I think we're going to see a lot of research on those as well.
- [62:18]
A
The body is such an incredibly elegant and intelligent mechanism that when we tinker with individual parts of it, we often get reactions and reactions to the reaction we can't often see.
- [62:34]
B
It's very true. And so you need to be with any intervention, you want to be careful. And we probably have about somewhere between three to 400 people on GLP1s right now. And we have had really good success at not just preserving, but building muscle in these individuals. Because the signal for building muscles in my mind should come from a complete lifestyle change. 90% of the people that we have on GLP1s have never set foot in the gym for six months. And so we don't even give them the GLP1 unless they're gonna get with the trainer and get into a regular gym routine, specifically strength training routine. We also make them step on our scale that we have in the office every few weeks to measure their skeletal muscle mass. Creatine is also added to their supplement regime as well. So there's a lot of ways of doing GLP1 correctly. I think the other big problem around GLP1s is because the way the dosing algorithm is given to doctors is start off at the lowest dose and go all the way to the highest dose and stay there. And that's not how you want to do it. You want to start off at the lowest dose and you want to go to a dose that allows you to lose about one pound a week at the most and stay there.
- [63:50]
A
Okay.
- [63:51]
B
Okay. Because if you lose weight too fast, you're not going to be able to keep up with the weight loss with building muscle. You know, if you're working with a doctor and you're listening to this podcast, don't just keep automatically increasing your dose. If you're happy with the weight loss and you're losing about one pound a week, just stop there. That's how much weight your body can keep up with that you can lose in a healthy way. And then you want to have an off boarding program, like, how are you going to get off of these? You know? And so the off boarding program needs to include a complete relationship change with food, starting to cook at home, rebuilding your gut microbiome with fiber and with probiotics and doing all those things. And if you do those things, you'll get off of the GLP1 and you won't need to go back on them.
- [64:33]
A
I love that. You know, just to repeat what I said at the beginning of the hour here, I found these populations where people are living about 10 years longer than Americans with a fraction of the rate of chronic disease. And I believe it's their environment, and I believe there is wisdom which never expires. Our producer, Pat Weiland, had that line, that wisdom never expires. I think the wisdom of the Blue Zone never expires. However, I always applaud innovation, especially when it's done responsibly with the heart and with compassion. And I think you do that, which is why I've asked you to be on the show, and I really do. So have we missed anything that we should talk about?
- [65:14]
B
I love everything that we talked about. This is such a great. I feel like you're, like, the most incredible interviewer, because everything I wanted to talk about, like, you naturally just got it out of the conversation.
- [65:25]
A
Well, that's a big compliment since you've been on Jay Shetty's podcast twice.
- [65:29]
B
So maybe the one other thing that we should talk about is, you know, community and purpose and those. Those pieces. Glad to hear that.
- [65:36]
A
Figures into a doctor's toolkit.
- [65:39]
B
Yeah. I mean, more and more is number one in my toolkit. And, you know, I think people are searching for, why does community and why does purpose. Why does that create health? You know, I think in science, it's still like a big enigma. Right. And I think the missing piece there and the critical kind of link between those kind of softer elements and true health, comes from the reason you feel good when you're with community, the reason you feel good when you have a sense of purpose is because it creates this moment of where you're not on such high alert. Right. And, you know, when I'm here talking to you on this podcast, I love being around people and talking, and I feel a sense of relaxation.
- [66:28]
A
But I'm also putting you on high alert.
- [66:30]
B
What were those eight things exactly? You know, like, I just kind of zone out and feel like we're just having a conversation, like a dinner.
- [66:36]
A
I'm glad you do.
- [66:37]
B
That's it. Yeah. Yeah. And so when I'm around other people, you know, it decreases my sympathetic load. I feel more parasympathetic. And that parasympathetic to sympathetic tone ratio, which is measured by another biomarker called hrv Goes up, right? And the more time we spend with friends, the more time we spend reading a book and relaxing, the more time we spend away from our phone, the more time we spend in a parasympathetic state. And that gives our body and our mind and our spirit and our soul a chance to relax. And that relaxation, to me is becoming more and more number one on my list. So interesting of to dos.
- [67:18]
A
It's so hard to prescribe that, isn't it?
- [67:20]
B
Really is.
- [67:21]
A
There's very little money in purpose. There's very little money in reminding people to build friendships and nurturing those relationships. We just had Goldie Hawn on another podcast here who was ended almost tearfully about how her friends have really been the cornerstone to her happiness and therefore her health. But marketers can't make much money off of. That's hard. You make a lot of money off of GLP1 or a lot of money off of stem cell treatment, but not a lot of money off of, you know, remember your friend's birthday. Let them know that on a bad day they can call you and you'll care. Call them up out of the blue. Invite them over for a cup of coffee or for a dinner. These are the things that you see in the Blue Zones. And it just warms my heart to hear you as a doctor using these sort of complex ideas of parasympathetic and HRT or hrv. Hrv.
- [68:27]
B
We have HRT too, but hrv.
- [68:29]
A
No, but the fact that. Fact that real physicians and real scientists are starting to not only see the positive effect of friendships and purpose, but also measure them. And therefore we can better chance at managing them.
- [68:43]
B
Absolutely. But you know, it's so funny. We have all these great tools to measure all this stuff, but it all points back to what you talk about in the Blue Zones books, is that those are the things that are going to move the needle the most.
- [68:54]
A
Thank you, Darshan. I'm going to quote you on that.
- [68:56]
B
You should.
- [68:57]
A
All right, well, I'm going to go check out Next Health in this spirit of. Of exploration, innovation, and thank you so much. I know you 14 clinics and you have patients and you have a family and you came to spend some time on the Dan Buer podcast. And we thank you. And I'm sure people listening are. Thank you. And I hope you guys listening will check out Next Health and at the very least, give us that website again.
- [69:21]
B
Doctorshaw.com biomarkers yes, we have other tools on drshaw.com how to reduce your toxic burden, how to sleep better. So just go to drshaw.com and you'll see all my free tools on there. Everything's free.
- [69:34]
A
I love that. Thank you very much.
- [69:36]
B
Thank you. It's an honor to be here.