How long can we stay young?

This interview with Prof. Valter Longo was recorded on March 23, 2023 and transcribed using Sonix AI. Please check against audio recording for absolute accuracy.

Peter Bowes: [00:02:19] Food, obesity, fasting and the evolving research on what it takes to reach a ripe old age and still enjoy good health. Valter Longo. Welcome back to the Live Long and Master Aging podcast.

Valter Longo: [00:02:33] Well, thanks. Thanks for having me.

Peter Bowes: [00:02:35] And would you believe ten years since we probably sat in this very same laboratory here at USC and had our first conversation about human longevity. It doesn’t feel like a decade ago?

Valter Longo: [00:02:46] No, not at all. I would say maybe five. Yeah. So great. You know, we’re still going.

Peter Bowes: [00:02:53] And how are things going? You’re telling me you’re busy?

Valter Longo: [00:02:56] Things are going well, and I think we’re very happy about the lots of results and lots of different arenas. About aging and cancer and diabetes and both the Longevity Diet and the Fasting Mimicking Diet. I think we’re moving forward and beginning to show that it works in the clinical setting and especially in the randomized clinical trial setting.

Peter Bowes: [00:03:24] Well, I want to talk to you more about those just big picture to start with. If you look back over the last decade, what have you learned? Maybe something you didn’t fully understand ten years ago that’s made a really significant impact on you over the last few years in terms of your science and your goals?

Valter Longo: [00:03:44] Yeah ten years is a lot for our world. So for sure, if we think about the genetics of aging, you were involved in covering the Larons – these little people that have growth hormone deficiency receptor deficiency. And so now I think we’re getting closer to showing that the last component, which was heart is also protected or these mutations that are protecting clearly against diabetes, against cancer, against cognitive decline, people suspected that, yes, maybe you’re protected against those, but you get more cardiovascular disease. And so now we’re very close to showing that’s not the case, which makes it a very, very interesting drug target or nutritional target to prevent diseases, slow down the aging process. And so we’re very happy about that. And of course, that connects with 30 years of research from lots of different labs looking at growth hormone, IG-1, and also some of the original discoveries in our lab, in the lab of Cynthia Kenyon and others about IGF-1 and growth pathways like TOR or 6 kinase. So that’s very good at the at the genetics level, 

Peter Bowes: [00:05:04] Maybe you could just explain a little bit of the background there for anyone who hasn’t seen our podcast before. I went on a trip with you to Ecuador to meet the little people, as you call them, people with Laron syndrome that have a faulty receptor, which means they can’t utilize IGF one. What was the – that was a big breakthrough for you when you discovered this very small community of people and you were almost able to put pieces together in the jigsaw that explained some of the research you’d already been doing.

Valter Longo: [00:05:34] Right? So the research from my lab 30 years ago showed that if you take a unicellular organism and you mutate all its genes, the one gene that makes it live the longest, the mutation that makes it live the longest is in a growth pathway. And so these mutants lived three times longer, but there were also dwarf. So the cell is much smaller than normal. So then John Kopchick and Andre Barki showed this in mice. The mice that have growth hormone or growth hormone receptor deficient. So the receptor is what responds to the growth hormone. So it gets activated by the growth hormone. And so and they shown in mice that these have actually the record longevity extension in a mammal, right? So yeah. So then connecting the dwarf yeast and the dwarf mice then there was obvious to look at the, the dwarf people or the little people. We don’t call them dwarf and, and that’s when you came around, I think right when we were about to publish or we just had published the first results on diabetes and cancer just like the mice, these little people that have a deficiency in their receptor or the growth hormone they were, they rarely develop cancer, rarely develop diabetes. And so at the time, first of all, the criticism was probably not real. 

Peter Bowes: [00:07:01] Because the numbers are quite small, aren’t.

Valter Longo: [00:07:02] It’s about 100 people. It’s about 350 in the world and there’s 100 in Ecuador. And so, yeah, the skepticism was there. And so eventually then Zvi Laron in the Middle East and Europe showed something very similar with surveys that he was doing on 350 people and cancer and but also the parallel with the mice very similar effects on cognition. So, you know losing learning and memories ability. We clearly show that here. We actually brought them to Los Angeles a few years ago, and we showed that with what’s called functional MRIs, that they had a cognitive performance that was more similar to people much younger than they were.

Peter Bowes: [00:07:52] Actually I was here that very week. And you had a little party outside this building?

Valter Longo: [00:07:56] Oh, that’s right. You were? Yeah, You were here for that, too. Yeah, exactly. So so, yeah. And then, of course, the last criticism, the big one since it’s been 12 years since the original papers was, well, maybe they get more cardiovascular disease. And so then of course if you’re protected from diabetes, cancer and cognitive decline, but you get more cardiovascular disease, you get a problem. And and now it turns out that if anything, they seem to be protected from cardiovascular disease. I don’t go into the details because we haven’t published that yet, but certainly good news. Now, we brought a cardiologist down to Ecuador and we spent a lot of time with Ecuadorian cardiologists doing all kinds of tests. And and we also brought them here and did tests here and by cardiologists here at USC. And so the data in general confirms that they do not have increased cardiovascular risk factor, nor do they have increased any evidence of increased cardiovascular disease.

Peter Bowes: [00:08:57] But what was interesting to me about that community is that they might well be resistant, if you want to use that word, to getting cardiovascular disease, getting diabetes and the killer diseases of old age, they they don’t live exceptionally long. And they weren’t a particularly happy community of people. They didn’t want to be small. So it was almost the while you might see some benefits of having low IGF one for them, it wasn’t a benefit. It was a major hindrance to their lifestyle. 

Valter Longo: [00:09:27] Yeah, of course. Right. So they’re born with the mutation, right? So nobody’s is proposing that people should be small so that they can they can live longer and healthier. The point was to identify the genes that can have that effect and then, of course, allow people to grow to a normal height and size and then intervene at that point. Right. So with drugs or with nutrition, they can control the genes. They control the aging process. Right? So, yeah, so and also we have other mutations that even in simple organisms that do not affect growth, right? So we already know that you can intervene in other ways. So the what we call the protein pathway, it’s at the center of growth and longevity. But then on the other side, we have the sugar pathway. And the sugar pathway is not at the center of growth, just longevity. Right. So then then yes, we and this is why we’ve been then the other big side of what we work on is fasting and fasting mimicking diets and what’s called the longevity diet. And so these are interventions that are controlling the genes that control the aging process. And sure enough, now we’re we having more and more evidence that we cannot do a lifelong study, human study like we did for the Larons of Ecuador, because, of course, they were born with a mutation. And we can see how long did they live. And but we can do risk factor studies and we can do also biological age studies where we where we look at our biologically young someone when they do these dietary interventions or not.

SPONSOR MESSAGE 

Peter Bowes: [00:12:59] This is the Live Long and Master Aging podcast. Our guest is the longevity researcher, Professor Valter Longo from the University of Southern California. So in that first conversation ten years ago in this laboratory, you were just about to and you were preparing to do your first clinical trial involving human beings to look at the feasibility and the safety of the fasting mimicking diet that you’ve just mentioned. And full disclosure here, I was one of the participants, one of the first 19. 

Valter Longo: [00:13:26] That’s right.

Peter Bowes: [00:13:26] In that trial. And I think eventually you had about 100 people in.

Valter Longo: [00:13:29] And we had 100 for that. And then and then I think that the rest of it worked better than we would have expected. So it went all the way to cancer patients, diabetes, patients, and every trial thus far done independently of us, meaning that it was run by oncologists at University of Leiden, University of Heidelberg, University of Milan. And and so patients, for example, cancer patients, breast cancer patients that received cycles of the fasting mimicking diet together with chemotherapy, they were much less likely to be resistant to chemotherapy. And in fact, in the Leiden trial with 125 patients, the patients that did at least half of the cycles of the chemotherapy with the fasting mimicking diet were five times less likely to be resistant to the chemotherapy than if they did the regular diet. Right.

Peter Bowes: [00:14:31] That’s quite a remarkable figure.

Valter Longo: [00:14:32] Yeah, it’s very impressive. And so, I mean, it’s a good start when you when you do the first large clinical trial and you see these kinds of changes. And the interesting thing, I think that did this happen in spite of the relatively low compliance. So what happened in the trial was that we did not have dedicated, because we didn’t run it. And so they just had the typical nutritionist dietician that has been trained to think that a cancer patient should eat more. And and so we suspect that and we see this all the time that someone has been trained to tell a patient to eat more if they’re exposed to a trial, they may not be as as encouraging to patients. But in spite of that and in spite of the low compliance they still worked, which I thought it was remarkable. So almost everybody completed one cycle, but then it went down to 50% of two cycles of the fasting mimicking diet and then down to 35% when it was four or or three or more cycles. And the reason now we the trial University of Milan, the National Cancer Institute in Milan, suggests, as we have shown for mice, that the reason for that may be that the T cells, the immune system is now recognizing the cancer cell. So the fasting mimicking diet is making the cells much more recognizable by the immune system. So then all you need is that to happen once the cancer becomes an antigen for the immune system, then it doesn’t really matter if you keep doing it right. So that’s what’s interesting. And now we and a number of other labs have shown these effects with or without immunotherapy. So if you do if you do chemo plus fasting mimicking diet, it seems to stimulate immunotherapy like effects. If you do the if you remove the chemo and you do the fasting mimicking diet plus immunotherapy, now the immunotherapy works a lot better or better. So so, yes, so the cancer was very positive. And the other one even more positive and more solid than the cancer has been. The diabetes now because the diabetes now this is the the third trial one is published and two are not yet published with either diabetes or prediabetes. And they all showing very clear effects and a onesie. And for example, Heidelberg published a randomized trial when they had five days a month. They took diabetes, diabetic patients. They did six cycles of the fasting, mimicking that once a month for six months. And then they compared it to six cycles of a mediterranean diet for five days, once a month for six months. And those that had the Mediterranean diet cycles, nothing happened at all. And those that were on the FMD five, six cycles, there was a major drop in insulin resistance. And then I think it was about a seven fold higher reduction in drug use than with the drug in the drug group alone, right? So there were seven times more likely to reduce drug use if a diabetic if they’re combining the drugs with the fasting mimicking diet than if they were doing the the drugs alone. So, yes, there was a very impressive and now there is another one, several additional trials that are coming out that are going to show the same.

Peter Bowes: [00:18:05] You’re also looking at Alzheimer’s in relation to the diet.

Valter Longo: [00:18:08] We are also looking at Alzheimer’s. So we publish on the feasibility of the first I think 20 or 30 patients together with the mouse. In mice work very well. But also it was it was nice. At least that’s all we know thus far to see the Alzheimer’s patients, which are much older. We develop a special diet for Alzheimer’s patients.

Peter Bowes: [00:18:29] And is the theory that the diet can help with the progression of the disease? This isn’t a cure for Alzheimer’s, but this is something that perhaps soften some of the symptoms.

Valter Longo: [00:18:41] We don’t I mean, obviously, we don’t know what it is yet, but in mice and in lots of different models, let’s say when we did say pancreatic damage, gut damage and, you know, damage to lots of different systems, blood, we actually repair. Right. We in lots of these, for example, we we damaged the pancreas in a mouse and then they don’t make insulin anymore. And then we start the fasting mimicking diet. And you probably remember this and they the pancreas there is a reprograming of the pancreas that involves Yamanaka factors, by the way. Right? So the cell is now going into a more embryonic like state and then a transition to the state and then starts making insulin again. So then we now know this from multiple systems. Does it happen in the brain? We don’t know. So could it actually the brain become younger and repair itself? I don’t know. It’s science fiction right now. But but certainly in the mouse seems to be happening or certainly the slowing of the cognitive decline is happening. Now, how much of that is rejuvenation versus slowing down in the brain? We don’t know. But sometimes we start with mice that have already developed plaques and tangles and then we act and it seems to still work. So so then that’s suggesting that some of the effects at least in mice is, is making them better and not just slowing down the progression.

Peter Bowes: [00:20:16] So let’s talk about the diet itself. And I remember that clinical trial, little white boxes that are set out day one, two, three, four, five. And I subsequently did the diet several times over a period of years. What have you learned over the many, many years now that people around the world have been using this diet? Clearly you have a lot of data in terms of people’s tolerance of the diet, their likelihood to want to do it again and again and again. I found it quite repetitive. But I’m just curious in terms of what you’ve learned through people’s responses to it.

Valter Longo: [00:20:48] Well, I think that in general, we tell we tell people that maybe they should do it when they need to do it, and not just all the time. And so probably most people will have to do it, say, once every four months and it’s five days. Right. So I think even if it is repetitive, five days every four months or and and some people slip and maybe do every six months, I think it’s even hard to remember what you ate for those five days, six months ago. Right. So I don’t think that that’s an issue, much more an issue in a cancer patient than might have to do it every three weeks with the chemo or with the radiotherapy or with the immunotherapy, etcetera, etcetera. So that’s not an issue. I mean, I think that I’m I, I see that it’s if people realize the benefits that they can have the they don’t mind doing it and keep doing it. And I see that we saw that they have an easier time doing it as they’re used to it. But also I think that there is a lot of mentality, regulatory mentality. I think that is FDA driven and which is good and bad. I mean, it’s good. Why? Because obviously you want to regulate things. You don’t want to improvise. But it’s also I’m thinking that pharmaceutical influence is such that that there is not really a careful alternative for things, right? So basically the idea is you cannot say anything. You cannot even mention a disease. Right? Somebody told me some of the lawyers told me that I wasn’t even able to describe that I shouldn’t even describe our clinical trials, that we run in an independent hospital because I’m a founder of a company. And yeah, so so I think that it’s it’s very hard to unless something even it’s a food it’s. Very hard to explain to people what it can do. So I can tell you about the diabetes trial, but but nobody can really know about that unless they go and read the literature. So I think at some point the regulation should should just be careful as it is right now, but also allow for a more allow patients to have more options. Right. It’s not all about drugs. Yes, you may need drugs or you may need drugs plus the diet, or you may need drug plus a product that is based on food. You know, and that’s that’s what I hope is going to happen just to get people much more. And doctors and doctors, by the way. Right. More in tune with this having this in the toolkit. Right. That hasn’t happened yet. And I think a lot of it is because of regulatory sciences. 

Peter Bowes: [00:23:48] And just to explain the background here, you mentioned being the founder of the company. There is a commercial company that is selling this product around the world. This is presumably a question that you get asked a lot. And I know because you’ve explained to me in the past that any profits, any money that you potentially could make, in fact, you are putting that money into a non profit organization.

Valter Longo: [00:24:07] Yeah. Not just the potentially, you know, the one that I would make right now. They’re all given to the charity and universities so I don’t. I should have a consulting fee but I don’t get it. You know, this is given to charity, right? So so I thought it was important to, to not say, oh, one day, but it was important to also say right now I’m giving it up. And so anybody can come and check it. And yeah, so I just think that I thought that was very important. The shares I cannot use any of the, you know, the company was sold or it becomes public. I’m not I will not use the income or sell the shares. I mean I can sell it to give it to the to the charities but not to pocket anything. So I make exactly negative, you know, because sometimes I lose money out of out of this. Right. Just like my books. Also my book income all 100% goes to to the foundation. In fact, I don’t even own my books anymore. They’re owned by the foundation. And, you know, and the foundation bought in Los Angeles. Now we have three in in Italy.

Peter Bowes: [00:25:12] This is Create Cures

Valter Longo: [00:25:14] Create cures. And, you know, so it’s like we’re seeing thousands of patients a year with cancer, with diabetes and also seeing people. They’re seeing people that the clinical team without without pay. Right. So if you cannot pay, if you can show that you cannot pay the the treated for free.

Peter Bowes: [00:25:34] Obviously feel and just from what you’ve been saying, a certain weight of responsibility when you’re talking when you’re doing interviews like this and many other interviews that you do, the books that you write, the papers that you write a responsibility because you are something of a rock star. I know you wanted to be a rock star once upon a time, but you’re a rock star in the field of of longevity. And people listen to what you say and I just wonder to what extent that weighs on you in terms of the responsibility to talk accurately and especially not to give people false hope.

Valter Longo: [00:26:06] Yeah, it goes both ways, right? And that’s the hardest part. Not giving false hopes is easy. Don’t say anything. Right? What’s not easy is to say, okay, I want to give you some hope. Right. And so that’s a harder part, right? So how do you do that without upsetting the oncologist, the neurologist? And that’s where we’ve been navigating and that’s the hardest part. So I don’t think it’s a responsibility more. It’s like I feel like, you know, if I had that problem, I would probably want somebody to say, I don’t want to give you quackery, You know, I don’t want to give you crazy stuff. I don’t want to give you unsafe stuff. But if somebody just told you that you got to two years to live like we have glioma patients almost every day, the contacts, glioblastoma, you’re in trouble. Right? And so I don’t accept anymore. And it took me many years to develop this this courage. But I don’t accept anymore the explanation of the oncologist. You’re going to die. It’s like, no, we have people that have not died, right? We have people with advanced age. And we have just published. Vernieri just published on five cases, of advanced stage, breast cancer, pancreatic, colon, and the title in the European Journal of Cancer say exceptional responses. Right. FMD fasting mimicking diet together with the standard of care. Right. So so now I think the more than responsibility we feel like we have to say, hey, you know it may not work, but it may work, right? So work with your oncologist. Let’s form a team, work with the Foundation, and let’s see how far we can do this, you know? So, yeah, that’s that’s the hard part. Tell people, oh, you know, I cannot tell you this is what we used to do. And, and then at some point we felt like, come on now we have, you know, ten clinical trials, hundreds of papers in animals. I mean, at what? Point that you’re going to, you know, at least say there is a chance, you know, we don’t want to give you false hopes, but also we don’t want to not tell you what we know. Right. So we know what we know. And the clinical trials have results and you should be aware of it and you should have professionals to get working with your oncologist unless the oncologist refuses. And sometimes that happens. And but even then, we still help them and we say, okay, you’re going to have to get it approved by your oncologist or find another oncologist. We cannot override the oncologist or they cannot override the oncologist. But that’s the way we’ve been doing it with thousands of patients all over the world. And, you know, so far we haven’t got a single complaint. So I think we’re probably doing a pretty good job. I hope it doesn’t start now. You know.

Peter Bowes: [00:28:42] So let’s talk a little bit more about diet and food. And I guess another question that you get frequently is, well, okay, so you’ve got this five day regime that people might do every 3 or 4 months. What about the in-between times? And I know a lot of people gravitate towards and I have time restricted eating and that’s essentially is watching the clock in terms of how many hours you fast for and for most people, that’s overnight and and what the optimum number is in terms of fasting hours. How have your thoughts on that developed and where are you now on those in-between times, not only the regime that you follow, but what we eat?

Valter Longo: [00:29:21] Yeah. So as you know, I base everything on five pillars and we can list them if you want or people can go look it up in the book. But you know, epidemiological data, clinical trials, basic research, centenarian studies and complex systems. Right. So so we feel that this idea, this old idea, I just pick epidemiological studies, for example, studies of populations, it’s not enough. It’s great. I mean, it’s one of our big pillars, but it’s not sufficient. So you want to have a common denominator effect, right? And so if you look at everything, you get, as I used to say, and I keep saying it, 12 to 13 hours of fasting, right, 12 to 13 hours are now combining safety, high, high safety. It’s just hard to find a doctor that will tell you 12 hours of fasting per night is going to be bad for you or a paper or anything in any pillar. Right. And that’s really first do no harm. It’s really rule number one.

Peter Bowes: [00:30:19] And that’s pretty easy to do. Pretty easy to do. You finish eating at 6pm and you get up at 6am Well, there’s your 12 hours.

Valter Longo: [00:30:26] Yeah, exactly. But people don’t do that anymore. People in part because this idea still in the back of people’s mind that you should eat five, six times a day. And so these were bad ideas that were given to the world some years ago. But a lot of people still have this in the back of their head. And so, you know, now Satchin Panda and others have shown that people go for 15 hours a day on average, right, in America and probably in Europe. So.  

Peter Bowes: [00:30:56] that’s 15 hours of eating.

Valter Longo: [00:30:57] 15 hours of eating. Yeah, 15 hours of eating. So now you shorten it from 15 to 12. That’s already a big deal, right? So lots of Sachin’s studies are showing say going from 15 to 11. But you know, some people are probably doing 12 and some people are doing 11, 13 hours of fasting, right? 12 to 13 hours of fast. But but I will say in, in that range, I think that’s where Sachin and I meet, right? Because you might say 13 or 14, I say 12 to 13. And so let’s say 13 seems to be a good compromise for those that are like gung ho, right? The ones that are saying, oh, I got to do more. Exactly.

Peter Bowes: [00:31:36] And in fact, he says for some people up to 16. So that’s the area that 12 to 16 is the area of.

Valter Longo: [00:31:42] Yeah, but I will argue, and as I have always argued, don’t go to 16 unless it’s for a short period. Right. And why? Well, because gallstone formation, gallbladder operation and most people that do 16 hours, they have to skip breakfast and skipping breakfast. Now, there’s meta analysis on that. It’s just bad for you, right? It’s bad for you. And now, in fact, I wrote a little introductory article to three articles that just came out in cell metabolism and other journals, and they’re showing if you skip breakfast and you start eating at 12 instead of 8, your energy expenditure is reduced and you’re more hungry, right? Hunger goes up and energy expenditure goes down. So now you’re starting to have clinical explanation, not just epidemiological. Now you have two pillars, both of which are saying don’t skip breakfast.

Peter Bowes: [00:32:35] And when you say skip breakfast, what is your definition of skipping breakfast? Is it not eating within an hour of getting out of bed or what’s the timeframe?

Valter Longo: [00:32:42] No, it’s say most people will have lunch and not breakfast and you may have black coffee for breakfast. That’s not breakfast. Right. So and some studies have gone into looking at calories, but let’s say in general. If people say, I don’t have breakfast.

Peter Bowes: [00:32:59] It means nothing till lunch time for most people.

Valter Longo: [00:33:01] So it means that you had dinner and then you have lunch, right? A lot of people were under the impression that, Oh, well, I’m skipping breakfast, so it’s good for me. I eat less and it’s healthy for me. But that’s not the case, right? Well, you could argue and people argue all day long, but when you have a pillar, a central pillar like epidemiology, keep telling you that people that skip breakfast live shorter, more cardiovascular disease, potentially more cancer. Don’t mess with it. Right. It’s not a good start. Now, could there be an explanation that people that skip breakfast, usually epidemiologists adjust. Right. So they have adjustments for this. But let’s say even if they didn’t catch the right adjustment, still that’s not a good start, right? You want things that are associated with a longer lifespan and not a shorter lifespan and less cardiovascular disease and not more. 

Peter Bowes: [00:33:49] So I can see people thinking and applying what you just said to their own lifestyle and thinking, well, is this okay for me? So I’ll tell you what I do. Tell me if it kind of fits in with your way of thinking. So try to finish eating by 6 p.m. thereabouts, which is quite easy to do and not snack during the evening and get up at about 6 a.m. and the first thing I do is have coffee with a little splash of oat milk. So there’s a few calories there. But then I get out and do my exercise and I go for a long hike for three and a half miles. And I like to do that on an empty stomach. So I don’t feel good doing that kind of exercise having had a normal breakfast, which for me is is fruits and grains and it’s a mostly carbohydrate breakfast. But so I do that when I get back, which is 8:00, 9:00 in the morning. So there’s roughly 14 or 15 hours between my 6 p.m. meal and my substantial breakfast meal. I’ve had a few calories in my coffee at 6 a.m.. Where does that fall in compliance? Is that leaving it too long or is it kind of okay? Because I did have some calories in my coffee.

Valter Longo: [00:34:52] Nobody knows, right?

Peter Bowes: [00:34:52] No one knows.

Valter Longo: [00:34:53] Nobody knows. So you’re you’re now probably okay, because it is breakfast. It’s just a light breakfast happening, you know, 14 hours after your dinner and you had some calories in between. It probably is okay. And I will say probably the most of the data is based on people that have, say, 7:00 pm type of dinner or and then no, maybe black coffee and then noon. That’s probably. And even in the trials that I just described, they either you ate at eight or you start eating at 12. Right? So that was the sort of definition of breakfast keeping. You don’t do anything until 12. So in your case, because you have some calories and then you eat 8 or 9, that’s probably okay.

Peter Bowes: [00:35:43] I find that everyone’s individual and I kind of raise my example because everyone’s individual, different lifestyles, different morning routines, children, school, work, whatever people are doing. So it’s difficult to generalize. But but from my perspective, having a slightly later breakfast, so eight nine makes it easier to get through most of the day. Like as we speak now, mid-afternoon, I’ve had my 8 a.m. breakfast. I had half a banana at about 12:00 and that’ll be it till my evening meal. So it gives me the day. And I know this is the kind of practice that you have, I think, of pretty much having a second mini fast during the middle of the day. 

Valter Longo: [00:36:20] Right. Yeah. So me and lots of patients that we follow the clinics. So that seems to work very well now. We started a large trial in southern Italy, 500 patients where we’re applying that. So yeah, so we think that having this I have coffee for lunch five days a week, I don’t do a seven days a week. And it’s also trying to play with the understanding of maybe some of these adaptive mechanisms that, you know, you don’t want the body to necessarily abandon the lunch component. And so that’s why and this is hypothetical, we haven’t never tested it. Now we’re going to start testing it, but we to reduce the risk we rather have both. Right. So I have your week has lunches and no lunches. So your brain is now adjusted to both, right? So, for example, I didn’t have lunch today and I don’t care if I have lunch or not. So I can have it because in the weekend I’m used to have it and I don’t have it during the week. So I think it’s a good way to go rather than than skipping even lunch, because I’m afraid that eventually we’re going to find out that people that always skip lunch have the same problem than the breakfast skippers, right? Because ketone bodies actually start going high higher, not high higher. Even if you do this in within day fast. So I don’t like that. I don’t like to do spikes of ketogenesis and back down. I’m afraid that eventually we’re going to see problems with people that do this. Yo you ketogenesis. And and that’s why I, I like to avoid any potential problem. Now, any problem that we know of any problems that could arise 20 years from now. Right. So yeah, so our point, as you know, is getting can we get people to live to 110 healthy? And that’s just a very complicated lots of thinking that goes into it and a lot of sometimes not getting the best effect that you could. You get a little bit less, but much safer, right? So, yeah, I could go 16 hours and I would see a lot more benefits. I agree. But do I want to risk it knowing what I know about epidemiology, etcetera? No, I don’t want to risk it. I go 12 to 13 and and that’s a good compromise. Right.

Peter Bowes: [00:38:41] And final question on diet, you have a mostly pescatarian diet, so a little bit of fish a couple of times a week, getting your protein, a relatively low protein diet protein from legumes, beans, peas, that kind of thing.

Valter Longo: [00:38:54] Yeah, Yeah. So now as I’m getting older, I go to maybe 3 or 4 times a week fish. And that’s, I think that the kind of age adjustments, right, that the legumes, it’s not just about protein, it’s about also amino acid content. And I eat lots of legumes. And so I need maybe four days a week of four meals a week of fish or seafood, somebody that might have lots of seeds, lots of nuts. I mean, it depends on how much, especially the essential amino acids you’re getting from the plant based non-legume sources. Legumes just tend to have very low levels. And that’s why legumes are probably number one in the in the best food for longevity, at least based on this new large Norwegian studies. They came up number one. So the life expectancy increased in people that have high consumption of legumes, but they also have downside, which is because they have so little essential amino acids. They’re very beneficial for certain things, but not so good for your muscle. Maybe your bones. Et cetera. Et cetera. Right. So this is why we’re spending a lot of time and money now researching this balance, Right? What is the balance at every age, Biological, age now? Chronological age. Chronological age is irrelevant. Biological age. So what’s your best diet for your for you, but also your biological age and how you adjust it? And that’s what we do at the clinic. In these longevity programs. We have a team of molecular biologists, physician, you know, nutritionist, etcetera, just adjusting. Right? Let’s look at your muscle function, your muscle mass, your IGF-1, insulin, glucose ketone bodies. Yeah, lots of different things. And then we just adjust so that we we get you in the right spot. You know.

Peter Bowes: [00:40:46] You mentioned ketone bodies. What about keto diets, which I suppose is the …

Valter Longo: [00:40:52] don’t do it. 

Peter Bowes: [00:40:53] …polar opposite of what you say. 

Valter Longo: [00:40:55] Yeah. Don’t do it. So, so keto diet, don’t do it. I mean it may be okay for some people like I’ve seen a used like temporarily to get people from one state to another, let’s say to improve glucose levels and a-1c.

Peter Bowes: [00:41:11] Could you give me a 1 to 3 of why not do it? 

Valter Longo: [00:41:14] One don’t do it because studies, meta analysis and or large studies, epidemiological studies show that you live shorter. If you have a low carbohydrate diet. Two: it’s very difficult to maintain. So most people will do it for a while and then and then abandon it because it’s just tough to eat mostly fats, let’s say. And and three, also, there is a lot of at least some short term problems. Right. So some clinical trials are showing that there are problems. I mean, there are there is benefits and problems, both described for ketogenic diets. So, yeah, when you start seeing problems like this in all at all levels, I think is much better to to not do it. And I always quote one study. I think it was the Lancet or either JAMA or Lancet is better to have an 80% carbohydrate diet for longevity than having a low carb diet.

Peter Bowes: [00:42:20] Interesting.

Valter Longo: [00:42:20] So 60% I think 50 to 60 was ideal. 80% less years taken away than than a low carb diet.

Peter Bowes: [00:42:30] This is the Live Long and Master Aging podcast. Our guest is the longevity researcher, Professor Valter Longo. So you mentioned the goal is to try to extend our lifespan and certainly extend our health span, the number of years that we enjoy life and we can have full health and enjoy what we’re doing. But life span to about 110 you think is is possible. I know you’ve been studying centenarians mostly in Italy to learn, I guess, about their history and the older ways of life. And is this correct to try to identify the benefits of some of those lifestyles and meld that with the modern day science and the research that you do in laboratories like this? 

Valter Longo: [00:43:13] Yes, so the lifespan and healthspan, I will add my word ‘youthspan,’ right. So I actually I was very surprised years ago when I introduced this word because it didn’t exist. And I always thought this is the most important word that we don’t have yet. It’s like, how long can you stay young? Can we make somebody stay young from 40? Can we switch it to 60 or 70? Right. Young in the sense that you can compete in a in a soccer game or like Tom Brady in a football game.

Peter Bowes: [00:43:40] I was going to say how do you define young?

Valter Longo: [00:43:42] Well, we had in the paper we described like you have like maximum performance. It doesn’t have to be record. Right. But like marathon runners, right. They can still run world record levels around 40 years of age. Right. So even a lot less than that will still be young. But to answer the question about the centenarians, I think the centenarians have lived to 100. Right. So there are evidence of 100 ability to make it for 100 years, and some of them are ability to make it for 100 years healthy. And yeah, so then talking to them is really. Yes. N of one. Each one you talk to. But then you talk to 200 and you just had 200 examples of what did it take to get you there. Right. And some of them get to 110. So yeah, so then I think you learn a lot about, for example, one of the things, not surprisingly, that we saw was that a lot of them had a very poor diet for the first 70 to 80 years of life, and then they start moving in a nursing home or they’re moving with their sons and daughters and they start eating a lot more. And that’s exactly what the science would have predicted would be ideal for you. So you’re restricted, but you don’t. You’re no longer restrict the heavily restricted when you’re 75, 80, 90. And the epidemiological data and our own work shows that if you’re reporting a very low protein diet when you’re 90, you’re not doing so well. Right? So the person reporting a moderate protein intake is doing much better than those reporting a low protein intake. So so yeah, I think that the centenarians are very important pillar and you just have to be realistic. And so for example, sometimes we realize that there are genetically predisposed, right? So it’s not just a lifestyle. It’s this is like Sardinia, Calabria. It’s very clear. These families that were born with, I always say to be Michael Phelps, you yes, you have to train and and eat well, et cetera. Et cetera. But you also have to be born with the genetic predisposition that the height, the arm length. Yes. So I think they are starting out already as super, super longevity, genetic makeup and then adding the lifestyle, the labor and the nutrition and all of that. And that’s how they make it to this world record.

Peter Bowes: [00:46:19] Do you enjoy, you must enjoy speaking to centenarians. I’ve spoken to a couple at least for this podcast, and I have the same feeling when I come away from the conversation every time. It’s it nurtures my enthusiasm for doing this kind of work. Do you feel the same?

Valter Longo: [00:46:37] Yeah, I think that of course we go to the centenarian for scientific and technical reasons and every time we walk away, we walk away with a smile because of a story, because of something that we experienced the war and just really remarkable. And some of these words just stay in my head, you know? And so, for example, the lady I always talk about the lady and maybe I already did it with you, but in southern Italy, where we asked her, So when you were, you know, 40, 50, 60, how often did you eat red meat? And she turned to her niece and she didn’t understand because she was from Calabria, Italy. And then she realized what we were asking. And she smiled and said, Yeah, I had red meat one time because we crashed our wedding. And so we. We are so poor that that’s the only time in like 30 years that she had red meat. Right? So so here we are talking about thinking, asking epidemiological questions like how many, how frequently do you have red meat? And the lady answering, never. Rarely. So this is very interesting. And of course, telling about how poor they were and what conditions they lived in for a long, long time.

Peter Bowes: [00:47:56] When you mentioned I talked about healthspan and lifespan and you say youth span, youth span.

Valter Longo: [00:48:02] Youthspan and juventology. So so I think the neither the word the study…. so we’re in the School of Gerontology, the most famous school of gerontology in the world, and one of the few schools of gerontology in the world. And so the study of aging, gerontology, the study of aging. But I’m always very surprised that the study of youth was not there. So I always said I’m much more interested in learning how to stay young than why I get old, right? So there’s two different things.

Peter Bowes: [00:48:28] So you’ve just used in the same sentence there, young and old. And I’ve been having this debate recently about the use of the word old. It’s almost always used in a negative sense. Society looks at old as being decrepit, as on the decline without any of the positive aspects of being old. And you ask a child what their age is. They don’t say, I’m ten years young. They say I’m ten years old. So my point is we’re all old to a certain degree. And I see getting old, whether it’s 110 or 99 as a privilege and something that people in the longevity space should be perhaps cheering a little bit more than society does.

Valter Longo: [00:49:14] Yes. I don’t have a problem with old. I think that so yeah my mine is a view as a technical view on what’s more interesting, the process of what keeps you young or what makes you old. But yeah, I think that I always say violins age and they get better and wine ages and it gets better. So an old wine is oftentimes better than, than a young one. And yeah, so there is nothing wrong with the word old, especially like you say, it’s already used when you’re three and and so yeah. So then the stigma of the word or associated with the word should go away.

Peter Bowes: [00:50:01] And I bet a lot of those centenarians that you speak to, by and large, they are happy people. They’re not depressed. The fact that they are 100 plus years old, generally, everything is great in that world.

Valter Longo: [00:50:15] Uh, that’s when you only talk to 2 or 3, right? When you talk to 2 or 300, a lot of them are like Emma Morano, the oldest person in the world. When I was followed there in the last five years of her life.

Peter Bowes: [00:50:29] Was that the famous lady for eating eggs.

Valter Longo: [00:50:31] Eggs and steak, and raw meat every day. And she’s complaining all the time. Yeah. So very isolated and only dealt with a few people. Yeah. So you always get bored, you know. And this is also coming out of the demography studies. The demographers. Demographers will say, you get the two personality, you get the one you just described, nothing can kill them. And then you get the ones that are like tough, tough warriors like Emma Morano. And they just they don’t care you they’ll just keep on going. And they’re not necessarily pleasant to be around and they don’t have a lot of friends but they just keep on going and yeah so it’s interesting right that these two person so I always say yes of course if you can have a lot of social interactions and happy life have that but don’t feel like, you know, if you don’t have it, you’re doomed and you’re going to die at 72. So you’re fine. You can you can do well and you can keep on going and live live a long life. Yeah.

Peter Bowes: [00:51:37] So we had our first conversation ten years ago. If we meet again in this laboratory or somewhere else in ten years time, 2033, I will be 71 years old. You I think I’m correct in saying we’ll be 65. Yeah. What do you think we’ll be talking about as it relates to this longevity space?

Valter Longo: [00:51:58] I hope we’ll be talking about the nutrition and fasting mimicking diets. Et cetera. Being in the teams, right? Having changed the way we keep people healthy and long lived and having, I just wrote an article for the Milken Institute and and I was quoting, I think someone, Dana Goldman here from USC and others and saying that the savings in the next 50 years, I think it was $7 trillion. And that’s probably way underestimated, way underestimated. If we think that the impact of really having the teams and the nutrition and the lifestyle and the exercise and integrative medicine and trying to keep people away from the expensive interventions, I think that, you know, that’s what I hope we’ll be looking at, right? So we’ll look around and say, you remember ten years ago people went to the doctor once a year to get drugs and now look around. There’s teams that practice a very different preventive juventology. Right. Or preventive gerontology. Right. And it’s no longer just the doctor is the doctor, the molecular biologist, the nutritionist, the psychologist, you know, the kinesiologists working in a team to say, okay. And the artificial intelligence people working at and the technologies, the apparatus, that that is going to be necessary, that the portable technology that’s going to be necessary to not having to go to the hospital, to the doctor. So we want to just keep people away from hospitals. Right. That’s going to be our goal. And yeah, I sincerely it’s doable now. It’s doable now. We already have the data. It is not some idea that that it’s just a matter of can we influence enough the system to allow this because a lot of people don’t want to see this happening. Right? There’s a lot of money going around into into the system that sells bad food, bad drugs. Et cetera. Et cetera. I mean, there are a lot of good drugs, right? I’m not attacking the pharmaceutical companies. I’m saying we just need to take drugs when drugs are needed and not take drugs just because. Oh, yeah, you’re diabetic. Well, let me load you up with drugs. 

Peter Bowes: [00:54:30] So society has to be on board with this. It can’t be just the scientists.

Valter Longo: [00:54:34] Journalists, number one, most important.

Peter Bowes: [00:54:36] Journalists number on?

Peter Bowes: [00:54:38] Journalist by far. Number one, the journalists have to make the decision that from now on, we’re just going to talk about this revolution. Right?

Peter Bowes: [00:54:46] Well, that’s what I’m trying to do Valter.

Valter Longo: [00:54:48] Let’s talk about the revolution. Yeah, the doctor is great. The doctor should be part of the team. The doctor should also make the final decision. But the team assembles the complex intervention and applies it in as easy as possible of a manner to the patient. Less low invasiveness. Maybe you have a continuous glucose monitor or a ring or a blood pressure bracelet, whatever it is, so don’t worry about it and don’t need to come in. We’re following you from the distance and maybe once every six months you come in and this is what we already do at the clinic and the clinics. Yeah. So I think that’s the journalists are going to have to sort of push the system, challenge the status quo and push the systems. What’s going on? Why can we save trillions of dollars? And this is nobody’s going to argue with that. And yet and this is why I say in my article in the 60s, over 10% of the US population, the prevalence of overweight of obesity when over 10% in the 60s in the 70 when over 20% in the 80s, when over 30% in the 90s went over 40%. And nobody did anything about it. This is crazy right? And I contrast it with COVID and I say, you know with COVID came around but everybody that you can every journalist in the planet all they talked about was COVID is great. And it should even be more than that, right? Fine. Preventive, preventing viral and microbial diseases is extremely important. But in 2017 alone, 11 million people die of dietary preventable causes of death, preventable by dietary changes. And nobody talks about this, right?

Peter Bowes: [00:56:33] So more podcast conversations like this and perhaps I through your eyes, should be talking to decision makers, to politicians, people who can make things happen.

Valter Longo: [00:56:45] Challenge them like you challenged the COVID when when the virus was spreading, the journalists went crazy and said, Hey, what’s going on? Are we going to deal with this? People are dying. Right? And it’s just all over the news, all over the place. When 11 million people in one year die of bad food and too much food. Okay, that’s okay. You know, that’s part of life. That’s not right. That’s not part of life. This is not where we come from. We don’t come from bad food and too much food we come from. And we don’t come from eating all the time. We come from a history of eating. And then, you know, sometimes you fast, right? And sometimes you have poor food and sometimes you have rich food, meaning sometimes you might have had meat, but some lots of the other times you have whatever you can grab from your garden.

Peter Bowes: [00:57:29] So, yeah, a lot of work still to be done. Valter, it’s always a pleasure.

Valter Longo: [00:57:33] My pleasure.

Peter Bowes: [00:57:33] We’ll continue talking. Thank you so much.

Valter Longo: [00:57:36] You’re welcome.

Peter Bowes: [00:57:41] The LLAMA podcast is a Healthspan Media production. We’ll be back soon with another episode. In the meantime. I wish you the very best of health and thanks for listening.