Claudia von Boeselager: Welcome back, Nina, to the Longevity & Lifestyle Podcast.
It's such a pleasure to have you on today as a part two. 

Nina Lauc: Thank you for having me again. 

Claudia von Boeselager: Such a pleasure. 

So, in our last podcast episode, we covered a lot of ground, including everything from glycans to biological age and biological age testing and what influences our biological age. And I'm so excited to continue our conversation today about something so important in women's health and their health journey, specifically around female reproductive aging, testing, and how to optimize it.

So Nina, I'd like to start with a question on an incredible statistic that menopause is the world's second largest market after aging, yet it doesn't have any diagnostic tool. How is that possible? 

Nina Lauc: Well actually I think, even in three years time, you're going to have 10% of the global population in menopause. There'll be 1.2 billion women. 

And obviously aging affects everybody, but menopause is a key aging inflection point in women. Basically, right now menopause is diagnosed 12 months plus one day that you haven't had a cycle, but it's already known that you can be in peri-menopause or this transition phase into menopause up to a decade before then.

So somebody was telling you, oh, you can't be diagnosed with, for example, arthritis for a year and one day then you had it. And also another 10 years before that you had the start of symptoms, that would be completely ridiculous. But for menopause, that's how it's currently done. 

And one fault is the lack of tools. So if you're just looking at hormones, they fluctuate a lot. And that's similar to the problem you had with diabetes and glucose, where if you measure it daily, you get very different results, even if it's fasted. Similar to estrogen, you can try and measure it in certain days of the cycle, but it does fluctuate a lot. And it particularly fluctuates a lot in peri-menopause.

So you may be having a completely normal result one day, and then you have a very abnormal one a few days later, and then you don't really know what's going on there. It's hard to tell you the trend of what's been going on. And that's one problem. That's why when women come in with symptoms, there's no tests you can run, so they're mainly treated for the symptoms. So they will come with anxiety and depression and automatically they're put on anti-depressants or they come with joint pains and they get referred to a different specialist. Or heart complications, they go to cardiologists. He can't find a problem cause he's a cardiologist. He's not menopause specialist. And you're often just put the wrong drug and that goes on for a long period of time until you actually enter menopause. 

Claudia von Boeselager: Which is quite scary, right? I mean, being put on a wrong drug, which has its own side effects. I mean, why is there such a gap in knowledge for general practitioners or, you know, physicians? Is it just not been trained in medical school enough? Or why are people being sent to a cardiologist if they have menopause symptoms?

Nina Lauc: It's not really taught a lot in medical school, or there's only a couple hours on it, and there's many reasons, so it's not just one. Another one is aging. So, in a way, menopause is also not the disease. although it's medicated. So it's not treated as a condition. It's not given the same weight and value as it would to something else. So I think that's one of the reasons it's not prioritised. 

Another one is women's health is actually very poorly managed in general. So if you're even looking at PCOS, and endometriosis, the time to diagnosis is horrible. Nine, seven years. So generally women's health is a very neglected space. And then also it's a taboo. Like, my mother didn't tell me when it was going on. I just saw her change shape within a year and I didn't want to say anything. We don't really talk about it enough. It's been hidden behind. Nobody really shares their experiences. 

Claudia von Boeselager: Yeah. That's such a good point. And I recently did a podcast episode just to talk about women's superpowers and actually that they're four different people in the space of a month as well.

And I think that the more it becomes okay to talk about symptoms, to talk about this, and share experiences that women are not left so feeling isolated, and that they realize it's okay and actually all women go through the same thing. And it's better to be open about it and discuss it. And this leads me to my next question. Can you explain for listeners why every woman over the age of 30, and every partner of a female over the age of 30 should be listening as well, why it's so important to be on top of your hormonal health and where you are in the perimenopausal journey? 

Nina Lauc: It actually starts far earlier than we think. So even when we looked at our data and we followed over 150,000 people and some longitudinal cohorts, so you have historical data, we see that some of the changes start at 45 as an average while 51 is the average age of menopause. So even in your mid 40s, you're probably in the average where hormones will start to decline. In one in a hundred women, it happens below 40. And one in a thousand, below 30. It happens a lot earlier than we think. And right now, in a way, you don't expect it until you're 51. So you tell yourself, oh, I'm not in menopause or I'm not close and actually, maybe it's been going on already for a few years. 

Claudia von Boeselager: Exactly and I think, and we'll get into it, around information, but I didn't realize that even under the age of 30, that it can affect women as well. And I think this point is not to actually just scare people, but it's almost scare people into action because the beauty of it is that you can actually do something about it.

Can you talk a little bit about the famous wording "inflammaging", what it is exactly. And then I'd love to discuss peri-menopause. What type of effect it has on the body, and the mind as well. 

Nina Lauc: So "inflammaging" is this accumulation of damage as you age. So your immune system creates inflammation. And a lot of our, also, age related diseases are connected to inflammation, from autoimmune to cardiovascular, and metabolic, neurological, pretty much the majority of them. And then, as we are aging, we overactivate the immune system or the immune system gets dysregulated. So often there's a misconception that says, as we're getting older, we have an underactive immune system, and that's wrong.

We have an overactive immune system in the wrong direction. We create inflammation. And we don't shut it down fast enough. So we overreact to the wrong thing and underreact to the right one. And this low-grade chronic inflammation, we see it go naturally up with age, but there is a gender difference. So whenever we look at the data, we always see the men are very simple. They have a straight line going up, so they just accumulate these pro-inflammatory structures and lose the anti-inflammatory ones. And women have a curve where, in a way, they have an early advantage. So in reproductive age, they have a better functioning immune system and they have less inflammation. This is probably why we have the "man flu". They're not wrong. It's a different type of disease. They have a different immune system. 

And then that rapidly changes around menopause. And, in our data, we see in terms of biological age or infla-aging. So we measure biological age by looking at the immune system and your antibodies and these glycans around them. And we see that, in woman, peri-menopause to menopause, the rate to biological aging is more than double. In the transition, the average increase in biological age is about nine years, but it can go from five to thirty-plus. So it can be a very rapid shift. 
Claudia von Boeselager: Just to repeat that. That women can age up to, I mean, this is more of an exception, but up to 30 years, biologically, in this short space of time between peri-menopause onset and menopause.

Claudia von Boeselager: Okay. Wow. 

Nina Lauc: Yeah. And that's by looking at the immune system and it is actually a good proportion of women. So we see that some are phenomenally young, so they have very young biological age, right until a couple of years before menopause, where they have a very rapid shift. While in other women, we would see more gradual aging, more similar to what we see in men. So gender is [inaudible]. And differences within gender are more than the differences between the two. 

And that, when we connect it to perimenopause, it's probably connected to when estrogen drops. So in some women that may be more of a rapid drop over a couple years. In others, they lose it gradually, maybe over a decade.

So potentially also when they receive therapy and what type should be different. 
Claudia von Boeselager: Yes. Exactly. And I'd love to move on to this exciting product that you're working on, MenoAge. How does it solve for this testing and what can be done? Can you talk a bit about it? 

Nina Lauc: Well, the first challenge is to identify it correctly. So to identify menopause, not when it's already over so you haven't had your cycle for a year, but hopefully years before.

And because the glycans we look at, they have a long half-life. So one way we try to interpret it is, for example with diabetes, if you look at glucose, it's really hard to make a conclusion on the trend. While if you look at HB A1C, which is glucose over the last few months, then you can make a reliable decision or if this is or it isn't diabetes. Similar to menopause because it's long half-life and this direct connection with inflammation and the immune system, we see a type of HB A1C for estrogen or something we're trying to call long estrogen. So you're seeing what's going on with your hormones over the last couple of months and weeks rather than what happened this day, or what happened in the last couple of days. 

So it can be more stable. Hopefully one day it can be something that your GP can run. So when he's trying to make a decision, if you have depression, anxiety, or some other problem, he can just run a simple test and know if this is related to your hormones, rather than you having to come in all the time and test your hormones. And one day your normal, the other they're you're abnormal. And nobody's really giving you a straight answer. 

Claudia von Boeselager: Or you get sent to a cardiologist instead of being treated for menopause. 

And so once you have the results, what can be done? Is it just a matter of getting on to hormone replacement therapy? Or what does that process look like? And maybe you can actually talk about how the test is also done.

Nina Lauc: Glycans that we have in the biological aging test, but we don't interpret them in terms of menopause. As soon as we can make the clinical claims we will. But you can already, looking at your biological age, if you're looking at the shift in biological age, you can even use GlycanAge for it now, but you would have to have a baseline before and after it happens, so if you're already there, we can get, make these claims. 

So a couple of years ago, we had this first study with hormones and we had no idea it would have such a big impact. So we always knew that there was some type of gender difference in aging, and we thought that it was menopause, but we only really got menopause data last year, so we can make a conclusion. And there was a study done in the States where they manipulated hormones in women. So they gave them the PRP they'd usually have with IVF to block hormones for a couple of months, it was about five months. And one received placebo, the other received an estrogen patch. And in the placebo, they aged nine years within five months. And with the estrogen patch, they don't age or they stay in the healthy range. So you can potentially prevent this increase in inflammation with estrogen. Similar to, let's say, hysterectomy. So you rapidly cut up hormones, so it's easy to make a decision on what can prevent it. 

With natural menopause, because different hormones decline at a different pace, it's a bit more complicated. So we're interesting of what happens in the menopause clinic when you're treating patients as you usually would. So we followed a group of women in a menopause clinic, and this is not published yet so this is something we're hoping to publish next year, but we saw that even in natural menopause, and now with body identical hormones we see a reduction of seven years on average after three months, and 10 years on average after six months. 

And not all women respond, some don't change. We haven't had anybody change in a negative direction yet, but we probably haven't looked at enough woman, but the response rate is much better than any other intervention we looked at before.
Claudia von Boeselager: That's so exciting. And also maybe for people just to better understand what is the benefit of reversing your biological age? 

So with GlycanAge, we have really good data. So our data previously always focused on cardiovascular and metabolic, and we knew that these certain levels of glycans were predictive of cardiovascular events, diabetes, and sometimes up to a decade in advance.

Nina Lauc: We never actually correlated the acceleration of GlycanAge with general health risks. And that was done last year by an independent study. So it wasn't even us. We analyzed the glycans a few years ago, it was a biobank called the Arcadis which had 1000 people. Followed them over a decade, going from age 18 to over 100. So it was a very vast age range. 

And they did a study where they compared all different biomarkers. So they looked at DNA, methylation, proteomics, metabolomics. They modeled the aging clock on top of the clinical biomarkers. Everything you do at your doctor's at the moment. And the glycans were most predictive of future hospitalization on a broad range of conditions. So methylation and glycans track this very molecular aging process, so they're not disease-specific, they're general aging, with your early phase.

Proteomics, metabolomics, clinical biomarkers were risk-specific. With clinical biomarkers they're risk-specific because already a certain organ has failed and you can identify this organ, which is really the late stage of disease. So you want to be finding things much earlier on, and then the glycans and metabolomics where the most predictive of your future health or hospitalizations, which is a very concrete metric.

So we know that when your GlycanAge is reducing you're effectively reducing future risk of hospitalizations and of broad cause, increasing your extra years of healthy life. 

Claudia von Boeselager: So basically you're increasing your health span by reducing your biological age. And ideally then we'll have no reason to end up in hospital for a very long time, hopefully, if you manage it correctly and don't have any accidents. 
Before we dig into some more details, I just want to switch over to some rapid fire questions, Nina. So what are some daily or weekly routines and practices that help you perform at such a high level? 

Nina Lauc: Oh, I am a horrible example at the moment. I don't think lockdown was helpful. But I meditate and that helps the most. So I think that if I would not meditate I wouldn't be so resilient to stress. I wouldn't be able to handle it as much as I can. And then I make sure I sleep. I can compromise on a lot of things, sometimes, particularly if you're working 15, sometimes 18, hours a day, you can make some sacrifices, but I try not to compromise on sleep. If I do compromise then I feel the effect. If I don't, I can be quite resilient. 

Claudia von Boeselager: And tell us a bit about your meditation practice. You follow a certain type? Or do you mix different ones? What do you find most effective? 

Nina Lauc: About maybe eight years ago I did this meditation retreat called Vipassana. It's like a thousand-year-old type of meditation. And it's a 10 day silent retreat. So you're forced to learn how to meditate. And I think it took me about six days to learn how to meditate. And the impact is very much long-term. So the type of my response to stress, any type, positive, negative, stimulus in a way has changed. I don't respond to things automatically. I feel at the moment, then it's gone. So I don't recreate things. And that was pretty permanent. I did think a couple of times after, and I practice it, not even as regularly, but I do. And the effect is permanent. And before I went there, I was nearing burnout or proper full burnout. And when I came back to the equally stressful environment, nothing changed in it, but I wasn't stressed. 

So my environment didn't change but I changed. So I think that that's a really powerful way to -I'm sure other ways also work. I think I needed something radical, but it's a very interesting one. 

Claudia von Boeselager: And do you do it every day for a certain amount of time, or on twice a day? Or how do you incorporate it into your schedule? 

Nina Lauc: You're supposed to do twice a day, I do it maybe 20 minutes every few days. And that works for me. 

Claudia von Boeselager: But it still works for you. Exactly. I can come from, you're always very calm and collected. So clearly it works very well. 

Nina, in the last five years, what have you become better at saying no to, be it distractions or invitations, and what new realizations or approaches helped? Do you have any other tips for people struggling with too busy schedules and too many things going on?

Nina Lauc: I value my time more. I think before I would say yes to everything, or I wouldn't notice how the kind of value for money and the time investment. And now I really focus on things that make a big impact. Also, if you are running a business, you're liable for all the people in it, so you have to invest your time in a way that you can support the whole team.

So I make sure that I always choose to focus on things that will make that return. And I say no to the things that wouldn't. 

Claudia von Boeselager: Excellent. If you feel overwhelmed and unfocused, which I think with your meditation practice, it doesn't happen very often, but if you lose your focus, even temporarily, what do you do?

Nina Lauc: I'm pretty good at focus. And I sometimes hyper-focus, so it's more complicated for me to get out of it than get into it. But if I feel overwhelmed, I would just take a moment to do something like go for a walk. Go for a walk and listen to something, take a break in a way. So stop the work and just think or try and do something which takes me out of the overwhelming scenario, at least for five minutes or ten, but whatever I can afford to do.

Claudia von Boeselager: Amazing. So let's change gears and dig a bit more into the science. And we talked a bit about glycans and measuring that, and I'd love to talk also a little bit more about the hormones and HRT, which is obviously, it can be controversial for some people. First of all, maybe just taking a step back, in terms of hormones there are different types. You have the synthetic hormones, for hormone replacement therapy, you have the body identical ones and then the bio-identical ones. Can you explain the difference and what your view is on the different ones? 

Nina Lauc: One thing we maybe should have started with is, what is menopause? If you look at what is menopause, so menopause, the technical definition is when your periods stop, but actually it's your ovaries stopping to work in a way. So if you look at the ovaries as an essential organ that's important for your health, as it is, then menopause is a hormone deficiency. So say if you have an underactive thyroid you have a hormone deficiency and your health is at risk unless you address this. Similar to menopause it is a hormone deficiency and it's a health risk. And if you look at it as a hormone deficiency, then the way to balance it out is to give back the hormone. And that's where HRT comes. 

But I think similar to aging and longevity, you have this conflict that it's a natural event. So everybody ages, all women go through menopause and because it's a natural event, we have this mentality, oh, we shouldn't meddle with nature. We shouldn't treat it. Although, you know, that organ has died, it's not there anymore.

So I think that's wrong and that's why menopause was probably underlooked and mistreated because they looked at it as a natural event. But if it's a hormone deficiency, then you need to address it. And there's different ways to address it. Addressing it with lifestyle is very hard. So we're trying to do a lot of research to see what lifestyle interventions you can do. And we haven't found any evidence that was positive, but replacement works really well.

And there's different types of HRT. The old forms of HRT, so the ones that were in the first study, there was a huge women's health initiative trial, which created the whole scandal. It was actually the first ever longevity trial because you were treating aging or a natural event in healthy women. And it failed dramatically. And a lot of it was political or politically driven or exaggerated in a way as well. But that type of hormones was made from pregnant horses urine. It was the first hormone drug, it wasn't the nicest one. It's still in some developing countries, I think it's still the primary type. I think it was called Premarin and it's not really used in practice anymore. It shouldn't be used.

And then you have these more modern types of HRT like body-identical, which are synthesized from wild yams. So they're the same molecule as your body produces in the most natural form. And they haven't been identified with some of the increased risk. And what was found is that really the synthetic progestogen was the one that had a little bit of an increased risk and that's the same progestogen we have in the contraceptive pill.

So with the body the body-identical synthesized from wild yams, they call it micronase progestogen. That seems to be the best form. 
And then you have bio-identical compounded hormones, which is a separate, in a way, industry, because it's not a regulated drug or it's not as well-regulated, which is compounded by a pharmacy.

And because it's compounded, you don't have one type and dose, and there's very few trials they will run with it. So you don't really know the efficacy and the safety. And there's some concerns that they wouldn't be really absorbed as well, in terms of progestogen, and if they're not absorbed as well, and you still have a womb, so you haven't had the hysterectomy, then you need that progestogen balances out estrogen so you don't build up this lining of the womb.

And if you build up this lining of the womb then some women are in danger of endometrial cancer. The best form is his natural regulated body-identical drug, which is available, for example on the NHS. You can hopefully get it with your doctor if you can battle him enough to get there, which you know, the efficacy and the safety profile. While with the compound, they also help. There is a lot of women that have benefits from it and they help them, but they're a little bit less regulated or, I would say, safe, but maybe somebody would argue.

Claudia von Boeselager: Yeah, but of course, if it's regulated, then it's a bit easier as well. And I think, out of the US you hear more about the bio-identical versus in the UK, they have the body-identical, or would you say that the body is also available in the US? 

Nina Lauc: So the body-identical, you can call it bio-identical as well. So in the US you also have, basically their bio-identical is the body-identical, unless it's compounded by- 

Claudia von Boeselager: A pharmacist, okay, got it. 

Nina Lauc: The compound, it is the pharmacist that puts it together.

Claudia von Boeselager: For people wondering, how do you know when to start on hormone replacement therapy? I've just turned 40 and I have a bunch of friends, also, that are older. Experiencing symptoms, and because of learning more about this myself, I encourage them to speak to their doctor about it and actually be proactive versus, kind of, waiting and be reactive.

But I think the concern is, it's not really well-known when you're supposed to start on the hormone replacement therapy. So is there a typical biomarker, or when is it decided to actually start on estrogen and progesterone and maybe even testosterone as well for women, which I think a lot of women don't realize, but it's also a key hormone that we need to get through the day.

Nina Lauc: Currently there's no test. So hopefully we'll have that test. But at the moment, it's all symptoms-related. So if you have symptoms which relate to it, and in some countries you just treat it because of the symptoms because of menopause. And you have lots of ways to track these symptoms now, so we'll definitely look at them longitudinally and see how severe they are.

And then it's your choice. You can do it to prevent it, or you can do it when you feel things are getting a little bit worse. 

How HRT is prescribed is post-menopause at the moment, or that's the labeling on it, but it's probably way too late. And because we don't have at least a year when you've started to lose your cycles, should be the better time than waiting a year. But hopefully there'll be a blood test you can run. And then you can make a simple decision and personalize it as well, because we all respond differently and it's different doses of hormones for different women. 

Claudia von Boeselager: So, so helpful. Especially getting ahead of the curve. As you know, I want to live to at least 150 in a 20-year-old body. So I think as a female, this is such an important area to really tackle because of the aging that does take place by ignoring hormones and waiting too long. So for all listening, I really encourage you to be proactive in this field so we can all stay as youthful and enjoy life as long as possible. 

What are some other developments in the longevity space, Nina, that you find most exciting? 

Nina Lauc: There's a few exciting biotech startups looking at ovarian aging. Addressing different hormones to see if they can extend the lifespan of ovaries or the quality of eggs, affecting fertility. Which would be amazing because we have first this inequality that comes from having a biological clock, which runs out quick. The ovaries are the fastest aging organ in the body. Which is not quite lucky for women. 

So we need to make some decisions a bit earlier. We need to manage it in different ways, which are, none of them are ideal. And then we also have menopause. So I think when we handle ovarian aging or fertility and menopause, then we can have a level playing field. But until then it is working against us.

Claudia von Boeselager: I agree. Which is such an interesting space to see how this develops. Nina, what are some bad recommendations you hear in your area of expertise? 

Nina Lauc: So one area we did a lot of research on is exercise. And we've also talked about exercise and menopause, I think this is interesting. But we did both studies of people going to the gym for the first time in competitive sports, and we see the generally people do one mistake, which is combining caloric restriction plus intensive exercise. And we were first really confused, because that's what everybody does. That's the recipe to lose weight. Reduce calories and increase exercise load. 

On the biology front, it's completely wrong. It doesn't work. It just creates damage. And probably a reason why the fitness industry works as it does but when you are building muscle and you're restricting your calories, building muscle, if it's acute, it's a stress to the body. So if you do it in, for example, intervals, and we have a few studies with, let's say, interval sprints, and we saw this group of guys get younger in three months. So yes, interval sprints makes you younger, but these gym studies we did in competitive bodybuilding, and we did women's competitive bodybuilding, they all become older. And significantly older. Or their inflammation levels go up. So if you're building this muscle and you're restricting your calories, then you're not fueling the repair process. So you are in something we call it energy insufficiency and you're potentially just accumulating scar tissue. So it's not healthy muscle. You haven't fed it properly. 

And this is probably why now, from January, you have this big influx in the gyms, for the last 30 years, they make 40% of their annual revenue in the first three months, January, February, March. And then all of a sudden all members drop off and you have a thousand people paying membership, but maybe a hundred come to the gym.

And, you know, you can argue that they're lazy or out of their wealth, or they failed their new year's resolutions, but actually I think the body just tells them this is too much, you know, this is stress for you. It's not healthy for you. Please stop going to the gym. But then you get all this guilt tripping that you should. And I think this combination of dieting and exercise is really the dangerous part. Exercising alone is positive. We should do it in a smart way. But we shouldn't be doing both of those at the same time. They don't even work for weight loss because if they worked for weight loss, we wouldn't have such a big obesity pandemic as well. 

Claudia von Boeselager: That's a very interesting, but totally makes sense way to think about it. I mean, how many people sign up for new gym memberships and like, this is going to be the year and I'm going to do it, but actually what you're just saying there, and what you can see from the test results is that typically it's, you know, going on a very severe diet in January, plus then probably trying to go to the gym like five days a week. And the body's just saying it's not possible. So I guess it's finding the more moderate form of a) going to the gym, but also b) just shifting the foods to quite healthy food and a little bit less focus on calorie restriction and more on just eating healthy whole foods. Interesting point. 

Nina Lauc: Smart exercise, not just hard. And then in women we really understand what's going on now. So we had these very tightly controlled studies where we looked at gene expression on the immune system and for the immune system, and also they suppressed normal hormones. So that's different to men. Men boost testosterone. Women suppress their hormones when they're exercising. And they lose bone density. So overexercise in woman mimics menopause and mimics osteopenia, and all of the damage to the immune systems. And your glycan age goes up. So it's at least four levels of aging damage you can do with overexercise. 

And now you have, because the population is aging, you have more and more of these fitness programs, or PTs for women in menopause. And a lot of that is just a completely wrong concept because a lot of times in menopause you gain weight because your body is losing estrogen, it was a fuel that your body was used to and needed. So now it's accumulating fat just to create more estrogen.

And then if you are exercising and you're suppressing these hormones, when your body's already trying to do this to survive, you're just basically accumulating more and more of this inflammation. And that's something we see in our clients who are trying to tackle menopause with exercise and overdieting, it just works against you. And even if you're trying to eat the diet for menopause, you can't eat that many almonds and you would need to eat them every single day because, you know, they're in and out the next day. So you're not going to find this - and also the Westerners, we don't have the microbiome for the plant estrogens, you know, maybe Asian countries have it. Maybe they even have different menopause symptoms. There's a few theories there. But we can't really out-eat a hormone deficiency. So all these diets and exercise programs for menopause or just a money-making scheme that could be not benefiting your health. 

One thing that has potential, so we did this diet study for perimenopause and usually nobody researches women in perimenopause or menopause because they fluctuate so much, so the researchers just kick them out 'cause it's noise in the data, but we did one for dieting and all of them kept going up. So the diet really didn't tackle it for them. But there was one woman who started meditating. She's six years after six payments and there was an, the next cycle so we can get three months. And then we did another few months and this lady started meditating in lots, three months.

So we maybe - and this is one woman. So it's not the conclusive evidence, it's end of one, but it could be potentially some stress management and meditation that could manage it a bit better, which we're very keen to research because HRT works very well, but there are some women who don't respond to it and they need some solutions as well. And it shouldn't be the menopause diets and exercise programs. Maybe some yoga can work, but you shouldn't go and attend bootcamp for menopause. 

Claudia von Boeselager: I love that and how interesting with the meditation as well. I mean, we know across the board what you were saying before, just from peace and calmness, et cetera, and potentially, do you think that stress is - obviously meditation is, sort of, a balance to stress, right?

So I guess stress ages the body a lot. Do you think that that maybe is the reason behind the meditation reducing biological age? 

Nina Lauc: Potentially. Certainly we need to look into further, cause it's hard to study stress. We did some mice stress or rat stress studies and that that's very different. But we know that, for example, people with PTSD are on average 15 years older by GlycanAge. And some depression has a connection to information as well. So that's the area of research for the future. And PTSD is like you're stuck in chronic mental stress. And stress is created in the mind. We're the only animal species that get stressed for missing a meeting or having a deadline. Our dog doesn't have the same stress.

Claudia von Boeselager: Exactly, because they missed the meet up. Or having FOMO. 

What are some of the learnings and insights that your clients you work with have found the most valuable, Nina? 

Nina Lauc: A lot it does come to this overexercise 'cause we, as a company, mainly have biobank data or different clinical trials. So it was the average population. And it was a very good baseline. So 150,000 people in total. From both genders, a little bit more female actually, and pretty different countries around the world. But that was the average population.

So our customers, when they buy commercially, they already have this, we call it "healthy user bias". So they're already, in a way, making good decisions for their health or they're proactive - and not all of them, of course, we have clients who are not in great shape and are using this as a motivator to get into a healthier state, but a lot of them are healthy people who are making mistakes.

And that's when we find the overexercise, we find the over-dieting, also now very trendy for longevity is fasting. And fasting is great. It has lots of benefits. Maybe you shouldn't do it every single day for 20 hours, 18 hours. I don't know. Maybe for some people it works, for a lot of people, clients that we have, it sometimes creates more damage. And one way it creates damage is the thyroid. Underactive thyroid. So it looks like a Hashimoto although it's self-created in a way. 

So a long, long time ago, they had the mice trials where they restricted calories in mice, and then they lived 20% longer. So you had this group of people called the cronies who lived like that. So they only ate about 20% of the calories they should be eating, and I'm sure they didn't calculate very well. And all of them had a thyroid problem. I don't know if they got extra longevity, but I know they, all of them, had a thyroid problem. And the quality of life was, you know, you're hungry every single day. 

There's benefits to all of these interventions, but more of something is not always more. So we find a lot of these misconceptions where you're actively investing your time, sometimes money, into something that is causing you more harm than benefit. Apart from that, you always have sometimes a bit more of a mystery and then takes a bit more digging but we had the recent lady who was 10 years older and she's been looking at it for some time now. And she had the perfect BMI, very healthy lifestyle, tried to change her diet, do everything as much as she could to affect it and nothing changed. And then she looked at all - if she potentially had any celiac or fiber problems, anything autoimmune related, and nothing came up.

Every - all of her blood tests were normal, everything was coming back normal, but she was 10 years older and she was trying to get pregnant and she had recurrent miscarriage. And when she got pregnant, she developed gestational diabetes. So lots of these symptoms were related to it, but she didn't know the cause.

And then she tested the protein called zonulin, which basically controls this distance of the cells in the gut. So if you have too much that you can have leaky gut and it's triggered by gluten, gluten and stress but gluten is a big part of it. So although she wasn't celiac, and didn't seem to be intolerant to gluten, she had these high levels of this protein in her gut, and now she went gluten free. And finally we had her reduced too. So sometimes it's a little bit of a guesswork until you find a problem. Because there's an anomaly, or there's something invisible that - 'cause it can be such a broad range of causes that's driving your accelerated aging or inflamaging. Sometimes it's very obvious. So you don't need to do any digging at all. And we make a lot of easy conclusions, but sometimes it's a big more digging and when you find it and it's really amazing that you caught this early, or as early as you could, and you've responded to it in a positive way.

Claudia von Boeselager: Yeah. I mean, I don't have the statistic off hand, but the amount of people that are gluten sensitive, so not celiac disease that they are allergic, but insensitive, which causes the inflammation in their body. And I think also my learning was that I had this chronic sinusitis and it was only until I managed to really, with clean eating, healthy eating, reduce inflammation in my body to actually get rid of chronic sinusitis. So I, you know, I had doctors saying, oh, you're allergic to dust, but, you know, lo and behold, when the inflammation isn't there, then my body can deal with dust wonderfully. So really reducing that and knowing that gluten sensitivity could be it.

So I think for many people, it's even just doing a test. You know, stay off gluten for a few weeks and see how you feel. 

Nina, do you have any particular books, documentaries, or movies that you recommend people must watch. Again, it can be across the spectrum of anything. 
Nina Lauc: I think some older books I love when I was first reading them. So I think one entrepreneur I always looked up to was Richard Branson, probably because he was dyslexic so I could associate with him. I think it was Screw Business As Usual, this is a very, very long time ago. And I haven't read it in a very long time, but I loved that book in my teens. 

And then I think there was another entrepreneur. I think he was called the Maverick, which was an entrepreneur in Brazil who basically - his company did everything opposite of what you were supposed to do with a company and it worked amazingly. So no - a very flat structure, no managers, all kinds of, like, complete contradictory to where there were no secretaries and they worked amazing. So I like the rebel entrepreneurs, I think that's a theme in all the books I enjoy a lot. And then for movies, I guess also like entrepreneurs, but there is a nice movie called Joy I think I watched it a bunch of times -

Claudia von Boeselager: Joy? J-O-Y? 

Nina Lauc: Joy. Joy. And then there was the Hidden Figures, which I also liked, which is women in the space industry.

Claudia von Boeselager: Oh, I love it. Excellent. Thank you for the tips. 
Nina if you could get one message out to the world. Say sky-write it, metaphorically speaking, what would it say and why?

Nina Lauc: The way we detect health problems now is way too late. And even now you have technology that can detect it a decade before it happens. So being afraid of the future health or living in this waiting until something happens and for traditional healthcare discovers that a certain organ is not working, and then we respond to it, is wrong and very dis-powering. So I think that this movement of preventive health, because it's not coming from the health industry at the moment, it's driven by consumer demand. And we really have all these tools to take control over our health. So we don't need to worry about what will happen in the future. We can be empowered and control it. And, you know, at least with biological aging, you know, when you're getting extra years of life and when you're taking them away and you can do it in a very measured way, so you know that how you're living, the time, money, energy investing in something is actually paying off for your longevity. 

And longevity still needs this, so I love your podcast, and everything that's happening in the space, but if we are tackling aging on a biological level, before it turns into diseases, then that's the ultimate way of health prevention. It's nothing to do with superficial. It's protecting your health and the health of your loved ones for as long as possible.

Claudia von Boeselager: Yeah. And I think just, you know, knowing cases of the alternative. I mean, I have an uncle who's had several heart surgeries and my aunt's living in a constant state of stress, you know, with strokes, et cetera. So there's so many things you can proactively do to increase these healthy fun years. And, you know, why not?

I think, I don't know a person that wouldn't like to be healthier for longer, sort of, suffer all these preventable diseases. And thanks to tests like GlycanAge and MenoAge, when it comes out, you know, you can stay ahead of the curve and actually do something about it. So it's really so exciting. 

Nina, what advice would you give to a smart, driven, say, college student about to enter the real world? And what advice should they ignore? 

Nina Lauc: That's complicated because I'm clearly biased on this. So I would say go into entrepreneurship early. You can gain some experiences, maybe you have to self-learn as an entrepreneur, but it definitely pushes you in every way, from mental to any limitations you think you had, so I think that's the best way of learning and we should have more entrepreneurs, particularly more young entreprenuers who are bold in starting things.

So I would say, go for it. And also pick yourself. So don't wait for them to pick you. You, you don't need this whole selection process to get there. Just find ways how to start small and build up from where you are. And yeah, don't depend on anybody's approval. 

Claudia von Boeselager: Nina, for listeners interested in understanding the perimenopause and menopause for longevity better, which resources be it online or books, would you recommend they start with?

Nina Lauc: I haven't seen any good books, but the Buck Institute and Jennifer Garrison has some amazing talks. And I think they hold regular webinars. And a few podcasts as well. So I would look at her and listen to some of her talks. And then for menopause, in the UK, there's Dr. Louise Newson who's an amazing advocate, and what she's done is, she's really changed the perception of menopause in the UK and put it in the public eye. And she also happens to run the largest clinic in the world now. And she did all on her own with a lot of resistance and criticism at the beginning. So I think her story is amazing as well. 

Claudia von Boeselager: Yeah. And she's been on the podcast. She's really excellent. 

Nina, where can people learn more about what you're up to and GlycanAge and MenoAge. Where can they follow you, be it websites or social media? 

Nina Lauc: We're pretty active on Instagram, just GlycanAge, and a little bit on LinkedIn. And I am mainly on LinkedIn or Twitter. 

Claudia von Boeselager: So GlycanAge, yeah, G-L-Y-C-A-N, age A-G-E for people unfamiliar with the spelling.

And then Nina, do you have a final ask or recommendation or any parting thoughts or message for my audience? 

Nina Lauc: So if you'd like to learn about the new and exciting part of the biology, I didn't spend too much time on it today because it's a bit technical, but learn about glycans. Follow us on social. We'll be launching a podcast soon about glycans only, and it'll be the first in the world. So it's the biology of sugars, and you probably didn't know but you're made of sugars. And it's really important for your future health. 

Claudia von Boeselager: Amazing. So you'll have to share that with us when it comes out. Thank you so much, Nina, for coming on again today. This was a fabulous Part Two. So thank you so much. 

Nina Lauc: Thank you.