Reverse Biological Age with Food, Sleep, and Stress Control with Dr. Kara Fitzgerald

with Dr. Kara Fitzgerald

Aug 22, 2025 · 00:50:24

Today's guest is one of the most respected voices in the science of longevity. Dr. Kara Fitzgerald is a pioneering functional medicine doctor, researcher, and author of Younger You, the first-ever clinical study to show biological age reversal through diet and lifestyle. Her work is changing the way we think about aging by demonstrating that your biological clock is not fixed. It is flexible and responsive to how you live. In this episode, we talk about the cutting-edge science behind DNA methylation, what it takes to age well while living with purpose, and how entrepreneurs can use her research to boost resilience, clarity, and long-term health. Welcome to The Total Entrepreneur Mind, Body, Spirit, where we turn cutting-edge science into practical strategies for entrepreneurs. I'm your host, Dr. John Torrance, Entrepreneur Inc. 5000 honoree and professor of entrepreneurial practice at Syracuse University's Whitman School of Management. Each episode, we dive into mental, physical, and spiritual health with expert guests offering actionable insights to help you thrive and perform at your highest level. Let's get started. Dr. Fitzgerald, thank you so much for being here. I'm so excited to talk to you.

Yeah, likewise. It's great to connect with you again, John.

Yeah. So, my first question has to do with the idea that a lot of people have, you know, they think that as you age chronologically, you just have to accept the fact that it comes with chronic disease and decay and lower quality of life. And I was wondering for your perspective on that.

Yeah, um, sir, I certainly understand that that is what people would anticipate their life needs to look like. Because if you look around you, uh, really in any country, not just the US, the US seems to be really good at, you know, deteriorating health as we age. But really any nation, you'll see the older we get, We develop a litany of chronic diseases, and one disease begets another disease, one drug begets another drug, one procedure begets another procedure. And then we're just on this horrible slippery slope, this horrible, expensive slippery slope where we get sicker and sicker and sicker. And, you know, it's absolutely heartbreaking, but the statistics really show, the statistics bear out that we We have a longer lifespan than we did, you know, 150 years ago or something like that prior to antibiotics. But our healthspan, our quality of life is terrible. So especially in those final decades, that is indeed what things look like. So for people to have that pessimistic attitude, they'd be, you know, they'd be reflecting on something real that exists. However, the fact of the matter is, the very, very clear, you know, soundly scientific fact is that we sit in the driver's seat of how well we live. That's absolutely true regardless of how old we are. So we don't have to descend into, you know, what you're describing.

Yeah, I was reading something, maybe it was in Peter Diamandis's newsletter this morning, but they, they identified a, a nearly a 13-year gap between healthspan and lifespan in the US. So, in other words, our, at least our period of morbidity is, is really long.

Yeah.

And, yeah, so it makes sense why people wouldn't wanna live through that.

Yeah. Yeah.

Right. A final 13 years of hell. Yeah.

Well, and I mean, like, just sketch it out a little bit. You know, it, it's not just us. So, you know, we work, we work really hard. We're excited about our retirement. We've got plans. You know, we just, you know, we're going to explore. I mean, my mom, thank God, has chosen to live her best life, and now she's in her 80s and she's a potter and she's happy and she's, you know, she's not on any medications. And anyway, things are— things are really— she's getting to live the retirement dream, I think. Um, but for a lot of us, we descend into diseases and medications and procedures, and our hard-earned money goes towards all of that. You know, maybe we have a home and we have to turn that over to the government so that they, you know, provide care for us and home care, etc., etc. A lot of that burden falls on our family and our family members, you know. So that nest egg we wanted to pass down to our kids, to our grandkids, wherever it's going— we wanted to donate it to some, you know, beautiful resource— all of that gets sucked into this medical complex that may be prolonging our life, but the quality is horrible. And just the burden we become on our family if we're lucky enough to have family to care for us. I mean, it's really depressing when you tease out that reality.

Yeah. I talk to a lot of entrepreneurs a lot about why spend a lifetime creating wealth only to see it evaporate in your final few years. And the other thing they don't talk about a lot is just the burden that you talked about, right? Not only are you seeing your wealth evaporate, but the people who you hope to spend time with and enjoy are now just caring for you. And it's, yeah, it's difficult.

And you're not present because, you know, dementia is one of the big, one of the big final 4, you know, that we're going to confront, or we have limited physical mobility. You know, just on and on. It's not pretty. And I think that it's important that we, you know, really call it out clearly and also call the solution out clearly. And that is, we've got a choice whether or not we walk that path.

Right. Which is what some of your research that I wanted to talk about was. So, can you walk us through, you know, how you were able to demonstrate that biological age can actually be reversed, and not only just reversed, but in a mere 8 weeks, which is incredible. Yeah.

So we're, you know, we're still learning a lot about, you know, what biological age is and how best to measure it. But we're definitely in this extremely exciting sort of fast-paced, you know, lots of changes, lots of empowerment happening in the world of medicine and science. And so now we, you know, we all have a chronological age that we can't change, how many trips around the sun, you know, we've experienced, how many birthdays we've celebrated. So there's nothing we can do about our chronological age, but that number is becoming less and less relevant, less and less important now that we can actually measure our physical rate of aging. And that's the biological age. That's how fast we're aging. We can look at it as a whole person, you know, my rate of aging, you know, as a being. We can look at organ system rate of aging, skin, you know, lungs, heart. kidneys, liver, et cetera, brain. And we can't— and we're getting better and better at finding that, identifying the tools that will enable us to measure them. And there's different ways. Like, for instance, you know, your listeners are probably familiar with VO2 max, you know, and the utility of keeping that young and the association with a younger biological age. the more robust your VO2 max is. So it's all, I mean, and it's just, we're finding more and more super cool tools and we can kind of put 'em all together. In fact, I just did an MRI, I just, and we can talk about that later, that used an AI tool, a really important, actually powerful AI tool to analyze brain age. And I was, you know, obviously happy that my brain is, you know, a few years younger than my chronological age. It's all good. But the area of biggest focus on measuring biological age Age is something called epigenetics. The field of epigenetics is you know easy definition: epi above genetics to genes. So it's the field of epigenetics concerns itself with measuring, looking at gene expression and changes to epigenetic expression. Changes to gene expression happen consistently from in utero. Actually, when we're developing a fetus all the way to death. These very consistent changes happen over time. And you can look at epigenetic patterns and see the rate of aging. And so now there are a lot of different tools out there measuring the epigenetic, they're called epigenetic clocks, and they measure the rate of aging. This is the biological age as measured by an epigenetic clock. And now we can use interventions to see whether we can slow the rate of aging. We can also look at epidemiological data and see what accelerates the rate of aging. So there's 2 conversations we can have in there. But if you want me to, I'll go into our research and talk about what we did. Do you want me to start there since that was your question? Yeah, that sounds great. And then I digressed a tad.

That's great.

Yeah, so our research, we got a lot of attention for it because it was the first study of its kind. You know, we were, you know, blessed to be funded. We were given an unrestricted grant from, you know, a professional supplement company, Metagenics. And they gave us the funding to be able to study biological aging in a treatment group, in a randomized control structure. So we had a control group that didn't do the intervention, and then we had a treatment group that did do the intervention. And it was the first of its kind. study ever in the world to date. And we looked at a diet and lifestyle intervention on the rate of aging. Prior to our study we published in 2021, and we conducted the bulk of the study in 2018 and 2019, most of that kind of data was in preclinical. So cell studies, animal studies. So we had 2 groups of middle-aged men. We wanted to kind of isolate the aging phenomena We didn't, it's expensive to run a randomized clinical trial. So we had to keep it at a pilot level, meaning there weren't a ton of individuals in each group. We had a division of about 20 and 20. And we limited it to men because women in middle age are pre-, peri-, and postmenopausal. And so we would've needed a much larger group to kind of tease through the influence of those really complex hormonal changes as well. So we started with men, although we did later publish on women. Obviously, I'm extremely interested in how this works in women. But it was an 8-week diet and lifestyle intervention in healthy middle-aged men. So they had to be disease-free. Most of them were actually really very healthy, you know, athletic, already eating cleanly and so forth. And our dietary pattern was designed in our clinic. We had used it for many years in our clinic, and we could see that it was a very effective intervention on clinical outcomes. You know, anything from autoimmune to metabolic issues, cardiovascular, et cetera, et cetera, weight, et cetera, inflammation. We could see how useful it was in clinic, and we built it to influence Epigenetics. But at the time, that kind of testing wasn't available to us in clinic. So we were really basically making our best guess and using surrogate markers to see whether or not we were moving the needle on it. So a diet, a very intentionally designed diet, an exercise prescription, a meditation prescription, and then we wanted people to sleep well. So we supported them with sleep hygiene tips. We gave them also a probiotic and a greens powder. So that was our intervention. We have a strong nutrition team in our clinic. So in our research study, we had our participants meet with the nutrition team weekly just to make sure that they were on point, that they answered any questions, that they were doing the program right. So we started group A on our intervention. Group B just showed up for their blood and for their various questionnaires and so forth at the clinical research center we hired to conduct our study. And, you know, when we unblinded things at the end, we could see that as measured by the first epigenetic clock, the Horvath— it's called the Horvath Multi-Tissue Clock— we could see that our research participants in 8 weeks' time got over 3 years younger using the clock as compared to the control group. And the within-group comparisons, so the the individuals, the individuals doing the intervention, their final biological age as compared to their baseline biological age was a significant, you know, 2-plus-year difference. So they got 2 years younger, and then compared to the control group, they got younger still. So it was mind-blowing at the time, John. I mean, more— there's a lot of research now. This is a hotbed of science now, which has been super exciting to see. see. So probably some of your listeners are aware of some of this research. But when we looked at our data, when we unpacked our data, like, this hadn't happened before. This hadn't happened. In fact, the guy, Steve Horvath, who really the father of epigenetic clocks, you know, the guy who really created the science, he's at Altos Labs. He used to be at UCLA, but now he's at Jeff Bezos' Alto's lab. He didn't think that biological age could be reversed in humans. Only 2 other studies prior to were done in humans that, you know, showed this change. So, but there were no diet and lifestyle interventions. So ours was a first. Ours was the first randomized control actually ever. And we got a ton of attention. And now you can see the book behind your head and the book behind mine. You know, we, we, you know, we were asked to— to write up our intervention, you know, basically as soon as possible because it was a big deal. It was very exciting to see the power of diet and lifestyle on changing the rate of aging, however you wanna language it. You know, and science is kind of wrestling. Do we say you've reversed aging? Do we say we slowed aging? You know, is it biological aging? It's measured by what? So we can say conclusively that we, you know, reversed or slowed aging. slowed the rate of aging as measured by these epigenetic clocks, you know, in a really short period of time. So super exciting stuff.

Very exciting. And, you know, among the things that are exciting is just the thought that, you know, your, your genetics, um, don't make all the decisions, right? You have a lot of control and a lot of say over how you age.

That's right. That's right. Yeah. You know, depending on the statistic you look at, maybe 10% of, you know, our healthspan and lifespan is genetically determined, maybe 10%, perhaps less than that. You know, we're getting more and more sophisticated with our interventions, so that number will probably change, you know, and lower still. So yeah, 90% of how well we live is on us. For me personally, that's incredibly exciting. You know, that is just—I mean, I'm a—I—I—I have one daughter. I—I became a mom late in life. I need to live my best life for an extremely long time for you know the human closest to me to just kind of walk her through, and just because I love—I love life, and it for me, the fact that ninety percent of this rests on my choices is absolutely extraordinary. I know for some people, I think. I think a lot of humans are still grappling with the idea of taking responsibility. And they'll, you know, they'll, you know, they'll pay the piper. I mean, hopefully over time, we'll all just really rejoice and be empowered by this and just really change the course of humanity.

So tell us a little bit about DNA methylation, at the risk of being geeky and that sort of thing, right? So that seems to be at the, at the center of a lot of what the book and the program more about.

Yeah, that's right. So it's an epigenetic mark. So again, it's, it's one of the main ways that we change— our body changes gene expression. Our body dictates what genes are on and what genes are off. Um, epigenetic DNA methylation is used in, you know, in basically, you know, virtually every cell in the body, every cell, every DNA-containing cell. So for example, there's a certain DNA methylation pattern allowing a skin cell or a retina cell or a heart cell or liver cell to be just that. So it's the exact same DNA in my eye that's in my liver, but it's a shift in DNA methylation patterns that allows, you know, a retina cell to be a retina cell and a liver cell to consistently be a liver cell. So we're using DNA methylation for all sorts of incredibly important things. You know, when we're building a baby, you know, these— it's just like a bunch of pluripotent stem cells, and those cells are defined into what we call somatic cells, or, you know, building the very different organ systems through DNA methylation. There's other epigenetic processes happening as well. It's actually— it's incredibly complex, but DNA methylation plays a foundational and very important role in all of this in gene expression. And you can think about it as a continuum. Like, so a liver cell is not going to all of a sudden become a skin cell. These are not changing. These are very resilient methylation marks that will change with cell division after cell division after cell division. A liver cell will always be a liver cell. However, on the other side of the continuum, The information from the environment is always, you know, our epigenome, our DNA methylation patterns are responding to this information all the time. And, you know, sometimes at a pretty fast clip. So the food that we're choosing to put in our bodies, whether or not we're sleeping, if we're stressed out. I mean, you know, I know you talk to, you know, you're speaking to entrepreneurs and that's your area. And you and I were talking offline about, you know, sort of this culture of being stressed out. And one of the most extraordinary learnings for me in my journey in this science was how potent stress is as a pro-aging phenomenon. It may be the most I have— I've described it before as just like gasoline on the fire of aging.

Mm-hmm.

It so potently can change gene expression towards something pro-aging. And, you know, cool is that turning the volume down on stress, engaging in a meditation practice, engaging in exercise, good sleep, tai chi, yoga, et cetera, whatever your flavor is, that Also has this anti-aging balancing phenomena on gene expression. So all these environmental inputs, our thoughts, you know, are you know the the the air in the environment, the pollution, or you know if it's clean, the individuals in your environment. Like if I were to map out your epigenome, look at your DNA methylation, and look at your families, all those in your world. world, you would see some shared characteristics there, which is really pretty cool. You know, you're not twins, but you know, you would see some shared stuff there just because you're in each other's environment, you're sharing each other's space. So, um, so yeah, on one hand, epigenetics aren't changing. On the other hand, they're responding to everything, and we can at any moment in time step in there and change that response.

So tell us how we do that. So what's the, what's the basis for the Younger You program?

So we set out, we, we really got into epigenetics, I want to say as early as 2013. It was quite a while before, it was before even the first clock. I guess Horvath was sort of just, you know, starting his work in that arena. But for sure, no one thought You know, we were going to be changing biological age. We got interested in epigenetics and diet and lifestyle because I think the the first big aha for me was that diseases hijack epigenetics. They hijack gene expression and cancer. So there's a ton of research on cancer. It's been one of the most well studied. of all the diseases to investigate epigenetic phenomena. So cancer very efficiently, very wily, very nefariously hijacks gene expression from us, takes over epigenetics, turns on genes to push its survival forward to allow for cancer growth, turns off the genes in us that control cancer growth. This is what we call tumor suppressor genes. So cancer will go in there and move the levers of gene expression and really allow its own proliferation and growth. And this is universal. This is such a known and reliable phenomena in any type of cancer that the most sophisticated technology we have to measure the earliest stage of cancer is looking at DNA methylation patterns. So there is, there are a handful of tests out there, but the one that I use in my clinical practice is called GRAIL. And the GRAIL test will look at, you know, early evidence of those changes for over 70 different cancers. It's, it's incredible. So back in the day, you know, me and I, I've got a smart clinic team and our, our nutrition director and, and still kind of my right-hand woman in these, you know, in a lot of the cool work we've done. Her name is Romalee Hodges. She and I really started to dialogue about this. We understood DNA methylation. We understand methylation. Anybody practicing functional medicine really understands what methylation is. It's, you know, it's a carbon and 3 hydrogens, and we make this molecule in our body all of the time, and we use it to detox. We use it to make hormones, we use it to make neurotransmitters, and we use it to regulate gene expression via DNA methylation. We know that the way we support methylation is through a whole host of nutrients, that it's a very dense nutrient process, and there are things like B12. If you know B12 is essential, well, this is a key reason why it is. If you think about folate, If you're like, oh yeah, that's a vitamin. I know I'm— that's in greens. That's why I need to eat greens, or whatever your thinking is. Mm-hmm. Or that's why I take a multivitamin. Um, especially, you know, we need it when we're pregnant, uh, or preconception, cuz we have to build a baby and we're engaging in all sorts of methylation then. Um, or choline. Be wondering why eggs are so good for us. Well, one of the reasons is it's this key player in healthy methylation. Uh, and minerals like magnesium and zinc and potassium and so forth. So there's a bunch of key players, key nutrients involved in methylation, making the methyl donors so we can put these DNA methyl groups onto the genome and influence whether genes are on or off. Actually, just as an aside, when there's a lot of these DNA methylation groups and I'm going like this, because if you look in the scientific literature, they're always denoted as these red lollipops dotting the genome. And so that's just sort of a habit I have. If there's a lot of these red lollipops on a region of DNA, that gene is going to be inhibited. If those lollipops are off, that gene can be on. So we know that we need to keep this methylation cycle humming. We know that it becomes compromised as we age. So we have that piece of information. The second really huge and important piece of information was that there are these nutrients, mostly plant phytochemicals or polyphenols, that regulate where this methylation happens. So you don't want to put a bunch of methylation groups on a gene that you want on. Those tumor suppressor genes that protect us, you want them on and functioning. Oncogenes that push cancer forward, you want those off, you want those methylated. Incidentally, as we age, that completely gunks up. It's interesting, like the aging epigenome kind of looks like what's happening in cancer. Things just get really scrambled. And so our thinking back then was we can build out using our best read on the scientific literature, a dietary pattern that would be packed with healthful nutrients, macro and micronutrients, and we could make every biteful be an epinutrient, be something or a sophisticated combination of nutrients that will regulate gene expression towards you know, our best health. And so that's what we set out to do. And then, you know, further read on the literature also showed that exercise is as potent, and in some cases more so, an epinutrient, if you will, you know, than the nutrients. Exercise is a ridiculously potent DNA methylation, you know, gene regulator. It's incredible. It looks like kale. It really does. If you were to look at the epigenome, sleep, you know, also has important powerful activities and, you know, stress reduction, some sort of a stress balancing habit. All of these things that we built in our program have, you know, were based on the best science for, you know, optimizing DNA methylation.

Yeah, I went through the program. So I read the book, And then I did your 8-week program, and, you know, it's not hyperbole to say that it was, it was profound and life-changing.

That's cool, John.

I, uh, I really appreciated the focus on meditation and mindfulness.

Yeah.

You know, you don't get that a lot in, in these types of programs, so I thought that was really good. As a matter of fact, I've maintained my practice since then, which was kind of cool.

Yeah, that's awesome.

And one of the other things that really stuck that I hadn't done before was, uh, just incorporating bone broths and tonics and things like that, which—

Yes.

Never really was in my vocabulary. It wasn't in my, you know, sphere of awareness. But now I make my own bone broths. I love it. That's how I, you know, when I have it, which is usually, uh, you know, I start my day with it before I even have my first cup of coffee. So it's, uh, it's really— it's been, it's been amazing. So, so thank you for that.

Oh, that's awesome, John. That's cool. I mean, I'm so glad that we stayed in touch. It's always— it's, it's just, it's a lot of fun to see people who've really gotten the utility of this program. It was very intentionally designed to optimize gene expression and we used it in clinical practice for years before we actually studied it. So we could see our patient population responding to it extraordinarily. We just needed to get the evidence that in fact it is changing DNA methylation, it's changing gene expression. You know, a fun little anecdote is there's this woman, Julie Clark, who did— there's a, there's a Rejuvenation Olympics going on. If people have here have probably heard of Bryan Johnson, he's got, you know, the Don't Die.

Yeah.

Yeah. So, like, it's funny because this was not a thing when we published Younger You, you know, or when we published our paper. But now it's just like taken off. Like, wildfire. So now everybody's really aggressively engaged in changing their biological age, reversing their biological age. So they have this Olympics, of course, start a competition. Why not? Right? It's funny, right? Because that's probably in part the entrepreneur mindset that you're trying to, you know, everything's a competition. Right. Which is, which is fun and can be motivating. But, you know, everything in balance. But anyway, it was very exciting for me to learn. She reached out to me, Julie, and gave me and just said, hey, you know, I'm using Younger You and Better Broths and Healing Tonics, the broth book over there on the other side that, you know, that has— you can use broths to get those all-important epinutrients. And so she just happened to reach out to me one day and say, she said that that's how she— she's second on the leaderboard, I think, behind Brian And she's doing this budget, you know, in the kitchen. She's a single mom. Like, she's just a badass 50-something-year-old woman who took this on, created her own program, and is using, you know, the nuts and bolts of what we designed. And just, I was thrilled to hear that. It's always really nice to, you know, to see these people adopting it. such as yourself. And it's doable. I think it's doable for the long haul. It is. It's something that I, you know, every day when I'm building my lunch or I'm cooking for my kiddo, I'm, you know, I'm, I'm packing our, our lives with these all-important epinutrients.

Yeah, it's completely sustainable. And yeah, I had read about, I, I didn't know that she was using Younger You though, but I had, I had read about her cuz a lot, a lot of my students ask about Bryan Johnson, right? When they know I'm interested in longevity and maximizing healthspan over lifespan, everybody talks about Bryan Johnson. And I usually give that example of, you know, the 50-something-year-old mom, single mom who is doing just as well and not spending $2 million.

Right, right. I mean, she's making it real within the context of real life, you know, with a kid, you know, with a job. I mean, I just, I love her. I just think she's such a great inspiration.

Yeah. And I think that's the thing is that, you know, you need something that's gonna work for you in the wild, right? In your natural environment. You know, not everybody has the money to have you know, $2 million protocol, right? Or should you even want to, right? Because, you know, quality of life is also a big part of your longevity.

Yeah. I was actually just talking to a friend of mine, Sarah, Sarah Zall, actually former Sarah Gottfried. And I know, I know she's, you know, she's done, well, she's been on my podcast and she's got a bunch of bestsellers. So people may be familiar with her name. And she was talking about Bryan Johnson's, I guess this is like the rumor mill. I don't track what he's up to that closely, but apparently he's sleeping alone now because of his numbers and his metrics. And he seemed— he made the decision that that would keep him younger longer and in some form or fashion. And, you know, we were just reflecting on how compromising that is. I mean, there's so— there's actually a whole load of data out there on community and connection and influencing gene expression. And the longevity data on community and connection is just amazing and has been around for a long time. So it's interesting. He's an interesting guy to watch because he's taking it to an extreme that will probably allow us to learn a few lessons. You know, maybe some of, yeah, okay, let's do this. Let's do some of what he's talking about and then some. Yeah. No, I think I'll pass on that choice.

Yeah. No, no, it's true though, right? Like, by, by going to the extreme, we can, we can learn things on, you know, what works, what doesn't, what we want to incorporate, what doesn't. I think I read recently that he just stopped taking rapamycin cuz he didn't, wasn't getting the, the benefits that he thought or something. So yeah, it's, it's interesting just to, I don't follow him that much either, but he, he pops up. Yeah. In my feeds all the time. Yeah. You know, so yeah, yeah, you can't avoid it. Yeah.

Yeah, yeah, yeah. It's interesting. Well, he's doing this is, it's an N of 1, so we can't fully, we can't extrapolate it that far. But I know that he was doing a lot, lot, lot, lot, lot of therapeutic plasma exchange that will, is a great intervention, is a great evidence-based intervention. We're getting more human data anyway, but the frequency is concerning. There's a U-curve.

Yeah. So tell us about plasma a little bit. I'm I'm not that familiar with it. I've seen things here and there, but it, you know, not nearly enough to make any kind of informed decision.

And then I'll talk a little bit about our diet. Actually, there's, there's another thing that I wanna say. When I was talking about Sarah, Sarah Godfried now, Sal, we have a masterclass that I wanna, I wanna give you information for when you release this podcast. It's coming out in September 2025, and it's going to be a veritable who's who of people from functional medicine, as well as the science, the cutting-edge scientific world, as well as some really cool longevity investors. So it's gonna have it all. Like Mark Hyman is gonna be there. David Perlmutter will be there. Dale Bredesen will be there. Sarah Zall. In fact, it was a conversation I was having with her that, you know, where Johnson came up, actually her and Patrick Hanaway, who's a longtime Institute for Functional Medicine faculty. Anyway, so we've started to do the recordings. It's going to be a pretty— it's going to be an incredible conference. And it's, and it's free. Jeff Bland is going to host it with me. And yeah, it's just going to be a bunch of rock stars with really interesting content. So I'm very excited about it. So anybody who wants to do a deep dive into what we're touching on here could attend there. Darshan Shah, who has a series of, you know, Next Health clinics in the US and abroad, he'll be there with me talking about TPE and, you know, why it's important and talk— and talking about some of the next generation therapies. And Julie Clark will be there actually. I'll talk to her. So lots—

Oh, cool.

Lots of information about fundamentals, you know, diet and lifestyle, our research publications since, but also next generation stuff. So yeah, therapeutic plasma exchange is something that we've had, that we've been using in the hospital setting and clinically for many, many, many decades to help with overpowering infections, profound inflammation, autoimmune disorders, et cetera, et cetera. And you're basically cleaning out the inflammatory compounds You know, the plasma fraction of blood, and then, you know, putting the blood, you know, the cellular material back into circulation. So it's, it's this deep clean of the blood. And it's, you know, it's when you do a full plasma exchange, it's, it's about 2 hours.

It's really relaxing, though.

I've done it a couple of times. It's kind of a nice process.

Is it very expensive? Like, is it accessible to most people?

Yeah. It is expensive right now. It is expensive unless if you have a need for it, you can get it insurance covered. So it's worth, you know, looking into whether or not you would qualify if you have some kind of an inflammatory, potentially autoimmune, infectious condition. You know, it's been used for Lyme. It's been used for actually hyper, you know, familial hyperlipidemia. There's a whole host of different conditions. So it would be worth a talk. With your physician if you think you might get coverage for it. Using it in the longevity setting is an out-of-pocket expense. And yes, it's expensive. Prices are coming down though as it gets more popular and it will continue to. They're doing such cool research, research with neurodegenerative conditions like Alzheimer's and Parkinson's, et cetera, et cetera. So it's just going to become more and more affordable. You can donate plasma. It's just a fraction of the quantity, but we use plasma. They harvest some of the immune components from that plasma, immunoglobulins. So that's a therapy that comes from donated plasma. So you can donate plasma, and in the process of donating plasma, which is free, or in some cases you'll get paid for it, Um, in the process of donating plasma, even though it's less, you'll still be pulling out some of those inflammatory compounds. Uh, so that would be a poor man's alternative for sure. Yeah. And that's worth— that's worth looking into.

Yeah.

That's where— I mean, I— for anyone who's interested in plasma donation, um, you know, go through— I would start with the American Red Cross, you know, wherever blood donation is happening in your, in your world, start there and and, or, you know, or Google it and see what's happening. Sometimes they only take certain blood types. And so you may or may not qualify and certain medications will prohibit you from being able to do it, but it's worth, it's definitely worth checking. But yeah, that's basically what it is. It's clearing out pro-inflammatory compounds. And we know as we age, one of the fundamental processes that turns on and aggressively pushes the aging journey forward is, is this inflammation. Um, so it's— I think it's a, a worthy endeavor to have that as a piece of our, uh, you know, stack of interventions.

Yeah. So, so let's go back to the diet, right? Because that's obviously— that's something that everybody can do. And I gotta say, the, the one thing that I just couldn't get with was the liver. So I took liver— I took, I took liver pills instead. But, and I did try I just, I don't know.

I just couldn't get my head around it. I'm totally with you. I'm not, I'm, I'm not, I like pâté actually, but, um, I don't, yeah, I, I did not consume a lot of liver. I couldn't get on board with liver. I wish when we had done our study, I knew of clean source liver capsules. That was something I discovered after. So when I was doing your group, I knew about liver capsules. So I And that's what I use now.

Yeah.

So one, so we had really amazing adherence from our participants. And I think that was because we had a great nutrition team support. But I also think the guys really got that we were doing something cool. We were looking at epigenetics, we were doing something that hadn't been done before. And so those, they were into participating. But yes, of all, we could look at their adherence data and very high adherence numbers for the interventions with the exception of liver. But liver's like a multivitamin in a food matrix. And you can do it in a capsule and then that's fine. You can, you can just cut corner and get really clean source New Zealand liver and don't even think about it.

Yeah.

So the diet is full of these methylation nutrients that I talked about and the polyphenols. So we wanna make the methyl donors. to be able to just have enough, and we stop making them as efficiently as we age. So the diet has to be packed with those nutrients, plus it has to be packed with these nutrients that regulate where this methylation is taking place. It's these 2 classes of nutrients. So the methyl donor group, we're looking at a lot of B12 and a lot of folate. Um, you know, there's certain key amino acids, so protein needs to be adequate, minerals, Again, like magnesium, potassium, you know, just a host beyond B12 and folate, B6, et cetera. So the methylation cycle, choline from eggs is dense with those kinds of nutrients. And then these exquisite food as information compounds, these phytochemicals we just wanted the diet packed with. And indeed our diet, when we look at other dietary patterns in the scientific literature, you know, like the Mediterranean dietary pattern, which gets tons of attention and has shown to slow or reverse bioage. Our phytochemical composition really kind of dwarfs a lot of the other diets out there. So think lots of greens, lots of colorful fruits and veg, polyphenol-dense compounds like green tea or oolong tea, Garlic, curcumin, rosemary, turmeric. Actually, spices are extraordinary. Berries, you know, beautiful blueberries, blackberries, strawberries, raspberries, and on and on and on. There's there are a lot of extraordinary epinutrients, and we wanted the diet to be packed with that. The diet is high in are higher in good quality fats. So olive oil, avocado oil, avocados themselves. What else? Coconut oil a little bit, or short, medium-chain fatty acids. We don't shy from animal protein. Obviously we're including liver, fatty, beautiful fatty fish, salmon, sardines, et cetera, whatever, whatever you're interested in eating there. Mushrooms are rock stars. Mushrooms are rock stars. I always have good quality mushroom capsules on hand if I can't source good mushrooms, but even button mushrooms that you can get in any grocery store anywhere in the United States are decent. But you can turn the volume up if you go for, you know, shiitake are incredibly important, or maitake, or, you know, really any turkey tail. You know, any selection of portobellos, you know, of mushrooms. The diet's a little bit keto-leaning. So triglycerides dropped in our study group. Actually, they lost weight, their triglycerides dropped, their LDL dropped. They increased their circulating folate without taking vitamins, et cetera.

Mm-hmm.

And then they got, you know, of course, biologically younger as measured by epigenetics. So we had them keto-leaning, and that's why their triglycerides dropped. That's where I digressed. Adequate hydration. Coffee is totally allowed. It's definitely an epinutrient. We wanted people to abstain from alcohol for the 8 weeks. You don't have to forever, but we wanted people to lay off of it for the 8 weeks. No dairy, no grains. for that 8 weeks. It's not, it doesn't have to be a life sentence. If these are foods that you want in your life and you can tolerate them, we have in the book something we call the Everyday Younger You. And that's the pattern that's still epinutrient dense, but allows some of these other foods. So that's, that's the basics of the dietary pattern.

Yeah. So it's, it's sleep, it's mindfulness or meditation, focusing on your nutrition. And like you said, some, some movement, which is just as powerful. Yes. Yeah, that's great. So, so what's on the horizon? Like, what are— what's some of the research that you're really excited about?

Well, we are, um, well, first of all, I'm actually super jazzed up about our masterclass. I think that's going to be a lot of fun. But it does sound amazing. Yeah, I— we're— we just published a study doing, um, we reanalyzed that original cohort to see if we could tease out what element of the intervention did the heavy lifting on biological age reversal. And it turns out that it's the group of nutrients we call methylation adaptogens, those phytochemical epinutrients. So heavy lifters included the curcumin, the rosemary, and other spices. garlic, green tea, oolong tea, berries. Those polyphenol-dense foods or phytochemically dense foods really, really did the heavy lift. But that was in the context of an overall improved dietary pattern. So I don't want to suggest that someone continue with the McDonald's diet and then just start adding, start taking some green tea, drinking a cup of green tea. I don't know that you'll achieve outcome that way. But what our findings suggest is that these polyphenols, these plant phytochemicals are no joke. I mean, they are really potent. They are really strong. And we're seeing those kinds of findings elsewhere. So there's other dietary studies that have, you know, really isolated and suggest the polyphenols did the heavy lifting. There's more research looking at, you know, single nutrient, single compounds that have a collection of polyphenols in them that seem to, you know, change the rate of biological aging, change immune health, et cetera. So there's, I mean, we're seeing the power of food as information of, you know, what is on work as powerfully regulating gene expression. And I think that that is really what's lighting me up. We are just touching our knowledge here. I mean, for a long time, these phytochemicals were termed the dark matter of nutrition because there's hundreds of thousands of them and many of them haven't been identified. and they interact and work synergistically. And they're influenced by the gut microbiome, by digestion. They're absorbed systemically and sometimes in a modified state. And this is how they work their magic. But we evolved with this complex information. We evolved eating these kinds of compounds. Our microbiome evolved with that kind of information from those foods. And we're just teasing out how it exquisitely, exquisitely powerful they are. So I think we are going to continue to appreciate a well-designed dietary pattern like the younger you. We're going to continue to understand why. We'll probably be learning what levers to turn up, what levers, you know, we can turn down a little bit, maybe doing some individualization. Polyphenols, as supplements, you know, to, to, to support, um, you know, what we're doing otherwise will probably become a thing. It's just, you know, it's, it's, it's kind of— it's an exciting time for, you know, nutrition science.

Yeah, it really is. Well, if people are interested in learning more about you and your work or buying your book, where can they find you and where can they look you up?

Easy. Just— it's Dr. Fitzgerald— Dr. Cara Fitzgerald, excuse me— drcarafitzgerald.com. Is the website, and you know I'm a longtime podcaster as well, and you can find all of that. We have a blog, and we have a clinic. We've got you know we've got the nutritionists who we did the study with, and subsequent studies actually we showed in a cohort of women better outcome. We used a slightly different tool to test, so it's not quite an apples to apples comparison, but the ladies did. did really well as far as bioage reversal goes. But yeah, drkarafitzgerald.com is where you go and, you know, you'll find links to the books and the papers. In fact, actually, we have a free biological age quiz. It's called the BASA quiz. So you can go there, you know it, you would probably, you already took it, I'm sure. You can go there and access the quiz and that can be kind of your first step on the journey.

Amazing. Yeah. And I can vouch for the, the power of the program and the quality of the team. Tell us a little bit more about the masterclass. How would people find that?

That— follow me on social media if you can, just Dr. Kara Fitzgerald over at Instagram, and we'll be posting how to sign up for that. And we, you know, that will launch in September, free. It's gonna be fun. It's gonna be live. I'm gonna be there chatting with people. Some of it will be recorded, but a lot of it will just be me chatting with you. And, you know, we'll have live dialogues with some of the leaders in the longevity slash functional medicine space.

Amazing. Well, Dr. Fitzgerald, thank you so much. This was a, I thought, a great conversation. I really appreciate it.

Yeah, a lot of fun. Thanks for having me, John.

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