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The Age of Scientific Wellness: Why the Future of Medicine Is Personalized | Nathan Price | #112

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Nathan Price 7:07

around these digital twin technologies, so we've built a capacity for doing a really deep

model of how the brain maintains health. So we've gotten into that and in a very big way. And then like a lot of other people were just really looking at AI, you know, and I did this article in the Wall Street Journal last weekend for you know, on AI that Lee and I did. And it's just going to revolutionize everything. So the ability to do personalization. Next year is radically better than this year, two years will be radically better than next year. I mean, it's just moving so fast. It's that super exciting. I can hardly wait to get that stuff built. So what's like your best selling product at Thorne? Is it like a test? Like one of like something you just described? Or is it like a an actual consumable product?

So the bet, so the natural products of supplements are the biggest sellers, we have about 200 of those. There's no single product that dominates sales, though I don't think there's any product that's more than about 5%. One of the things I like about that, as a scientist is that, you know, as I can, I feel totally free to just evaluate evidence around anything and like it, like it or whatever. Because we're not, you know, thorns, bottom line is just not tied to any particular product. What it has is just a really broad portfolio. So you can do a lot of personalization. So I like that. And then on the testing side, the number one selling test that we have is the microbiome. And so the really cool thing with the microbiome at Thorne is that we invented this thing called the microbiome wipe.

And so this is basically a special, just what sounds like special toilet paper. So, you know, if people have done their own microbiomes, then there's a step that people really don't like, which is you have to poop in a bucket or on a piece of paper or you got to take a little scoop you have to scoop up a little bit of poop and put it into a vial. You some of the tests actually require freezing and I don't know what you keep in your freezer but food in our freezer, I usually don't have a separate sample freezer laid around. So there were all these issues. So what we did with the wipe was was to come and figure out what we thought was the easiest possible way to collect a sample. And so you just wipe like he normally would but it's a special polymer and you put it in a vial and close it you shake it and within 10 seconds it dissolves away and you know that becomes and then you anyway released the salt solution preserves the DNA. We showed that you could get high quality DNA in a paper for frontiers in immunology. And it just makes the collection experience a lot better. So that anyway that's that It's become our number one selling test, what?

Nick Jikomes 10:04

What would what would that look like for a typical person? So let's say they do that test and they get their results back. What exactly do the results look like? And you know, let's say that their microbiome isn't quite optimal, whatever that means. How, how would they know that? And then how would they start to change that?

Nathan Price 10:22

Yeah, that's a great question. So the science on on the microbiome is continuing to evolve, and we learn more and more every year. But I would say there's already quite a lot that you can say, off of getting your microbiome done. So some of the categories that we look at our digestion. So your microbiome contributes substantially to the breakdown of different foods, you can get negative aspects of that, for example, if you have bacteria that are making too much ammonia, that can cause your stomach to become more basic and not break down foods as well, like that's, that's an example. A lot of just vitamins and nutrients that you need in your body are produced in the microbiome. So if you have a mike, you know, microbiome, and we look at the gene content across all the species, but if we don't see any genes that are associated with the production of, say, some of the vitamin B's, that'll full light, which is one, actually, I just, I just did my microbiome test, I was deficient in that. And there was no evidence I was making that in my microbiome. So you know, just something to look at and say, Okay, I'm, that's a production capability, you'd like to be there that isn't. Serotonin, one of the most important neuro transmitters think the latest evidence is that 95% of the serotonin that you use is actually made in your gut. That was a surprising paper from a few years ago. And so you would want to look at that gut brain access. So that's another area that we look at. pathogens, right. If you just have something that causes disease, you can see that in these kinds of reports. The thorn microbiome test is not a clinical test. So you know, there would be a doctor or something on the back end that would call someone if there was a, you know, a significant issue, but you do see those things. And then and probiotics. So if there's something that you're taking, as a probiotic, and you want to see if it is it actually getting into your gut and staying there, you can see that in the reports. And so we've tried to cover pretty much all the probiotics that we know about that are used, you know, at some scale, and the community. And so you can watch that and just see, hey, I'm not getting the benefit that I'm supposed to be getting, because a lot of probiotics, you can take and they won't actually get into your gut and stay there because they have to outcompete the bacteria that are already there. And those they've been successful and living there. They're very competitive, because they already want a whole bunch of times in a row. And so when you introduce probiotics is not a given that, that they'll actually engraft and stay with you. So all of those kinds of things are things you can pull off of these kinds of reports.

Nick Jikomes 13:00

Interesting. And so what's this new book all about?

Nathan Price 13:05

Yeah, so the new book is called the age of scientific wellness. Why the future of medicine is predictive preventive data rich and in your hands. And it's a book that Lee hood and I wrote together. And for listeners that don't know Lisa is very famous scientist, invented automated DNA sequencing that made the Human Genome Project possible, and won the National Medal of Science from President Obama, amongst other things. So what we really set out to do was to talk about how healthcare is to focus now on care after illness. And that starts all the way back from the beginning of the research enterprise, all the way through how care is delivered, and the economics by which we reward pharmaceutical companies or doctors or healthcare systems. It's all focused around disease, and especially late stage disease. And so the the argument in our book is that this approach is not terribly successful against the chronic diseases that plague us most. And that while we had an incredible success last century against infectious disease, if you fast forward to the chronic diseases that we deal with now, it's not a great strategy to wait until you have that disease. Because when you were talking about getting sick from a pathogen, there's this find it and fix it right you find it kill the pathogen, you recover. With a chronic disease, you're talking about a lot of specific and personalized problems that are in your system. And if you wait till you have these late stage symptoms, it can be very difficult, if not nearly impossible, to reverse back to where you were in health. And yet for many of these things, prevention is a much much easier task and it and it results in much more high quality life to the patient. So our point of view is that if we shifted the focus of health care too much more towards the extension and expansion of healthspan, slowing your rate of aging, slowing your rate of moving into negative health, that we would have a much cheaper system that delivered many more years of positive, healthy life than what we get now. And so the book goes into a kind of an extraordinary area, amount of detail around studies and science and what's emerging over the last several years of why we think this is something that is a, a worthwhile vision, and actually something that is worth striving for and becoming doable in certain pockets today.

Nick Jikomes 15:42

Yeah, like, when you think about quality of life, I think you use the term healthspan. So thinking about healthspan versus lifespan, everybody knows what lifespan is just, you know, how many years you've been around. And we all know that historically, that has gone up, right? People in general, on average, most places, most of the time, are living longer and longer. But they're not necessarily living longer in good health. Oftentimes, you know, that extra 10 or 20 years that we've got compared to what people were, were living, you know, a century or two ago, is not necessarily a healthy 10 or 20 years, you might have various chronic diseases, and you might not be very active. So is there really like a number that can be measured for healthspan? Is that something that's changing that, that people are going to be thinking about more like, when you go to the doctor, they'll know not just what year you were born and how old you are your lifespan but but actually have something like a health span number that they can point to and, and use as kind of a guidepost for what you should be doing.

Nathan Price 16:42

Yeah, and, you know, and it's not used that much today. But under this concept of scientific wellness, that's exactly right. Like that's the number you're actually trying to maximize. And if you look at another just really beautiful book that was written a few years ago, by Atul Gawande called Being Mortal, probably aware of this book, very famous book. And it it talks about the end of life. And in our current paradigm, we have this, yeah, there's this vision of, oh, if I'm extending my life, I'm living in a hospital, I'm uncomfortable, I'm unhappy. And I most people would, very logically say, they don't want to extend their life. And if you look at where we spend a lot of our money, if you, when you when you ask people, when they're young and healthy, younger and healthier, how they want to die, they'll always say they'd rather die a little bit earlier, but they'd rather die at home and with their family. And yet, 90 plus percent of us will die in a hospital artificially kept alive for longer periods of time, which is what will go on his book is really about. And so that's kind of this dystopian situation that we're in, and we spent, I forget the exact number, but it's some high percentage, like 40% of healthcare dollars or something are spent on that last bit of your life. And so what we want to do is refocus and reframe medicine, such that you are trying to extend that that health span, so that you are vibrant and active and enjoying your life into your 90s maybe even into your hundreds, although that gets into some genetics and and some life extension kind of arguments. But that's really the goal is is how do you stay as young and vibrant and healthy as possible? And then how do we refocus healthcare, so that it's actually focused on that? Because right now, if you think about almost every test that you take in medicine, is do I have this disease? Do I not right, and you're trying to find a disease? But wouldn't you rather understand, you know, am I getting biologically younger? what's the, what's the pace of my biological aging? Have I slowed it down? You know, am I good at you know, there's pre diabetes. So you get into things like, am I controlling glucose? Well, right, that's an important very important piece of, of healthy aging. But am I is my body good at combating oxidative stress? Is it getting worse at that? If so, why is it getting worse? How do we make it better? Is it better at dealing with chronic inflammation, et cetera, et cetera? And you can just imagine a proliferation of lots of these different metrics for wellness that can be improved, as opposed to just do I have a disease or not.

Nick Jikomes 19:33

And so how does you know how much of this ties into technology and requires people to, you know, buy testing kits or download apps and you know, have stuff on them that that they're looking at every day and seeing the line go up into the right or down to the right or whatever?

Nathan Price 19:53

Yeah, I think that that's really an exciting element is the degree to which you can see In wearables, and so forth, if you're actually making progress, one of the conversations we've been having a lot around my house is, you know, my wife's been working out a ton in the morning. And, you know, there's these cardiovascular scores that hers just keeps ticking up at a pretty fast rate right now. And it's a positive thing to be able to watch that and see, okay, the computed vo two Max is getting better, you're seeing progress you're seeing, you're seeing benefit. And you can actually look and track that on a day to day basis, which I think is is exciting. flipside of that is people can get warning signs, if they're, if they're, you know, even things that look like they're monitoring their heart health, for example, or you can get pings about warning signs or things to improve. And just the degree to which this is extending and accelerating, I think is just super exciting.

Nick Jikomes 20:59

And you mentioned, you mentioned the brain health test. And it's a little bit easier to imagine, you know, thinking about, you know, your your VO to and your co2 levels and your breath, these things can be measured pretty easily. You know, counting steps, counting, heart rate, BPMs, and all that stuff. How do you? How do you know what kind of tech is out there today that allows people to assess anything about their brain health.

Nathan Price 21:29

So brain health is one of the really important factors for enjoying a long health span for sure. And we don't typically treat it in a really proactive way in health care system. And for a long time, it was really fairly taboo to talk about brain health issues, because no one wants to admit that there's a problem with the brain. And I think that's starting to shift in our society where there's a lot more openness to this now and working with healthcare professionals on this. So if you want to monitor the health of your brain, it's a bunch of different things you can do and different buckets to look at. So one is certainly through cognitive assessments. One company that I like quite a lot is called posit, we we talked about them quite a bit in in chapter six of the book. This is a company that comes out of work from Mike mazet merzenich, who's emeritus professor at UCSF, the University of California, San Francisco. He's a very eminent neuroscientists, he actually won the Kavli Prize, which for those that don't know, is basically the Nobel Prize of neuroscience, except it's about I think, three times larger in terms of the size of the award. It's this massive prize that they put together, but it's a and so what he's really studied is brain plasticity. So you know, how malleable is your brain. And so they've put together a set of cognitive assessments, and then cognitive exercises that you do in order to improve the health of your brain. And the reason that we like what Mike has done is he's published, I think, well over 200 studies now on this in the scientific literature, so he's got substantial evidence behind what they do. But the idea is just like with muscles, when you're trying to do progressive overload, this is essentially the same idea of progressive overload, but applied to the brain, which is, of course, a physical object that has certain properties. So it will test things like processing speed. And so it will push you to your absolute edge and figure out how fast you can process certain kinds of information. And it will try to push you as far as you can go, which is what makes it more like progressive overload. So it's not like just doing a crossword puzzle or something like that you're not really at your capacity, these these tests will push you to what's the fastest that you can recognize an object right? So it'll flash it for, you know, fraction of a millisecond down to it finds like what's your absolute limit, and then a trend and pushes that limit until you make it a little bit better, and so forth. So with processing speed with memory with with perception, and so that's one bucket that I think is very interesting and they have a product called Brain HQ I have no affiliation to it so I have no financial stake in it at all but it's it's a product that we think is a good one for that a second is that our blood measures so so you know, the thing that we worry about a lot with brain health, you know, later stage of course, is dementia and Alzheimer's disease and things of that nature. So, there are measures that you can look at in the blood and we will put a number of these into a into the tests that will launch from foreign later this year. But there are a bunch of different factors as to some of them are just very basic things. So one is inflammation. So you can monitor for example, CRP. You want to keep low or There are associations with vitamin D. So vitamin D deficiency is strongly associated with higher degree of incidence of dementia. So you'd want to watch for that. Omega threes is another one that you might you might look at. The biggest factor, though, I think, is really keeping high oxygenation to your brain. So one of the triggers for dementia, at least under our model for it, is that you your neurons have struggle to make enough energy to stay alive when they get under low oxygen conditions. And as you get older, this has all been measured your ability to perfuse oxygen through the blood into your into your brain as you get older goes down. So as that as that gets squeezed, it becomes harder for neurons in certain parts of your brain to maintain enough energy to stay alive. And so when that threshold flips, and they can't satisfy the amount of energy that they need to stay alive, they'll die. And so once some of your neurons are dying, that puts a lot more stress and pressure onto the other neurons, and they have to make more energy. But as that so as supply is going down, demand is going up, and every time it flips, you lose more, and you get this cascade that leads to loss of cognition and your synapses and so forth. And so another huge factor then is to monitor and this why exercise is protective against Alzheimer's, by the way, because you're you're you're able to keep that perfusion rate high. And so anything that you can do to maintain that becomes really important, in fact, under hypoxic conditions, in in these digital twin models that we've built, basically, one of the things we see is that as you go into, under these lower oxygen or hypoxic conditions, that as you get into that lower oxygen, and we run simulations on how you maintain energy under that, under that load, you turns out, you certain nutrient becomes rate limiting, which is phosphatidylcholine. And so you literally run out of that, at least, you know, in the endless studies that we've done. And so, so that's another thing you can do is you can actually just supplement with something like phosphatidylcholine, to keep that nutrient higher, so that you have more of a capacity to generate energy under low oxygen conditions that can make a difference, and so forth. So there's all kinds of things. Yeah,

Nick Jikomes 27:29

so what is phosphatidylcholine? So it's got choline in the name, so I think of acetylcholine the neurotransmitter. But what is this thing doing sort of at the molecular level, in terms of its physiological, you know, where it plugs into, you know, just our metabolism, generally speaking, and is it something that you can get in the diet, from certain foods,

Nathan Price 27:48

you can, so you can get you can get this in the diet from eggs, for example, is probably the, you know, the highest source of where you can get that. You can also you can supplement with it if you want to just get it specifically as at a higher level. And so the so the phospholipid part, so this is going to relate to, to functions such as integrity of the membranes, and then it also gets trafficked in the cell as part of as part of the process by which you generate energy from astrocytes to support neurons. So what happens in the brain is that you have so astrocytes will create a lactate, there's this thing called a lactate shuttle. And then the lactate will get uptaken by the neurons in it uses that as a source for it to generate energy. And so when we run that as a complex simulation, that under those conditions, dealing with this cholesterol trafficking, which is really important part in and Alzheimer's, that's where when we run the simulation, that phosphatidylcholine is, in part, a key input for that metabolic process. And it at least in the simulations that we run based on data from about 900 different papers, but in the models that we run, that becomes rate limiting you run out of it, and that's one of the triggers then for the neuronal death.

Nick Jikomes 29:13

Can you talk a little bit more about cholesterol because cholesterol is super interesting, and I think people are really confused about it in general. On the one hand, you often learn that cholesterol is essential it does like super important things that have to do with the way our cells work. But on the other hand, it's really got a lot of negative connotation associated with it. You don't want your cholesterol to be too high. You don't want to eat too much cholesterol that's that's a common belief out there. So So what is cholesterol doing and how should people think about cholesterol in their diet?

Nathan Price 29:45

Yeah, you're exactly right. Because you know cholesterol is a set is essential for life. So you've got to have some of it but we know that you know, really high cholesterol levels are associated with cardiovascular disease and also can become a problem, you know, with neurological issues as well. So one thing I do want to point out, though, is that this can be personalized, to quite a high extent. So let me just give you an example. So we did a study a few years ago, where we were taking people through a wellness program. So they're trying to get healthier. And one of the markers that we measured amongst 1000s of others, was LDL cholesterol. Right. So LDL cholesterol in the blood is used for diagnosis of a problem often for prescription of statins and so forth. And I'll leave aside right now that particle size is what matters the most and so forth. But let's, let's just talk about that for a moment. So one of the questions we had, as we put people through this program was whether or not through lifestyle intervention, you would be successful at lowering your LDL cholesterol. And when we when we ran several 1000 people through this program, and when we did that, it turned out, some people were able to lower their LDL cholesterol and some not. And that's kind of what's been seen in a bunch of studies. Now, what was interesting in the studies we did, because we had this huge amount of data that we generated, including genomics, was, it turned out that who was able to lower their LDL cholesterol versus not, was predictable. And so and it was predictable from the genome. The key thing that mattered is that so if I have your genome sequence, then, you know, we're able to do a calculation that would that would predict what your LDL cholesterol level would be that's absent of lifestyle or anything else. And it captures, when we did the paper, it captured about 11% of the variance in terms of the total variability. So lifestyle matters more but but you can get a signal. Now the genetic signal, because these have gotten so much better over the last few years is up to about 20% Little over 20%. So what that means then is you get a prediction for your LDL cholesterol on a per person basis. And then you can compare that to the actual level. Now, if there's a gap, so if someone has high LDL cholesterol, but their genome predicts low, those individuals, by and large, were able to reduce their LDL cholesterol by lifestyle. However, if they had high LDL cholesterol, and their genome predicted high, there wasn't much of a gap, we did not, we saw no statistically significant change in their LDL level at all, that's across 1000s of people. So what this means is that we we have the ability to understand something that's a totally new category of variable into healthcare, because today, we just treat, you know, high, high cholesterol against a population average, right? That's what, and there's a range and you're high. And that's it. But with genome genomics, you can actually personalize that and introduce the notion of the Delta, or the gap between your measure and the prediction from your genome. And that lets you know, what's changed what's not just true for LDL cholesterol, we looked at this for HDL cholesterol in terms of what you might want to raise, we looked at it for hemoglobin, a one C, a marker for prediabetes and on and on. And so you can you can amplify that in the healthcare system across basically every single biomarker and know, how does this compare to your genetic prediction, and I'll on all argue that that will turn out to be much more informative than just the marker alone.

Nick Jikomes 33:26

So if people have naturally high LDL levels, and they are supposed to have that, quote, unquote, because because of their genome, is that still predictive of cardiovascular risk? Or is it really about this gap between what your genome is, is expecting or telling your body where those LDL levels should be? And where they are compared to that based on your lifestyle?

Nathan Price 33:54

It's a great question. And the answers that we don't fully know yet, because there are at least two possibilities, right, which is that you have the genetics for high LDL, you're so the first possibility is you're just dealt a bad hand, right, you're dealt a bad hand, and we're going to have to deal with it. But it's going to be hard for you to change by lifestyle, so very likely, you need a drug solution, or something like that. The second possibility, which you just raised is that that LDL cholesterol level is actually not so worrisome for you because based on your genetics, you have a different steady state. Therefore the marker is just not as is not as meaningful for you. So I'll get all so for cholesterols I think we've still got to dive in and really understand that we're trying to figure out some big populations where we can ask that question and and nail that down so we know for sure, I'll give one other example though, which is for hemoglobin a one C. So for hemoglobin a one C, which is a marker for pre diabetes and diabetes. They're more is understood about the potential mechanisms. So there are genetics that are associated with residence time of red blood cells. So red blood cells will circulate in your body, and they do so for about 120 days. But based on your genetics, you might have higher or lower amounts of time. So let's just say that you had a hemoglobin year that your hemoglobin is circulating your body, your red blood cells are circulating for 130 days. And let's say mine are circulating for 110 days. So we're at opposite ends of that, that spectrum. So if we had exactly the same hemoglobin a one C measurement, and just to remind people hemoglobin a one C is the accumulation of sugar molecules on the outside of hemoglobin. And it's the amount that they accumulate over the lifespan of the time that protein is there and the red blood cells. So if we had the same, let's say, borderline, hemoglobin a one C of being pre diabetic, pushing towards diabetes risk, if you were circulating for 130 days, and I'm circulating for 110, my measurement would be much more worrisome. Because my mind has accumulated that amount and not in less time than your stead. Under that, you know, that hypothetical. And so, so that's a case where I think it's quite clear that the genetics would not suggest that the hemoglobin is a one C is, is, that's not an argument that it's different in terms of its risk. In that case, it would just be difference in interpretation. So there's all kinds of things we can get into. And it's going to be different answers for different biomarkers, depending on the mechanism, but I think it's one of the most important frontiers in medicine right now. Which is to figure out how do we reinterpret all of these markers that we use for for diagnosing disease in this case? And how do we refactor them, understanding what we know about the genome and personalizing that for every person, personalized that across the board. So in

Nick Jikomes 37:05

thinking about like, the cholesterol example, some people have this gap, where their genomic data tells us, they should have relatively low LDL levels. But in fact, you measure relatively high levels, that tells us that that gap is there. And also it can be closed, because because their genome allows for it, basically. So for people like that, when you see them lower their cholesterol levels by changing their lifestyle, where does that come from? Is it by just eating less dietary cholesterol? Does it come from somewhere else? And I guess the underlying question here is like, when someone has cholesterol levels that are too high, is that your cholesterol levels get too high? Because you're just eating a lot of cholesterol? Or are they high because something else is broken? And that's just sort of an indicator that something else is broken, but it doesn't necessarily have to do with how much cholesterol you're consuming?

Nathan Price 38:02

Right? Yeah, it's not just a function, certainly, of dietary cholesterol. And I don't think the correlation is super high. It's been a little while since I looked at that, but you know, I don't recall that it's that it's super high, and that correlation. So there's a bunch of other factors that are gonna matter, there's the usual things that always matter, which is how active you are, or how much you know, what your what your, your your BMI, although I'm hesitating because BMI has issues. And we can talk about we actually came up with a new measure for BMI that we published in Nature Medicine last week, we talked about that a little bit more later. But you know, where your weight is that, you know, do you have, if you're carrying around too much fat that's going to have, you know, a big, a big role to play in this so that these factors will will adjust to a reasonable degree based on those overall health metrics. And then there are other things you can do to just target. You know, these molecules, these measures, even from just a natural state product standpoint. So for example, a compound called Berberine has been shown in trials to lower cholesterol using, you know, just a natural product that you find in food. So there's different ways that you can try to have a subtle effect on this. But a lot of those just general overall health measures and just getting more active, getting your weight under control, the usual stuff we think about will make a big difference there as well.

Nick Jikomes 39:29

Yeah, what? The gap? So So yeah, talk more about the BMI thing. So let's remind everyone like what BMI is, and sort of what its, what its limits are.

Nathan Price 39:41

So BMI stands for body mass index. And so this is a metric that's basically just derived from two measures, which is your weight and your height. And so when you do this, you get a number that represents real Roughly speaking, you know whether or not you're in a healthy weight category or not. Now it breaks down in certain cases, because if you're a champion bodybuilder or something like that, and you've got a ton of muscle, you're going to have a high BMI. And that doesn't mean what it means for most of us, which is that for most people, you're going to say, you're carrying a lot of excess fat. So on average, it's not a bad measure, we estimate that it's probably, you know, a mismatch about 30% of the time and about 70% of the time, it's, you know, pretty, pretty reasonable match. So across a population, it's it's not, it's not bad. But it does have limitations to it, because it doesn't take into account your fraction of protein to fat. I don't want to overstate that, because look, for most people, if you have a super high BMI, it's really hard to get there on protein, that's really easy to get there on fat. So it's, you know, in general, not a bad metric. Now, what we did, and this was led by Noah Rapoport, who's a senior research scientist in my lab, and Lee hoods lab, she, well, we did a study that we published in Nature Medicine a week or two ago. So it just came out called biological BMI. So to do this, we took a population of about 5000 people, where we had measured genomes and metabolomes, and proteomes. And that's people that aren't aware of that, you know, so metabolomics is, like all the metabolites in your blood proteome, the proteins in your blood, we measured about 100, and between 100 and 150 different clinical labs microbiomes out of the gut. And we did this multiple at regular intervals over a few year period. And so one of the things we did was just to identify whether or not we could come up with a measure that was better, by looking at especially these metabolites that are in the blood to that would better represent a person's metabolic health and you get from a BMI measure. And we call this biological BMI. And so when we did that, what we found was that this biological BMI was more associated with health outcomes than was BMI itself. So being higher or lower and biological BMI was more predictive of whether or not you would enter into a metabolic disease state, for example. And it was also more highly related to your gut microbiome. So if we tried to say, Alright, how you know, the inflammation overlap, or that's shared between your gut microbiome and your biological BMI, that was stronger than your relationship between your microbiome and BMI itself. So just across a whole host of different analyses, what we found was that if you did this, this deeper dive, which would differentiate between the person that is, you know, that has the same BMI, but one might be much more metabolically healthier, they might have a better body composition, their body might just be able to deal with, you know, different, you know, with glucose differently, or different metabolic processes better and whatnot, that was really captured much better, and this high dimensional biological BMI score, then it was just the simple measure.

Nick Jikomes 43:23

And so how do people learn what that score is for them? Is there like a test for that?

Nathan Price 43:29

Yeah, so we'll, we'll be developing a test around that, you know, we're still kind of figuring out what that looks like, is, is the Institute for Systems Biology, where I've been a professor for many years, you know, did file a patent around this. So you know, it's, it's gotta be commercialized in some form or another. So it's just kind of getting decided exactly how that will be. But we'll make sure that this becomes a test that is, you know, easily accessible for people. So I think there's just a bunch of discussions going on around, you know how to get that out. So individuals could do it. If they're, if you're the bio hacker type, you can get the paper at Nature Medicine, and you could get a, you know, you could get the measurements done from a medical omics test or something like that, and then apply the algorithm yourself. But it's not it's not yet in a form, like I said, just got published a week ago. So it's not yet in a nice commercial forum for people to analyze. But we'll we will have that in the not too distant future.

Nick Jikomes 44:28

Another thing that I've been thinking about recently is this concept of metabolic flexibility. You know, it's like our cells can be in different metabolic states, they can use different sources of energy to create their molecular energy. They can and they can switch, they can switch how they do things. So you know, the example an example that many people may maybe have heard of, is something like ketosis, so when you fast for an extended period of time, or you're eating this high fat, low carb diet The ketogenic diet, your cells go from, you know, one metabolic state to another. And they start using different types of molecules to do all their stuff. And this can have profound effects on just our general health. So that you know, a very famous example is the ketogenic diet can be used to treat certain forms of epilepsy because it changes the metabolism of your neurons. But also just you know, even outside of any specific disease state, it just changes your metabolism. So people report feeling different to their energy levels changing this, that and the other. And I've been using this device for a few weeks. Have you seen this, it's like a breath. breathalyzer type thing. It's kind of a lumen, you inhale and exhale out of it for a few seconds. Apparently, the way it works is measure co2 levels in your breath. And that is a proxy for are you using mostly carbs versus mostly fats for energy. And you can get a snapshot of that at any given time, but it also captures how much you're changing from burning carbs to burning fats, back and forth throughout the day and throughout the weeks. So that type of thing work? And is this idea of metabolic flexibility important that you should actually be able to fairly rapidly switch between how you're actually creating and using energy throughout your day?

Nathan Price 46:17

Yeah, absolutely. So first of all, there are definitely differences in you know, the co2 conversion, and the that ratio that you get between otoo and co2, that change depending on what you're metabolizing. So there's definitely signal there that you can, you know, amplify, and learn off of there's, there's massive flexibility in metabolism and humans. Going back a long time, but you know, in my PhD, the lab I was in, you know, that was one of the big efforts was to build out, you know, the first global model of human metabolism at a molecular scale, and building that all out. So, you know, we used to get into these all all the time. And, and it's, it's just a fascinating area that way. So there are all. So like you said, so there are signals that you can pull from that. Now, switching back and forth is, is another really interesting aspect of that, because, you know, we've learned over the recent years, things like intermittent fasting that if you spend more time away from food, there are all kinds of processes that happen, including autophagy, where you're recycling some of these broken materials from cells that are breaking down, and in getting them remade into newer cleaner cells, which is an important process. So you know, spending time, not eating turns out to be really important for longevity. And there's, you know, that's really come around. In a lot of studies over the last several years, this notion of metabolic flexibility is also really interesting from the standpoint that, especially if you're in a regime where, for example, you're trying to lose weight, then there's a benefit to, you know, a lot of people like to stay in ketosis because you're, you're basically breaking down fats. Under that model, you're using that as your primary energy source. So the notion is, if you don't get yourself out of that your body is staying in a state where it's a little easier for it to tap into your fat stores and, and burn them down. And so that that's quite interesting. There's an interesting company called Tecton, you know, that's been working on, you know, these ketone beverages, there's a, there's a number of different ones. But that's, that's the one that I know. Ketones are not the greatest tasting things in the world, they've worked really hard to make them better. So you know, we do keep them in the office, I have them every once in a while. And I think it's it. So there are some of these products that are actually getting out there too, along with just being very careful about you know, the food that you eat if you're if you're wanting to stay in a state of ketosis, and I know that works really well for some people.

Nick Jikomes 48:53

And so in, so there's no one universal diet that will work for everyone. And, you know, you know, the whole point of your book, I think, but one of the big points is, you know, personalization, you really have to think about this at the individual level. But one thing that seems pretty true, mostly true most of the time, for me, or in our culture, at least, is that our diets have gotten proportionately higher in carbohydrates over time, and written more and more carbs and sugars and things in that class. And this has probably a lot to do with things like diabetes and obesity, etc. So in terms of just basic macronutrients should people be thinking you know, if you had to simplify things as much as possible, should we be thinking about things like just decreasing our carbon take and or just doing intermittent fasting more, you know, in terms in terms of the basic metric macronutrients and sort of when and how we eat, you know directionally what's it going to work for, for the majority of people in our culture?

Nathan Price 49:58

I think monitoring your macronuclear rants is really helpful and really important, but I'll talk about this in a few different ways. So first, the, we have a massive overabundance in our society of processed carbohydrates. So these are simple sugars, these are the kinds of things that will spike your glucose tremendously. One of the great instruments that you can use now are these continuous glucose monitors. They're primarily used for diabetics. But there you can also get them for, you know, other general health issues. You know, and I've worn these, you know, at two week intervals periodically for, you know, a few years as, as a number of others have, and you can, you can actually monitor lots of people's personal experiences on these on social media, and so forth. So there's tons of data on this now. But you can see the degree to which you get spikes, and these processed sugars, that you get in, you know, chips, or candy or sodas, or you just get massive spikes, and they're much more than we would ever experience from real food. So what that means is that our bodies aren't really adapted to deal with that kind of an insult over and over and over again, because in our natural lives, before we got into all the modern processing that we do, you would never, never run into that if you eat a piece of fruit, there's a bunch of sugar in there, or there's fructose in there. But there's also fiber, right? There's there's pieces that are built in that, that help to blunt that that shock. So that's one and that leads directly to the huge diabetes and diabetes epidemic we have and so forth. In terms of macronutrients, you know, one of the really big things, especially if people are trying to reduce their weight, which a lot of people are, of course, and they're trying is that is not to eat too little protein. So you want to keep your protein content as high as possible. And I do think that, you know, this is pretty generic advice that you know, that people will go for, but the, or that a lot of people give, but you want to have kind of as higher protein content, subject to the number of calories you're trying to hit. And one rule of thumb that I have found personally just super helpful, is if you look at the number of calories that something has, and you divide it by 10, that's roughly the amount of protein you'd like to have in it. So that means if you're if you're targeting a diet of 1700 calories, you would get 170 grams of protein. If anything that's on the high side, you probably don't need to be quite that high. But if but one of the things that I found it just because it's so simple, and I've been using this a lot in my own life, the last little while, because I think that this tip is so useful. It's so if I pick up something and I see Oh, it's 200 calories. Well, if it has 20 grams of protein, or more, I think, all right, that's good. That keeps me you know, if it's 20, it's that level. And if it's higher than that, it's great. So like, I have Greek yogurt almost every morning with with berries or not, but the Greek yogurt is, you know, it's for 90 calories, you get 18 grams of protein, which means it's double my target amount. So I know that that gives me something that's higher. And then if I'm going to have something that's lower, it gets balanced out. But I find that Oregon, that very simple metric to be just super useful. And then and the more that I focus on, okay, let's just make sure that everything that I do is, you know, averages out to around that target is has been super helpful, super helpful for me so far.

Nick Jikomes 53:22

Yeah, yeah, I had a conversation with a couple of guys who wrote a really interesting book a few weeks ago, the book is called Eat like the animals. But long story short, you know, they basically said what you just said and explained why they, you know, humans, and many other animals, animals are a protein leverage species, which, you know, according to them means, you know, based on our history as a species, and how we evolved, our bodies want us to get the minimum amino acid requirements fulfilled, to you know, build our muscles and just, you know, build the stuff of our body. And we'll be motivated to eat stuff until those amino acid requirements are made. So, you know, over time as processed carbohydrates have become proportionately more more and more common, you know, the percentage of our diet, that is protein has fallen. And so we just, our bodies motivate us to keep eating until we get that minimum amino acid requirement met. So, you know, I think basically, what you just said is if you keep your protein content, relatively high, doesn't need to be radically high. But if you bring it up relative to those processed carbohydrates, it's gonna have a satiating effect, you're gonna get everything you need, then your body won't want to continue eating as much.

Nathan Price 54:37

It's exactly true. If you if you focus on these macros, and you're getting that level of protein. By and large, you won't overeat. But those simple processed sugars and we all know this, right? If you eat 1000 calories of that, you'll be hungrier at the end than you were at this at the beginning. And it also the other thing about those processed sugars, and you can just look at it when you see eat sugar. What is it oh, it looks a lot like cocaine or anything like that, right? It's a it's a white bear, it's massively bioavailable, and it hits the plant the pleasure centers of your brain, which is why it's addictive. And so when you, you know, when you take these kinds of things, it really reinforces and it gets you on a cycle that is incredibly hard to get off of. But if you stay away from it enough, so that you have, your brain has a chance to recalibrate, and you focus on and I really liked the positive of just focusing on the protein macros, because you're exactly right. You don't have to feel deprived, you just make sure you're eating food that will satisfy you, and then you stop when you're full. And it's pretty, it really makes a big difference.

Nick Jikomes 55:44

Yeah, I mean, and we all know, you know, eating less sugar and processed food is hard, because it does taste good. It does feel good, it is it for sure. It is you know, caloric cocaine, so to speak. But, you know, you mentioned the these, you know, blood monitoring, you know, using, you know, I've done that a couple times using literally the same thing that a diabetic would use to monitor their blood sugar levels. And one of the things I learned there that was even more like insidious was, things were there were things that I was eating, that was making my blood sugar spike, that you probably think are healthy. So like I was eating a lot of quote unquote, healthy cereal. And you know, it had it had the heart sticker on it, it said, you know, ama approved heart healthy, whole grains, no added sugar, blah, blah, blah, blah, blah, you know, every vitamin you can think of is on the nutrition facts. But it would make my blood sugar spike so much, like more than anything, and there's a lot of that stuff out there that is sort of camouflaged as healthy, that that really isn't any better. And sometimes even worse than something that is, you know, eating a spoonful of sugar.

Nathan Price 56:55

Absolutely, there's so much of this, that's just marketing. I forget the guy's name, I'm sorry, I don't remember it at the moment. But there are these, he makes these videos. He is an advertising guy, and he'll and he'll take a product. And he specializes in rebranding it as a health food. And he has taken you know, very unhealthy food, you know, a soda full of sugar, and then you know, how would he rebrand that to be something that is, you know, that's good for you. And there's all kinds of things that you can say on there. And we saw that this was very commonly done earlier as to what you take someone's full of sugar, and you put on the front, fat free exclamation points, like, yeah, it's literally straight here, there's no fat at all in there. And that's not even a good thing. If you're having some carbs, you really want some fats, because it slows it down. And, and, and things like that, or, you know, there's all kinds of positive things you can that you can say on there, right? It's non GMO, it's fat free, it's all natural, all natural, it's, you know, et cetera, et cetera, et cetera. So you really can't go by marketing for what's healthy. So you're exactly right about that, because it's such a. And that's why I think being able to do measurements on yourself, whether it's a CGM, or you're looking at your own blood measurements, you're looking at, you know, the health indicators, you can get off a wearable or whatever it is, that you get a sense for what really is having an effect on your health. And the more you can get away from things that are that are overly processed, and so forth, and not buy in too much to the marketing around that, the better.

Nick Jikomes 58:39

Um, what about sleep? And, and sleep tracking? How to sleep, you know, tie into metabolism? And what are the are there convenient and non invasive ways to monitor your sleep, not just if you're sleeping or not, but, you know, if you're going into deep sleep and things like that.

Nathan Price 58:58

Yeah, it's sleep is obviously one of the most important elements of health. And there are a lot of ways to track how you're sleeping now, you know, in addition to just kind of how you fill in your body, and I find those to be very instructive. And there are a lot of there's a lot of practical advice out there. You know, now that you know around this so one of the things that turns out to be really important is seeing sun you know, seeing sunlight early in the morning, and kind of getting a reset on your clock. Andrew Huber is really popularized that and made everyone aware of that, and the over the past year or so. That's an important that's an important feature. There are a lot a lot of connections between sleep and dementia as well. And in fact, there was a study that showed that even small amounts of sleep deprivation, you would lead to increases in beta amyloid levels in the in the brain And that, you know, beta amyloid is a good biomarker for, you know, something bad is happening in the brain. We'll talk more about that. And so that that is a Yeah, so there are these feedback loops that are associated with this. And we've been building some, you know, some models around sleep that I think are quite interesting, we're just delving into this a little bit more. But there, there are these factors for when you go into, into sleep. because sleep is such an interesting phenomenon, because, you know, we take our bodies offline for a third of the day, every day. And that is an incredibly dangerous thing to do in the wild. And yet, we all do it, and all these animals do, you know, so the needs there are really important. So, so as you go through the process of thinking and living your life, you basically build up waste products that have to be cleared, in order for you to keep that process going. And so you get this sort of urgent need. And so one of the triggers that has to get flipped, is you actually have to go into reverse cholesterol transport, so you're actually taking some of your basic metabolism, and you're flipping it backwards, in order to clear out some of this debris. And so when you do that, one of the things you're doing then is you're actually lowering the amount of available energy that you're generating, because you're you're flipping some of these metabolic pathways in reverse. And so that immediately explains why your body has to shut down and, and all motor function, right, so that you're there, and you can't be operational while you do that. And you remember, we talked earlier about, you know, in dementia is this, this notion of having to keep enough energy in your brain to keep it alive. And just just a basic fact that that around this is your brain consumes 20% of your body's energy, and it's 2% of your body's biomass. So your brain is a massive energy hog, and you have to feed an energy all the time. So when you when you take this metabolic pathway and sleep, and you have to flip it. And in fact, this is why you go into deep sleep and REM sleep in the cycle, because you actually have to, to first before you go in and you take this thing offline, you have to generate a bunch of ATP. And and, and store it up so that you can get through that next cycle. And you've shut down your body so that you're not wasting any other energy anywhere else during that process, because you've got to maintain that amount. So that was you're doing the necessary cleaning in your brain, you're not falling below threshold, and you're not, you know, your neurons aren't dying, that kind of process. So, so anyway, we don't need to get into all the details on that. But it becomes a really fascinating process, about the physiologic physiologically what your brain is achieving during sleep. And then and how you go around doing that we're actually pretty interested in that. Because, you know, maybe there's ways to optimize those processes in in kind of prime yourself, or can you guarantee you have an amazing night's sleep every night? I don't know, it's gonna be super interesting.

Nick Jikomes 1:03:23

Yeah, one of the things that kind of scares me about this area. And I know that there's a lot more questions here than answers, we don't really fully understand it yet. But like, you know, the importance of cycling through those different phases of REM and non REM. And it's actually that that cycle that's important, not just that you are immobilized and asleep. What, but the part that scares me is like a lot of like, SSRIs. And pharmaceuticals actually suppress REM sleep. So people sleep the whole night, but they don't cycle through those phases of sleep the way that they're supposed to.

Nathan Price 1:03:58

Yeah, and that strikes me as a very serious problem. Yeah. Because those, just like you say, the cycling, the sleep cycles, really, you know, make a make a huge difference. And the timing is, is necessary in terms of how you know of how you cycle through. So it's. Yeah, you've just got to be very, very careful with that for sure. Yeah.

Nick Jikomes 1:04:29

I want to ask you a question two about just, you know, select science communication. So, you know, you're coming on to podcasts. You're writing books. You mentioned Andrew Huberman. I've listened to his podcast quite a number of times, he's become super popular. And like, what I start to see when people become this popular is two things happen. One more people are listening to them. That's good. They're learning more science and they're becoming educated and they're learning things. But then to you know, people, you know, people like you and me, experts. To have degrees and they know about certain things that, you know, they start to point out like, oh, well, you know, he said this one thing, and it wasn't completely accurate or this was simplified a little too much, or, you know, there's really only one study that showed that and it wasn't that big, et cetera, et cetera, et cetera. And all those things are valid. But you know, I think you and I probably both know that, you know, if you're packaging something from, for public audience, you're trying to simplify things and use simple language as much as possible. You're talking about things that are super complicated, especially not not only there are they inherently complicated, but you know, if they're cutting edge, if you're talking about stuff that we're still very much learning about, and discovering new things about, you know, I always tell people, Look, it's impossible to get 100% of things right 100% of the time. And so how do you thread that needle? of, you know, accuracy and simplicity and digestibility, when you are speaking about these things, when you're writing your book, and when you're just just communicating and educating?

Nathan Price 1:05:59

Yeah, it's a great question. And it's interesting. So, you know, in the book, The Age of scientific wellness, it was published through the commercial arm of Harvard University Press, it is aimed to be a general audience book. So it's written at a level that, you know, that's accessible, I think, to pretty much anyone. But it was interesting, because we turned it in and actually, a year earlier, and our editor felt like we had gone too far in the direction of trying to simplify it. In fact, she she wanted and, and wanted it sourced, like an academic paper basically, for every fact or every statement in the book. And so I spent a massive amount of time over it. And it took me a whole year to go through and re and go through and re annotate everything in the book, and have cite, I think I added something like 350 citations into the book, to verify as best as I can, I'm sure there are errors in there. 100 100%, there's no way that there's not, but I tried my very best to not have to not have that by going through every statement. And our editor, Joy Demento. She really, really pushed that hard. And I'm really glad she did, because the book is massively better after that year than it was before. And then the second time around, she was really convinced I really, really, really loved what was in there. But it was very interesting, because as I went through that process, there were many times that I had said something that I really believed and I thought for a long time, and then I end up reading a bunch of papers. And it's kind of true, but it's actually more complicated than I thought and you read it. And so there's so many things in there that are like two sentences now that I know took me like, half a day to figure out what I was gonna say, because some of these things really do have rabbit holes. So so that's one. So I think in terms of your larger your larger question, you're trying to simplify the message to the degree possible, because if you put in every caveat, this was the other thing when I started writing the book, is, you know, some of the people who are really good writers, and that gave us advice, or helped us in this first foray into this, this kind of an effort. As scientists, we're very prone to caveat everything. So we don't get out what we're trying to say. Because we're caveat auditing it before. And because there's always exceptions, and there's cept, in this case, and it's not exactly like this. And as scientists we're so train that way. And within our scientific communities that that makes a lot of sense, because you're just being so careful about every word that you say, and you're trying to be as accurate as possible. Now, when you start doing public communication, you can't do that. If you caveat everything, it's so boring and hard to understand that people will just not listen to it. So you have to learn how to say things more clearly. But you can do that in a way where you're still saying what is true. And you can follow the set, you can actually get to the caveats or the exceptions, but you have to follow it in a narrative where someone might ask a follow up question or, or once you've laid out the main point you're trying to make, you can then address you know, there's a few exceptions and talk about and but you can't try to do it all within the same statement. Otherwise, you never state anything clearly and no one comes away with a clear message of what you're actually trying to say. So yeah, so it's something that I'm trying to get, you know, get better at and we're doing tons of podcasts and things is to get that message out. But it was an incredible experience to write the book and just get the process going.

Nick Jikomes 1:09:49

Yeah. I mean, a lot of my day job in the private sector has to do with explaining things and answering questions and educating the public or or just My colleagues. And I remember this one time, a couple of years after I moved from the academic world to the private sector. I was in a one on one meeting with someone and they were like, Nick, like, we love you. You know, your job is to explain things and to make sure we know what's going on. That's great. But your answer to everything can't be it's complicated. And so what I what I learned to do is sort of say directionally, what's true? This is true for most people, most of the time, we think, and I can use the word but one time, like, this is true for most people most of the time, but there could be exceptions here. But you can't, you can't turn every question into a book length answer with every possible caveat, because you just end up saying, it sounds like you're saying nothing. In the end.

Nathan Price 1:10:47

It's the joke about science, the end of every scientific papers, more research is needed. And at some level, and we get into this too, especially as we develop products, right, so you've asked a couple questions as we've gone along around products, or trying to get things out to people. And, and I think you have to do that, like, you have to figure out ways to take what we've learned. And it's always imperfect, and there's always more to learn. But at some level, you have to take the leap and say, Okay, I think, you know, we know enough about the microbiome, it's really worth generating a test and telling people what they can learn from it. Like, I think that becomes something that is essential and important. Otherwise, you can't take action, even even myself in my own position with, you know, and having run a lab for many years before I especially, you know, before becoming Chief Science Officer at Lauren, and it's, you know, in doing all of those things, but even I can't really action on all the things that I understand without turning it into a, it's just, it's too hard, you have to make it simple and actionable and give people information ability to move forward. And we just have to be able to take those those leaps. So to your earlier question, you know, you were bringing up, you know, Andrew Huber amount of people like that, that are out popularizing, and yes, people can take issue with a couple, you know, for many of these great science communicators of well, you know, that didn't quite capture all the nuances, or I'm a super expert in this area, and you didn't really capture that. And I'm very much on the on the side of the people that are out there communicating and trying to sit, there's such a huge difference between trying to accurately convey something that is complicated in a simple way, versus someone that is, you know, really out in left field and, and pushing something that is nonsense, you see that as well. But, but I'm very sympathetic to those that are really fighting the good fight and trying to get things out. And there is there going to be a mistake here or there a lack or there's not enough depth on a topic or to 100%. And the same will be the same is true for me. So I'd like to be generous to them, as I hope others are with me. And we try to get to what is the, you know, what's the truth? And that's what we're all trying to figure out is? What's true, and what's helpful to us in our own lives.

Nick Jikomes 1:13:07

And so you said your book is for a general audience. What about, you know, you know, I imagine that many, you know, a good chunk of the people who read it will actually be physicians. And maybe even you intended that to be part of the audience. How would you? How would you like someone like a physician, or a nurse or someone who works in health care, to, to take in your book and digest it and what should they come away with?

Nathan Price 1:13:37

Yeah, physicians are definitely one of the biggest audiences that we hope to reach with the book. And in fact, I've gotten a lot of nice notes over the past week or so since the book came out from physicians who have read it and and liked it. And we've gotten into further discussions with with a number of them which has been, which has been great. So the age of scientific wellness is a very, it has an expansive vision. And it fundamentally, we want to see a pretty big refactoring of the way that healthcare is done into a wellness paradigm versus a disease paradigm. And there's no chance of that happens over a really short period of time. And because the scale of what's going on in healthcare is so large, and it's so disease centric, but finding allies within the ranks of physicians and nurses and other health care practitioners is hugely important. And I think it's it's so important that we are able to embrace approaches that will better align how the economics of healthcare systems to what's really beneficial for our health and there are Many incentives that are not aligned, in terms of, you know, maximizing our healthspan. Right, if you could actually eliminate, you know, if you could seriously reduce chronic disease across the board, a lot of people would make a lot less money under the current scenario, right? These things are not, you know, it's not aligned, in terms of, you know, maximizing health and maximizing, you know, economics for healthcare systems, and so forth. And so, I would like to see, as many of you know, leaders in these various different areas to become acquainted with at least the arguments that we're making in the book, I think there'll be a, it's already starting to catalyze a lot of those discussions, which I think is is helpful and useful. And there'll be a long path of trying to figure out how do we make these things viable, and working in a way that it really benefits? Everybody, and especially, you know, all of us. And that's why when we talk about this, you know, medicine as PII for which is predictive, right? So we want to be able to say something about what, what are the risks that are coming, preventive? How do we stop them from coming, personalized, because it is specific to every individual, and participatory, which is the last one. And the reason that's so important is that it's really each of us that ultimately bears all the benefit and risk of our own health. And that, ultimately, is the only person that's completely aligned other than perhaps loved ones, right, that is completely aligned with the what is the best for you and your health. And so that is part of the reason also that we wrote the book was just that we think that there has to be a lot of, of demand that that that we do for the way that we interface with healthcare, to push it in a way that is as aligned with our own health needs as possible. Because that's really what people deserve is to have systems that are serving their interests to the best that we can possibly do.

Nick Jikomes 1:17:16

What, um, so you know, with, like, one of the tests that's available through Thorne, that people could actually go out there and buy and use and try out, what's an example from your own life where you were really surprised by something or you got a result about your microbiome or about your diet, that, you know, maybe something was off that you wouldn't have expected to be off, or you realized you had to make some kind of change that you weren't even thinking about before.

Nathan Price 1:17:42

Yeah, and go back a few years, and I'll do an I've had both negative and positive surprises. So a negative surprise I had some years ago, was that I had become pre diabetic. And I had not been aware of that this was before I really got into a lot of the, you know, I held space, you know, more personally. And that was a bit of a wake up call to see you know, how poorly my body was doing at regulating carbs. I had, as a younger person, done way too much on processed sugars, I had gained significant weight, my metabolism was terrible. My knees were horrible, I couldn't straight my knees without severe pain, I couldn't walk without pain. I couldn't stand without pain. I couldn't sit without pain. It was horrible on that front, but you know, on the earlier times that but just being able to open up, you know, on some of the on some of the measurements, it was, you know, eye opening to see how many of my body systems were messed up. And I was much too young for that to be to be happening. That was part of the motivation for getting into this space and making the progress has come since then. One of the really positive things I found, so I went when I went through this was before Thorin. This was a company that I co founded with with Lee hook called arrow Vale. And I had gone through that program for four years. And then we developed the biological age score, which we ended up later commercializing at, at Thorne. We did a retrospective analysis on all the bloodwork as we were and we published this in journals of Gerontology of a biological aging score. And when I did that, well, I'll just I'll just say so when I had gone through air avail I had been it made a huge difference in my health, I felt a lot better. But I had I had lost a bunch of weight and regained it. I did the very typical unfortunately like yo yo thing of down and then body just, you know has a set point it just wants to go back up. And so I was very disappointed in myself for that, you know that during that period. But it was interesting is that when I applied the biological age test to my blood scores, what it showed was that I had in fact were reduced biological age on that measure, relative to my chronological age by two and a half years, every single year in that program for four years in a row. So my biological age just dropped 10 years. And that was eye opening to me, because I had felt like I had made some progress and, you know, some forwards and backwards and forwards and back, you know, and that I had been fighting to get, you know, healthier, but I hadn't quite gotten to where I really wanted to be. And, and yet the biological age, as you know, and just looking at it told me the story of, at least in the biochemistry, you're getting better, better, better, better. And that was, you know, that was eye opening in a positive way. That's one of the reasons we ended up launching the biological age test, because I found that so just personally motivating, that it made me feel like, okay, my journey is going better than I thought, and I, you know, just kind of re motivating to to start, you know, and push that even harder. So, so I think it can it can be revealing in a in a negative way. Right. I also found it you know, I have higher risk for Alzheimer's disease, because I have a bowie for one copy, not to so I'm in the middle group. But that's motivating to say, Okay, well, what are the factors that I can do to help prevent dementia have super high risk for macular degeneration, like 59 times average or something? Well, that's motivating to say, Okay, well, let's learn a little bit more about that what, you know, what can I do to mitigate that risk? And we go through that. So there's all kinds of things that that you go through, that you can learn both negatively and positively in this kind of journey.

Nick Jikomes 1:21:33

Interesting in the book, so the book is out already.

Nathan Price 1:21:37

The book is out. Yeah, the book released officially about a week ago. And so it's available everywhere. Yeah.

Nick Jikomes 1:21:44

Is there so just as a reminder for people to So Nathan was on the podcast previously, back in 2022. So Episode 47, we talked about a lot of the stuff we talked about today. But I think we went into a lot more detail on certain things like aging and blood sugar physiology. So I would encourage people to go back and look at that one, too, if they if they want to dig a little bit deeper. So I'll put a link to the book in the episode description and everything. Is there anything? Is there anything in the book that we haven't really touched on any major areas that you think are worth mentioning, or maybe interested in any interesting stories that that might whet people's appetite?

Nathan Price 1:22:22

So one, one area we haven't really gotten into is the role of AI. Not so we did just write an op ed or off of an excerpt of the book for The Wall Street Journal this last weekend. If people want to check that out, it goes into it. But this is an area.


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