Unlocking the Secrets of Lifespan Extension With Karl Pfleger

This week, we speak with Karl Pfleger, PhD, who, after studying machine learning at Stanford and working a successful tech career, now does all he can to support longevity research and biotech. Karl discusses the inadequacies of traditional healthcare in addressing the root causes of aging and shares insights on groundbreaking research that can slow down or even reverse aging processes. He emphasizes the significant impact of lifestyle choices on longevity and previews promising future therapies, including stem cell treatments and mitochondrial health interventions. 

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Key Moments

“So, the traditional healthcare and medical practice in our country, in the US and most of the world, concerns really considering everyone to be baseline healthy until they get sick to a level where they’re very sick and they cross some kind of a threshold for diagnosis of having an actual disease. So, even though we call it healthcare, a lot of people kind of pejoratively describe it as sick care.”

“In short-lived species, you can extend lifespans manyfold. One single gene mutation in worms can extend their lifespans by 10X, for example. And even in mice, we have interventions now that can extend their lifespans by 30% or 40% sometimes. And many of these interventions work across multiple species. So, we believe they’re likely to work for people as well.”

“I wanted them to realize how big [the longevity field] had gotten so that they wouldn’t delay getting into it with more serious amounts of money. They didn’t realize that they were two years behind given how fast it was growing.”

Connect with Karl Pfleger

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• AgingBiotech.info
• LinkedIn

Transcript

00:00:00:05 – 00:00:03:14

David

Hey, Carl, Great to meet you. Great to have you with us today.

00:00:03:17 – 00:00:04:09

Karl

Glad to be here.

00:00:04:12 – 00:00:06:20

David

Where does this podcast find you today?

00:00:07:01 – 00:00:07:18

Karl

San Francisco.

00:00:07:20 – 00:00:13:14

David

You have quite a background. Could you tell us a little bit about where you were and where it’s brought you to today?

00:00:13:16 – 00:00:33:03

Karl

Yeah, the sort of capsule comment of history is I was a tech guy. I have a Ph.D. from Stanford in artificial intelligence in computer science, focused on artificial intelligence, machine learning, Gillnets. I did that a little bit early before the explosion in AI and deep nets from the mid 20 tens. I was about 20 years before that and I started working on it.

00:00:33:05 – 00:01:13:04

Karl

Then I worked at Google for about a decade doing practical, big data, machine learning stuff and then I decided to refocus my attention on things that would most help the world, most help the most people in the world. And cursory analysis suggested that besides the poorest of the poor, you know, living in sub-Saharan Africa and places like that on less than $2 a day, the the highest leverage other thing in the world was to fight against the aging process, because aging is what kills the vast majority of people, 70% globally, 92 and a half percent plus in Western developed countries.

00:01:13:04 – 00:01:35:15

Karl

That’s really a science and technology play more than a lobbying political play. So I decided and also I lived in the San Francisco Bay Area, which was kind of ground zero for that science and the biotech and the entrepreneurship and so I just basically whole hog switched fields and have just been ramping up the bio knowledge ever since.

00:01:35:17 – 00:01:46:04

Karl

Started with philanthropy then got into investing and I’m also doing a whole bunch of other things involved in community building and information dissemination with my website Agent Biotech and.

00:01:46:06 – 00:01:59:06

David

It’s an incredible resource, this thing that you’ve built. Aging biotech dot info and we will put that link in the show notes. And I’m going to ask you a little bit about that in a minute. But first, before we get that, let’s get to sort of baseline definitions. What does aging mean to you?

00:01:59:12 – 00:02:45:02

Karl

So the traditional health care and medical practice in our country, in the US and most of the world concerns really considering everyone to be baseline healthy until they get sick to a level where they’re very sick and they cross some kind of a threshold for diagnosis of having an actual disease. So even though we call it health care, a lot of people kind of try to accurately pejoratively describe it as sick care because it’s really what we what the science in the last two or three or four decades has discovered is that the reality of the situation is that the process of aging from the time an organism, animal or person becomes an adult, in

00:02:45:02 – 00:03:26:03

Karl

some ways, in some cases starting even before they become an adult. There are a bunch of biochemical molecular processes and there’s and there’s multiple of them, maybe 5 to 15 ish. And people argue about exactly how many that which which things count, which together underlie all chronic diseases that people have for decades as they get older. And that set of diseases includes all the top killer diseases, heart disease, cancer, all the dementias, including Alzheimer’s and Parkinson’s, diabetes and a bunch of things that don’t kill you but make life really terrible as you get older, like osteoarthritis, osteoporosis, age related blindness, and not.

00:03:26:03 – 00:03:27:23

David

Only.

00:03:28:01 – 00:03:54:16

Karl

Do the do all those terrible conditions sort of directly attributable to the molecular changes of aging, but traditionally people thought of aging as this sort of the unalterable clock that just ticks at a constant rate. But we now know after the science that’s gone on in the past half century that one can actually interfere with the rate at which the aging process is marked on.

00:03:54:18 – 00:04:23:15

Karl

You can slow them down considerably and in short lived species you can extend lifespans by manyfold. One single gene mutation in worms can extend their lifespans by ten X, for example. And even in mice, we have interventions now that can extend their lifespans by 30% or 40% sometimes. And many of these interventions work across multiple different species. So we believe there’s likely to work for people as well.

00:04:23:16 – 00:04:31:05

Karl

It’s harder to tell the people because to do the study you have to wait so many decades. And so we’re working on other ways to tell if it’s working or not.

00:04:31:11 – 00:04:38:19

David

You mentioned the word clock. How do you feel about, you know, there’s a lot there’s a Horvath clock there, these methylation clocks, there’s a number of.

00:04:39:01 – 00:05:08:19

Karl

These new kinds of cool biological clocks are an attempt to measure the underlying molecular changes so that you can tell better how well, how fast somebody has been aging, how old they effectively are from a biological standpoint. And there’s a big history there. The big you know, there’s multiple ways to build a clock. One can do functional readouts like how fast can you run, how strong are you, how fast can you think?

00:05:08:21 – 00:05:28:06

Karl

The big clocks that have happened in the field recently are based on DNA methylation, which I think one of your previous guest has already described, which are these small chemical groups get attached to the DNA which basically affect which genes can work or not in a given cell. And that epigenetics is what controls the difference between different types of cells.

00:05:28:08 – 00:05:52:12

Karl

But those changes can also be measured because they sort of progress in certain patterns as people age. And there have been multiple generations of these clocks. And we can talk about, if you want, about which ones are better and worse. But there’s all kinds of interesting things happening with these clocks, making them better. And every year or to a new fangled realization comes out from some basic science that shows that the previous clocks weren’t as good as they could be.

00:05:52:12 – 00:06:15:10

Karl

And here’s a way to make them better. And there’s been two or three of those developments just in the last two or three years. So all the clocks from five plus years ago are really there’s just much better stuff available now. And some of these are available direct to consumer. The companies and I don’t have any financial stake in any of these companies, but the company, true diagnostic and the company, at least in both cell 300 to 500 clocks to consumers.

00:06:15:10 – 00:06:38:11

Karl

And those are some of the best ones that are currently available on the market. One of the recent developments is that they can now tell from these DNA methylation patterns how fast certain individual organs or systems in the body are aging, not just the age of the entire body. So you get like a liver age and a brain age and an immune system age, etc., for, you know, nine or ten ish systems.

00:06:38:13 – 00:06:48:02

David

I’m curious, you’re a data guy. How much utility do you feel these clocks have? I know a lot of people we’ve we’ve had some of those folks on the show. As you said, you don’t have an interest in them. I’m just curious.

00:06:48:02 – 00:07:13:16

Karl

This is a big debate. Like how much utility those clocks give to humans right now. I can’t tell you definitively what the answer is, but here’s a few pieces of information about that question that you can use to triangulate what you think the answer might be. So first of all, the reason people are very interested in these clocks is what I alluded to a minute ago, which is that to do a lifespan study in humans would take decades and people don’t want to wait that long.

00:07:13:19 – 00:07:35:11

Karl

Ideally, what you can do if you have a clock that really did tell you the true underlying biological age is that you could test various interventions and see which ones made people younger or which ones made them age more slowly. And that would tell you quickly whether or not you had a good intervention and which things you should take, etc., what things you should do.

00:07:35:13 – 00:07:55:12

Karl

So that’s the reason why there’s a lot of interest in this. And people are already using that strategy in developing new drugs by looking at clocks on mice and by looking at clocks on people. And we’ll see, you know, the proof will be in the pudding as we start putting those things to clinical trials, which things we whether that clock strategy actually works.

00:07:55:16 – 00:08:18:08

Karl

In the meantime, the clocks are getting better. And so even if it doesn’t work in the past, we’re getting closer and closer to true accuracy in terms of the clocks that are available. Now, what I’ll tell you is that there’s a growing interest in these treating aging and longevity as a direct target by medical doctors. So there’s a there’s a usually this goes into the umbrella term and a phrase longevity clinics.

00:08:18:08 – 00:08:42:21

Karl

And there’s a few places in the world where people are coming up with these clinics to directly assess people’s aging and try to help treat, you know, even essentially trying to help make healthy people even healthier. It’s sort of like functional medicine, but with a slightly different bent. And most of those longevity clinics, at least the most prominent ones that go to the global conferences and things, are using these clocks directly on their patients.

00:08:42:23 – 00:09:05:15

Karl

So they think that they’re good enough. Most people in the field don’t think that they’re good enough to be surrogate endpoints in clinical trials, right? So good biomarkers like blood pressure and cholesterol have already been approved by the FDA as things that you can use as targets for your drugs to get a drug approved on the market. Right.

00:09:05:15 – 00:09:26:09

Karl

So nowadays, to get a drug approved to help with heart disease, you don’t have to run a 30 year clinical trial. If you can show that it decreases cholesterol, you can get it approved. And similarly, if you can show that it decreases blood pressure, you can get it approved. We don’t we aren’t at that point where people trust the clocks well enough that if you just lower the clock, you can get a drug approved.

00:09:26:11 – 00:09:50:09

Karl

So that indicates that the clocks aren’t good enough for prime time yet, yet on the other side. So that’s sort of about upper bound, you know, on how good they are, the lower bound on how good they are that not enough people in the field talk about is that and this is a bugbear of mine that I repeat a lot is that most of the data suggests that they’re already better than chronological age.

00:09:50:09 – 00:10:15:10

Karl

Right. Chronological age basically represents the number of times the ball we live on is going around the big hot ball in the middle of the solar system to use a phraseology that Jordan slain doctor in San Francisco here gave me a few a week ago. And that seems like a pretty arbitrary way to measure, you know, something that you’re going to use clinically.

00:10:15:14 – 00:10:35:07

Karl

And yet in medicine, we do use what is called in your medical chart age clinically all the time. Right? The age at which you supposed to start getting asked these is based just on that chronological age, the the age that is used as cutoffs for when you should have COVID shots or whether you should have COVID shots during the pandemic was based on age.

00:10:35:07 – 00:11:07:23

Karl

And there’s a hundred other ways that people medically make decisions based on thresholding. That one number, the clocks that we have now are probably already at the point where they’re better than that, but they aren’t used that way at the moment. So, for example, you know, all clinical trials, another way we use age is that we look at the baseline age of the treatment and the control groups and we make sure they’re reasonably balanced so that if you run a clinical trial on a new drug, you didn’t put all the old people in the in the control group and all the young people in the treatment group, you know, instead of using chronological age, we

00:11:07:23 – 00:11:27:17

Karl

should probably at the very least be B, testing biological age, using these clocks and using that as a way to make sure that there wasn’t a skew that we didn’t detect in a clinical trial. And I think that kind of realization of this increased use of these clocks over time is going to is going to happen in terms of the system aging clock.

00:11:27:17 – 00:11:54:04

Karl

So I’m very excited that, you know, getting a clock that tells you that, you know, you’re mostly aging fine, but one particular organ is actually way out of whack and aging much faster. Those are a good way to detect that. It’s time to use conventional medicines, way to assess organ health more specifically. So, for example, if it says your kidneys are way, you know, 20 years older than the rest of you, that’s a good sign.

00:11:54:04 – 00:12:09:12

Karl

You should maybe go do some extra blood tests and maybe some scans on the kidneys. And so I think that that’s going to come along soon as well. But we’re not quite there yet. World where traditional doctors or even the longevity clinics are doing that with the systems that’s play a couple of years away.

00:12:09:15 – 00:12:31:12

David

I’ve had Ryan from True diagnostics on and we’ve talked about his clock and pace done and that stuff. What I would like to see is someone someone probably clever from your field to make a composite of the methylation clocks with functional inputs like what’s your VO2 max, How long can you hold, what’s your grip strength, you know, this sort of stuff put together something that that goes together.

00:12:31:12 – 00:12:34:05

David

That’s a that’s a big math problem far beyond me.

00:12:34:05 – 00:12:55:15

Karl

But and in the meantime, other omics are coming along. Right. Methyl methyl that the true diagnostics commercializes is based on on the systems clock there is based on work at Yale from Morgan Levine’s group, she then Altos and the Ph.D. student stayed Rive officer’s name and finished that work and then to diagnostics just licensed it and sells it.

00:12:55:15 – 00:13:22:21

Karl

But a paper just came out of CUNY was Corey’s lab at Stanford in the past six months or so with a similar kind of systems clock based on the proteome. So based on just looking at proteins, based on some logic as this array where you can test 5000 different proteins in blood. And so they basically made a clock and we haven’t even started doing the detangling of the math of like correlating those and seeing how you can use both to get a better overall read, let alone to combine the functional stuff too.

00:13:22:21 – 00:13:25:22

Karl

So yes, there’s there’s a lot going to come down the pike.

00:13:26:02 – 00:13:45:07

David

And not to get too heavily into clockwork, but I did sort of off the record books, Ryan from True Diagnostics. And I said, listen, you’ve got, you know, a lot of data here. What are you seeing that actually moves the needle, like I said. So metformin move the needle is not HGH. He’s like near Slate. Negative. I said you know, sirolimus rapamycin, that stuff.

00:13:45:12 – 00:13:47:13

David

He’s like, Oh yeah, that works. Yep, that works.

00:13:47:19 – 00:14:08:19

Karl

Part of the trick here is that what moves the needle will vary depending on what your baseline starting point is. People are very different. Right? Right. If you’re very, very overweight, a different set of drugs are going to move the needle versus if you are not. And if you are, you know, if you have certain weird conditions that not a lot of people have things that help.

00:14:08:19 – 00:14:15:14

Karl

Correct. That won’t appear in his overall data set because he’s just looking at the data set on most people who’ve used his test.

00:14:15:16 – 00:14:39:23

David

That’s right. He’s just looking at large populations. Brian Johnson, who I’ve had on the show, uses that test and he makes a big deal out of his greatest reduction. But you have to look at where Brian was to where he is now. And actually myself, the delta between my my actual age and my biological age is measured. The same clock is better than Brian’s, but it’s only because I wasn’t coming from such a bad place as he was.

00:14:39:23 – 00:14:41:23

David

So something to keep in mind.

00:14:42:01 – 00:14:55:05

Karl

I posted this this point, too, on social media, which is that, you know, the amount of improvement isn’t the right measure because that just rewards you starting getting yourself in the job right before you start measuring.

00:14:55:06 – 00:15:00:05

David

And that’s not what we want. Let’s tell everybody about aging, biotech. What I got.

00:15:00:05 – 00:15:24:10

Karl

Into the field in the mid 20 tens, there was it was much smaller field. It’s grown considerably, which is great. It’s still a very small corner of the overall biotech world. But but it’s growing because there’s an inevitable logic of treating these underlying biological causes that underlie so many different bad conditions. But when I got into the field, it was small, but there was still quite a lot written about it.

00:15:24:12 – 00:15:58:09

Karl

Most of the stuff that was written was just prose, right? There were books and there were blogs, and it was a lot of blobs of text, and there were some companies already in the space, and I decided to get into investing in the 2016 ish and started investing in biotech companies in 2017. One of the things I did once I started doing that was every time I went to a conference or an event where any company was mentioned, I wrote it down on the list and quickly my list of companies was 100 to 120 companies.

00:15:58:09 – 00:16:23:18

Karl

You know, I hadn’t investigated each one, so I wasn’t sure whether I counted each one as, you know, really being an aging and longevity related company or not. But so it was all new. So I didn’t have an exact count 100, 120. And I kept reading these stories of people talking who were giving an overview of the whole aging or longevity field, talking about how there’s 30 companies where there’s 40 companies or usually there’s 25 companies, something like that.

00:16:23:20 – 00:16:44:13

Karl

And I was like, Wow, these people don’t know about a lot of the companies. And I would talk to the professors who work in the field. So just north of me here in San Francisco, there’s a place called the Buckeye Institute for Research on Aging. It’s the largest independent. It’s essentially a sort of Ivy League Stanford at MIT level biology department, sitting all by itself without it, the rest of the university around it.

00:16:44:15 – 00:17:05:04

Karl

But and we’re it’s not just the biology department. Every single one of the 20 on the order of 20 pitches are all focused specifically on the biology of aging. And, you know, the professors and postdocs there didn’t even realize how. And that was the most that was sort of like ground zero at academia for aging stuff. And they didn’t even realize how many companies there were at the moment.

00:17:05:06 – 00:17:23:07

Karl

So I decided that instead of keeping my list of companies as sort of some kind of internal secret to make my investing be better, I would just open source it, essentially. And so I put it together and put it on this website. I called it Aging Biotech gut info, and I made it just a pro-bono open, open, free nonprofit for everybody.

00:17:23:09 – 00:17:58:12

Karl

And it’s worked pretty well. The goals when I the you know, the use cases I envisioned when I started it were I wanted the post-docs and Ph.D. students and even professors to realize they had an exit ramp from academia if they wanted to do something else. As they could start a company. And I wanted to invest one of the tech people in Silicon Valley, the venture capital groups, to realize that they should be putting more than a few percent in this field, that there was a lot more going on than they thought, and they should be ramping up to five, ten, 15% of their mostly tech portfolios, which they, you know, which they have done.

00:17:58:12 – 00:18:17:22

Karl

I’ll never know how much this website contributed to any of that, but that has certainly helped. I’ve heard people tell me it’s helped. And I one of the big investors, the investment banks in this sort of instance, you huge institutional money, pension funds and all, they were kind of vaguely paying attention to the field, but one or two of them would release a report every now and then.

00:18:18:03 – 00:18:52:14

Karl

I wanted them to realize how big it had gotten so that they wouldn’t delay getting into the field with more serious amounts of money just because they didn’t realize that, you know, they were two years behind and realizing how fast it was growing. So that was the goal. And and because there were all these blobs of text and prose, I decided that in making it, I would not make, you know, for example, a Jim Mellon wrote a book in 2017 that had a list of 50 or 60 companies with like a paragraph on each one, you know, and had little it had fields like a database and that it would have a, you know, something

00:18:52:14 – 00:19:09:23

Karl

in a coal and in some things would have a few categories for each one. But they were also present in this text. So I decided my website would all be about structured info. So it’s, it’s basically a flat file database and table and it’s got lots of fields that you can sort by the number of employees which clinical trial stage and the people are really like the companies list.

00:19:09:23 – 00:19:41:00

Karl

And since then I’ve expanded the set of information on the site to include basically being a one stop shop for linking to everything important in the aging and longevity field that’s outside of academia. So it’s too, too complicated and intractable to make a list of every single lab at every single university all across the world that’s doing anything related to aging, especially as the field grows more and more biology departments and more and more biology professors have at least something in their lab that’s touching or related to aging.

00:19:41:00 – 00:20:12:17

Karl

And so that’s just pretty crazy amount of stuff. But for people to get any benefit from all this science and biotech development, it will have to go through companies. And so essentially this site now has not just the list of companies, but it also has a list of the best books, the best podcasts. I just put this one on this weekend, the best journals, the best conferences to go to a sort of a one stop shop of everything important in the field.

00:20:12:17 – 00:20:41:10

Karl

If you want to ramp up your knowledge from nothing. Even for researchers, there’s useful things. There’s a list of databases that a post-doc, Francesco Neri at the Buck, helped put together that has a bunch of free public databases that researchers can download and play with lots and lots of data. And there’s there’s a wealth of really good data as because this is the new thing in the 2020s and beyond is that biology generates huge amounts of data and a lot of that’s just given away for free.

00:20:41:10 – 00:20:56:18

Karl

Just have to do the glue code to make sure you can access it. And so there’s a lot of really interesting stuff going on there. There’s even a list of the common objections people hear when they when they hear about the field, like, Oh, it’s going to cause overpopulation or oh, it’s going to be only for the rich.

00:20:56:18 – 00:21:18:21

Karl

And, you know, smart people have thought about each of the sort of top ten or so of these objections and analyze them very carefully and come up with two or three or four good counterarguments that show why that objection is not a good reason to not do science in this area. And so there’s a one page sort of summary of the top three counterarguments to each of the top ten objections as one of the tables there.

00:21:18:21 – 00:21:23:19

Karl

So anyway, it’s a it’s a one stop shop. It’s free. Check it out if you are interested.

00:21:23:21 – 00:21:34:07

David

Just repeat. It’s called aging biotech dot info and I will testify it is, if not the most information dense website I’ve ever seen. It’s up there.

00:21:34:11 – 00:21:53:14

Karl

It’s yeah it’s amazing site is very much like you know Google the company I worked at for a long time which is you know it’s not flashy its UI is not optimized to be flashy it’s just optimized to get information to you all. Almost all the information on the site, you know, all the information on the site comes from other web pages.

00:21:53:14 – 00:22:13:15

Karl

It’s all public. I don’t disclose anything. I find out privately from conversations with companies, anything like that. And so most of the of the cells in the tables are direct links to where the information came from, which allows you to, a, verify the accuracy and be tell if anything’s new, you know, to the extent to which it goes out of date, you just have to click the link to actually get the up to date.

00:22:13:15 – 00:22:27:07

David

And so that brings me to what’s working now and what will be working and the reason I to come on the podcast, Carl, is to answer those questions because you are an investor with a long term horizon, as you say.

00:22:27:09 – 00:22:53:17

Karl

Let’s see what you can do now and what the and what the ranges. Exactly. If people want to follow me, I’m on Twitter and I’m on LinkedIn, I’m easy to find. And I posted it on our social longevity as well. Covered a lot of these topics there but I’ll but I’ll give a capsule overview here. There’s enough epidemiological data on humans to show that it’s very clear that lifestyle ill affects your rate of aging to the point where it affects longevity, human longevity.

00:22:53:17 – 00:23:28:16

Karl

And so there’s multiple papers that show that doing the unhealthy things versus doing the healthy things in terms of diet, exercise, inactivity, sleeping and abuse of of alcohol and other other substances makes a 12 to 14 year difference in lifespan. And that’s, you know, and you can do this in various different ways. And there was you know, there’s multiple papers that suggest, you know, a couple of years for each one of these things, you know, eating at least five servings of fruits and vegetables, you know, not being a couch potato, etc., etc..

00:23:28:22 – 00:23:59:08

Karl

And you can go into the details. There’s there’s some papers that suggested some in the mid-teens like that, 12 to 14 years. That’s if you sort of take each one of those lifestyle factors and just make them a binary like do you eat healthy versus unhealthy? Do you smoke versus not smoke? If you if you break those down into like finer grains deciles and then you take, you know, what is the you pick the best one, you know, that’s the best level of exercise versus completely non smoking nothing versus smoking a lot.

00:23:59:13 – 00:24:19:01

Karl

You’ve maybe that maybe the difference goes up to 20 years in lifestyle. But essentially what’s happening is that a lot of people think of it as the sort of this sort of an average lifestyle of what people are living right now today, 2020s in the US, for example, and that there’s better lifestyle you can do that will get you extra years.

00:24:19:01 – 00:24:45:14

Karl

I think of it the other way around evolutionarily. A lot of the things that we do to shorten our lives now after the Industrial Revolution are things that have changed compared to the long evolutionary history. And so I think of it as like the optimal is the sort of baseline, and that’s the sort of normal rate of aging for a human before we, you know, lived in offices and didn’t do much activity during the day and ate real food.

00:24:45:16 – 00:25:03:08

Karl

Instead of all this packaged, processed, largely junk. And what we’re doing, what a lot of people do, what the average does and what a lot of people do is speeding up your rate of aging. And it’s very easy to speed up your rate of aging by doing bad things right, smoking, being couch potato, etc. not new chronic sleep deprivation.

00:25:03:10 – 00:25:27:07

Karl

So one can control those things to a certain extent and get longer life and not just longer life, but importantly, a longer duration of health. Because you stave off the biological processes, you slow them down that cause all these terrible things that make life unfun and and cause death. So so that’s what’s happening now is that we have this ability with lifestyle to control these things.

00:25:27:07 – 00:25:48:05

Karl

And there’s not just it’s not just the sort of typical grandmotherly exercise and eat right. There’s also fine tuning one can do with some personalized medicine in terms of, you know, you don’t want to be deficient in anything super, super important. It seems pretty clear, for example, that vitamin D deficiency probably speeds aging Omega three. Deficiency is probably not good, especially for brain.

00:25:48:11 – 00:26:14:21

Karl

And there’s a whole bunch of these kinds of things that that also will speed things up that are more in the realm of supplements and optimizing one can address some with food. Okay. So all that’s happening now in the now what’s also happening is we have some drugs that we’ve identified on the market that exist already, and there’s lots more in development and not just drugs, but other kinds of advanced biological therapies like cell therapies, like stem cells and like gene therapies that are coming.

00:26:14:21 – 00:26:37:12

Karl

They’re being developed to try to improve on a number of things. And broadly speaking, I put them in two different categories on those that are attempting to slow the rate of aging and those that are attempting to reverse or undo some of the molecular damage or molecular changes that happen with aging. And there’s lots of work in both areas.

00:26:37:12 – 00:27:18:10

Karl

So for example, there are a lot of drugs that can directly act on the same pathways that are affected when one simply eats healthy food and not too much. And you can essentially mimic some of the lifestyle things biochemically with with treatments. Rapamycin is an existing drug that a lot of people talk a lot about. It affects the immature pathway, which is the same pathway that’s affected when you don’t eat and when you don’t when you have protein restriction or calorie restriction and you and you eat less and there’s lots of people working on better versions of that and there’s a whole bunch of other drugs that affect various aspects of the very complicated biochemical

00:27:18:16 – 00:27:37:03

Karl

web of metabolism that can slow down your rate of aging, essentially. But we don’t know just how well any of them work yet because of this problem where you can do we know how well they work in mice, but we don’t you know, it doesn’t translate well to people usually. And we don’t have enough time to figure out exactly how well they work in people.

00:27:37:03 – 00:28:02:00

Karl

So there’s lots of debate about a lot of these things. But, you know, there’s two, three, 400 companies now working on bringing these things to market that will either slow down your rate of aging or fix some of the subcategories of different molecular changes that underlie the age related disease. So so we can talk about what are some of the sub areas of the field.

00:28:02:00 – 00:28:27:12

Karl

And there are a couple different papers and ways that people have tried to break down the overall aging field into different categories of molecular and biochemical processes that are happening as one ages. And there’s the most famous one is a paper called The Hallmarks of Aging. That came out in 2013. But about a decade before that, Aubrey too.

00:28:27:12 – 00:28:50:13

Karl

Gray had his 7 seconds areas. And and there was also one called the Pillars. And about a decade after the Hallmarks, they expanded the original nine into 12 or 13 or 14. We won’t talk about there’s especially still arguments about exactly which ones are important but there are some that everyone kind of agrees on. So let’s just cover a couple examples.

00:28:50:13 – 00:29:12:14

Karl

Right? The accumulation of senescent cells. So senescent cells are normally some of your cells in your body don’t divide anymore. The call post mitotic, but but many of the cells in your body are stem cells that will continue to divide over the course of your life and provide renewal to pools of cells that are constantly turning over and dying.

00:29:12:16 – 00:29:42:06

Karl

Many immune cells are constantly turning over and dying, and new ones come along when a cell sometimes cells get damaged and they get damaged in such a way. Most of the time when cells get damaged, they just die. But some of them, when they get damaged, go into this state called senescence where they can no longer divide. And that’s good because then they don’t go into the other state that a lot of cells get damaged and go into, which is cancer, which of course means they do divide too much.

00:29:42:07 – 00:30:15:09

Karl

But but it turns out that people now know that senescent cells accumulate with age, so the body has more and more of them as you get older. And they’re they’re better than cancer cells. That’s good. But they’re bad because they send out these chemical messages that cause inflammation constantly. They’re basically part of the normal immune response. But when they accumulate and they don’t get cleaned up and they live a long time, they cause the body to go into this sort of hyper and inflammatory state all the time.

00:30:15:09 – 00:30:38:03

Karl

And as a result, they they damage cells around them that are getting these signals and make them more likely to turn senescent to and also more likely to turn disease. So they figured out this a while ago that if you kill all the senescent cells in a mouse or kill all the P16 positive cells, which is an approximation for senescence, the mice lived 30% longer in better health.

00:30:38:08 – 00:31:13:22

Karl

And so that kicked off a big race to come up with some lytic drugs. Some lytic is the word. This means to kill the senescent cells. And now there are 12, 15, maybe 18 different companies working on various ways to treat the accumulation of senescent cells. Most of those companies are working on killing the senescent cells, and the idea is that you would do that intermittently so every couple of years would kill all your senescent cells and then you would let them start accumulating again because you don’t want to like there are some good benefits, like when wound healing is involved.

00:31:13:22 – 00:31:33:22

Karl

When you get wounds and you heal the senescent cells involved in that process. So blocking the whole process might be bad, but there are companies that are working on that is an angle anyway on hope to get around the negatives. So besides just killing the senescent cells, there’s companies that are working on preventing cells from turning senescent in the first place, or at least reducing the rate at which they do.

00:31:34:03 – 00:31:54:15

Karl

And there are other companies working on letting senescent cells be there, but blocking their inflammatory signaling. So those are typically called center morphic companies. There are a couple of companies working on taking the senescent cells and reverting them back out of senescence to become normal, normal state again. But the majority are working on just killing them. And there’s a lot of different approaches to that.

00:31:54:17 – 00:32:15:12

Karl

And that’s one of the things that’s been going on the longest in the field since the mid 20 tens and is there’s one company that’s publicly traded called Unity that’s famously had a couple of clinical trials, some of which have failed, some of which have done okay, one of which did okay. And phase two. And they’re pursuing a diabetic retinopathy indication right now.

00:32:15:17 – 00:32:37:14

Karl

This is one of my favorite areas of the field is the killing of senescent cells. For a long time, a lot of the work was approached by repurposing chemo drugs that are good at killing cancer cells. Cancer cells and senescent cells. Both have the property that they’re damaged in some way and they end up that end up making them more fragile than normal cells.

00:32:37:14 – 00:33:00:20

Karl

So of course, the idea behind chemotherapy originally, now we have more targeted ones. But you know, originally it was just basically let’s give all the cells in your body some poison and the weak cells will die and the rest will survive. And the weak cells are mostly the cancer cells. And so that’s a way to differentiate. Now we have better chemo drugs that are more targeted, and we’re applying the same kind of targeting or slightly different targeting to senescent cells.

00:33:00:20 – 00:33:22:15

Karl

But at first, the senescent cells, we’re being approached by this find chemo drugs that we can repurpose that happen to particularly like to kill senescent cells. Nowadays we have some even better Gen2 therapies coming along, but they’re still in preclinical development, so there’s still going to be a few years before they can start, or a year or two at least before they can start phase one clinical trials in humans.

00:33:22:17 – 00:33:50:08

Karl

But some of the interesting approaches, for example, are of do the same thing that they did in the mouse studies where they showed that the killing the cells every now and then, the way they did that in mice is they created they did something they can’t really do easily in people. They created a transgenic line of mice, but they created a whole new strain of mouse by affecting the genome and made it so that a simple drug would just kill all the P16 positive cells.

00:33:50:10 – 00:34:17:13

Karl

Well, to do that equivalent thing as a treatment, not without affecting the genome in utero or before conception, you would have to have gene therapy. So there’s a company that’s working on non viral gene therapy to basically kill P16 positive cells in exactly the same way. There’s another company that’s working on figuring out which cells in the immune system actually inhibit, normally kill senescent cells.

00:34:17:13 – 00:34:32:17

Karl

And one of the reasons why they accumulate with age is because the immune system is gets worse at killing in the same way that it gets worse at killing cancer. And that’s one of the reasons that cancer gets more likely as you get older. And so, of course, the separate part of the field is working on restoring the immune system to full health.

00:34:32:18 – 00:35:03:22

Karl

But within this analytics world, there’s a company that’s working on figuring out that specific part of the immune system that works in killing senescent cells and poking that back into higher gear. So that works more like when you’re young and there’s a there’s a variety of other approaches. So that’s just one example area of what’s going on. So in five years to eight years, maybe the outside ten years, I think you’re we’re very likely going to have multiple companies with approved therapies on the market to kill senescent cells.

00:35:04:00 – 00:35:38:11

Karl

One of the problems is we don’t actually know. We don’t actually have a good measure of just how many senescent cells one a human has in their body. So figuring out who will need these therapies will be a little bit tricky. So right now, of course, also senescent cells accumulation isn’t an FDA indication. So all these companies have to find official diseases that are have a high build up of senescent cells as implicated in their pathology and then go after treating those diseases on the assumption that there’s a lot of senescent cells in the bodies of people who come down with those diseases.

00:35:38:14 – 00:36:00:03

Karl

And so that’s the way all the companies in this field get to market, is they have to find some disease that happens to be related to the aging change they’re working on. So for senescent cells accumulation, there’s there’s James Kirkland at the Mayo has a slide of about 20 or 22 different conditions that there’s good evidence that senescent cells accumulation is a part of the pathology.

00:36:00:05 – 00:36:23:09

Karl

Some of the popular ones that the biotech startups are going after are chronic kidney disease and idiopathic pulmonary fibrosis, a lung condition. So that’s just one example area. There’s lots of other interesting things going on in the field. We could talk about cellular epigenetic reprograming, we can talk about stem cells and regenerative medicine. We can talk about the slow aging.

00:36:23:09 – 00:36:43:04

Karl

You know, there’s a whole bunch of, as I said, companies going after medics for exercise, aromatics for calorie restriction. There’s a lot of work on mitochondria, real health, and there’s a lot of different approaches to that. I haven’t fully wrapped my brain around all the different ways people are going to address the aging mitochondria, but there’s a lot of work there.

00:36:43:05 – 00:36:58:19

David

If so, okay. I’m going to ask you a personal question, Carl, since you feel strongly about senescent cells. So what do you personally do it? You have access to the highest levels of knowledge and technology out there. How are you personally incorporating this into your life?

00:36:58:21 – 00:37:23:11

Karl

So I’ll I’ll give you the background to the answer, but then I’ll give you the answer. So one of my personal frustrations with the field is that if you look around, there are a number of things available now besides just exercise and healthy eating and sleeping enough. There are a number of drugs that are accessible now. Besides rapamycin and metformin.

00:37:23:11 – 00:37:45:08

Karl

There’s there’s a bunch of others that are in the rate of aging modulation category. And there’s even things in this analytic category, the Saturn IB plus Quercetin is a combination that’s been shown to work well in rodents and lots of case reports of people having success with it. This attention is another one, and there are clinical trials underway in humans run by the Mayo Clinic.

00:37:45:08 – 00:38:04:18

Karl

On these. James Kirkland is adamant that people shouldn’t be doing them themselves, but lots of people are. As with rapamycin and some people report good results. But if you look at the list of all the different things that are available now and I have a bunch of a draft list of this that I’m going to launch on aging biotech got info in probably a month or two.

00:38:04:19 – 00:38:34:21

Karl

The problem is that we almost certainly know for sure that different people need each one of those to a different extent, extent and at different parts of their life, especially in sort of midlife. Many people don’t need each one. So for example, metformin, you know, there’s good evidence to suggest that the diabetics really get life extension and slowing rate of aging from it compared to their accelerated rate of aging from their metabolic disease.

00:38:34:23 – 00:38:54:14

Karl

But there’s not good evidence that healthy mean not metabolically black people get benefit from it. And especially people who are in their thirties near Barzilai is the biggest champion of metformin and he was sort of aghast at the idea that people who were under 40 were taking it because they thought it was going to help them live longer.

00:38:54:16 – 00:39:10:05

Karl

For all of these things. For a couple of them, you can kind of gas like with metformin, you know, you can look at, you know, your your diet. Are you pre-diabetic, You can look at your glucose and your HB one C and your and your weight and things like that. But for most of these, we know something about their mechanism of action.

00:39:10:09 – 00:39:30:06

Karl

We know what pathways they affect. We even know what biological state we’re talking about, like accumulation of cells and cells. We don’t actually have a good diagnostic or biomarker here to tell who actually needs it when they need it. And how do you titrate the dose to tell that you’ve been successful in treating that and bringing it back in the range?

00:39:30:06 – 00:39:53:00

Karl

Right. Most things in biology have this sort of U-shaped or reverse j-shaped curve or optimal, you know, lump if you want the good to be up where there’s sort of a range of optimality and things get out of whack and you the treatment can can move it back in the right direction. But you know, we don’t have the right readouts to know if you’ve moved it too far or if you’ve not moved too far in arm.

00:39:53:02 – 00:40:24:20

Karl

And so that’s definitely true for senility or for nested nothing cell accumulation, and that’s true for a lot of other things. And that makes it difficult to decide which of the things that are actually available one would want to use on oneself or one would want to use. If you’re a longevity clinic trying treat your patients. So as a result of that, even though there’s a lot of available, I don’t do much outside of the sort of things people would have judged as pretty normal decades ago before the field came along.

00:40:24:20 – 00:40:49:22

Karl

Right? So I, I very instead I take the approach of really trying to optimize as much as I can lifestyle while we wait for the data and the clinical development of the better thing. So I, I eat a whole food plant based diet, mostly sugar, oil and salt free. So that means basically I just eat vegetables, fruits, whole grains and legumes with a little bit of nuts and seeds, pretty low fat.

00:40:49:22 – 00:41:29:08

Karl

I tend to follow the Ornish Esselstyn style of of that whole food plant based paradigm. I think there’s good pretty good data there. And there’s some interesting work in the field of nutritional geometry from invertebrates and mice that show that low fat and low protein is actually better for all the hoo ha people make about protein sufficiency. I exercise both cardio and resistance several times a week I do a lot of tracking and quantification of all these things heart rate monitor, you know, Garmin, watch or ring, etc. etc. I sleep and I start and I track the sleep and I try to sleep as well as I can.

00:41:29:13 – 00:41:46:17

Karl

I don’t smoke and I don’t drink alcohol anymore. So that’s just the basics. And then, you know, I try to make sure I’m not deficient in anything. I make sure I test vitamin D levels and omega three levels, and I take good quantities of those which are more than what the RDA is. And there’s some good science there.

00:41:46:19 – 00:41:49:14

Karl

We can talk about vitamin D and a whole other podcast if you want. I just want.

00:41:49:14 – 00:41:52:10

David

To ask you one question. What’s your ideal Vitamin D level?

00:41:52:16 – 00:42:18:18

Karl

You know, everyone should be above 20 milligrams per milliliter, which is the clinical deficiency threshold in most countries, and the Endocrine Society recommends above 39 grams per milliliter, which is 75 nanomoles per liter. A lot of doctors I know concierge medicine doctors recommend between 40 to 69 grams per milliliter is a sweet spot. I try to make sure mine’s above 40 and I don’t.

00:42:18:20 – 00:42:22:05

Karl

I don’t push it too far above 50 to 60.

00:42:22:06 – 00:42:23:20

David

Okay. Just curious, how are you going.

00:42:23:22 – 00:42:40:18

Karl

To use that multiple times a year if you live in a not at the North Pole and not on the equator because the amount varies so much by winter versus summer in terms of assuming you’re getting outside at all that. And for me that requires more, you know, many times the RDA Yeah.

00:42:40:18 – 00:42:41:17

David

Just me too.

00:42:41:19 – 00:42:42:09

Karl

You know, it’s like.

00:42:42:10 – 00:42:43:21

David

I take 5000 a day.

00:42:43:23 – 00:43:16:15

Karl

Yeah, I think I’m taking 4000 at the moment in the winter and I was taking 2000 but also getting several hours of sun in the summer. Okay. So anyway back to what I do so that, that’s basically that you know basic supplements plus you know, and lots and lots of paying attention to the details of blood tests. So for example, I take more B12 than I need for based on blood levels because my homocysteine was high and I needed to keep cranking B12 and a few other a few other related things to get the homocysteine down.

00:43:16:15 – 00:43:40:21

Karl

For example, I take creatine because I’m vegan. You don’t need to take creatine as a vegan because your body will make 1 to 2 grams a day, which is about how much the meat eaters get. But the process of making it, according to Michael Greger, has homocysteine, is a byproduct, and so you can help lower homocysteine to get it exaggeratedly.

00:43:40:23 – 00:44:05:12

Karl

But I don’t take the weightlifting the typical weight lifting five grams day that seems clearly super physiological, two and a half to five times more than what bodies normally get for produce. So so things like that. So basically I and while I do all these things to optimize my rate of aging to the extent to which I can, I’m paying attention to all the other data that’s coming out on things that are available now.

00:44:05:13 – 00:44:31:04

Karl

And I’m investing in the companies that are making the next generation things that could really work and have a lot of clinical proof once they get on market. Excellent to hopefully provide all those things for everybody, you know, because I think that I truly believe that almost all the treatments of this field is going to produce are going to be paid for, inexpensive enough for everybody or are paid for by the government because they’re much better than paying for old people to be sick for decades.

00:44:31:04 – 00:44:37:10

Karl

And so I think they’re going to be accessible to everybody. That’s that’s that’s the overall goal is to save as many lives as possible.

00:44:37:12 – 00:44:49:15

David

Agree with you hundred percent. My my feeling is that initially a lot of this is going to be funded by billionaires who want to live forever. It’s fine. They can throw as much money at it as they want. I think that’s great because more.

00:44:49:16 – 00:44:51:00

Karl

Than they are currently growing.

00:44:51:02 – 00:45:06:02

David

They can they can keep doing it. I think that’s a great idea. And as you said, if we can just extend I had an economics professor from Oxford come on and describe the economic benefits to just if you add another like one healthy year.

00:45:06:02 – 00:45:07:21

Karl

And that’s working great.

00:45:07:23 – 00:45:12:11

David

Right? Yeah, it was. Andrew So you know it’s it’s astonishing.

00:45:12:11 – 00:45:23:14

Karl

So that scales right? It’s one one year adds 38,000,000,000,037 trillion and in ten years and ten times that like it’s not it doesn’t to like plateau.

00:45:23:16 – 00:45:39:18

David

Yeah so it it just makes sense that this is going to happen. It’s interesting I think one of the some of the things that you brought up are fascinating. One of the reasons why I started with the clocks. So what’s the metric like? What are we looking at here? How do we need to understand how these different things interact?

00:45:39:20 – 00:46:11:23

David

The personalized parts of this I tried to be a vegan. It about killed me. It doesn’t work for me, but it’s very individual. So you know what works for different people? What I’m next interested in is you’ve described yourself as investor with a very long term horizon. So could you give us, say, the five top sort of therapies, technologies that you see out there that that will actually come to fruition in ten years and and what those effects could be?

00:46:12:01 – 00:46:34:05

Karl

So, I mean, I think some of the VIX will come within ten years. I think that treatments based on stem cells are going to be here within 5 to 10 years. There are, of course, clinics now where you can get stem cell treatments. What’s happening in the regenerative medicine stem cell world right now is that the FDA is rightly nervous about inserting whole cells with DNA.

00:46:34:11 – 00:46:59:16

Karl

With DNA in them. There’s broadly speaking, in the stem cell world, there’s two subcategories, autologous, where you take your own stem cells out and then put them back in and allogeneic, which is you get one person, you know, you get a source of stem cells from other people. Or both of those are sort of getting falling out of favor compared to taking the secretions from the stem cells and and giving those as a therapeutic.

00:46:59:17 – 00:47:21:00

Karl

And because it seems like the stem cells themselves, most of their power comes from the things that they secrete when they after you insert them into the body. And I think that there’s lots of companies working on what are called exosomes, which are the sort of little vesicles that the stem cell packages secretions into as it releases them.

00:47:21:02 – 00:47:40:10

Karl

And I think that that there’s lots of efficacy there right now. It’s a Wild West in terms of the clinics you can go to and what you can get. But there’s companies proper clinical trials in this area. I think those are going to come to fruition within a decade. So some of the stem cells or region medicine stuff, epigenetic reprograming, there’s huge amount of money going with that.

00:47:40:10 – 00:48:08:12

Karl

I think that at an earlier stage there were still a little more basic science, but the amount of money going in and the rapidity of the progress is really, really fast. And so, for example, there are ways that that will probably come to market within a decade, at least in some areas, such as topical application for skin, for things like wound healing, at least probably that will be something we’ll see within a decade.

00:48:08:15 – 00:48:35:11

Karl

And there’s just a huge potential for treating all kinds of diseases, as well as slowing down aging or rejuvenating not not so much slowing down aging. The promise of that is really just rejuvenating cells to a younger state. Let’s see. You asked for five one of the big areas that I think and I’ve invested in two companies in this area, you know, heart disease and cardiovascular disease, that the top killer is single disease according to our current disease categorization paradigm.

00:48:35:13 – 00:49:08:22

Karl

And that right now is treated in clinical medicine with only treatments that essentially slow its rate of progress. It does. There’s no disease modifying treatment that reverses you back to a fully healthy young adult state of of of cardiovascular health. Because the plaques that build up in the arteries and the stiffening of the blood vessels are simply not reversible, for the most part by statins and PCSK9 inhibitors.

00:49:09:00 – 00:49:32:03

Karl

There are multiple companies now coming out of the aging in longevity communities that are working on true reversal technology. So there are two companies working on and I mean, you know, disclaimer I’m an investor in both of these companies working on actually reversing the plaques, like getting rid of the plaques. And there are two different approaches to do that.

00:49:32:09 – 00:49:59:21

Karl

And then there’s multiple companies working on the stiffening of the arteries, next caused by extracellular matrix cross links and other problems with the ECM. And so I think that within a decade we’re going to see some progress on meaningfully reversing cardiovascular disease, not just slowing it down by by trying to floor your cholesterol as as low as possible.

00:49:59:23 – 00:50:27:21

Karl

So that’s for I think probably the other area I would highlight is that within a decade, we’re going to see some treatments that really dramatically affect mitochondrial health and that those are going to be huge because mitochondrial aging, it’s such a big and complicated part of both the sort of metabolic aspect of aging, but also it’s possible to reverse some aspects of aging by making mitochondria healthier.

00:50:27:21 – 00:50:49:12

Karl

There’s all kinds of different sub, and I can’t predict which sub area within mitochondrial aging biotech is going to be the winner. Probably there’s going to be multiple. There’s kinds of things. The mitochondria are these some parts of the cell, the sort of energy factories within the cell cell has lots of them in it. And there’s all kinds of things that are important there.

00:50:49:12 – 00:51:16:03

Karl

The the membrane around the mitochondria, the stronger that is, the better. And that’s what where you get reactive oxygen species and anti all kinds of interesting biochemistry to interfere with to try to reduce the the stealing of the electrons and the and the sort of crazy things that oxygen and iron do reactively in the body that sort of sort of like human equivalent version of rust.

00:51:16:05 – 00:51:40:12

Karl

But there’s all kinds of approaches. Mitochondria divide and merge vision and fusion and we can regulate that. We can make the mitochondrial membrane stronger. We can give exogenous mitochondria and cells take them up. And there’s a there’s a probably a dozen different mechanisms of action. People are using that area. But I there’s at least 20 companies working on it with one or more of those mechanisms of action.

00:51:40:12 – 00:51:54:01

Karl

And I think that some of those are probably going to get through clinical trials within 5 to 10 years and they’re going to make everyone feel more energetic. Part of the reason why you don’t feel as energetic as you get older is you mitochondria are just not nearly as healthy and this is going to be a wonderful thing.

00:51:54:01 – 00:51:58:20

Karl

It’s going to be like a caffeine shot. But but it’s just all natural mitochondria.

00:51:58:22 – 00:52:18:12

David

I’m going to try and summarize and you let me know where I’m wrong here. It it sounds like the best program here is to keep your organ systems in as good a shape as possible by doing the sort of normal things that we talk about here. Like if you’re not sleeping well, figure it out. Get an exercise program, eat, take care of your stress.

00:52:18:12 – 00:52:44:21

David

What’s your connection to purpose and humanity? You get sort of that stuff dialed in and that’s 95% of it. And then make sure your biomarker figures are where they should be. Keep an eye on that stuff with the idea that we don’t have to self experiment at some point in the very near future. 5 to 10 years. Like if we can keep everything relatively good shape for that amount of time, there’s going to be some significant therapies available that get that right.

00:52:44:23 – 00:53:09:12

Karl

So your summary is best available summary I could give for a generic person without knowing their age. I really one should adapt what you just said based on how old someone is. If you’re young, if you’re in your thirties and forties or even your twenties, then you know you can even have more flexibility on how how you optimize your lifestyle as long as you don’t really shoot yourself in the foot too badly.

00:53:09:18 – 00:53:32:03

Karl

And there are like the best things you can do are help support the field, you know, write to your congressperson to support the the aid for a large organization that’s doing lobbying on behalf of the field, you know, give philanthropically to the foundations and, you know, maybe get a in the field or do you know or learn biology is as your chosen career and the other end of the spectrum right.

00:53:32:03 – 00:53:49:12

Karl

If you’re in your eighties or nineties or late seventies then you might not have the time to wait the decade for these new things to come along. And so, so plenty of people who are in their late life are not waiting. They’re just taking their best guesses with some of these things that are available now. And you know, I can’t fault them for that.

00:53:49:14 – 00:54:08:23

Karl

I’m not that old. And so that’s not what I’m doing. You know, plenty of people in the field would admonish them not to do that and to just like go quietly in, you know, the way you based until we have good data. And some of them just don’t like that idea. So some of them go offshore to do the more experimental things and some of them find the more experimental things and ways to access them.

00:54:08:23 – 00:54:32:12

Karl

Here I’m young enough, I don’t have to worry about being quite that desperate yet. But, you know, in midlife, in forties, fifties, sixties, that’s where your summary comes along. But you know, it’s different if you’re 65 versus if you’re 53 versus if you’re 40, 46. You know, these are these might all have different shades where you want to nudge toward one or the other of those extremes.

00:54:32:14 – 00:54:40:18

David

Very well said. Thank you for making that a little more granular. I appreciate that. Is there anything you want to leave our audience with today?

00:54:40:19 – 00:55:10:01

Karl

I think the field is clearly going to grow. More people are going to read more and more about it, and it’s already getting to be more popular press articles and just regular newspaper articles for the people who aren’t paying attention to podcasts like this one and your website and anybody who wants to help get involved. There are it’s not necessarily an easy field to break into, but there are going to be more and more ways to get involved in terms of philanthropic donation.

00:55:10:01 – 00:55:30:11

Karl

Right. And a lot of people donate to something, you know, in addition to donating to your local food bank and church. You know, this is a great philanthropic area for everybody to donate to because it’s really going to affect everybody. And, you know, if you really are energetic and have extra time and have want to do things, there are ways to engage with the field.

00:55:30:11 – 00:55:49:19

Karl

And so some of the ways to engage with the field you can find on aging biotech got info in terms of forums, you can participate in blogs, you can listen to podcasts, you can just do blogs, you can read conferences you can go to depending on what your background is, pay attention and engage politically, socially. Tell other people about it.

00:55:49:23 – 00:55:52:17

Karl

This should be a topic of dinner conversation around the world.

00:55:52:20 – 00:56:12:06

David

Absolutely. Absolutely. I want to encourage everybody to check out Carl’s Twitter feed. That’s how I initially found out about Carl. He also has an incredibly informative, useful Twitter feed. Now have a look at that. Carl, It’s been a pleasure. I’ve been a follower of your work and your writings for a little while now, and I’m glad that we were able to get together and make time for this today.

00:56:12:07 – 00:56:14:12

Karl

Wonderful conversation. It was really good to connect with you.