Episode 59: Creating A Younger Biological Age and Long, Healthy Life with Dr. Kara Fitzgerald

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Dr. Kara Fitzgerald:

An aging is the biggest risk factor for virtually all chronic diseases like we need to get that because that is such a motivating factor. Lung cancer, the first thing you think of as smoking, aging is a far, far stronger risk factor. So, and as I said earlier, the patterns that are changing as we age look like these diseases. So if you look at the epigenetic expression of cancer, it looks like the pattern in aging. It’s, it’s like aging makes us vulnerable to developing cancer to developing diabetes, developing heart disease, etc. So, if we could slow biological aging by even a year, there was a paper out of of, of David Sinclair and his colleagues looking at the the savings, the cost savings, trillions of dollars, so one, so if we can slow down by age, by extension, we’re improving healthspan. And we’re reducing the cost of care. I mean, the statistics are really kind of overwhelming. In our 60s in our very early 60s, most of us have two chronic diseases, most of us are on medication, I mean, and the trajectory, one disease begets another disease begets another disease. So once we get into that slippery slope, it can be easy to just really move into huge, huge, huge problems. But we could turn it around. I mean, that’s the that’s the promise of this.

Dr. Andrew Wong:

What if I told you you could reverse your biological age, effectively bringing your body and cellular health into a younger state? Would you believe me if I told you that this could be achieved with simple measures such as nutrition and lifestyle? We are excited to be joined today by Dr. Kara Fitzgerald:, for a conversation all things about her groundbreaking research on reversing biological aging using diet and lifestyle showcased in your latest book, younger you. Dr. Fitzgerald is the lead author and editor of case studies in integrative and functional medicine, and is a contributing author to laboratory evaluations for integrative and functional medicine, and the Institute for Functional Medicine textbook for functional medicine. With the helfgott Research Institute, Dr. Fitzgerald is also actively engaged in clinical research on the DNA methylome using a diet and lifestyle intervention developed in her practice. I am Dr. Andrew Wong, co founder of capital, integrative health. This is a podcast that is dedicated to transforming the consciousness around what it means to be healthy, and understanding the root causes of both disease and wellness. I can definitely say that this conversation with Dr. Cara was really amazing because it really transformed my consciousness around what it means to grow older. And knowing that chronological age does not always mean biological age. If you want to know how you can eat and live to reverse your biological age, this is a conversation you don’t want to miss. Thank you, Dr. Fitzgerald for coming on today. It’s such an honor to have you.

Dr. Kara Fitzgerald:

Oh, it is so great to be with you. I’m really looking forward to our conversation.

Dr. Andrew Wong:

So Dr. Fitzgerald, as we were just talking offline is the author of this amazing book that I really love. And I’ve read a couple of times now younger, you reduce your bio age and live longer and better. So Dr. Fitzgerald, what was the inspiration for your latest book?

Dr. Kara Fitzgerald:

So the so the inspiration from this book actually started I want to say around 2013. I mean, it goes back quite a while when I first started to read the literature on epigenetics, and it ended up influencing our practice, it’s kind of crazy, because it’s changed the trajectory of my career now, but so, you know, the papers were coming out, they were coming across my desk, and so forth. And, you know, back then, and really still today, probably the bulk of the research is looking at cancer. And so the in the tumor microenvironment very efficiently, that the tumor takes over our epigenetic machinery for its own survival and growth and propagation etc. And so just to define epigenetics, epi above genetics, the genome, so this is all of the biochemical processes that are occurring that influence what genes are on and what genes are off. So tons of science coming out, showing that, you know, epigenetics is just taken over in the tumor microenvironment. And one of the most important ways we regulate gene expression is through something called DNA methylation. A methyl group is just a carbon and three hydrogens. We use methyl groups in the body in every cell all of the time, like methylation is think about it, like sort of like breathing you know, if you’re not doing it, you’re not live blank. So it’s happening everywhere. And it’s one of the very important tools we use to turn genes on and off. When there are a lot of methyl groups on a gene, that gene is inhibited when there are a few that gene is allowed to be on. So here I am reading the literature and methylation is, you know, taken over with cancer. And for me as a functional medicine doctor, I mean, I know you know, this as as a functional medicine physician, we think about the literature and how we can translate it into clinical practice. If there’s always a question in our minds. Could I be How could I be? How could I are my interventions influencing my patients in a way that may, you know, negatively influence epigenetics or positively influenced epigenetics? So anyway, way back in the day, I started to think about this as these papers were coming across my desk, and honestly, back then it felt it was almost a rabbit hole that I was right Believe it or not, I know I’m such a geek, but I was somewhat resistant to diving into and probably because maybe I, I had some sort of a psychic foreshadowing that it was going to change my career, but I just, I realized it was too important and that I needed to embrace it. And so by 2016, my nutrition director, romiley, Hodges, and I had created what we called the methylation, diet and lifestyle. So in fact, we decided that epigenetics was an incredibly important thing to be considered in the functional medicine space, and that we were going to take a stab at actually creating a diet and lifestyle, based in the literature. So based in the literature, and you know, not everything at that time was human studies, and we’re still building our human database. But we ended up creating something that we started to use in practice regularly. In fact, I started I taught on it that IFM might, I lectured in Ireland, and you know, in Australia and South Africa, so this, this content in the functional medicine world was interesting. But the question was always, are we changing epigenetic expression? are we actually doing what we’re hypothesizing? We’re doing in our book, what are we we could see that our patients responded to it. We could see changes in biomarkers that suggested Yes, like we were dropping homocysteine, people felt better, et cetera, loss weight, whatever they needed to do antibody markers dropped, etc. So we knew that we were onto something beneficial. But were we actually changing epigenetics. At that time, you couldn’t just send somebody to quest. I mean, you still can’t order an epigenetic panel, you know, really, there’s a few hoops one needs to jump through, but at that time, it was even less available. We were blessed with an unrestricted grant from Brent acts as the CEO of metagenic. So he supported this vision supported us studying it, and we were able to hire a Clinical Research Center actually at my alma mater, helfgott Research Institute at National University of natural medicine, to conduct a randomized, double blind, controlled trials, that double blind but a randomized controlled trial. And we start we embarked in that in 2018. At that time, no studies had demonstrated bio age reversal. But we so we were we knew we would look at it. And and we’ll talk about that a little bit more, but and the study, actually, I know, we’re going to discuss the study in the book, but it was really pretty, pretty life changing for all of us the findings, the fight, the power, that diet and lifestyle influenced gene expression, was mind boggling. But that’s a very long, interesting introduction as to, you know, how, how I got to where I am, and ultimately, the study led to a book deal, and this is younger you

Dr. Andrew Wong:

awesome. Thank you, Kara. Let’s go into the study. But before we do that, I think the prelude question, of course, is, is something I had just on my way, and I was listening to your podcasts with the, with a Yale professor, the, you know, talking about the clocks and everything. I forget her name, Dr. Morgan. Thank you. Thank you, Dr. Levine. So the bottom line is there’s real difference between or there could be a big difference between what’s called biological age and chronological age. We all know that there’s this chronological age and, you know, we celebrate birthdays, and we talk about in our, you know, when you go to the doctor’s office, let’s say, you know, you got to put in your age, right and things, but then there’s something called the biological age as well. Because if you could just kind of outline real quick, some of the basics of you know, what is chronological first biological age, and then we can I would love to go into your study at that point.

Dr. Kara Fitzgerald:

Yeah, absolutely. So chronological age is the number of birthdays we’ve celebrated. We can’t change that. We can live at it, but it’s not going to it’s not going to change. biological age is actually the rate or body is aging. So how fast are those changes that are predictably associated with aging happening? Are they in step with our chronological age? Are they happening faster than our chronological age? Are they are they happening slower? Going back to DNA methylation and epigenetics, the way that we measure the rate of aging is by looking at DNA methylation is looking at patterns of gene expression. So that brought us you know, that’s what brought us here to looking at biological age.

Dr. Andrew Wong:

So in your book, you go into the detail about biker study, I believe it was in middle aged men. And there was a control group, and I wanted to ask you later about about other studies, but then there was an intervention group, and that to my program, it sounded like reverse the biological age of the participants by over three years, which is really amazing. The first study, like you said, that showed reduction and a reversal of bio bio age. So how did you recruit people for that? What What kind of interventions were in that study? You know, where they kind of reverse their age by three years?

Dr. Kara Fitzgerald::

Yeah, compared to the controller, by 3.3 point

Dr. Andrew Wong:

I know is about four years, it was about two years within the group within?

Dr. Kara Fitzgerald:

Yeah, yep. So again, just going back to 2013, through 2016, when we published our methylation, diet and lifestyle ebook, sort of our early iteration of this in the literature. methylation becomes basically to use the scientific term really wonky as we age, they’re less methylation is happening on the DNA, and imbalanced patterns of methylation are happening. So we’re turning again, going back to cancer, the cancer changes actually look a little bit like the aging changes. Genes are getting turned on that we don’t want on pro inflammatory genes, good guy genes that protect us are getting turned off in the aging journey. The aging journey, when you look at gene expression, doesn’t just look like cancer, it looks like heart disease and diabetes. I mean, it’s really kind of crazy. And so we we began to train our vision on if we can actually make a difference in the epigenome with, with it ate what’s happening aging, you know, with an aging phenomena, we may be able to, by extension really influence chronic diseases, because there’s such similar patterns. And so we just scoured the literature for evidence. Clearly, we needed a very methyl donor rich diet. So we have to keep that methylation cycle happening, we have to keep methylation happening. So our diet is very heavy and things like folate, B 12, Patane, Coleen, etc, nutrients that help methylation happen. And what does this look like it translating it to food, lots of greens. Eggs, if you if you eat eggs, if you’re willing to dive in and do some liver Wildeman, mushroom things like shitai, inochi, my Taki, et cetera, has lots of folate and choline. So there’s a whole bunch of nutrients and we can just pack them into the diet. And then there’s this class of nutrients that extraordinarily appear to have an ability to sort of determine where methylation happens on the epigenome so that you’re turning on good guy genes, you’re turning off bad guy genes. And this class of nutrients we already know and we already love for a variety of reasons, there are phytochemicals or polyphenols, things like green tea, which has you know, millennia use history across across countries. curcumin in turmeric luteolin or resveratrol in red grapes. Queer sittin is a compound we know and love. So all of these, these rich, beautiful compounds that are found primarily in colorful fruits and vegetables, but also elsewhere. Again, mushrooms have some of these, these epi nutrients are also as important. So we want our fork packed with methylation rich foods. And we also want it packed with these traffic directors, what we call methylation adaptogens. And I and I want to throw out there too, likely as important as what we’re eating, sleep, sleep plays a huge role in what’s happening with DNA methylation, as does exercise, and you know, how well we’re managing our stress all of these things. So even though they’re not directly methyl donors in, you know, making methyl groups, etc. They’re certainly influencing how our body is, is doing it. And so let me stop there. So the diet was the diet and lifestyle program was designed to just optimize DNA methylation very intentionally

Dr. Andrew Wong:

care out, we’ll get back to the diet for a second, but on the exercise, sleep and stress management pieces, is there any evidence in the literature individually or you know, either in basic or human studies, that those components, you know, influence either I guess, DNA methylation, amount or activity and then like, where things are getting methylated or D methylated? Yes. Yeah. That’s awesome. It’s

Dr. Kara Fitzgerald:

such a cool, it is so interesting. I mean, I mean, there was a paper not too long ago, and I mentioned it in the book that, you know, they hypothesize that the that exercise, its fundamental mechanism of action is through epigenetics. And it’s, it’s fascinating. So all of the benefits, you know, the root cause benefit of exercise starts at its influence on the epigenome that these these scientists posited, and they’ve and they provided a nice trail of evidence for

Dr. Andrew Wong:

it. This is so this is great. Yeah.

Dr. Kara Fitzgerald:

Let me let me just say one other thing, because I get some cool exercise acts like green vegetables. So if you’re not going to down that play to have to get outside, it really does. When you look at what’s happening. epigenetically it’s, it’s allowing us to turn good genes on and turn off bad genes in this extraordinary way. And let me say one more thing about exercise. I’m literally a big fan of it. Some of the changes that happen with continued exercise, if we’re, if we’re preconception, we can hand down some of those about beneficial changes. So it there’s a heritable component to exercise.

Dr. Andrew Wong:

And as they said in the book, really there’s there’s a, I guess transgenerational component to methylation with no with conception, and then of course, as kind of people have their descendants and you know, everything. It sounds like, there’s a huge role there.

Dr. Kara Fitzgerald:

Yes, yes, beneficial or not. I mean, I think too much research thus far has been in sort of negative heritability or transgenerational activity, but I think the more that we look at it, we’ll see resilience patterns, I mean, the sky’s the limit, and this research is just going to keep happening and happening.

Dr. Andrew Wong:

And I love what what, what, you know, everyone, including yourself, lectures on the IFM, about your genes are not your destiny, right? Because there is so much focus on the negative, like, you know, people say, you know, might see a patient in the clinic is like, Oh, my grandmother had diabetes, my mother had diabetes, you know, I’m gonna get diabetes, that kind of thing. So there’s that patterns of resilience that it sounds like can really be influenced by the DNA methylome? Yes.

Dr. Kara Fitzgerald:

Yes, big time. I mean, we’re driving the car, you know, I think, in when we mapped out the human genome, so when when scientists kind of cracked that nut back in the early 2000s, the idea was that genes were, in fact, our destiny. But we realized pretty quickly that they weren’t, so the human genome was mapped out and you know, the one gene gene, one disease, expectation, or a couple of genes, you know, causing a disease was just fell apart. That whole hypothesis that we were that we were just raised on that was embedded in our training, it really fell apart. And that made way for the era of epigenetics. And that is how we how our daily choices, how we’re living our lives, influenced which genes are on and off. And, yes, today, just with regard to longevity, maybe 10% of genes, you know, influence our, our course, choice is up to us. I mean, we’re sitting in the driver’s seat. So for some of us, we’re going to be taking this on as a challenge is something really inspirational of something very empowering. And then some of us are going to, you know, be overwhelmed with this and need to be sort of supported into the recognition of how much responsibility, you know, they really need to take for their health.

Dr. Andrew Wong:

So there’s a lot of sub questions that have been generated by just a few minutes here, but I’ll get to this a minute. I want to talk about real quick, something i i saw from one of Dr. David Brady’s posts, just just today, he was actually talking about it, he was I think, trying to you know, get get some funny reactions to but he was saying that that, you know, two of my favorite foods, banana and avocado have Polyphenol oxidase is and so this idea of, you know, and I love berries and tea as well. So he was basically saying don’t eat, you know, polyphenol rich foods with foods that have Polyphenol oxidase is, I don’t know if you’ve run across that, but I’m not I’m not sure. It was like, Oh, darn, I can’t have my Avocado Chocolate pudding anymore. Something you know.

Dr. Kara Fitzgerald:

That’s great. That’s awesome. What? Um, no, I have not run across any any reason to be concerned. In fact, there there’s such extraordinary interaction between food combinations, and how they influence not just our microbiome, but then the compounds our microbiome, produce, and then, you know, our absorption and then their action internally and on EPI, you know, on gene expression. I just it’s myopic to isolate an enzyme you know, in a compound it could act on and may as, you know, far reaching clinical determination of food combination, although I wouldn’t be surprised if there’s going to be some really crazy food combination, of

Dr. Andrew Wong:

course in our clinic and we love Dr. Brady we love his tests. And that’s so just a shout out there. But um, you know, I’m wondering about the study, the one that the pioneering study there, do peep did people have to be? This is something I think listeners would be interested in. Because I know this is something personally I’ve struggled with too. It’s like, you’re kind of juggling these five balls, you know, sleep, stress management, of course, nutrition, exercise, etc, trying to methylate better trying to methylate more efficiently at the sites that we want to meth laid out to someone has to be perfect to achieve these these results of bio age. Yeah,

Dr. Kara Fitzgerald:

that’s a great question. That’s actually a really good question. Two cool things about our study that are worth commenting on, is we had very high rates of adherence. We had our nutrition or nutrition team, connected with the participants, at least weekly for the first month and then as needed after that. So that was built into the study. They didn’t get to cheerlead them, you know, and do sort of motivational coaching as we do in our practice, they had a very dry IRB approved script. Do you have any questions did you do to do got it but but even with that contact, our adherence rates were high, however, to your point, if your answer wasn’t perfect, I mean, we had participants who said, No, I’m not giving up my beer, you know, this was the eight weeks is no alcohol. And not everybody was perfect about that. I’m glad that they actually shared. So we know. And we have nice adherence data that we that we should write up and publish on at some point. Some people continued with their carbohydrates, there’s no way that I can or their grains, you know, and it is an eight week grain free program. So they didn’t they didn’t do it perfectly. And yet, we still made a difference, you know, we still achieved statistical significance in our, in our population. So there is some, there is some allowance for you know, being human with this, at least that’s what our data agenda,

Dr. Andrew Wong:

I love the positive focus in the book to younger you on, on how things you can do to improve nutrition and what you can eat, you know, how it’s always like, yeah, you know what I mean? Like, oh, Kenny, you know, so but we can eat, you know, this, these other foods that are really good for you. So I love that and the recipes? Yeah. Are there any me favorites? Let

Dr. Kara Fitzgerald:

me just speak to let me speak to that for a second. And we can talk about my favorites. But so there’s still there is the program that our that our participants followed in a study, and it is pretty rigorous. So one can do that, especially if they want the promise of what our findings were. However, if you flip to the appendix, it’s my the epi nutrient appendix on page 407 is one of my favorite parts of the book 30 pages of nutrients that have some evidence for influencing gene expression, so favorably, and that it’s 30 pages, people who are anxious about starting a program who are anxious of any of the restrictions, any anybody who is triggered by any dietary pattern can go into our appendix with a highlighter, and at least a dozen foods they’re already eating, so they can look and see what they’re doing right now. And then they can also look and say, Oh, I’ll eat this, or I’ll eat this. In my mind, there’s no reason why every forkful can’t be packed with these important epi nutrients in a in a way that’s doable. for that for that individual. I mean, we’re in clinic, we’re a functional medicine clinic, we’re prescribing this program all of the time in practice, and we’re making we’re meeting the person where they’re at. So we do all sorts of modifications, and I invite people to do it so that it works for them.

Dr. Andrew Wong:

It’s like there’s that proverb, I think it’s like the journey of 1000 miles begins with a single step or, you know, something like that. So that’s always Yeah, we’re, you know, start with the are and, but But yes, I would love to hear, you know, cares favorites of favorite foods, favorite DNA methylation foods, or you know, foods that would, I guess, affect methylation?

Dr. Kara Fitzgerald:

I’ll show you actually what I have for lunch. What I’ve got for lunch today. Yeah, I had to rush out of the house I had. Okay, this is a massive container of broccoli Rob in the

Dr. Andrew Wong:

glass, so it won’t get any glass. Nice. Do you do put some olive oil or something on it? Or

Dr. Kara Fitzgerald:

Yes, I have olive oil on it. It’s packed with garlic. So two things that I’ll do when I eat this I’ll add I’ll actually add a smidge of a high phenolic olive oil that I have here in the office just as a finishing oil. And I will add some rosemary so I’ve got a rosemary grinder. Here’s the two things that go on most of my foods. I just have them here. I did. My co author made me magic salt. This is epigenetic salt. It’s got rosemary, garlic, oregano and sage. So I’ll sprinkle some of the kosher. Isn’t that cool. She pays us for me and sent it. And my mom found a rosemary grinder for me.

Dr. Andrew Wong:

I’ve never seen that before. I always just sprinkle the rosemary. I love the grinder. That’s a great idea.

Dr. Kara Fitzgerald:

Yeah. So it just kind of does a coarse grind. And I’ll put that on. You know, any savory food that I bring into the cell? Throw a little like a script

Dr. Andrew Wong:

on any food. What about protein? Where does protein fit? And I know you said I think nine Yeah, maybe. But what where do you where do you see protein? And you know, I’m also curious about you know, I’m sure we have people out there listening that are some are on a vegan diet. Some are on vegetarian, some are Mediterranean, of course, some are on keto, and paleo or even carnivore. You know, there’s some people that are doing that. So love to hear your thoughts about what the research shows on these on these types of plans and how that fits into the younger youth program.

Dr. Kara Fitzgerald:

So far, the research there is there’s definitely evidence out there that what you eat matters to gene expression and biological age. So there’s definitely an accumulating body of information that suggests it’s important. So I talked about the New Age study in in my book that was looking at a Mediterranean dietary pattern and biological age reversal, and it did show favorite favorable changes to gene expression, and to biological age in a subpopulation none of the studies out currently show as profound changes as we were able to demonstrate in our so and again, I just have to underscore that ours was very much designed to influence gene expression and DNA methylation in particular. So the whole program is designed towards that. So we haven’t seen anything yet. Also, our program is multifactorial, multivariable. You know, we have exercise, diet, meditation, etc. But there is accumulating evidence. So caloric restriction, so shows favorable changes to DNA methylation, that slowed down a third generation clock called the pace of aging. What else have

Dr. Andrew Wong:

seen that with CR? What What kind of intervals are we doing? Are you looking at in that study that 68 Or something longer for

Dr. Kara Fitzgerald:

it was actually it was actually it was actually caloric restriction? You know, there was an actual drop in in overall percentage. Okay. Okay. And for quite for quite a while, but it did slow. The pace of aging, which is the which is a new generation clock, significantly. So that’s pretty cool. Yeah. Yeah, so so. So evidence is, is definitely accumulating, but that what you eat makes a difference. There is no study, to my knowledge on the carnivore diet, I don’t think that there is other than ours, ours is pretty is is paleo leaning for sure. And we showed what we showed, I don’t know that there’s any other research out there. So there’s lots of room for these, these things, these diet dietary patterns to be explored and how they influence gene expression. I’m sure that they are and it’ll be interesting. I mean, you know, people who adopt these austere diets, like a carnivore plan, some of them, you know, you can clear diabetes in a hot minute using this. But but there’s going to be you know, it’s a you curve, you’re going to you’re going to be doing fabulous for a while, and then eventually, you know, your microbiome microbiome damage done. Yeah. And that will influence us systemically. So my vision if somebody wanted to actually study carnivore, or some of those radical plans is probably great initially, and then you would eventually see some negative changes, you

Dr. Andrew Wong:

got to get this short chain fatty acids keep keep those up. And I think this is this is often at least we see that affected sometimes when there’s there’s not a focus on on things that nourish the microbiome, you know,

Dr. Kara Fitzgerald:

well, and all of these EPA, the EPA nutrients in the book, definitely there’s there’s animal based epi nutrients, but you know, the lion’s share of them come from plants.

Dr. Andrew Wong:

Yeah. Yeah, that makes that makes a lot of sense. Just for the listeners to more generally, what are the benefits for us when we become biologically younger? Why is this so important? And I think just to your point of, you know, how aging actually affects all diseases and you know, health?

Dr. Kara Fitzgerald:

Yes, yes. I mean, aging is the biggest risk factor for virtually all chronic diseases like we need to get that because that is such a motivating factor, lung cancer, the first thing you think of as smoking. Aging is a far far stronger risk factor. So, and as I said earlier, the patterns that are changing as we age look like these diseases. So if you look at the epigenetic expression of cancer, it looks like the pattern in aging. It’s, it’s like aging makes us vulnerable to developing cancer to developing diabetes developing heart CES, etc. So, if we could slow biological aging by even a year, there was a paper out of, of David Sinclair and his colleagues looking at the the savings, the cost savings, trillions of dollars. So one. So if we can slow down bio age, by extension, we’re improving healthspan. And we’re reducing the cost of care. I mean, the statistics are really kind of overwhelming. In our 60s in our very early 60s, most of us have two chronic diseases, most of us are on medication. I mean, the end the trajectory, one disease begets another disease, but begets another disease. So once we get into that slippery slope, it can be easy to just really move into huge, huge, huge problems. But we could turn it around. I mean, that’s the that’s the promise of this.

Dr. Andrew Wong:

It’ll be great if Medicare Vinci would pay for, you know, biological aging, clock measurements. I don’t I don’t know if they’re there yet. But I certainly think of Yeah, amazing.

Dr. Kara Fitzgerald:

Yes, they would have to Yes. And it would be incredible. If the NIH, you know, in your neighborhood, yeah. started to study it instead of siloing. All of our research investigations and giving them built, you know, all of you know, the silos of cancer and everything is is totally siloed. And billions of dollars are poured into these investigations. If we unified and actually looked at biological age, actually considered biological age as a disease, if you will. We would by extension, be addressing all of these other areas.

Dr. Andrew Wong:

Are there a lot of functional medicine? Researchers at the NIH? I don’t know if they were but I would love maybe.

Dr. Kara Fitzgerald:

I don’t think so. Maybe seven? It’s probably generous.

Dr. Andrew Wong:

Yeah, it would be amazing National Institute of functional medicine. Yeah.

Dr. Kara Fitzgerald:

I mean, longevity science, because we’ve got these bio age clocks. That was such a revolutionary achievement, you know, originally created by Steve Horvath, and other postdocs in his laboratory, but it’s just changing the whole research landscape. Lunch, you know, want longevity science, or biogerontology is, as some scientists call it is hot. And there are so so so many dollars going into it and not just in the US, but in other countries. Like I read Saudi Arabia is investing a billion dollars a year in looking at longevity and, of course, altos lab, rumored to be started by Bezos, and others who and altos lab is it’s focused on this solely and there’s altos outposts here in San Diego, and then, you know, at by University of Cambridge in the UK, and Asia. And they’ve recruited all all of the best scientists. So Horvath, the inventor of the of the first clock, Morgan Levine, who you mentioned earlier, left Yale to go to altos. So massive, massive amounts of dollars are going into looking at slowing or reversing biological age massive investments

Dr. Andrew Wong:

care in terms of in this is a bit of a controversial question here or opinion. Question is, what is your opinion on on, you know, would reversing bio age lead to an increased lifespan?

Dr. Kara Fitzgerald:

Yes, I definitely. I think so. Yeah, yeah, I do. I let me just say, I mean, obviously, if you’re going to increase lifespan, I mean, we’ve increased lifespan, you know, over the last 200 years in our country. But, you know, it’s, it’s not pretty at the end of life. So, one may continue to have a pulse, but they’re propped up on drugs, etc. So an increased lifespan has to be accompanied by increased healthspan. Yeah, I agree. The promise of I think younger you and you know, thinking about diet and lifestyle isn’t a life to 120. But it’s a lifespan that walks with healthspan. And ideally, you know, death is a simple, gentle, less painful process. So it’s the compression of morbidity as James freeze.

Dr. Andrew Wong:

I love that and it’s healthy aging, right? Because, you know, we’re all mortal. And, you know, this is part of the natural cycle and everything. And I think it’s, it’s always good to just remember that it’s really about quality of life to You know, how we talk about, you know, enjoy our moments and, you know, live our best lives and things like that. Thank you. What do you what do you think about the future of research with younger you in terms of are there any studies out there on say, like women or different age groups? Yes, groups.

Dr. Kara Fitzgerald:  

Thanks for asking. Yeah, yes, yes. So we’re writing up a we’re just going to do a case series right now. We’ve got we do have an As a sidenote IRB approval to continue to study and we’ll continue to do that in our app. But we have a cohort of, of six women, our first cohort of six women who finished doing the program, and they did great. And so we’re going to publish them as a case here. So they’re outside of, of IRB. And so we can’t publish it as a as a research study. But we can publish it as a case series, a case report, and we’ll get that out as soon as possible. So we wanted to absolutely look at women. The only reason that we didn’t in case some listeners are wondering, because that was a top question that I was asked is that it was a pilot study, we were looking at middle aged men. So between 50 and 72, if we had included women into those small numbers, between 50 and 72, women are pre menopausal, perimenopausal and postmenopausal. And that influence of hormones on outcome wouldn’t, we wouldn’t have been able to tease it out, it would have been just just really too small. So we’ll continue to look at women, and we’ll just look at broader populations, we’ll look at different populations, you know, going forward within the structure of our

Dr. Andrew Wong:

app, thank you. And that that gives me an excuse to touch on another rabbit hole. I do have a pair of rabbits at home, by the way, but so I do I do like, yes. Yeah. So yeah. So so we can talk about a women and that sort of changes in their in the life, sort of like life changes. What is your thought on on hormone balance, especially during those transitions and women’s lives, or men’s lives to about hormones and how that affects the health of DNA methylation?

Dr. Kara Fitzgerald:

Well, unfortunately, we know that when estrogen tanks women age, biologically, and we can see it, right, we know that, you know, heart disease, numbers increase, etcetera. We know all of you know, the negative fallout of when we hit menopause. It is a pro aging phenomena menopause. And that has been, you know, that’s been published on actually Morgan Levine wrote on that, so my, I mean, do all of us need HRT? Yeah, that’s what? Yeah, do we all need HRT? I don’t think so. I don’t know. I mean, I don’t think that the evidence suggests that we need to, but we probably for those of us who are into paying attention to biological agents slowing it, I think age, HRT is a worthy consideration, you need to you know, you obviously have to look at risks, and you want to track bio age and see what see what your responses. I just, you know, my little no one, I just like, off the top of my head, I’m thinking of my mom at 80, who’s just so healthy and active and you know, never, never used HRT, there’s plenty of women who just don’t require it to keep a nice bio age and stay healthy for the long haul. But some of us, it’s an absolutely important consideration.

Dr. Andrew Wong:

And it may come back to lifestyle to anecdotally what I’ve seen is a lot of people that have sort of more stressful lifestyles, they’ll have that DHEA being lower, and we know that that has influence, you know, biological age as well. So and then when they, when they change their lifestyle, sometimes, you know, they might do some meditation, they might kind of quit the job they don’t like or, you know, something like that. And then their DHEA DHEA actually starts going up without without herbals, without supplementation sometimes. So it’s kind of interesting. salutely Interesting, your prescription? Well,

Dr. Kara Fitzgerald:

stress is such a potent driver of aging. I mean, it’s such a potent driver of aging. So yeah, if you make those sweeping changes you just outlined, of course, of course, we’re gonna see changes. Now. There’s

Dr. Andrew Wong:

some supplements and the studies that you’ve that you’ve done. Why though, I think you mentioned this wire Whole Foods better than supplements, or processed foods as a form of nutrition, especially with with methylation. I think I really want to touch on something I had emailed me about one time this comment on non dietary supplemental methyl donors long term and how some studies I think you published in your paper, actually, some of the other papers that were done on, say, supplemental b 12, or folic acid, if it was long term, I think there was some statistical significance for increasing the LR for cancer.

Dr. Kara Fitzgerald:

Yeah, that’s right. Yeah, and that was our that was our was our entry again, going back to 2013 1415. Our entry into thinking about epigenetics was through the lens of cancer, and cancer shuts down efficiently. A class of genes called tumor suppressor genes, and these are incredibly important. We have many, many, many, many of them. And tumor suppressor genes do exactly what their name suggests, they suppress tumors, they suppress cancer, cancer and aging, by the way, hyper methylate and inhibit the expression of these tumor suppressor genes. So they’re just they’re just we don’t want hyper methylation, where it shouldn’t be happening. We do not want it Each turning off genes we shouldn’t be turning off. So the question is, if we’re giving our patients very high dose folate, very high dose b 12, could we be influencing tumor suppression inhibition? Could we be doing harm to our patients? And my read on the literature suggests that, yes, we may it there may be times when high dose supplemental isolated folate and B 12. Could be negative. And I want to say especially, we’re talking about folate here, there’s less solid research on B 12. So, probably, and this is still being teased out, if there’s a pre cancerous a yet to be identified pre cancer with prospects

Dr. Andrew Wong:

or something maybe,

Dr. Kara Fitzgerald:

yeah, exactly. some level of tumor gene, tumor suppressor gene inhibition is probably happening in that individual. So in that precancerous or active cancer, or even, you know, post treatment, we want to be careful, you know, we want to be careful, however, methylation is essential. So we have to be methylating, healthy regard, you know, whether we have cancer, or we’re at risk for cancer or not, we need to be pouring methyl donors into our bodies, we just want to be mindful about how we’re doing it. There is no evidence in the literature, that methyl donors, you know, folate, B 12, called the invitation, et cetera, et cetera, from foods is negative at all, and most of the studies demonstrate, you know, healthful outcome with food based methyl donors. So my practice here in the clinic, and my suggestion in the book is that you do a food forward approach. And then if you need to use supplemental methyl donors, do it by all means. But just be mindful. You know, plenty of people have come to me over the years taking massive amounts of self prescribed supplements, the era of epi genetics and our ability to see it shows the power of the supplements, and I think should give all of us pause.

Dr. Andrew Wong:

Yeah, it kind of kind of getting even more personalized than than we have been even in functional medicine, I would say, Yeah, that’s great. I wanted to spotlight vitamin D, because there was a study that you mentioned your paper on, on actually obese and overweight African Americans and trying to get the D level above 50. And how that actually reversed the bio age by a really good number, just with above 4000 I use of data. So I felt that was a pretty incredible, isn’t it paper? Because I think in your study, most of the most of the guys were were healthy, right? They didn’t really have a lot of health issues. Okay. So So even for, you know, kind of a standard American population, you know, SAP that’s eating a SAD diet, you know, how can we? And it sounds like sounds like there’s, that’s apps, that’s apps. Yeah. I mean, this sounds like there’s a there’s more, there’s more wiggle room to improve on? Yeah, based on that.

Dr. Kara Fitzgerald:

Yes. And by the way, that study, there was a second study that came out demonstrating similar in D deficient individuals a bio age acceleration. And then to address addressing, the D deficiency actually just slowed bio age. So there was another subsequent study that came out of the Netherlands with a much, much, much larger population, with with with the similar outcome. So it’s really exciting, simple, simple, fix simple, could have, you know, a bio bio always slow down, when we have a chronic disease. So diabetes, I always think of classically, just because I, there’s, there’s a paper off the top of my head, when we have a chronic disease, we’re aging faster. I mean, that’s just the definition, if you want a surrogate marker of the fact whether you’re aging faster or not, if you got a chronic disease, and then there is some accelerated eight by always happening in diabetics, there’s about a six to nine year, bio age acceleration, however, and so this is just tying it back to vitamin D, we can turn that around by you know, correcting the chronic disease. I mean, we can you know, we can slow it down. So yes, our study specifically focused on healthy men, it actually took us quite a while to do it, because we were so selective in our recruitment. But if we had studied diabetics, or if we had studied, you know, autoimmunity or inflammatory bowel, you know, whatever we had looked at, we might, we might have seen bigger changes. You know, because there’s an accelerated age,

Dr. Andrew Wong:

I’m really excited to see the research in the future on some of these chronic diseases, reversing that using using a kind of functional medicine approach and then really seeing those changes in bio age. I think that’d be really amazing to see the data down the line. One of the things how, how seriously should we take avoiding toxins you know, this is sort of the age of, you know, climate change plastics up the wall. through, I don’t know, 90,000 chemicals or something. Glyphosate obviously what what are what are things that we should either avoid? Or do you know, from a, from a root cause perspective that would, that would improve our methylation from a, I guess, environmental health perspective.

Dr. Kara Fitzgerald:

You know, earlier, I was actually going to make two comments on our study. And this was the second comment that I wanted to make, but I, I forgot about it. We didn’t require our participants to eat organic, if we had, if we had made that a part of our study, we would have had to provide study food, and it would the cost would have been so so high. So they didn’t, and I’m so glad that we made that choice, because we were able to show that, you know, eating regular grocery store food, one could still reverse Biolage. So there is an I talked about this in the book. You know, even if you’re sourcing food that has been conventionally raised, there are still some nutrients within that food that actually counteract the toxins. I’m not advocating one, eat a conventionally raised diet. I’m not advocating that. But if that’s what you have access to know that there’s still benefit there. And I think that’s incredibly important. That’s a great that said, it is because we want this to be broadly adaptable, we want this available to everybody. We don’t want people you know, being required to go to shopping stores that just price, you know, that we’re they’re priced out of access to certain quality foods. So it is it is important. And of course we can if we’ve got a little bit of dirt, you know, in our yard, we can plant things or do porch pots, etc. But we want this to be broadly accessible. It’s incredibly important. That said, Yes, toxins absolutely negatively influence gene expression, there’s just no doubt about it in a variety of different mechanisms, toxins, or not, biological age or longevity or chronic, you know, the the French to not, thanks. So we have, yeah, we have to do the best that we can in general, you know, this is in this and bio age and epigenetic expression is no so

Dr. Andrew Wong:

so it’s no para, you’re in your near New York City and Connecticut, I’m wondering about sort of the final common pathway of regenerative agriculture and farming as a way to make these type of organic foods more accessible to help people’s methylation. Is anything happening right now, either in the city or kind of where you live? In terms of? I don’t know, I’m sure there is. But you know, regenerative farming and things like that.

Dr. Kara Fitzgerald:

More and more here is Yeah, more and more. I mean, certainly we’re, you know, in the era of many farmers markets, you know, in our neck of the woods, so there’s Yeah, it’s pretty nice. It’s pretty nice. And community supported agriculture. And so it’s so so it’s, it’s happening, and it’s popular, and some of them are competitive and difficult to get into. So we’re certainly seeing some favorable movement in that direction. Yeah,

Dr. Andrew Wong:

that’s great. Well, I think just to wrap things up, for the listeners, I mean, it sounds like this. This book is, you know, I can tell you just from, you know, reading this and doing this program myself, this is a real game changer, this book. So again, younger you by Dr. Carrie Fitzgerald here, Dr. Fitzgerald Kara, thank you so much for joining us today, we have a few other just kind of closing questions. But before we get to the kind of the fun questions, which is always one of my favorite parts of this podcast is what is the one or two things you wish everyone knew about reversing their aging?

Dr. Kara Fitzgerald:

That we can do it? You know, when we can do it in a very simple way. We can start today that we have so so so much more choice and power over it, then then we’ve been taught or then we’ve been thought

Dr. Andrew Wong:

we’re in the driver’s seat. It sounds like

Dr. Kara Fitzgerald:

we’re in the driver’s seat. Yeah. Cool. And we’re in the driver’s seat together. I say, Let’s get younger together. I mean, it’s just so funny to be on this just it’s just fabulous. Let’s do it together. Yes,

Dr. Andrew Wong:

that sounds great. I’m here for the ride as well. And do you have a morning routine? Because we do have a question about fun question about if you don’t mind sharing your morning routine, because we know that’s really, really important for health and kind of setting up the methylation for the rest of the day.

Dr. Kara Fitzgerald:

Yeah, yeah, it is. Okay. So, yes, I do have a morning routine. I start with meditation. I actually do my meditation before I’m even out of my bed. You know, cortisol awakening response, like, you can predict a heart attack when people have huge spikes. And I’ve been known I’m sure I have massive spikes when I wake up with work brain. It’s horrible, right? Yeah. And, and so and I’m vulnerable to that unless I really set a different trajectory. And so one of the things that I’ve been doing over the last, I don’t know maybe, almost a year now is starting just in bed with a med dictation that brings me down and it is just so fabulous. And it just it changes what I’m doing. And then I have some water I started my day with a little bit of water. I have a four year old at home. So, you know, it’s not long after that. She’s, she’s, she’s hanging out with me. So there’s a lot of play and laughter It’s a fun time. You know, a nice, well rested. It’s super fun and a well rested kiddo was a happy loving kid. I was so juicy oxytocin for me in the morning. And I do I also do my exercise in the morning, as well, a

Dr. Andrew Wong:

lot, a lot, a lot of great things in the morning there for your routine. Kara, thank you so much again for joining us today. And how can listeners learn more about you and work with you and get your book and programs and stuff?

Dr. Kara Fitzgerald:

Dr. Juan, thank you so much for having me. It’s it’s fabulous to connect with you. And I just I really appreciate your work. So they can find younger you at younger you program.com You can find all things book. If you order the book, hang on to the receipt, there’s a bunch of freebies that you can get if you just upload your receipt onto that site. There’s just lots of stuff. We have groups people can join again community. We have the do it yourself version in the app. There’s all sorts of information over at younger you program. And then Dr. Kara Fitzgerald:.com Dr. Kara Fitzgerald:.com is the website that will connect you with the clinic and the podcast and blogs etc with

Dr. Andrew Wong:

big K K K AR AK and folks listening read the appendix. This is a really important part of book you know how like a lot of times in books that’s like the middle is that I would say the entire book is amazing. But the appendix is like blows blows me away. So thank you so much. It is it is. Thank you so much care for coming on today and we’ll chat soon. Awesome. Okay, take care. Thank you for taking the time to listen to us today. If you enjoyed this conversation, please take a moment to leave us a review. It helps our podcasts to reach more listeners. Don’t forget to subscribe so you don’t miss our next episodes and conversations. And thank you so much again for being with us.