Understanding Biological Age to Live Well Longer
What’s your true age? Not the number of years you’ve been alive, but the age of your cells. Did you know those numbers could be different?
In this episode, longevity and anti-aging expert Dr. Rajka Milanovic joins me for a discussion about biological age and what we’re getting wrong about longevity. We cover everything from how you can get an accurate measurement of your true age to the factors that impact it and lifestyle measures that can help reverse the clock.
Plus, she shares her most valuable tips on what you can do right now to start turning back time.
If aging powerfully is important to you, this is an episode not to be missed. You just might discover the one tweak that will help slow down your cellular aging and make all the difference.
Freebies From Today’s Episode
00:00:57 – I took this test and didn’t do as well as I expected
00:04:06 – Longevity is not extending your life
00:05:31 – Why Dr. Milanovic became a longevity expert
00:07:27 – Is there a test for aging?
00:09:11 – What can the test results give you insight into?
00:11:14 – What drives up biological age?
00:15:48 – Measuring toxic load
00:18:21 – The myth of the juice cleanse
00:21:22 – How do we lower biological age?
00:23:51 – Where does exercise fit into this?
00:26:38 – About fasting and calorie restriction
00:30:58 – The role of protein in aging
00:34:33 – Other key factors that influence how fast you age
00:40:27 – Peptides vs. bioidentical hormone replacement
Resources Mentioned in this episode
Get a DEXA scan
Study: Bulletin of Experimental Biology and Medicine: Geroprotective effect of epithalamine (pineal gland peptide preparation) in elderly subjects with accelerated aging
ATHE_Transcript_Ep 593_Dr. Rajka Milanovic Galbraith
JJ Virgin: [00:00:00] I'm JJ Virgin, PhD dropout, sorry mom, turned four time New York Times best selling author. Yes, I'm a certified nutrition specialist, fitness hall of famer, and I speak at health conferences and trainings around the globe, but I'm driven by my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information I uncover with as many people as I can, and that's why I created the Well beyond 40 podcast to synthesize and simplify the science of health into actionable strategies to help you thrive.
In each episode, we'll talk about what's working in the world of wellness from personalized nutrition and healing your metabolism to healthy aging and prescriptive fitness. Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out at 100.
So I took a little test [00:01:00] a couple months ago, and it was supposed to look at what my true age was. And it's the difference between looking at your biological age and your physical age. And I figured I would blow this one out of the park. I did not. And so we are going to talk about aging today in a very different lens.
And what we're going to look at are, what are the things that could age you faster? You know, you might be living a totally healthy life, but there's something that you hadn't considered. Maybe you've got exposure to toxins you weren't aware of. Maybe it's some old stress or trauma that is in there. That is accelerating aging.
Conversely, and more importantly, what are the things that can drop that biological age? And what's interesting here is if your biological age is higher than your actual age, your risk of dying sooner, like I said, It's 100 percent higher. I mean, it's something crazy. And I'll let our amazing guest, Dr. Rajka Galbraith talk to you about that. And let me tell you a little bit about my buddy, Dr. Rajka. She's a leading triple board [00:02:00] certified functional medicine doctor. She's an international speaker. She's a physician mentor and a peak performance coach. She got into all of this because she had two decades of debilitating fatigue, and that got her into, okay, like, how do I produce more energy?
Then she started digging into different ways to do that, became very well versed in peptides, which you're going to learn more about here, but really digging into biological age. And you know, the more I look at this, here's the realization. If you really look at what could be Accelerating your aging versus what I would call de aging, do you start to really focus in the de aging camp?
And I think of that and go, if you want to be built to last, do super cool things in your 60s, 70s, 80s, 90s, 100, this is where your focus is because it may be one tweak in there that's accelerating your aging that can make all the difference. So that is what we're going to be digging into today. I'm super excited about this.
And we also are going to have an assessment for you so you can start to look at some of these factors that you'll be able to get at [00:03:00] jjvirgin.com/BIOage. And I will be right back with Dr. Rajka. Stay with me. All right, Dr. Rajka, we are going to dig into longevity and I'm super excited to have this conversation with you.
Dr. Rajka Milanovic Galbraith: So am I. I think it's not talked about enough.
JJ Virgin: Well, it's not, I never was interested in it. And then 10 years ago, I was like, oh, oh, this is important. You know, I was making a joke the other day and Tim says, you can't say that. And I said, you know, really, I started training for being 80, 90, a hundred years old when I was 16.
He goes, you can't say that to people. That will not. Be helpful. I go, but I do think that if you're listening and you're 25, 30, 35, 40, you have a really good competitive advantage because any of these things that I'm sure you're going to talk about, the sooner you start them, the better. However, I'm guessing that most people listening are 40, 50, and 60.
So I'm going to emphasize. This to them there, because I think that's when we all start going, Oh, longevity, anti aging, I [00:04:00] want to know more. When you think about longevity, what does it mean to you?
Dr. Rajka Milanovic Galbraith: I love this question. So the way I think people should not think of it is just extending your life. Because if you do that, you want your health span.
So that's how good you feel and how you're able to get around and remember things and enjoy life. That should really equal how long you live. So if you're 80, you want to be able to do the things that you've worked all your life to do, and hopefully you're doing them all along the way. You don't want to be bed bound or having difficulty just getting up off a chair.
And there's actually a test that we do on our seniors called the get up and go test. And we time them for them to stand up and walk so many feet out and return. And I'm like, I want everyone to have some good get up and go. Really to me, it means living long well is my hashtag and mantra. Live long well.
So not just living long.
JJ Virgin: Yes. Living long poorly would feel like the longest time ever. My mom is 93. Sadly, we do not share the same genetics I'm [00:05:00] adopted. You know, golfing, lives in a two story house. Which I think is important, right? And doing all of these things. And she'll probably be like my grandmother who just was going, going, going.
And then just one day it was like, boop, she was a light bulb, which is, I think, the great way to go, right? I like what Peter Attia talks about with the centenarian decathlon and think about the things you want to be able to do in your eighties and nineties. And what do you need to be doing now to be able to do those then?
I thought that was super cool. So how did you, besides the obvious of we are getting older, like what made you decide you really wanted to become an expert in longevity?
Dr. Rajka Milanovic Galbraith: Well, it seems like a lot of us have found the way in our own health journey or a family member's. And sadly, over this pandemic, my mom has had the misfortune of being hospitalized multiple times.
And, you know, this is a woman who worked three jobs to put three of us through school. And as I reflect back, was my biggest cheerleader. She literally flew all over the world, lived all over the U. S. and world. And she'd just meet me there and be there for [00:06:00] support. She even pitched in and served as our nanny when we got into a little pickle.
And a major metropolitan couldn't find one. And I was supposed to be going home to kind of be there for her. She's losing that independence. Sadly, she was hospitalized. And so instead I was cooking her healthy meals to bring to rehab and I arrived and it was like late at night and she just looks so frail and that, and that just like really struck me as like, this is the woman who has been the chiller all my life.
And what if I had only known? You know, as I was starting functional medicine, what I know now, what could I have prevented? And what could I have done to spare? You know, what she's doing is living poorly right now.
JJ Virgin: Yeah. And you mentioned frailty and I just saw these statistics that Blew my mind that between the ages of 50 and 60, that 11 percent of the United States population, I got to believe this is more women than men, have sarcopenia.
Dr. Rajka Milanovic Galbraith: Yeah, that's a huge issue. So even women that are lean and that are exercising, I love [00:07:00] that you brought this point, we're starting to have sent out people for DEXA scans to look at lean body mass and to see are they actually sarcopenic when you wouldn't think they would be. That's one of the things hopefully we'll talk about is, you know, prioritizing protein for women and eating more than you probably think you need, because it's, it's huge.
And some of the things we're doing in longevity help to prevent sarcopenia outside of the diet alone. So I love that you brought that up. Cool.
JJ Virgin: We're definitely going to talk about that. I know you have a test and we're going to talk about this in terms of if you want to get this test, how to get it, but also just the lessons learned from looking at these You'll get a lot of information and what you've been able to discern from being able to do this type of test you've been doing that helps people find their true age and what it's been doing now in terms of what recommendations you would give people.
Because I would assume that even without doing a test, a lot of these recommendations would hold true. So let's talk about this test that you've been doing because you did it on me called the True Age and [00:08:00] first talk about the test and then we'll kind of dig into how people could even use some of the generalized findings in their own life.
Dr. Rajka Milanovic Galbraith: Yeah, until recently, the tests for aging were only looking at one marker and your audience may or may not have heard about it and they were measuring the length of our chromosomes called the telomeres and those typically shortened with age and the shorter the chromosome end, which is the telomere length, then it doesn't bode well with longevity.
And now they've found that maybe that isn't the whole picture and they've started to look at biologic markers that can tell you what is your true biologic age versus chronologic age. And. Being able to look at some of your immune cells to look at what is the age of your immune system and how fast are you aging.
So it's all fascinating is that we now have several different markers to go by. And I love what you said, JJ, is that you may not even need to do the test, but I always say tests don't guess if you can, and if you can't, then do everything to support healthy aging or living long well.
JJ Virgin: Yeah, to [00:09:00] me, I think as many of these things you can possibly do, do, but I also want someone listening right now to be able to go, okay, I'm definitely going to look into that and what can I do today?
You've now been doing these tests. What are some of the findings that you see when you do this test?
Dr. Rajka Milanovic Galbraith: The first thing is to know that if you measure your biologic age, so that's how old you are internally by all these biochemical markers, these fancy things they measure versus how old you are by your birthday.
What the studies have found is that if you measure seven or more years older, your risk of dying increases a hundred percent. So it's super important.
JJ Virgin: A hundred, yes. Wait, but no, no, no. Our risk of dying, we know we're going to die, but it's like quick, more quick. Oh, okay. I was like, well, we know we're going to die.
Dr. Rajka Milanovic Galbraith: So it's definitely no, it increases more quickly, but if you lower that, you can reduce that risk of dying. And that's by seven years, you can reduce that risk of dying and improve quality of life. So that's secure and improve quality of life. Cause you don't want to live longer by 50%. What [00:10:00] we're saying is say that.
You're 50 years old, but then you measure biologic age and it says you're 43. Well, think about yourself seven or eight years prior. All of us had a little bit more get up and go. And then the goal is to keep us as young as possible internally so that we also equate to what we're able to do externally.
JJ Virgin: So how closely usually does your biological age and your physical age, like, should they correlate? Do you want it to be way lower? When you're seeing the tests, how much are you seeing those two correlate?
Dr. Rajka Milanovic Galbraith: What's normal and what's optimal? I love this. So what I'm seeing, unfortunately, is most people are measuring a ton older.
So I do take care of a wide variety of patients and I have an aging man who has Alzheimer's, you know, between me and all of his other practitioners. I mean, he has neuro biofeedback and he does various things. Outside of the scope of what I do. And he was only three years older, which is quite good based on just some of his cognitive decline.
But [00:11:00] where you wanna be is at least seven years younger, and I'm not seeing that. And so that's before intervention. So that's what I'm tracking right now. We're keeping spreadsheets to see how quickly can we reduce that, that aging.
JJ Virgin: Okay. So here's the obvious questions then. What are some of the things that would drive up your biological age?
Dr. Rajka Milanovic Galbraith: That's perfect that you asked that. Sleep disturbances are number one. So the circadian rhythm is super important. So being able to sleep adequately and waking refreshed. So I would prioritize sleep.
JJ Virgin: Dig in a little bit deeper on that because I want people to really hear this because you just said it was number one.
That's awesome. And when you say that, what would quality sleep really look like for someone?
Dr. Rajka Milanovic Galbraith: Yeah. So, you know, falling asleep within 20 minutes, you know, getting an adequate amount of all the different types of sleep. I measure it by do you wake refreshed and that's seven to eight hours for most people.
So everyone's seven to eight is going to be slightly different. [00:12:00] You know, these people would say, Oh, I've only ever needed five hours. I'm like, I don't think so. And what's interesting is one of our glands that we don't talk about, the pineal gland, makes our melatonin. So it's a small bean sized gland in our brain and it makes and produces melatonin and it regulates our circadian rhythm.
And unfortunately, with age, it gets calcified and it shrinks. I mean, part of that's normal, but it more quickly does that if you have poor sleep hygiene and sleep poorly. So that's why it's important. So it's kind of like a double edged sword. It's going to start to worsen with age. And that's why now we're using melatonin for some of our anti aging protocols to support that quality sleep.
Okay, so sleep's number one. What else? Probably number two is blood sugar dysregulation. So obesity shrinks the pineal gland, you know, it's right up there in that top three. And so that would be, when I think of that, I think of blood sugar control and really measuring, you know, we're starting to measure how much visceral fat or fat around our organs someone has.
Super, super [00:13:00] important to lower that to a healthy range and also to regulate blood sugars. And unfortunately with the regular medical society looks at regular ranges as far cry from what we're looking at for fasting blood sugars, you know. We don't want people trending one point below pre diabetic, you know, which would be 99.
So hundreds pre diabetic, but we want them down about 85. What after blood sugar? Stress. So stress is really, really high up there on the list. And so part of our protocols, what we do is we know it's a component to every single chronic disease and no one can change how much we're exposed to, but you certainly can become more resilient.
So we teach a form of biofeedback in the office. And it's perfect for those type A, high level executives and entrepreneurs and high performers because it gives them a tangible way to measure, are they out of fight or flight? And that's what I need them to be. And I'll tell you, this came after a year or two of seeing people who said, well, doc, I meditate 30 minutes a day.
I've done this for a decade. And you measure their [00:14:00] cortisol markers, which is our body releases cortisol naturally, should be high in the morning. So you feel alert and come down at night. And unfortunately, most people are chronically stressed. So it's high, high, high. Eventually it'll invert, be low in the morning.
People say I'm tired. And then at night they feel wired because the cortisol is coming up. So I said, well, that's great. You've been meditating, but it's not working. We need to find a way to, to ensure that you're actually getting out of fight or flight. And you know, certainly there are dietary measures you can take to support the adrenal glands and then even to adaptogenic herbs to give people support while they're working on that resilience piece.
JJ Virgin: All right. Any other big ones besides those three?
Dr. Rajka Milanovic Galbraith: Yeah, toxins. So toxins will age you like nobody's business. So yeah, I'm sure you've seen pictures of smokers and non smokers and you look at their skins. And so that's an obvious one and probably not so obvious, you know, even just the social drinking.
That people do alcohol is a toxin. We have numerous genes that control its breakdown because it's so toxic to us. So I'm not saying don't have a glass of wine [00:15:00] or two with dinner or when you're out at an event, but the chronic daily drinking is probably as bad as the binge drinking. But even more than that, you know, what I've discovered, I measure toxins.
So the whole wide variety of them, and I've had people surprise me who live clean lives, have air filters, water filters, and they come back really high for certain environmental toxins. And you say, oh, Your water filter is not what you think it is. And so there's contaminants in our water, unfortunately, pretty much across the US and certain areas are worse than others.
So if you're not filtering your water and air, chances are you're probably exposed on a day to day basis.
JJ Virgin: Well, the reality is I travel 75 percent of the time. So we have totally filtered everything in our house, but we leave our house. And I think most people do. So that's the other big challenge. So how are you measuring toxic load?
Dr. Rajka Milanovic Galbraith: So there's a few different tests. So one test looks at all the environmental toxins. There's one predominant company doing it now, Great Plains Labs. And they [00:16:00] look at things like MTB, which is a gasoline by product and it leaches unfortunately into our groundwater exposure to dry cleaning solvent. And sadly.
You can have a household where the child's not dry cleaning and it's only, say, the husband or the wife, and it's in the bedroom, and the child measures really high for this. And then of course, pesticides and you name it. Those are probably the big ones. And I'd say there are other ones, but the pesticides are big.
BPA and phthalates, which are found in a lot of our personal care. So we really run through the whole list. So if someone can't test, we have them avoid. But I tell people test if you can, because you'd be surprised. I've had people who are living the cleanest lives that come really high.
JJ Virgin: Well, have you ever done a test and not seen people have some level of toxic load?
No. Are they just great detoxifiers?
Dr. Rajka Milanovic Galbraith: Typically, you know, that's the third step when I run someone through my protocol is we'll look at that. So we've already started to optimize all that, the detox. So ensuring they've got adequate protein because protein [00:17:00] breaks down amino acids, that they've got adequate nutrients, that they're hydrating and they're eliminating all the toxins.
So it is shocking, but yeah, typically they are living healthier. So I don't find someone who tells me they're living unhealthy, that they're low.
JJ Virgin: Living in the world we live in, it's not like we can avoid them. It's that beyond just avoiding as much as possible, we've got to be doing things to get them out.
Dr. Rajka Milanovic Galbraith: I tell people, you know, there's a combination product I use that eliminate environmental toxins. And because I look at genetics, I kind of know what their predisposition to what you just said, Hey, is it because they're not detoxifying? So I know that oftentimes in most of my patients, but. I'm starting to recommend it more and more as a maintenance.
And it's, they're gentle binders that don't bind, they're binders that will bind everything under the sun, your nutrients, your vitamins, and even the food you ingest. So those aren't good for long term, but these you can take longer term kind of as a maintenance dose.
JJ Virgin: Yeah, that makes a ton of sense. First of all, I'd love you to crush one myth that makes me crazy all the time.
And you started to [00:18:00] mention it before we get there. You look at these detoxes that people will do for a week or two and think, okay, check the box. I'm like, yeah, but you're living in the world with toxins. And the other one is when they're doing something like a juice cleanse to detoxify, and you just mentioned the importance of protein and detoxification.
Can you please just crush that myth?
Dr. Rajka Milanovic Galbraith: Here's why that can get you into a whole world of hurt. So to detoxify, you need protein broken down into amino acids. So that's what it breaks down into. And you need adequate amounts of amino acids and B vitamins and even something called glutathione to eliminate toxins.
So here's what happens when you do a juice cleanse. The juice cleanse is going to naturally filter out some of these toxins. And what our body does is as that toxin breaks down, it breaks down to a more toxic breakdown product. And then the way we eliminate it is we attach a water loving molecule so we can poop, pee, or sweat it out.
I know that's not very glamorous, and if [00:19:00] that's the step that requires protein, or actually it requires amino acids. So if it gets stuck in that more toxic metabolite state, guess what? You feel terrible. You feel really crummy. That's why the, I'm not a big fan of, of juice fasts and especially for someone who decides, oh, I haven't eaten a healthy a day in my life.
This is how I'm gonna jumpstart it. Don't do that.
JJ Virgin: Yeah, , don't do that. And I feel charitable, so it must be working. Okay, so toxins. Any other ones here that really increased your biological age?
Dr. Rajka Milanovic Galbraith: So sleep, stress, toxins, the blood sugar dysregulation. I have a list of things that cause inflammation and that all and to, you know, add to it.
And I always say, you know, nutrient deficiencies, and that's just vitamins and minerals, that fancy little term. And I've been measuring for a decade now, all kinds of vitamins and mineral levels, some through specialty companies, some through your regular local lab company. [00:20:00] And the average vitamin and mineral deficiency is about 5 to 7 in adults.
And as people get younger, now in my 20 year olds, I'm picking up 10, 15 vitamin and mineral deficiencies as you get into the children who are now eating what I call the brown diet, macaroni and cheese, McNuggeties, and pasta, they're significantly deficient. So you want to make sure that's optimized. So you first support that right through general supplementation, you say, even with eating a whole food diet, you're not going to be able to support every single vitamin and mineral you need.
You just simply can't. Yeah. I remember
JJ Virgin: I was teaching for metametrics way back when and teaching organic acids, amino acids, food sensitivities is how the virgin diet came to be. And so we were running tests on all of that healthcare professionals. So these are people who are eating healthy. I never saw an organic acids test where everybody was optimized.
Never. It never happened. I was like, wow, if you are not taking at least bare [00:21:00] bones, better get a good multivitamin, mineral, antioxidant, essential fatty acids. Cause you just never see it. And we all want to do these fancy schmancy things. And I'm like, You wouldn't go to the car dealership and sit there and talk about what kind of rims you're going to get on your car if there's no engine in the car.
Get the engine firing. So those are the things that could raise biological age. Now I'm assuming that a lot of how we lower biological age is the reverse of this.
Dr. Rajka Milanovic Galbraith: Exactly. So, you know, the reverse then would be prioritizing sleep. And, you know, I'll tell you the, probably the biggest thing people are have the toughest time avoiding is that blue light.
at night, you know, myself included, but I have blue blockers I can wear. And I always say, you know, I like health made simple and that's why my clinic is Simply Health Institute. And I always say I give people top three. If I can't teach you the process in a couple minutes, you're not going to remember it.
So I have a whole thing where I'm teaching this and I'm like, you know, morning light, get to bed and wake at the same time and avoid the blue light. [00:22:00] I'd say a fourth in that one. One of my patients actually highlighted this is that one of the things I do sometimes to support sleep is a supplement called 5 HTP, but it really depends on what the issue is.
So I don't just give it to anyone. And after a few months I said, Oh, are you still taking that? She says, you know, doc, I did what you said. I turned off my wifi at night. And I found it works as good as the 5 HTP. Wow. And then, lo and behold, there is a gene mutation, JJ, because you know I love the genetics.
It governs that some people are more predisposed to being sensitive to Wi Fi. Wow!
JJ Virgin: What gene would tell you that?
Dr. Rajka Milanovic Galbraith: So it's C A C N A C 1 or N A 1, yeah, it's like a, it's a calcium channel, it governs the calcium channel. That's fascinating. Yeah. So we really hit them hard and I tell people, if you're not sleeping well, and so I have a two page handout, I'm like, you do everything on this handout, and then I laugh, I said no.
Let's hit the top three or four, cause I know they can't do everything, but you're right. You're going to reverse engineer what [00:23:00] we said, increase stage to decrease it.
JJ Virgin: So I've got to ask the obvious question here. If we are looking at biological age, I'm trying to remember who's podcast and who said this. And I'm like, Oh, that's so good. Cause I always like to give credit, but I can't remember who it was. So sorry, I'm not giving you credit. But what they basically said is that there's only one thing that can reverse, or at least with all the hallmarks of aging.
Exercise. And, you know, my whole start was as an exercise physiologist. The biggest challenge with exercise is it's as weird as diet. Like diet can mean anything. It could mean that you're eating pork rinds and tab. It could mean that you're eating a whole foods diet, you know, it could be anything, right?
And same with exercise. There's cardio, there's HIIT, there's SIT, there's resistance, there's plyometrics, like there's all sorts of stuff, but where does exercise fit into this biological age?
Dr. Rajka Milanovic Galbraith: Yeah, so it turns out that weight training is slightly better [00:24:00] than aerobic training in extending life or the longevity piece, but studies found that combining them, so the combination of strength and aerobic, and on the flip side of that is all those people who overexercise and do those ultramarathoners.
They age the quickest. So it's kind of like a little bit is probably not enough, but too much is going to really do you. And it does the exact opposite.
JJ Virgin: And yeah, it's really the endurance though. Like here's the thing. So interesting. So I've got endurance athlete friends. Who I've been friends with for decades who are now like in trouble.
And what they found is endurance athletes actually have the same muscle mass as a couch potato. Like how unfair is that? Whereas you'd be hard pressed to overdo resistance training. The minute you said that about resistance training, I'm like, okay, what would be the reasons as we age, we're losing type two, we're losing the faster twitch, and that is the first place we can become more insulin sensitive, which we lose too.
So it would make sense that. The resistance training would [00:25:00] make that impact and having some cardiovascular fitness, especially doing some HIIT training for your back fat.
Dr. Rajka Milanovic Galbraith: Yeah, absolutely. The combination. And so the other thing too, for all the women listening, unfortunately, you know, they would talk about weight bearing exercise.
Walking is not enough. To spare your bones.
JJ Virgin: So you, you definitely Walking's not exercise. Walking. Like, you know, I had a friend say early on, walking's just controlled falling. But when you look at it, like, we need to be walking and moving more all throughout the day. That is not exercise in my mind. Don't you think?
Dr. Rajka Milanovic Galbraith: No, I agree. I mean, it's important, but it's not exercise. It's a starting point for someone who hasn't, but yeah, you're right. It's not going to get you the gains, especially, you know, 40 on up. You know, you said these people who are 20s, 30s, and 40s, we start losing muscle mass at 40. So if you're not doing something to support that, you'll end up with, you know, what we call the skinny fat, where they'll have more fat than they'll have muscle and they don't look bad.
JJ Virgin: There is apparently, like, I'd love to see the new research on this because [00:26:00] this was, I think 20 years ago, they were looking at MRIs and they found that 50 percent of the people that they looked at with MRIs who were of normal weight were skinny fat, sarcopenic, what they call sarcopenic obesity. And so you look at that and go, wow, if that's the case.
It actually flows into all of the statistics we're finding now for being metabolically healthy. Cause you can't be metabolically healthy with sarcopenia. If you don't have enough muscle, there's no way you're going to be healthy. It can't be.
Dr. Rajka Milanovic Galbraith: They call it the currency of aging. So I love that you said that.
JJ Virgin: So getting good sleep, doing good blood sugar balance. Managing stress, detoxifying, exercising. Now you've also talked to someone, I would love to explore this cause I'm battling in my brain on this one. And I know there's a lot of controversy right now about fasting mimicking diets, intermittent fasting, caloric restriction, and how this fits in here.
What are your thoughts about that with aging?
Dr. Rajka Milanovic Galbraith: Yeah, all of the above. Do them all, but at [00:27:00] varied times. So you're going to pulse dose it in. So the intermittent fasting, your listeners probably know, is just a period of where you don't eat and a period where you do. And there are genes that govern how long you should be doing that.
So if you have an APOE gene that says you're predisposed to Alzheimer's, then maybe you're the one fasting 16 hours. I don't have that gene. So, maybe I can get by with 12 hours on a day to day basis, but regardless, every adult should be fasting for 12 hours, period.
JJ Virgin: See, that shouldn't be fasting. That should be how we eat.
Don't you think? Like, I don't know if you saw Dr. Sachin Panda's work where he said, the average American's eating 15 hours plus a day, holy smokes, means you got up, you started eating, you ate right before you went to bed. That's craziness. I think that the 12 hour fast should be this hard rule and it's just the way we should be.
Dr. Rajka Milanovic Galbraith: Agreed, agreed. I think we need to do a whole re education of America or even the world, perhaps.
JJ Virgin: What was it? Taco Bell started that fourth meal. I'm like, well, that's super helpful for all of obesity crisis. [00:28:00]
Dr. Rajka Milanovic Galbraith: Yeah. And I'm sure you'll appreciate this. So, you know, I work sometimes with trainers and sometimes I don't work with trainers, meaning that I don't agree with what they say.
There's one that I just don't align with at all where she has her clients eating three meals, three snacks. And I'm like, that patient of mine that you're personal training is bottoming out because we need to support her blood sugar, you know, getting her glucose into this health versus giving her more carbs and, and feeding the whole problem.
And she was able to solve it herself and see that I'm like, because every time she's eating, she's driving insulin. So it was not healthy.
JJ Virgin: So 80s. That was so the 80s. I tell you a funny thing. I used to teach this course called Overcoming Weight Loss Resistance and taught it to docs all over the country.
And when I started it, I was on Dr. Phil. And in Dr. Phil's book, he had you eating six times a day, three meals, three snacks. And this was in the nineties. And I started to look at this like, why are we doing this? It started when we started taking the fat out of the food and everyone was [00:29:00] hungry. And then there was this whole thing of we should graze.
That is one of those clear things of like, eat, stop eating.
Dr. Rajka Milanovic Galbraith: I have to laugh because I went through the 90s too, where it was the no fat, error, low fat, and it was all processed foods. And you're right, it was the worst diet ever. The Snackwells diet. 100 calorie snack pack that had no nutritional value.
JJ Virgin: That you would eat like a gazillion of because there were only 100 calories.
Let's talk about calories because it's kind of looking at this going, okay, there's caloric restriction. There's things like fasting, mimicking diets, but then there's this goal of making sure that we've got this great muscle and they're kind of in conflict. So how do you put those things together where you want to do some autophagy and clean out, but you also want to make sure you're building muscle?
How do you pulse those like you've talked about?
Dr. Rajka Milanovic Galbraith: Yeah, so I would cycle. So it's really hard to do a water only fast. So a lot of people don't start there, particularly people who have not been living a healthy life because you're going to detoxify and then you have nothing to get rid of those toxins. So there are these fasting mimicking [00:30:00] diets that support with food.
So it mimics as if you're fasting and you and I both have done them and I'll prescribe them as well. And typically we'll cycle people in five days in the month. They're doing a fasting mimicking diet. And then the rest of the month, they're eating normal calories or even with caloric restriction. You're not talking like a lot of calories.
So if a woman's eating, say 15 or 1700 calories, you're looking at 10 to 25%. So I've seen various amounts reported, and certainly you're not going to do that caloric restriction on anyone that has an eating disorder. So I'm very careful to say that as well, is that you want them nourishing their bodies.
And so one way, if you're not going to measure is, you know, eating till you're 75 percent full. So why do we have to be over full and over stuff? Like most people do on holidays, like Thanksgiving, Christmas.
JJ Virgin: The challenge is that whole eating till you're 75 percent full, there's a word for it. It's a Japanese word.
Sadly, I've never figured that out until I'm over full. Now you [00:31:00] mentioned briefly the role of protein. And so how are you dosing protein and using protein and does that help with biological age at all?
Dr. Rajka Milanovic Galbraith: Yeah, because it's going to help support, you know, muscle formation, prevent the breakdown. And anyone who's in maintenance, I'm talking 40 and under, you're looking at a gram per kilo.
But now it seems like for those of us that are, you know, over 40 or 50, you're looking at a gram of protein per pound per day. So a much significant jump. And I was advising. A woman who wanted weight loss and I'm like, look, just to even prevent loss, she was pretty lean, but shorter stature at 60 grams.
She's like, Oh, I can't hit that in a day.
JJ Virgin: At 60 grams in a day, she couldn't hit? No. That's like the average woman now is getting somewhere between 45 and 60 grams of protein. in a day. That's like amazing to me.
Dr. Rajka Milanovic Galbraith: Yeah. And so I have them track. I have a whole method. I call it the task method and the C is for track.
And I tell them, [00:32:00] you don't know. I had a woman that we had to go back and explain it over and over again. And when I, this happens, you have to say, okay, maybe I'm not teaching it. And when she got it, she's like, oh, and then she started losing weight and she was eating a whole foods diet. Yeah. Let's walk through that.
JJ Virgin: So you had her start tracking. What did she think? Because I've heard. That we underestimate what we eat by 40%. I'm guessing that we think we eat more protein and we think we eat probably less fat and carbs than we actually do. So what did she think going in and what did she find out by tracking?
Dr. Rajka Milanovic Galbraith: When you looked at her diet on paper, it looked good and I could already visualize that you probably need a little more protein.
I'm like, you know, if you have insulin issues, probably sweet potatoes every morning or is not the thing to do. It's probably too high for you. And when she really was tracked and found out she's at 150 or 200 grams a day of carbs. It was all healthy carbs, right?
JJ Virgin: Sweet potatoes have gotten this like hall pass as if you can just eat as much [00:33:00] of this as you want.
Dr. Rajka Milanovic Galbraith: Yeah. Bananas are high up there. Oatmeal. So if someone's dealing with blood sugar dysregulation, and it's also a balance, so when she dropped it down under 100 and then down to 75, and so she was playing with the level. She said, I don't feel hungry at all. I'm not tired in the afternoon. Well imagine that, the blood sugar drops.
And my colleagues say I visibly look leaner and I've had to go out and buy a whole new set wardrobe for the summer because I've dropped at least a size. So I said, Hey, and what I do with people that, you know, the one on one work we do, I have a weight loss program, but that wasn't a weight loss program.
I was just teaching someone how to eat for their metabolism.
JJ Virgin: But the reality is you have to get metabolically healthy to be able to burn fat. Everything that's going to help someone lower their biological age. Is going to help them become metabolically healthy. If they become metabolically healthy and they're eating the foods that are satiating like protein first, all of a sudden they're like, Oh, and what's awesome is like you, what [00:34:00] you just described is weight loss was a benefit.
And I'm assuming because she had to go buy a new wardrobe, it was fat loss.
Dr. Rajka Milanovic Galbraith: Yeah, it was fat loss.
JJ Virgin: The last thing that a woman really needs to do is lose weight. Like, that's important thing we've got to get through to our gals is quit trying to be small.
Dr. Rajka Milanovic Galbraith: Yeah, I think there's a couple concepts we haven't touched upon.
I think your audience may not know about for just improving biologic age and aging and pace of aging. That I think would be interesting if you're open. Oh, heck yeah. I love it. Well, we touched upon a little bit. I think there's two little well known glands and I'll tell you why each is important. So we said that, you know, having terrible sleep ages you very quickly.
And so the pineal gland really deserves a little special attention because there are ways to support it with peptides. So that's something I've been utilizing in patients. And believe it or not, you can reduce that biologic age and you can. Decrease that [00:35:00] mortality by a lot and then improve outcome. And so again, the pineal gland produces melatonin, helps us sleep.
And the top three things that kind of shrink it quickly are sleep, obesity, and then unfortunately, living plus equator. Now I try to figure that one out cause they're getting a ton of light, but I think their sunset and sunrises are very fast. So I don't know if it's allowing the brain to process the changing of when they should be shutting melatonin on and off.
So I couldn't figure that one out, but those are the three. And so there are things people can take that will support that, the aging of the pineal gland. So I think that would be really important for people to even have that notion or that concept that, hey, we can provide you with something that will support that.
And in fact, they treated a group of 60 to 74 and they were able to reduce it. Mortality rate by 50%, the same that they found if you reduce biologic age by seven years. And then they even did that same study. And by dosing, you're giving [00:36:00] two courses a year for three years. And they follow these people for 12 years.
And that's the reduction in, in mortality and improved quality of life that they saw. So I'm like, well, that's kind of a no brainer is do two courses a year for three years and nothing further, you're going to get great gain.
JJ Virgin: And this was two courses of a specific peptide for your
Dr. Rajka Milanovic Galbraith: pineal gland. Yeah. It's called, and just for clarity, it's called epitalamin, but yeah, it supports the pineal gland.
So. How long is the course for? 10 days. So two 10 day courses. Does it do anything?
JJ Virgin: Cause as part of the problem with the pineal gland, this calcification that is happening. Cause I mean, I've been hearing some crazy stuff about what some biohackers are doing to try to break up this calcification. I'm like, whoa.
Dr. Rajka Milanovic Galbraith: I'm not certain it was on that at all. That's a great question. So I'll have to, I'll have to look that up for you.
JJ Virgin: And how much could someone. And how quickly could someone lower that biological age? So they take the true age test, which it seems like [00:37:00] there's kind of a nice little entry in quiz where you could look at, okay, let's look at some of these things that we've seen now in people who have a high biological age.
Where do you score in that platform? Okay, let's go do the test. And then like, how quickly can someone reverse that accelerated aging?
Dr. Rajka Milanovic Galbraith: You can re measure that whole test in six months. So you can drop it by a few years in that six month timeframe. So there's some gazillionaire who's lowered it significantly, but he is also Is that that weird guy
JJ Virgin: in Silicon Valley who's doing all sorts of obsessive stuff?
Dr. Rajka Milanovic Galbraith: I read that and I'm like, I don't think you need to spend a million dollars a year to Revert the age or to lower your biological age. The funniest
JJ Virgin: part is the majority of things you've talked about, it's really what you're doing is going through, it's getting the test. And I know the test really looks at very specific areas.
So you can target the treatments. But a lot of these treatments are lifestyle. Like, I don't know what he's spending a million dollars on. What's the other one besides this [00:38:00] pineal gland? Yes.
Dr. Rajka Milanovic Galbraith: So the, the thymus gland, which is actually, it sits behind our breastbone. Same thing. It's pretty small gland. And as we hit puberty, it starts to be infiltrated with fat and involute.
And the role of the thymus gland was to protect us from infection. And the thymus gland actually utilizes a lot of our energy. So it keeps us alive to about reproductive age. And then it says, okay, I'm giving you the chance to reproduce, bye bye. And you know, that's why people didn't age very well back in the day until we had all these advances in medicine.
And there are things you can do to support that. And so they actually, in that first study where they study those elderly patients, they included an older group of patients when they took the 75. To 85 year olds. And what they did with them was gave them the pineal peptide and they give them a thymus peptide.
So they combined them and they got 48 percent reduction in the mortality. They gave them two courses a year for three years, but they followed them only for six [00:39:00] years cause they were much older.
JJ Virgin: So a couple things, number one, just let everybody know who's listening. What are peptides?
Dr. Rajka Milanovic Galbraith: So peptides are actually amino acids.
So they're breakdown product of protein. Our body, there's, you know, 7, 000 plus naturally occurring ones, and they've been utilized probably since the 1970s. And what they do is they improve the messaging between cells. So the function, the way your cells function. There's various ones that have different functions, but they can improve your production of growth hormone and therefore all your hormones without actually giving you hormones.
So where I'm seeing benefit is they can improve exercise recovery. And so that's something a lot of people talk about as age. Well, it takes me a few days to recover. I can't just. As hard as I used to and very limited side effects, which is nice. And there's one that's probably being overutilized. So insulin is a peptide.
And you know, the one I'm talking about for weight loss being overutilized. I mean, it [00:40:00] certainly has its role, but that's not the one I'm top.
JJ Virgin: But I think that's important for people to realize that these types of peptides, like I always call it semaglutide, they said the other way. I'm like, oh, I can't even say that.
But it just shows how powerful these things can be. Right. I actually have a bunch of friends who are using this, which blows my mind. I'm like, this is not for the person who needs to lose 10 pounds. Stop it. It really feels like these peptides, like this is going to be a whole area of medicine. Now, are peptides something that you could use in place of having to do, say, bioidentical hormone replacement, or could they possibly get your body working so you wouldn't have to do those things or, or not?
Dr. Rajka Milanovic Galbraith: So the role is some people just don't want to do a bioidenticals where they're just opposed to them or maybe feel like their risk is higher or don't want to assume the risk. Even with bioidenticals, the risk is not so great where there's so many good benefits, but. For sure, you'll decrease, you'll end up decreasing the amount of hormones they need.
So that's a benefit too. So they're just naturally producing it. That's a great [00:41:00] question. Yeah,
JJ Virgin: this is a very cool burgeoning field that I think is about to explode in the next couple of years. Very exciting stuff. So, You've given us, I think the most important concept, which is your physical age is not necessarily your biological age and that honestly, you gotta know what your biological age is because it's like a life or death difference.
And you did my test and, you know, I think I'm a super healthy person. I've had a lot of stress, but beyond that, I don't even remember. Like it wasn't great.
Dr. Rajka Milanovic Galbraith: You're under that seven years, but we were in that same boat. And you know, that's what governs that biologic age is that everything leading up to this.
It governs how old we are, but you can change that. Now that we have that data, we can say, all right, we're going to do something about it. And we can drop it. You know, if you drop it in that three to six months, by a few years, you're already healthier and you just keep going.
JJ Virgin: Yeah. I was just looking to see if I could pull it up.
Cause I remember looking and going, what? Well, there's intrinsic age and [00:42:00] extrinsic age.
Dr. Rajka Milanovic Galbraith: So one measure is biologic and that's where you measured a little over, as did I, you know, that was the lifelong sleep deprivation for me with medical training. Children. And then you can measure how fast you're aging in a given time period.
And that's over the last three months. So both you and I were aging slower than one year per year. So that means what we were doing the three prior months. was right on the money, so we just needed to do more of it. And then the immune age that looks at how is that thymus gland functioning, you want that younger, but the key thing to note there is you can measure two immune subsets of cells and that ratio, what they found is no 100 year old has a ratio less than 1.0. So, if you see that in someone who's 40, so I have a 40 year old that's less than 1. 0, you have to say, what's driving that? You know, a simple thing would be vitamin D. That supports the immune system. And then all the way up, making sure there's not an infection going on and then [00:43:00] considering the thymus peptides.
JJ Virgin: It's an interesting approach because it's From everything I'm looking at here, instead of going and doing all your labs, if you started here, it would show you where the dysfunctions were, and then you could specifically target them, and that would get you metabolically healthy. And I've always talked about, because anti aging to me sounds like you just died, so it's like, well, don't we want to de age?
And this truly is de aging, what you're showing here. And very specifically how to do it, which is super cool. And I can't imagine why anyone 40 plus wouldn't be obsessed with this because I think life just starts getting good around 50. So then you want to keep going.
Dr. Rajka Milanovic Galbraith: Yeah, absolutely. I agree. In many ways, it gets better.
JJ Virgin: Well, this has been fantastic. I'm going to guide everybody. You have so much great information, and I'm going to just push you to put together that quick assessment that can tell people if they should go deeper into testing for their true age because there were a lot of markers that you [00:44:00] indicated, so I'm going to just push you to do that, and then we're going to give that to everybody.
So you're going to be able to get that. I'm going to put that at jjvirgin.com/BIOage. And really, I think it's super helpful to think about all the things that could accelerate aging, because that's the last thing that you want to do. And the converse of this, of course, is what can you then do in reverse of it?
But. For so many of us, you know, the first thing is to look at what are those things that we need to look at not doing. So what could be impacting that biological age? We will have that for you. Again, I always like to look at what is the biggest picture here. And if the big picture is we start to look at this, we'll fix all the other things.
And it will give you a priority map, which is also important because there's so many things when you start to look at what you need to do to improve your health that you just get overwhelming and kind of get out the white flag and say, forget it. But if you really looked at, well, here's the top priority, and then you did that and that started helping you feel so much more energetic and younger that you [00:45:00] then just continue down the process.
Great. And that's what I see here that I really love is it gives you that individual priority map of what you need to do to de age.
Dr. Rajka Milanovic Galbraith: Yeah, that's why I love it too,
JJ Virgin: so. Yay. Well, thank you for going through it with me. I'm going to go back over my test again, too, because clearly I need to do some things. And I appreciate you coming on board.
And again, everybody, we will put that at jjvirgin.com/BIOage.
Dr. Rajka Milanovic Galbraith: Thanks for having me.
JJ Virgin: Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life to ensure you look and feel great. And more importantly, that you're built to last. And check me out on Instagram, Facebook, YouTube.
And my website, jjvirgin.com. And make sure to follow my podcast so you don't miss a single episode at subscribetojj.com. See you next time.[00:46:00]