ATHE_Transcript_Ep 623_Dr. Kara Fitzgerald
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.
What if you [00:01:00] could de-age a couple years, like 1 year, 2 years, 3 years, 5 years just by making some shifts?
It is possible and our guest today actually has done the research to show it and so we are going to be unpacking what are those foods and by the way, they're not what you're thinking they are. There's things that are de aging foods that are going to be new to you. I'm betting. But what can you do to de age?
That's what we're going to be talking about today with Dr. Kara Fitzgerald. She is the first ever recipient of the Emerging Leadership Award from the Personalized Lifestyle Medicine Institute in the recognition of her work on DNA methylation. She's a leading voice in the intersection of nutrition, epigenetics, and aging.
She has been featured in Prevention, Fast Company, MSN, Everyday Health, and many more. And she has a book, Younger You. You are going to want this book. You're also going to want [00:02:00] to take her bio age test and we're also going to give a couple other cool things that I will have at jjvirgin.com/youngeryou.
And again, it's younger you, reduce your bio age and live longer. And we are going to be talking about the study that she did where she showed that she could reverse bio age quickly, eight weeks, through some very specific interventions. And so that is what we'll be unpacking. We'll be unpacking, you know, what is bio age, what's the difference between that and chronological age and what things are very aging so that we can make sure that we stop doing those right away.
All right. I will be right back with Dr. Kara. Stay with me.
Okay. We are talking my favorite subject today, everything around how to reduce your bio age. And I am so happy that you're here, Dr. Kara Fitzgerald.
Dr. Kara Fitzgerald: Thanks. It's great to be with you.
JJ Virgin: Well, I want to ask the obvious [00:03:00] question. Is the, how did you get into this? Cause you've really gotten into this and I'm thrilled to talk to you about it.
Like, how did you get into the whole.
Dr. Kara Fitzgerald: Yeah, well, you know, it was because of our research. I'll go back a little bit before. So I'm going to say around 2013, 2014. You know, epigenetics was really gaining some ground in the literature, but also in my brain. So epigenetics is, it's all the, the chemistry that regulates our gene expression.
Basically epigenetics above the gene, what genes are on, what genes are off. And in that time, you know, about 10 years ago, most of the research looking at what genes are on and off was related to cancer. So the tumor microenvironment potently and powerfully hijacks our gene expression. For its own nefarious end.
So it will turn genes off that protect us from getting cancer. It will turn genes on that drive cancer forward. And at that time, a decade ago, there was no thing called [00:04:00] bio age reversal or, you know, this whole space that we're in now, but. I was stopped in my tracks at a certain point in time. I had to ask the question, how does functional medicine influence epigenetics?
Because clearly we do, and much of what we do has to support good epigenetic expression, but does everything. Like I just really started to want to translate this epigenetic science into clinical practice. We decided to design a diet and lifestyle intervention that would sweet talk gene expression. And we built it brick by brick based on our read on the literature for everything that could optimize gene expression.
And we did that. We released it in 2016. I presented it at the Institute for Functional Medicine. We put a white paper out. We just made this available for clinicians. And we used it in practice, and we saw good results. You know, it's a really clean eating, it's a smart dietary pattern by any measure, and we have a diet lifestyle [00:05:00] component.
But our big question was, are we moving gene expression? But at that time, you couldn't send in a little, you know, cheek swab and get an epigenetic panel like you can today. And it was a miracle, JJ, that Brett Eck, who was the CEO of Metagenics, he and I were dialoguing at an IFM AIC in San Diego around 2016.
And he was so enthralled with this intervention that we designed, they gave us an unrestricted grant to run a randomized trial using our dietary intervention. We finished that in 2019 and then we published, actually 2020, we finished close to when COVID hit. In 2019, while our trial was moving towards the end, the first study in humans showing biological age reversal, looking at epigenetics, specifically at DNA methylation, which we'll talk about in a sec.
The first study in humans came out to [00:06:00] show biological age reversal and this, at this point we were in our study. So, we were Measuring the epigenome, the methylome. We had all the ingredients to be able to look at bio age and we wanted to, but when we started our study, it was in the thought in our mind that we would be able to reverse it because it was thought at that time that it wasn't possible.
Like the key scientists, the guy who developed the first bio age clock was like, yeah, we can't do this in humans. So this study came out, and then as we crunched our data a little while after that, extraordinarily, I mean this was just so exciting, I can just still feel it, we were in McGill University and in Montreal and, and just.
We saw that we reversed bio age in our study population by over three years as compared to the control group. So you can just imagine it was a big deal. So an eight week diet and lifestyle intervention. Eight weeks,
JJ Virgin: three years. I mean, it's 16 weeks. Could you get six? Yeah, [00:07:00] yeah. If you do it for too long, you're just going to get two.
Yeah. Benjamin Button, you did it. The Benjamin Button diet. We have got to unpack all of this. But the big thing I think we better start with is, you know, we got to talk about the difference between it's obvious, but let's unpack chronological age and bio age and then really how do you determine someone's biological
Dr. Kara Fitzgerald: age?
So chronological age is the number of birthdays we've celebrated, the trips around the sun, and we can't. Change that, and that has been the most important number, but it's going to be supplanted by bio age. There's just no doubt about it. So chronological age, you know, is how old we are by number, but it's biological age.
It's the rate at which we're aging is where the rubber meets the road, you know, because clearly, I mean, you're biologically younger. There's just no doubt about it.
JJ Virgin: I like you so much. And I think, I mean, it, it ties into like lifespan, healthspan. Exactly.
Dr. Kara Fitzgerald: That's right. That's right. Because in the United States, the final 16 years for the majority of us, [00:08:00] our final, you know, almost two decades will be spent with.
Multiple illnesses on multiple drugs. Oh, that's so awful. It's the worst statistic ever. It's such a bad step. We do not age well in this country. In fact, our biological age is accelerated as compared to our chronological age. And we've got to turn that around. You know, we've got to choose, you know, to take control over what's happening with our rate of aging.
And we, and we have a lot of say.
JJ Virgin: Wow. Well, you said a very important word there. You said two important words, choose and control. Like you can choose and have control. I'm adopted and I know genetics. And I'd love to also address that part is like, cause I think people think genetics pay a way bigger role than they do, but.
You know, I'm adopted. I have my adopted dad and mom. So adopted dad smoked, drank five martinis every night, had high blood pressure. Always [00:09:00] stressed out, would come home every night, sit down, start eating like the canned peanuts in the jar that my mom would bring out for him, and literally start in on the martinis.
Then you'd have dinner, then you always had dessert, and you would always jokingly tell me like, bring me the butter to put on the cookies, right? And Literally would tease me about being a health nut. And then my mom, on the other hand, you know, golfed a couple of times a week, carried her bags, did all the housework.
So not like she didn't go to the gym, but she basically had her home gym. It was the home and she was moving, right? She was moving all the time, eating healthy and, you know, didn't smoke, would have one martini a night. Dad who always talked about when a ship would come in and the company that he worked for was gonna sell and then he'd have a boat and then life would begin.
And you know, when that company finally sold, my dad was at home in their bedroom in a hospital bed. Mm. He'd gone from two 20 to 150 dying of cancer. No big surprise, like yeah, yeah, he got lung cancer, you [00:10:00] know, but you know, it's 70 years old. My mom just passed literally two months ago and everyone's like, I'm so sorry.
I go, my mom was 93 up until about two months prior, maybe a month prior. She was fully independent. She did her grocery shopping. She lived in a house that you'd go up and down the stairs all the time. She had all her own housework totally there. And then just went, boop, slid. I was like, she just slid into home.
Exited and I was like, I call that a win. And I had no I, these 16 years, I can't. Wow. But that's what I say. It's like you saw the choices. Yes.
Dr. Kara Fitzgerald: That's there. Right. And it's the rare, rare, rare, rare micro exception. I thought you were going to give the opposite story where the George Burns the George Burns story.
Yeah, yeah. And I mean, we just have to be real on that. That is the absolute rare exception. And we don't even know really what those genes are. There's some big ideas, but. Our genes are not our [00:11:00] destiny. I mean, that's the bottom line. Our choices day in and day out, God, like those amazing choices. You know, there's actually research on housework and biological, you know, epigenetics.
I mean, it's funny that some scientists decided to study it. Did they do that so we'd
JJ Virgin: go back to start doing it again? Like, it's not going to make me start.
Dr. Kara Fitzgerald: No, I know. No way. But it's funny. I mean, it's just, it's a very real and effective way, you know, to keep yourself moving and keep yourself healthy.
JJ Virgin: Right? Well, think about housework as it used to be where they didn't have like the Roombas that did that. Like, yeah, right. And you actually had to do the stuff. So let's break that down between genetics, epigenetics, because I was listening to a podcast you did. I don't remember who it was with and she stated it was like 10 percent was genetics.
And I've been looking through the research. It looks like somewhere between 10 and 25 percent could be genetics. Which means there's a whole lot of choice and opportunity in there.
Dr. Kara Fitzgerald: Yeah, that's right. And I think it might even swing a little lower than 10%, but [00:12:00] that's right. What we're doing day in and day out, you know, with the choices that we make, how we live our lives and not just what we're putting in our mouth, you know, people will often ask me, was it the nutrition intervention that did the heavy lifting?
And it's easy to say yes. But the research on exercise is absolutely extraordinary. The research on meditation, on practicing yoga, the research on paying attention and doing something about stress, and the research on the stress experience driving it, like all of these, tons of good science behind them.
The way that we measured biological age, looking at DNA was a particular clock where a full 25 percent of it is influenced by glucocorticoid response genes, meaning 25 percent of this particular clock is driven by the stress experience. Wow. Yeah, exactly. And that really hit home to me as likely evidence or contributing evidence to how toxic, you know, excessive stress [00:13:00] is.
JJ Virgin: Here's a big question there. Well, there's two questions there. One's totally self serving. I admit it already. Is it someone's experience of stress? Because I remember having a client early on who was so stressed out because she had to put her daughter's bat mitzvah on. She was a stay at home mom. She lived in this big, beautiful house.
Her husband made great money as a doctor. And I remember at the time I was a single mom working my butt off with a special needs kid. And I'm like, that's stressful. Like you don't even know what stress is, honey. And I thought, but it's really your perception of stress, not the, you know, that's the problem, right?
Dr. Kara Fitzgerald: Yes. That's been demonstrated actually very elegantly. I talk about this in my book around, there was a, an ice storm in Montreal, it's called Project Ice Storm. It was a long, intense ice storm. I think people were, you know, I think it hit them for a couple of weeks. So not that long, but you know, a good chunk of time.
And women who were pregnant in Project Ice Storm [00:14:00] gave birth to. infants and kids who, who had higher rates of asthma and autism, and they were able to tease out physical stress and emotional stress and it made no difference. Wow. No difference. Isn't that extraordinary? It was how you perceived it or how you were literally experiencing it.
Both didn't make a difference.
JJ Virgin: Then if you train your body to be able to tolerate higher levels of Then, like, you could be in the same stress situation and not have that. But then, what about good stress? What about, like, exercise stress?
Dr. Kara Fitzgerald: Well, we know exercise stress is just ridiculously exquisite. And it's been argued that it exerts a lot of its influence on the epigenome, which obviously I'm like, okay, that goes with my work.
But it really favorably augments gene expression. Absolutely. Let me say something interesting, though, on the stress conversation. First of all, resilience to your point is something that hasn't been adequately studied. [00:15:00] What does the gene expression pattern look like for resilience? There's been a lot of investigation on what trauma looks like on like inheriting sort of predisposition to PTSD and stress.
It's like a lot of in the pathological stress and less in the resilience, but I think that will change and we can look at people who've survived and thrived. You can look at there's research on. tracking offspring of huge traumas like holocaust and there are different patterns, but there's more attention on those negative patterns.
So to your client who had such a hard time, we can come into this world with a lower threshold. We can inherit a lower threshold for our stress experience. And I think for that reason, we need to Go easy on, you know, how we perceive stress. Because we may have inherited some sort of a bias towards getting stressed at less intense things or less obvious things.
And even though we've inherited this, it's still changeable. Like, we [00:16:00] still have the tools to move through and move past that.
JJ Virgin: I look at that like, let's say that you Are naturally more of an ectomorph and naturally tend to have lower muscle mass and are more frail. Well, then you need to do more resistance training.
So then I would look at this and go, if you have a tendency to be more in flight or fight, to me more sympathetically dominant, well, then you have to focus more on meditation and things that are going to help there. You know, Cool. That makes a ton
Dr. Kara Fitzgerald: of sense.
JJ Virgin: Yeah. Yeah. And I see people who I go, gosh, that little thing, I think because of the level of stress I've had to undergo in my life, you know, I go, that little thing made you ups like that?
That, that didn't even like, I don't even recognize that
Dr. Kara Fitzgerald: as stress. But you know, it's pretty cool because you obviously have some kind of really neat resilience patterns going on. You know, you write books so people can learn from the habits that you're engaging in that have supported these resilience [00:17:00] patterns.
And perhaps you came into this journey with some resilience patterns built in. Just on this, another cool inheritable potential is exercise. Like we can actually inherit the benefit of. You know, our parents and probably prior generations, good or not exercise habits. It will influence our, I know. I feel
JJ Virgin: like for the first time ever, you know, my whole training all the way up to doctoral level was exercise physiology.
And then I always felt like this lowly exercise, but like, you know, nutrition and functional medicine was so much more interesting. And now as we start to look at aging, I'm like, oh, exercise is like the single most effective thing you could possibly do. I know it is. I do think. I'm a late bloomer in the meditation space.
I didn't start till 2021. I joke like in the pandemic when everything shut down and Dr. Joe Dispenza had a retreat. I'm like, I'll go there. And that's when I really dove into four of his retreats in less than a year and just went [00:18:00] into all of it. And I think I finally got out of flight or fight. I literally said, I've had shortness of breath since I was 20 years old.
But what I used to deal with all of it, I'm an adopted kid. I really think that I felt unsafe since birth, probably before birth, you know? And it has taken a long, long process to go through all of that. But what I used before meditation was just a lot of HIIT training, like exercise, almost like a wild animal shaking it off.
Yeah, that's how I would handle it, but it was so temporary.
Dr. Kara Fitzgerald: Wow. Yeah, but it got you, it got you here. It was sufficient enough. It's a great way to kind of keep you intact.
JJ Virgin: I remember when Grant was in the hospital, you know, in a coma and between life and death, I would go run up and down the hospital stairs because I was like, I just have to get this off of me.
You know, that was how I would deal with it. So the other side of that question, the self serving side of the question is, Let's face it, the last couple of years, especially people have had a lot [00:19:00] of stress, and I think for a lot of people, especially since stress has been such a difficult thing to quantify, you know, it's one thing to see high blood pressure or to see your blood sugar, which of course we could argue are all signs of stress, but stress itself is just still this amorphous thing.
And someone under chronic stress, can they undo the aging damage that that has done?
Dr. Kara Fitzgerald: I would say that the answer is yes, and I don't know that that exact question has been studied, but I'll tell you that we know that you can see epigenetic changes. You can see favorable changes with one meditation or one yoga event.
Like you can see this, and then practice meditators are just biologically younger. And then we can also look at acute stress experiences and see them as very pro aging. A surgery, giving birth, super pro aging. And then it [00:20:00] resolves and you bounce back. So my guess would be that you can turn around the damage of that chronic stress exposure.
Now the longer something is in place, let's say the epigenetic patterns, they're being And You know, every time a cell divides, that pattern is going to be shared and down and down and down. Like, so it's going to proliferate. I think it has the potential to become more entrenched the longer it's been happening, but we can get in there.
I mean, we already know that we can move bio age. Like we've already shown, you know, via a variety of interventions that we can slow biological age by enacting good habits. And we can change gene expression favorably by enacting good habits.
JJ Virgin: You're seeing that by doing a cheek swab, like what are you looking at to
Dr. Kara Fitzgerald: see this?
Yeah. So again, going back to epigenetics, we're looking at gene expression, specifically the epigenetic [00:21:00] mark DNA methylation. So DNA methylation, think about a strand of, you know, DNA and these little methyl groups, a carbon with three hydrogens, can be dotted on promoter regions, they can, of a gene. If there's a lot of, of these methyl groups in the literature, sometimes they're denoted as these red lollipops.
And so I just by habit, in the promoter region, there's a bunch of these red lollipops. And that gene can then not be turned on. These red lollipops can be removed or they may be absent from a gene and then that gene can be turned on. So that when the red lollipops are present, the gene is basically blocked.
When they're not there, the gene can be turned on. The way that we measure these red lollipops is when, in our original study, we used saliva, but we've since moved on to blood. So you can use a variety of different specimen. And I would say The best specimen to use right now in our current state of the state is blood, but saliva is still, you know, still available and I think it's pretty good.
JJ Virgin: And when you see these tests, [00:22:00] is it like, you know, with hormones, it would be you could take a test one hour and take a test the next hour and see different measures with changes in your epigenetics. Is it more stable?
Dr. Kara Fitzgerald: Yeah, it really should be, you know, it should be. And depending on the clock, so there, you know, once upon a time there was one, you know, one or two clock, not that long ago, there were not that many clocks, but we're up to what's being referred to as the third generation collection of clocks.
Some of them can change pretty quickly. Like the one that we're using these days, it's been just researched really nicely is called the pace of aging. And that can change, you know, consistently pretty quickly. I want to say though, we showed in a clock that wasn't supposed to change quite so quickly, pretty profound changes in a short order of time.
So we used a first generation clock. We used what they called the Horvath pan tissue clock. And we did show changes in that, as did the other study that predated us, the TRMM trial. They used that clock as well. So Our interventions [00:23:00] were strong enough to make a difference. But I think day to day without changing variables, like if you just consistently measure yourself and you're doing the same thing, you're not going to see shifts.
But intentional shifts can change them. So
JJ Virgin: let's dig into this study. What I'd love to know is what you did And then has there been new research that would make you do anything further or different? So like, how did you guys design this? What were the big needle movers that you put in
Dr. Kara Fitzgerald: there? Okay. So again, you know, like I said, we really scoured the literature for what changes gene expression, specifically DNA methylation.
That was what we were interested in. And we designed a diet with two nutrient components. methyl donors. It's very, very dense in the ingredients that make those lollipops. When we age, we don't produce those lollipops as efficiently and we wanted the diet to be dense in methyl donors to support DNA methylation.
There's also another class of [00:24:00] nutrients that we just colloquially termed methylation adaptogens. And these guys are well known. These are the beautiful polyphenol compounds like curcumin, resveratrol, luteolin, sulforaphane, lutein. And on, you know, alazic acid, probably, you know, urolithin A, like all of these beautiful polyphenol compounds, genistein, that seem to, they don't move methylation, they don't make the lollipops, but they seem to sweet talk where those lollipops go.
So they seem to support Methylation happening on the right gene in the right way. It's just such a cool concept. So it's the combination of these nutrients that we loaded the diet up with. It's loaded. We didn't give any supplements in our study and our participants increased circulating methylfolate significantly as compared to our group.
Yeah, they did. So we pushed it forward. How did you make
JJ Virgin: sure that they were staying? I mean, obviously if that happened, they were staying compliant, but I'm assuming they weren't like living in a lab together. So how did you make sure [00:25:00] that they were getting what they were supposed to get?
Dr. Kara Fitzgerald: Sticking to them like glue.
I'm like, you know, I'm not going to be getting six figures grants, you know, go ahead, you know, study it again. Gara study does diet and lifestyle. People were blown away that we had gotten it. It's such an extraordinary gift because. Funding for nutrition, diet, and lifestyle interventions just doesn't happen.
So we had our nutrition team. We have an amazing nutrition team here. A requirement built into the study was that they met with a nutritionist weekly. And the nutritionists didn't do coaching as we usually do in practice. They had to follow a really dry script that was approved by the institutional review board.
Did you do this? Did you do this? Do you have any questions? So they didn't even do motivating talk, but that contact, that consistent contact, I think made the difference between adherence and not. And we had really high adherence rates. This was an eight week, an eight week intervention.
JJ Virgin: Give [00:26:00] me some examples of some of the foods that you were having them eat.
Dr. Kara Fitzgerald: So, methyl donor nutrients are, if we'll just get to the worst, liver. If you're willing to do it, liver is a seriously potent epineutrient. And anyway, we call all of them now epineutrients, the methyl donors and adaptogens. So liver is a huge player if you're willing to do it. We have since switched to caps because people just do
JJ Virgin: much better with capsules.
I've been using this seasoning. Pluck from the, from James Berry I've been using, which I was like, this can be gross. It actually tastes great. So I was like, yeah, I can do this. Yeah. Yeah. Cool.
Dr. Kara Fitzgerald: Yes. I know. I know. I know. It's the rare, it's the rare human of all of the adherence data we have, liver was the worst, but yeah, go to CAPS.
It's easy. It doesn't have any taste. It's just the texture is just icky. Yeah. Icky texture. Seeds, particularly pumpkin seeds, sunflower seeds, greens, lots and lots of greens. There's about nine cups of veggies, between seven and nine. Beets, because we want that. Betaine, [00:27:00] which is what will help make those red lollipops.
Meat, you know, we want you to have some protein. Methionine in animal protein will help produce those. Mushrooms, I mean, who knew? Mushrooms were such a brilliant methyl donor superfood. They have choline in them. We wanted people to do eggs. So those are the main, some of the main players. Actually, salmon is in there too.
We know that omega 3 fatty acids can help with methylation. So those are the methyl donors. They're making the lollipops. And then the adaptogens are directing where they're going. And so we had people consume green tea. They needed to have turmeric daily. We wanted them to have blueberries or other good berries.
We wanted them to eat cruciferous veg, colorful veg. Just the dense polyphenol nutrients, we wanted them to have multiple servings per day. They hydrated, they ate good fat, this was a low glycemic, anti inflammatory eating pattern. A little bit ketoleaning, and we saw that we were successful in that. We didn't want it to be [00:28:00] a ketogenic diet, but we wanted it to be ketoleaning.
We dropped triglycerides in our participants significantly, which suggests they were probably in just a modest bit of background ketosis. And those are the main pieces of the dietary pattern.
JJ Virgin: Before we go off the food, I just have to ask your opinion because it is making me absolutely nuts. And I was talking to our buddy Deanna Minnick about this.
I brought her on. I was like, can we please talk about the vegetables are our friends? It was, you know, it's like 40 years of being in this, watching different things be vilified all the way through. And I'm like, and like the one thing I always said, you know, the one thing I think if you put everyone nutrition word together, we'll agree on water and vegetables.
I'm like, nope, not now. So what do you say about some of the bad raps we're getting now with lectins and oxalates and all of this?
Dr. Kara Fitzgerald: It is a high oxalate eating pattern, so kidney stones I would say you want to be mindful about. But yeah, we're in a, I mean, I guess it's [00:29:00] just the internet, you know, social media driven weird time where foods are vilified in, in fairly esoteric ways.
I don't think that there's good evidence for, you know, lectins driving this toxicity story that's told about them. Maybe the rare individual could be sensitive. Probably it's a GI issue. Probably they're not breaking them down. They're not, you know, enzymes are at issue or something like that. But yeah, the data don't support it.
And in fact, we know people who are alive today living very long, healthy lives and all those blue zones are loaded up on lectins. We kept them out of the eight weeks. This has been a big question from people to us. We kept them out of the eight weeks because we wanted to omit GI issues as much as we could, you know, bloating, gas, et cetera, that can happen with a high lectin intervention if it's new.
And we wanted to minimize glycemic cycling. You know, we, as I said, we had it a little bit ketolening. [00:30:00] But we want people to reintroduce them after you're done. So this eight week intervention isn't your sentence for the rest of your life. It's just do it for the eight weeks and then move on with it. If it's a dietary pattern that works for you, stay with it.
But you know, you certainly don't need to. I think it's wise to bring those lectins in. There's just really nice research on them. Yeah,
JJ Virgin: I love what Dr. Will Lee's done with eat to beat disease and eat to beat your diet because he just goes through all of this in such great detail. From a guy who used to formulate pharmaceuticals, like looking at all the compounds and plants and it's like, well, what if these supposed anti nutrients, like Look at Dr.
Jeff Glantz. It's like the resilience of the plant is what's doing something great for you. It's
Dr. Kara Fitzgerald: awesome. It's an epineutrient extraordinaire. And we actually feature a recipe for it and I talk about it in the book. There's just no doubt. I'm bullish on Himalayan Tardigrade buckwheat for sure. So
JJ Virgin: beyond diet, was it just a diet?
It wasn't. It was lifestyle stuff too,
Dr. Kara Fitzgerald: right? Yeah. And I should say we had a very modest [00:31:00] Time restricted eating structure. 12 hours on, 12 hours off. 'cause you mean the way we normally should eat? Yeah. Like the way we normally Yes, that's right.
JJ Virgin: Like when they called it intermittent fasting, I'm like, why did that have to become a fast?
That's like, that's so funny. Yeah, normal eating before we got into the, like the Taco Bell fourth meal and all the snacks, garbage.
Dr. Kara Fitzgerald: Oh my gosh. That's super funny, jj. Yeah, it's true. So a normal eating pattern. So additionally we wanted people to exercise. So again, meeting people where they're at, you know, you don't need to move into hi.
You do it, all of that is good, and I go into detail in the book, but for our intervention, it was just 30 minutes, 5 days a week, minimum, with a perceived exertion of 60 80 percent of your max. So breathing a little heavier, you know, maybe perspiring a little bit and do whatever you want. And I did mention the house cleaning study in our book because, you know, do whatever the heck you want.
Like my mom gets to her 60 to 80 percent gardening outside, you know, and then she zooms around the block [00:32:00] a couple of times. I mean, we just do what we want. The most important thing is doing it, you know, whatever that looks like. I do think that there's a place for, without question, resistance training and high intensity interval and all of that for sure, but entering into the conversation, just
JJ Virgin: start.
Yeah, these things just have to be super simple and easy to comply with. And I love that it was, you know, the rating of perceived exertion, because that means it wasn't just simple walking. It was like you had to push yourself a little bit.
Dr. Kara Fitzgerald: Yes. And it's cool that perceived exertion is a reliable measure.
You know, it actually is a validated, reliable measure. When you think you're at your 60%, you probably are. Anything else besides that? What about stress? Yeah. So we prescribed a twice daily relaxation response protocol developed by Herbert Benson. So he was basically studying meditation. at Harvard. And, you know, when meditation was somewhat of a bad word, I guess, when he started, and so he referred to it as the relaxation response.
And we used his method just because it's been well [00:33:00] validated. Ten minutes, twice per day, we wanted our participants to do. And then we gave them a probiotic. We gave them lactobacillus plantarum. Because a healthy gut will make a multivitamin, first of all. And there's some evidence that lactobacillus plantarum will specifically support folate production.
So we used a lactobacillus plantarum and then we used an additional greens powder. So another hit of fruit and veg. So just to underscore how important I think that they are, you know, we added some more in and we quantified the polyphenols in our intervention and People are getting about up to 3, 000 milligrams, close to 3, 000 milligrams per day, which is a massive amount.
There's other research coming out now using polyphenol interventions like the Mediterranean diet and there's something called the Green Med, which is sort of a polyphenol jacked up Mediterranean. And they are. You know, not close to what we were prescribing there and they're getting really cool outcome.
I think the green med is at about 1, 200 milligrams, 3, 000 milligrams is a, you know, it's just a whopping [00:34:00] amount. And that probably that's a piece of why, you know, we saw this turnaround, I think, in such short period of time.
JJ Virgin: You know, though, when you eat, like I'm looking at the diet and it's good protein, lots of vegetables, little bit of fruit, some healthy fats.
Yeah, that's right.
Dr. Kara Fitzgerald: It's not rocket science. And
JJ Virgin: so I would imagine. That people felt remarkably better, fairly quickly doing this as well. What did they do at the end of eight weeks? Did you, do you happen to know one of the things that used to drive me crazy with doing TV reality show stuff is like our time with the people would end and I'd go, okay, now what are we going to do with them?
And they're like, oh, the season's over. I go, no, no, no, we can't like. You can't just let them go. We, we need to keep working and follow. And it's like, nope, no budget. I'm like, Oh my gosh. I know. That's crazy. Like dagger to the
Dr. Kara Fitzgerald: heart. Yeah, it similarly. So I didn't have the foresight at the time to build into study design, [00:35:00] continued contact, cause we, you know, it would have been awesome if we had the A budget and B design to allow for continued contact and a follow up.
You know, biological age test, like six months out, a year out. That would be a different design today for me. However, at the very end, they amended the, you know, some of our documents where they could join a Facebook page. So folks were told and invited over to Facebook page and we had a handful of the participants, you know, stay with us there for a while.
And yeah, for those that stayed in context with us, it was a life changing event. You know, it changed their eating patterns. It changed their lifestyle habits. Although, I will say, people came to us healthy, so we only recruited healthy middle aged men. And we'll talk about women in a minute, but for this particular pilot study, since we were looking at middle aged, we omitted women because we're in transition time.
Some of us are still menstruating, and some of us have been in menopause for a long time. And [00:36:00] given that it was a small, it was a pilot study, that would have been a tough variable for us to See through and identify, you know, true changes that weren't influenced by hormones. So we limited it to middle aged men, so they were fully into the aging journey, but we wanted them to be healthy, which actually lends kind of a cool extra bit of energy to our intervention.
Cause we weren't treating a disease process. We were actually taking already healthy men and making them. So they came to us with good habits at baseline. And then to my knowledge, many of them adopted what they learned through us and sort of carried that on. It would have been cool to, to see. I mean,
JJ Virgin: it was like, if you take an unhealthy, you would have really seen a shift,
Dr. Kara Fitzgerald: right?
So that's right. We know that, you know, disease is pro aging period. I mean, that's why we're aging at an accelerated rate in this country. Diseases are pro aging. So if we turned around the metabolic syndrome or turned around a diabetes or something like that, yes, we would see at baseline, they would be older epigenetically.[00:37:00]
And then at, you know, at conclusion, if they really hung in with the intervention, they would be definitely younger than they were at baseline. Our participants started their intervention biologically younger than their chronological age. And so that's a good piece of evidence that they were, they came to us healthy.
It's easier to
JJ Virgin: work with healthy people. They get more motivated to get even healthier, but boy, it's just like when you take someone who's never exercised and start them exercising and this dramatic thing happens, like you take somebody who's worked out their whole life and you're like, yeah, we can get a little bit, we're not, this isn't going to be dramatic.
That's right. What about women then?
Dr. Kara Fitzgerald: Yeah. So what about us? Well, we published earlier this year, a case series looking at women and they actually responded. You know, better. Their bio age reversed by a little over four years on average, but we were using a slightly different method. We were using blood. So it's not quite an apples to apples comparison, but you know, it's pretty cool to see the ladies rocked.
We've used this intervention, you know, in our practice and in the groups [00:38:00] that we're running and in our research that we continue with plenty of women and women just really seem to respond well. I will say in general, you know, we're biologically younger than men until we hit menopause, unfortunately, and then we catch up.
Menopause is a pro aging phenomena, and unfortunately, the earlier it happens, the more we're hit with the pro aging effect. So I would say that that is The big piece to think about in perimenopause and menopause, I mean, I wouldn't have said this, you know, in my 30s as a naturopathic physician, but there's no doubt the literature supports really considering bio identical hormones.
I mean, was just going to ask about that. I was
JJ Virgin: like, well, couldn't you just offset that by, yes, bio identical hormones.
Dr. Kara Fitzgerald: I mean, I really think that there's, there's just no doubt about it. We need to be. We need to be using them. And I think the safety profile, I think the era of the women's health study. I mean, I think we're [00:39:00] past that bad science.
I think we've challenged it sufficiently. We've got bioidentical forms. We know how to do it safely. We can measure metabolites. We can take different interventions to support metabolism, et cetera, et cetera. Like we know how to do it in a smart, healthy way now, and we can preserve our brain health, our heart health, our bone health, skin, you know, just you name it.
JJ Virgin: Well, what would be really interesting. is to have three groups on the intervention group. One would be no bioidenticals at all. One group would be bioidenticals. They'd been on them and the next group would be eight weeks with no bioidenticals than eight weeks with bioidenticals to see the difference.
Cause you know, it was interesting. I just did a talk out in Austin. This woman came up and she goes, I've been doing all the things you talk about. She goes, I've been in menopause five years. I just can't get. And I want to do it naturally and I'm like, hormones are natural, you know, I'm like, give me a break.
Now you're throwing 10 tons of supplements on it. What is the difference? You know, it's like, come on. [00:40:00]
Dr. Kara Fitzgerald: Yeah. I think when I went to school, there was still that cautious pause. I mean, we were trained in it, but there was still that cautious pause. I just, I think we'd really moved past
JJ Virgin: that. Gosh, you look at the heart, brain and bone situation without hormones and it's pretty darn clear.
Yeah. If you were going to give someone the perfect formula for what I would call de aging, what would it look like?
Dr. Kara Fitzgerald: There's two conversations to have here. There's our intervention. There's the lifestyle intervention. I think our diet is essential for any eating pattern. We need to be incorporating some components of around what we studied.
So there's the lifestyle piece. Like we have to be exercising and we have to be exercising more than we think we should. Now, I like Peter Itea's idea of, you know, project what you want to be doing when you're centenarian decathlon. Right. Project it, and then design it now. And if we want to be carrying our grandbabies around, if we want to be like your mom, walking up and down stairs, [00:41:00] like if we want to be living this big life, flying, you know, hiking, etc.,
we need to have the muscle mass today. I mean, I think that's a really cool and powerful way to think about it. And so, Our minimum intervention of 30 minutes, five days a week isn't enough. Is it enough to get you started if you're not exercising? Heck yes, of course it is. It's incredibly important, but as you really embrace the longevity journey, you need to turn the volume up there in some really, you know, specific ways.
We need to be eating these epineutrients. Like every forkful of food has to be bathed in this epineutrient information. There's no doubt about it. Now, can we tweak it so that it's appropriate for us? Maybe it's more vegan, maybe it's meat heavy, whatever. Of course we can, but this information we need to be giving all the time.
Stress is toxic. Excessive stress is toxic. And so we've got to be thinking about how to remedy that. You know, the connection, community. Sometimes I joke if there was one other piece I would have added in the study, it would have been You know, hugs and community in the study group and [00:42:00] then nothing. Yeah, right, right.
But I would do, yeah, can't really control for that. So, all of those things are ridiculously essential. Biodentical hormones, maybe for some people, for some people, obviously, there's caveats. I think metformin is an appropriate intervention. I think the research coming out on rapamycin is, you know, is pretty cool.
So, there's things that we can be thinking about today. And then, as my friend, Sierga Yen, talks about, there's this longevity bridge. I mean, there's some pretty radical stuff on the You know, on the horizon. I mean, it does appear that these predictable epigenetic changes. These changes to DNA methylation patterns, you know, that drive biological age forward or backwards, it sits at the core of the aging phenomena.
And there's, you know, scientists like David Sinclair, Vittorio Sebastiani, who out of Stanford, who I podcasted with, you know, reversing bio age. Profoundly in cell models and in animal models using changing DNA methylation. So there's going to come a time when that will translate into humans. [00:43:00] So right now we've got to do all the stuff that we know, and there's some pretty wild stuff on the horizon.
And here's
JJ Virgin: what's cool. The basics don't cost money. Yeah, that's right. Available to every like meditation, exercise. And eating methyl donors and methyl adaptogens, these were not expensive foods that you just talked about.
Dr. Kara Fitzgerald: You know? Yeah, that's right. And you know what's cool? In our study, we didn't require people to eat organic.
So arguably you can get these results if you can't afford organic food. So to your point, you know, wow. Yeah. I
JJ Virgin: know. Yeah. Although you can now get the organic food at Costco. So I mean, it's like it's so much easier to get
Dr. Kara Fitzgerald: all this stuff. That is right. Yeah. Especially in this country. Actually, in other countries, they have more organic food
JJ Virgin: than we do.
You know, every time we travel, we're like, how come we at home get ButcherBox, Vital Choice, BuyOrganic, do everything else. The minute we go to Europe, we're like, I feel so much [00:44:00] better. You know,
Dr. Kara Fitzgerald: it's like, I know. Yeah. They're doing something right already. Yeah. So it's very, it's a doable today. And it's, and the ball's in our court.
It really sits in our court. It's a choice.
JJ Virgin: As you said at the beginning, it's a choice. We have a lot of this under our control. And I know that everybody listening is going to want to know there. bio age, and that you also have a supplement guide that you'll be giving everyone. So I'm going to put that, I'll put the connection to your Younger You book, connection to the quiz, your supplement guide.
I'm going to put that all at jjvirgin.com/youngeryou. And thank you so much for coming on.
Dr. Kara Fitzgerald: Yeah, it was great to, it was great to connect with you. I hope it helped. See you in real life, and then that's a distant future
JJ Virgin: soon. All right, thank you. 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 [00:45:00] follow my podcast so you don't miss a single episode at subscribetojj.com. See you next time.
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