Supplements, Lifestyle, and Strategies for Longevity and Optimal Health

Substances 0:54 0
“today we are going to discuss the so-called NAD pathway this is a pathway that's received a lot of attention and recent years as a potential Target for improving lifespan that is for living longer today we discuss the various molecules in this pathway and the various approaches to increasing NAD which is the end Target goal of anyone that's trying to augment the NAD pathway so to speak so for instance we talk about taking NR versus nmn versus direct infusions or even orally taking NAD and we compare them in terms of both what's known known and what is not known about their ability to get into cells and any efficacy they may have for either longevity or health span”

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Substances 1:39 0
“Dr at and I compare and contrast the literature on this again both research and clinical literature and we discuss whether or not he or I take NAD nmn or NR and if so or if not the reasons for that we also each go through our own supplement regimen which of course reflects what we do believe can potentially have an effect on health span and or lifespan”

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Hydration 3:00 0
“proper hydration is critical for the optimal functioning of all the cells in your body and that's especially true for the neurons the nerve cells in fact we know that even a slight degree of dehydration can diminish both cognitive and physical performance”

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Sleep 5:23 0
“each night one of the best ways to ensure a great night's sleep is to control the temperature of your sleeping environment and that's because in order to fall and stay deeply asleep your body temperature actually has to drop by about 1 to 3u00b0 and in order to wake up feeling refreshed and energized your body temperature actually has to increase by about 1 to 3u00b0”

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Exercise 7:16 0
“namely you want to move appropriately and often enough so get enough Zone 2 cardio do your resistance training keep nerve to muscle connection strong”

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Genetics 7:42 0
“know your genetics and make some good decisions on the basis of your genetics”

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Nutrition 12:10 0
“there's nobody listening to us who doesn't eat but again you can choose how much you eat and what you eat and when you eat”

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Exercise 12:19 0
“there's nobody who's alive who isn't moving because Locomotion is life and the absence of life is the absence of locomotion but you can certainly choose to move very little you can choose to move a lot and you can choose to decide on how you move”

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Sleep 12:49 0
“similarly we all have to sleep right Matt Walker would probably tell us the number of days you could go with sleep without sleep before you would literally perish um but again you have a lot of choices in how you do it”

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Substances 13:09 0
“what are the molecules that you would exogenously take to try to impact any of those systems”

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Disease prevention 14:39 0
“you can take Metformin or an sgt2 inhibitor or a glp1 Agonist and you will directly impact those things you could take uh a pcsk9 inhibitor or a Statin or bidic acid you will directly impact those disease processes you will delay the onset of those diseases and you will reduce the mortality associated with them”

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Mental health 16:23 0
“none of this other stuff matters if you're kind of unhappy and so so you have to and and you've done so many podcast on that topic right you've had Paul Con on where you kind of go through the understanding of ourselves and our minds and and why that's also a very important part of it because it actually does impact how long you live because if that piece isn't working it's very difficult to regulate the first bucket”

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Substances 17:29 0
“I take a few right so I take some that are disease specific right so I take a pcsk9 inhibitor I take bidic acid uh I take an sglt2 inhibitor um and then I take at least one that is purely just uh based on the belief of its capacity and Juro protection which is rrap ayin and um and also the SG the sglt2 inhibitor I think is probably just broadly geroprotective.”

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Substances 18:08 0
“what dosage of rapamycin do you take I take eight milligrams once a week for as long as I can tolerate it but that I usually have to take breaks.”

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Substances 18:18 0
“I get these vicious apus ulcers uh little mouth sores canker Source yes about 10% of people get them.”

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Substances 19:04 0
“my conviction around mtor is far more based on the experimental data um something that is actually sorely lacking in the NAD story which we'll discuss so the experimental data are far more convincing right which is when you look at the administration of Ramy or its analoges for example ever alus um when you look at the administration of these molecules to organisms that are as close as possible to the species of interest.”

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Substances 25:03 0
“Let's talk about NAD yes it's in essentially every cell of the body except red blood cells correct you know I I don't even know if it's in red blood cells my intuition is I I I've never looked to be honest with you but given that red blood cells um have a different metabolic pathway right where they're purely glycolytic I don't they wouldn't have the need for it in the way that others would but they might right because they still undergo Redux potential so it's possible NAD is in every single cell yeah and it's generally thought to be associated with energy production and mitochondrial Pathways in every single cell right so NAD is again one of the most ubiquitous molecules in the body and most of what it does and I mean most meaning like somewhere between five and 600 Pathways of it utilize NAD as a co-actor meaning that it's not consumed in a chemical reaction but rather it serves as an electron shutle”

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Genetics 29:03 0
“so with respect to cerin as I recall they deleted the cerin let's use another example of what the gold standard is here or what a great example is so so I recently did a podcast with Dina dubal from UCSF on clotho which is an amazing scientific story and it's a great story because it shows how accidents can lead to great discoveries right so there was a a researcher in Japan who was really interested in understanding hypertension high blood pressure and they had created a mouse model where they were trying to knock out certain sodium channels to see if they could perturb blood pressure and then there was this one strain of mouse with this one knockout that died really really quickly and it developed like devastating neurogen disease and died very quickly and you know like a good scientist he didn't say well that sucks I'm going to discard that one CU it didn't give me what I wanted which was the blood pressure change and he kind of went and figured out what was going on and he figured out that there was a certain Gene that he had hit that wasn't a sodium…”

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Nutrition 30:53 0
“there is so much conflicting information out there nowadays about what proper new nutrition is but here's what there seems to be a general consensus on whether you're an omnivore a carnivore a vegetarian or a vegan I think it's generally agreed that you should get most of your food from unprocessed or minimally processed sources which allows you to eat enough but not overeat get plenty of vitamins and minerals probiotics and micronutrients that we all need for physical and mental health”

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Nutrition 34:50 0
“if you calorically restricted them they lived longer”

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Nutrition 35:49 0
“caloric restriction extends life across the model systems we discussed”

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Nutrition 36:36 0
“severe caloric restriction will absolutely reduce the risk of most chronic diseases”

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Nutrition 37:30 0
“it's not always the case that caloric restriction extends life”

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Genetics 41:01 0
“I talked about knockout mice that's when a gene or genes in some cases is deleted from the genome so it's null it does not express that Gene the gain of function would be to put back that Gene in that would be a Knockin Mouse.”

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Genetics 41:13 0
“in that case you still get some normal expression of the gene from the endogenous genome but now you have a trans Gene that's inserted there and there are all sorts of important intricacies that relate to for instance where the trans Gene is inserted.”

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Genetics 42:24 0
“we have this one transgenic Mouse you put CT six you over Express search six and all of a sudden the males were living 10% longer again to be clear the females didn't experience a difference.”

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Genetics 46:58 0
“those are the two Hallmarks of cancer so so we know that that only happens in the context of genetic mutations but why does this happen later in life and not at the beginning of Life with very few exceptions”

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Genetics 47:40 0
“it's probably that as we are aging we are undergoing more DNA damage and um or at a minimum the DNA damage we're undergoing is less amenable to repair”

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Substances 48:00 0
“we don't have enough of the substrate that the ceran needs to repair DNA and that substrate is NAD”

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Substances 49:18 0
“Resveratrol which gained a lot of Fame and notoriety because it happens to be found in Trace element elements in the skin of grapes and therefore shows up in wine”

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Substances 53:07 0
“there was no effective RIS veratrol and that result has been consistent across the board”

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Substances 54:58 0
“why don't we just give people NAD”

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Substances 55:06 0
“NAD levels are declining with age in most tissues.”

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Substances 56:57 0
“in 2015 a study was published in pnas that looked at NAD levels in whole blood over time and it found indeed NAD levels were going down about 10 to 20% over four decades or so but that same study said nadh levels were going up by the same amount”

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Metabolic health 1:00:04 0
“NAD levels are going down as we age but NADH levels are going up, suggesting that the total amount of NAD and NADH is the same and what's declining as we age should less be thought of as a reduction in NAD and should more be thought of as a reduction in what's called Redux potential, the ability to do what I just said.”

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Disease prevention 1:00:45 0
“A fair number of so-called anti-aging approaches are targeting the so-called reactive oxygen species (ROS), which impede mitochondrial function.”

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Substances 1:02:18 0
“When I hear about the role of NAD in this pathway, I think like most people I think okay well then I should just take more NAD and maybe I will age more slowly or I will replace some NAD that's missing as I age.”

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Substances 1:05:31 0
“I'll go on record now saying that I take NMN and in some cases I will take NR and NMN and I observe a very clear positive effect but I don't think it has anything to do with extending lifespan.”

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Substances 1:06:01 0
“we believe supplementing NAD in one form or another makes sense but before we do that we should acknowledge something yes NAD levels are going down but we have no reason to believe that raising NAD levels will correct a problem.”

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Substances 1:07:49 0
“I've taken NR in capsule form, I've taken NMN typically in powdered form where I put it sublingually under the tongue.”

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Substances 1:10:40 0
“the single most let's say Salient to me anecdotal data on taking sublingual NMN is that it makes my hair grow really fast, it makes my nails grow really fast and I do feel an increase in energy.”

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Substances 1:10:54 0
“I take it first thing in the morning, morning um and what dose one and a half gram 1500 milligrams so by the way if you translate you know the the doses that they give mice in the studies where they're testing the efficacy um are typically on the order of 500 to 1,000 milligrams per kilogram.”

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Substances 1:11:36 0
“NR can cross the cell membrane directly very easily there's no obstacle to NR getting into cells okay and NMN cannot because of that extra phosphate group.”

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Substances 1:13:01 0
“Sublingual NMN is also a bit of a laxative so there all these and I say that you know somewhat chuckling but you know some people say it makes them feel better well is that because you're you know evacuating your bowels a few minutes or hours later and then you feel less bloated and you have more energy.”

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Substances 1:17:43 0
“my understanding is that there are some studies that have explored the role of supplemented NR maybe nmn as well but certainly supplemented NR for sake of lowering inflam to offset some of the negative effects of time zone shift alcohol um I have a few others listed here um overnutrition.”

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Disease prevention 1:18:11 0
“you take 100 people more or less with fatty liver disease now this was documented with um uh an MRI of the liver so um they're looking at um hepatic fat in the liver um by Mr and um using this type of MRI if your hepatic fat index is over 5% that's a high enough degree of what's called steatosis that you have fatty liver disease.”

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Substances 1:19:33 0
“this study randomize people to either uh a placebo or a regular dose of this product or a double dose of the product and I can't remember exactly how much is in the product I think it's either 250 or 500 so then that would be what the regular group got of NR and then the other group was getting 2x that so it's either 250 and 500 or 500 and a th000 I don't recall.”

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Metabolic health 1:23:49 0
“there was a statistically significant increase in glucose disposal with insulin infusion but it was quite small”

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Metabolic health 1:24:15 0
“you can actually reduce like postprandial glucose by 8% is that meaningful not really”

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Substances 1:25:19 0
“I'm questioning whether or not I'm wasting my money taking NMN or NR.”

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Disease prevention 1:28:13 0
“this one study found somewhere between a 60 and 80% reduction in basal cell and squamous cell carcinomas”

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Substances 1:29:16 0
“nmn reduce the risk that significantly of sell and basal carcinomas I think you could make a case that if you're an individual who's at risk for those things clearly I'm not right like I've never had a sunburn in my life I mean I I don't work outside so it's like it wouldn't matter to me but there are a lot of people for whom either either their skin color makes them more susceptible or their their um you know their pastimes or or frankly their their their line of work makes them more susceptible you know maybe there is a case to be made for it there if if you could if you could literally take 60 to 80% of your risk away on S Mr basell carcoma that could matter”

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Substances 1:31:05 0
“most people considering supplementation to augment the NAD pathway are going to default to either taking INR or taking nmn”

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Substances 1:33:34 0
“NR can cross the cell membrane directly NN cannot okay but you can just CLE the phosphate group right exactly um NR they claim I'm not this is not my claim but they claim that NR is quote unquote 25% more effective than NN in raising whole blood NAD levels but I'm guessing that's milligram for milligram right okay so then you just adjust the milligram dosage a little bit and so on”

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Substances 1:34:55 0
“I don't even think it's worth arguing about whether nmn or NR is more bioavailable because to your point you can sort of adjust the dose and I trust that whatever you're taking NR or nmn you are getting some NR into the cells and that's being converted to NAD.”

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Substances 1:36:31 0
“the supplement nmn suddenly the FDA decided that it should not be sold over the counter anymore because there was a clinical trial initiated on nmn which essentially makes nmn a drug for clinical testing and thereby can't be classified as a supplement any longer.”

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Substances 1:39:21 0
“I do think NR and nmn are probably um there has been some voice around the idea that NR could increase the risk of cancer right and the experts in this area like Charles brener have pushed back hard on that arguing that the studies were not done well.”

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Substances 1:40:27 0
“interesting positive effects of augmenting NR as a means to increase NAD for sake of anti-inflammation and some of these other effects that we've been discussing”

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Disease prevention 1:42:46 0
“Joan manik um and Lloyd klickstein when they published that paper in 2014 using everolimus where they took a group of 65y olds and randomize them to either a placebo or different Doses and dosing schedules of everolimus found an enhanced immunity in response to an influenza vaccine”

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Metabolic health 1:47:16 0
“I would argue that that's a crude assumption because it doesn't take into account the fact that you're metabolically healthy that you do all of the things that you do.”

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Sleep 1:48:53 0
“not enough sleep s nutrition not great not just not doing the right things but just gave gave my 20s to being in in lab basically.”

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Stress management 1:49:24 0
“it's adjusted for by stressors and adjusted for by positive things in life life and the goal for me is to figure out what are the behavioral tools and other things I can do or take that are going to keep the Vigor as high as possible.”

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Metabolic health 1:53:15 0
“the only way you could really get a triglyceride measurement and put any weight to it is if you've been fasting for 8 to 12 hours then we can at least say hey a triglyceride level of 50 milligrams per deciliter is excellent whereas a triglyceride level of 120 milligrams per deciliter is lousy”

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Environment 1:55:35 0
“the NRC recommends that a human being or at least an American should expose themselves to less than 50 MTS of radiation a year”

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Genetics 1:58:29 0
“I've got very good genes in terms of longevity on one side of my family, pretty good on the other although not as robust.”

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Sleep 2:00:41 0
“A night of poor sleep shows up more right when you were working in the lab as hard as you were describing it you could probably walk through walls when you were exhausted, yeah a short nap would reset me near completely.”

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Exercise 2:00:12 0
“We still do hard workouts but recovery plays a greater role in other words we're just not quite as resilient as we used to be.”

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Exercise 2:03:45 0
“imagine if you and I were walking through the mall and I just started running ahead and running back you'd be so sore the next day but it's like it just wouldn't occur to me to ever run unless being chased right like it's just I mean like like we now live a life like I think our ancestors did which was you know if we're not deliberately in the business of moving for a reason like you're exercising you're going for a walk for the sake of going for a walk like you just wouldn't it wouldn't occur to you go and expend energy for no reason and yet kids do this it's amazing”

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Substances 2:05:11 0
“I take my nmn and my NR and I feel a little bit of a boost in energy but I can't say that it's so significant that I feel like I can Sprint back and forth Just spontaneously”

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Exercise 2:05:35 0
“good exercise and good nutrition do for your energy levels and vitality”

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Sleep 2:06:14 0
“to sleep is not easy right like we all are busy as hell we don't want to have to stop what we're doing to undergo nighttime routine to put ourselves in the right head space to be able to sleep do all the things necessary give ourselves that eight hours in bed to hopefully get seven seven and a half hours of sleep”

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Nutrition 2:06:43 0
“for many people certainly for me food is the hardest of these all right if left my own devices I'd eat freaking Froot Loops all day like I love fro Loops right interesting by way of contrast the food party is easy for me I like healthy food”

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Exercise 2:09:10 0
“yes you should exercise do resistance training do cardiovascular training but play with the timing of those and see how at a given intensity it impacts your energy levels for the remainder of the day”

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Exercise 2:10:46 0
“I just have noticed that in the few times in my life where I've kicked my own butt to get out and start working out really early I have more energy all day long”

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Substances 2:11:29 0
“I take NR and NMN with not a lot of religious adherence. If I ran out I might not buy it for a while and the only observed effect for me is this accelerated hair growth”

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Substances 2:12:28 0
“I take EPA and DHA in the form of liquid or capsule fish oil capsules”

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Substances 2:13:31 0
“I take vitamin D because interestingly despite the fact that I'm outside every day without supplemental vitamin D my levels are surprisingly low”

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Substances 2:15:57 0
“we know that if you take methyl folate and uh uh methyl B12 you're going to lower homocysteine that's abundantly clear so the the thinking is that that might actually lower um adma sdma and raise nitri oxide synthes again relatively low cost lowrisk you know thing to take at modest doses”

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Substances 2:16:40 0
“I take magnesium L3 and8 and ashwagandha for Sleep um i' take slow mag which is just a a magnesium chloride slow relasing version of magnesium and I take magnesium oxide so I take magnesium in three forms”

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Substances 2:17:30 0
“I take creatine monohydrate five grams a day”

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Gut health 2:17:36 0
“I take pendulum the probiotic got it y as far as I know there's no other probiotic that has any meaningful effect on the body outside of pendulum right pendulum is the because CU if you buy the argument that a probiotic for your gut needs to have Anor robic bacteria in it there's no value in giving you aerobic bacteria so you have to have something anerobic so acrania which works through the um glp1 butyrate pathway is anerobic and pendulum is the only company that can make it”

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Substances 1:41:28 0
“for a few months I was playing around with let's say um nicotine gums I stopped doing that um first of all I was dipping it and I ended up lifing for uh an entire episode of The Lex Freedman podcast and I only realized later so I stopped taking it also because it gave me a kind of a tick and off when I wasn't chewing it and then I felt like I needed to chew it and it's a little too stimulatory for me”

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Substances 1:41:58 0
“before sleep I take magnesium 3 and8 I'm really bullish on magnesium as well appenine 50 milligrams which is essentially chamomile extract and theanine and occasionally I'll take 900 milligrams in netl also um or instead I kind of mix those up and around”

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Substances 1:42:16 0
“I use a quality whey protein as a protein replacement that kind of thing and I've played around with various things like Sheila G and you know sometimes get the sense that it's having an effect but then I'll stop taking it for long periods of time”

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Substances 1:42:46 0
“I ingest caffeine in the form of yerbamate and coffee I've played around with caffeine tablets you know taking you know 50 milligrams of caffeine in tablet form I mentioned that only because it has a distinctly different feel than ingesting caffeine through liquid form it feels stronger and I don't know why that is”

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Exercise 1:43:23 0
“I do a lot of things as I know you do mainly based on suggestions you've made about getting zone two cardio rucking weight vest walks and Hikes three times a week resistance training three times a week cardiovascular training one long one medium one short and I try to hit the sauna and the cold once a week”

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Substances 2:25:32 0
“everything we have talked about on this podcast today whether it be NR NAD nmn thumin magnesium this supplement that supplement all of that stuff while potentially mattering I would put in the category of was the Titanic serving LOB Lobster or steak”

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Exercise 2:27:14 0
“I'll show you my conviction on exercise I'll show you what I do”

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Sleep 2:27:16 0
“I'll show you my conviction on sleep this is what I do”

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Substances 2:27:41 0
“I don't take these supplements full stop. I passionately do not believe they do anything for me and why would I waste time money anything on something that I really don't believe makes a difference.”

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Across this extensive review of expert commentary and peer‐reviewed studies, a clear, multifaceted blueprint for supporting both lifespan (how long you live) and healthspan (how well you live) emerges. While pharmacological and nutraceutical interventions attract considerable attention—particularly around the NAD⁺ pathway, rapamycin/mTOR inhibitors, and other “anti‐aging” compounds—foundation remains firmly in lifestyle and behavior.

Supplements and Molecular Targets

  • NAD⁺ Augmentation: Nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) receive heavy scrutiny. Both serve as NAD⁺ precursors, fueling hundreds of cellular reactions, including DNA repair and mitochondrial energy production. Animal and early‐phase human data suggest NAD⁺ levels decline ~10–20 percent over decades, yet direct proof that boosting NAD⁺ slows aging remains elusive. Dosing regimens vary (e.g., sublingual NMN ~1.5 g/day; NR in capsules), with anecdotal benefits (energy, hair/nail growth), but inconsistent clinical impact on biomarkers like insulin sensitivity or inflammation. Regulatory shifts (FDA classification of NMN) also complicate over‐the‐counter use.
  • mTOR Inhibition: Rapamycin analogs (e.g., everolimus) show robust lifespan extension in rodents and improved vaccine responses in older adults. Typical human regimens are ~8 mg/week with periodic “drug holidays” to mitigate side effects (e.g., mouth ulcers affecting ~10 percent). These compounds’ longevity potential appears more substantiated than NAD⁺ boosters, though immunomodulation and metabolic trade‐offs warrant careful monitoring.
  • Other Geroprotectors: Metformin, SGLT2 inhibitors, GLP-1 agonists, PCSK9 inhibitors, statins and bile acid sequestrants each target specific disease pathways—metabolic disease, atherosclerosis, cancer risk—and collectively reduce morbidity and mortality. While not classic “anti‐aging” drugs, their broad, disease‐modifying effects contribute significantly to extending healthy years.

Lifestyle Cornerstones

  1. Exercise
    • Cardio: Frequent Zone 2 efforts (moderate heart‐rate workouts) support mitochondrial health and insulin sensitivity.
    • Resistance & Stability: Strength training, ECCENTRIC (lengthening) emphasis, and explosive power drills (e.g., broad jumps) preserve muscle mass, nerve–muscle connections, and fall‐prevention capacity.
    • Recovery: Aging bodies demand greater focus on rest, saunas, and cold exposure to sustain resilience.
  2. Sleep & Circadian Hygiene
    • Temperature Control: Facilitating a 1–3 °C drop at night and rise at wake‐up enhances sleep depth and morning alertness.
    • Routine & Duration: Prioritize 7–7.5 hours nightly, with consistent pre‐sleep rituals to combat modern lifestyle pressures.
  3. Nutrition & Hydration
    • Whole Foods First: Emphasize unprocessed or minimally processed diets rich in vitamins, minerals, probiotics, and phytonutrients.
    • Caloric Moderation: Severe caloric restriction uniformly lowers chronic‐disease risk in model organisms; real‐world effectiveness depends on context and feasibility.
    • Hydration: Adequate water—and when necessary, electrolytes—is critical to maintain cognitive and physical performance; even mild dehydration degrades both.
  4. Mental and Social Health
    • Emotional Well‐Being: Addressing anxiety, depression, and chronic stress is foundational—poor mental health undermines motivation for all other healthy behaviors.
    • Connection & Purpose: Meaningful relationships and a sense of purpose buffer against cognitive decline, neurodegenerative risk, and emotional distress.
  5. Genetic Insight & Personalized Interventions
    • Knowing one’s genomic background (e.g., APOE, PCSK9, CLOTHTO) can guide proactive screening, early interventions, and tailored lifestyle choices, though deterministic mutations remain rare.

Environmental and Preventive Measures

  • Sun & Toxin Exposure: Minimize UV damage (skin cancers are nearly 100 percent preventable with screening) and avoid carcinogenic pollutants (asbestos, PM₂.₅, pesticides).
  • Radiation Safety: Keep annual exposure under 50 mSv as recommended by regulatory bodies.

In sum, while novel supplements and drugs hold promise, consistent application of exercise, sleep hygiene, balanced nutrition, stress management, and social engagement constitute the bedrock of sustainable longevity. Pharmacological strategies—whether NAD⁺ boosters, mTOR inhibitors, or cardiovascular agents—should be viewed as adjuncts, layered atop these core behaviors and guided by individual risk profiles, genetics, and emerging clinical evidence.