Claudia von Boeselager (00:00)
I'd love to start with your personal transformation. I always think that's always a powerful place to start

Robert B Lufkin (00:05)
Yeah, sure. Well, my background is ⁓ I'm a physician. I'm actually a medical school professor. So I not only practice medicine, but I teach and do research and all that. ⁓ everything was going fine. I was minding my own business doing that when all of a sudden I came down with four chronic diseases. ⁓

⁓ I went to my doctors and the doctor said, know, hey, you've got these diseases. Don't worry, we're gonna give you pills ⁓ and, ⁓ you know, take the pills and you'll be fine. And I go, what about lifestyle? They go, no, that really doesn't work. yeah. They said, you know, you're gonna be on these pills the rest of your life, so get used to it. And, ⁓ and.

Claudia von Boeselager (00:45)
You don't need that. Doesn't matter. ⁓

Robert B Lufkin (00:53)
I knew enough about medicine, you know, that this wasn't going to end well. And I had, you know, two young daughters at the time and ⁓ they're still, they're still in high school. So that wasn't that long ago. But I realized if I didn't do something, you know, this is going to be a big deal. So I began to question what I'd

Claudia von Boeselager (01:12)
you you

Robert B Lufkin (01:18)
what I've been told, what I taught, what my colleagues were taught. And I realized there was a whole bunch of knowledge, research that I wasn't aware of, my colleagues, many of them still weren't aware of that. ⁓

shows that a lot of things about these diseases that I didn't realize. And short story, basically, I was able to transform

my lifestyle and ⁓ do implement relatively simple things in my lifestyle that ⁓ when I did them actually reversed the diseases. The doctors couldn't believe it. thought ⁓ they.

they thought the labs were broken or something. So at that point, I've now made it my mission to help others take back their health and not ⁓

Claudia von Boeselager (01:57)
Okay.

Robert B Lufkin (02:08)
make the same mistakes that I did. So I wrote a book and now spend my time helping other people not go down the path that I was going down.

Claudia von Boeselager (02:20)
I love that too, and it's almost from mess to mission. I had also multiple chronic disease. I was totally in denial. I'm like, I'm fine, but I had zero energy, blood markers in the red, two weeks away from being hospitalized, but I was fine. It's like, something is wrong.

And I think that that's the beautiful thing about this space is that so many people have gone from their own personal stories and histories, but we all have so many loved ones and family and friends. Sadly, my mother just passed from Alzheimer's dementia, which my audience will know about, just last week as well. And just to see someone that was such a shining light, thank you, go to have to suffer from this chronic disease. And had we picked up on things much earlier.

Robert B Lufkin (02:52)
I'm so sorry.

Claudia von Boeselager (03:00)
She might never have gotten to that and my father is cancer, etc. And as we know about 80 % of US healthcare spending goes to chronic disease management. So it's so important for people to understand this. So I really appreciate your mission and turning your own challenges and revelations, I guess, into your mission as well. I'd love to touch on your book, The Big Lies in Medicine. So your book is The Lies I Taught in Medical School.

You challenge some of the most common lessons doctors still learn. Given that 42.5 % of US adults are obese and 73.6 % are at least overweight, which medical lie do you think has been most damaging in fueling this crisis?

Robert B Lufkin (03:44)
Wow, that's a great question. Unfortunately, there are so many. And let me just say, I'll put a disclaimer out there. The book is very critical of... ⁓

what do you want to call it? Western medicine. It's not necessarily in the West, but the East has it also, but more like allopathic conventional medicine. you know, obviously confession, I'm a part of the problem because, you know, as a medical school professor, I represent the establishment and the Western medicine, if we call it that.

Claudia von Boeselager (04:09)
Okay.

Robert B Lufkin (04:18)
Even though the book is critical about that, I want to say that in the 20th century, those of us who were around then, least ⁓ Western medicine was truly transformative. You know, it made our lives

Claudia von Boeselager (04:28)
Yeah.

Robert B Lufkin (04:30)
so much better. The pills, the surgeries that were invented made all of humanity much, better, largely through public health measures and other things. But medicine was really magical then. the problem...

full, even today, if I get hit by a car out on the street, I'm going to want Western medicine, you know, I'm going to want that blood transfusion, I'm going to want my bone set, I'm going to want my spleen, my ruptured spleen removed, all those things that Western medicine can provide. But the problem is, you know, as you point out, 80 % of healthcare is now spent on what are called these chronic diseases, which were present in the 20th century. But now they're

Claudia von Boeselager (05:01)
Mm-hmm.

you you

Robert B Lufkin (05:15)
They are really truly in biblical proportions, biblical numbers never before seen in history. And these these diseases are things like ⁓ basically obesity. Most adults in America are overweight.

Hypertension, most adults are hypertensive where they have, they're on hypertensive

medicines. Diabetes, type two diabetes especially, cancer, Alzheimer's disease, ⁓ heart attack, stroke, even mental illness. And the problem is, when Western medicine is faced with these chronic diseases, what's the response? Well, we have all these pills and surgeries that were magical.

Claudia von Boeselager (05:42)
.

Robert B Lufkin (05:58)
you know, in the last century. The problem is when these pills and surgeries are applied to these chronic diseases, they

may work for symptoms and they can handle the acute things, ⁓ but they don't, in most cases, change the underlying chronic disease and the disease continues to progress. And that's really the problem that we're not addressing these things.

Claudia von Boeselager (06:05)
You.

Robert B Lufkin (06:24)
And maybe that's the biggest overall lie, that the pills and surgeries don't work for the chronic diseases other than the acute symptoms.

In other words, ⁓ if I'm a diabetic, ⁓ insulin is life-saving. No question about it. It saves my life from a hyperglycemic coma. ⁓

Claudia von Boeselager (06:36)
. you

Robert B Lufkin (06:49)
But the problem is treating type 2 diabetes with insulin and the other drugs like metformin and sulfonylureas ⁓ may keep you alive, but

it doesn't keep...

diabetes, type two diabetes becomes a chronic progressive disease. What does that mean? Well, it progresses to things like amputations. The number one cause of surgical amputations today is type two diabetes. What else? Renal failure, kidney failure. The number one cause of dialysis is type two diabetes, blindness, retinal blindness. Number one cause of retinal blindness is that on and on and on. you know,

Claudia von Boeselager (07:16)
you you

Robert B Lufkin (07:27)
Type 3 diabetes, Alzheimer's, heart attack, stroke, all these things. And if we treat type 2 diabetes with the drugs, ⁓ it progresses to these complications.

But when we treat them with lifestyle...

We actually reverse the disease and people who treat diabetes with lifestyle type two diabetes, they don't tend to have those complications. In other words, they arrest the disease. And that's the idea that there is a way and ⁓

Claudia von Boeselager (07:51)
You

Robert B Lufkin (08:02)
that the message isn't getting out there. And that's for all sorts of reasons.

Claudia von Boeselager (08:06)
And it's so exciting and so empowering, I think, for people to know this. And it's not taught in medical school, right? So I think that's where the challenge is, is that people are going to their doctors and like, we have a pill and this will prolong, you know, your lifespan, but in what state? And I'm curious, what were the lifestyle interventions that helped you solve for your four chronic diseases?

Robert B Lufkin (08:26)
Yeah, I mean, one of the lies that I believed and one of the truths is that ⁓ my four chronic diseases and indeed all the chronic diseases that I mentioned were separate diseases. In other words, one of the truths that I came to understand was that I didn't have four diseases, I only had one. And that's another empowering liberating concept for me is that ⁓

Claudia von Boeselager (08:48)
Hmm

Robert B Lufkin (08:55)
these chronic diseases, although they seem very differently, know, Alzheimer's disease seems very different from cancer. And it is, you know, in the manifestations, it's, it's very different from gout or arthritis, which, you know, which is one of the things that I had. And, and it's very different from diabetes, but

the evidence is very, very strong to show that they all arise from a fundamental metabolic dysfunction, a fundamental abnormality involving things like insulin resistance, oxidation, ⁓ inflammation that drive all these chronic diseases. the the empowering message is that lifestyle will impact

Claudia von Boeselager (09:16)
. .

Robert B Lufkin (09:39)
and improve

our metabolic health. if we do lifestyle to improve our metabolic health, we'll improve our risk for all these diseases. What does that mean? Well, it means that the same intervention that, know, God forbid, you know, your mom, I'm so sorry, my mom passed from Alzheimer's disease a few years ago also. But, you know, what it means is that diseases like Alzheimer's, we find that ⁓ ketogenic

Claudia von Boeselager (09:57)
That's fine.

Robert B Lufkin (10:08)
diet

helps people with Alzheimer's disease. Fair enough. It's a metabolic ⁓ fix for things, improves metabolic health. Well, a ketogenic diet also improves people with cancer. It also reverses mental illness in some but not all cases. It also stops seizures. It also reverses type 2 diabetes. The same types of lifestyle interventions affect all these diseases.

Claudia von Boeselager (10:20)
Mm-hmm.

Robert B Lufkin (10:37)
Back to your question, I haven't answered yet. What were the lifestyle changes? There are four big categories. it's what ⁓ a lot of, there's a lot of consensus about this. and the question is,

Claudia von Boeselager (10:37)
Mm-hmm.

Robert B Lufkin (10:54)
Everyone thinks you should have a good lifestyle. No one disagrees with, know, hey, have a good lifestyle, you'll be healthy.

Claudia von Boeselager (10:59)
Mm.

Robert B Lufkin (11:00)
Of course you will, you know, if it's but what does good mean, right? And for many years, a good diet meant a low fat, high carbohydrate diet. And there's some medical institutions that still recommend that but and my mom was a dietician. So I was raised on a low fat, carb diet. ⁓

Claudia von Boeselager (11:19)
We had it

in our house too, because was fat was bad and you want low fat and yeah, but knowing that what we know.

Robert B Lufkin (11:25)
Yeah. So

in my opinion, and what worked for me, and I would submit it's it's not a special case, this works for most people. In other words, it can be broadly applied. Everyone's different, we're all slightly different. That's why, you know, one person gets metabolic dysfunction, and they will get they will manifest as Alzheimer's disease, another person will get metabolic dysfunction, and they'll get cancer.

Claudia von Boeselager (11:48)
Thank you.

Robert B Lufkin (11:50)
somebody else will

have a heart attack. Well, what's that about? Well, we're all different. We all have different genes and epigenomes that manifest, but at the root cause is our metabolic dysfunction. And we can improve that with lifestyle. nutrition, ⁓ simple things, low carb, higher fat diet, good fats, don't eat seed oils.

For some people, a lot of people I would submit avoid grains also and then restrict your window of eating to a narrower time restricted window that will benefit everybody. Even if you don't change what you eat, just eat less often and you'll be healthier. So that was nutrition and then sleep. Sleep is key. Stress.

Claudia von Boeselager (12:31)
Mm hmm.

Robert B Lufkin (12:38)
mind state, you know, stress mindset, ⁓ how we look at the world, how we deal with the world, and then also exercise, both mental and physical exercise. And then the key thing is, if you you have to do them all, in other words, you can't like fix your diet, fix your stress, fix your exercise, but then your sleep is messed up because any of these will put you off the rails. So you really have to really have to do them all. But it's

Claudia von Boeselager (13:04)
So,

Robert B Lufkin (13:05)
It's

fun, it's a great lifestyle. I I feel better doing these things. mean, it just, not only I think I'm gonna live longer and I've reversed my chronic disease, but I literally have more energy, my mind's clear. It's just, it's a great way that I choose to live. It's not a diet, it's the choices I'm making for myself and my family for the rest of my life.

Claudia von Boeselager (13:23)
Mm.

Beautifully and beautifully said as well. And you can tell your vibrant energy. And I think that's the thing that people forget. They're like, but it's not just about living really well till you live a hundred. It's really having more energy today so you can do more of the things that you love doing and be more present, be there for your family, your loved ones, et cetera. it's ⁓ really impactful. And I think for a lot of people that are like, but it's difficult to change. And I think if you understand that it's the beginning,

When you start on the journey, yes, it's more complicated and there's adjustments, but it's, soon it becomes your day to day and your routine, you don't even think about it. So it becomes easier. Would you say?

Robert B Lufkin (14:05)
Yep. Yeah. Yeah, absolutely. Yeah. For sure. I mean, what? Go ahead. Yeah. Well, I was just going to direct it to one more thing on the, because your podcast is about longevity as well as lifestyle. Interesting thing that I realized is, ⁓ you know, I fix all my lifestyle and everything, right? And we reverse our, we...

Claudia von Boeselager (14:08)
Yeah, yeah. Yeah, and.

Yeah, I wanted to talk.

Yes.

Robert B Lufkin (14:33)
we lower our risk for all these chronic diseases. No question. The evidence is very, very strong. Whatever you're on the path for, will improve your chance of getting them and in some cases even reverse those diseases because one of the other things I became aware of is that these diseases don't start when the doctor diagnoses them. In other words,

Claudia von Boeselager (14:40)
you you

Robert B Lufkin (15:01)
I walked in the doctor's office, I got that diagnosis, but then I realized these diseases were present years

to decades, literally decades before I get the diagnosis. And if I wait until the doctor makes the diagnosis, I'm missing a tremendous opportunity for prevention, reversal, and maybe stopping it so I don't even get it at all. So that's, that's a key point. And the problem is, even though I'm a doctor, a physician, I know

Claudia von Boeselager (15:22)
Okay.

Robert B Lufkin (15:29)
that doctors don't make me healthy, right? Doctors, our

Claudia von Boeselager (15:31)
Okay.

Robert B Lufkin (15:33)
job is just to make people less sick, right? We deal with sickness, we don't deal with health, and we're not equipped. Doctors are too busy trying to manage disease to help me as a patient be healthy. And out of fairness to doctors, the medical system isn't really equipped for doctors to...

Claudia von Boeselager (15:33)
Okay. you

Robert B Lufkin (15:53)
to manage lifestyle and all these other things. That's why coaching and communities and so many other things. And really, if I

want to be healthy, that's on me as the patient. And that's the empowering thing too. I'm in charge of my health. My doctor may be in charge of my diseases, but if I manage my health right, I'm gonna get fewer and fewer of those diseases later and later on. But the point I was gonna make, go ahead, yeah.

Claudia von Boeselager (16:01)
Now, I

just wanted to applaud you. mean, that is so well said and that people really feel empowered because I go, but I have my doctor and they're outsourcing their thing, but

It's true, doctors don't have the time to do the deep dives. They don't have the time to read your sleep tracker and if you're just wearing a CGM and see what you're doing day to day. They only see you once every six months, once every 12 months. There's no way they're able to keep on top of everything. It's not fair. So I think, you know, people really feel empowered to get on top of it. So you said it so beautifully there. So I just wanted to come in.

Robert B Lufkin (16:50)
thank you.

Yeah. And yeah, the health care system is not set up. It's much easier to write a prescription for a pill and things. furthermore, you have to wait to cross a certain threshold for the disease. In other words, I used to think type 2 diabetes was, you know, in many diseases, we're like an on and off switch. You either had it or you didn't. Right. And that's the way the medical system set up.

Once your hemoglobin A1C, which is a blood marker for diabetes, crosses a certain threshold, you have diabetes or pre-diabetes, which is really diabetes. But below that, you're normal, you know? And the problem is, an interesting thing I didn't realize that changed my thinking about diabetes is that if you look at hemoglobin A1C markers, ⁓

Claudia von Boeselager (17:14)
Mm-hmm.

And.

Okay.

Robert B Lufkin (17:37)
in non-diabetic adults in America, this is from a large population studies like the Framingham data and Haynes data, it shows that hemoglobin A1c increases with age. In other words, the older we get, the higher and higher our hemoglobin A1c goes. What does that mean? Well, what it could mean and probably

means that...

Claudia von Boeselager (17:57)
Okay.

Robert B Lufkin (17:58)
Type 2 diabetes and hemoglobin A1c elevations, insulin resistance, is like gray hair. In other words, if I don't die of something else sooner, earlier, I will eventually get diabetes. And I would suggest that many, perhaps most people, are on the path to type 2 diabetes. But

Let me circle back to make the longevity point if I can. Your podcast is about longevity. And that was a

real wake up call for me because I wrote this book. It made New York Times bestseller. All this stuff. got all this publicity and it's all about lifestyle. And I'm going along. I fixed my lifestyle. Everything's good. And then the question is, well, you fix your lifestyle. You're still going to die of something, right? And so ⁓

Claudia von Boeselager (18:26)
Okay. Okay.

Robert B Lufkin (18:49)
what do old people die of? You centenarians, super centenarians, ⁓ 100 year olds, 110 year olds. Do they

die of special diseases? Not, you know, other than the ones we're talking about. Well, as it turns out, they don't they die of the same things that you and I and most of us die of, for the most part, except they get them much later in life. So what does that mean? It means by doing the lifestyle stuff, we're pushing the disease back but like

Claudia von Boeselager (19:10)
Mm-hmm.

Robert B Lufkin (19:18)
Like my old neighbor in Venice, California, once said, Jim Morrison, nobody gets out alive. We all have to die of something. So yeah, exactly. These chronic diseases are still there. And if you look at the numbers, ⁓ lifestyle, bad lifestyle is a huge risk factor for chronic disease. Diet is a huge risk factor. Smoking is a huge risk factor. Sedentary life.

Claudia von Boeselager (19:19)
It's a one-way ticket, as I say.

Robert B Lufkin (19:48)
poor sleep. These are all drivers of chronic disease, but there's one driver that exceeds all of them. And that is age. Aging. Aging is a greater driver. In other words, a 70 year old woman who's never smoked cigarettes has

Claudia von Boeselager (19:54)
You

Robert B Lufkin (20:05)
a 10 times risk of getting lung cancer than a 30 year old who smokes four packs a day. now that's, you know, there's some, some nuances in there because

Claudia von Boeselager (20:10)
Wow. Okay.

Robert B Lufkin (20:17)
you know, there's

a latency time with smoking. you know, 30 year olds not going to get lung cancer for a while. But anyway, the point is that as you get older and older, your chance of these chronic diseases increase greater and greater so that age becomes a single greatest risk factor for these diseases. then the question becomes, well, is it true? Go ahead. Do have a question?

Claudia von Boeselager (20:32)
I want

to ask, and I'm curious if I may start to drop, is it because the detox pathways and mitochondrial function and are all declining with age so that the risk factor is exponential because if something actually happens, the immune system, the bodily functions are not there to clear it out? Is that the reason why it's so high?

Robert B Lufkin (20:39)
Sure.

It's a, it's,

that's a great question. I mean, that's, that's what it comes down to. Well, what happens with aging is we talked about insulin resistance. It goes up with almost everybody over time. Insulin resistance is, is a driver for, for metabolic dysfunction. Inflammation increases with aging. Oxidative stress increases with aging. So all these things increase and increase the older and older we get. Well, fortunately,

There's also been a revolution in longevity in geroscience anti-aging to now there are actual drugs that reverse aging. there's a number of them now. There's a molecule called mTOR that

Claudia von Boeselager (21:42)
And

You take it? Yeah? Yeah.

Robert B Lufkin (21:45)
you know, we may have talked about that it's part of a complex metabolic pathway with AMP kinase and sirtuins and a bunch of other things that drive metabolism, but mTOR famously ⁓ can be affected by a single drug called rapamycin. And rapamycin is the single most powerful longevity drug in animals that's ever been shown. And now humans can take it. I take it for longevity.

Yeah,

yeah, and it's, it's pretty remarkable that it works. mean, the ⁓ you can ask, well, ⁓ is there any evidence? mean, there's evidence in animals, right? But is there any any evidence, let's say the phenotypes of aging, if rapamycin is truly an anti aging drug, what is it? What is the evidence? Well, phenotypes of aging, like wrinkles? Well, there's human there's a human study and others coming where

Claudia von Boeselager (22:14)
Yeah.

is

Robert B Lufkin (22:42)
the actual wrinkles and collagen is increased with rapamycin use, and this has been shown in humans. Gray hair, wrinkles, hair loss, that's been shown with rapamycin. Things like periodontal disease is seen with aging. That's why old people lose their teeth, right? Inflammation, that's also reduced in animal models with aging. Now they're studying it in humans at the University of Washington.

Claudia von Boeselager (22:49)
Your skin looks great, so.

Robert B Lufkin (23:09)
What about the one disease that half the population gets for sure and the other half never gets? It's an age-related disease. It's called ovarian failure, right? It's a disease of aging, right? Menopause. Well, if rapamycin is an anti-aging disease, what does it do to menopause? Well, it's been shown in animal models that rapamycin actually delays menopause in mice.

and increases the litter size, so much so that was a human trial that's underway currently at Columbia. Yeah, yeah, you know that. Yeah, so basically it hasn't been, it's a prospective randomized controlled study. So it's very, very solid. The results haven't been published, but the leaked information is that, and they've done it only with 50 people. So it was just a pilot study, but it showed that rapamycin

Claudia von Boeselager (23:39)
At Columbia University, yeah, exactly.

you

Robert B Lufkin (24:01)
you know, six milligrams once a week had the effect of delaying menopause projected up to five years in women. And so much so that they're now expanding the study to a thousand people. but then the question. Yeah, it's really tight. But then the question you say, well, as you say, hey, nobody dies of baldness or gray hair or even nobody dies of menopause. So

Claudia von Boeselager (24:15)
Wow. It's really exciting. Yeah.

for lack of due.

Robert B Lufkin (24:29)
does it really affect longevity? It may affect aging, but does it affect longevity? Well, let's look at the diseases of longevity that we all die of, know, basically heart attack, stroke, cancer, and Alzheimer's. So just quickly in heart attacks, rapamycin is FDA approved to coat the stents in the coronary arteries. When we get a heart attack, the surgery we get is a stent. But, you know, like we said,

The surgery doesn't do anything for the chronic disease, right? Your disease still progresses and you still die of a heart attack later and the thing still clots off, but rapamycin slows it from clotting. So it slows atherosclerosis in this indication. Cancer, there's evidence too. There's eight indications, FDA approved indications for rapamycin for cancer. ⁓ And

Claudia von Boeselager (25:00)
Mm-hmm. Mm-hmm.

Robert B Lufkin (25:16)
then finally for Alzheimer's disease, we talked about the thing, but ⁓ you know, that's...

That's those are the diseases of aging and then longevity itself. You can look at the ITP data where it actually prolongs mouse life greater than any other pharmaceutical intervention. But then then the question becomes, OK, well, hey, wait, I'm to take rapamycin and screw all that lifestyle stuff. I'll just sit on the couch and watch Netflix. Right. So well, actually, no, that's probably not a good idea. Why?

Claudia von Boeselager (25:40)
Okay.

Robert B Lufkin (25:49)
Because every few months there's a new study coming out.

The ITP is you may have talked about they give they give a drug to mice and then a control group and then they see if the mice live longer in a nutshell. Well, every few months, there's more and more data like rapamycin by far was the most the longest prolongation like 20 30 % lifespan improvement. Well, then they combine rapamycin with metformin and they got an even greater effect and they combined it with other

Claudia von Boeselager (26:11)
Mm.

Robert B Lufkin (26:19)
a carbo's and then other drugs and other drugs and then hey, who knew a few weeks ago. ⁓ They took a mouse model same thing, longevity study and they gave them psilocybin, which is an active ingredient magic mushrooms once a month dose, which is very interesting in 70 year old equivalent ⁓ mice. So they started late in age once a month.

Claudia von Boeselager (26:33)
Hmm.

Robert B Lufkin (26:45)
and they got a significant improvement in the mice and then some questionable data on human fibroblasts also. So there are a lot of different molecules that actually improve aging and it

Claudia von Boeselager (26:54)
Mm.

Robert B Lufkin (26:56)
may be that we can improve aging and in addition to just the longevity thing, just the lifestyle things we're doing.

Claudia von Boeselager (27:04)
I love that and I think it's that compounding or stacking or however you want to call it. But just a question on the psilocybin study that's really interesting. I for neuroplasticity for Alzheimer's, there's a lot of things being studied around it, which is really phenomenal. Mental health, of course. Was it paired with a rapamycin? So that was psilocybin once a month and a weekly ⁓ rapamycin dosage or was it independent?

Robert B Lufkin (27:23)
Yeah, yeah. To be clear, the

ITP is a interventions testing program. ITP is run by the National Institutes of Aging. It's a government program that it's been running for 20 years. You can suggest things that they will test. They've test green tea, curcumin, coenzyme Q, ⁓ statins, ⁓ know, all sorts of stuff. And, you know, to see if they have an effect. This was run by another lab somewhere else.

again, using mice, but a similar ⁓ approach. And ⁓ it just came out literally in July. everyone's scratching their heads. And we can all think about improvement, ⁓ default mode network, ⁓ reprogramming. Personally, think ⁓ psychedelics use are going to become very important as a normal.

Claudia von Boeselager (28:03)
Yeah.

Robert B Lufkin (28:17)
part of therapy as we all go through life that we periodically reset things with those. And, you know, we'll see time will tell, but it's fascinating that there's this direct evidence. They hypothesize it's related to telomere function, which is the lengthening of the chromosomes. But nobody knows, it's kind of speculation now.

Claudia von Boeselager (28:40)
I agree with you. It's very exciting. And I've had some pioneers in the space, ones that are working with Ibogaine and that have rallied with the Texas Senate as well. And now it's opened up in other states as well, which I think is really interesting. And there's research out of Stanford on it that it reverses brain aging, essentially neuroplasticity by a year and a half through one flush dose to others that are working with psilocybin and other things, you know, out of John Hopkins or Imperial College. I've had multiple conversations.

And the results of the research are staggering compared to SSRIs, which again, it's looking at that sort of Western medicine, SSRI temporary fix, not solving for the underlying versus actually getting to root cause and having deeper therapy essentially, and that reset as you're calling it. And so not only for therapeutic benefits, as it originally started with, right? In the 1950s before the whole war on drugs and all the rest of it, but...

⁓ I think it is a very, very exciting area for helping humanity also fix this mental health crisis that we are so desperately struggling with. ⁓ So if you can compound that with living longer, but living really well longer and bringing in different tools, including the lifestyle, etc., then it's a really exciting time.

Robert B Lufkin (29:56)
Yeah, and even ketamine, is a different molecule and a different principle, but it has remarkable effects on depression and other things. And ketamine is much more widely available. It's basically available ⁓ through a doctor and through clinics. ⁓ we'll see the effect of longevity on that. There's an interesting nuance, though, for people who take ketamine. ⁓

depression they did a study a very small study they wanted to show that they thought rapamycin would block BDNF which is brain-derived neurotrophic factor because it blocks it it blocks mTOR which turning mTOR down would seem to turn BDNF and proliferation down so they gave six milligrams of ⁓ rapamycin before a ketamine experience for these depression patients thinking it would somehow

blunt the effect of ketamine. And what happened was it actually doubled the effectiveness of ketamine at two weeks for depression. And the study hasn't been repeated. It's kind of a one-off thing, but it's interesting showing that there's like so many things we don't know and we don't understand about the effects of interactions of all these

Claudia von Boeselager (30:59)
Wow.

Robert B Lufkin (31:12)
other one that's super exciting now ⁓

is ⁓ partial epigenetic reprogramming that you may have talked about on your podcast where the idea is, you know, we have our genome, which stays the same, basically, you know, a few mutations there, but not not really much, but our epigenome is what reacts to our environment and the lifestyle. And we program it throughout our lives by the choices we make by our lifestyle. And but

Claudia von Boeselager (31:18)
Mm-hmm.

Robert B Lufkin (31:39)
Every generation, the epigenome is wiped clean when we have new offspring. Basically, that's what's rewound to make stem cells and stem cells are the pluripotential cells that make all cells, right? But they have to rewind and sort of wipe the epigenome.

of a lifetime kind of back to that basic one. And famously, Shinji Yamanaka in 2006 discovered some compounds that he won the Nobel Prize for six years later in 2012 that would allow us to rewind adult cells to this.

Claudia von Boeselager (31:59)
you you

Robert B Lufkin (32:13)
stem cell say this this embryonic stem cells and they were pluripotential stem cells or Yamanaka factors. It was remarkable. So people began doing research as well. If we can rewind them to stem cells, can we

Claudia von Boeselager (32:26)
Pause.

Robert B Lufkin (32:26)
rewind them and just, hey, I'd like to be 20 years old again. I don't want to be an embryo. If you rewind stem cells to

If you go back all the way, you

induce things like cancers and tumors called teratomas and things. So you don't want that full player potentially, but can you get rejuvenation without that? And the short answer is yes. Guys like Dave Sinclair out of Boston and others have been using a subset of the Ominaka factors, O, S, and K, to rewind the genome back to a...

Claudia von Boeselager (32:44)
You know.

Robert B Lufkin (33:01)
a younger the epigenome, excuse me, back to a younger state. And they've, they've actually progressed very rapidly with this. Dave has shown work showing a model of optic nerve damage in the mouse and

in nonhuman primates. And this damage mimics age related changes. And by giving Yamanaka factors, they rewind the genome back to where

it heals and the idea is it's a younger state so these chronic diseases reverse and literally this fall and in early 2006 they're trying the first trials in humans for non

they're doing a couple types of optic neuritis ⁓ and glaucoma ⁓ in humans and they're doing trials with these Yamanaka factors. The idea is it's interesting if you think about it because they're not treating the specific disease, they're actually treating aging. The disease gets better because the cells get younger. The idea is that the same thing could- ⁓

Claudia von Boeselager (33:53)
Mm.

Robert B Lufkin (34:04)
a rejuvenation tool could make everything younger. it's super exciting. The downside is these Yamanaka factors are transcription factors. So you've got to inject a ⁓ viral carrier and they're very expensive to make. fast forward, OpenAI has started working with these longevity companies and now ⁓ Dave's lab and other labs have come up with short

chain, ⁓ basically small molecules that have the same effect as the gene therapy. So they're they're like Yamanaka factors, except they're, they're cheap, inexpensive, you take them as a pill, you know, so the idea would be, I mean, and this is this is a lot of speculation, a lot of fast forward, but you could take these pills, and rewind your epigenome back to a more youthful state and, ⁓ and

Claudia von Boeselager (34:42)
Well.

Robert B Lufkin (34:58)
And it's super, super exciting.

Claudia von Boeselager (35:01)
It's super exciting, but what do you think are some of the risks or consequences? So let's say that it is possible to just take a pill and we're staying youthful forever. What are some of the potential risks that you see?

Robert B Lufkin (35:17)
⁓ Well, they're, yeah, that's a great, it's a great question. Like increasing longevity, you know, I grew up, I'm of the generation where we were taught that overpopulation was a problem and that the world was going to be overpopulated. Well, we now know that population collapses the problem. you know, many, perhaps most Western countries, ⁓

are having population decline. In other words, there aren't enough babies being born to make up for the people who are dying. So there's one argument there that, you know, ⁓ that will help that. But I think it's an interesting thing. I think our mindset has to change about longevity because, you know, ⁓ if I ask a 60 year old, know, 65 year old, they just retired, right?

Claudia von Boeselager (35:53)
We need this.

Robert B Lufkin (36:08)
Say, what do want to do for the rest of your life? They go, well, I love golf. I want to play a lot of golf. I love my children. I want to spend time with my children and my grandchildren now, and hopefully my great-grandchildren. Well, those are great things. What can you say about that? Well, if I ask my 14-year-old, hey, what do you want to do with your life? And they go, well, I love Frisbee. And ⁓ you're a great family. I want to hang out with you guys.

Claudia von Boeselager (36:16)
Okay.

Robert B Lufkin (36:36)
That's not acceptable, right? You've got, you know, at least another 40 years until age 65 that those

Claudia von Boeselager (36:37)
Okay.

Robert B Lufkin (36:45)
things, they're good to do, but they're not acceptable. Well, why are they acceptable in a 65 year old who's going to live another 60 years to just hang out on the golf course? No, no, no judgment against golf. I'm a miniature golfer myself, but or any sport, you know. But I think it's about

Claudia von Boeselager (36:45)
So.

Robert B Lufkin (37:05)
finding our purpose. What if we looked at our lives

from age 20 to age 60? In those years, how much we grew, how much we changed as a person, how much we evolved. And then at age 60, we take that same perspective, going, I'm in the next chapter of my life. And that's not, no, a golf course in a nursing home and bothering my grandchildren, know, annoying them. No, it's about reinventing myself and

Claudia von Boeselager (37:10)
If.

Robert B Lufkin (37:33)
evolving into something that I can't even imagine that isn't even possible, know, and doing doing

great things make the world a better place. You know, the wisdom of the elders, you know, that's that's something that shouldn't be, you know, shouldn't be overlooked. So I think, you know, I think there's a lot of possibilities, but our world is changing so fast with AI and, you know, humanoid robots and people jobs being displaced, you know, post capitalist society, I think.

Claudia von Boeselager (37:44)
Yes.

Robert B Lufkin (38:01)
Longevity is going to be one thing in there, they're so, you know, I think the world at 10 years is going to be unrecognizable.

Claudia von Boeselager (38:08)
There's so many pieces of gold in there too. I think it's looking at the blue zones also that one thing you really notice is the respect of elders and

cherishing the wisdom that they have and that intergenerational exchange. So I think that is really phenomenal. And then also to the state of the world, I was listening to a interview with Sam Altman of OpenAI and the interviewer was asking him, what do you think in five years time? And then she asked, what do you think in 10 years time? said that too far out, can't predict it.

And that's the exponential pace. And so I agree with you. I think there is so much opportunity, but I think it's also an opportunity for us to become more human, to spend more time with social connection, to leave these little boxes we carry around with us, these little telephones down, be present, have conversations, connect with people as well and share wisdom and knowledge. yeah, exciting times ahead in all aspects, right?

Robert B Lufkin (39:03)
Yeah.

Yeah, no, that's a great point. And back to the Blue Zones, I love the Blue Zones, the concept of family and the idea of aging as a model into your hundreds. Why not? It's a great thing. I'm disappointed that the Blue Zone as a brand has been co-opted. It was recently sold to a religious organization, which has a specific nutritional agenda that they're

Claudia von Boeselager (39:30)
Okay.

Robert B Lufkin (39:33)
going out with the Blue Zones and even the Blue Zones, the science that the Blue Zones are based on, although there are a lot of great messages about community and everything like that, it appears that the science that the Blue Zones is really an artifact. They're typically.

poor communities with poor birth records. when recently a study came out when they analyzed the birth dates of the centenarians and know, few super centenarians in the blue zones, they found that the birth dates were non random. In other words, they were more frequent at the beginning of the month or the middle of the month or something like that. Whereas a normal population, the birth dates are going to be random, right?

Claudia von Boeselager (40:04)
Hmm.

Yeah.

Robert B Lufkin (40:15)
And

this has come up with, you know, like income tax fraud and stuff. know statistically that when people make up numbers, they make up numbers, you know, they'll pick the beginning of the month or the end of the month, you know, people aren't very good at randomizing things. So anyway, the point is there's, there's strong evidence that the, that the longevity, the longevity numbers that the blue zones are based on.

Claudia von Boeselager (40:31)
Okay. Okay.

Robert B Lufkin (40:41)
is probably not trustworthy, but that doesn't mean we can't learn from community

and, you know, exercising and eating well and having a good lifestyle, whatever that means.

Claudia von Boeselager (40:56)
And

living well. But I'm curious to this point. So the data is saying that all these centerians, they're all born at the beginning or the end of the month. So as in like, let's make up a number so that the amount of centerians don't truly exist in these blue zones. Or I just want to understand what your

Robert B Lufkin (41:15)
Well, a of

them are a lot of them have their poor socioeconomically, which which is kind of a red flag because zip codes and longevity skew with socioeconomic status. You know, the wealthier people are, the longer they live and poor people don't live as long, you know, and it's it has to do with being poor. So

Claudia von Boeselager (41:28)
Yeah.

Robert B Lufkin (41:38)
it doesn't make sense. First of all, why were all these poor people living really long? Well, maybe there are other things in their lifestyle, but it appears there's record keeping. So when you follow the blue zones over the years to as more modern record keeping comes in, they're not living longer. know, that the sort of that that effect goes away if you accurately check your birth records, rather than someone you just ask them when were you born? I was born in 1865, you know, on June 1st, you know, but

Claudia von Boeselager (41:54)
You. You.

Robert B Lufkin (42:07)
So those tend to go away, that effect tend to goes away. Now, on the counterpoint, people are saying, well, no, no, that's the effect of junk food because these communities, even now, even as isolated as they are, they're still being bombarded with crappy food that we all eat now. that longevity effect is being, you know, so who knows, but it appears at least,

Claudia von Boeselager (42:15)
.

Robert B Lufkin (42:35)
We

should be cautious about interpreting it. But I think they're good messages to take from the Blue Zones.

Claudia von Boeselager (42:40)
Yeah, there is some fundamentals with family and good food and intergenerational wisdom. We'll stick with those good ones. I have so many questions remaining, but I'm appreciative of our time here. So have some closing wisdom, Dr. Lofkin. If you had to leave people with just one red flag symptom to watch for or

Robert B Lufkin (42:45)
Yeah, who can argue with that?

Claudia von Boeselager (43:03)
one lifestyle change to make immediately or one mindset shift to carry forward? What would those be?

Robert B Lufkin (43:09)
Well, think it's about how you feel about life. ⁓ Optimists live longer. And the world we experience is the world we create. The reality we see is seen through the lens of our expectations and our memories. just a final thing, people ask me, go.

hey, aren't you depressed after writing this book, seeing all this, seeing how far we have to go and all the issues. And actually, no, I'm empowered. I wake up in the morning feeling great because I think it's a new era in medicine. think doctors are still going to be important. They're still going to take care of disease. But like we talked about earlier, health, that's me as a patient. I'm the CEO of my own health.

And this is something I get to choose every morning when I get up. What I eat, what I exercise, when I sleep. All the choices I make in my lifestyle is very empowering. And that's something that no doctor can do for me. And it's a new era in medicine, I think. And we see that people are demanding to take charge of their own health. And it's so exciting. I can't wait to see what happens.

Claudia von Boeselager (44:19)
Very, very exciting. So thank you so, much for your time today. Where can people find you? Where would you like to send them to? Website or on social media?

Robert B Lufkin (44:28)
⁓ well, say my website's robertluffkinmd.com. ⁓ I'm very active on social media. My wife says too active, but yeah, but yeah, please, please say hi. I'm out there.

Claudia von Boeselager (44:37)
He's like, don't forget about me over here.

Yeah.

Beautiful.

Do you have any parting thoughts or message or piece of advice or ask for my audience today?

Robert B Lufkin (44:55)
Yeah, just ⁓ listen to what Claudia says, and it's great advice. And I love your podcast, and I'm looking forward to seeing your future episodes down the road.

Claudia von Boeselager (44:58)
you

Well, it's been such an absolute pleasure to have you on. really much enjoyed our conversation and we'll have to do a round two at another stage to get through all these other questions that I had. But thank you again so much for your time.

Robert B Lufkin (45:18)
Definitely. Thanks a lot, Claudia.

Claudia von Boeselager (45:20)
That's a pleasure.