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Your Genes Load the Gun. Your Environment Pulls the Trigger. Here's What the Science Says · The LIVING Room Podcast | Inside The WNDR Lab

0:00
SPEAKER_01: If you go into a doctor right now and you're in the doctor's office, you are the result of all those past exposures.
0:07
SPEAKER_01: And so essentially, you are keeping the tape recording of your past exposures.
0:12
SPEAKER_01: Epigenetic changes that occurred because of a stressful situation.
0:15
SPEAKER_01: It's still there.
0:16
SPEAKER_01: The nonstick cookware, it was all about you don't have to use as much fat and oil.
0:20
SPEAKER_01: So you're gonna trade in using olive oil for a chemical to prevent that.
0:24
SPEAKER_01: And it was like one of those shortcuts we took that we didn't really need to take.
0:27
SPEAKER_01: When you push people and avoid grapes or bananas because there's pesticides, they don't eat grapes and bananas.
0:33
SPEAKER_01: But there's a net benefit in eating grapes and bananas, even if there's a pesticide residue.
0:37
SPEAKER_01: If you looked at all-cause mortality, the polyexposome assessment had a much higher prediction of someone dying than their genetics.
0:45
SPEAKER_00: I've heard you say on a call before that genetics loads the gun and the exposome pulls the trigger.
0:52
SPEAKER_01: For a long time, people have thought your genetic makeup sets up your baseline, but then it is the environment that acts upon it.
1:00
SPEAKER_01: What drives natural selection and evolution is the environment.
1:08
SPEAKER_00: Today's guest is Dr.
1:09
SPEAKER_00: Gary Miller, a professor of environmental health science at Columbia University.
1:14
SPEAKER_00: He's the founder of the first dedicated Exposome Research Center in the United States, and is the founding editor of the journal Exposome, published by Oxford University Press.
1:23
SPEAKER_00: Gary is one of the scientists who's helped define the entire field.
1:27
SPEAKER_00: He's one of the world's leading voices on something that most people have never even heard of, but that may be quietly shaping every single aspect of your health.
1:35
SPEAKER_00: The exposome.
1:36
SPEAKER_00: While we've spent decades obsessing over genetics, Dr.
1:39
SPEAKER_00: Miller's work asks a more uncomfortable question and arguably more important.
1:43
SPEAKER_00: What about everything else?
1:44
SPEAKER_00: From the air that you breathe to the chemicals you're exposed to, to the environments you move through every day, these invisible inputs that may be driving disease, aging, and performance far more than we realize.
1:55
SPEAKER_00: This is a conversation about the things that you can't see, but that may matter the most.
2:00
SPEAKER_00: I want to start a bit by trying to get a better understanding of this term exposome.
2:06
SPEAKER_00: I think most people listening, including myself until relatively recently, won't have heard of this term or understand what it means.
2:12
SPEAKER_00: So maybe that's a good place to start.
2:15
SPEAKER_01: Yeah.
2:15
SPEAKER_01: So the idea came about almost 20 years ago by this person named Chris Wilde, who worked for the World Health Organization and ran the group that oversaw like all the carcinogens and how World Health addresses that.
2:29
SPEAKER_01: And it was at the time where the human genome had advanced quite a bit.
2:33
SPEAKER_01: And he'd seen how that had helped advance our understanding of like the genetic causes of cancer.
2:40
SPEAKER_01: And he thought we need the environmental equivalent of that.
2:43
SPEAKER_01: And he coined the term exposome for this environmental equivalent of the ex of the genome.
2:49
SPEAKER_01: The problem, though, is that when he proposed that in 2005, we couldn't do it.
2:56
SPEAKER_01: The technology didn't exist to actually pursue it in that way.
3:00
SPEAKER_01: And it's really only been like the last five or 10 years that the technology's got to this point where we can systematically study not three or four different types of exposures, but hundreds to thousands of exposures at the same time.
3:15
SPEAKER_01: And so the idea of this is that we're trying to get a comprehensive analysis of the non-genetic factors that impact our health.
3:23
SPEAKER_00: And so is the intention to map those out in the same way as you would the genome?
3:28
SPEAKER_00: Not in the same way, but you know, to get a clarity of the exact example.
3:31
SPEAKER_00: Exactly.
3:31
SPEAKER_01: Like we want to have the same level of resolution.
3:34
SPEAKER_01: The mapping will look differently because you have one genome throughout your entire life, but your exposures change throughout your life.
3:41
SPEAKER_01: It's much more dynamic.
3:43
SPEAKER_01: And so how we map it is different, but we still want to have that very comprehensive analysis of these exposures.
3:50
SPEAKER_00: And so when you say exposures, what does that mean?
3:54
SPEAKER_01: Very broadly, I you know, from my view is that it's any of the external forces acting on our bodies.
4:02
SPEAKER_01: So this includes what's in the air we breathe, the water we drink, the food we consume, the social sort of dynamics around us, our relationships and work pressures and things, um, the medications that we take, the supplements that we take, uh, if we consume alcohol or tobacco, these are all part of your exposome.
4:23
SPEAKER_01: And they all have differential effects on our health.
4:28
SPEAKER_00: I've heard you say on a call before that genetics loads the gun and the exposome fires the trigger, pulls the trigger.
4:37
SPEAKER_01: Pulls the trigger.
4:38
SPEAKER_01: Um, I think that this is something for a long time people have thought like your genetic makeup is really kind of sets up your baseline, but then it is the environment that acts upon it.
4:48
SPEAKER_01: And if you, you know, thinking about going farther back in genetics and thinking about um evolution, is that the what drives natural selection and evolution is the environment.
5:00
SPEAKER_01: The exposome is what drives natural selection.
5:02
SPEAKER_01: And it's your genes respond to it, but it's still that combination of that nature and nurture.
5:07
SPEAKER_01: And to me, the exposome addresses the nurture part of it.
5:13
SPEAKER_00: I'm trying to compute that.
5:15
SPEAKER_00: Um, it makes perfect sense, but the the genetic element of it is driven by the exposome.
5:20
SPEAKER_00: It's just like millennia of evolution is responding to the environment.
5:24
SPEAKER_00: And so, like, what are the you know, it that that seems extremely broad.
5:29
SPEAKER_00: Um, like it's basically everything that we either consume or are exposed to makes up our exposome.
5:36
SPEAKER_00: How do we even start trying to map that out?
5:39
SPEAKER_00: And then more importantly, how do we ever correlate between those exposures?
5:43
SPEAKER_01: So I think when I first started thinking about this, and people were saying, well, how are you going to figure out what people were exposed to over their entire lifespan or last 30 or 40, 50 years?
5:54
SPEAKER_01: And the way I viewed it was that if you go into a doctor right now and you're in the doctor's office, you are the result of all those past exposures.
6:03
SPEAKER_01: And so essentially you are keeping the tape recording of your past exposures.
6:09
SPEAKER_01: And so epigenetic changes that occurred because of a stressful situation or a past smoking history, it's still there.
6:16
SPEAKER_01: There's still fingerprints of those past exposures.
6:20
SPEAKER_01: But that doctor has to work with the data they have that day.
6:24
SPEAKER_01: Yeah.
6:25
SPEAKER_01: And so the idea is like, yeah, I may not be able to figure out what you were exposed to when you were two years old, but if that exposure was impacting your health, there should be a biochemical signature of that.
6:34
SPEAKER_01: And so the idea is to focus on the things that are having the biggest impact on our health and not necessarily worry about, well, I can't remember what happened to me when I was five years old.
6:44
SPEAKER_01: But you know what you've been doing for the last few years and you've seen when your health has gone up and down.
6:48
SPEAKER_01: Yeah.
6:48
SPEAKER_01: And how you can, you know, modify things to improve your status at that time.
6:53
SPEAKER_00: Can you just briefly explain the difference between genetics and epigenetics for anyone watching?
6:58
SPEAKER_01: Yeah.
6:58
SPEAKER_01: I mean, so the simple way of thinking of this is that you're if you do the sort of like 23andMe or you know, genetic profiling or other companies that can do this, Ancestry.com, that is giving the primary sequence of your genes.
7:11
SPEAKER_01: And so that's what's in your chromosomes, that's the base that's there.
7:15
SPEAKER_01: Unchangeable.
7:17
SPEAKER_01: Well, that that primary sequence, you can have mutations in it, but for the most part, yes, it's it's like this the steady state.
7:24
SPEAKER_01: What the epigenetics is, is what happens kind of on top of the genome.
7:29
SPEAKER_01: And so the idea is that genes can be turned on or off.
7:33
SPEAKER_01: And that is what the epigenetics part is.
7:35
SPEAKER_01: And if you think about this, like you have two copies of all your genes, but both of them aren't on all the time.
7:42
SPEAKER_01: Like one of them is actually turned off intentionally, and that's an epigenetic event doing that.
7:47
SPEAKER_01: And we know, for example, like a person who has exposures like to cigarette smoke or a lot of air pollution, there'll be an epigenetic pattern on their genes that is either shutting off or turning on certain gene pathways from that.
8:00
SPEAKER_01: So the epigenetics is the one of the ways like that the genes react to these environmental exposures that can lead to long-lasting changes.
8:10
SPEAKER_00: And they're things we largely have control over.
8:13
SPEAKER_00: But but another layered question on top of that is there any epigenetic carryover from what your parents did, for example?
8:22
SPEAKER_01: So that that's a whole area of like that sort of inherited part.
8:26
SPEAKER_01: And like there are some studies that suggest that there is transgenerational inheritance of these epigenetic marks, but many people think there's a lot of resetting that occurs.
8:36
SPEAKER_01: Right.
8:37
SPEAKER_01: And so I'm not, I think that when you look at uh we know that we inherit genes from our parents, but we also share the same environment growing up.
8:49
SPEAKER_01: And so whether or not it's an epigenetic thing you inherited or the fact you lived in the same house for 18 years when you were growing up, it's hard to tease those things apart.
9:01
SPEAKER_01: But that's the idea of exposomics is we're trying to look and see if we can tease those things apart.
9:05
SPEAKER_00: How did you end up going down this path?
9:08
SPEAKER_00: I mean, you mention this is a relatively young science when we compare that to genetics, but it sounds like something that we should have known earlier.
9:18
SPEAKER_01: Yeah, like I mean, this started as a scientist when you know, I was finishing my PhD 30 years ago.
9:23
SPEAKER_01: I was studying Parkinson's disease, which at the time didn't really have many genetic links to it.
9:29
SPEAKER_01: Uh, but we knew that people that lived in more rural areas that drank more well water or had exposures to pesticides or farming had a higher incidence.
9:39
SPEAKER_01: And that was like the opposite of what you see with cancer.
9:41
SPEAKER_01: So it was like, why do people in the more rural areas have a higher incidence?
9:45
SPEAKER_01: And so my background in toxicology had me very focused on, you know, what could those pesticides be?
9:51
SPEAKER_01: And the idea that it wouldn't just likely be one pesticide because you're seeing these in multiple studies.
9:58
SPEAKER_01: Um, and so I was trying to address that for many years and felt that the tools were insufficient.
10:06
SPEAKER_01: Sure.
10:06
SPEAKER_01: And so when I learned about the exposum, I'm like, that's what you need to study a complex disease like that.
10:11
SPEAKER_01: Because, for example, we know that pesticide exposure is a risk factor for Parkinson's, but tobacco smoking decreases the incidence of it.
10:21
SPEAKER_01: Caffeine consumption decreases the incidence of it.
10:24
SPEAKER_01: And so when you're thinking about you have positive and negative risk factors, you need to study that disease in its totality.
10:32
SPEAKER_01: Yeah.
10:32
SPEAKER_01: And Exposomics, if you combine it with genetics, lets you go in and do that in that systematic way.
10:37
SPEAKER_01: So I think that I was just kind of primed for that sort of approach.
10:42
SPEAKER_01: And then once I really learned about it and saw that the problem was the tools had to be developed, that was when I just focused all my attention on developing the tools to actually do Exposomics.
10:54
SPEAKER_00: So, given that is obviously incredibly impactful and important for us to have some kind of indicational control over this really broad set of impactful things that we get exposed to.
11:10
SPEAKER_00: You know, the story is for many years, if not decades, been, you know, genetics is where we start.
11:16
SPEAKER_00: And this feels like the other sort of side of the equation.
11:19
SPEAKER_00: Is there, and I've heard various different answers here, but is there any good data to suggest like how much they impact our health length and quality of life?
11:29
SPEAKER_00: Which Yeah.
11:30
SPEAKER_01: So there's there was a really good study that came out last year that analyzed people in the UK Biobank.
11:36
SPEAKER_01: So this is like a half million person study in the UK, and they had polygenic risk scores for the top 20 diseases in the UK, and they had an exposome estimate based on all these epidemiological characteristics.
11:52
SPEAKER_01: And if you looked at all cause mortality, the likelihood of you dying from the time you entered the study, uh, that the polyexposome assessment had a much higher prediction of someone dying than their genetics.
12:07
SPEAKER_01: So mortality.
12:08
SPEAKER_01: Now, this isn't to say the likelihood of you getting that particular disease, but of you dying after the study.
12:14
SPEAKER_01: So it's it's a very kind of crude estimate, but but it was probably more than you know, 75% of it could be attributed to the environmental factors in that.
12:24
SPEAKER_01: Again, I my my definite exposures is very broad.
12:27
SPEAKER_01: It's everything that's really non-genetic.
12:30
SPEAKER_01: Uh, but the idea is that how we how diseases progress, how we respond to therapy, the the exposure has a huge impact on that.
12:40
SPEAKER_00: Yeah, I mean, that's wild.
12:42
SPEAKER_00: 75%.
12:45
SPEAKER_00: So so I think when we think about our exposure to things that we have control over, we think about our exposure to stress, like a um good or bad, to exercise, to um our sleep, to the foods that we eat.
13:01
SPEAKER_00: What are some of the things that you are studying that fall outside of those, I don't know, I'd call them fundamental sort of interventions?
13:08
SPEAKER_01: Well, I mean, I think because we take this very agnostic approach, like we're we want to go into our studies with really no uh assumptions of what's gonna come out of it, is that we use these methods that measure the biochemicals in our body, whether they be a pesticide from something, a residue on your food or from air pollution outside your your house.
13:34
SPEAKER_01: Uh, and so we're measuring just as much as we possibly can.
13:38
SPEAKER_01: And so in that way, it's like we we've performed studies where we might identify a pesticide that had never been studied before in a condition or disease because we didn't go into the study thinking these were the compounds we should study.
13:52
SPEAKER_01: Sure.
13:53
SPEAKER_01: It's just what the peaks are on the mass spectrometer that come out.
13:56
SPEAKER_01: And so it's like we're measuring everything that we can possibly detect in someone's blood or urine or whatever the sample is.
14:03
SPEAKER_01: Um, you know, we've been very interested in seeing how these sort of exposome factors affect the drugs that we take.
14:10
SPEAKER_01: And so when you think about most of the medications prescribed in the United States do not work as they're predicted to.
14:19
SPEAKER_01: They don't have the efficacy that that would came out of the trials.
14:22
SPEAKER_01: There's incredible drug variability, even for things like the GLP ones, which you know work amazingly well, almost 20% of people don't respond well to them.
14:32
SPEAKER_01: Why is that?
14:32
SPEAKER_01: Well, they've done the genetics and the genetics can't explain it.
14:35
SPEAKER_01: And so it comes back to these other exposures and stressors in our lives that are that are interfering with that.
14:41
SPEAKER_01: And so what we're doing now is we go through and we measure, uh, we've set up a system where we can measure hundreds of drugs in their metabolites at the same time that we're measuring these thousands of environmental chemicals, dietary factors, and trying to tease out why people don't respond as well to a drug or why people respond better to a drug.
15:01
SPEAKER_01: Again, we're not we're not always looking for negative things, we're looking for the negative and positive.
15:05
SPEAKER_00: Would you would you say that carries over to how they respond to other things that we are doing to try to optimize our health?
15:11
SPEAKER_00: So, in the absence of disease and illness, if I'm, you know, trying to work out more or improve the nutrient density of my food, are these other environmental factors impacting that?
15:20
SPEAKER_01: Right.
15:20
SPEAKER_01: When when you think, like, think about this idea of like optimizing your nutrition, is when I think someone that's doing that, they're increasing the nutritional density and they're likely decreasing the sort of additives that we think are negative, whether it be plasticizers or pesticides, if they're eating more organic.
15:39
SPEAKER_01: But all of those things I just said are chemicals, good and bad.
15:44
SPEAKER_01: And we're measuring that in people.
15:46
SPEAKER_01: So if a person said, I've changed my diet extensively, have I changed my biochemical profile?
15:53
SPEAKER_01: Like that's exactly what we're measuring.
15:54
SPEAKER_01: And the idea is that people that have that exposome profile that is healthier, as if we define it as being healthier, it should predict better outcomes.
16:06
SPEAKER_01: And so that's exactly the sort of things we're doing is, but again, because we're not saying what we're going to look at and we're measuring tens of thousands of things, it really becomes more of like a pattern recognition exercise where you're saying, does this person have this profile that looks to be more towards health and resilience and farther away from that sort of disease phenotype?
16:29
SPEAKER_01: Um, and so that that's really kind of the approach, is how you can look at how people, how those interventions they're doing, are they actually improving their health?
16:37
SPEAKER_01: And that that's important when you think about interventions, is that you may think someone's going on a different sort of diet and exercise regimen, but you don't want to wait 20 years to find out if it was helping them.
16:50
SPEAKER_01: But those biochemical signals change within a matter of days to weeks.
16:54
SPEAKER_01: And so that's the place you can go in and say, yeah, like you now, you were here and you've moved into this healthier profile that looks more like the people that don't get that disease.
17:04
SPEAKER_01: Like you can actually see people moving in those sort of uh those exposome profiles that are healthier.
17:10
SPEAKER_00: So we'll be able to get like very high-resolution data on our biochemical profile, and we can then use that to refine the tools, technologies, interventions we use to improve the markers that matter.
17:23
SPEAKER_00: Exactly.
17:23
SPEAKER_00: This might sound naive, Gary, but I'm gonna ask it anyway.
17:26
SPEAKER_00: Um, how are you measuring it?
17:28
SPEAKER_00: Like when you say measuring their biochemical profile, like what does that mean?
17:31
SPEAKER_01: Well, I mean, like, so we've all gone to the doctor and had blood work done, right?
17:35
SPEAKER_01: And they measure cholesterol and they measure liver enzymes and they measure, you know, electrolytes, they're all the things you see in a normal blood test.
17:44
SPEAKER_01: Those are just uh analytical chemistry techniques they use to measure those things.
17:50
SPEAKER_01: Um, we just have really fancy, expensive machines that can measure so much more.
17:57
SPEAKER_01: Like the routine clinical chemistry needs to be high throughput, you know, for those sorts of indications in the clinic.
18:04
SPEAKER_01: But we're doing a research grade method of it.
18:07
SPEAKER_01: So it's really a lot of the same methods that we use for that clinical chemistry.
18:12
SPEAKER_01: We're just doing it at a very deep, you know, when you think about like uh people using like electron microscopes to measure things at a much better level than we did with the light microscope, it's the same thing.
18:24
SPEAKER_01: It's just much higher sensitivity measurement in those sorts of instruments.
18:29
SPEAKER_00: And do you see a world where that becomes accessible for everyone?
18:34
SPEAKER_01: So so the idea is that the research grade things, we're doing research projects and we're in a discovery mode.
18:42
SPEAKER_01: But if we can identify, let's say like we're measuring 10,000 things that we think are predictive of a certain outcome, it's likely these things cluster together.
18:51
SPEAKER_01: There's likely 50 markers that would predict what the 10,000 are giving you.
18:56
SPEAKER_00: Right.
18:56
SPEAKER_01: If I only have to measure 50 things, that's something I can put in a portable device.
19:01
SPEAKER_00: Yeah.
19:02
SPEAKER_01: It's a matter of what are those 50 things.
19:04
SPEAKER_01: Right.
19:04
SPEAKER_00: And you need the data.
19:05
SPEAKER_00: Exactly.
19:06
SPEAKER_01: You need the data to get there.
19:07
SPEAKER_00: Yeah.
19:07
SPEAKER_00: So we we we are hopeful that there will be, I mean, much like the human genome project, right?
19:13
SPEAKER_00: Like these things start very expensive and then there is a cost compression.
19:17
SPEAKER_00: Because it sounds like this is more important than anything, right?
19:20
SPEAKER_00: That we have I tend to agree.
19:22
SPEAKER_00: Yeah.
19:25
SPEAKER_00: I certainly think like as consumers, all of us are just desperate to have some agency over what we should and shouldn't be doing.
19:32
SPEAKER_00: And I think in the press, and we've discussed this in the past, in the press and on social media, it is so incredibly difficult to discern signal from noise.
19:43
SPEAKER_00: Like, what should I be doing?
19:45
SPEAKER_00: And what sh what is just something there's an overreach or it's too early, or it there's no access to this?
19:51
SPEAKER_00: And and it sounds like a lot of those things.
19:53
SPEAKER_00: If we knew much more with much more clarity what works for you and your biology, what are the interventions, like what are the things that we can be doing to then improve those metrics?
20:04
SPEAKER_00: Because it sounds like they're all pretty accessible.
20:06
SPEAKER_01: I mean, I to me, I think that the like that you can do certain testing and get a baseline and see where people are.
20:12
SPEAKER_01: But I think, like you said, the the way that we're given information in the media is often like in these sort of single things at a time.
20:20
SPEAKER_01: And if people start thinking about their health at this exposome scale and they know that they want to eat a diet rich in antioxidants, and a paper comes out saying that blueberries are good for you, they say, yeah, that's part of that antioxidant diet part.
20:34
SPEAKER_01: So I, and it's uh it's a healthy food, it's not processed.
20:38
SPEAKER_01: And if you start looking at all the things that come in that way, they start fitting into this exposome matrix.
20:43
SPEAKER_01: And you say, it's like, well, yeah, like these, you know, there's they've shown that this pesticide is linked to cancer.
20:49
SPEAKER_01: I know I'm supposed to be reducing my exposures to those things anyway.
20:52
SPEAKER_01: I'm already doing that.
20:54
SPEAKER_01: And I think it helps people filter this that it's not just individual things, but how they integrate together.
21:01
SPEAKER_01: And even you get to the point where I think when people are taking very good care of themselves and they're exercising and they're eating a very healthy diet, that they become quite resilient to many of these exposures.
21:14
SPEAKER_01: And so they may think it's like, okay, I need to go to this very polluted city for a day and a half or something, but it's only a day and a half.
21:22
SPEAKER_01: Like I know that I'm healthy if I take care of myself and I get sleep and everything, that I'll be fine.
21:26
SPEAKER_01: Um, it I think it helps are kind of like moderating the individual exposures when you think about it in the context of the thousands of exposures.
21:35
SPEAKER_00: Okay, let me double-click on that because um it strikes me that a lot of the things that we are exposed to that we ultimately find out are detrimental to our health are not acutely detrimental to our health.
21:48
SPEAKER_00: Like we don't notice in the moment.
21:50
SPEAKER_00: So I would suspect, and you might tell me I'm wrong, that you know, spending a few days in a city with that has terrible levels of pollution, we don't notice that with.
22:00
SPEAKER_00: That week, for example, or we don't feel worse.
22:02
SPEAKER_00: Maybe we do, um, subjectively at least.
22:05
SPEAKER_00: But then are these not things that compound over time?
22:09
SPEAKER_00: And the reason I say that is because I heard you say that on a podcast before.
22:12
SPEAKER_01: Yeah, they they do compound over time.
22:14
SPEAKER_01: I mean, so this is like where, again, like you're looking at your overall sort of risk profile.
22:21
SPEAKER_01: And and so, for example, if I was going to go to a city that that I knew had very high levels of pollution, very low air quality in that city, there's a very good chance I'd be wearing a K95 mask when I was there.
22:35
SPEAKER_01: Because I know that exposure is bad.
22:38
SPEAKER_01: Do you wear one here in New York?
22:40
SPEAKER_01: I wear, I still wear a K95 on the subway and on airplanes.
22:43
SPEAKER_01: Wait, what's the K95?
22:44
SPEAKER_01: The that thick map that it's not the N95s are the really the really big ones.
22:50
SPEAKER_01: It's actually You got one with you, of course.
22:52
SPEAKER_01: Of course.
22:52
SPEAKER_01: I took the subway down here.
22:53
SPEAKER_01: So the K95, it's not the really fancy ones, but they're relatively inexpensive, readily available, and they filter out most of the particulate matter.
23:03
SPEAKER_01: And I'd gotten COVID a couple times, and I don't like what it does to my body.
23:09
SPEAKER_01: And so I want to reduce that.
23:10
SPEAKER_01: And when I'm on an airplane where I know that I'm really close to a bunch of people who I don't know, or I'm on the New York City subway, I still wear a mask on that.
23:18
SPEAKER_01: When I'm walking down the street, there's I know there's a lot of ambient air around, there's much more air exchange.
23:23
SPEAKER_01: But for me, those are my two highest risk exposures.
23:26
SPEAKER_01: So I do something to reduce my risk of it.
23:29
SPEAKER_00: Do you know what's incredibly um frustrating, actually, I think for the public in general, myself included, is that we hear so many like opposing opinions on things like this, right?
23:40
SPEAKER_00: And like I you listen to some of the most popular podcasters in the world saying this is nonsense.
23:46
SPEAKER_00: Like you shouldn't, no one needed to wear a mask through COVID, or they didn't help.
23:50
SPEAKER_00: Like, how is this is, I guess, the the problem for all of us is like who who's they all these people are seemingly credible, right?
23:57
SPEAKER_00: Not the podcasters necessarily themselves, but the guests.
24:00
SPEAKER_00: So how do we pass?
24:01
SPEAKER_01: Well, I mean, it's interesting.
24:02
SPEAKER_01: Like when you it's when you go to the extremes, they're usually wrong, right?
24:05
SPEAKER_01: I mean, it's something, oh, it's always something in the middle.
24:07
SPEAKER_01: And and I think that you know, when people it's COVID was a very good example, there was just the sort of confusion is that the World Health Organization couldn't admit that it was airborne for like two and a half years, which was ridiculous because the data clearly show that it was.
24:24
SPEAKER_01: And uh, and so to say that like masking doesn't work when when people are talking about at a large scale, a population scale, that also factors in like how well people comply to it.
24:37
SPEAKER_01: But I know if I'm wearing a mask, I'm gonna reduce my exposure to particulates and viral particles by about 90%.
24:45
SPEAKER_01: It's not 100%, it's not perfect, but I'm I'm looking at it from am I reducing my risk?
24:50
SPEAKER_01: Yeah, and you get to control that.
24:52
SPEAKER_01: And I can control that.
24:53
SPEAKER_01: And so I can't control what everyone else is doing.
24:55
SPEAKER_01: I can't control if someone says, I have a cold, I'm gonna stay home, because not everyone does that.
25:00
SPEAKER_01: Yeah.
25:00
SPEAKER_01: But I I can control this part of it.
25:02
SPEAKER_01: And I know that for me, I want to, I want to do that.
25:05
SPEAKER_01: So it's, and it's also you have different risk categories, like as I'm I'm not 20 years old anymore.
25:11
SPEAKER_01: And when I got COVID, like I got really sick from that.
25:14
SPEAKER_01: I had a headache for over a month the first time.
25:17
SPEAKER_01: And and so I'm like, I care about my brain.
25:20
SPEAKER_01: So I don't want to have inflammation in my brain, and I want to reduce the likelihood of me getting getting that again.
25:26
SPEAKER_01: So I try to take steps to prevent it.
25:29
SPEAKER_00: Given that it's such a young science, and I doubt there's, you know, uh a huge number of people in the world who are studying in the way that you are, probably very few.
25:40
SPEAKER_00: Do we have any kind of um foresight on some of those things that we uh we think are going to compound over time?
25:48
SPEAKER_00: Because if it's that young, like how do we know?
25:50
SPEAKER_00: Like, how do our parents, our grandparents, how do they, you know, yeah, how do you know given that it might have accumulated over so long?
25:56
SPEAKER_01: I mean, there's no, we've been studying environmental influences of health for a long time, but it's been more like what are the major exposures?
26:04
SPEAKER_01: Let's you know, worry about lead exposure and cadmium and air pollution.
26:09
SPEAKER_01: And I think it's just been a just a more coarse approach.
26:12
SPEAKER_01: And so the exposomics is just becoming more systematic.
26:16
SPEAKER_01: I don't think we're gonna discover a single exposure that's gonna be worse for brain health than lead is.
26:24
SPEAKER_01: Like that's why we got lead out of gasoline.
26:26
SPEAKER_01: It's it's bad.
26:26
SPEAKER_01: We want to reduce our lead exposure.
26:29
SPEAKER_01: But what we will probably start seeing is that combinations of lower levels of lead in combination with cadmium or some other heavy metal with pollution, like those combinations could be bad.
26:43
SPEAKER_01: But the idea is that we haven't done the combinatorial analysis of that.
26:47
SPEAKER_01: Yeah, yeah.
26:48
SPEAKER_01: And so again, it's I think it's still going to be this point where the really, the really bad things we do already know about.
26:56
SPEAKER_01: Like we really have a good idea of what these really bad exposures are.
26:59
SPEAKER_01: But the idea is that if you're exposed to 18 different pesticides, we haven't had a way of studying those 18 in combination.
27:09
SPEAKER_01: Yeah.
27:09
SPEAKER_01: How they're gonna do that.
27:10
SPEAKER_01: And that's that's what we're missing there because very much like we have with genetics is that we have these polygenic risk scores.
27:17
SPEAKER_01: We see these for many diseases now, whereas the individual genes don't really have a big effect.
27:22
SPEAKER_01: But when you put 15 of them together, you now you start seeing this effect.
27:26
SPEAKER_01: I think we'll see the same thing with the environmental exposures through exposomics.
27:29
SPEAKER_00: Gary, I've got so many questions.
27:32
SPEAKER_00: Um, so do you think it's worse now than it was 50 years ago?
27:37
SPEAKER_00: Like is our exposure to these things?
27:40
SPEAKER_00: Is it getting worse?
27:41
SPEAKER_00: Is it getting better?
27:42
SPEAKER_00: Is it about the same?
27:43
SPEAKER_01: So if you go back, let's go back 100 years.
27:47
SPEAKER_01: We are the lifespan since like 1900 has increased steadily up into the last couple of years, and that COVID had a big effect there.
27:56
SPEAKER_01: But we've introduced many more chemicals over the last 50 to 70 years, but we're living longer.
28:03
SPEAKER_01: So I'm not like anti-chemical, it's the judicious use of the chemicals that's critical.
28:09
SPEAKER_01: So the the challenge is because we are living longer, we have more time to develop age-related diseases.
28:16
SPEAKER_01: Yes.
28:16
SPEAKER_01: And and so it's it's like, how do we increase the quality of that life that's increasing at this point?
28:25
SPEAKER_01: So overall, when when you see an overall risk of like disease going down by age, uh, like I don't think we're in a situation like a sky is falling thing where everything is getting terrible now, but the complexity is there.
28:41
SPEAKER_01: And because we are living longer, there's a higher likelihood of us getting dementia.
28:46
SPEAKER_01: And like if you're worried about that, you want to continue to work to decrease the likelihood of those things occurring.
28:52
SPEAKER_01: So it's, I think the world has been getting better from a chemical standpoint.
28:58
SPEAKER_01: We have better environmental regulations and things than we had 60, 70 years ago, but they're still not perfect.
29:05
SPEAKER_01: Yeah, we still need to make them better.
29:07
SPEAKER_00: And I assume the better we get at measuring the things, the more we observe that they are there, right?
29:12
SPEAKER_00: Right.
29:13
SPEAKER_01: And I think this is where it also comes into how do we prioritize what to focus on.
29:17
SPEAKER_01: And that's if we can do these very comprehensive studies, we can then say we need to put, you know, all of our resources into reducing these particular exposures over the other exposure.
29:30
SPEAKER_01: Yeah.
29:30
SPEAKER_01: Like I think we're gonna learn a lot from the recent wildfires because there's been very good systematic studies done there.
29:37
SPEAKER_01: Like, I think we'd probably should have better interventions when those wildfires occur.
29:42
SPEAKER_01: Like, there's not really a public health plan for people in those areas to, from like a ventilation standpoint.
29:48
SPEAKER_01: There's some recommendations, but I think we can do so much better.
29:52
SPEAKER_00: Yeah.
29:52
SPEAKER_00: It was almost something that wasn't spoken about.
29:56
SPEAKER_00: Interesting.
29:57
SPEAKER_00: We we touched on nutrition briefly earlier in the conversation.
30:02
SPEAKER_00: I think there's a few questions when it comes to nutrition that most of us have no idea about the um the truth behind some of the answers we hear.
30:12
SPEAKER_00: You know, one of I'm gonna list some, if that's right.
30:15
SPEAKER_00: So pesticides on food.
30:21
SPEAKER_00: What should we be looking out for?
30:23
SPEAKER_00: What should we know about?
30:25
SPEAKER_00: Is it something we have control over?
30:28
SPEAKER_01: Yeah, so the pesticides on foods is a very uh important concept.
30:35
SPEAKER_01: I remember seeing photos before DDT was developed.
30:41
SPEAKER_01: And how DDT is one of the older pesticides that we we banned it back in the 70s, but it still persists in the environment.
30:49
SPEAKER_01: The sort of silent spring story, this was around the DDT, is the pests can damage crops and make it very difficult to grow foods.
30:59
SPEAKER_01: And so we do need to have chemicals to control those aspects of it.
31:05
SPEAKER_01: But what tends to happen is that if more of those chemicals can increase the yield more, the companies are motivated to do that.
31:15
SPEAKER_01: And and I I recall like, you know, several years ago when people were really pushing a lot of organic food.
31:20
SPEAKER_01: I I haven't been like I personally do not purchase organic food for the most part.
31:26
SPEAKER_01: Not that I'm trying to avoid it, is I'm trying to get the most healthy food I can.
31:33
SPEAKER_01: And I think when you push people to say, oh, you want to avoid because there's pesticides on grapes or bananas, they don't eat grapes and bananas.
31:40
SPEAKER_01: Right.
31:40
SPEAKER_01: But then that there's a net benefit in eating grapes and bananas, even if there's a pesticide residue on them.
31:46
SPEAKER_01: It's still a net benefit to eat fruits and vegetables, but you can still wash the fruits and vegetables.
31:52
SPEAKER_01: Like a banana is actually not as bad because you peel off the skin.
31:55
SPEAKER_01: It tends to be on the outer parts of it.
31:57
SPEAKER_01: But you do things to reduce those exposures and so that you can afford more of the healthy foods.
32:04
SPEAKER_00: Does washing the food actually?
32:07
SPEAKER_01: It depends like what it does for the compounds that tend to be on the outsides of foods, which most of the pesticide residues tend to be on the outside, that gently washing uh fruits and vegetables does decrease the amount of it.
32:19
SPEAKER_01: Does it make it zero?
32:20
SPEAKER_01: Probably not, but it reduces it some and doesn't wash away the nutritional quality.
32:25
SPEAKER_00: Yeah.
32:26
SPEAKER_00: Do you do we have any good data on whether organic food is worth eating over normal food?
32:33
SPEAKER_01: I I mean there's certainly data that shows eating an organic diet decreases the amount of pesticides in the people doing it.
32:40
SPEAKER_01: So, I mean, if you can easily get your hands on organic food over other, yeah, it makes sense to do.
32:45
SPEAKER_01: When I was my wife and I have six children, when they were little, I was going for bulk.
32:50
SPEAKER_01: Like the idea is I needed as many fruits as vegetables as possible, and the organic limited the amount I could get.
32:55
SPEAKER_01: Yeah.
32:56
SPEAKER_01: And so it just made more sense just to do that and take the steps of like washing the fruits and vegetables.
33:00
SPEAKER_00: So the takeaway there is, you know, don't let the fact that it's not organic put you off eating it in the first place because you're gonna miss out on the but if you have the choice, yeah.
33:09
SPEAKER_01: If you can have the organic, sure, choose the organic food.
33:12
SPEAKER_01: But like if you're driving down the road and there's a fruit stand that has all these healthy fruits and vegetables there and like it's not organic, don't drive past it.
33:20
SPEAKER_01: Sure.
33:21
SPEAKER_01: Just when you go to the store the next time you get the organic things.
33:24
SPEAKER_00: Talk to me about microplastics.
33:26
SPEAKER_00: This seems to be something that is incredibly trendy at the moment.
33:30
SPEAKER_01: Yeah.
33:30
SPEAKER_01: I mean, so this has been a challenge scientifically, is that the micro and nanoplastics, which are definitely in our food system and and water systems, uh, I think the the jury's still out on what the overall health risk of these are.
33:48
SPEAKER_01: Again, you go back to how plastics were introduced decades ago, right?
33:53
SPEAKER_01: I mean, actually, probably, I don't know, 80 plus years ago.
33:56
SPEAKER_01: And during that time, uh our lifespan has increased.
34:01
SPEAKER_01: You know, so the idea is that they can't be completely just killing us because we would only be living 50 years.
34:07
SPEAKER_01: Yeah, that can't be the net bullet.
34:09
SPEAKER_01: But it's still, if we don't need to have these things in us, we shouldn't, you know, and so what can we do to reduce that?
34:15
SPEAKER_01: So one of the challenges, though, is that even measuring these things is very difficult.
34:20
SPEAKER_01: There, that's the challenge.
34:22
SPEAKER_01: A lot of things in the news about questioning certain studies because these are hard things to measure.
34:28
SPEAKER_01: And so we're still developing the methods and technologies to do it, but it still makes sense to reduce your exposures to plastics because when we think about uh, you know, ultra-processed foods, part of that processing is wrapping it up more, right?
34:46
SPEAKER_01: We think about individually wrapped things, it can make it last longer on the shelf, but you're using more plastics that then get on the food.
34:56
SPEAKER_01: And the question is, do we need to do that?
34:59
SPEAKER_01: When when I was growing up, you went down the beverage aisle, it was all in glass.
35:03
SPEAKER_01: Yeah, now it's all in plastic.
35:06
SPEAKER_01: And do we need to be drinking water out of plastic water bottles?
35:12
SPEAKER_01: Like, why not use glass bottles and reduce that individual exposure?
35:16
SPEAKER_00: Should we be using glass bottles and not plastic?
35:19
SPEAKER_00: I assume the answer is yes, but do we know that?
35:22
SPEAKER_01: We know that using filtered water and glass to drink it out of reduces one's exposures to plastics.
35:30
SPEAKER_01: Does that make them healthier?
35:32
SPEAKER_01: That's what we don't know, but it seems like a reasonable thing to do.
35:36
SPEAKER_01: It's a pretty simple thing to do.
35:38
SPEAKER_01: Like I use uh a fill, I filter all my water and I put it into glass water bottles in my refrigerator.
35:43
SPEAKER_01: And so I just try to minimize the storage and plastic for the beverages that I drink.
35:49
SPEAKER_00: Do you think there is um any health, any detrimental health impact from drinking tap water?
35:57
SPEAKER_01: It depends on the quality of one's tap water.
35:59
SPEAKER_01: It's easy to test tap water to see the quality of it.
36:02
SPEAKER_01: Um, I remember when I moved to New York City, I everyone told me how great the water was because it's coming from upstate New York, but I'm also living in a building that's 120 years old.
36:10
SPEAKER_01: And so, like, I don't know what the condition of those pipes are.
36:13
SPEAKER_01: So I still filter my tap water, but I never had it tested because it was just easier just to run it through the filter.
36:21
SPEAKER_00: Yeah, the the the filtering is relatively unexpensive.
36:23
SPEAKER_00: How would one test for their tap water?
36:27
SPEAKER_01: There, there's different laboratories, like you can just take a sample and mail it to different groups.
36:30
SPEAKER_01: There's multiple companies that offer this sort of testing.
36:34
SPEAKER_00: Um you don't think that's worth doing?
36:37
SPEAKER_01: Well, I mean, it's it's not a bad idea if you, especially if you live in an older home, because it's not always clear like what type the pipes are and the corrosion that has built up on them.
36:49
SPEAKER_01: Like, and so even if they may have gotten rid of lead pipes 80 years ago, you don't know what the residues are and things in it.
36:56
SPEAKER_01: So, like testing it uh for older homes, I think is a very reasonable thing to do.
37:01
SPEAKER_00: Yeah.
37:02
SPEAKER_00: Well, what about like um the use of things like microwaves or like heating things up in plastic containers?
37:08
SPEAKER_00: I assume it's the same story.
37:09
SPEAKER_01: Yeah.
37:09
SPEAKER_01: I mean, so when when you think about uh going back to chemistry and reactions, temperature makes things react more.
37:16
SPEAKER_01: And so, like I I try to never microwave things in plastic because it leaches the things that are in the plastic.
37:23
SPEAKER_01: It may not be the plastic itself, it may be the plasticizer, the bisphenols and things that are there to make it flexible.
37:30
SPEAKER_01: They leach out into the food.
37:32
SPEAKER_01: If I just dump it into a glass dish and heat it up, I've avoided that.
37:37
SPEAKER_01: Am I healthier because of it?
37:39
SPEAKER_01: I don't know, but I know I don't have those plastics in me now.
37:43
SPEAKER_00: And so you think the sort of risk, the effort reward is worth it.
37:46
SPEAKER_00: Yes.
37:47
SPEAKER_00: I I heard, and I hope I didn't dream this, but I heard that the volume of these microplastics on average in someone's body made up to like a plastic bag within the brain.
38:00
SPEAKER_00: Is that just made up?
38:01
SPEAKER_01: I I think that that's that gets back to this measurement issue, is imagine you're you're trying to measure the presence of plastics in a biological fluid, in a brain sample and blood.
38:17
SPEAKER_01: And if you've ever been into a laboratory and you look around, there's plastic everywhere.
38:24
SPEAKER_01: Like, how do you know it's not coming in from the sample?
38:28
SPEAKER_01: We we pipette.
38:29
SPEAKER_01: Sure, yeah.
38:30
SPEAKER_01: There's a plastic tip on the pipette.
38:32
SPEAKER_01: I mean, everything we do touches plastic in the laboratory.
38:35
SPEAKER_01: And and this is like where it gets into like what is the baseline?
38:38
SPEAKER_01: What is the background for measuring plastics?
38:41
SPEAKER_01: And to me, the scientists, that's where we're working on that, is trying to figure that out.
38:45
SPEAKER_01: And so to me, I think some of the estimates that have been reported, like a T, like a plastic spoon worth or a plastic bag worth, it's I think those are probably escalated, but it's not to say there's not plastic there.
38:57
SPEAKER_01: Yeah.
38:58
SPEAKER_01: It's just how much of it is actually from the background or actually in there.
39:04
SPEAKER_01: But the idea of having any amount of plastic in your brain, like it, I don't need to have that.
39:12
SPEAKER_00: Yeah.
39:12
SPEAKER_00: So what about with that?
39:13
SPEAKER_00: Like, you know, there are um some businesses now charging kind of crazy amounts of money to do a blood transfusion that allegedly removes those things.
39:27
SPEAKER_00: Is there any credence to that?
39:28
SPEAKER_00: Or is that that something that we we can't even prove that is working?
39:33
SPEAKER_01: I I would say there's probably no evidence of a health benefit of that.
39:37
SPEAKER_01: And I would argue there's probably a risk of doing that.
39:41
SPEAKER_01: The risk of having your blood transfused is real.
39:46
SPEAKER_01: The benefit of doing that is unknown.
39:50
SPEAKER_01: And so to me, like you're it's a net increase in risk by doing something that's unproven.
39:56
SPEAKER_00: No, I love this concept of uh like having these slight edge principles that we can lean into where we are assessing the sort of benefit, risk, the effort, risk, reward across all of these different elements of our um exposure to these things.
40:12
SPEAKER_00: And I think there's so much that is within our control.
40:15
SPEAKER_00: You know, like if you don't need to drink out of a plastic bottle, don't because the risk is is high and the reward is you know could also be high.
40:24
SPEAKER_00: What are some other things that the everyday person can be doing that we either have good evidence for working or we suspect would be very beneficial?
40:34
SPEAKER_01: Yeah, I mean, I I think some of these things, uh, like your parents could have told you many years ago, is you know, we I think in our modern world, we're always trying to do things faster and and we tend to eat foods that aren't as healthy and we just take all these shortcuts and avoiding those is a good thing to do.
40:53
SPEAKER_01: And so the idea is if you're preparing food like in a kitchen, it's very likely gonna be healthier than if you buy it at a restaurant.
41:02
SPEAKER_01: Not to say that restaurants aren't nice, but like it's they're they're putting more sodium, they're putting more fat in because it tastes better.
41:10
SPEAKER_01: And and so, and just kind of like slowing things down and taking time to prepare foods and not making impulsive decisions.
41:17
SPEAKER_01: Like you're saying, I, you know, I'm gonna make coffee.
41:20
SPEAKER_01: Like I should probably have my coffee filtered, I should have it fresh coffee and maybe organic beans with it, versus like always like buying it quickly at a store somewhere.
41:28
SPEAKER_01: Like it's like just being more thoughtful in those processes.
41:32
SPEAKER_01: Um, I think the same thing comes with a lot of exposures, is that you know, people will worry about things like microplastics or other sort of conditions, and then they they will go engage in certain activities that have very high risks.
41:46
SPEAKER_01: They're within their control, but they're still doing it.
41:49
SPEAKER_01: And but if it's something that, you know, gives them like they want to go to a concert that's inside Madison Square Garden with 20,000 other people, uh it's a known, you know, they're going in, it's something they're they're gonna go in and enjoy doing that.
42:04
SPEAKER_01: But that exposure was probably much worse than this little worry they had about a micro plastic and something that they were eating, you know.
42:11
SPEAKER_01: And so it's kind of just like just taking a step back and thinking, what am I gonna do today to make myself healthier?
42:18
SPEAKER_01: And and so like you're saying, I need to make sure I exercise, I need to eat healthy throughout the day and have a plan for it.
42:24
SPEAKER_01: I I think it's when people like don't have a plan, they tend to do these more impulsive things that lead to the the more unhealthy choices.
42:33
SPEAKER_00: Yeah.
42:33
SPEAKER_00: And we talk about this often, like how do we do all of this without sucking the fun out of life?
42:38
SPEAKER_00: Right.
42:38
SPEAKER_00: And so I think there are things that that might be uh little risk, but they add zero fun.
42:45
SPEAKER_00: Yes.
42:45
SPEAKER_00: Like, and then there are things that are slightly higher risk, but they're great experientially.
42:50
SPEAKER_00: Yeah.
42:50
SPEAKER_00: Um one of the things that fits within that really nicely in a project that you and I have been working on um internally is this concept of improving the environmental health of your home.
43:01
SPEAKER_00: And I love this, and we we've spoken about this in depth.
43:04
SPEAKER_00: Um, you know, are there things that we can do that that are almost one and done that will improve the likely health benefits for our entire families?
43:15
SPEAKER_01: Yeah.
43:15
SPEAKER_01: Yeah.
43:16
SPEAKER_01: I mean, like we spend the majority of our time indoors and we talk more about outdoor air quality.
43:22
SPEAKER_01: Uh so the idea is that, you know, you have every home has some sort of you know, heating and ventilation AC system.
43:30
SPEAKER_01: And we have filters in them that sometimes we change and sometimes we don't.
43:35
SPEAKER_01: And the more expensive filters do a better job of filtering our air.
43:40
SPEAKER_01: And and so simple steps like just buying the the filters that have the higher quality filtration can reduce the exposure to allergens, viruses, even particulate matter.
43:53
SPEAKER_01: Um, and just routinely having those sorts of systems in your house can do that.
43:58
SPEAKER_01: Um You know, we've we've talked before just about like kind of monitoring the the quality in general through various devices.
44:06
SPEAKER_01: Is again going, I I think back about like opening up the windows and airing your house out, like people would talk about decades ago.
44:13
SPEAKER_01: It still makes sense to do.
44:14
SPEAKER_01: Is we've had such a efficiency on uh energy efficiency in homes is that we've kind of locked these things up in a very tight way, and you often have very little air exchange, and that becomes problematic because your levels of carbon dioxide can build up if you don't have a way of exchanging air.
44:32
SPEAKER_01: But there's settings you can put on in your HVAC systems that improve the ventilation in your home.
44:39
SPEAKER_01: And I think people can just take a few steps to make sure that that air quality is better in their everyday living space and workspace.
44:46
SPEAKER_01: So for example, I have a HEPA filter in my bedroom in my apartment, but I also have one in my office where I spend most of my day at work.
44:54
SPEAKER_00: Yeah.
44:55
SPEAKER_00: That makes perfect sense, but I think is something that we probably relatively few people think about, right?
45:02
SPEAKER_00: And and I guess the question would be do we know that that meaningfully improves these markers of health?
45:11
SPEAKER_01: So, like that, it's a good point about meaningfully, like in that situation.
45:15
SPEAKER_01: Like, have I taken my blood to see when I installed my HEPA filter?
45:19
SPEAKER_01: I'd say no, but I was monitoring the air quality, yeah, and I know the air quality got better.
45:23
SPEAKER_01: Yes.
45:24
SPEAKER_01: Other studies have shown that low air quality do affect people's health.
45:27
SPEAKER_01: Like, so I haven't done it in me, but there's enough pieces of data that link these together that show that decreasing the amount of this particulate matter improves the quality of that air, which in turn should improve the quality of health for that individual.
45:43
SPEAKER_00: And you mentioned about like testing for this in the home.
45:46
SPEAKER_00: I've actually got a device here that you made me buy.
45:51
SPEAKER_00: I didn't take much persuading.
45:54
SPEAKER_00: And this is called a TEMTOP.
45:56
SPEAKER_00: This is not a product placement.
45:57
SPEAKER_00: We are not sponsored by them.
45:59
SPEAKER_00: And this is measuring.
46:00
SPEAKER_00: Can you maybe explain what this is measuring, by the way, all greens within this room?
46:04
SPEAKER_01: Yeah.
46:04
SPEAKER_01: So I actually got kind of turned on to these sorts of devices during COVID because one of the things we knew very early on was that the carbon dioxide levels in a room tell you a lot about the air exchanges.
46:17
SPEAKER_01: Um, the carbon dioxide levels um outside are about 350 parts per million.
46:23
SPEAKER_01: And inside they tend to be about 500, 600 parts per million.
46:28
SPEAKER_01: You put 20 people in a room, it'll go over a thousand.
46:31
SPEAKER_01: And what this means is that a higher percentage of the air you're rebreating is other people's air.
46:37
SPEAKER_01: During COVID, that meant they potentially could have virus particles in it.
46:41
SPEAKER_01: And so the idea is that if your air was around 500, you were having very good air exchanges in that building.
46:47
SPEAKER_01: Um, on an airplane, it'll get up to 2,000 or 3,000.
46:52
SPEAKER_01: So the idea, like they do have HEPA filters in the planes that help with some of the viruses, but it shows you that you're rebreathing everyone else's air.
47:00
SPEAKER_00: And so do you wear a mask on a plane, Steve?
47:03
SPEAKER_01: Absolutely.
47:03
SPEAKER_01: I absolutely, I think it's the highest risk situation.
47:05
SPEAKER_01: Now, again, there's HEPA filters there, but I'm in a tube, usually with dry air.
47:11
SPEAKER_01: And I just know, Mike, from my historically, I tended to get sick more when I traveled.
47:16
SPEAKER_01: And I think it's a combination of the sleep changes and the dry air and and then being around a bunch of people on an airplane.
47:23
SPEAKER_01: Um, and so that's like, again, one of the places where I just think it's a very clear risk to decrease.
47:27
SPEAKER_01: So the carbon dioxide itself, it's not like toxic at that level, but it's an indication of how many air exchanges you're having in the room.
47:35
SPEAKER_01: But the temp top also measures particulate matter.
47:38
SPEAKER_01: And so this is like when we think about air pollution and things, and it also measures total volatile organic compounds.
47:44
SPEAKER_01: And so if you have a gas stove in your house, the volatiles go up when you're doing that.
47:50
SPEAKER_01: More particulate matters there.
47:51
SPEAKER_01: If you're burning candles or have a fire in your fireplace, um, it'll increase those particulate matter.
47:57
SPEAKER_01: But if you have good ventilation in the room and you have filters in your room, it's it's counteracted by that.
48:03
SPEAKER_02: Yeah.
48:04
SPEAKER_01: Um, but like, you know, I've seen oftentimes, like during the winter in New York City in my in my old apartment, is the carbon dioxide levels could get up quite a bit because we have everything sealed up.
48:14
SPEAKER_01: So you just open up a window and you get fresher air in there, and that's better.
48:18
SPEAKER_01: But then you're saying, what is fresh air in New York City?
48:20
SPEAKER_01: Yeah.
48:21
SPEAKER_01: Which is why I have the HEFA filters in my apartment, you know.
48:23
SPEAKER_01: So it's it's like you want to have good ventilation.
48:26
SPEAKER_01: Um, and this is just a way of monitoring the sort of air exchanges in your home, the particulate matter that's there.
48:33
SPEAKER_01: For example, if there were when the wildfires came through and we even had those effects in New York City, the PM 2.5 went way up on those devices.
48:42
SPEAKER_01: And we turned up our HEPA filters at that time.
48:45
SPEAKER_00: And I love this.
48:45
SPEAKER_00: I love that these are things that we can easily measure and then easily intervene with.
48:51
SPEAKER_00: You know, I had when I when I got this um delivered, and it was only a few weeks ago, I did check every room and that our living room was completely different, like uh particular number to to the bedroom.
49:04
SPEAKER_00: And so we just added a filter and it immediately went back to green.
49:08
SPEAKER_00: And so I think that is so actionable and actually relatively unexpensive, right?
49:13
SPEAKER_00: Like there's I think that's an affordable thing to do for the reward that you could potentially get for your whole family.
49:19
SPEAKER_00: And I love that about it.
49:20
SPEAKER_00: Um, is there are there if if money were no object and you could go into a home and and make these these changes, are there additional things that that we could be doing or testing for?
49:32
SPEAKER_01: Yeah, I mean, I think that uh, you know, depends more on where you live.
49:37
SPEAKER_01: But for example, like radon, this was a concern people had many years ago.
49:40
SPEAKER_01: It's still a concern because this is like the natural radioactivity coming from the earth.
49:45
SPEAKER_01: And there's things we do in our buildings, like to shield from it, is you don't need to be checking radon every day, but you should check the radon levels in your house.
49:53
SPEAKER_01: It can be done one time.
49:54
SPEAKER_01: If it's good, you're probably gonna be fine.
49:57
SPEAKER_01: Um, but again, like monitoring uh if you're, you know, if your family has a lot of like allergy sort of symptoms thing, like, do you know why that is?
50:05
SPEAKER_01: Do you have mold in your house?
50:06
SPEAKER_01: And there's ways of you know testing for things like mold and other allergens.
50:11
SPEAKER_01: I think you you kind of need to do a risk assessment for your home.
50:14
SPEAKER_01: Yeah.
50:14
SPEAKER_01: Like what are the challenges your family has and where you live and what sort of things, and and think about how do I optimize that?
50:21
SPEAKER_01: And so it, I think it is kind of dependent on geography and and things about what things I'd have different concerns about.
50:29
SPEAKER_01: But in California, where there are a lot of wildfires, like I'd want to know I have a plan for when they come through to make sure to keep that the levels of the particulate matter down in my in my house when those things occur.
50:42
SPEAKER_01: Um, like I think a lot of people don't realize that their their heating and air conditioning systems can pull in more outdoor air versus recycling the air.
50:51
SPEAKER_01: Right.
50:51
SPEAKER_01: And you would think that often it's good to bring in external air for exchange.
50:56
SPEAKER_01: It's not as efficient.
50:58
SPEAKER_01: But if there's wildfire smoke outside, you probably don't want to do that.
51:02
SPEAKER_00: Are there systems that can switch between the two?
51:04
SPEAKER_00: Yes.
51:05
SPEAKER_00: And so you can do that intentionally.
51:06
SPEAKER_01: Yeah.
51:07
SPEAKER_00: And you can then test for it.
51:08
SPEAKER_01: Exactly.
51:09
SPEAKER_00: Huh.
51:10
SPEAKER_00: What about things like um, you know, we hear some, these might be old wives' tales, but we hear like the the cutting board in your kitchen is more contaminated than a toilet seat, for example.
51:22
SPEAKER_00: Like, how how much truth is there to like work surfaces and you know, the bedroom and all of these things that I think we're we're often led to believe?
51:30
SPEAKER_01: Yeah, I mean, it's that's it's a very interesting thing.
51:32
SPEAKER_01: Like uh my my wife's a veterinarian and a virologist, so you can just imagine the discussions we have.
51:38
SPEAKER_01: But uh, like when you think about like a cutting board and things like raw chicken, and you have like things like salmonella there, it's like that that is a concern, but bleach is pretty good at killing it.
51:49
SPEAKER_01: And so when you just think about what do I have to do to kind of have like so to me, like I don't think you just say, Oh, I can't have a porse surface for a cutting board.
51:58
SPEAKER_01: You just want to clean it, you know, and like just think like if I'm using a wood cutting board that I love, I should probably, you know, bleach it after I use raw meat that I'm cutting on it.
52:08
SPEAKER_01: Uh but like when you think again, like this is like getting back to the sort of plastic discussions.
52:13
SPEAKER_01: Plastic is cheap.
52:14
SPEAKER_01: So we have so many products in our homes now that are made of plastic that we don't need to.
52:20
SPEAKER_01: Like you could have a marble cutting board that doesn't have some of these other concerns about the plastics, and it's much easier to cross core.
52:28
SPEAKER_01: Yeah, like it just like using more of these sort of like natural products, more glass-based things, uh, tend to have fewer of these problems than cheap aged plastic.
52:39
SPEAKER_00: What about things like um frying pans?
52:42
SPEAKER_00: And like we hear horror stories about these as well.
52:44
SPEAKER_01: When you're like if you scratch a frying pan, yeah, like the sort of PFAS stories there, like, you know, so we use these compounds that are great for making things non-stick, but you know, if you use a cast iron pan enough, it becomes pretty slick and actually becomes really nonstick.
52:59
SPEAKER_01: Is like when you buy things that that seem to be like solution oriented, like, oh, they become non-stick, it's like, well, there has to be some sort of sealant or chemical that's making that happen.
53:11
SPEAKER_01: And do I need to have that?
53:13
SPEAKER_01: And so it's like if I could like the nonstick cookware came about, I don't know, when I was a kid, it was all about, well, you don't have to use as much fat and oil when you're cooking if you use a nonstick thing.
53:26
SPEAKER_01: So you're gonna trade in using olive oil for a chemical to prevent that.
53:32
SPEAKER_01: And it's like, why not just go back to the cast iron pan in olive oil?
53:36
SPEAKER_01: Yeah, right.
53:37
SPEAKER_01: Because like you actually get the iron from the cast iron, and the olive oil is probably okay for you.
53:42
SPEAKER_01: And I think again, it was like one of those shortcuts we took that we didn't really need to take.
53:46
SPEAKER_00: Yeah.
53:47
SPEAKER_00: When you and your wife go to someone's house, um, do you judge that?
53:53
SPEAKER_00: Do you look around and you're like, do you do you give them advice, unsolicited advice?
53:59
SPEAKER_00: I wouldn't be able to help myself if I were you.
54:01
SPEAKER_01: Well, like I think like I think going to friends' house, like not so much, maybe family though.
54:05
SPEAKER_01: Yeah.
54:06
SPEAKER_01: Like I think when we're you know visiting our our parents and things, like you're always looking at ways of trying to to optimize uh um their their surroundings.
54:17
SPEAKER_01: Uh, but I mean, I it is something that often people, you know, just knowing the science that I do, people often ask me questions.
54:24
SPEAKER_01: And so I I certainly will give advice as as provided, but um, it kind of gets back to like when you're saying when you're gonna go do something, is that if you're gonna go visit your friends to have a nice evening, like you're not there to criticize.
54:39
SPEAKER_01: I'm not gonna I'm not there to worry about it sort of thing.
54:41
SPEAKER_01: You know, it's like, yes, they have a dog, and I haven't seen a dog in a while, so I like dogs, and I'm not gonna be concerned about what the dog's bringing into their house because I just like dogs, sort of thing.
54:49
SPEAKER_01: You know, so um I yeah, I think that it's something where uh the the bigger concern is like where you spend the majority of your time.
54:57
SPEAKER_01: And that's what you tend to control.
54:59
SPEAKER_01: It's like your workspace and your home space, like that's where your concern should be.
55:03
SPEAKER_01: It shouldn't be about everyone else's space.
55:06
SPEAKER_00: What about dogs, pets in general?
55:09
SPEAKER_00: Is that a big contributing factor?
55:12
SPEAKER_00: I think my dog certainly does.
55:13
SPEAKER_00: Yeah.
55:14
SPEAKER_01: I mean, so it's actually it's a it's a really good thing to kind of consider there is that people that own pets, and there's actually a lot of good psychology on this.
55:22
SPEAKER_01: It brings they bring joy to us.
55:24
SPEAKER_01: Yeah, no doubt.
55:26
SPEAKER_01: But you also want to keep uh things like ticks off of them and you don't want them to get heartworm.
55:33
SPEAKER_01: So they need to have medication for that.
55:36
SPEAKER_01: But when you think about those sorts of things, they can also become exposures to you and the and the pet.
55:42
SPEAKER_01: And so it's like balancing those things out.
55:45
SPEAKER_01: So if you're gonna apply the flea medicine to your animal, you want to make sure that you wash your hands after you do it, but you don't want to not use it because the fleas and ticks coming to your house are probably a bigger risk than treating the animal with it to keep them out.
56:03
SPEAKER_01: And so I think it's to me like you're that that environment in that sort of uh um symbiotic relationship with pets is you just want to think about what how the pets are contributing to things.
56:15
SPEAKER_01: Like so, you know, we know that uh there's certain um infectious agents involved, like you know, when women are pregnant, they should avoid changing the cat litter sort of thing.
56:25
SPEAKER_01: But like you just do those things to make sure that you're avoiding those other risks.
56:30
SPEAKER_01: But uh, but I think we do know that pets do bring us joy.
56:34
SPEAKER_01: And so it's like it's just a matter of like optimizing um their health as well, because you're you're in the same space together.
56:42
SPEAKER_00: It it feels like such a complicated puzzle for us all to try and figure out.
56:48
SPEAKER_00: You know, there are so many different variables, and it's clear that there are so many of these elements that are impactful, but then we have to weigh them all up, right?
56:56
SPEAKER_00: And I think that's a great example.
56:58
SPEAKER_00: Would you say that even if you didn't factor in all of those um things that you should think about with the pet in the home and any exposure there, if it meant you get an extra 10,000 steps outside each day because you're walking your dog, right?
57:12
SPEAKER_00: One could argue that that very easily outweighs the other.
57:15
SPEAKER_00: I think the challenge for all of us is does it outweigh the other?
57:19
SPEAKER_00: And how much does it, and how much of this exposure matters, and how important is walking for the steps of the dog outside?
57:26
SPEAKER_00: And given that all of us are entirely unique, our own genetics, our biology, our exposure to all of these things, um, geographically, we're so different.
57:37
SPEAKER_00: There can't, there is no single answer collectively for all of us, and so we have to just experiment, right?
57:43
SPEAKER_00: And I think that's kind of one of the exciting things about being alive today, is like you and I are both wearing a wearable right now, and that is one very small element that we can track.
57:53
SPEAKER_00: But as we start getting more tools and technology and we see the results of some of this research, we can effectively all be running these end of one trials on ourselves, right?
58:02
SPEAKER_00: And I think that's the most exciting element of where this is going, you know, way above and beyond the ability to have some silver bullet.
58:10
SPEAKER_01: I still think one of the challenges we have is we've spent so many decades studying diseases.
58:16
SPEAKER_01: We still don't have a great definition of health.
58:18
SPEAKER_01: Yeah.
58:19
SPEAKER_01: Like what is optimized health?
58:21
SPEAKER_01: And that's all the things that you do here, like trying to assess all of that to say, how do and to me, the the whole idea here, it's not necessarily how do I put myself into perfect health?
58:33
SPEAKER_01: Yeah.
58:34
SPEAKER_01: It's how do I make incremental improvements in my health?
58:37
SPEAKER_01: How do I make sure I'm on the right trajectory?
58:39
SPEAKER_01: Strendering in the right way.
58:40
SPEAKER_01: Exactly.
58:41
SPEAKER_01: And so I think that we are seeing more uh advances in kind of this health space to get better ideas of like things like the epigenetic clocks and things.
58:52
SPEAKER_01: I'm there's still a lot of work that needs to be done in the space, but I think we are getting closer to having better definitions of a healthy state.
59:01
SPEAKER_01: And I think that's what we have to use more that our interventions and our lifestyles are more not just about running away from the disease, agreed, but going towards more of these health goals.
59:11
SPEAKER_00: And not only how do we avoid disease and illness, how do we feel, look, perform our best today?
59:17
SPEAKER_00: And I think we've all got so much more potential to do that.
59:21
SPEAKER_00: And I think at times we we and we're all guilty of this, like we get used to feeling suboptimal and that becomes normal, right?
59:28
SPEAKER_00: And then I think when when you and and it's so cyclical, like the psychology of trying to improve your health.
59:34
SPEAKER_00: Like some days we feel really motivated to go and work out or to, you know, cook a uh meal of Whole Foods.
59:40
SPEAKER_00: And some days we don't, right?
59:42
SPEAKER_01: It's like when you think about like general like performance, is that I think we can all think of like times in our lives or certain times, like you have these fantastic ideas, like you always want to kind of get to that level, but it doesn't mean you have to always be at that level, you know.
59:57
SPEAKER_01: And so the idea is that if you could be more at that prime performance level, 15% more, that could triple your productivity, you know, if you're if you're doing those things.
1:00:06
SPEAKER_01: And so what does it take to get there?
1:00:08
SPEAKER_01: And I think that's where when you're thinking about health, like people are are so they're trying to put the hours in, but like the sleep part of it is what gets you closer to having those breakthroughs.
1:00:22
SPEAKER_01: And I think that's like where like the idea is like, oh, I don't have time to eat lunch.
1:00:25
SPEAKER_01: It's like, well, if you want to be performing really well when you have that big meeting coming up, you do need to do that.
1:00:31
SPEAKER_01: And I think that people are just too concerned about the clock and not thinking about, I and I talk with like this with I'm you know, a university professor and I work with graduate students, is it's not about how many hours people put in, is I I need them to be brilliant.
1:00:48
SPEAKER_00: Yeah.
1:00:48
SPEAKER_01: And it's flashes of brilliance that often lead to these big discoveries.
1:00:53
SPEAKER_01: And if they're exhausted because they're they're they're not getting enough sleep and they're not exercising and they're not eating well, they're not gonna be able to perform at that level I need them to.
1:01:02
SPEAKER_01: And and so, like to me, like this is like you're you're trying to kind of figure out what you have to do to perform at a super high level, but that's not you can't do that 50 hours a week.
1:01:12
SPEAKER_01: Yeah.
1:01:12
SPEAKER_00: I think if we're honest with ourselves as well, we we know, you know, when you're when you're not looking after your health in the ways that you know you should, you may be at work for a few hours longer each day.
1:01:23
SPEAKER_00: But is that like is the actual standard of the work any good?
1:01:26
SPEAKER_00: I'm certainly guilty of that.
1:01:28
SPEAKER_00: Do these things like our exposure to these things, um obviously it's impactful across our lifespan, but does the level of impact change throughout our different age groups?
1:01:40
SPEAKER_01: Yeah, I mean, I think there's certainly uh periods of development that are more vulnerable.
1:01:46
SPEAKER_01: Um, if adults are sitting around having the conversation, we're past these, some of these key stages uh during development, um, which is I think why it's important to optimize your home environment for your children because they are going through those phases.
1:01:59
SPEAKER_01: Um, but I think in adulthood, um, I think we're aware of kind of changes that go on through our lives.
1:02:08
SPEAKER_01: I don't think there's really single things you can point to.
1:02:11
SPEAKER_01: Um, you know, there have been some studies that have shown there's some inflection points that might be occurring there.
1:02:16
SPEAKER_01: Yeah.
1:02:17
SPEAKER_01: But I think on average, it often tends to be more of like situational for individuals, like when they have major changes in their lives.
1:02:26
SPEAKER_01: Like I would say, you could say, well, when someone, you know, when a male reaches 50, there's some big physiological effect.
1:02:33
SPEAKER_01: But I would say when their family first has kids is probably a bigger disruptive effect, good and bad, that for them, that's like when their life changed more.
1:02:43
SPEAKER_01: Yeah.
1:02:44
SPEAKER_01: And so it's more, I think it's much more situational for people's overall health.
1:02:47
SPEAKER_00: If you could give people like some really simple, low-lift, just obvious winning hacks.
1:02:59
SPEAKER_00: This is layered.
1:03:01
SPEAKER_00: One, what would they be for someone of your position?
1:03:06
SPEAKER_00: Like, what do you do?
1:03:07
SPEAKER_00: But also what advice would you give to your children and to your parents?
1:03:12
SPEAKER_00: And does that differ?
1:03:14
unknown: Yeah.
1:03:14
SPEAKER_01: So let me let me think what I try to convince tell myself every week.
1:03:18
SPEAKER_00: Yeah.
1:03:19
SPEAKER_01: It is I think that it's important to be very deliberate in what you're doing.
1:03:25
SPEAKER_01: And so if I if I know I need to perform well, which at work it usually it's always seems to be there, is I think about how my sleep is going to be that week.
1:03:36
SPEAKER_01: And if I have some early meetings, like how I make sure I still get enough sleep over the course of the week.
1:03:41
SPEAKER_01: Um, I think about my food and activity.
1:03:45
SPEAKER_01: Um, you know, the to me, like the last couple of months have been so hard.
1:03:48
SPEAKER_01: The short days in New York City, it's so I can't wait for daylight saving time to switch over and actually have more activity.
1:03:54
SPEAKER_01: But you I think about, you know, kind of like each week is the the sleep, the food intake, the physical activity, and then my schedule.
1:04:05
SPEAKER_01: And I think this is what's happened is that uh I've like kind of taken more hold of my own schedule because I tend to get people trying to fill in my calendar all the time.
1:04:15
SPEAKER_01: And then that prevents you from doing these things you have to do to take care of yourself.
1:04:20
SPEAKER_01: And then, like, you're all burnt out and you can't solve the problems, and it doesn't really help.
1:04:24
SPEAKER_01: And so I think it's like really, you know, whether it be each day or each week, is like having a plan for your own health.
1:04:32
SPEAKER_01: Um, and if you do that, I just think you can perform better in whatever that is, whether it's your family life or work life.
1:04:39
SPEAKER_00: Um, and so it's it's like planning out all those different I love, I love, and we've said this um before on previous episodes, like carving out time for yourself as a non-negotiable.
1:04:50
SPEAKER_00: And like however you need to do that, whether it's through your your diary, with your family, with your friends, through work, have a non-negotiable amount of time to contribute to the things that we know are going to be impactful.
1:05:03
SPEAKER_00: Because I think that is in the same way as, and again, we use this analogy a lot, but like in any good investment portfolio or investment strategy, you need to contribute frequently and start as early as possible.
1:05:16
SPEAKER_00: And so I think when we can carve that time out, it could be 10-15 minutes a day for some people.
1:05:20
SPEAKER_00: I know people that do that.
1:05:22
SPEAKER_00: I I mean, I very rarely work out for more than 20-30 minutes a day, but the consistency really does compound, right?
1:05:29
SPEAKER_00: And it makes a huge difference.
1:05:31
SPEAKER_00: Can I ask you two polarizing questions?
1:05:34
SPEAKER_00: Um one, what would you say given the the the things that you're working on day to day and the and the field that you're in, what would you say is the most sort of uh overhyped longevity or health span intervention?
1:05:50
SPEAKER_00: Something that you think sounds very promising but yields very little outcome or data?
1:05:55
SPEAKER_01: All right, polarizing.
1:05:57
SPEAKER_01: I think the entire supplement industry.
1:06:01
SPEAKER_01: Is overall a waste.
1:06:05
SPEAKER_01: I think we are urinating out billions of dollars.
1:06:11
SPEAKER_01: The thing the supplements that do work tend to be things that we can get through our diet.
1:06:19
SPEAKER_01: And it's much better to do it that way.
1:06:21
SPEAKER_01: There are some situations, like if people don't get a lot of sunlight, like maybe they need to supplement with vitamin D or things, but I think the vast majority of the money spent on supplements is a total waste of time.
1:06:32
SPEAKER_00: Do you take zero supplements?
1:06:33
SPEAKER_01: I take a daily vitamin.
1:06:35
SPEAKER_00: Yeah.
1:06:36
SPEAKER_01: Um I will sometimes take more vitamin C or D, depending on the time of year and like when I'm traveling more.
1:06:43
SPEAKER_01: Um, but I try to eat more citrus than take that vitamin C pill.
1:06:48
SPEAKER_01: So it's only like when I'm traveling or something and I'm not sure what access I'll have to food.
1:06:53
SPEAKER_01: Yeah.
1:06:53
SPEAKER_01: Uh, but but I think that so many of the supplements, like, well, the fact that they don't have to have evidence that they work is is a big problem there.
1:07:01
SPEAKER_01: And they don't, they don't even have good evidence that what they say is in the pill is in there.
1:07:06
SPEAKER_01: Like there's really very poor quality control.
1:07:09
SPEAKER_00: Yeah.
1:07:09
SPEAKER_01: Um, and so that that bothers me quite a bit because I the quality control in fruits and vegetables and meat and cheese is actually quite a bit higher.
1:07:19
SPEAKER_01: Yeah.
1:07:19
SPEAKER_01: And so I know I can pursue that exactly.
1:07:22
SPEAKER_01: And I'm ingesting it.
1:07:23
SPEAKER_01: And there's a lot of people.
1:07:24
SPEAKER_00: Would you say there are times um where they can actually be counterproductive?
1:07:28
SPEAKER_00: You know, certain things like vitamin A, we know they're kind of easy to overdo it.
1:07:31
SPEAKER_00: But yeah, but um, you know, the ingredients themselves, the way that they are manufactured, like if we have no control over that, and there's an obvious um ambition for things to yield a high return financially, is that is there a there have been very uh clear stories where there's various contaminants in many of these things because of the quality control not being there.
1:07:53
SPEAKER_01: I think that there is definitely a risk in many of these uh poorly characterized supplements.
1:08:02
SPEAKER_01: And just based on there's like really no supplement company that I fully trust because of their motivations for it.
1:08:09
SPEAKER_01: It's they this they are trying to sell more of them and they're trying to produce them as cheaply as possible.
1:08:15
SPEAKER_01: And often they're shortcuts that are made and they're not routinely tested.
1:08:20
SPEAKER_01: So it's you're bringing things into your body that potentially could cause harm.
1:08:25
SPEAKER_00: Yeah.
1:08:26
SPEAKER_01: Um, when I always think about like sort of supplements and things, when people say that they there's no side effects.
1:08:31
SPEAKER_01: If anything someone's selling you has no side effects, they probably have no effects.
1:08:37
SPEAKER_01: Because everything or you would eat them through a food.
1:08:39
SPEAKER_01: Right.
1:08:39
SPEAKER_01: But like the idea is if something has a beneficial effect, it also has a risk of an adverse effect.
1:08:45
SPEAKER_01: And and that that's just the reality.
1:08:48
SPEAKER_01: Because if they're giving you something that does nothing and there's no side effects, it's at best a placebo.
1:08:54
SPEAKER_01: Like at worst, it could be causing harm because they haven't tested it in people that have your genetic composition.
1:09:02
SPEAKER_01: Sure.
1:09:02
SPEAKER_00: And and so to me, it's you know, it's expensive right now.
1:09:07
SPEAKER_00: But yeah, you know, I think I I I agree with you.
1:09:10
SPEAKER_00: Um, I think that the only sort of caveat I would say is not many people do eat the right variety or nutrient density or volume of those things.
1:09:20
SPEAKER_00: And so, you know, I personally take uh a and a good high quality omega-3 creatine and vitamin D occasionally throughout the winter months.
1:09:30
SPEAKER_01: All of those have evidence that those are reasonable things to do.
1:09:33
SPEAKER_01: Like it's not unreasonable, it's just that most people aren't as selective.
1:09:38
SPEAKER_01: Like if you go through the aisle of a various stores and there's hundreds of these supplements, and there's a lot of people that are taking dozens of them.
1:09:47
SPEAKER_01: Yeah, and they don't have there, like one study 20 years ago that showed some little effect that hasn't been replicated.
1:09:55
SPEAKER_01: Uh, but the studies that have dozens and dozens of them, the things you kind of mentioned, there's definitely evidence of the omega-3s and things in there.
1:10:02
SPEAKER_00: Uh I guess even then, like take creatine and caffeine, for example, two of the most studied of all time, right?
1:10:10
SPEAKER_00: Like really robust human clinical data.
1:10:12
SPEAKER_00: But then you go into a store and there's six different types of creatine, then how does one understand?
1:10:18
SPEAKER_00: Like, we have the the privilege of being able to test for the quality of those things.
1:10:22
SPEAKER_00: Um, but then it's a bit of a minefield, right?
1:10:24
SPEAKER_00: And I think when we scroll on socials or in the press, and everyone is trying to sell you a different compound because they're pulling on some thread of evidence that you know it worked in a mouse once five years ago, that's where it's really, really challenging.
1:10:39
SPEAKER_00: And so I think you're right.
1:10:40
SPEAKER_00: Like if you if you're and we always say if you're not majoring in the majors, you're you're putting down boulders to pick up pebbles.
1:10:46
SPEAKER_00: Yeah.
1:10:46
SPEAKER_00: And that's a great example of that.
1:10:48
SPEAKER_00: Like, are you really doing everything that you can to optimize for nutrient density first?
1:10:53
SPEAKER_00: Which we have obviously more complex.
1:10:54
SPEAKER_01: And like if you say if you're a person like just has your in offices all the time and you and and in the winter, like you can't get out in the sun enough, a vitamin D supplement probably makes sense at those times of the year.
1:11:06
SPEAKER_01: But that's being very deliberate.
1:11:08
SPEAKER_01: Like the idea is it's just like, oh, I'm just gonna take these pills all the time.
1:11:12
SPEAKER_01: It's kind of like, do you really need to be taking them all the time, or is it only during these key periods of the year or like when you're traveling or whatever it would be?
1:11:20
SPEAKER_00: And I think we all look for that path of least resistance, right?
1:11:22
SPEAKER_00: And that's kind of a box ticker when you're like, oh, I've taken all of these things.
1:11:26
SPEAKER_00: I don't need to go and eat fish, or I don't need to have four or five different fruits and vegetables today because I've done the thing, and that's not that's not how it works.
1:11:34
SPEAKER_00: What about within your particular domain?
1:11:36
SPEAKER_00: Like anything, let's take like environmental health, anything that you think that we see in the press that perhaps doesn't have as much robust evidence for and that we might be over overthinking.
1:11:49
SPEAKER_01: Or am I asking the wrong person that we might be over?
1:11:53
SPEAKER_01: I mean, again, I think that one of the concerns, like there's so many different exposures that are out there, and and it is again like for the individual, like, are you in a situation where that exposure is a real thing for you?
1:12:09
SPEAKER_01: And that's something often people don't know.
1:12:11
SPEAKER_01: Like, so this plastic thing and the papers that came out that were, you know, we had plastic everywhere, and people are then gonna stop using plastic, that's probably okay.
1:12:23
SPEAKER_01: Like, you know, like what have they given up by not you know, not having as much plastic around them?
1:12:28
SPEAKER_01: And so it's a reasonable thing to do.
1:12:30
SPEAKER_01: Um, I I think that again, like when I've seen things on various supplements, again, like though these come out every few months, someone's like, oh, this is the combination of what you have to do.
1:12:40
SPEAKER_01: And you're talking, you're trying to get someone to take medications often that have effects, and you're doing it not for the reason that they were prescribed, and there's not really good clinical information on it, it just becomes a concern to do that, you know, because you don't have that, you know, long-term evidence on it.
1:13:00
SPEAKER_01: Uh, but it's it's hard to point to individual things because it's often like how they're presented in the world.
1:13:05
SPEAKER_01: And it's different for every different individual.
1:13:07
SPEAKER_00: Yeah, yeah.
1:13:08
SPEAKER_00: Would you say there's like some, again, within your specific area of of expertise, some things that we're not as worried about as we should be?
1:13:19
SPEAKER_00: You know, like are there some really things that we could very easily fix, but we just don't think about that.
1:13:24
SPEAKER_00: I mean, we've spoken about some of them.
1:13:26
SPEAKER_01: Yeah, I mean, I I really, I really think that I'm very glad to see this attention on ultra-processed foods.
1:13:33
SPEAKER_01: The when you look at the percentage of people's diet that has gone to these ultra-processed foods to where it was 50 years ago, it it's really kind of an embarrassment for the US health system to see what we've let happen.
1:13:47
SPEAKER_01: And again, it wasn't, I don't think this was all something that was nefarious.
1:13:52
SPEAKER_01: It was just that, again, this convenience and the timing is if you go to Europe, which I'm going next week to Europe, the way they approach food is totally different.
1:14:04
SPEAKER_01: They they experience the food, they take time to prepare the food.
1:14:08
SPEAKER_01: Lunches in France are very different.
1:14:10
SPEAKER_01: They look at a cafeteria in the US.
1:14:12
SPEAKER_01: Like, why can't we focus more on the quality of our diet than other countries that get us just as much done as we do?
1:14:22
SPEAKER_00: Well, why can't we?
1:14:24
SPEAKER_00: This policy, I mean, it feels like a lot when in in the US, it feels and in the UK to some degree, like it feels like a lot of this is out of our control.
1:14:33
SPEAKER_00: And like I know we spoke about, you know, let's control the controllables and do what we can, but you know, as and and this is especially true with this sort of socioeconomic divide, you know, when there are kids living in a different part of New York whose lifespan is 10 years less than than ours.
1:14:48
SPEAKER_00: Like that is so I mean, I think there's so much you can do.
1:14:51
SPEAKER_01: Yeah, I think that, you know, for the Department of Agriculture has done amazing things in improving our food system, but their focus has often been is avoiding the bad things, making sure you don't have contaminants and viruses and things and foods.
1:15:07
SPEAKER_01: But I don't think there's been enough in that steering the quality of the food because it's not their domain was regulatory to make sure the food was safe, but that's different than making sure what got on someone's table was healthy.
1:15:21
SPEAKER_00: Yeah.
1:15:22
SPEAKER_01: It's not really their responsibility.
1:15:24
SPEAKER_01: That responsibility comes much more into the school systems.
1:15:28
SPEAKER_01: You know, it's it's like as long as we're getting those in there.
1:15:31
SPEAKER_01: And I think that we just haven't uh, I don't think we're taking very good care of our children.
1:15:36
SPEAKER_01: Like we've decreased recess and physical education, and the quality of the food in the cafeteria isn't as good.
1:15:42
SPEAKER_01: It's like, why we're not investing in our children's health?
1:15:45
SPEAKER_01: It's not right.
1:15:47
SPEAKER_00: Like the the standard of the food in the cafeterias is not improved.
1:15:51
SPEAKER_01: I well, I think the the challenge is they can tick the boxes of what needs to be there, but putting an apple on a tray doesn't mean the child's gonna consume that.
1:16:03
SPEAKER_01: Right.
1:16:04
SPEAKER_01: And I don't think we work enough in teaching children why they need to eat these certain things and actually making it making the easy decision for children to eat healthy.
1:16:14
SPEAKER_01: We we don't do that.
1:16:15
SPEAKER_01: There's nothing.
1:16:18
SPEAKER_00: And then it becomes a lot more than that.
1:16:20
SPEAKER_01: Yeah, like I mean you you train a three and four-year-old on fast food, their palates have have developed at that point.
1:16:26
SPEAKER_01: It's very hard to make them appreciate things that have lower levels of sodium in it.
1:16:31
SPEAKER_00: Where do you see this?
1:16:33
SPEAKER_00: How do you see this playing out?
1:16:34
SPEAKER_00: Are you optimistic about the future of your specific area?
1:16:38
SPEAKER_00: Like, where do you see this in five, 10 years?
1:16:41
SPEAKER_00: Like, what's the future look like?
1:16:42
SPEAKER_01: Yeah.
1:16:42
SPEAKER_01: I mean, my my hope is that in from a medical system is that when they get your routine blood work, is you can have like an exposone profile.
1:16:50
SPEAKER_01: And so everyone has information about their exposures, but they're equipped with things that they can do to improve it.
1:16:58
SPEAKER_01: And at a societal level, we can use that data to drive better policy.
1:17:03
SPEAKER_01: And so I do think that that is like a knowledge's power situation once you, once you have that.
1:17:08
SPEAKER_01: But it does have to become a routine thing that's relatively inexpensive for people to do that.
1:17:13
SPEAKER_01: Um, but I think my hope is that people, like you said, can focus on the major things, but we have to study all of them very systematically to say this is what we should focus on.
1:17:25
SPEAKER_01: And again, if you get back to like the diet aspect of it, which is where the nutritional quality comes in and many contaminants come in, that just seems to be the place that we need to do a better job of doing that.
1:17:38
SPEAKER_01: Um, you know, I remember talking to one of my colleagues at Columbia, Mark Bittman, who's written a lot of things for New York Times and cookbooks, is that he he really focused on how do we get people just to eat better and cook foods.
1:17:51
SPEAKER_01: And that's it's something where like he's held like summer camps and things for kids.
1:17:55
SPEAKER_01: Like we we really need to kind of build that in because investing in those things for children, like the payoff for that is huge.
1:18:02
SPEAKER_01: Yeah.
1:18:03
SPEAKER_00: And and for us, and for us, yes.
1:18:06
SPEAKER_00: Yes.
1:18:06
SPEAKER_00: I mean, the eating whole foods could be the greatest single health hack of all time, right?
1:18:11
SPEAKER_00: And I think that is is challenging, especially in big cities like this where the food is so convenient and tastes pretty good as well.
1:18:19
SPEAKER_00: You know, it's not and the cost, right?
1:18:21
SPEAKER_00: I think the cost is not the the the cost to live in a big city now is kind of frightening.
1:18:28
SPEAKER_00: And then on top of that, having to try and afford to buy the foods that are nutrient-dense, that are whole foods or organic, and you know, things for your home, I think this is not easy to pass through what's most imp impactful.
1:18:42
SPEAKER_00: Um, okay, a few more questions.
1:18:44
SPEAKER_00: I I could talk to you for hours and hours, and I'm not gonna keep you here much longer.
1:18:49
SPEAKER_00: How has studying this field impacted your life?
1:18:54
SPEAKER_00: Like, how has this changed your life and the lives?
1:18:55
SPEAKER_00: I mean, you've got six kids, by the way.
1:18:57
SPEAKER_00: That's remarkable.
1:18:58
SPEAKER_01: They're all semi-adults now, they're older, but um you know, I I think that again, having been a scientist who was looking at a lot of these different exposures and things, I've always been kind of paying attention to it.
1:19:10
SPEAKER_01: But I think this more systematic analysis has like refined that to really think about, I try to think about like the upstream drivers, is like what one thing can I do that improves four or five different things?
1:19:24
SPEAKER_01: Because I I am too busy and thinking about like how to, and so for example, like in thinking about like just diet, for example, is like, what do I have to have kind of stockpiled at work so that when I'm rushing that one day and I don't have a chance to eat, I do have a reasonably healthy alternative or at least a less bad alternative.
1:19:45
SPEAKER_01: Um, and just again, thinking about uh what sort of things do you stockpile?
1:19:50
SPEAKER_01: So, like trying to get some of the higher quality energy energy bar sort of things that have minimal ingredients in it that are more like they're still wrapped up in plastic, likely.
1:20:00
SPEAKER_01: Yeah, but just something where there's an RX bar or something.
1:20:03
SPEAKER_01: Yeah, yeah, something where they're just available so that rather than grabbing a bag of chips or something or or food that may be left over from a seminar, that I'm like, no, I want this many hundred calories and I want to have minimal ingredients in it, sort of thing.
1:20:17
SPEAKER_01: Um, and then also just uh, you know, I to me like it's the sort of like convenience of New York, it is so easy to eat out all the time.
1:20:27
SPEAKER_01: But again, when I when I was a child, like we always ate dinner together as a family, like just the idea of like dinner time where food is prepared.
1:20:36
SPEAKER_01: Um, I think one thing that people in places like New York City need to get over the idea is it's still cheaper to prepare your food at home.
1:20:44
SPEAKER_01: You buy a 10-pound bag of rice, you you buy a bag of potatoes, you buy fruits and vegetables, you buy meat.
1:20:50
SPEAKER_01: It's still, it seems expensive when you're buying it that first time, but it's like that's like 10 meals you're getting out of that.
1:20:55
SPEAKER_01: Yeah.
1:20:57
SPEAKER_01: And I think this is also a place where we've been talking about children quite a bit, but I think college age is also a transition time for people and how they're gonna feed themselves when they gain that independence.
1:21:09
SPEAKER_01: And I think that's a place where if you can influence people like like there's poor college students can be very resourceful in getting calories in.
1:21:18
SPEAKER_01: And often like they're cooking things and and do they learn to kind of, you know, when you actually have resources, how you keep doing that in a more enjoyable way.
1:21:27
SPEAKER_01: Yeah.
1:21:27
SPEAKER_00: They're good at being um uh frugal because they're trying to save all the money for partying.
1:21:33
SPEAKER_01: Exactly.
1:21:33
SPEAKER_00: I think.
1:21:34
SPEAKER_00: Yeah.
1:21:35
SPEAKER_00: If you were not a scientist, what would you be doing, do you think?
1:21:39
SPEAKER_00: Or or or if you had to pick another area of science to study in.
1:21:43
SPEAKER_01: So have you done Berkman inventories before, personality tests?
1:21:46
SPEAKER_00: Uh I've done the equivalent of the Bright Myers-Briggs.
1:21:49
SPEAKER_01: Yeah, so when you go through Berkman's Meyer Briggs sort of things, like I I'm green salesman type person.
1:21:54
SPEAKER_01: Is my wife says if that science thing doesn't work out, you could sell cars.
1:21:57
SPEAKER_01: Yeah.
1:21:58
SPEAKER_01: Is I mean, like the idea, I think I'd be selling something.
1:22:01
SPEAKER_01: Um, you know, for maybe now I'm selling the exposome, but it's still uh from a standpoint of like I've I've been a scientist, I think since I was a kid.
1:22:11
SPEAKER_01: Like I've I just that's that was my interest.
1:22:14
SPEAKER_01: And um, like why I like traveling and and activity and things, it's I'm a scientist and I don't know how else I'd do anything else.
1:22:22
SPEAKER_00: Yeah.
1:22:23
SPEAKER_00: Gary, are uh like personal care products like deodorants and soaps and things like that, are they meaningful exposures, do you think?
1:22:31
SPEAKER_01: Yeah, I think personal care products are certainly exposures, but they also have purposes.
1:22:38
SPEAKER_01: So uh they they do bring pleasure if it's a fragrance, um, they can uh prevent odors, which can also be a positive thing in people's lives and those around you.
1:22:51
SPEAKER_01: Um and and they're also, I mean, they're part of like our hygiene routines.
1:22:57
SPEAKER_01: And so I I'm not so concerned about uh everything in a person's personal care product being uh organic or things.
1:23:07
SPEAKER_01: I mean, it's I think it's a matter of just kind of paying attention to what you use.
1:23:13
SPEAKER_01: And so uh when you think about what is being used and how often you use it, um like a great example of this is that I'm not as concerned about the chemicals in a sunscreen as I am about the UV radiation that it's blocking.
1:23:32
SPEAKER_01: And so I I use sunscreen every day because I know it decreases my risk of skin cancer.
1:23:39
SPEAKER_00: What about things like deodorant?
1:23:41
SPEAKER_00: Like I we hear like horror stories about deodorants and hairsprays and makeup.
1:23:46
SPEAKER_00: Is there any treats to that?
1:23:48
SPEAKER_01: I mean, I think that uh as men, we have an advantage is we don't use as many personal care products.
1:23:54
SPEAKER_01: And I to me, like for the most part, the things that men use are less of a concern.
1:23:59
SPEAKER_01: When you start thinking about uh women, you know, they dye their hair, they, you know, they tend to use more things like you know, permanent sort of curling things.
1:24:10
SPEAKER_01: There, they're much harsher chemicals that are being used in those situations.
1:24:14
SPEAKER_01: And and I think that is something to kind of like weigh the the cost-benefit ratio of that.
1:24:21
SPEAKER_01: Uh but I think that they have done a lot like to to improve the quality and reduce the toxicity of many of those compounds.
1:24:29
SPEAKER_01: Um so so yeah, it's something where I don't think it's helpful to worry too much about those things.
1:24:35
SPEAKER_01: I think that I'm more concerned that people are healthy from the inside out.
1:24:40
SPEAKER_01: And if they if it's they're happier wearing makeup, I would just not buy unlabeled makeup from a place that might have no regulations on it, it might have lead or cadmium in it.
1:24:51
SPEAKER_01: Yeah.
1:24:52
SPEAKER_01: You know, like so buying high-quality products.
1:24:54
SPEAKER_00: Okay, I'll take that into account.
1:24:57
SPEAKER_00: Gary, is there one environmental exposure specifically that you try your hardest to avoid?
1:25:03
SPEAKER_00: Is there one that like feels much like heavier in terms of its impact than others?
1:25:08
SPEAKER_01: To me, I think some of the things that I'm concerned about is when I am using products like around my house or like so, like insecticides, herbicides, I will use them, but I would typically put on gloves or a mask or something, depending on what it was, just to minimize my own exposure and make sure like I wash my hands really well afterwards.
1:25:30
SPEAKER_01: And so, like from a yard work perspective, I need to kill the poison ivy because I'm really allergic to poison ivy, but I make sure I protect my skin before I apply those things.
1:25:40
SPEAKER_00: Should we remove candles from our home?
1:25:43
SPEAKER_00: Candles, incense, should we use that?
1:25:47
SPEAKER_01: Uh I think that candles and fragrances like that, again, can bring pleasure and joy to people.
1:25:53
SPEAKER_01: And I think if you if you're dedicated to having candles, I think having a device like you know, we talked about to monitor the particulate activity, you know, levels in your house that you can keep them in a safe level, you're probably fine.
1:26:08
SPEAKER_01: If you're monitoring them and you see these, you know, the bells and the red lights go off on the things, is that you probably want to rethink that.
1:26:15
SPEAKER_01: But I think the occasional use of such things um is is reasonable, uh, all other things being equal.
1:26:23
SPEAKER_00: If someone followed you around just day to day, is there anything that would stand out as unusual that you do to protect the your exposure?
1:26:35
SPEAKER_01: I mean, I think a lot of people would like wearing the mask on the subway every day.
1:26:39
SPEAKER_01: You know, it's something where I started doing that during COVID.
1:26:43
SPEAKER_01: And I while the the virus risk is lower, there's still just you're in New York City.
1:26:50
SPEAKER_01: There's a lot of you get on the subway platform, there's the air quality is not that good.
1:26:55
SPEAKER_01: And so I think seeing that the other thing is I always put in my headphones, and it's not to listen to music, it's decibel reducing headphones.
1:27:04
SPEAKER_01: I wear like industry standard headphones because the sounds on the subway are very loud, and I have a little bit of tinnitus in my ears, and so I just reduce that uh that noise coming in from it by wearing the the headphones every day.
1:27:19
SPEAKER_01: And you think that could be damaging that sound, or just you just can tell it is, but like when I after wearing these higher quality, my ears don't ring as much.
1:27:27
SPEAKER_01: And and they're just very sensitive to the screeching of the brakes when the subways come in.
1:27:32
SPEAKER_00: What's one very obvious myth that we're led to believe in your space?
1:27:37
SPEAKER_01: I don't know a myth.
1:27:39
SPEAKER_01: I I would say that organic food is healthier borders on that.
1:27:48
SPEAKER_01: Organic food has been determined to have fewer chemical residues on it, but it doesn't assess the quality of the food.
1:27:57
SPEAKER_01: So I think the assumption is that it's healthier.
1:28:00
SPEAKER_01: All I would say is that it does have fewer chemicals on it.
1:28:05
SPEAKER_00: Yeah, but we don't know if that actually makes a difference.
1:28:07
SPEAKER_00: Exactly.
1:28:08
SPEAKER_00: We can assume it does.
1:28:09
SPEAKER_00: Is there anything that you want me to ask?
1:28:11
SPEAKER_00: Anything you want to talk about?
1:28:12
SPEAKER_00: Anything that you think would be like a something you're working on?
1:28:16
SPEAKER_01: Yeah, I'll talk a little bit about the about the medication thing.
1:28:18
SPEAKER_01: So one of the projects we've been working on is trying to address why medications don't work as well as we think that they they should.
1:28:28
SPEAKER_01: And again, we've you have this field of pharmacogenomics where you go through and like we know from the people's genetic variants, they may respond better or worse to a certain medication.
1:28:39
SPEAKER_01: But that only accounts like for 10% of the variability that we see.
1:28:43
SPEAKER_01: And so we're using exposomics to see if we can figure out why some people don't respond as well to a medication.
1:28:50
SPEAKER_01: And and like in the US healthcare system, we do a lot of trial and error for medications.
1:28:55
SPEAKER_01: And I don't think we should have to do that.
1:28:58
SPEAKER_01: I think that people's, if you have their genetics and you have their exposome profile, we should be able to make better predictions about how they'll respond to medications.
1:29:08
SPEAKER_00: And I assume that that applies to nearly all medications, but also a lot of our lifestyle interventions, our skincare products, are the timing of when we eat or when we exercise.
1:29:21
SPEAKER_00: Like the combination of the exposome, our circadian biology, and our genetics, I suspect they're all things that influence the efficacy of those things, right?
1:29:30
SPEAKER_01: Absolutely.
1:29:31
SPEAKER_01: And the but the types of analyses that we're doing, when you measure things in people's blood, like the levels of those medications and their metabolites, those are all downstream from all those things you just mentioned.
1:29:43
SPEAKER_01: So it's capturing all of that.
1:29:44
SPEAKER_01: And so if you see a person, if they have a weird response to a medication, it's due to all of those things.
1:29:51
SPEAKER_01: But if that can help drive them into a different therapy that works better for them, that's that's the goal.
1:29:57
SPEAKER_00: That would I I imagine that's gonna be completely life-changing for nearly everyone if they had that like very clear resolution on their exposome.
1:30:07
SPEAKER_01: Combine that with that's the goal.
1:30:10
SPEAKER_01: Yeah, that's exactly what we're hoping to do is to demonstrate that you have that uh value from having that information.
1:30:16
SPEAKER_00: How far off do you think you are from being able to do that?
1:30:19
SPEAKER_00: Or is that a difficult question to answer?
1:30:21
SPEAKER_01: I mean, in in the research, like we're we're doing it right now in the laboratory in these large research studies.
1:30:26
SPEAKER_01: The challenge will be getting to the end of one.
1:30:28
SPEAKER_01: Yeah.
1:30:28
SPEAKER_01: Yeah.
1:30:28
SPEAKER_01: Like, so once we kind of care, like so.
1:30:30
SPEAKER_01: The idea is that I think what we need to get to this point in this sort of exposome-wide association studies is to prioritize which are the conditions that you should focus that effort on.
1:30:41
SPEAKER_01: Like, so for example, is it for blood pressure control?
1:30:44
SPEAKER_01: Is it for cholesterol control?
1:30:46
SPEAKER_01: Like, where is there the greatest variability where you'll get better value out of adding in this additional exposume information?
1:30:54
SPEAKER_00: Well, hopefully, as we begin to understand more about some of these signatures of aging as well, that that would move towards aging itself.
1:31:01
SPEAKER_00: Yeah, exactly.
1:31:01
SPEAKER_00: Right.
1:31:02
SPEAKER_00: And then that's the real sort of true north goal, I think, given that that is the biggest determinant of or or sort of influencing factor on all of those diseases.
1:31:12
SPEAKER_00: If you had unlimited resources, like any amount of money and access, is there something that you would love, a question you'd love to ask, solve, a hypothesis you'd like to test?
1:31:24
SPEAKER_00: Like what would be the real sort of true North ambition within the research if you if you had no restrictions?
1:31:31
SPEAKER_01: So, yeah, after the human genome project was completed, geneticists could do genome-wide association studies.
1:31:37
SPEAKER_01: They could study all the genes systematically.
1:31:40
SPEAKER_01: And this is what we're proposing now is that we think we could do a comprehensive exposome-wide association study for like 10 different diseases, probably about$150 million.
1:31:52
SPEAKER_01: And we're trying for phase one, and we're trying to convince the various funders in the US to do that because we've never had that level of comprehensive analysis of all these complicated exposures.
1:32:05
SPEAKER_01: And uh, I want to do that large-scale science.
1:32:09
SPEAKER_00: What would be the outcome?
1:32:10
SPEAKER_00: Like what if there was someone watching that could fund that sort of thing, what would be the return?
1:32:16
SPEAKER_00: Like, what would be the benefit of doing that, not necessarily financially, but for the for the world?
1:32:20
SPEAKER_01: Yeah.
1:32:20
SPEAKER_01: So, I mean, I think that you would have a much better understanding of the genetic and environmental, because if you know the environment, it helps you fill in the gaps in between the G by E.
1:32:30
SPEAKER_01: Is these are the places for interventions.
1:32:33
SPEAKER_01: So is the intervention a modification of diet?
1:32:36
SPEAKER_01: Um, pharma focuses on gene-based discoveries.
1:32:40
SPEAKER_01: They use GWAS to say that's the target, but we know that the environment induces diseases and problems.
1:32:47
SPEAKER_01: Like, why aren't the environmental targets the new drug targets?
1:32:51
SPEAKER_01: And we've actually used this.
1:32:52
SPEAKER_01: We've act, we're doing drug development for Parkinson's now, and it was based on an environmental modifier of the disease, not a genetic modifier.
1:33:00
SPEAKER_01: So I think it's going to open up this area of discovery for, you know, lifestyle interventions, policy interventions, and medication interventions across many different diseases.
1:33:11
SPEAKER_00: And I think that is really the sort of true north, that that's the big objective we should all be aiming for, right?
1:33:18
SPEAKER_00: And that is across all of these things that impact length and quality of life, being able to understand right now, in this moment, what should I be doing for my biology, my genetics, and my preferences, all in one go.
1:33:30
SPEAKER_00: And I think if all of us had access to a tool that could say, Gary, today this is what you should do and ignore everything else because we know this for all of these different reasons that are so layered, it would change the world.
1:33:43
SPEAKER_00: And I think that's gonna go some way towards it.
1:33:46
SPEAKER_01: And I think this is like something like I can imagine this app, like where you just think about are you on the right trajectory?
1:33:51
SPEAKER_01: Is your vector changing based on what's happening?
1:33:53
SPEAKER_01: And so if it's feeding in data from the right places, it's like, is this decision I'm making putting me in the right direction?
1:34:00
SPEAKER_01: Yeah.
1:34:00
SPEAKER_01: For whatever the decision is, like the sort of multiple integrator of all these things that you're I love that.
1:34:05
SPEAKER_00: I think that then gives you the agency to say, is it worth going to this concert?
1:34:08
SPEAKER_00: Yeah, right, exactly.
1:34:09
SPEAKER_00: What's the reward or the risk?
1:34:11
SPEAKER_00: And I think we're moving towards that very, very quickly because of brilliant work like people like you.
1:34:18
SPEAKER_00: Um, I'm gonna ask you one more question.
1:34:20
SPEAKER_00: Okay.
1:34:21
SPEAKER_00: This is probably the toughest one.
1:34:24
SPEAKER_00: But based on all of the decades of research that you've been doing in this space, if you had to give the listeners to this show one single takeaway, and that is one action that they could take that would be most impactful, what would that be?
1:34:40
SPEAKER_01: Boy, it's a hard question.
1:34:41
SPEAKER_01: I have to pick one.
1:34:43
SPEAKER_01: Um I I think you could do more than one.
1:34:45
SPEAKER_00: Okay.
1:34:46
SPEAKER_01: I I think that physical activity is one of the most important because it I'm not, I didn't, and I didn't say exercise.
1:34:55
SPEAKER_01: It's it's the physical activity is as we age, the it's that decreased activity that ends up causing so many problems and figuring out ways to increase your physical activity throughout all aspects of your life.
1:35:11
SPEAKER_01: Because like you might say, like, I I was a I I was a runner or something all through my you know 30s and 40s, but then like you injure your knee and you can't run anymore.
1:35:20
SPEAKER_01: Like you have to find ways to be active because as you age, things get harder to do.
1:35:25
SPEAKER_01: And like you may have been like a competitive baseball player, but you playing baseball when you're 50 years old, that's not gonna happen as much.
1:35:31
SPEAKER_01: And so finding ways to increase your physical activity um in in your day-to-day life, I think is one of the most important things we can do.
1:35:39
SPEAKER_00: Yeah.
1:35:40
SPEAKER_00: Build that suit of armor.
1:35:42
SPEAKER_01: Exactly.
1:35:43
SPEAKER_00: Gary, it's been a pleasure.
1:35:44
SPEAKER_00: Thank you so much.
1:35:45
SPEAKER_00: And having you back for sure.
1:35:47
SPEAKER_00: So in a year's time, I want to I want to know what's what changes have been made, how we've improved.
1:35:52
SPEAKER_01: Okay.