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Dr Rangan ChatterjeeDr Rangan Chatterjee

Anti-Aging Expert: "STOP These 3 Habits After 40+! – They Predict Early Death" | Rose Anne Kenny

This episode is sponsored by: AG1: Get 10 FREE Travel Packs and Welcome Kit worth $80 visit: https://bit.ly/43FwxQl VIVOBAREFOOT: Get 20% off your first order https://bit.ly/4eAxtvK Order MAKE CHANGE THAT LASTS. US & Canada version https://amzn.to/3RyO3SL, UK version https://amzn.to/3Kt5rUK Longevity is a hot topic these days. We’re obsessed with anti-ageing, as if getting older should be avoided or even reversed at all costs! Of course, we can’t do that and I’m not sure we’d really want to. But today’s guest brings valuable insights about what we can do, to make sure we age healthily and happily. Professor Rose Anne Kenny is a medical gerontologist and Regius Professor of Physic and Chair of Medical Gerontology at Trinity College Dublin. She’s the Founding Principal Investigator of Ireland’s largest population study of ageing (TILDA) and the author of the international bestseller Age Proof: The New Science of Living a Longer and Healthier Life. In today’s conversation, Professor Kenny reveals that while 20 percent of ageing is genetic and can’t be changed, 80 percent is epigenetic – in other words, we have the power to influence how quickly or how slowly we age. #feelbetterlivemore #feelbetterlivemorepodcast ----- Follow Dr Chatterjee at: Website: https://drchatterjee.com/ Facebook: https://www.facebook.com/drchatterjee Twitter: https://twitter.com/drchatterjeeuk Instagram: https://www.instagram.com/drchatterjee/ Newsletter: https://drchatterjee.com/subscription DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Dr. Rangan ChatterjeehostRose Anne Kennyguest
Jul 30, 20252h 8mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:00 – 1:58

    The 3 biggest midlife levers: friendship, diet, exercise (plus stress)

    1. RC

      Let's say if someone's in midlife, in their 40s or 50s, and you were gonna say one or two things for them to focus on, what would you say?

    2. RK

      I'll give the- my top three, and the first one I'd start with would be friendship, and to culture friendship, how important that is. Maybe we can take a step back. You mentioned there that 80% is in our control, and isn't that wonderful?

    3. RC

      Yeah.

    4. RK

      'Cause everybody assumes it's genes. You know, aging is about your genes, and your j- you're, you are stuck, more or less, at the moment anyway, with whatever genes you've got. But that isn't the case. Genes only contribute to 20% of the aging process. 80% is within our control, so that's fantastic. And then what are the things that we know are in our control that influence the process, that influence that 80%? And so if my top three would be, as I said, friendship, having good friendships. Um, it's not about quantity, but it's very much about the quality of relationships, qual- quality of friendships, and we can come back to how that works later on. I, I'm, and I'm sorry to say the next two, because the la- once I said this on radio in Ireland, and the interviewer said to me, "Oh, my God, not those old chestnuts again."

    5. RC

      [laughs]

    6. RK

      But I have to mention diet and I have to say exercise, because they are very important, and they are something that certainly definitely makes a difference. And then if I were to include a fourth, I'd say stress. How, you know, th- th- stress is so bad for us, so anything that we can do to attenuate stress processes or attenuate stress itself is important-

    7. RC

      Yeah

    8. RK

      ... for the aging process.

    9. RC

      Yeah, brilliant. So friendships.

    10. RK

      Mm-hmm.

    11. RC

      Well, let's broaden that out.

    12. RK

      Mm.

    13. RC

      I guess relationships-

    14. RK

      Yeah

    15. RC

      ... the food we're eating-

    16. RK

      Yeah

    17. RC

      ... how much we're moving our bodies-

    18. RK

      Yeah

    19. RC

      ... and how much stress we're being exposed to. We're gonna get into all of those in detail.

    20. RK

      Yeah.

    21. RC

      But as you say, a lot of us who are health-conscious these days have heard some of these messages, right?

    22. RK

      Yes.

  2. 1:58 – 8:00

    How advice shifts by decade: 40s menopause prep, 70s “do more,” and starting in your 20s

    1. RC

      You have been publishing papers for years. You've been treating patients for years. You teach medical students. You've got a lot of experience, and I think everyone comes to the aging conversation at different times in their lives, right? So you've mentioned your top three there, but I'm, I'm interested, how would you frame it differently depending on the age of someone who's coming to see you? So for example, if someone is a, I don't know, a 40-year-old female, for example, how would you change that messaging slightly to be super relevant for them?

    2. RK

      Good question. So 40-year-old female, uh, will be coming into menopause, so to be preparing for that, I would say that's the first thing. We can talk a little bit about that. Um, it doesn't change what I'm saying about friendship, but it's sometimes much more difficult, because there are an awful lot of other pressures on someone's life.

    3. RC

      Mm.

    4. RK

      So they don't have the time to be culturing friendships, et- et cetera. So but to use some mechanism for retaining friendship is very important. You know, when you're picking up kids from school and having to do the housework piece and your work piece, that makes your life much more difficult in the context of diet, in the context of exercise. I can absolutely say that I almost came to a full stop when I was in that period of my life with my children and with my professional life, et cetera. All of the things [laughs] that I'm going to be talking to you now about, and the, and your audience, and sharing as being important for manipulating the aging process were almost at a full stop, because I wasn't able to do everything, and I focused on those other things. But I think to, uh d- not to... It's not all or nothing, so at least to try and do some of-

    5. RC

      Yeah

    6. RK

      ... the things we know are beneficial.

    7. RC

      I mean, on that, that's really interesting. At this stage in your life now-

    8. RK

      Yeah

    9. RC

      ... with all the experience that-

    10. RK

      Yeah

    11. RC

      ... you've got-

    12. RK

      Yeah

    13. RC

      ... with the knowledge you now have-

    14. RK

      Yeah

    15. RC

      ... if we rewind back to your 40s, had you known what you know now, do you think you would've been able to make different choices? Would you have made different choices back then?

    16. RK

      Oh, that's such a great question. At a personal level, I probably wouldn't, 'cause I adore my work, and obviously I love my family. But I, I wa- I, uh... In order to really focus on, on factors we just talked about, you really need to pull back from one or t'other, and I would not have done that. At a personal level, I wouldn't have done it. However, I didn't know as much as I know now, and now that I know [laughs] as much as I know, I'm working really hard on it-

    17. RC

      Yeah

    18. RK

      ... to be honest.

    19. RC

      Well, that, that, that thing-

    20. RK

      Yeah

    21. RC

      ... about work and, and purpose, of course, is something you, you've written a chapter on, which we're definitely gonna talk about. So I get the messaging for a 40-year-old. Um, if I was 70 years old talking to you, saying, "Hey, listen, what can I do?" how would your messaging change for a, let's say, a 70-year-old?

    22. RK

      Well, then the messaging is very different, 'cause generally speaking, we have more time, although I've met a number of 70-year-olds who say, "I've never been busier," since they retired. Um, generally speaking, we have more time, and I think that there's a, a perception out there, a societal perception, that as you get older, you shouldn't be doing as much, you should slow down. We don't expect as much of people, and I would love to see that concept changed, because I, my advice would be do a little bit more every year. I definitely mean that applies to exercise. A little bit more ex- whatever your m- movement is that you enjoy, do a bit more each year after 50. But I would also r- um, recommend that in the context of food. Put a, put a bit more variety into your food every year. Think of something different-

    23. RC

      Mm

    24. RK

      ... that you can do. But also creativity and purpose. Change that also every year of your life so that you have something that you want to do newEvery year. Variety in our, on our plate and in our lives and in our exercise regime are really important. So I would say that applies. Can I say something about the age thing? 20-year-olds, this is important for, and that's the age I'd like to see starting to engage in the process.

    25. RC

      Yeah. I was gonna come to that.

    26. RK

      Yeah.

    27. RC

      And that's so, so far away.

    28. RK

      Well, I've a great story about that because I was giving a lecture in Trinity recently, and we've a, what's called a TEP course, which, um, draws students from non-health related courses in the university into a module, uh, modules they might be interested in, and aging is one of them. So I had students from geography and law and mechanical engineering, et cetera, in, in the audience in front of me. And after the lecture, two young chaps came up, and they were from Durham University on an Erasmus, um, Ben and Dominic. And they said that they were looking for the university f- to choose for their Erasmus, and they chose Trinity because of the longitudinal study on aging that was being done in Trinity. And I was like, just like you-

    29. RC

      Wow

    30. RK

      ... wow. And, and I said, "Why?" And they said, "Because we feel it's such a, an, an important area." Now, they were not... One, one was in bioengineering, and the other was in w- one of the, um, the humanities. And, and they said, "And we're interested in becoming, maybe setting up an SME in this very space," but an SME for 20-year-olds.

  3. 8:00 – 11:51

    TILDA explained: what a longitudinal aging study can reveal

    1. RC

      So, um, w- I wanna talk about TILDA. Um, you mentioned it.

    2. RK

      Mm.

    3. RC

      Uh, and I'll be honest, growing up, my familiarity with that term was to do with-

    4. RK

      Right

    5. RC

      ... a particular make of basmati rice, which we would have at home, [laughs] TILDA basmati rice. I'm sure many people listening will, will resonate with that.

    6. RK

      Yeah, yeah.

    7. RC

      But when you talk about TILDA-

    8. RK

      [laughs]

    9. RC

      ... you're not talking about a rice brand, are you?

    10. RK

      No. [laughs] I'm talking about the Irish Longitudinal Study on Ageing. That's where the D comes from. There was already the Italian Longitudinal Study on Ageing, so we had to, uh, we had to recreate it. We couldn't use the S from study.

    11. RC

      Let's just understand what that means.

    12. RK

      Yeah.

    13. RC

      Why... You say longitudinal.

    14. RK

      Mm-hmm.

    15. RC

      What does longitudinal mean? And, and I just want a bit of context here. People who've been listening to my show for a while will know very recently I had on Professors, uh, Robert Waldinger and Mark Schulz-

    16. RK

      Yeah

    17. RC

      ... who are the director and associate director of the Harvard Adult Development Study that's been going on now-

    18. RK

      Yeah

    19. RC

      ... I think 85 years-

    20. RK

      Yeah

    21. RC

      ... or more, right? So they're familiar a little bit with that study and some of the learnings from it. So can you explain what your study is? What does longitudinal mean, and how would certain elements of your study compare to what they're doing in Harvard?

    22. RK

      Okay. So longitudinal means, generally, that you have a cohort of people, and in our case in TILDA, it's a, an Irish population of people aged 50 and older, chosen through a randomly selected sample, which means that whatever findings we get, we can generalize to the population. And the same people are studied longitudinally at regular intervals, in our case, every two years. And the study has been running for 16 years now, with a three to four-year pilot run-in. So every two years we go back to the same people. Now, that's what longi- the long- longitudinal bit is. That allows you to understand the process of aging. So you're looking at the same person now for 12, 16 years, as it stands at the moment. You knew what they were like at baseline, and then you can actually look at changes in the components, I call it the tapestry of that individual-

    23. RC

      Mm-hmm

    24. RK

      ... which makes up how they are now. For example, we, we, we measure a number of different factors. Of course, we measure genetics, the epigenetics, all of those new biomarkers of aging, the common things, like you get in a blood screen, your kidney function, urea, your, your kidney function, your electrolytes. [laughs] I was gonna say urea and electrolytes.

    25. RC

      [laughs]

    26. RK

      I'm so used to saying that when I'm ordering them. Your kidney function, your electrolytes, your hemoglobin, et cetera. But we also measure social factors-

    27. RC

      Mm

    28. RK

      ... and economic factors, and, and they're really important for... to understand who we are biologically. So we measure all of those factors and, for example, at age 50, if we had a man who, who was, had that broad assessment, including a very detailed health assessment, who had a stroke 16 years later, we can go back and see, okay, what were the things about that man compared to others in the study, which were probably the risk factors at that time, which led him to be a victim-

    29. RC

      Oh, yeah

    30. RK

      ... to stroke in 16 years.

  4. 11:51 – 13:47

    What TILDA has found so far: metabolic syndrome as a major accelerator

    1. RC

      And so what are some of those key learnings that you've found so far?

    2. RK

      Oh, there's a host of them.

    3. RC

      [laughs]

    4. RK

      Now, okay, so let, let, we've published nearly 600 papers from the study to date, and not only us. We make sure that the data is publicly archived after it's been cleaned and we've done m- you know, an- analytics on it to make sure that it's-

    5. RC

      Wow

    6. RK

      ... c- c- yeah, uh, kosher. Um, and then it's publicly archived in Ireland, but also in Michigan, so that it's available to universities worldwide. This is a great asset for us because, um, that means that you get researchers all over the world tapping into your data source. So s- let's see, what have we published so far? So depends, we, we, we, we carve it into three big domains: social, economic, and health. From the health, in the health domain, we found that things, this won't be a, a surprise, metabolic syndrome is very common. It, it starts early. Metabolic syndrome is where you've a mix of obesity, central obesity particularly, h- high blood pressure, early diabetic markers, and abnormal lipids in the blood. That, that cocktail makes you much more at risk for cardiovascular events later on.

    7. RC

      And does it, does that cocktail-

    8. RK

      Mm

    9. RC

      ... speed up the rate at which you age?

    10. RK

      Yes, absolutely it does.

    11. RC

      A- and can we just-

    12. RK

      Yeah

    13. RC

      ... um, Rose Anne, if you don't mind, just pause you for a second-

    14. RK

      Yeah

    15. RC

      ... because I think we talk about aging a lot, where it's, it's becoming more and more a part of the vernacular, I think.

    16. RK

      Mm.

    17. RC

      You know, certainly in my world-

    18. RK

      Mm

    19. RC

      ... the people I communicate with are very health conscious. We're hearing a lot about anti-aging these days. What exactly is going on when we age? Because then I think it'll be helpful if we understand that, then we can understand, well, metabolic syndrome, which is so common now, how is that influencing those kind of parameters of aging?

  5. 13:47 – 16:11

    What “aging” really is: the iceberg model and disease emerging above the line

    1. RK

      Okay. So, so just imagine you have, you know this very famous image of an iceberg and a threshold, a line going through the iceberg. That's the sea level, and we can see the iceberg at the top.

    2. RC

      Yeah.

    3. RK

      That's your older person. Um, and below that w- there's a whole lot of stuff, and below that is the process which has been accumulating for years and years and years of all of the biological biomarkers, we'll talk about those, influenced by the social and economic factors, which eventually lead, in the case we're talking about now, to, to health diseases or disorders, to a health outcome. So all of that's been going on for many years, as you've said, and then it creeps above the threshold, and we get a heart attack or stroke or n- dementia or whatever. So aging is actually really the manifestation of disorders or diseases that we're very familiar with, and, and, and multiple diseases, 'cause having multiple diseases is not uncommon as we get older.

    4. RC

      Mm.

    5. RK

      An average of four to five is common. Um, so but the process that we're trying to understand are the earlier stages where it isn't a disease as such, but it will ultimately evolve into one or other disease-

    6. RC

      Mm

    7. RK

      ... um, if something isn't done about it and checked, and that, and that's what we're most interested in. So if we come back to metabolic syndrome, what we're looking at is early physiological changes in blood pressure, that's the hypertension, and in the lipids, in li- fat lipids, triglycerides, cholesterol, et cetera, and in your w- waist-hip ratio or obesity markers, um, and, and early diabetes, just creeping hemoglobin A1C, and, and then how they evolve into a disease state. So it might be that you then develop type 2 diabetes, full blast, or kidney disease as a result of atherosclerosis or a heart attack, et cetera. But it's the early combination of those. And metabolic syndrome itself is very common in Ireland. 40% of people over the age of 50 have it. It's remarkably common.

    8. RC

      40%. Do you know what that figure-

    9. RK

      Yeah

    10. RC

      ... is in the UK?

    11. RK

      Oh, very similar. Yeah.

    12. RC

      Very similar.

    13. RK

      Our, our data is almost a, a, a, a duplicate of what's happening here.

    14. RC

      And, and generally America tends to be a little bit worse than us, doesn't it?

    15. RK

      They're, they're, they're, they're fatter and generally sicker-

    16. RC

      Yeah

    17. RK

      ... than in Ireland and the UK, actually, yeah.

  6. 16:11 – 24:45

    Actionable midlife testing: blood pressure, lipids, and HbA1c—plus why thresholds mislead

    1. RC

      So if someone listening to this wants to take action on that, right, to go, "Okay, uh, you've said a few things there about metabolic syndrome-

    2. RK

      Yeah

    3. RC

      ... what can I do now at home?" You know, what would you advise? Would you advise them to measure these things, go and see a healthcare professional, you know, find out if they have it? How, how would you advise people to tackle that?

    4. RK

      So I would definitely say we should all know our blood pressure, and we should know it every single year after the age of 40. Know what your blood pressure is, and know what your seated blood pressure and your standing blood pressure is, because we get, as we get older, we're more likely to get a drop in blood pressure standing, and that actually has to be managed a little bit differently. So know your blood pressure seated and standing every year. Know your lipid profile, and it's not just about c- uh, cholesterol. It is about triglycerides and HDL, LDL ratios, et cetera. So know your lipid profile every year, and know your hemoglobin A1C. Hemoglobin A1C is a very good marker for diabetes, obviously, but pending diabetes and pre-diabetes.

    5. RC

      Yeah.

    6. RK

      Um, and it actually is, um, an indicator of what your glucose has been doing over the last two to three months. So that's why it's such a good marker. It doesn't shift up and down with the food intake, et cetera. So at least those three things we should all know.

    7. RC

      Yeah. So what I like about that, there's a lot of, um, talk about anti-aging now and, and some of the testing that is being spoken about is not widely available to everyone yet, right?

    8. RK

      I agree.

    9. RC

      Whereas the three things you just mentioned, blood pressure-A blood lipid panel and an HbA1c, uh, measurement from your blood is pretty commonly available. Certainly in the UK those things are-

    10. RK

      Yes

    11. RC

      ... freely available on the NHS-

    12. RK

      Yes

    13. RC

      ... right? From the National Health Service.

    14. RK

      Yes.

    15. RC

      So th- they're very accessible things, and so if we just go into those a minute, let's take HbA1c. Okay, two to three-month average m- uh, measurement of our blood sugar.

    16. RK

      Yeah.

    17. RC

      So one of my frustrations with, I guess, the way the practice of medicine has evolved over the years is that it's become very black or white, and much of the time we interpret things in a very black-or-white fashion.

    18. RK

      Mm-hmm.

    19. RC

      It's either normal or it's pre-diabetic or it's diabetic, right? Type 2 diabetes I'm talking about.

    20. RK

      Mm-hmm.

    21. RC

      So, you know, if your HbA1c is 6.5 or above, we say type 2 diabetes. If it's between 6 and 6.5, we say that's pre-diabetes.

    22. RK

      Mm-hmm.

    23. RC

      But if it's 5.9 or 5.8-

    24. RK

      Mm-hmm

    25. RC

      ... or 5.7-

    26. RK

      Mm-hmm

    27. RC

      ... it will often be reported as normal.

    28. RK

      Mm.

    29. RC

      So I'd love you, with all your knowledge, to expand on what do you like to see with an HbA1c? You know, of course you want it normal, but are you of the school of thought where lower is better?

    30. RK

      So when I started off as a junior doctor with respect to blood pressure, we were treating blood pressure, systolic pressure, if it was more than 160.

  7. 24:45 – 31:25

    Early-life acceleration: Dunedin study, adverse childhood experiences, and ‘aging as disease?’

    1. RK

      So I would sit them down-

    2. RC

      [laughs]

    3. RK

      ... and I'd show them a great gla- graph from the Dunedin study, which I'll share with you now. So the Dunedin is a different model longitudinal study to ours. It's 1,000 babies born in the same year, studied longitudinally, and they're now in their 50s. Um, and in the Dunedin study, they looked at their whole cohort of 1,000 when they were all aged 38, and at this stage of the study, they had the ability to measure their biological aging, their epigenetic clocks. Okay? So they were able to actually look at their biological clock, and of course everybody was the same age, had the same chronological clock, in other words, number of candles on their birthday cake. And remarkably, they showed that some people aged 38 were behaving biologically like 28-year-olds. But some aged 38 were behaving biologically like 48-year-olds, a 20-year distribution in their biological aging, although they were all the same chronological age. That's an amazing study.

    4. RC

      And so the practical take-home for someone in their 20s is what?

    5. RK

      So the practical take-home is this, this process starts really early on. Now, you know, the, the trite thing to say, it probably [laughs] starts in the womb, but for an individual, that doesn't help. But the process does start, uh, in your 20s, and you can do damage in your 20s. When they looked back on the 38-year-olds who had the almost 50-year-old biological aging through the clocks, the factors which drove that accelerated aging were adverse childhood events.

    6. RC

      Mm-hmm.

    7. RK

      You know, traumatic experiences in childhood, depression in childhood, or depression in a household, divorce in a household, or, or bad behaviors early on in the, in lives, like smoking and alcohol in, in, in the participants' lives.

    8. RC

      I- if we just talk about these ACEs for a minute, these-

    9. RK

      Mm

    10. RC

      ... adverse childhood experiences, this is something that I've covered on this show many times through the lens of trauma-

    11. RK

      Mm

    12. RC

      ... with people like Dr. Gabor Maté, Dr. Bessel van der Kolk, recently with a, a chap called Dr. Russell Kennedy on anxiety, and we're seeing very clearly for many years now data on adverse childhood experiences, on how, you know, difficult childhoods, trauma, divorces-

    13. RK

      Mm

    14. RC

      ... um, you know, abuse.

    15. RK

      Mm.

    16. RC

      The impacts of those things play out in your adult risk of disease, illness, autoimmune disease-

    17. RK

      Yeah

    18. RC

      ... all kinds of things, right?

    19. RK

      Yeah.

    20. RC

      But you're saying it also plays out these emotional factors-

    21. RK

      Yes

    22. RC

      ... or what we consider emotional factors, that also plays out in terms of how quickly we're aging.

    23. RK

      Well, you see, because how quickly you're aging is what's driving those diseases later on in life.

    24. RC

      Mm-hmm.

    25. RK

      That's my point. The aging process, all it is, is the precursor to having one of those diseases, and the pace of that aging process, i- is, i- all that is, is, means is that you'll have one of those illnesses earlier. That's what aging is.

    26. RC

      Professor David Sinclair, who I spoke to maybe two or three years ago on this podcast, he makes the case in his book that we should consider aging a disease. What's your perspective on that?

    27. RK

      Well, I, I, I don't entirely agree with that, although I can see that there's some overlap in concepts. Um, there isn't a diagnosis for aging-

    28. RC

      Yeah

    29. RK

      ... as such. Um, it, it's a very multifactorial process. Um, it's something that we all will experience in one way or another. It doesn't necessarily lead to a disease outcome that we recognize, um, so there are some of the reasons that I wouldn't-

    30. RC

      Yeah

  8. 31:25 – 36:25

    Quality of life often improves with age—and why longevity gains are stalling

    1. RC

      10 free travel packs instead of the usual five, and an awesome welcome kit containing your shaker, scoop, and canister with your first subscription, go to drinkag1.com/livemore. I know you know all the biology and the, the blood markers, and you've done all the science of aging, but from a philosophical point of view, what's your perspective on that?

    2. RK

      That's a ... It's a great question. First of all, factually, quality of life gets better [laughs] as we get older. That's the first thing to say, and this has been shown by many, many studies. I- i- in our own study in, in TILDA, um, aged 50 upwards, quality of life continued to improve year on year until late 70s, and the factor which actually impacted then on positive quality of life was physical ill health. That was the biggest factor-

    3. RC

      Mm-hmm

    4. RK

      ... that impacted on quality of life. But the, the m- measures that we were using for quality of life, very good tool, didn't get to the same level in the 80-year-olds as they ... It was in 50 until people's ... was, were, were 84. So in other words, it went up, and it slowly came down, and it was only at age 84 that your quality of life was the same at 50.

    5. RC

      So hold on.

    6. RK

      So it gets better.

    7. RC

      So, so once you've hit 50, on average-

    8. RK

      It gets better

    9. RC

      ... your quality of life gets better-

    10. RK

      Yes

    11. RC

      ... and doesn't get down to that level until you're 84.

    12. RK

      Absolutely.

    13. RC

      So you have 34 years of good times.

    14. RK

      Maybe longer-

    15. RC

      Maybe longer

    16. RK

      ... because the only factors that were influencing beneficial quality of life o- ... This is on average now. This is for at a population level ... were physical disability, so not being able to do what you were previously able to do because of arthritis or another physical illness.

    17. RC

      So is that the point for you? I think that's the point from your book is, is not necessarily about trying to live to 150.

    18. RK

      No.

    19. RC

      Right?

    20. RK

      Yeah.

    21. RC

      The, the message I get from your work is that it's just about how do you make sure you've got that quality of life until you do drop down dead?

    22. RK

      Yes. Yes. Yeah. And, and living independently and having a good quality of life. They, they should be our two metrics, um, for, for happy lifespan.

    23. RC

      So, so on that then, um, what are some of the myths that are currently being propagated, would you say, around aging? There's all kinds of talk about living to 150 or 120, 130. You know?

    24. RK

      Yeah.

    25. RC

      What, what's your ta- ... Well, first of all, are there any myths out there that you'd like to share a different perspective on? And I guess related to that, how old do you think it is possible for a human to live in good health?

    26. RK

      Well, well, for the latter question, I would answer to Jeanne Calment, who I wrote about in the book, we know therefore 126 is feasible, right?

    27. RC

      Is that what she lived to?

    28. RK

      Yeah, she lived to 126, so that's, that's feasible. I think it was 126 or 122. So we know that that can happen. That's the first thing to say. Um, the, the, the, the second thing is that actually longevity is attenuating at the moment. It's, it's ... The, the curve has started to slow down and flatten out in the UK since 2012, and in the US. Now, the attributable reasons for that are disparities in socioeconomic status.

    29. RC

      Mm.

    30. RK

      That's what we've ... That's what most of the researchers in this area would now agree in, in the UK. And in the US, a dominant feature driving that is younger deaths due to opioids.

  9. 36:25 – 43:58

    Socioeconomic status, community buffers, and volunteering as a health intervention

    1. RC

      And I know you've studied this as part of the TILDA-

    2. RK

      Yes

    3. RC

      ... study.

    4. RK

      We have.

    5. RC

      And I, I, I know many researchers around the world have also studied this. But when we think about socioeconomic status, we think about income, we think about poverty-

    6. RK

      Mm-hmm

    7. RC

      ... what exactly is that doing on a cellular level? How, how is that affecting the aging process?

    8. RK

      Um, I have a colleague, Cathal McCrory, who's actually studying this very thing across the life course, and showing the biological, the epigenetic, the clock changes that we're seeing a- a- a- associated with socioeconomic divides. So you've got five different groups, say, quintiles, of socioeconomic status, and those who are in the lower, the, the worse socioeconomic status, have much accelerated biological clocks. And because of the richness of the data we're collecting, I'm able to say to you today that that is the case independent of anything else which might be driving accelerated aging.

    9. RC

      Yeah, I mean, it's absolutely fascinating. Let's just contrast then, um, the lady, I think Jeanne Louise Calment-

    10. RK

      Mm

    11. RC

      ... who you wrote about in the book, the French lady-

    12. RK

      Yeah

    13. RC

      ... who went past 120.

    14. RK

      Yeah.

    15. RC

      You, you've written about her in quite a bit of detail-

    16. RK

      Yes

    17. RC

      ... um, which is, it was just so fascinating reading about her story.

    18. RK

      She had a, a privileged life, um, and probably all of the components that we have got control of with respect to the aging process, she illustrated throughout her life. That's what I liked about her life. Um, very positive attitude.

    19. RC

      Yeah. I w- I wrote this down. Um, you p- you put in... I mean, it's, uh, as I say, I love your book. I think it's jam-packed full of really practical information. Um, at the time of writing, the record-holder for longevity for the human species at 122 years and 164-

    20. RK

      Oh, wow

    21. RC

      ... days is a French woman, Jeanne Louise Calment. And you know, there's many paragraphs on her, but this one I, I wrote down, and I think this really speaks to what we're talking about with socioeconomic-

    22. RK

      Yeah

    23. RC

      ... status, which is, "Jeanne never had to work."

    24. RK

      Mm-hmm.

    25. RC

      "She employed servants and led a leisurely lifestyle within upper society, pursuing hobbies such as fencing, cycling, tennis, swimming, roller skating, playing the piano, and making music with friends. In the summer with her husband, she would mountaineer. She enjoyed an idyllic, relatively stress-free-

    26. RK

      Mm

    27. RC

      ... and fun-filled life." Now, you can interpret that two ways. You can either interpret that and go, "Okay, wow, that has shown us what is possible," and I can see-

    28. RK

      Mm

    29. RC

      ... that the various elements that you write about in your book, a lot of them are, you know, are there within her story. Or, that can be incredibly off-putting to people and go, "Yeah, all right for her," you know. "My life is completely different to that. No wonder-

    30. RK

      Mm

  10. 43:58 – 55:23

    Attitude and ageism: feeling younger, COVID isolation, and inflammation biology

    1. RC

      I wanna talk about attitudes.

    2. RK

      Yeah.

    3. RC

      Our attitude towards life.

    4. RK

      Mm.

    5. RC

      Because if I continue what you wrote about, uh, Jeanne Louise Calment, you, you, you write that she did actually move into a nursing home, I think it was after a fall-

    6. RK

      Yeah

    7. RC

      ... aged 110.

    8. RK

      Yeah.

    9. RC

      But again, some really interesting things there. Even though she was in a nursing home, Calment initially followed a rigorous daily routine. She was woken at 6:45 AM, started the day with a long prayer at her window. She thanked God for being alive and for the beautiful day that was starting, underscoring her positive attitudes-

    10. RK

      Mm-hmm

    11. RC

      ... and outlook. Then she sits on her armchair and does gymnastics wearing her stereo headset, right? So this is fascinating. I've got this wonderful image-

    12. RK

      Yeah [laughs]

    13. RC

      ... of this 110-year-old lady basically practicing gratitude every morning.

    14. RK

      Yeah.

    15. RC

      Right? And, you know, we've touched on gratitude several times on this podcast over the years. There's really good research on gratitude. It seems as though she naturally had this positive attitude. From what you know, from what you've studied, how important is attitude to the aging process?

    16. RK

      Hugely important. That's what I would say. Probably, you know, the most im- important thing that... Now, now, it's hard to change your attitude. I mean, attitude is very much about being an optimist or a pessimist, you know? Um, but, but knowing it's important, people might be able to put more time and effort into creating a positive attitude or being positive or less negative about things. Um, we, we talk about resilience in, in, in the science of aging and what makes some people resilient and others not, and how you perceive yourself aging and your attitude towards your own aging and towards others is a major factor. Um, again, in the TILDA study, we have shown, we've measured perceptions of aging or aging attitudes at baseline and at, and obviously follow-up. And people who saw themselves as 20 years younger than their age, as I do, um, actually were fit- physically fitter and mentally, cognitively better, independent of all of the other factors we were able to adjust for 10 years hence.

    17. RC

      So, so the, so-

    18. RK

      So it matters

    19. RC

      ... so the, the, the phrase, "You are as young as you feel" actually has scientific validity.

    20. RK

      Yes, it's biologically embedded. [laughs]

    21. RC

      I mean, that is-

    22. RK

      Absolutely. Yeah

    23. RC

      ... it's just fascinating that. You know, I, I think a lot about, I guess, what might be considered the more softer aspects of health, right? Attitude, our perception-

    24. RK

      Yeah

    25. RC

      ... these kind of things, but-

    26. RK

      Yeah

    27. RC

      ... but really they're not, they're not so soft when you start studying them. [laughs]

    28. RK

      No.

    29. RC

      The- there's actually hard data on them. I spoke a few months ago with someone called Professor Anice Mukherjee. Um, she's, you know, very, very experienced consultant endocrinologist, a women's hormone expert, and in the conversation, which was all about women's hormones and the menopause, I shared with her some research that I came across showing that in societies where they perceive aging as a good thing, they associate it-

    30. RK

      Yeah

  11. 55:23 – 1:05:56

    The power of social architecture: Rosetta’s secret and what blue zones reveal

    1. RC

      Talking about community, um, in, in your book you wrote in detail, was it Rosetta?

    2. RK

      Rosetta, yeah.

    3. RC

      And, and it was, it was truly fascinating. So I wonder if you could talk us through Rosetta-

    4. RK

      Yeah

    5. RC

      ... and what does that teach us about the power of community and social relationships?

    6. RK

      This is a great story, and it was probably the start of the link between social sciences and health. Um, so Rosetta was a town in, a small town in Northern Italy, and in the 1800s, they, they needed to emigrate. There wasn't any employment. So they emigrated to a location in the States, in Pennsylvania in the States. They called it Rosetta, the town in the States.

    7. RC

      Wow.

    8. RK

      And they, um, they replicated an awful lot of their lifestyles in, in Italy in terms of the, the infrastructure, the way the town was designed, et cetera. And then more and more from Rosetta, Italy, um, emigrated to Rosetta in the USA. And a scientist called Steven Woolf... He wasn't a scientist. He was actually a gastroenterologist, but he got interested in epidemiology, and he was very interested in the brain-gut response, uh, and, and interaction and network. So he had a holiday home near it, um, and he gave talks to towns and villages nearby. And one night he was speaking in one of the towns, and a GP came up to him, a general practitioner, and said, "You know, you're talking about," what was the big killer at the time, cardiovascular disease, um, in men in their m- mid-40s, 50s in the USA. He said, "I'm, I'm working in this town. It's one of a two or three towns I work in nearby, and I'm seeing... I'm not seeing that. I'm seeing people living well into their 65s and beyond." This is in the 1900s, 1930s and '40s. Um, and, and he said, "I'm definitely seeing something different there than the other towns I'm working in nearby." So Steven Woolf didn't just take that as a, you know. He went with medical students the next summer. They took over the town hall, and they did all of the measures we know lead to longevity, 'cause in the interim he'd checked their, their death rate books and found that, yes, it was true, they seemed to be living longer in Rosetta. And he found no suicides, et cetera. So he, they went, and they s- installed themselves in the town hall and started doing blood pressure. They took blood tests for blood glucose at the time, uh, et cetera. And they couldn't find anything. Then they looked at diet, and they couldn't find anything. And I'm sorry to say, but they actually found that [laughs] they were eating, you know, quite, quite luscious pizzas regularly.

    9. RC

      Mm-hmm.

    10. RK

      And he, he looked at everything he could think of. Smoking wasn't more common. Exercise, there wasn't any difference in all the factors we're talking about. And he was sitting one morning in the town square in Rosetta on a Sunday, uh, outside the church, and the next thing, the church doors opened, and everybody piled out of church. But they didn't move from there. They stayed outside the church. And for an hour or two afterwards they were still there chatting-

    11. RC

      Mm-hmm

    12. RK

      ... kids running around mixing. And he realized that the secret of longevity in Rosetta was Rosetta itself.

    13. RC

      Yeah.

    14. RK

      And then he started to explore their, their social engagement, their social networks, their social infrastructure. Three generations living in one household. For, for a to- a town of 2,000, um, civilians at the time, there were 22 different civic societies. [laughs]

    15. RC

      Wow.

    16. RK

      People were always doing something. So that was... He, then he, he got other researchers from his university involved who were interested, and social scientists. And they started this whole research field, which is so huge now, of how important sociology is in determining our health.

    17. RC

      It's, it's just fascinating. And particularly what you said, their diets probably weren't that good because, of course, we're trying to promote healthy lifestyles. But what, what does that mean? You know, if you could live by yourself and hit all your exercise targets and hit a clean, organic, no-sugar diet, sleep eight hours a night, right? But you didn't have community, you didn't have connections. You know, who would be better off? And I'm inclined more and more to think-

    18. RK

      Mm

    19. RC

      ... that social connections-

    20. RK

      Mm

    21. RC

      ... are right at the top of the tree.

    22. RK

      I, I, I actually, I believe that.

    23. RC

      R- yeah.

    24. RK

      That's why I started when I made my list at the beginning. You asked me what were the top few things, and I said friendship. You know, that's social connection. That's friendship. That's engagement. And we know ourselves, if you've had a good night out, in my case, with the girls, with lots of laughter, um, and, you know, there'll be a couple of drinks involved potentially, very likely. Um, the next day you feel so good.

    25. RC

      Yeah.

    26. RK

      And it's been such a good experience. So we know this. It's intuitive. And yet we need to make an effort, particularly since COVID, to build that now back into our daily routine.

    27. RC

      Yeah

    28. RK

      And you come back to your yoga. That's why it's so much better to go to the yoga class and not do yoga on YouTube on your own all of the time.

    29. RC

      You write about the blue zones.

    30. RK

      Mm-hmm.

  12. 1:05:56 – 1:14:09

    Movement without metrics: building activity into modern life (and why nature helps)

    1. RC

      But if we talk about, you know, exercise for a minute, clearly physical activity is important-

    2. RK

      Mm-hmm

    3. RC

      ... right? And, um, right at the start of this conversation when I asked you if someone was in their 70s, what would you say to them if they wanted to, say, "Professor Kenny-

    4. RK

      Yeah

    5. RC

      ... how can I slow down aging? How can I make sure I'm as well as I can be when I'm 80 or 90?" One of the things you said was to do more, move more.

    6. RK

      Yes.

    7. RC

      And, and I know I've heard you talk about that before, and it's something I've become aware of now. I'm in my mid-40s.

    8. RK

      Yeah.

    9. RC

      But I'm realizing that actually movement-I was chatting to people at this family do at the weekends. I was saying, one thing I'm realizing, you just cannot get away with not moving. Once you stop moving, it goes downhill very rapidly.

    10. RK

      Yes.

    11. RC

      And as you get older, you gotta move more.

    12. RK

      Yeah.

    13. RC

      And so I'm massively increasing now how much I move. And a lot of this is just, it's not anything flash, it's just walking more.

    14. RK

      Mm.

    15. RC

      Just walking an hour a day, and then trying to, you know, just trying to build that in more and more. But what I find fascinating, particularly as aging is being spoken about and sold to a lot of us in the health space, it's a lot about tracking and hitting various metrics, and this will be good for your strength, this will be good for your heart, this will be good for cardio. And what you see in the blue zones is that no one's measuring a damn thing.

    16. RK

      No.

    17. RC

      Right? These guys aren't thinking about, "Oh, I need to get my resistance in. I need to get my cardio in." What's your perspective on that? 'Cause that's fascinating. That's really, really interesting to me.

    18. RK

      So I don't do any tracking or anything, 'cause actually, frankly, it would stress me. Um, uh, I, I, I, I think with respect to the blue zones, it was built into their natural day. So for us, how would we do that? Yes, go for a walk, but also when you've to nip down to the shop for groceries, give yourself the extra 10 or 15 minutes to walk down-

    19. RC

      Yeah

    20. RK

      ... to the shop for, or get on your bike. I cycle to work all of the time because some days that's my only way of getting any activity into my day. Um, and, and that is very doable, you know, to... There are other op- o- opportunities. The other thing about the blue zones is they did them in nature.

    21. RC

      Mm.

    22. RK

      So there was a lot of n- of nature, the sea obviously, but also a, a, a green nature. And I think we underestimate how good nature feels.

    23. RC

      Yeah. There's also, though, purpose to their movement.

    24. RK

      Mm.

    25. RC

      Right? And-

    26. RK

      Mm

    27. RC

      ... again, I think really trying to go deeper below physical activity. You know, as you said at the start, right, you were in an Irish television interview talking about diet and exercise-

    28. RK

      [laughs]

    29. RC

      ... and the, the, the TV presenter's like, "Oh, come on." You know?

    30. RK

      Yeah. Yeah. Yeah.

  13. 1:14:09 – 1:20:57

    Sarcopenia, strength, and the convenience trap—plus Kenny’s own behavior changes

    1. RC

      Two things about movement that I'd like your perspective on. One is sarcopenia. The other one is how fast we walk. Can you speak to those two things? 'Cause they're, they're really interesting and super relevant to how we age.

    2. RK

      So sarcopenia is, it's, it's a fairly r- new diagnosis, if you like, or disorder that we've become aware of, and it's an infiltration of skeletal muscles. They're the muscles we use for moving. Um, and it's very much age-related, um, much more prevalent than we thought. I mean, in people who don't move much, 70% have this sarcopenia. Um, and what it is, it's fairly toxic to skeletal cells, and actually, sarcopenia is probably underlying what we know of, uh, as frailty because muscles maybe haven't been moved as much as-

    3. RC

      Mm-hmm

    4. RK

      ... they were moving because that's how you prevent sarcopenia, by keeping muscles moving, continuously waking up those muscle cells and muscle tissues to, to keep functioning. Um, and as we get older, they need to be reminded to keep moving.

    5. RC

      And is this particularly resistance training and strength training that we're talking about here, or is it just generalized?

    6. RK

      It's, it's predominantly strength training. It's predominantly strength training.

    7. RC

      So why is it, do you think, that we need guidance on strength training, which makes people think about the gym, which is off-putting for many people? Yet in the blue zones, from what I understand-

    8. RK

      Yeah

    9. RC

      ... the people who are living to 100, 105, 110 aren't really going to the gym.

    10. RK

      No, but they're doing strength training, 'cause she was chopping wood, and they're lifting the crates of, of fish that they carry in from the sea, et cetera. And they're, you know, they're, they're, they're, um, going to the s- stores and walking back with their bags of whatever they're carrying, et cetera. I mean, s- strength training is, it, it can be part of an aerobic exercise, pa- part of a walking exercise. It doesn't have to be deliberately weightlifting. Again, y- y- your analogy of the treadmill was brilliant. [laughs] Likewise, they came and saw people lifting heavy things while seated on a very strange chair-

    11. RC

      [laughs]

    12. RK

      ... in a gym. You know, that would have the same probably-

    13. RC

      Trying to keep their back straight-

    14. RK

      We-

    15. RC

      ... and in a certain posture, like, what, what, what-

    16. RK

      They would say-

    17. RC

      ... what are you guys doing?

    18. RK

      ... what the hell is this about? So, so we can do s- we can build strength training into our, into our daily routine as well. We, we, we, um, b- just because the, of the way our society has evolved, we're not really doing strength training that much as part of our day. We buy the wood in, in the local s- supermarket and then throw it in the boot of the car when we're... and drive home, et cetera. So, so that's why we have to focus more on strength training.

    19. RC

      It, it's been eroded everywhere. Like, even for those people who engage with online shopping, which is very common these days, right? Which is very time-saving. But a lot of online shops now, the driver will bring the shopping in-

    20. RK

      I know

    21. RC

      ... and put it in your kitchen.

    22. RK

      I know.

    23. RC

      Right? Now, I get it. Not everyone does that. Not everyone has access to that. But it's just another example of how bit by bit any movement that we did have is just being slowly [laughs] eroded away.

    24. RK

      Yeah. Uh, uh, it comes back to the convenience thing. Everything we're doing is about convenience. But in fact, convenience isn't necessarily what's best for us.

    25. RC

      Mm.

    26. RK

      So, um-

    27. RC

      Do you strength train?

    28. RK

      I do.

    29. RC

      And, and-

    30. RK

      I do weights. [laughs]

  14. 1:20:57 – 1:35:05

    It’s never too late: rapid epigenetic shifts and what ‘epigenetics’ means

    1. RC

      ... my aging. But I guess related to that, one of your other core messages is that it's never too late.

    2. RK

      No, it isn't ever too late. Yeah.

    3. RC

      Right? It's never too late to make a change.

    4. RK

      Mm-hmm.

    5. RC

      And I think that's a really important message. Can you just speak to that a little bit? Because people may go, "Oh, yeah, in my 20s this happened," or, "In my 30s and 40s I was a carer. I, I was really, really stressed." We can still make changes even if we've had maybe some toxic behaviors in the past?

    6. RK

      So, okay, I'll, I'll approach that in two ways. Um, we, we, we certainly can make behaviors, and there have been cha- changes that make a difference. There have been studies of patients in wheelchairs, for example, who have started strengthening exercise programs, upper limbs or whatever they can, whatever they can move, and they've had an over holis- overall benefit, including a benefit in some of the epigenetic activity by doing that. So that's, that's that cohort. So I use that as an example because people would assume, oh, you know, I think very often that that's not something that you're gonna modify, but you can. Within the context of whatever your disability, you can-

    7. RC

      Wow

    8. RK

      ... modify other beneficial a- aspects, including sarcopenia. But the second thing is there is, um, a, a recent study, a randomized control trial, where four different interventions were used. One half of the study just carried on as ever, and the other half of the study modified diet, did exercise to 60 to 80%, so whatever they could do maximally, they did it to 60 to 80%, for 30 minutes five days a week.

    9. RC

      Would that be the equivalent of, let's say, a, a-

    10. RK

      W- walking-

    11. RC

      ... a brisk pace walk?

    12. RK

      A brisk pace walk so you're too breathless to talk.

    13. RC

      Got it. So nothing-

    14. RK

      S- simple stuff

    15. RC

      ... crazy.

    16. RK

      Simple stuff. So that's... So they modified, um, a diet, and the diet was very much, um, a microbiome-focused diet, so lots of diversity, polyphenols, carotenoids, et cetera, probiotics, and the exercise was as we've discussed. But they also, uh, did breathing exercises a few times a day to modify stress and to calm stress, and they also, um, worked with sleep and in- invoked different measures which would improve sleep. Epigenetic markers were measured at the beginning of the study. That's the biological clocks I was talking about earlier on. And the study lasted for eight weeks and at the end of the study. And remarkably, I think, in the cases which, um, it had these changes, uh, these interventions in the eight weeks, everybody complied. That was the first thing. They watched compliance very carefully. Epigenetics showed that their aging clocks had reduced by 3.6 years. Isn't that amazing?

    17. RC

      Hold on, hold on.

    18. RK

      In eight weeks. [laughs]

    19. RC

      Okay. In eight weeks-

    20. RK

      Yeah

    21. RC

      ... by focusing on small changes in our lifestyle, small changes that are under our control-

    22. RK

      Yeah

    23. RC

      ... they could change their biological aging-

    24. RK

      Yes

    25. RC

      ... by over three years.

    26. RK

      Yes.

    27. RC

      In just eight weeks.

    28. RK

      Yes.

    29. RC

      That is utterly remarkable.

    30. RK

      It is. Now, I don't know whether that would be sustained. I can't imagine it would because what I'm saying is that there must have been a rapid change over the acute phase-

  15. 1:35:05 – 1:43:01

    Sex, intimacy, and aging: health signals and biological benefits

    1. RC

      ... if the clinician is being attentive, for example, you've written an entire chapter on sex and intimacy-

    2. RK

      Mm-hmm

    3. RC

      ... with respect to aging. Now, this is a topic that is not often spoken about. It's a little bit taboo for many people to talk about this. So my first question is-

    4. RK

      Mm-hmm

    5. RC

      ... were you nervous when writing it? Why, I guess, did you think it was so important to put this chapter in?

    6. RK

      So I wasn't nervous in writing it, because I've had a bit of a journey, as it were, in, with respect to this topic, and the person who opened my eyes to this is a girl called Stacy Lando, who's a professor of gynecology and aging in Chicago, and she is passionate about this area, and started writing, uh, maybe 20, two decades ago, um, in, uh, with respect to sexual activity and aging. Um, so I'd followed her and her work for some period of time, and have become very friendly with her, actually. Um, and I, I've been really interested in the area, and it's, what, what fascinates me about it is it's almost like it's, it's invisible in society. It's not discussed. And when I became enthusiastic about it at the dinner table, 'cause we always made an effort when the boys were in school to kind of get together and we al- had an evening meal together. I would say, "Oh, gosh," start talking about something I'd learned about sexuality and aging, and they went, "Right, Mum, we're gone now. We've eaten. Thank you. We're leaving the table. I don't want any more. No more." Like it just... I think younger generations find it im- almost impossible to conceive that there would be sexual activity between, you know, older persons. In the TILDA study, 70% of couples are still sexually active, and our mean age now is 68, but that's the data for, for the, from the first wave of the study. So it's, it's, it's common. Um, we, it's becoming more discussed. It's be- we're becoming more aware of it at a societal level. We as doctors don't talk to patients enough about it. We don't ask patients, "Would you like to discuss sexual activity on a regular basis?" S- People, I think, find it hard to discuss it on an in- individual level. So I had no problem writing about it at all, because I'm-Very enthusiastic about it, and I think it's something that we need to be discussing more. And there are issues with it as people get older. Um, erectile dysfunction is not uncommon. Now, erectile dysfunction can occur at any age, and probably one in three, as you know from your-

    7. RC

      Mm-hmm

    8. RK

      ... general practice men have experienced it at some stage or other, and there's lots and lots of reasons f- for it. But there are reasons which need to be investigated, um, even if it's intermittent, and it can be indicative of underlying atherosclerosis, that's thickening of vessels, blood vessels, uh, in, in, in older adults. When I say older, people 50 and above, and that needs to be investigated early. Uh, you know that iceberg we talked about? That's the process happening down here below the threshold of the iceberg. It can be, uh, managed early.

    9. RC

      Yeah, I, I think that's a, a very important take-home for people that we perhaps haven't spoken about enough on this podcast, which maybe [laughs] speaks to exactly what you're talking about, about how taboo this topic is. But I think a lot of people, women and men, don't realize that e- erectile dysfunction could be-

    10. RK

      Yeah

    11. RC

      ... an early warning sign that you already have thinning of the blood vessels in your heart.

    12. RK

      Yes, yeah.

    13. RC

      Like, the blood vessels exist everywhere.

    14. RK

      Yes.

    15. RC

      You know, if there's a problem-

    16. RK

      Yes

    17. RC

      ... with your erections-

    18. RK

      Yeah

    19. RC

      ... that could be a problem in your heart, so if you're having it, you, you really should get that checked out, particularly-

    20. RK

      100%, yeah

    21. RC

      ... if you're 40s, 50s, 60s.

    22. RK

      So that's very important to, to be aware of. That can be an indicator also of un- uh, of, of, of early-stage diabetes, et cetera, et cetera.

    23. RC

      Mm-hmm.

    24. RK

      So it needs to be ... And then for women, vaginal dryness is a huge issue. So some of the reasons why older people don't take part as frequently in sexual activity is because it's painful or uncomfortable, particularly for women. Now, that can be dealt with. So dry mucosal surfaces, we know about dry eyes, dry mouth postmenopausally, but dry vagina, dry vulva is also not uncommon, and it can be dealt with with ho- hormone replacement therapy, local hormone therapy, and gels. But there's something that we should be discussing with our patients, and I really think as doctors, for those age groups, we should just ask about it, "Have you any problem with..." And if there's a problem, that'll open up the discussion.

    25. RC

      So how does this relate to aging, right? So let's say a couple want to be intimate-

    26. RK

      Mm

    27. RC

      ... and have sex as they're older. Okay, so that's a desire, but in terms of the biology of aging, how does sex and intimacy play, play a role?

    28. RK

      Oh, well, this is really interesting because actually, um, it probably decelerates the aging process.

    29. RC

      Decelerates it.

    30. RK

      Yeah, it's really good. It-

  16. 1:43:01 – 2:04:00

    Sleep and aging: chronotypes, circadian light, and practical sleep-support strategies

    1. RC

      Let's talk about sleep. Uh, what is the relationship between sleep and aging? And I, I've gotta say one of the things I really, really enjoyed reading about was these four sleep chronotypes.

    2. RK

      Oh, yeah. [laughs] Yes. Uh, I reckon I'm a lion. What do you think you are?

    3. RC

      I'm definitely a lion.

    4. RK

      Okay, yeah. [laughs]

    5. RC

      From, from, from the description in your book-

    6. RK

      Yeah, yeah

    7. RC

      ... I'm a lion. Um, in fact, let- shall we... Do, do you wanna go through those?

    8. RK

      I'll go through them. So there are four types. There are dolphins, lions, bears, and wolves. Um, and the wholePoint about this is what, what's our chronotype? Our chronotype is almost our personality type coupled with our 24-hour circadian rhythm.

    9. RC

      Okay.

    10. RK

      Now, all of our cells have a 24-hour circadian rhythm, and they're all governed by a central clock in the brain called the suprachiasmic nucleus-

    11. RC

      Mm-hmm

    12. RK

      ... SCN. Um, and it basically, every single thing about us is governed by that. Um, so that at nighttime when it's dark, different rhythms are turned off and different rhythms are turned on, and then in the daytime, different rhythm- rhythms turned off and on. That's what's important. Now, our chronotypes, which are our sort of personality types coupled with our rhythm, are roughly divided into four groups. There's the dolphins, the lions, the bears, and the wolves. Dolphins struggle to fall asleep, sleep approximately six hours, wake up unrefreshed, may experience anxiety, irritability. They're perfectionists. Lions, medium sleep drive, wake up early, lots of energy, little energy at bedtime. I'm almost supine after 9:00 in the evening.

    13. RC

      Yeah, me too.

    14. RK

      I'm useless. Optimistic, overachievers, go-getters-

    15. RC

      Yeah

    16. RK

      ... health-conscious, e- eat well, take exercise, and they're leaders, right?

    17. RC

      Yeah, I, I definitely-

    18. RK

      Maybe we're choosing [laughs] maybe we're... Anyway.

    19. RC

      Maybe we like to think of ourselves in this way, but I, I, I think-

    20. RK

      No, I'm pretty much a lion

    21. RC

      ... I think I'm a lion.

    22. RK

      Yeah. And then bears are deep sleep at night, rise with the sun, strive to be healthy, team players, hardworking, easy to talk to, and they've good people skills. And then the wolves, I'm married to a wolf, um, wake up in a haze, groggy in the morning, I recognize that, energy in the evening, so he's much better in the evenings, tend to miss breakfast, come alive after dark, creative, pessimistic, moody, comfortable alone. And they're, they're very often the, the, the chronotype which is actually aligned with great creativity. Um, and they're also most likely to be addicted [laughs] than o- other sorts of chronotypes. And by that, we mean to... N- my husband is not, by the way. But by that we mean to alcohol and drugs or, or gambling, uh, behaviors. They're very often wolves in their chronotype. They're just fun chronotypes.

    23. RC

      They are fun.

    24. RK

      They've been shown to be scientifically more or less aligned, um, um, to-

    25. RC

      And what, what benefit is there for us knowing what we are?

    26. RK

      So the point is that all of our society is orientated towards the dolphin, the lion, and the bear, but the poor old wolf finds it really difficult, 'cause they come to life later on in the afternoon and the evening. And about one in five of us, 20%, are, are wolves. To, to comply with the timetable that society sets, i.e., be in school at 8:00 or 9:00 in the morning, you know, come home at 4:00, et cetera, go to bed early, get up early in the morning, they struggle with that. That's the first thing. The second thing is our chronotypes are very closely aligned to f- sleep habits, as you can see from the description, also to food intake. So, um, it's a, i- it, it's important that people who have the latter chronotype we described, the wolves, are aware that they're more likely to get health, negative health outcomes from negative lifestyle behaviors. And I'm sorry if that sounds miserable, but it's just that they're more likely to overeat-

    27. RC

      Mm

    28. RK

      ... or maybe over-drink. Um, and, and that's part of their struggle with this imposed clock which isn't their natural clock. Um, now, now, you can turn that around, and that's the good news, um, by bit by bit bringing the, um, clock that you are comfortable with as a wolf into maybe the bear or lion clock. And d- by doing that, to do that, by going to bed, uh, i- i- consecutive nights 15 minutes earlier, but you have to stick to it. You have to be very rigid with yourself and stick to that until you kind of get more into a natural clock. And that does reset some of the-

    29. RC

      Yeah

    30. RK

      ... neurohumoral, we're going to come onto again, changes that are very closely aligned with the circadian rhythm.

  17. 2:04:00 – 2:08:57

    Purpose and laughter: emotional biology that reinforces healthy aging (final takeaways)

    1. RC

      Yeah. I gotta say, we, we've been ch- chatting for a long time, and there's so much more to talk about. You, you've, you really have written a wonderful book, Age Proof. It's, it's so succinct. It's full of science and research, but it's also very, very practical. So I can see why it's proven so popular with people. I did wanna cover this. I'm not sure we got a time to go into it in detail, but there's one chapter on purpose-

    2. RK

      Mm

    3. RC

      ... and laughter-

    4. RK

      [laughs]

    5. RC

      ... which is really interesting. Any kinda top line thoughts on those two things you wanna share?

    6. RK

      Well, first of all, laughter is really important, and we know this intuitively 'cause we feel good after, but it releases a whole lot of neurohormones, which are, which are very important for us, and that's actually used therapeutically now. I'll just cite one study which I find amazing, is that people who had had a heart attack, who, who were exposed to laughter therapy, were 48% less likely to get a recurrence of a heart attack. Now, that's a massive figure. So, so that's the benefit. So just carry that moment and know that laughter matters. Laughter is a way of us to bond socially, so it's all tied up with this whole social engagement piece.

    7. RC

      Yeah, and it plays into what you said about friendships before.

    8. RK

      Yeah, absolutely.

    9. RC

      Like, if I think about hanging out with my best mates, what do we do? Well, we do lots, but one thing we're, we're always doing is laughing when we're together, right? So-

    10. RK

      It's-

    11. RC

      ... you know, a- again, that speaks to everything, that they're not all in isolation. They all... All of these behaviors-

    12. RK

      Absolutely

    13. RC

      ... kind of-

    14. RK

      Interact

    15. RC

      ... interact

    16. RK

      And, you know, kids laugh 400 times a day. There are studies to show this. Toddlers laugh 400 times a day. But we, we laugh so much l- less as we get older. So let's introduce laughter as part of it. [laughs] As, as-

    17. RC

      So laughter really is the best medicine

    18. RK

      ... laughter is the best medicine. And then purpose. Purpose is terribly important. And, and actually our... my message about that is anything can have purpose. You know, m- if making a shopping list and go down to the shop to get the st- that's purpose. You, you can create purpose in your day. We need to feel purpose. If we feel we have no purpose or, or almost unwanted or unnecessary, and we come back to this whole concept of social isolation of people over 70 and cocooning people over a certain age, if we feel we have nothing to contribute, we have no purpose, that's really bad for us from a physiological perspective.

    19. RC

      Yeah, one of the things in that chapter I particularly liked, and it's something you just echoed now, is that you can find purpose in anything. It really makes me think of what we were saying about attitude.

    20. RK

      Yeah.

    21. RC

      Right? Like, you know, the going to get the shopping can be seen as a chore. "Oh, man-

    22. RK

      Mm-hmm

    23. RC

      ... I gotta go and get the shopping now," or whatever it might be. But you can actively reframe that. You know, maybe a bit of gratitude, maybe a bit of, "Oh, wow, I, I get to go and actually get the food now that feeds my family or feeds me and my partner," or whatever it might be.

    24. RK

      Yes, yes.

    25. RC

      And I know it sounds very soft and very simple, but I honestly believe that you can train yourself to have this attitude. You can train yourself-

    26. RK

      Yeah

    27. RC

      ... to look at the positive side of everything, even washing the dishes.

    28. RK

      And, and purpose is tied into control, and we need to be in control. There are lots of, lots of studies showing that. In an employment hierarchy, those who are in control, that is one of the most important contributors to good health in those individuals compared to those who maybe are often in the bottom of the, of the hierarchical chain and have no control. They have to do what they're told, et cetera. So purpose is part of that. Purpose, if you can reframe it, um, gives you control over your life.

    29. RC

      Yeah.

    30. RK

      It is your purpose and you're framing what your purpose is, therefore you're in control, and that's really good for us biologically.

Episode duration: 2:08:57

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