EPI 232: Michael Snyder, PhD. Stanford Professor Shares His Thoughts On Full Body MRI Scans, DNA Testing, Continuous Glucose Monitoring, And The Future Of Health & Longevity Optimization

Welcome back to another episode of the Peak Performance Life podcast. Today we have a very special guest. His name is Michael Snyder, PhD. He is a genomicist, professor and former chair of genetics at Stanford University School of Medicine. He also serves as a director of the Stanford Center for Genomics and Personalized Medicine. I know he's run a lab that does lots of studies. I think they're even looking for people who are wanting to still do studies these days. So he is someone who is really in it, really doing research. And I'm so excited to have this conversation with you. Thank you so much for joining us here today. It's a pleasure to be here. Amazing. Well, let's start with a little bit of a background of kind of like how you got interested in the work that you're doing today and maybe some kind of interesting stories or studies that you did along the way. Sure. So Irish stick, if you will, it's actually to do deep data dives on people. It came from my work in studying biological systems where people used to study them one piece at a time. And we came up with it. It sounds obvious, but to try and study the whole system at once. And I moved to Sanford about 16 years ago and the goal there was to do this for medicine. And actually rather than trying to study, say, you know, your heart or your cardiovascular disease, maybe your metabolic conditions, things like that. Let's really try and get a deep, you know, global profile of people. And not only that, let's not just study them when they're sick. Let's study them when they're healthy. And so basically we had to create a lot of new technologies for doing deep data dives on people, if you will, meaning we can sequence their DNA. We can profile literally hundreds of thousands of molecules out of their blood and your urine and we even follow your poop, your microbiome, which is very important for your health. So we do these very, very deep measurements on people. And that's what we started about 16 years ago. And really the goal was to transform medicine, convert it from sick care into health and the true health care. Don't just study people when they get ill. Let's try and keep them healthy. That's our big push. Amazing. Amazing. I know you also wrote a book, right? Called Genomics and Personalized Medicine, What Everyone Needs to Know. Yeah, we did. And I did that because when I arrived at Stanford, I was a little surprised people were scared of genomics, even at a pretty enlightened place like Stanford. Most clinicians were scared about the idea of people getting their DNA sequence. They thought it would turn everybody into hyperconjurts. It was going to cost us millions, millions of dollars. This is a really bad idea. In fact, I was even yelled at by some of them, we should not be sequencing healthy people's genomes. Now, they mostly more warmed up to that. Of course, we did anyway. And basically it turns out, you know, sometimes this is very useful. It's useful to know nobody wants to know they have a brachia mutation, for example, you know, a mutation puts your wrist for breast cancer or ovarian cancer for your woman. You don't really want to know that, but it's important to know that because then you'll get screened more often. And and if you want, you can actually take, you know, prophylactic surgery for these things. So anyway, the point is that this information can really help keep you on the alert for what your risk for. We're all risk for something. And so the idea is that again, this is very, very powerful. And so that's kind of how we got started in this with genome sequencing, then these other measurements. And as I say, it's turned out to be very, very powerful. And we do this again, while people are healthy, we're trying to keep them that way, know what they're at risk for, monitor them carefully. And if I were to carry this a little bit further, we actually started out as a test subject just to get the whole thing going. We started profiling me, if you will, with these deep data dives initially. And my genome predictors, I was at risk for type two diabetes. And once you know it, about a year into the study, I became diabetic right after a nasty viral infection. It's called respiratory sensational virus, common virus. And and we caught it because I was, you know, following myself pretty closely. And I got it under control through lifestyle. It did come back later. And and that time I couldn't fully get it under control by lifestyle. So I am on some drug. We can talk about that later, GLPs, for example. But anyway, the point out of all this is because I was on the alert, I did catch it early, got it managed and I've generally kept my glucose under reasonably good control. That was one example of how to steep profiling. And so in the end, we've been profiling somewhere on the order between 100 and 200 people over the various years. And sure enough, just from the first hundred plus people, we had 49 major health discoveries, half the people learned something pretty important by these deep profiling, meaning we caught somewhat early lymphoma, two people with pre-cancerous, a concovert to aggressive cancer. One did actually. And then two people with serious heart issues and they were picked up with these various technologies. What we like to say is that we're getting a much more complete picture of people's health with these these new assays we've been using. And that tells us better what's going on. We found these things all pre-symptomatically, meaning they didn't have symptoms yet. And no one technology did it. Again, sometimes it was sequencing their genome, tipped us off. We did, in fact, have a person with a BRAC mutation, person with a serious had a mutation of heart gene and turns out has a significant heart defect that was picked up by genome sequence. Others were picked up by biochemistry or imaging. So again, we're getting a much more complete picture of people's health. And then we see what's going on. And then, you know, you can manage their health better this way. If you wait till people get seriously ill, it's a it's a problem. Right. It's very hard to cure them, especially like late stage cancer. Good example. You can't really cure people very well with late stage cancer, usually. Yeah. Yeah. So you're so it sounds like you're a big fan of like these full body MRIs, body scans, all that kind of stuff in conjunction with obviously DNA testing and things like that. And because I've heard lots of mixed results about it, but the one thing that makes a lot of sense that is kind of consistent is at least get a baseline. Right. And that way, you know, because sometimes I have, you know, you hear a lot of weird situations from people that come through this thing. Like I know someone who got two scans and the second scan, they made a big deal out of some, you know, growth or whatever, something that they found. But when they went back, they looked, it was like, oh, it was actually on the first scan, but no one mentioned it on the first scan. Right. So it was good that they at least had that baseline before going and getting brain surgery or whatever, you know, was potentially recommended. When they saw like, oh, wait, this was actually here a few years ago and it hasn't grown and kind of making decisions based on a baseline. 100% agree. And in fact, if you ask any physician today, nearly all of them will tell you, you should not get a whole body MRI because they will find these nodules. We all have them. That's the thing. Men have them in their prostate, women in their ovaries, if you scan high enough resolution. And that's not the issue. If you ask me, I say 100%, you should get a whole body MRI. That's not what they have nodules. I guarantee you nodules. That's do you have any growing nodules? And the only way you know that is if you have a baseline and you can see this change. And it's exactly like you just described. In fact, this happened to a friend of mine. He woke up one morning, could move his arm. They scanned his chest and sure enough, he had a tumor on his spine. So they cut it out. He regained his mobility and things were looking OK. But a month later, they did a whole body MRI. They found three nodules on a spine. And they had no way to know if they were there to begin with or if the cancer had metastasized. So they had to treat him as though they were metastatic, meaning it had progressed. And so I think it's really, it's absolutely what you say, to Laura, it's just knowing what your baseline is so you can see the differences. And we've spent off a company that does a deep data profile, not as deep as we do in the research lab, but they do whole body MRI just for this reason. And they've caught, you know, early ovarian cancer, early prostate cancer, even early pancreatic cancer, which is almost never found early. And it was a longitudinal measurements in that last case that were critical, seeing that growth, that case they did see something shifted from baseline to the next measurement. And that's what you want to be following. So I am a big believer in know your baseline and we're all different. We all have to know what that is at a personal level. Yeah, yeah. Please tell people, what is that company that was spun out? And, you know, do you have any recommendations? And I was going to actually ask, kind of give a couple of different levels. One is like, if if money wasn't an issue, what are all the tests you would recommend people do or scans or whatever? And another one is if someone's on a budget, what would you recommend? Yeah, great question. So that company was called QBio. They are a little pricey for most people. It's about thirty five hundred dollars. But it's, you know, when you think about it, a deep day to die plus a whole body MRI. And, yeah, but not everybody can afford it. I get it. To be honest, we've spun off quite a few companies. That's our lab, you know, but that's my day job. I do research, but the way we try to get this out to the world is spinning off companies. So another area that we do a lot of work in is actually in remote monitoring. And so we do a lot with smartwatch. You can see all my watches, my ring, even my hearing aids, believe it or sensors. Oh, no, by the way, for those watch for those listening and not watching, he just held up his wrist. He's got two looks like tracking watches on each hand or four in total. And I guess you've got a ring that are in a ring. So and I have an exposure. I wear eight of these devices every day. So, well, the point out of all this is that they're tracking you passively. And we have actually shown we put these on our cohort pretty early on. The group people are studying. And what back when they came out as fitness trackers, we realized they're pretty powerful health monitors. And right away we discovered, well, in about a year into the study, I got Lyme disease. And I figured it out because my heart rate jumped up and my blood oxygen dropped in advance of symptoms. That was the first alert was that something was off with my watch and a pulse ox I had at the time. And then I knew something was off and then we got it checked out. Sure enough, it was Lyme. And then we went on to show that you can tell when people are getting ill from respiratory viral infections in advance of symptoms, 80 percent of the time. So we showed this first this pre covid. We published 2017 for influenza, things like that. And then once you know it along came covid, we can now tell you same number. 80 percent of the time when you're whether you're getting covid in advance of symptoms because your heart rate jumps up. And I know we can make that better. So we can talk about studies you can roll in at the end. But it's very, very powerful. It turns out covid has a long pre symptomatic period time when you don't have symptoms. And your heart rate will be up during that time. And we can pick it up with a smart watch. And, you know, the value in that is if you do see, you know, your heart rate does jump up. And by the way, it's an alerting system. You'll get a red alert. You I should warn you, it's not it's not specifically for covid. Any viral infection will do up. And some other things will trigger to actually work place stress. It's the number one trigger of red alerts. But the point out of all this, it is a monitor for your health, both mental, we think, and physical. And if something is off, you can pick it up. And again, if you think it might be respiratory viral, maybe you stay home and don't go to that party and go out and affect everybody. That's the idea. Right. Right. Yeah. Really smart, really smart. So I'm going back to kind of the question of and feel free to mention any of these companies that you spin off, because people want to obviously learn about kind of the best ways to track. So what if someone is on a budget, you know, DNA sequencing these days is pretty is like a few hundred bucks in many cases, right? Yeah. So yes, I think I forgot to bring up some of those parts. So you can get your genome sequenced for 500 bucks from a company like my own, this few other companies out there. I'm not conflicted for that one. Cubio does it as well as part of their $3,500 version. Some of the other companies we've spun off. So one of the other areas we've gotten into is the idea of this I mentioned remote monitoring with smartwatches, when we do it with continuous glucose monitors, I want to talk about that for a little bit. And then we also do something called remote sampling, where you give little drops of blood, mail it in and we can profile 650. Well, in the lab will profile thousands of metabolites, but in this company called IOLO, I-O-L-L-O, they will profile 650 metabolites. And basically they cover these 20 wellness categories, things like oxidative stress, inflammation, heart health, kidney health, all kinds of various, even your so-called biological age. So they can monitor all these things from a simple little drop of blood. By the way, I spent seven years perfecting that technology. It wasn't. And I know what it sounds like, but ours actually does work. It's not a joke. Anyway, so you can get that test. That one's not that expensive. It's a few hundred dollars. And what's so cool about is you get this information back, including I mentioned your biological age, and it breaks it down into what we call agotypes. Your aging patterns. And so you can see, like if your inflammation's up, it'll use your information as well as information from the literature with AI. It can give you very, very specific recommendations, not just exercise, more eat better, but eat some of these things you've probably never heard of that will help improve, for example, your inflammation, your oxidative stress, your kidney function. So and I think that's the future. I think we're all going to get measured. And when things are out of balance, well, there'll be these very we'll all have personal agents, if you will, that will be coaching us, telling us what to do. And they'll draw on information from the entire body of literature that's out there, which will be very, very powerful. And I think this is how we're going to keep people healthy in the future. And this has been done on me at one of my companies called January Eye. They do continuous glucose monitoring, but they also build these personalized reports called a mirror. And I want to get back to continuous glucose monitoring. But on these reports, they've taken I have literally two petabytes of data. That's a lot of data on me. They've taken that data, they analyze it. And I have all these doctors who all tell me what I should be doing. So I think I feel like I've heard it all, but they came up with AI. Two recommendations I had not heard of before. One of which is probably correct that I should be doing. The other which is more controversial, but it was a logical thing for them to say. And I am looking into it, actually. So so the point out of all this is AI, there's so much information out there. We need AI to collect this and build these personal management systems. And I think that's how we're going to keep ourselves healthy. Yeah. Yeah. Amazing. You this just really seems like the future of health. It really does. Yeah. Your best doctor is going to be your, you know, probably your phone. But your doctor won't go away, by the way. You will need them for for advice for various things. But anyway, I do think but no doctor can learn all this stuff. And I'll give you a fun example. We're teaching a class now with a friend of mine and it's on vibe coding and things. And he wanted to look at supplement interactions. So people take a lot of supplements. I do. I take about 10 or more a day. And so he asked, you know, he built this little program, which you can do. Vibe coatings where you tell basically a for those of you know, listeners who don't know, you can basically get this thing to program for you and write little algorithms. And this one, he had him write what, you know, supplement recommendations. And he asked it. Well, then he gave it as supplements. What supplements might interact with one another? And it spit out that he should take a zinc in his magnesium six hours apart because they use the same transporter. Now, no physician is going to know that, right? But AI could collect us from the literature, saw they were the same transported and tell you to make sure you take those supplements apart, right? Who who else would know that? Nobody else. Nobody would. So this is the power of the future. There's so much information out there. Now you'd want to check and make sure it's right. In this case, it was. But you can see where this is going. Yeah. Yeah. Yeah. And I know you wanted to get back to glucose monitors, which I think is a really important topic as well. Is that something that you see kind of everyone, even people who are, you know, maybe quote unquote healthy using and and getting data from? Absolutely. This is one of the most important areas of people. Ask me what's if I can only get one monitor, which I get. I always tell me glucose monitor. So these measure glucose every five minutes. And our claim to fame was there. They're being used a lot for insulin dependent type one and type two diabetics. So people need insulin, but we started putting them on so called normal people and prediabetics. What we discovered is that a lot of these normal and prediabetics aren't normal at all. Some of them are spiking just as bad as diabetics. Some are moderate spikers. And generally, you may know, you, you know, diabetes comes along with age. So the older you get, the greater your chance of getting diabetes. So discovering this stuff early and then managing your your diet is a big deal. Why is that important? Everybody spikes to foods differently. So some people spike to, you know, grapes, some of the pasta, some of the potatoes. Everybody's different. And so we had discovered that early on as another group in Israel. And basically, more recently, we've broken the stand. Why are people doing this? Well, we subtype diabetes. So most most diabetes is called type one. That's 10 percent or type two. That's 90 percent. And of those type twos, it turns out, they belong to subtypes we've discovered. So many people are muslin to resistance. Some have a beta cell defect, meaning they don't release insulin from their pancreas. And believe it or not, I'm type two diabetic. I mentioned that earlier. It's predicted from my genome, at least I think I did, was predicted from my genome. And I caught it through this tracking. And the bottom line is that I have a beta cell defect. OK, very specific type of diabetes. Some people have these GLP one defects. They're called incretins. Other people have liver insulin resistance. So we're all they're all different. Do most diabetics know which type they have? I've never heard anybody talk about it. Yeah, they're all lumped together. And you might say, so who cares? Well, it turns out, depending on the type of diabetes, the terms what foods you'll spike to. So if you're muslin to resistant, you'll spike the potatoes and pasta. But not if you're sensitive. And if you have a beta cell defect like me, you'll spike to potatoes. So different people spike to different foods, depending on their subtypes. And not only that, they'll respond to drugs differently. So it turns out I don't respond to metformin. But I do respond to a pre-independent derivative that's called Rapitoli that works pretty well for me. And I you would know, but I used to be a runner. I shifted from running to weightlifting. I gained 10 pounds of muscle mass. It had absolute zero effect on my glucose. The idea was that if I increased muscle mass, I bet I get better glucose. It's called homeostasis, better glucose control. So I lift the weights, I gained 10 pounds of muscle mass, zero effect. And the reason is because I have a beta cell defect has, you know, it doesn't matter what my muscle mass looks like. If I can gain as much muscle as I want, it's just not going to help me release insulin from the pancreas. So knowing the type of defect is a big deal. And that's why certain drugs work for me, but they wouldn't work for others. So knowing your subtype is, is, we think, very important, both for your diet, so by lifestyle control, as well as pharmaceuticals. If you do have to ultimately get to that point, you know, my world, we get everybody under better control, so they don't need pharmaceuticals myself included, but I think I got there too late for me. Yeah. And then how. So how can people figure it out? Like, so let's say someone listening now, either they're a type two diabetic or someone in their family is, and they're saying, well, this sounds interesting. Maybe I can figure out how to solve a lot of my problems here. How do I even figure out which type of diabetic I am? Yeah, great question. The answer is you'd probably have to be in a research study because they don't normally do this. But one thing we've discovered, and by the way, I recommend everybody wear one of these glucose monitors because you will see what you spike to and you'll never eat the same again. And I mean that in a good way, meaning once you see what spikes you just avoid those things and eat the things you like that don't spike you. And one of my favorite stories is a New York Times reporter called me up after he put on a glucose monitor. He said, Mike, I thought I was eating the healthiest lunch every day. I had salmon on salad every day for lunch. What could be healthier than that? But then he wears his glucose monitor and sure enough, he's spiking super high. And guess what it turned out to be? Like the dressing or croutons or something? I don't know. Bingo. Yeah, yeah, it was the dressing he put on which had sugar in it, right? A lot of stuff is obvious in hindsight, but you don't think about it while you're doing it. So all he had to do is leave off the dressing and he got the healthy lunch he was looking for. And this is how simple the stuff is. And so I'm a big believer I've been wearing these things for about 10 years. You might think I learned it, but I still learn new stuff from these monitors. So they're very, very powerful. And I think they're going to at least they may not prevent you from getting diabetes, but hopefully they'll push it off for five years, a decade, whatever. So you don't ultimately need those drugs and you can just you know, do it all through lifestyle. That's the plan. So anyway, these glucose monitors, if there's only one device you can use, try that one. And so again, I back to your earlier question, this other company have January I, they actually have a whole program built around this where you wear a glucose monitor and they teach you how to actually control your glucose better. So most people will spike the white rice. And of course, most people spike to their favorite desserts because they're loaded with sugar. If you are going to eat those things, recommend you don't eat any you know, ultra processed foods. But if you are going to eat that stuff, do a brisk walk and you can you show you suppress your spikes. So these lifestyle things are very easy to implement to better control your health. Yeah, yeah, that sounds amazing. And so and so the name of the company where they can get the app, anyone can get a glucose monitor, just any person who goes to the website. You can now you can get them over the counter. That's fairly recent. So you can get them in a pharmaceutical company. But the company I'm referring to is called January I like the month, January with AI. And they basically have a glucose control version where you can order through that. But believe it or not, they can also calculate your glucose without a C. Gem. It's not as accurate as if you had a C. Gem. But the ways of doing this with smartwatch and things that is sort of a proxy. And so that also can be powerful too, because not everybody likes to wear a C. Gem. I recommend you wear a C. Gem. But if you're not going to, this is the next best thing. So anyway, we think that's very, very powerful. So there's a couple of, again, totally conflicted. But I think the reason we're we're doing this is to try and get this out to the world for people to wear and use these things, because I really the goal is really to keep everybody healthy. I don't know if you know this, but, you know, people's health span, meaning the time they live healthy is shorter than their life span by about 11 to 15 years, meaning people are living their last decade of life, usually with one or more chronic conditions, diabetes, coronary artery disease, what have you. And we really want to have everybody living long, healthy lives and then pass away, frankly. So that should be the goal. And that's sort of a big focus of our research. We've had a few people on the podcast in the past that talk about the benefit of ketogenic diet for diabetes and potentially reversing diabetes and things like that. Have you seen anything like that in your studies? Yeah. So I myself on a low carb diet, too, that helps keep my glucose under control. And I think, you know, for many people, that's the salvation. It's a go completely carb free. By the way, for certain conditions like bipolar, ketogenic diet seem to be, quite frankly, a therapy. They seem to be very, very effective for controlling people's, you know, bad states, if you will. So it's, and this is where it's very personal. Everybody reacts to food very differently and things. My biggest concern about being totally ketogenic, I do think you want fiber because I do think you want to fill your gut. Your gut has a lot of microbes that make essential vitamins. Fiber is the best fibers of course, are long chain carbohydrates that they're not like sugars, which is maybe for the listeners, if those of you who don't know, sugar is just absorbed directly into your blood through from your small intestine. Fibers go into your large intestine where your microbiome is, they feed your microbiome, which in turn then makes essential vitamins that will break down those fibers and get useful things like polyphenols, which are antioxidants, anti-inflammatories. There's a lot of useful stuff that goes on in your colon. So I do think you want to feed that so that you can make that. So I do think it's a balance that you're watching out for, but you're right for a lot of people. I do think you want to avoid, again, ultra processed foods tend to have a lot of these simple sugars that were just straight up sugar, and that stuff is generally quite bad for you. And it's not just the sugars and the carbs, by the way, it's not just your muffins and cakes and cookies, but actually ultra processed meats. There's a recent study that's come out that's shown, and you may know this, that cardiovascular disease goes up quite a bit with highly processed meats, hot dogs, things like that. They're not so good for you. Yeah, would that be cold cuts as well, the bologna and salami and stuff like that, you think? I think so, yeah. Yeah, it seems that way. Yeah, it's an interesting thing, the whole meat thing as well, right? Because I've also heard you talk on a different podcast about how more of the Mediterranean style, longer living diets, they don't eat a whole lot of, they don't eat a whole lot of red meat. Yet I also know many people who have changed their lives by eating more meat to satiate themselves so that they don't have to eat as much carbs or processed foods or things like that. And I wonder, I've never seen a study where it's like people ate meat, but ate a very healthy non-processed food diet, right? Like, if you're eating McDonald's, right, it's like, yeah, you're eating meat, but you're also eating the bread, the french fries, the soda. So, which one's actually doing the most damage there? It's hard to tell, you know? Yeah, no, there's a lot of bad stuff and everything you just said. So, I would agree. I mean, it is true that, again, if you have diabetes problem, which I do, then avoiding carbs is a big deal, especially the ultra-processed ones. They'll just stream right into your blood. And so then red meat is better than other, but of course, a lot of people say, well, make it more fish, which is, you know, high in omega-3s and high in protein as well. So, you can get your protein in different forms. Obviously, you know, unfortunately, I don't like a lot of vegetables, which is a tough spot to be in for a guy who's diabetic, but people, you know, get your legumes and things like this for high protein as well, as well as high fiber. So, there are ways of, you know, trying to avoid... All carbs aren't the same. I think that's a, you know, misnomer that people don't realize. Fiber is carbohydrate, but it's a better form of carbohydrate than, you know, those sugars and those sweets that you're getting at Halloween. Yeah. And in fact, I think many people, especially like in the keto diet, you'll see people calculate net carbs, which would be like the carbs minus the fiber equal. So, they're like, we don't count the fiber because the fiber is good, right? So, we just kind of calculate that. Yeah, it's a much better calculation. Yeah. And even all fiber is not the same. We've run some studies where Arabian xylean, which are fiber and metamucil and fission-mahast things, very common fiber. Actually, it will lower your cholesterol. But another popular fiber called inulin, which is in chicory roots and things like this, turns out has no effect on average. Although, once again, this can be very personal, meaning there are individuals who will drop their cholesterol with inulin, but not a rabinous eye land. So, it's not one size fits all. This is where knowing your personalized response is a big, big deal. Yeah. I actually, believe it or not, because I eat kind of a lower carb diet, and then I do want to get enough fiber in because I'm kind of aware that, you know, maybe my fiber intake is a little low because I eat such a low carb. I actually blend, I think it's about 16 grams of kind of like prebiotic fibers in my morning coffee with some unflavored protein powder as well to get. I don't like to eat a big meal for breakfast, but I want to get 40 grams of protein and I want to get fiber and some healthy fats and stuff like that. And that kind of really satiates me and kind of helps me get close to hitting my daily fiber needs. Yeah, it sounds pretty healthy to me. It turns out that women are supposed to get 25 grams a day, men 35 grams. And yet the average person is getting somewhere between 12 and 15. So, they're about half of what they should be. And so, you've gotten your fiber at least over half of it simply from your coffee, which is one way to get there. Yeah, I take fiber supplements myself. Yeah, Cillium Husk seems to have a lot of good recent studies and information on it being very effective, right? It is. Yeah, it's good for lowering cholesterol, as I say, on average, and quite effectively. And yeah, and in general, these things also, they, you know, I don't want to gross anybody out, but they're good for your bowel movements and things. They give you very consistency. So, that's another nice thing about fiber. It does do that. And they're all different. Again, I like to say fibers are fibers like animals. They're all different in the case of fiber. They have long change, short change, you know, hydrophobic, which means greasy or hydrophilic, positive, negative charge. It's like calling all animals the same. Dogs and cats are not the same as humans or the same as cockroaches. Yet they're all animals. And I think you have to really know what they do. And to be honest, to know what they do exactly to you, if you really want to maximize benefit. Yeah, yeah. You mentioned GOP ones, obviously, big topic. They certainly work in terms of, you know, reducing your HBA1C or whatever kind of blood sugar markers you're measuring. Obviously, for weight loss as well. I actually had a friend who was, I thought he was healthy and not really overweight at all. But I guess he just wanted to have that summer body and he went on it. And he said the alarm was going off that his blood sugar levels were too low. That's how effective it was going on. Like the alarm woke him up in the middle of the night saying your blood sugar is too low here. But tell us a little bit about the GOP ones. Obviously, it seems to be very effective for for diabetics and maybe pre diabetics and weight loss. But what's your kind of overall thought on them? Yeah, I mean, I think they've been miracle drugs for a lot of people. I myself am on GOPs, believe it or not, because of my diabetes. And I did shift, I mentioned before I was on this Rapinolide, this drug to release this for my pancreas. And it was working, but not quite as effective as I wanted it. So I tried the GOPs. To be honest, my hemoglobin A1C crept up to eight four. That's very, very high actually. And I went on GOPs and went to five seven just like that. Incredible. So I take it for for my diabetes. Now, it is also the case that my fat, I do whole body MRIs, I've done 21 in the last nine years. And so I just saw my fat just totally evaporated. And on top of that, I'd spend nine years building muscle mass. I lift weights every morning. I'm a big fan of exercise. I do like these heavy days to alternate. I'm a big fan of strength training, by the way. And as you get older, that's really, really important. Anyway, and of course, as you may know, GLPs, they can cause muscle mass loss. And that happened for me. I've lost some muscle mass, which I'm trying, you know, I'm a pretty thin guy. So the last thing I'm trying to do is lose weight. So that's the minus for the side effects. Good for most people if they're overweight. Well, certainly if you're overweight, that's a good thing. For me, it's a bad thing. So I'm lifting weights, I'm eating all the time trying to keep my muscle mass up. To be honest, these days, I moved into myocardosing because I felt like I was getting too thin to the point you were raising earlier. And this is this is off label, meaning this is not approved. But people are now recommending this myocardosing because it's thought these GLPs are not only good for improving weight, as you point out, and glucose control. But there's some evidence suggesting that they're great for kidney function, good for cognition. They may turn out to be the wonder drug for longevity. We'll see. It's too early to say, but there's people are very excited about that possibility. I'm not endorsing it for that one way or another. I want to see how it's all going to play out myself. But I do know that they've and for people are overweight who've tried many, many, you know, years trying to lose weight and can't hold the diets or even they do a diet, they still have trouble losing weight. And there are people like that. The GLPs have been a miracle. They've basically been able to get their weight under control. So so I think in some cases, they're just fantastic and essential. And whether they turn out whether or not we'll be having GLP in our water, I don't know, we'll see what happens. Well, it won't be. It would have to be a small molecule. It couldn't be the drug they inject now. But yes. Yeah. Yeah. I mean, I kind of wonder, right? Like, I mean, look, if you lose 50 pounds, your mental clarity, probably get better mental energy, physical energy, so many other kind of downstream effects of that. And I just wonder, is it is it a longevity drug because people are losing excess weight that would cause them to not live as long of a life? Or is there more? That's a great question. And one should be able to sort all that out. In my case, I can safely say that I my glucose went down a lot faster than my weight. So it was definitely having a more direct effect on the glucose because I was doing everything it could to keep my weight up. So I do think it's not entirely weight. I do think and knowing how the drugs work, there's a lot we don't know about how those drugs work. And by the way, for a lot of people, the GLPs can cause nausea. So they're not without side effects. Some people severe. That's not so common. But it does happen. I get a little bit of nausea from the GLPs myself. So and with the microdosing, another reason why cut down on it, because basically I get close to zero. So anyway, that that is a minus with these. And so, you know, I'd always recommend if you can control these things without doing drugs, you're probably better off. But if you have to use it to improve your health, by all means do so. Yeah. Yeah. Do you try to hit a certain protein count every day? Because that's another thing is that like, you almost some people have said, like, when they're on the GLPs, they almost have to force feed them. So like, they don't want to even eat that much. But they know they want to hit a certain amount of protein and strength train so that they don't lose muscle mass. It's recommended you do strength training. I think you should be doing it anyway. You should get older because sarcomenia is one of the biggest problems is people get older that dementia. And the people lose their mobility. You know, if people hurt themselves, lose their mobility. That's it. They're health plummets. So it's really, really important to keep, you know, mobile, keep active. And I think strength training is an important part of that. Now, you can't lift heavy weights every day. So I alternate between light days and heavy days myself. And then I have sort of a specialty day where I build my core, this kind of thing. And, you know, you can look at me, I'm not, you can't tell from this, but I'm not overweight at all. If anything, I'm definitely on the thin side. But I do it to keep my strength up. And I just think that's so important. You know, a lot of people run, any movement's better than none, of course. And as you get older, you know, people often say, you know, when people get really old, grandpa, it's okay, take it easy, sit in the chair. That's actually bad advice. No, grandpa, get up off that chair and start moving around. That's better advice if you want to, you know, keep your cognition up. Exercise is really embedded in all aspects of health, mental health, physical health, everything you can think of. Absolutely. Yeah, 100%. It was interesting, you said, because it sounds like you eat healthy. And but you said you mentioned your glucose or your HB1C, was it was eight points something or something like that? Was that like, were you eating healthy at that time and still hitting those kind of levels? Recently. And I think part of my problem is, see, I got, I'm at the high end of the genetic risk prediction for type two diabetes. And so, and then I became diabetic after this viral infection. And this gets into the weeds a little bit. But we could see that my DNA change, it's called epigenetically, my metabolic genes and promoter regions shifted actually in this modification. It's in my glucose control genes. And so I think that's what's happened. And this is again, it's hypothesis, but you may know two to 4% of people get COVID wind up as diabetic. Wow, that's pretty high. Yeah, it is high. And I think it's the same. And it turns out there's a lot, there's not appreciated, but if you've heard a chronic fatigue syndrome, which is a lot more prevalent than people realize about 4%, that's counter of the US population has chronic fatigue syndrome. And a lot of that's thought to be pathogen induced. So I think these pathogens can cause stresses that can lead to chronic conditions. And it seems pretty clear that's what happened in my case, I really became diabetic right after this viral infection got under control. Another viral infection came back. And once you know, at that time, it was even more severe. So I think there are these things that can happen. And this is thought to be true for chronic fatigue syndrome, the pathogens are thought to induce it. And my guess is they're affecting things epigenetically. That's the conjecture, if you will. But it's something that's testable. So I've tried to manage it as best I can through diet and exercise. But in the end, I did need some, I am on the GLPs to help do this. But I just say without the diet, I'd be in what pretty bad shape. The diet does probably count for most of my glucose control. Yeah, you mentioned epigenetics, which is such a fascinating kind of field of study as well. Because on one hand, you know, I listened to some podcasts where people are like, oh, you know, it's your genetics is actually only a very small part. And because there's epigenetics. And, you know, genetics is much less than we thought in the past. Actually, it's you can by by making healthy choices and doing the right things, you can change these things. And so like, what are your thoughts on on kind of genetics versus epigenetics? And, and, you know, because it is also a little bit like someone gets a DNA test, let's say, and then they find they have something like, for example, the Alzheimer gene, right, is a common one that, you know, so someone finds that then, you know, are they going to create some self-fulfilling prophecy and placebo effect kind of thing here? Or are we going to, or I guess, I guess it's useful if they take action and actually do something, maybe go on a ketogenic diet or something like that. But yeah, curious. Well, I hope they do the opposite. Yeah. So let's start with genetics in general. Genetics counts for about 16% of your lifespan. There's a big error on that. But it's only still everyone would agree it's a small that somewhere between 10 and say 25%, 16 is a number that's thrown out a lot, meaning that then that most of your lifespan depends on lifestyle and environmental exposures, things like that, things that you have control over or to some extent. So genetics is important. I was chair of genetics. So I'll be the last person to poo poo at. I think genetics is important. But these other things are probably more important. Now it is true for people live to be 100 or older. Genetics is thought to be a bigger component, maybe as much as half. So it goes up. So to live a really long life, genetics does help even more. But nonetheless, even there, environmental exposure is a big, big deal. And so again, it's something we can control. And there's studies out there that show that people, the foods they eat, their exercise does affect this epigenetic print, if you will, on their DNA that's been shown in some ways. Now, how that all works is not worked out. We don't know it. That's an area of active research. So anyway, the point is that you have a lot more control over your lifespan and your health span than you think you do. It's not all genetics. It is true that there are these single gene mutations, like Brack I mentioned earlier, or cystic fibrosis, things like that, that can put you at very, very high risk. Some of the things like the Alzheimer's gene you mentioned, if you do nothing, males with that one copy of, males in general have about 17% chance of Alzheimer's. It's 25% if you have one of these bad copies, we all have two copies of our genes. And if you have both bad copies, it's 60%. But even now for cognition and dementia, people talked about brain training to try and reduce dementia and things like that. So which does seem to work now to the extent and such. And this is an area of active research. What is the best formula? That's not all worked out yet. But I do think if you are at risk, to your point earlier, if you do have those risk alleles, well, start playing chess, stay in social networks. Social, if you look at the blue zones, this is areas on earth, they're scattered all over the planet, where people live to be long, long healthy lives, they live long, healthy lives. They're in Japan, they're in Loma Linda, in California, they're in the Mediterranean, they're all scattered about. And the one thing these people have in common is they're all active. So coming back to exercise, they tend not to eat ultra process foods, they have a Mediterranean or vegan diet. They tend to have good social networks. So they're very engaged. And I think this is where the cognition part comes in. You keep, when you're socially engaged in a community or in a family, you're just a lot more, you're using your brain a lot more. And I think that helps from the cognition side. And it's not stayed as much, but my prediction is they also sleep pretty well too. Because I think, you know, they tell you optimal sleep seven or eight hours, most of us don't get enough. Yeah. Yeah. I want to be respectful of your time. I would love to hear real quick though, before we wrap up about any studies you currently have going on. Maybe you need some people who are listening to participate in some of these studies or what else you got going on right now? Oh, we have a ton. So you can go visit our website. I'm easy to find Michael Snyder at Stanford. If you go to our lab page, you'll see a whole bunch of studies there. But we have studies in the area. Some of you have to be in the Bay Area, like to do the deep profiling, because of the way we collect blood, we want to make sure everything's perfect. But some of you do anywhere on the planet, like the smartwatch study for detecting COVID. We have a study to look at environmental exposures and how that impacts your health. I'm holding up an exposometer that measures airborne exposures. So we have a lot of fun studies out there. Feel free to roll there. Some are very easy. Some are a lot of work. You find the one that's right for you. We're always looking to roll more. Then we're doing a bunch in the area of this continuous glucose monitoring that I think is going to be very, very important for the world. Yes, I agree. I agree. Well, Dr. Snyder, this has been amazing. The work that you're doing is really, really empowering people, very powerful work that's going to help a lot of people. You're measuring things. Real quick, actually, one more thing I wanted to ask you on the DNA thing. So if someone changes their whole lifestyle and the way they eat and the way they live, will their DNA actually change? Yeah, their DNA sequence won't change. But the way it might get modified could change. And that has not been well studied. I predict it will change. So there's something called DNA methylation that can modify your DNA. And there's been studies showing that with exercise, that does shift. So this modification of DNA, and that affects, again, not the sequence itself, but which genes get turned on and off again. And in general, this part's not understood. But exercise we all know is healthy for you. It makes all kinds of good hormones and things like this. But exactly how that whole thing works and turning on your DNA and off isn't clear. But that's an area of active study. A lot of research labs are working on that, including ours. Yeah. So your DNA sequence, you get it sequenced, you only need to get that done once because that sequence is not going to change. But is there a way, is there a test where we can see, I guess, the methylation? Is there some test for that? Well, there's one that measures biological age. That's a methylation test. So you can get your biological age, which by the way, is not necessarily the same as your chronological age. So your chronological age, say maybe 45. But your, you know, your biological age could be 30. You might be in better shape or it could be 60 in worse shape. So there are tests for that. They measure a subset of those sites. So it doesn't measure exactly what we would like to measure for all the health things. But it can tell you something about your biological age, which can be useful. That IOLO test I mentioned earlier is, we think is a better one because it not only tells you biological age, but it tells you, we call it the agotype. What your pattern is. And so if you know your oxidative stress is off, it'll tell you, you know, eat more of these things, these antioxidants like blueberries and polyphenols and things that will help you. And if, yeah, Nat will help fix that. That's the idea. Amazing. Well, this is the future of medicine. Your lab is leading the way. And we really appreciate all the work that you're doing and really enjoyed this podcast. And I hope we can do it again sometime. Terrific. Me too, Talur. Thank you. Thank you for listening. If you enjoyed this episode, it would really mean a lot to me if you would forward this episode along to any friends, family members, anyone that you think that would get value out of it and learn something important. The mission at peak performance is to help people prioritize and transform their health. And so if you think someone will get value, please, please, please do forward this episode along to them. 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