← Tom Bilyeu's Impact Theory
Tom Bilyeu's Impact Theory
Civilization Is About To Change Forever: Truth About Immortality, Rich Vs Poor, AI & Ending Disease | Dr. Mehmood Khan PT 2
01:20:32
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- [00:00]
A
If you work in university maintenance, Grainger considers you an MVP because your playbook ensures your arena is always ready for tip off. And Grainger is your trusted partner, offering the products you need, all in one place, from H VAC and plumbing supplies to lighting and more. And all delivered with plenty of time left on the clock, so your team always gets the win. Call 1-800-GRAINGER visit grainger.com or just stop by Grainger for the ones who get it done. If you work in university maintenance, Grainger considers you an MVP because your playbook ensures your arena is always ready for tip off. And Grainger is your trusted partner, offering the products you need, all in one place, from H VAC and plumbing supplies to lighting and more, and all delivered with plenty of time left on the clock, so your team always gets the win. Call 1-800-GRAINGER visit grainger.com or just stop by Granger for the ones who get it done. Welcome back for part two with Dr. Mahmoud Khan. Let me ask you a question. Do you believe in free will?
- [01:10]
B
Free will as a person living in the free world, saying, I'm deciding what I want to do, yes. Not 100%.
- [01:19]
A
So I. I will confess something which my audience will have heard multiple times. I don't believe in free will. I There's.
- [01:28]
B
So then we're agreeing.
- [01:29]
A
Well, I'm maybe even more hardcore free will is an illusion, but I don't think there's any way to live your life other than as if you had free will. And so every argument that I make, so, oh God, this. This really gets complicated very quickly. But here's how I look at this. Free will is an illusion. However, humans still change. So the question then becomes, if we don't have free will, but we are changeable now what? And so I think of myself quietly. I don't talk about this out loud very often because it just will drive people to distraction. But I think of myself as an algorithm. I cannot help but say the things that I'm saying right now because of all my genetics, my microbiome, all the things I've encountered, all the n of one things about me. But because of that, I am compelled to put certain ideas out into the world. Now, the reason I think that's incredibly powerful and the notion, or not even the notion, the sense of compulsion I have to put certain ideas out into the world are because I know that even though I don't have free will and the people listening to this don't have free will, they will still be changed by these ideas so it becomes a question of what ideas do we put out into the world, knowing that all of us lacking free will are going to be shaped by the ideas that we encounter? Because I think it only makes sense to act as if you had free will. Then it's like, okay, acting as if you had free will. What are the ideas that are going to shape people in the direction that makes the most sense to shape them into? Now, that requires you to have a North Star. There has to be something that you're aiming at. You are the right person to have this conversation with. Because I've heard you say a thousand times that a leader's job is to give people vision. You have to know what it is that people should be aiming at. So I believe people should be aiming to maximize human flourishing, to minimize human suffering. We can get into what human flourishing means, but basically, to thrive, to not be in emotional or psychic pain, to uplift not only yourself, but other people. Because if you're a sociopath and you get joy out of punishing others, that's. That does not qualify in my book. You have to be elevating other people as well. So the reason that I harp on choice, even though I don't think we have free will, the reason that I say that being a type 2 diabetic is a choice, is because that idea is going to influence that person's behavior. And if they believe, oh, it's just my underlying biology, there's nothing I can do, then they won't do the things they need to do. To reverse that problem you spoke earlier about. You have to be able to show that this thing is the problem, this biomarker is the problem, and that I've done an intervention and I can measure that. It moved me backwards in the right way. And without that, we're never going to make progress. So that's my whole thesis with whether it's weight loss, whether it's diabetes, I get it. It's way harder for some people. I come from a morbidly obese family. When you put me next to my wife, we can eat calorie for calorie, the exact same thing. I will put on fat. You will literally hear me getting fatter as I'm chewing. It's crazy. And my wife will just get very hot. So she'll sweat through her clothes, her sheets, in the middle of the night. I won't, but I will put on fat. Cool. So we now both have a genetic predisposition for one way of dealing with excess calories. I put it on as adipose tissue. She uncouples heat. Great. Now, I am very emotionally traumatized by the fact that my wife can eat basically whatever she wants and she doesn't get fat, and I do. But if I just lament that and I don't make different choices, then I will be resigned to be like the rest of my family and I will be morbidly obese. But instead, because I've encountered an idea that influences my behavior, which is that I'm in control of this now, I make different choices and I get a different life outcome. So I'm not sure. People that fall into your camp, they tend to be very compassionate. And everything in my research tells me that you are very compassionate. But I don't know that it actually helps people to not say, hey, you're in control, make a different decision, get a different outcome.
- [05:56]
B
So let me challenge part of it, please. You've using the framework of freedom of will and choice in related but two in my mind, distinct situations. One is you raise the question of the mechanism and etiology and causation of diabetes. And there my response is, it is not all choice. There's clearly genetic predisposition. You take two obese individuals, the risk of diabetes is not the same, even though both are overweight. In fact, if you look at identical twin studies, the concordance of type 2 diabetes and identical twins is not 100%. Even though their BMI is the same, they're genetically clones, they're not 100%. And you could argue they've grown up in the same environment, their behavior is nothing. So there's clearly biological difference. We know that from twin studies. So all of that suggests that the etiological discussion, causative discussion, is not a black and white choice or not. You've raised now a very different question, which is if you're going to help somebody intervene who already is on the trajectory to diabetes or has become diabetic, as a clinician, do you tell them and say, listen, this is not your fault, it's choices. Absolutely not. That's not the two different situations and two different arguments there. You absolutely would say if you do the following, this will improve your situation. And it's never as a clinician now treating patients with diabetes for many, many years, it was about, you're gonna see improvement. Now. Some patients made dramatic change. It was absolutely clear that they changed their life. We've seen obese people completely normalize their bmi. Something triggered it, got them going. Others did and then relapsed, while others made no Change continued to progress. So it's a spectrum. And so as a clinician, absolutely. You start with improving what you can and then you sort of say whatever doesn't work. Now what else do I have as an option? And that's a interventional approach, which is different than understanding the underlying causative mechanism scientifically. I hope that's clear. You have to put two different minds on when you're a researcher versus a clinician. Not the same. Now the other thing that we have to ask ourselves is that as we go forward, what is it that we need to unravel in order to help more and more? A higher percentage of these people you earlier mentioned about sensors. There's going to be some people who just basically you give them a diet prescription and exercise and they change their life. There's others who need a feedback loop. And that feedback loop might be weighing themselves. Feedback loop might be the sensor. There may be another feedback loop. Maybe there's a subconscious feedback loop, not just a conscious one, that continues a neurological signal, hypothetically, that continues to change their behavior. It's a self because when you make a conscious decision, I just saw my blood sugar go 300. I'm not going to eat that cake. That's a feedback loop. But what if the feedback loop is in that conscious. So I'm just raising. Those are all things that are technologically more and more possible. We're all hearing about neurostimulation of our autonomic nervous system. Given how impressively, and I mean this, you've read those are on the horizon too. We're starting to see neuromodulation of the autonomic nervous system through non invasive stimulation sound this, that and the other. If that's a feedback loop, is that a conscious. Is that a behavior change? Free will. Do you understand where I'm going? So we can't close the door on that and all of a sudden you're going to do a lot of public good potentially if you can unravel that.
- [10:03]
A
So I think we agree wholeheartedly. So one I've said many times I want my tombstone to read, you're having a biological experience. The reason I'm trying to get people to understand that is everything in your life, everything, everything, everything is mitigated by your biology. So whether that is my wife being able to eat more calories than I can without putting on fat because she turns it into heat energy, whereas I turn it into adipose tissue or something completely different, that's irrelevant to me. You are you as an N of 1 have you are a certain way, your brain works a certain way, your body works a certain way, your gut works a certain way. It's going to be slightly different than all of your other humans. You need to make sure that you tailor something exactly to you. But the reality is that if you act as if everything were a choice, you're going to be in a much better position. So I need to do something different to maintain my physique than my wife does. However, we both still have to do a thing to maintain our physique. And once you let yourself off the hook and you say, oh, well, I. I'm just born to be fat, right? I again, coming from a morbidly obese family, the number of times I've heard that, like, oh, they used to say this to me all the time when I was a kid, you're going to get fat, too. When you get older, you're going to get fat too. You're going to get fat, too. You're going to get fat, too. And so in my early 20s, when I started getting fat, I was like, well, I guess this is that. Like, this is the moment everybody warned me about. And then I realized that you can't eat an entire tub of licorice and not get fat. And I use. Yeah, I had many misconceptions about sugar primarily did not understand how it could become body fat. That did not make any sense to me. And so when I said, okay, hold on. My life is an exact reflection of my choices. If I want a different life, I need to make different choices. All of a sudden, even though my biology is different, even though I may need a different feedback loop than somebody else, even though something may be harder for me than somebody else, the reality is everything I do has a.
- [12:10]
B
Has.
- [12:11]
A
This will be interesting to see how you respond to this. It has a knowable outcome, not that we know it yet, because I don't think that we can parse the data yet. This is why I'm obsessed with AI is it is the promise of being able to find the patterns in an overwhelming avalanche of data. And right now we all just get paralyzed because there is so much data and we treat it as if it is not knowable. And what I'm saying is this is knowable. Human biology is knowable. That we live in a determined universe, that if I had the processing power to understand the beginning state of the universe, I could move forward or backwards. And I think it is only that we don't yet have the processing power to track all those Complex interactions. Now I've heard that refuted that once you get into, I think it's known as the three body problem, once you have that third variable, there's just too much complexity. But when I hear that, I just say we just don't have the ability to track the amount of complexity yet.
- [13:20]
B
So look, I have no doubt in my mind that as computational capability and the power of processing, structuring, processing data, et cetera, continues to go up and I think it'll continue almost exponentially. We're seeing that, we've witnessed it. It's going to unlock connections and associations in data that we never imagined. One word of caution, go back to 20 some years ago when the human genome project was completed and the human genome had been sequenced. A lot of people celebrated, said now we will be able to identify every cause of disease because we know the human genome. Two flaws in that. One is we hadn't sequenced the whole genome because at that time the computational power capability was such that anything smaller than about 100 base pairs of SOAS and going off memory now was considered noise. So we actually only sequenced part of the human genome. We just didn't have the computer capability to really sequence everything. Too much noise. Move forward. We eventually did more recently complete the human genome project because we sequenced everything. The second is we learned we had assumed that one gene sequence equaled one protein. Then we realized that there were more proteins than gene sequences. There was clearly a amplification of that variability. After the genome had been transcribed, the data code read into what the proteins. So there was even more variability, multiple, several fold. Then we realized that protein function was even further amplified in variability because of the so called epigenome. And so every time data has unlocked our understanding of this variability, which is what you're getting at, we've realized it's actually given us a window into how a billion years of evolution has created diversity. Not just through DNA sequence or now the types of rna, but all of these other things are happening. What do I mean by that? We will unlock more of what is in the biological data set. So it now becomes known, but it will also very likely open up new frontiers, which has happened every time because we have more precision in our tools to understand another level of variability. Which is important. It's absolutely important, but I'm not of the school of thought, say now given if we just take our existing data set, suddenly have the computational power, this will give us all the answers, it will give a lot more answers and it will raise Questions so that we can can continue to answer them and add more and more precision to our understanding. It's not going to be that simple. We've been through this already in two waves that I just gave you examples of. They actually allowed us to get to the next level of depth. Likely that's what's going to happen. Now, I may be wrong, I hope I'm proven wrong, but history tells us this is likely to be the case. Now, should we be doing this? Absolutely, for the reasons that I just said. My job as a leader, you quoted some of the things I've said as setting the vision is to help my organization and hopefully parts of the field put aside for a minute that noise, that complexity, and try and bring simplicity to what the first step in getting to that goal is, so that we harness and focus resource. Because progress is made through different organizations in somewhat coordinated way, taking on pieces of the puzzle and then bringing those pieces together. We need to be very clear as leaders, what does the end game look like? What are we trying to do and what's the first step to that?
- [17:27]
A
How do you do that? How do you take an incredibly complicated topic and boil it down to the first step?
- [17:35]
B
I always ask my team to be fairly straightforward questions. We all know what our vision is, right? We want to expand healthy lifespan for the benefit of all. Simple, powerful statement. We help craft it. Health span, benefit of all. So if we look at that as our sort of guiding North Star, then we can say we got to focus on health span. Not just health and disease, but health is linked to lifespan. And we've got to be able to democratize this so that it has scale and impact. So if you put that filter on, you say, all right, of all the things we could be doing, the first filter is, is this really in the healthspan space and can it really be democratized either because of in technology or because of moral reasons? Right. You've read the possibility of taking plasma from young people and transfusing it to old people to rejuvenate. I can't ever envision approving in my organization that type of practice simply because I don't know how to scale it ethically, morally, commercially, you take your pick. It's not scalable. But if we could understand what the circulating factor in young plasma is that rejuvenates a combination of peptides, whatever they are, and now manufacture them, that's scalable. So it's really understanding the scalability and the path to scalability and then asking ourselves, what is our right to Succeed. I don't like to use the word which I use when I was in corporate life where it was much more appropriate. I don't like to use the term right to win because right to win is a very competitive mindset which when you're in a corporation, in a business is your job. Right? You're winning market share, you're growing your market share, you're winning the industry, whatever, right? When you're trying to lead a field, convene the best minds, convene the different disciplines and lead and make this into a movement. You shouldn't be talking about winning, you should be talking about leading. Not the same thing. Sometimes our leaders talk about being winners. I don't agree. In fact, I gave a speech in Washington where I said the challenge we now have as leaders of a country is we're starting to talk about winners versus losers when we really should be talking about our history has been about leading the world and elevating everybody. Think about, we're both Americans. How did we see democratization of US Inventions? Agriculture, transport, communications, entertainment, Internet, gps, cellular phone technology all got democratized and we grew. The world grew. It was leading, wasn't just winning. So as a leader, how do I motivate my people? I say, let's talk about leading this field. What is our right to lead and what is our right to succeed as a leader? So the leadership I hope is clear now. The question is, what does success look like? And that's where the roadmap comes in. What, what's the first step in that journey to that vision? If I just say that is the end point and that's is so daunting, most people will not take it on. Probably the biggest role I have as a CEO and you have as a CEO is finding the best, brightest minds, those young people to come join you in sharing that vision. They can always get a job. Question. Really? I always ask myself, why would they work in my organization on our challenges versus another? Why is this their choice? You don't want the people who just coming because they need the job. You want the people who have 10 choices but they choose to follow you. And you've heard me say this leadership is not a choice by the leader. Leadership is a choice that their followers make. So how do I make it their choice? And that's where I give them a stretch goal, but something they can perceive is within reach. And that's I think is the job of leaders. Clear on the vision. And then point out, here's the first step. If you achieve this you will gather the momentum to go and by the way, attract many others to come. And that's the right to lead. Can you attract, can you bring people together? You think about this meeting. One of the things that we're seeing as we're starting to launch this meeting is the meeting of a typical aging geoscience gathering. It's about 150, 200 people in the core biology of aging and investing in the aging space. We've had 1,800 people register for this meeting. That's a log scale more. I can't take the credit for that. That's my team's job. And they don't get all the credit. The demand must have been out there. What was missing in that void was the leadership role of catalyzing everybody to come together. That's where the leadership and the right to lead. If we actually bring together thousand, two thousand people at the same venue talking about the same issue from its different perspectives, you have got the right to lead, but others did it for you.
- [23:13]
A
When you manage procurement for multiple facilities, every order matters. But when it's for a hospital system, they matter even more. Grainger gets it and knows there's no time for managing multiple suppliers and no room for shipping delays. That's why Grainger offers millions of products in fast, dependable delivery. So you can keep your facility stocked, safe and running smoothly. Call 1-800-GRAINGER Click Grainger, or just stop by Granger for the ones who get it done. It's very interesting. I am of two minds of that, so I will point out, dear listeners, that we are speaking to the former member of the Commission on Competitiveness or something like that.
- [23:56]
B
So the US Council for Competitiveness.
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A
There we go. So I know in your past is a real understanding and recognition of the power of competition. Going back to the idea you're having a biological experience. Humans are designed to be competitive. We, we are hardwired to other somebody else and to want to win, to put it in a nice way against that person. And I'm a big believer. Don't try to change behavior, try to leverage it. Try to figure out what people are already doing and how do you hijack that neuron? So I know that people want to win. I know that people are going to look at some people as in group and some people as out group. And how do I leverage that? So one of my tools as a leader is, hey, we want to win like we want to. We want to be the best YouTube channel on the planet. We want to make the best video Games as judged by who plays the most, views the most, whatever. Like, I want to win now. I want to do it in a healthy way. I don't want to look at my. The people that I'm competing against as anything other than a worthy opponent. That's a big thing for me. I want to go up against people that are worthy, people that I want to see them on their best day. But I want to win, I want to beat them, I want to go head to head, and I want to outperform them. Now, if I don't, like, I don't know if you remember Nancy Kerrigan, but I don't want to go hit somebody in their knee so that I can beat them. That is not interesting to me. I want them to thrive. So funny. I've never talked about this, but I had somebody reach out to me back channel about one of the biggest podcasters in the space. You haven't even heard this. And they were just lamenting like, oh, this person's trash. Like, why are they getting so many accolades? They're this, they're that. And that's not interesting to me. I'm like, they're better than me right now. Right now. I want to believe that I can outperform them on a long enough timeline. But they are currently better than me, which is why they're getting more results than me. And that lights me up like, I'm on fire for that. And, and I wonder, because, look, I love that. Evolution is in a very unique position in that you guys exist by royal order, not even royal decree or whatever. The slightly lower version, royal order. You guys are going to do this. This is like a mandate from the king himself. Cool. Love that. And so you guys don't have some of the pressures, but the human animal, like, if. If you told me you need to go solve XYZ problem, what do you need to make it happen? I'm like, oh, find a way to make the people that win at that rich and people will do it. I'm not saying that that's good. I'm just saying it is. It is true. And people want to claw their way to the top. The, the best, the brightest, the most aggressive. They want to win. And do you think that one, you've had a ton of success in your life, and so it's much easier for you at this point. You've not only do you have financial success, corporate success, it looks awesome on paper, you also have marriage, success, kids, grandkids. Like, you've really got the thing. And you've managed to align yourself with people that don't need a financial return. But do you think that that is a scalable model or am I positioned in a more scalable solution where I'm like, yeah, just find a way to help people get rich and the human tendencies will take over?
- [27:41]
B
You have, I think you've made some very profound statements, many of which I would not argue with, but I want to give them a slightly nuanced context. By the way, the only good decision I've really ever made was married the right woman 41 years ago.
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A
Smart.
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B
Everything else you just stated about my career and personal life is 90% hers. And the rest I sort of came along on the journey. So let's just put that on the record. There's very good scientific evidence that our motivations clearly change through our life stages. There's no question when we're teenagers, in our twenties, we're very self focused. That's natural. Why? Because as a species, as a young person, you're trying to find your place in the world. You want a voice, you want to be heard. But there's also very clear evidence that if you want to look at social impact, giving forward all those things that happens much later in your life, A because you have the capacity, but also because your thinking starts to become much more nuanced. The gray areas, what was black and white? You know, when you're a young teenager, 20s, things are much more black and white. You know, it's the classic saying. You know more about a topic when you've read the textbook than versus when you wrote it. Okay. Having been both a reader and a writer, I really knew far less after I written the textbook chapter than when I was a reader. You learn your limitations. So I think that's. We've got to take that. First.
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A
I want to make sure people understand what you're actually saying because you were talking about this earlier that as the island of your knowledge grows, so grows the shore of your ignorance. It's called the Dunning Kruger effect, which has been on full display, by the way, because I know less about this topic. I am far more bold in my predictions and my assessment of what the future is going to be. You know just enough to feel like you know everything and you don't know so much that you realize, oh my gosh, I know nothing about this topic.
- [29:53]
B
Yeah, well, so I've. I felt it personally. My son was a graduate school of business at Yale. Every class he'd come back and tell me all the things I was doing wrong. As a CEO, that was his latest management class. Okay, thank you, son. Got it. Next time I teach in your class, I'll make sure we come. That's normal. Okay, so that's one thing, put that in context. The other is competition is good. The desire to win ethically, morally, just like you pointed out, it isn't at the negative consequence of somebody else, that's good, but it's a tool. We know from, let's say competitive prizes even in the technical field. Right? Prizes like the SpaceX prize, which was sort of the publicly well known prize, not only achieved technical success, but launched three or four very valuable companies by the participants in the race to be the first. It's not bad. Our whole IP patent process incentivizes competition to be the first because you reap the greatest benefit from that return. Our whole IP structure in the western developed world is based on that. I'm not saying competition is bad, but I'm saying it's not the only tool. It is a tool in the armamentarium to bring forward and have social and public and better humanity. Think about which scientist in recent memory has had probably saved more lives than any scientist to come. If you think about it in life sciences, it's a Nobel laureate called Norman Borlaug, never made any money, he wasn't in a competition. But he was the plant biologist that invented dwarf wheat. That dwarf wheat funded by the US public health investment. He was coming out of the Department of Agriculture and through government tax, non patented research develops dwarf wheat, most of the benefit for which was in South Asia, because they went from one wheat crop a year to two. As a result, a minimum of a billion people were saved from starvation. Think of that. And so a billion lives saved, saved, not diseases treated. I can't think of very many drugs that have ever done that, if any. And so was that by competition? No, the competitiveness there was to win and succeed, to unlock a natural capability because it was natural breeding. He wasn't doing GM or he actually created that breed. So I give you that example to say massive good can happen at scale through collaboration. Now you use the word leverage. I love that word. But I give the leverage another context in addition to what you're saying. Leverage in my mind allows you to do things primarily in two, maybe three things. First, it results leverage results primarily from collaboration. When you collaborate, you get leverage. When you collaborate, that leverage allows you to have scale that you as an individual couldn't. And that scale allows you to get impact at a level that otherwise not possible. So Leverage is one of those ways. And so competition is one lever, but on its own is rarely enough. Take the space X Prize. Somebody got through. Did everybody suddenly start going to space? No. Now you attracted capital entrepreneurs, material scientists, people unlocked other things. And now you're starting to see commercialization. New countries are entering the competition for space. But it took somebody to prove it in a competition. On its own, it wouldn't go any further. Think of any competition. Think of. I gave you the example of cellular phones. Competition brought the private sector to give you cellular phone technology. They didn't invent it. The invention came from the US national lab system that actually created the underlying technology. Same with gps. Geolocation is happening because of that. So it's that public private partnership. When we think about as a private sector, we forget all of that which was actually in the non quote general competitive space. The COVID vaccine. Everybody says the private sector in 12 months gave us a vaccine. No. It was 10 years minimum of investment by the US taxpayer, primarily in academic centers and the government labs to give you the underlying technology that could be rapidly applied. That was the competitive part. But you Forget the other 90% which is not competitive. Without that there was no competition. So I just give you that it's important as leaders that when we think about competitiveness, we put it in the framework of what it will take, not just one piece.
- [35:08]
A
Well said. Okay. We've been talking a lot about extending people's lives. Why? What, what is a life well lived? What should people be doing with all this extra time you're going to give them?
- [35:24]
B
I think that those is. That's going to be coming back to people being able to do based on the choices they want to make. The loss of functionality and the decline in health results mostly in a person's inability to do the things that they choose to do. They make compromises. They may want to do things that they no longer can simply because of a decline in their health. A pilot who's flying gets grounded because their vision does not have the same acuity that they had when they're 30. They lose their medical in a time when we probably need three times as many pilots in the US could say the same for air traffic control. I'm just giving an example of an industry that's massively short right now in training. That's why so many flights are canceled because they don't have crew. Why? Because we ground the pilots at certain age. They don't pass their physical anymore. They're done. Loss of visual acuity is not A choice. That's an aging process. Being able to maintain that allows them to choose to continue to flying or retire. Most pilots that I know, and I happen to be a pilot actually will tell you they don't want to ground themselves. They enjoy it. They want to continue to contribute. Took decades of experience to learn. They're grounded. So I can give you lots of examples. A surgeon who no longer has the manual dexterity, but has amazing intellectual experience. 40 years of experience knowing not only how to operate, but when to operate.
- [37:08]
A
But what's the takeaway? That contribution is a life well lived.
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B
It's a choice. Contribution in the examples I've given you is professional. Another might be contribution because I want to be around to teach my grandchildren things about their heritage, my values as their grandfather, the society they live in is contribution. Being able to support, not just financially enabling my children to do things because I'm around to be able to do things with my grandchildren is a contribution. I remember my son coming to me and saying, dad. Actually it was my son in law, sorry, dad, your grandson just went through a health and human biology class in school and they have to talk about human health and reproduction. And I think he needs to have a talk with you. I said, when was I the designated. Oh, no, I think you do it best. And off we went for a walk. I would think that's a very important contribution. Probably took it in my family situation in a better context taking it from their grandpa than their parent. I play a role in their life. It's a cherished role. So that's contribution. I've given you two ends of the spectrum. Both are important. If I didn't have children, I could be mentoring other young people. I do mentor young people who are no longer employees of mine, but I'm still their mentor. Being able to do that is very fulfilling for me. Nothing to do with monetary return. And they're not doing it because they work for me.
- [38:45]
A
Have you read Man's Search for Meaning?
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B
No.
- [38:48]
A
Whoa. I think you will love it the most. It is one of the most influential books on me that I've ever read, written by Viktor Frankl, survived the Holocaust and he talked about how basically you have to find meaning and purpose. And it's sort of the Nietzschean line of he who has a strong enough why can survive almost any how. So same idea. And I think it's very much tied to contribution. When I think a lot about fulfillment, which for me is the ultimate point, I don't think that life intrinsically has meaning. I think we all give it meaning. But I think to your point, we've had a billion years of evolution. You are hardwired to. To pursue what I call fulfillment. As far as I can tell, fulfillment has a recipe. And that recipe is you have to work very hard to gain a set of skills that you care about that allow you to serve not only yourself, but other people. And as much as I, to get away from that need to serve other people, I really do think that that is intrinsic. The one thing I think I would really struggle with is if I were alone on a deserted island or I was the last human. I like to think that I would still be able to emotionally thrive. But I don't know. That's the one thing where if I didn't have another person to be able to do something for, it'd be tough. I think a lot about my life and why, because I'm a very solitary person, a very solitary person. But I'm nested within the context of a very happy marriage and so, and a business, for that matter. So while I don't pursue a lot of, like, friendships and go hang out with the boys and I just don't do any of that, my cockiness around my ability to be alone is still nested inside of my. A deep sense of the word that comes to mind is obligation, but in a positive way where I. There are all these people that I need to help and do things for and show up for and be strong for. And I think without that, it would get dark very fast.
- [41:02]
B
So you've just stated that like most vast majority of people, you're human. Here's why I say that to my knowledge, there may be an exception that I haven't come across. Many animals teach the next generation, all of them teach. Where the next generation emulates what the past, the parent does. It's mimicking. And eventually by repetitive mimicking, they pick up how to do something. And that's how knowledge is passed. And so if the adult chimpanzee cracks a nut in a certain way, the baby keeps doing it one way or another and eventually figures out that there's a certain way that it's done and it's figured out. Humans are the only ones that I know of that actively teach. And through that active teaching, they instruct. That instruction is hardwired into us as a human species. It's very unique about being human. It is not simply we don't learn passively. We learn through instructions. That's a human attribute. And what you're doing today is contributing to that active teaching of a very large following. So I would challenge your term of you are, you know, quote, a very individual, whatever way you want to put it because not only is the marriage, but you actually have an extended sphere of active influence through your current role, through the businesses you've built and even the nutrition business, food business you built was in part to change and actively, actively change and impart certain enable behaviors on your customers or consumers. That's what makes us human. That is very much the part of where almost all of us are wired. So there are some attributes and sometimes we forget we're actually the only active teachers in nature.
- [43:07]
A
Let me ask if we could live forever, should we.
- [43:11]
B
I don't know whether we should or not. I honestly don't know. However, it's the same as saying should we treat any biological process. In my mind I come back to being a physician. I want to alleviate suffering, I want to prevent suffering. Aging causes probably more suffering than any condition I know, even more so than hunger. Just look at the numbers. And so if we can alleviate that and allow positive contribution to society, I'm modest enough, ambitious enough to push that envelope and modest enough to say I don't know beyond that, what else might be possible? I'm a strong believer in. That's more of a moral question. And so science should not. Scientists shouldn't derive the definition of morality. In fact, one of the first things I did when we launched evolution, remember we had two employees, is I asked our number three employee of the team to put together an advisory, expert advisory panel of bioethicists. First thing I did, I was fortunate with a long standing friend who's professor at nyu, Professor Arthur Kaplan to agree to chairing that. He's one of the foremost thinkers in the world in this space. Not a biologist, but he's a bioethicist. And we approached him and said would you put together. And he approached, we both approached Professor Julian at Oxford, who was the founding chair of bioethics to join that. Then we approach somebody from Asia, the Middle east and put together global bioethics to start to ask the question where is bioethics on the areas that we're working in? Shouldn't be my job as a CEO to do that and it shouldn't be a scientist's job to define that. I think this is where it's important to get the people who are thinking about these questions, including that should be guided by us. I'm very, very firm with the team. We should be looking at what we want to Go what the possibilities are. We should always be guided by where that line is. And remember, as you know, I know from your discussions, ethics is itself an evolving science. If I may use the term science because use the word discipline. It evolves. It evolves with society, it evolves with knowledge. And evolves because the questions being posed 20 years ago I said 50 years ago cancer was incurable. And so there was never an ethical question of should you cure cancer? We had no choice. Now it raises a different question. By the way, cancer is very relevant to aging. I just wanted to throw that in. Science has made amazing progress in curing childhood cancer. Most children who got leukemia died today. More than half majority will get cured. We have the drugs, we have the treatment, lymphomas, young men getting lymphoma, young women getting lymphoma in many cases are curable. That's a win. However, we now, 30 years of treatment, of success have realized that most survivors of cancer have accelerated aging. Their body ages faster than their peers who didn't get treated for cancer. So was it the underlying cancer's existence changing their biology? Were their underlying biology different or was it a consequence of the treatment? We need to answer those questions now, which really will start to open a new frontier not only in what causes aging, but when to intervene. Let's say we figured this out and we could prevent the future accelerated aging of a young person, teenager, young adult, who's now being treated for cancer. Should we be intervening with quote, I'm using the general term anti aging therapy right after they've recovered from their cancer to prevent that? Don't know yet. But we'd better start looking now because we're going to have a lot of successes that now are living with that. There are some genetic diseases that we know cause aging. Down syndrome is an example. Accelerated aging. These children die as young adults. Their life expectancy is low. What is it about the genetic change of Down's that changes the aging process? It's a single chromosomal difference. Right? So there are now going to be ethical questions. When do you intervene? Who should you intervene on? So I don't want to be the only one answering the question. It's a long answer to your question. I've thought about this extensively and again I'm at a point in my life I say bring in the experts to help guide your thinking. Yes, I've got it. As the CEO I'm accountable for the decision at the end of the day. But it should not be in a totally top down here. Let Me tell you what the answer is. I don't have the answer.
- [48:37]
A
Has the bioethics team that you put together given you any warnings?
- [48:41]
B
They have raised questions. Right. I've given you an example of plasma transfusion. Right?
- [48:47]
A
Young blood.
- [48:47]
B
Young blood.
- [48:49]
A
Now here's another one actually ask you about the young blood. I'm glad you brought that back up. So I, I, I love the idea that somebody can monetize their body. And if somebody wanted to sell their blood, why does that bother you? Or a bioethicist tell you why it bothers me.
- [49:15]
B
It comes back to your question of free will and choice. Okay. Science over the years has evolved. We lived through a period where through persecution, genocide, we were experimenting on humans. That is atrocious. Go back to World War II. We then lived through a period where we were experimenting on African Americans without their consent. Right. We were at some point incentivizing paying volunteers to allow us to do research. If they're prisoners, they got extra privileges. That's a form of payment. Is that free will? Is that choice, or is that coercion?
- [50:01]
A
All of those were coercion.
- [50:03]
B
Okay? Now, if you are a poor person living in an inner city and you get a financial incentive to sell your plasma as a young man, I'm picking man because we're both to donate to somebody. It is quite possible, and the evidence suggests that the person selling their plasma is not of the same socioeconomic class as the person buying. If that happens. Is that coercion? Is that free will?
- [50:36]
A
That sounds like free will to me. Why, if I can sell my time, why not my blood?
- [50:42]
B
Selling your time, I think most biathicists would argue, and I certainly am of that camp, is an employment. Where there's a general, here's a transparent value proposition, or my time. When I'm selling a part, where do you draw the line? I've sold my plasma. Can you sell an organ?
- [51:04]
A
No, because it's not replenishable. That would be where I draw the line.
- [51:08]
B
Okay. So I don't know how much plasma I can take before I've done myself harm.
- [51:16]
A
Okay.
- [51:17]
B
I mean, let's, let's take a look at the city. Prevalence of iron deficiency, thin blood in lower socioeconomic classes. Much higher than higher socioeconomic classes. Are those the populations you want to be buying blood from, even if it's free?
- [51:30]
A
That's a different question. I'm just. For me, the ethics of the situation come down not to scalability, which was, prior to asking that question, the pushback I'd always heard you Give is I, it's not scalable. Some things just aren't going to be scalable. But at the same time I wouldn't want to, I wouldn't want to deny somebody the ability to monetize their time, energy, body, whatever in the way that they want if it is non destructive. Because I get, if it's like, if it were like, oh man, I can't make ends meet and I want to sell my kidney, I can see how that one can go gnarly pretty fast. And I would say I'm not a libertarian, so I'm not about like hey, no regulation. Like obviously if we were going to do this, you would want it to be something that's regulated to make sure if there is a limit to what people can give before it starts being detrimental that you draw those lines. But this is, this is a very interesting moment that we're going to live through. Anytime you're living through a hyper transition, it's going to get weird really fast. And so as we figure out what works, what doesn't, it's going to be weird. There was a time where iPhones were based basically only for the wealthy, but then you get very good at producing them and the cost begins to decline though they're still pretty expensive. But cell phones get cheaper and cheaper. So if you look at this, if there isn't a way to monetize it in the beginning, like if we have to go from nothing to democratized with no intermediate step, I think it's going to be extremely difficult. The place where bioethics starts to scare me in terms of should we all live forever? Going back to that question is I think it was Max Planck that said science does not advance one insight at a time. It advances one funeral at a time. You're having a biological experience. The mind works in a certain way. It is terrifying to me how hard it is for human beings to change. If I'm right and we are all roughly the equivalent of 120 sided dice rolled and whatever, your 120 sides roll up like that's just who you and what you're going to be like. And obviously the permutations are in the billions or trillions. And so the big question for me becomes all right, if I look at people that can't change, like they're crazy because my 120 sided dice came up that I'm just hyper malleable, which feels very true. And I think my brain should be studied for science because I forget very easily in a way that I find distressing that my wife wishes she had, but nonetheless may be the key to why I'm so malleable. I don't. I just don't get my identity doesn't get caught up in weird things, largely because I just don't hold on to them anyway. I don't know if it's a blessing or a curse yet. It's just how my dice have rolled. And so to me, experientially, it does feel like humans can change a lot. But when I step back and look at people, I worry that Max Planck is right, that the only way to refresh a population to keep things moving and to keep progressing is for people to die off. Here's how I think evolution has shaped us, and this really worries me. We are the ultimate adaptation machine, but the way that we are created is such that you're hyper malleable at the beginning of your life and you become less so as you age. And you more or less sort of post 25 are very rigid. Not that you can change, but you probably won't. And so functionally it becomes effectively the same thing. And so because of that, even though we are this extremely adaptable creature, we do migrate out of the age of imprinting. We become effectively a static being. And so you need to refresh the population just by killing them off. And so even though, like, I really want to see if we can get to living forever, I'm also not sure that it's wise.
- [55:27]
B
As I mentioned to you, and I think we're agreeing, I don't know if it's wise or not, but fortunately right now we don't have to answer that question to continue to do what we're doing. So what's the first few steps we've got to make progress? Agree. Whether I agree on the notion that you have to kill off in order to make progress, I don't agree with it as an absolute statement.
- [55:56]
A
Because you have a more profound belief in our ability to change.
- [56:01]
B
But societies continue to evolve, right?
- [56:03]
A
Does that mean people die?
- [56:06]
B
I'm not sure. Their ideas don't die, they evolve. Do we live because we're physical beings or we live because we leave ideas which continue to evolve themselves, but it's an evolution of those ideas, not a revolution. There's some things that challenge our norm and eventually we look at these laws of physics are being challenged. Nothing wrong with that. But it's an evolution. I don't think it's a revolution of a complete replacement. There's updated versions of our ideology. But are we biologically any different today than we were as cavemen. There's no evidence for that. Yes, there's been some culling of the herd, but modern humans biologically are modern humans. But what has evolved has been our thinking, our morals, our values. Those have been multi generationally been evolved. That's what makes us said uniquely human. So I don't think it's just a replacement. And I distinguish between our physical presence on this world versus the ideas we leave behind. Right. And our physical presence. Yes. We'll have a finite time as far as we can tell. Will it be permanent? I don't know. However, let's ask ourselves that as we, you know, this comes into the sort of our philosophy. How do we live on even biologically, we are still as humans going to be living five generations from now because our DNA will be our genetic code right down to that fundamental level. Your genetic code is still a derivative of your ancestors. Your germ cells are the oldest living cells from multiple generations. So we know that is happening. It depends on what you define as the unit. You're coming down to that level, you're coming down to the full society and culture level. Where do you want to draw the line of us living forever? I don't think it's that simple. And this is where we get into sort of the scientific debate of life and the definitions. But me as a biological organism being alive on this earth contributing, we have been striving to that contribution ever since medicine came about. Nothing new about it. The day we figured out we could treat somebody with a fever and stop them from dying from a fever by giving them bark of a tree, we were preserving life, we were preserving functionality. Just using more precision and more and more powerful tools. It's just an evolution of that. You know, a lot of people say to me, well, you know, in our grandparents generation, we never heard of cancer. Yeah. Because the life expectancy was 50. Nobody lived long enough to get a cancer. Most cancers are age related. Now that we're living long enough, we're getting those. So now we've uncovered challenges. Type 2 diabetes was almost unheard of. But at the same time, adults didn't live long enough to become have diabetes. Weight gain was part of that too.
- [59:06]
A
While age is certainly a factor in type 2 diabetes, I come back to my very strong conviction that this is. You can track it to the increased amount of sugar that people eat. And probably that's the ideology.
- [59:21]
B
But as I said, you define diabetes as hyperglycemia.
- [59:24]
A
Yes. What do you define it as?
- [59:28]
B
So how did we come up with the definition of diabetes at the, you know, we define a cutoff about 118 milligrams per deciliter. Right. It's an arbitrary definition. Doesn't mean depending on who you look at is 120, 118 is 116 not diabetes, 110 not diabetes.
- [59:48]
A
The pre diabetes stand.
- [59:50]
B
So you now you're putting the prediction right, so you're picking your cutoffs. What we do know is if you look at the onset of diabetes, it's clearly age related. It's not 100% weight related. It's a difference in our body mass, lean body masses, a whole variety of things. Two individuals. I'm Asian, you're of Caucasian descent. My risk of getting type 2 diabetes or the same BMI is at least twice yours as we get into the higher BMIs. Why is it my genetic risk from obesity is far higher than yours
- [60:27]
A
by
- [60:28]
B
making the same choices?
- [60:31]
A
Yeah. Okay, so let's dive into it. And the great news is that you will know so much more about this. You can correct me where I go.
- [60:37]
B
And by the way, this is why the WHO has challenged the definition based on BMI of healthy body weight in Asians versus Caucasians.
- [60:46]
A
You're talking about the classification of obesity
- [60:49]
B
and ideal body weight.
- [60:51]
A
Well, so ideal body weight is a very confounding issue. I'm talking specifically about the reason I think diabetes is something to pay attention to is I think sugar will again, layman, not again, but layman's terms, it will burn you alive from the inside out. You are going to glycate your tissues, it's going to get gummy. Things are your HA1C levels are effectively how much sugar is binding to your proteins, that the sugar binding to the proteins is a problem and your cellular machinery will not work well because there is just a raw biological reality of what happens when there is an increased amount of sugar in the system. Glucose in your bloodstream. You're, you are now in the same way that a senescent cell makes it. What we know is that it's not working properly. What I know when somebody has the presence of too much glucose in their system is something breaks down. Now whether that's a response to the level of insulin in your bloodstream, whether it's actually the sugar molecules binding up in your blood, I won't even speculate on that. I will just say it is self evident that there is a causal relationship between the amount of glucose that you like. I can break anyone. No matter how resistant you are or no matter how good you are at handling an excess amount of sugar, I can break anybody if you let me give them enough sugar. So given that that is a very predictable way to break the cellular machinery, I'm just saying you're gonna wanna pay attention to that. And you can do this to a little kid. It might be harder to do to a little kid, but if you let me feed that kid like we feed a goose to get pate, like it's just too predictable of an effect. So that one to me is, and look, I, I, I have a feeling, look you, if, if I were mapping your personality, I really have a strong instinct that you are hyper compassionate and that if you put humans on a spectrum, I think any social creature has to have people that are hyper compassionate and has to have people that are hyper on the personal responsibility. I'm probably somewhere in the middle but my thing is getting people to understand that you're not a bad person if you're a type 2 diabetic, even if it all was your choice. And we both acknowledge that it's going to be harder for some people than others. I think we also both acknowledge that free will is just an illusion anyway. But again going back to you're changeable and so the ideas matter, you're not a bad person if you're a type 2 diabetic. I want to be very clear about that. I don't pass any moral judgments. I'm a big believer that you cannot hate that which you love. I come from a morbidly obese family full of type 2 diabetics. I don't think they're bad people. I don't think they're less than a non diabetic. I don't think it makes me better that I'm not a diabetic. But when my North Star is to alleviate human suffering, you want to talk about suffering? Make somebody a diabetic, make them have to amputate their toes, then their foot, then their leg like that. That is a nightmare scenario. Also just being inflamed all the time is nightmarish and this is a, it is a solvable problem and it's all controlled through diet. And I hope that people hear a message of hope in that. Certainly not condemnation, certainly not. You're a bad person. Just hey, there is a different choice you can make that will give you a different outcome and that outcome is a better as judged by suffering life.
- [64:32]
B
I think as we talked earlier, I'm not disagreeing all the benefits of lifestyle choices. Absolutely agree. We came Back to this question. Based on the fact that we gain weight as we age, what is irrefutable evidence that for the same body weight, different populations have different risks of getting diabetes? It's very clear. Look at body mass index. You look at total body, whichever variable adjusted for height. Because Asians on average have a lower height in certain populations, the predisposition to diabetes clearly is different. If we look at populations with genetic disposition for diabetes, some populations have prevalences of over 50%. It raises the question, what is it about those populations that either they're all making bad choices and in some cases the risk is 60, 70% of their adults, or is it a combination of things? And I think as a scientist, one of the things that we must always do is question our assumptions. To say these exceptions to the rule may well be questioning the rule. That's where I'm going now. As you look at history, and I'm sure you've done that since you've read a lot about SUGAR the last 50 years, we had two camps. We had the London UK camp which was a strong proponent of sugar is the bad culprit. We had two camps in the U.S. minnesota and Boston. There were strong proponents of fat. Fat is the culprit. The fat camp won. The consequence of that was actually quite profound. We had a whole two to three decades of fat is bad. We had low fat foods. We had, you know, low cholesterol this, we had low that. And that fat was replaced in all of our supermarket foods with high starch, high fructose corn syrup. Everybody wanted a low fat food because fat was bad. That came because of the argument being now we can get into how food policy was changed and subsidies and what the drivers were. I have spent enough time in thinking about food policy in part of my life to really dug into understand it wasn't by surprise that the US became the industry driver of high fructose corn syrup. Wasn't by accident. Clear policy changes. Okay then. In the more recent past we've seen a rebalancing the sugar camp arguments have come forward which is all the things you're espousing. No question. I've given careful thought in actually performing studies on how our body responds all the way to quantifying using radio tracers and radioactive labels in humans to quantify what fraction of protein gets converted to sugar versus the different sugars stuff I've published. Given that collective. We do get a much better picture of what you're articulating is that however that itself, all of that on its Own doesn't leave you with the assumption of this all or none. It's one or the other. And all I'm saying is there's variability amongst us, and that variability results in different responses based on our underlying biology being different. There is not such thing in this context. Metabolically, a prototypical single human being. That's one of the challenges in creating a digital avatar human to do experiments on. It's likely going to be a digital twin, not a digital human. That's why. And it's not just in drug development, but understanding our biology. If you go back to a paper I published back in the 90s, when I was, you know, young, scientists really got interested in saying, hey, we eat a lot of protein. What happens to it? Why doesn't our blood sugar go up when we eat protein? Well, maybe it doesn't get converted to sugar until we quantified it. I published that paper. 60% of the protein, if I feed you within eight hours of consuming it, becomes sugar. 60% appears in your blood as sugar, and yet your blood sugar doesn't change. And yes, your insulin goes up. Why is that different? And then you start to understand it's not just the insulin and the sugar. The glucagon is different, the other hormones are different. And so it's the net of that. So that was the start of my career. I mean, I was supposed to be a classical physician and ended up trying to ask, when I got to be a graduate student at the Department of Agriculture, most of my peers said, why are you going from the medical school to the agriculture school? I really wanted to understand this. So I spent a fair amount of time thinking about this.
- [69:51]
A
Speaking of things you've spent a fair amount of time thinking about, your company's going to need time to get the breakthroughs, create the innovations. What lifestyle do you want to see people live so that they're still around to take advantage of the breakthroughs that are coming?
- [70:07]
B
I think somebody asked me the same question in a different context, which I think is a very important question, which is, why aren't we investing more in public health? The challenge with public health, which I think is a powerful tool, is that there's a lot we know on what needs to be done which would have an impact on individuals and populations. But the gap is the translating that knowledge into action. So we need to invest a lot more in translation of that knowledge. And the almost glib example I give is, if knowledge was the barrier, then doctors would never smoke. But we know many physicians, I personally know that still Smoke. Not because they don't know. Of course they know. I know cardiologists that smoke. It's crazy. They know, but they still smoke. So what is it? And understanding that gap between knowledge and behavior needs a lot of research and interventions. And so in the absence of that. So one thing is advocating for that. Absolutely. Another thing is figuring out and asking people to do what we already know. You and I, in some ways I would use the word are fortunate we have BMIs. I'm just estimating and I know my BMI below 23, you're below 23. We're in the minority and certainly in my age, I'm in my 60s. I'm in the minority with that BMI and I'm being healthy in that bmi. Why am I different? I asked myself that question. Why am I different? What will it take for others to do? Because if others were doing all those things, then yes, I would answer your question. I just don't know how to get others to do that. I know what they need to do. You live it every day. I just don't know how to do it at a scale. How do we figure that? And I think we have way under investigated in the translational public health science. And we need to support schools of public health just as we're supporting biology. We need to ask ourselves a question. I don't know the exact number, but it'd be interesting to find out what percentage of us research funding goes to schools of public health versus other part academic. An interesting question. I. My guess is a very significant minority. Yet they've probably had the biggest impact on population health and within that sum of individuals and probably any part of the medical school.
- [72:50]
A
But knowing what you know, assume you're speaking to people that are willing to do what it takes. They are out there. What would you advise them to do? I'm guessing not. We're not smoking.
- [73:02]
B
I've never smoked.
- [73:03]
A
Not doing that's an easy one. So what should they be doing?
- [73:07]
B
I think easy to state, but I'll state calories limited to keep your BMI down. So that's the quantity side. I personally believe I eat everything. I eat everything. Chocolate cake, Love it. Dessert, Love it. Fried food, love it. However, infrequently portion control. And if you make up, if you're going to indulge in one meal, make it up for the other. I don't have a problem with indulgence. The question is the frequency. Okay. And if you keep that in mind, quantity enough gap between meals, you have a large Meal, then skip a meal. That's what I do. I have one main meal a day. I'm not intermittent fasting. That's the fad. Maybe I was intermittent fasting for years. But skip a meal. Regular activity. I have a standing desk in my office. Yeah, I can sit down. You know, it's the luxury of being the CEO like you. Hey, guys. But I have a standing desk. I stand. I like to hold many of my one on one discussions with my executive directors standing up. They get used to it. They kind of come and talk to Mahmud about an issue. We're both going to stand up at my desk. It's this high. So they have no choice. They're going to sit and be underneath it. They'll be standing. So they stand. After every meeting. I go take a walk of the office. Little things like that. Good sleep pattern. I go to bed early. I don't eat late. I usually have my dinner around 6 or 7 o'. Clock. Yes, I have a busy travel schedule. I'm typically on a flight every other week. And they're not short flights. I'm going to the uk, to the us, to the Middle east, sometimes Asia. Right. Long flights. I get off a plane, I look at my sleep pattern. I make sure I go for a walk out in the sunlight. Everything. Nothing profound, but it's the sum of the little things that make up my lifestyle. Spend a lot of time whenever I'm around with my grandchildren. You know, people ask me, how come you're so chilled out? You know, you have a pretty busy lifestyle. The most calming thing I can do is have a conversation with my little grandchildren. Talk about it. One of the funniest things I heard my grandson, we were talking about space travel. And I told him, In 1969, we had a school class assignment which was to watch the landing on the moon, so we could write something about it. This was elementary school. And I was telling my grandson about this. A few weeks later, I heard him talking to his friend. He says, you know, my grandpa was alive when they landed on the moon. This was like the most remarkable. I thought, now I feel old, right? But telling them that story is part of that. You know, we immediately jump to things like what can we eat to stay healthy? Part of all of our friendships, our circles, our family. That balance is part of us. It's what keeps us healthy. I think it's a strong effect on our blood pressure, on our stress levels. We have the tools, by the way, to measure stress biochemically. We can measure in your blood. We can measure in your vascular system? Lots of tools. It raises a question to me as a clinician. I've got actually a team working on this. You were talking about feedback. I said if you didn't have to worry about reimbursement, insurance or Medicare or UK nhs, whatever, you didn't have to worry about it and you didn't have to worry about the cost of it. What are the best diagnostic tools we could bring to the table today that are available but not utilized? Because either they're not reimbursed or they're too expensive and they're scientifically proven. But the cost of getting them to a regulatory. I'm not talking about danger, I'm talking about just diagnostic tools. What would they be and if they were applied to assess function relative to aging, how would you put not one device but the aggregate of it, what would that panel look like? I don't know the answer to that, but I've got a team actually working on that. Not because we want to create IP around it, but I want to bring the best minds from around the world. So we got ophthalmologists who studying vasculature in the eye, cardiologists studying vasculature, musculoskeletal experts, biochemists, exercise physiologists using all the tools that they do in their profession. But now to the clinic domain. Put it under one roof, under one clinician. Say, what does that protocol look like? If you could do that and it's not going to take one specialty because there is actually not a residency you can do in that specialty. Pioneers like Peter Attia, sort of a self taught. But imagine now bringing all these disciplines in a formal training at that depth that hasn't happened. What would that look like? You know what, that would be fascinating if I could do that measurement on you today. I suspect you'd be curious. And if it could show, well, my eye vasculature is at this stage, my peripheral vasculature is this stage. My muscle biology, my stress level in my endothelium is this layer you might want to know that might change. So coming back to your question about what could people do? There's things they could do, but there's things we need to start thinking about doing to the profession so that that those who choose now we talked about democratizing, you're going to say, well that's going to be really expensive. And yeah, you and I might be able to afford to do that, but what about the masses? Well, do you remember? Well, I'm old enough, you may not be old enough. You remember? I remember when anti lock brakes came to the market you literally had to have a really expensive car. Because the first anti lock brakes came on Formula one cars and they were so expensive it was never considered a technology to be democratized. Now the cheapest Asian car you can buy has anti lock brakes. Just about that was democratization of a very expensive technology for the reason you were saying earlier where you were going, you need to have that test case of its potential in a limited market and then another part of industry figures out on scaling it do the same on diagnostics. Now one of the questions I'm curious what is that anti lock in the Formula one car equivalent? And there's lots of examples in Formula one that came inertial seat belts, this and the other airbags that could be democratized. But we need the investment to figure out what that prototype looks like. We haven't up until we started these initiatives it was really the domain of some very ultra wealthy client clinics. We want to bridge that, figure it out. Not to just create commercial scale of it and then figure out how to democratize but that we need to put to consumers. And I think there's a chunk of consumers I don't like calling them patients. Patients implies they're coming to you for a disease therapy. They're consumers just like we consume anything else. They're going to come forward and say I want to know if that now became part of your routine point of care assessment on an annual basis. I think the cost would come down. You could change behavior. I would want to know my stress level is at a much higher level than the average and I can change it.
- [81:00]
A
I know that feeling. This has been amazing. Where can people follow you online?
- [81:07]
B
We update. I say we because I have help supporting me to. I've never got up to speed how to do but I love posting things on my LinkedIn page. We have a LinkedIn page for evolution itself through that and podcasts like leaders like yourself. You're right at the cutting edge of this and then there's others who sort of and I'm not trying to flatter you but you know, you yourself influence and then inspire others to do other versions of this and you're going to see more and more of that. And if you think about the announcements that we're making in the next 48 hours and certainly in the next 24 hours, four hours, I think it'll get a lot of attention from people. I love it.
- [81:53]
A
I'm excited. Everybody speaking of things you should be excited about. If you haven't already, be sure to subscribe. And until next time, my friends, be legendary. Take care.
- [82:02]
B
Peace.
- [82:03]
A
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