#335 Saliva Tests, Poop Cameras, Digital Coaches and What the Future of Health Looks Like with Lara Lewington

On today's episode of The Doctor's Kitchen, we're going to be talking saliva tests, digital coaches, poop cameras, and the future of health and wellness and what that looks like with Lara Lewington. This is going to be a fun episode. I'm sure you're going to love it. Hi, I'm Dr. Rupi. I'm a medical doctor and nutritionist. And when I suffered a heart condition years ago, I was able to reverse it with diet and lifestyle. This opened up my eyes to the world of food as medicine to improve our health. On this podcast, I discuss ways in which you can use nutrition and lifestyle to improve your own well-being every day. I speak with expert guests and we lean into the science, but whilst making it as practical and as easy as possible, so you can take steps to change your life today. Welcome to the Doctor's Kitchen Podcast. now even though i'm a skeptic i love health tech i wear wearable i play with red light therapy gadgets and i monitor my bloods more regularly than a lot of my peers but rather than being overwhelmed with the data i thrive in it and i'm able to reasonably weigh up the information from all these inputs because of my experience of being a medical doctor for over 15 years But with so much interest in health tech, the landscape has become super confusing and it can be super hard to separate health from hype. So that's why we're chatting to Laura Lewington today. She's covered some of the world's greatest innovations, presenting the BBC's flagship technology show, Click, and many, many more. She's explored artificial intelligence and health, the use of home hormone testing, and whether there are any devices that can actually help us meditate better and stress less, something I'm definitely interested in. This is a super fun episode where we discuss what tech is actually available today that can help us eat, sleep and exercise better, as well as stress less and prevent disease. and I learned both about the world of breath testing to guide our food choices, an app to help me with jet lag, and the potential for intelligent and personalized cancer screening. Hacking Humanity is Lara's book and it dives into a lot of what we discussed today, plus a lot more, and it's available in all good bookstores right now. And just to make it easy for you guys, I listed some of the products that we discussed today in the podcast show notes. So whether you're listening to this on Apple or Spotify, give us a follow if you haven't already. It helps us boost up the algorithm. To make it easy for you guys, I've listed some of them that we discussed today. We don't have any affiliation with any of them, but I thought it might be interesting for certain people who want to do their own research about the breath test that we mentioned or the MRI scanner that we mentioned, for example. So you can check them out all there as well. And whilst you're there in the podcast show notes, you better click the link to get a free bag of XL coffee. If you're into delicious, healthy, high polyphenol coffee that is roasted for benefits and delicious flavors, I'm drinking one right now. Check it out. You'll get a free bag of XL coffee that they'll send to you directly. And you can also check out the doctor's kitchen app recipes. We've got a whole bunch of new recipes right now for February and they are absolutely delicious. I pull up the app myself every single week. I see what's new or what's trending. I click on it. I send it to Rochelle for sign off. Obviously, I go and get the ingredients and they are absolutely delicious because they're created to be high in protein, high in fiber, high in anti-inflammatory ingredients and taste delicious. And we've tested them a whole bunch of times in the Doctor's Kitchen studio. So you can be assured that they work and your family will absolutely love them. Go check it out. You can find it on the drskish.com or on the Apple and Google Play Store as well. For now, this is my wonderful conversation with Lara Lewington. I know you're going to love it. To keep our podcast completely free for you, our lovely listener, we're going to hear a quick word from sponsors who make that possible. Lara, great to have you in the studio today. I wanted to start actually by, why don't you give us a bit of background into how you get into your career? You know, you just told me that you used to do shifts and I don't know what kind of shifts they were, but, you know, tell us a bit about your career trajectory up into, you know, writing this awesome book, Hacking Humanity. Sure. Well, I spent the past two decades covering technology and innovation. Before that, I actually started out as a weather girl in my early 20s. Oh, really? And a showbiz reporter for Channel 5. So I've had a variety of experiences. And as the years passed, the technology thing used to just be a little bit of a hobby on the side that for Channel 5, I do these gadget reviews separately to my main job. And then eventually that became my real job. I'd contacted Click at the BBC because I loved the show, was really into the content and was delighted when they got me to do my first piece, which was about sleep. And at the time I was doing the weather working shifts. so I knew a lot about sleep and lack of it and this was the beginning it went from making a few pieces to becoming a presenter of the program and I was then there for 15 years and alongside that came the opportunities to do loads of other tech stuff panorama tonight woman's hour and I've been covering technology in print tv radio now for quite some time and then came the book which was the culmination of the whole journey, I think. Yeah, amazing. So you must be a mini expert on sleep. If you started doing sleep for BBC Click and you're a shift worker or used to be a shift worker and you just got back from CES, so you're very well accustomed to jet lag. Give us some of your sleep tips to start us off. Yeah, when I arrived here this morning, I told you I just had a triple espresso, so I'm talking very fast, but at least I should be awake. Yeah, just got back from the Consumer Electronics Show in Las Vegas, which I've been to every year for the last decade now. And it's always a brilliant start to the year because you just see how the next year is expected to play out. And also where we're at with tech. I walked around this enormous show floor, which it's really hard to explain the scale of it. It is so massive. And what was really noticeable this year was next to every stand, whether it's a massage chair or Withings Health Tech, it says AI. Everything claims to be powered by AI. I think the term is overused. Often it's used just to try and add value to something where it's not really relevant. But there's this weird relationship that we have with it, which was a real driver for why I wrote the book on health and AI as well, in that people really fear it. But at the same time, companies can't wait to tell you that they're using AR. So that was definitely a big thing with CES, as was the idea of robots doing our housework. Now, I think we are quite a long way off this being a reality for those people. Yeah, yeah. Yeah. I was watching one trying to do the laundry and it was so slow. I wanted to jump in, push the robot out the way, which of course was not the idea. Yeah. How far, this is going to take us on a bit of a tangent to start us off with, but how far do you think we are away from robots being commercially viable enough such that most households can afford them. Because there is this idea that's propagated by, you know, people like Elon Musk and a whole bunch of other tech entrepreneurs in the space who are saying, you know, it's going to become as affordable as a small car and it's going to be able to do some of those, you know, tasks, whether it's laundry or, you know, the domestic work that we currently rely on to do either ourselves or we pay people to do for us. Yeah, you are absolutely spot on with the kind of people in the tech world who talk about this. The reality, I think, is somewhat different because robots find it quite difficult to do a lot of things that humans find easy. I was at MIT last year at their labs where they are trying to recreate those basic household tasks by robots. And the robots were really struggling. There was one where a robot arm was trying to make a sandwich and it kept on trying to pick up this bit of lettuce and this bun and the hand was thumping down on it all. And it was moving all around. I wouldn't want to eat that sandwich after that robot hand had been playing with it. And even when we saw the robots at CES that were trying to do the laundry, it was looking around the room to map the space, see where the laundry was, work out where to pick it up. This is all taking a lot of time. Then trying to go to the washing machine. But the thing that it took a lot of training to do was to be able to open the washing machine door, something that we don't even think about. And the other question is, is it a humanoid robot that would do all of this? It's not necessarily the right form factor. Now, some people working in the world of humanoid robots say, well, the world around us is built for humans. It's built for that shape and size. So they are right. But actually, what about going up and down stairs? There are a lot of limitations to these robots, really high costs right now. And also, a lot of the demos that we see are in very controlled environments. And it's very easy to watch what they're doing and imagining this robot's going to just appear in your home and do it. But I don't think that's the reality. Plus, when I've been going around talking about AI and technology for health, and I've talked about the power of activity trackers, which is something I'm sure we'll get onto in due course, a lot of the response I'm getting from people is, isn't this really exclusive? You've got to spend a lot of money to buy an activity tracker. Activity trackers, you can buy something for 30 quid that will do a good job. Whereas you're talking about the realms of what a robot would cost, and it's a completely different ballgame. So they will be in some years' time probably there in some high-end homes, but the idea of them becoming the norm, I think we are a very long way off. Okay. So what are we talking about, 20 years? Oh, if ever. Well, I think it's hard to put a timeframe on it, But you've also got to work out what they're going to do because you probably don't want them doing just the laundry. You want the cleaning and the laundry. You want a device that would do multiple things. Maybe you have a device that has the bit that will mop and vacuum the floor, then has an arm which will come out and clean the windows or do something else. Because in isolation, those things exist now. You can have a window cleaning bot. You can have the mopping bot. And the mopping one was actually quite good when I did a big experiment years ago with the vacuums and the mopping. I was quite impressed by that. It's basically like a wet version of the vacuum. And obviously, these things get better and better. The cost comes down. You get competition from companies that can make them at a lower cost. I don't know how mainstream the entire cleaning operation of our own fire robot will be going. Yeah, it's a big market. So at the start of your book, Hacking Humanity, you set the scene for what a morning routine could look like with all of these gadgets. Could you set that scene for us now? And then perhaps what that might look like from a health and wellness perspective in the next five or 10 years? Yeah, I think one of the main things here is the seamless tracking of our health and life. And we don't want to feel like tracking our health is taking out time or energy. It would be great if it could just happen in the background. So this picture that I paint is if you're waking up in the morning, going into the bathroom, looking in your mirror, which is a smart mirror. So it might assess your blood pressure, your risk of type 2 diabetes, how well you slept last night, will have been tracked through your mattress or through a wearable. And all of this data is being collected. You're having this morning sync of all of it. You go to the bathroom, there's even something down the loo tracking everything. All of this is happening in the background. And if something is amiss, an alert will go off. This may require you to charge 14 devices. And there are probably elements of it that will seem very desirable and bits that won't. Because the important thing here is all of this is really possible. It's incredible what we could actually find out about our health through seamless tracking in the background. But how much do we want to do that? How much of that information do we want? And how do we not get obsessed with staring at that data? So the idea of it happening seamlessly and our baseline patterns, so what our normal is, being something which is collected so we can see if that pattern changes, if something goes amiss. And that's where we look at the data. That's where we look at what may have caused it or potentially the need to make changes. Sure. So this sort of seamless morning, at the moment, I mean, I wear a tracking ring. I've got a whole bunch of devices that I look at in the morning. I'm not like a Brian Johnson, but I'm somewhere along that spectrum where I'm intrigued by my health data. And it does guide some of my behavioral choices. But there is some friction involved in that. Do you think the future is going to be, well, it's just seamless. You get like an update, almost like a BBC news feed on your phone. It gives you the top line things that are the most impactful and very easy suggestions based on your own personal data. Yes, I think the idea of something like a mirror, which is something that I'd filmed at CES a couple of years ago, where it's very early days for the technology. but through tiny movements in blood flow in the face, it's correlating your data to the data of those, the 40,000 people it was trialed on the one that I filmed with originally, who had health conditions to be able to sync up those tiny movements with the likelihood of having a health condition, so to be able to figure out risk. So technologies like that, where it's not directly about tracking you or taking your measurements, can sit alongside the ones that do, and will start to understand more and more about risk. And so if it's something like that, if it's maybe some scales that are built into the floor of your bathroom that you're not even thinking about stepping on, this is something that Withings have demonstrated in concept stuff each year over the last few years. What can we do with that? Withings. Withings. I haven't even heard of that. So they do smart scales. They do a lot of other devices. They do a blood pressure monitor, which connects to a smartphone, which they've had out for years. Gotcha. And I tested that alongside a doctor actually years ago who said that it was actually really, really reliable. So all of these different elements of data, which I think right now, even though some of the technologies have been proven to work fairly well, a lot of it is still conceptual. And the idea of pulling all of this data into one place, air quality, so many other things that surround us, our lifestyle and our behavior, to really start to understand more about the correlations of how it impacts our health. And longer term, seeing all that data together, understanding who is at risk of what, when. And this is where we start to be in a position to better be able to predict the risk of illness. And if you can predict it, you can potentially prevent it or at least discover things early. So the power of this data is huge. And I think what is really, really important here is I'll go back to the idea of this baseline, understanding what our normal is. Because for me, wearing an activity tracker is nice to see that I've been active enough and to make me walk home instead of getting the bus if I feel I haven't done enough. It's a nice little push. But I also know I'm pretty active. We know whether we're active or we're not. So maybe it's more important than how many steps we did yesterday, the idea of understanding what our normal is over time. And there have been countless cases of people seeing something has been amiss in their data, in their heart rate, in their heart rate variability. And they've gone on to see a doctor and said, look, things aren't looking right. I've seen these movements in my data. And they've been diagnosed with heart conditions, even cancer, episodes of lupus. There are now many cases of this where they're not medical devices, they're not there to diagnose, albeit they do have some medical grade sensors in them, some of the brands do. But they just allow people to see a little bit deeper into their health. so they can see those signs of something just not being right and look into it further. Yeah, yeah. I definitely see the use of some of these devices in a predictive manner and for prevention. I guess the big thing, and maybe we're skipping a few steps here to go right to the end, but it's getting people to actually make the action. And this is where you see a lot of scepticism, particularly within the medical world, of all of these devices and all of these different sort of projects because if people aren't eating the right food or choosing the right foods, if people aren't moving, like you were just talking about, nudged in the right direction, or they are financially insecure so that such they can't make those choices, then this is kind of like much ado about nothing. What do you say to those kind of skeptics and how do we navigate that? Yeah, totally. And I actually think there's a lot of truth in what you've just said there, that I've traveled the world and spoken to the greatest scientists and medical researchers on earth, but all of them. All of them, without exception, no matter how incredible it is what they're creating, come back to this idea of lifestyle, of the power of what we eat, sleeping well, exercising, and that we're getting the right types of exercise and social connections. Our interactions with each other are so important. So no matter how advanced the scientific breakthroughs or the technology is, we can't ignore that. That is still so important. If exercise was discovered now as a medicine, we would all be talking about it being an absolute major breakthrough in human understanding. So we can't expect magic here. All of that is so, so crucial. And what I feel is that technology helps us understand what matters, what we're doing, log what we're doing, but also not just to log what it is, because you could write that down in a notebook if you wanted to, but actually see its impact on our bodies. see how our body is responding to any changes that we make because we're all different we'll all respond differently to different things as you well know yeah so i think that's crucial and that's actually why i start the book on where we're at with that now because there is so much information out there that people can get really really overwhelmed you can't do everything that you're told to do you can't eat all of the different great things you're meant to you'd be too full up, it will be too much food. So it's how do you do enough of the things that are right for you? How do you track those, see the impact on you? And look, not everybody is fortunate enough to be able to spend the time worrying about that. There are many people who are just worried about getting food on the table for their families. And that is an absolute reality. And the education for people to know how important it is to think about certain things, this doesn't need to be expensive. It doesn't need to be expensive gym membership. It can be doing some really basic exercises with your own body weight. It can be going out for a run for people who are able to. But naturally, there are a lot of challenges that surround this. When it comes to sleep, there are people working shifts. There are people caring for someone with childcare responsibilities. So it's taking on the things that we as individuals can do and that we can maintain. There's no point in doing something for a week. The tiny change that you're going to keep long term is way more important. Totally. Yeah, yeah. I think with that caveat acknowledged, let's dive into some of the tech around those key pillars of lifestyle that we all know are so important and we bang on about every single week here on the podcast. So diet. So I'm really interested in technology that can improve people's awareness of what diet suits them. At the moment, I think people fall for particular narratives online. A lot of people can benefit from ketogenic diets. In fact, I'm going to experiment with a ketogenic diet myself, but I'm going to do it in a way that is truly ketogenic with the guidance of a dietician and with ketone monitoring, continuous glucose monitoring and blood monitoring, looking at my cholesterol levels and how I respond to certain saturated fats. but a lot of people are following keto diets because they've seen someone online or they've heard about these you know magical benefits of a particular diet but when it comes to diet i think the holy grail is determining how one figures out what diet is best for them and there are a few technologies that you talked about in the book including microbiome tests breath tests or even blood tests as well that can help people navigate this like kind of murky landscape assuming that we've removed ultra processed foods and we're eating within an energy balance as sort of the first step. Yeah. So I suppose the first thing to say here and in terms of any of these lifestyle factors is if you're doing something in a really poor way to start with, a small change in the right direction is going to make a huge difference. And once you start to get towards the healthiest end of this, it's of course harder to not just reach a point of diminishing returns. So when it comes to diet, I think as you've alluded to there, there are a few different technologies. Now, OMED, which was the breath tracking, which you just mentioned, I think is probably one of the things that excited me the most. Okay. OMED. Yeah. So the company making it do breath tests and lactose and fructose intolerance testing, which is provided by the NHS. So you've got a really strong tech company here doing this. And the idea is that for people, and this is currently through a GP at the moment that this would happen, is that for people, and there are devices out there that you can buy yourself to do, but it was OMED that I specifically talked about here. And the idea is that for people who are not fructose intolerant and not lactose intolerant and not gluten intolerant, so you've ruled out all of those specific things that are understandable, but they're having real digestive issues. And this is so many people. We know how common IBS is. Just people who are struggling, but are struggling to actually figure what it is that's irritating them. Well, breathing into this device a number of times a day allows you to quantify through chemicals in the breath how your body is responding to different foods. So instead of you just making notes, which can be really difficult, and also you do necessarily know the ingredients of everything you've consumed, it can help take you to a point where you understand what it is that you eaten that is bothering you And so you might know something you should avoid And at the moment this is being done alongside a GP So it fully supported And this is something that in my book I really passionate about that everything is about 1500 citations from medical papers from the virus of Penguin at the beginning. And no reader needs to read them. I've done it so they don't need to. But I'm interested in real science and where the technology is really working. It's really easy to just believe the press releases and get caught up in a whole load of stuff on Instagram. And people want to believe and they want to see a great solution. But the technology that I've seen that appears to really be able to make a difference to people is interesting. Continuous glucose monitors, of course, had a lot of publicity over the past few years. And I know some longevity enthusiasts using them long term. But for most people who are not diabetic or pre-diabetic, then the use of one for a couple of weeks, I think is an interesting insight into your lifestyle and diet. And a few useful things that I took away from this experience, I am not a doctor or a scientist. And so when I approach testing all this stuff, and all of the people I've interviewed and everything I've done, I feel like I'm hopefully doing it as any member of the public who is just interested in this would. And yes, I've tested everything. But I also sort of feel like, you know, I have no agenda on any of it. This is just what I'm testing and my results. And my feeling from using a continuous glucose monitor for two weeks was I discovered that the vegetable juice I was making before lunch. Now, this had no apple in it to cheat. This was pure vegetable. Oh, really? It was the biggest spike of the day I was having. Whereas one of the two weeks that I used it for, I was actually on holiday for a week of that. And after dinner, I'd be eating an ice cream whilst walking back after dinner. And I didn't even go out of range with my ice cream. So probably I'd had it after my meal. There's also a whole thing of what order you eat your food in, having your vegetable first, keeping your carbs and sugar to the end. And I wasn't going out of range. Now, that's not to say ice cream is good for you, vegetable juice is bad for you. But it's all about the order of what you're eating it in. And, you know, as you'll know, taking fiber out of something changes the impact that it has. So I thought this was a really interesting finding. What was in your vegetable juice? It was, oh, I can't remember exactly. Did you make it yourself or did you buy it? Yeah, well, it was a mix, actually, but I was deliberately getting them without fruit. So kale, spinach, cucumber, celery, these were not wildly sugary things. But on an empty stomach after a workout often. And this was the other thing, seeing blood sugar go up when I'd worked out. Oh, yeah. Yeah. And now I understand that's normal. Yeah. But it's not necessarily what people expect. And I talked to other friends who had tried a continuous glucose monitor who were saying things like, oh, my blood sugar is going up and down. Well, it's meant to go up and down somewhat. It's not meant to stay level. But it's about moving out of that range. So I came away from it feeling like what's interesting is you learn a bit about your individual habits, no matter what end of the scale you're at. Because obviously, we know you eat a big dessert or lots of chocolate, lots of sugar, and it's not going to be great for you. But it's just learning those things that go beyond that. And so there's the personalization element. But I just felt like you can take away from a couple of weeks a bit of information. Did I change my habits? I did slightly change the order in eating food. They give you bread in a restaurant before a meal. That is so bad for your blood sugar. And I now have this consciousness every time I'm in a restaurant and bread is presented. I try and resist. Of course, I'm not perfect. But I think about it. I mean, some of the bread is incredible. It's really hard to just not go. I just got back from Australia a couple of weeks ago and we went to this amazing restaurant and apparently Oprah Winfrey had been there a few weeks ago and she'd openly said, this is the best bread I've ever tried in my life. I was like, what a statement from Oprah Winfrey. So of course we like dived straight into that and the bread was very good. It was like, it was warm. How can you resist it? Warm bread, freshly baked. You could see it being made in the wood oven, all the rest of it. And it was Fred's restaurant in Sydney, just in case people are wondering. But this is really interesting because in your book, I love how you weigh up sort of the pros and cons of some of these products. Like you openly talked about how continuous glucose monitors are a bit controversial in some circles. There are a few scientists who are really vocal about how CGMs should not be used in non-diabetic patients, how it produces health anxiety. We don't have long-term data to suggest that just keeping your glucose in range is actually going to prevent things like metabolic disease down the line. I personally disagree with that. I think we do have some evidence that high oscillations in your glucose over a day is going to put you at risk of type 2 diabetes. But there's nuance to the conversation. But I completely agree with you. a couple of weeks using a continuous glucose monitor, as long as you're maintaining your normal quote-unquote diet, will give you insights that are potentially actionable and are useful. I mean, like this veg juice thing, that's so unintuitive to me. I would have never have thought that. Totally. Yeah. And there's also the difference between the short-term impact and the long-term impact. And this is something I go into as well, as you've just alluded to. The idea of disease that could be prevented in the future is one side, but there's also just this idea of having the most energy you can possibly have on a daily basis. And elite athletes have obviously been able to do this in the best way that they can for years because it's absolutely crucial that they are performing at their best at a certain time. And it's giving this ability to optimize and perform our best to all of us. And for some people, that may be sat in an office. That's not necessarily going and doing a sprint. But it offers that as well. And how much impact that has on different people will vary and how much people are interested in it. But I would imagine that the reality probably is when it comes to non-diabetics and non-pre-diabetics using these devices, is it's likely to be the most healthy people who are interested. So it'll be all those who have specific health concerns that are worried a parent had type 2 diabetes and they're worried that it may happen. So there is, of course, that. And that all plays into the idea of preventative health and is incredibly important. But for many people, it would be those trying to absolutely optimise. And having seen the growth of Brian Johnson's popularity since, I was the first person to interview him about his wellness regime. When did you interview him? It was a few years back. I'd gone to his house in LA. I was making a documentary about longevity for the BBC. And at the time, no one was talking about longevity yet. I had gone out desperately trying to find people who were interested in longevity and what this movement was doing. And of course, you had people working in the longevity space, but it was nowhere close to mainstream. You weren't picking up a newspaper every day and seeing mentions of it. And I've managed to track down this great longevity doctor in the US called Jordan Schlain, who's introduced me to loads of brilliant people over the years. And it was just fascinating to see what was going on in an area of growing and reputable science like the Buck Institute for Research on Aging. Loads of really interesting studies happening there, but they're not necessarily that sexy to make headlines. But then the sort of wackier side of stuff and trying to figure exactly where the truth is, what is useful, what can we learn from, where is there really a step forward in a developing science in a world where longevity is actually something worth thinking about and what is something that is just still remaining on the fringes. So I was absolutely fascinated to make this program. And look, the reality is Brian Johnson is a brilliant character. And what he was doing was fascinating. And each individual thing, this was before his whole don't die thing, actually. And that's great marketing. I love the don't die slogan. I've interviewed him many times now and he's always a pleasure. And each individual thing he was doing was based on some form of science. Now, that's not to say the technology he was doing it with or the method he was using works. Sure. But it was based on something that should have been physiologically possible. And that was really interesting because when it came to reversing his skin age, he was doing amazingly. When it came to reversing his hearing age, he's got the hearing of a 64-year-old. He did a couple of years ago, maybe now of a 66-year-old. He couldn't do anything to reverse it. But if he found a way to do so, that could have been really interesting to people with poor hearing. Absolutely, yeah. And the fact that he gets all these headlines and he gets all this attention and he gets people talking means that anything that does unfold from what he's doing will be talked about. And going to his house, going to this clinic, which he has there, was fascinating. The fact he turned a bedroom with an ensuite bathroom and a big walk-in closet into the clinic. A lab, yeah. It was brilliant. It was brilliant. And I've been back since and I've seen the whole thing unfold. And obviously, it got somewhat more different with the don't die narrative. Sure. And I said to him, you seem to have become more extreme. And he said, no, it's just better explained now. Yeah. Look, he's a controversial character. Lots of people are bothered by what he's doing. And they think the idea of not dying is taking this too far. Of course, I can see that. But actually, if you sort of move away from a bit of that and just look at some of the experiments, not taking the son's blood, you know, I think that and giving his to his father, that has been happening for years in Silicon Valley. He's just been honest about it. But it's been going on for a long time. There doesn't seem evidence that it's been doing anything useful and he's stopped because he didn't think it worked. But there's plenty of other stuff that's going on there that was interesting. And that was fascinating to see unfold. Yeah, yeah. I find him a really interesting character. I mean, we've had people on the podcast who are really dismissive of Brian because they think he's just out to make money. He wants to increase his wealth. And my position is because he sold his company i think braintree for something like five six hundred million something like that yeah so he's close to a billionaire you don't try and make more money by doing something extreme where it's so much daily work no this is about ambition this is it's pure passion he says this you can't you can't do what he does every single day in the pursuit of money it does not exist like if you wanted to make money he'll just give a bunch of, you know, he's a smart guy. Tracker funds, hedge funds, he'll be able to increase his wealth to multiples of billions. And he's into it. I think there's quite a few dimensions to it. He's been depressed. He'd been through a very difficult time. He feels like this gave him something to focus on and he's been feeling great from it. It's given him some control back. And I think all of that he's talked about in the earlier interview with him. And this is, he sees it as an ambition. He called himself at the beginning a rejuvenation athlete. And I'm not sure if he still uses that term. No, that didn't stick. That couldn't have stuck. So he must have got some like good PR advice about, you know, if you call it, don't die. It's like controversial and sticky enough. It gets the headlines. But it's fascinating. And I think he, and I've spoken to many others who talk like this as well. And it is, yes, it is a bit of an extreme Silicon Valley thing, but they feel like the science and technology are moving so fast they just want to live through these years healthily because then something else will help them and they'll be able to keep going and they are also, well certainly Brian is fascinated to see the future so he's determined to want to stay around to see what that is. So it's the game is staying in the game, that's basically. I absolutely get all of the stuff that people say about him but I've made a couple of shows with him and he's been brilliant fun for it. He's been a great sport. He's laughed at himself when he's needed to. And it's interesting. Look, you try and jazz up programs about science and you need something fun because once you've filmed in one lab, you filmed in them all. Labs tend to look the same. Totally, yeah. If only someone could do something for sarcopenia, I think that would be great. I mean, he is doing stuff for sarcopenia because he does do a lot of strength training, specific movements that are aimed at the large muscles that typically reduce in size and function over the course of our lives. And we know that over the age of, I think it's 50 or post-menopausally in females, like your decline of muscle mass just falls off a cliff year after year. So I think you're right. Science needs sexier taglines to bring attention to it, amplify interest, and maybe even bring more pharma R&D dollars to it as well. Yeah, and there'll be incremental improvements. And I think the issue is you want headlines to say something really dramatic, but actually what we're seeing, especially in this area of aging science, is incremental improvement. We'll see small improvements, especially at a population level. I'm not dismissing what it means for individuals, but economically for a population are really important. and they don't make the exciting headlines, but that is certainly where we're heading. And I think across health in general, and that's why in writing this book, it's all about a direction of travel and the better future we can all have for our health, partly through understanding how our bodies are functioning, how we're declining, what our risks are, knowing what to look for. All of that is powered by technology, but actually we will see incremental change over the years that betters our health and betters our prospects for what we can treat for sure sticking on the the food train right now so we talked about breath we talked about cgms what what other gadgets are there that can improve you know the quality of our diet or like that whether it's our choices or yeah within that there's obviously a lot of talk about microbiome yeah i think it's probably pretty early days for us to talk about what that means for diet. There's a lot of disease association going on there. But I don't think we should rush ahead of ourselves. This is also something that's very important to consider. There's a lot of ability out there for people to test things. We need to make sure how useful what we're testing is. I've had my full genome sequence twice. And genome sequencing is incredibly powerful when it's for something actionable in a high risk population. So it cost $3 billion back in 2003 to sequence the first person's genome. Now any of us can do it for a few hundred quid. And we can understand a lot about certain things. Genomics England doing some really interesting things here with newborn babies who are at risk of rare disease, being able to avert blindness, for example. But there's also, when you move into the realms of diet and nutrition, it's really early days for genomic medicine and for microbiome to really understand a huge amount. So there may be elements that we can understand, but we also need to know how much we don't know already. And I don't doubt for a moment, a lot of that will continue to unfold. The other technologies out there were things like tracking what you eat alongside your activity and so on. And this is something that I've seen a lot over past years. And when I was testing the activity trackers, going back a few decades and comparing them all to each other, and there were also the options of MyFitnessPal type apps, where you are inputting all of what you consume. And it can be a really time-consuming and slightly painful process to log it all. Well, now many of those apps have progressed to be able to take a photo and it can even assess the size of the portion and the calorie consumption and how much salt and sugar and so on. But actually that has limitations because if you've got a dressing on your salad, well, it doesn't know anything about what the ingredients are. You can't guess that unless you're putting in something specific that was ready-made and then you're starting to move into the realms of stuff, which is becoming more processed. So there are limitations in this, in actually logging what you're eating. And as you know, a lot of it is habit. And once we transform our food habits a bit, I think most of us end up looking back at what we used to do and are appalled by our behaviour. So from the technology perspective, I actually think that's one of the harder areas to keep track of is logging what we eat. You know, it's interesting. So I agree with you, the tracking using snapshots is really tough. We actually introduced that feature into the Doctor's Kitchen app ourselves. So we have a tracking function where you can take a picture of your food and it will use, I think we use Gemini as the backend. So it will analyze the ingredients it recognizes, passes that information through our nutrition calculator because we don't trust any other nutrition calculators out there. We think that they're actually really flawed using old data. And that it gives you fiber, protein, and inflammation index using our inflammation index as an approximation. But it also gives you the ability to edit as well. So it will give you, if I took a picture of my kale salad, I don't have kale salad every day, but let's say I had a kale salad with white beans. That was right on brand. Yeah, I know. Yeah, yeah. Not every day. I saw what you had for breakfast. It was very healthy. That was the doctor's kitchen bread. I'll give you the recipe afterwards. Thank you. I'd love it. But it gives you the ability to like change the quantities or add things if you've added something different. But it is still like a bit of friction for people who aren't motivated to pull out the camera. I mean, I forget all the time. I forget to pull out my camera, take a picture of my food. And whilst I know that tracking all 21 plus meals every single week would be great. It'll give me an indication of whether I'm consuming enough protein. I consume enough fiber and give me those actual insights. There is still some friction there. This goes back to the idea of the seamless tracking, actually. Totally. That it's so much harder to do something that requires your time and attention. Yeah, yeah, yeah. I think if I had, imagine we're on Dragon's Den or Shark's Tank. If I had my wish list of what I wish an entrepreneur would bring to the table, it would be a scanner, either using your phone or something, that allows you to go to the supermarket and scan produce to determine the nutrient density of that produce. because there is this idea that conventional produce isn't as nutrient-dense as organic. And there are some studies to suggest that as well. Some produce is laden with more pesticides than others. So it would be interesting because there's not a lot of transparency across that. Like when you pick up a kale or an apple or something, I'd love to just be able to scan, is this actually nutrient-dense? Should I be choosing that one over there or from this farm or grown in this particular soil? I think that could give a lot more. Yeah, so the scanning will just, what you can do at the moment, you can scan, yes, it's a tomato. Yeah, exactly. But to get beyond that. Yeah, yeah. You haven't come across anything like that, I'm assuming. No, the nutrient density, I think, would be rather hard for any AI system right now to be able to assess. Unless, of course, you had the sourcing and there was a lot more data provided that you could go back to where it came from. Yeah, or you take a little sample of it and it goes into like a little, you know, handheld laboratory. Yeah, but the supermarket would have holes in all of that. Yeah, yeah. Or maybe one person could just do a batch and they're like, okay, this batch is really good. Don't go for that batch. Yeah, well, yes. And I suppose the price would be relevant to that. Yeah, yeah. Well, Able & Coal, you told me about you just started an Able & Coal subscription. So, you know, like an Able & Coal could do the nutrient scanning for you. In the same way, because I'm very hot on independent lab testing, particularly for supplements, because there are a lot of contaminants that we find. And so good brands will actually be transparent about that batch's independent lab testing to show that it's free. Actually, Brian Johnson does this on his website as well. Yeah, he did it with some cocoa, didn't he? Yeah, that's low in lead, low in cadmium. That unfortunately is commonly found in dark chocolate or certain brands of dark chocolate because of the soil. So going that extra step, I think, again, this is in the future and for people who can actually afford this. But I think going that extra step gives me a lot more clarity and a lot more trust that what I'm consuming isn't going to be putting me at harm down the line. Especially people who've been dealing with chronic illness post a cancer diagnosis. People who are really, really cautious about what they consume and want to really focus on diet. Yeah. Interesting. Should we move on to sleep? This is sort of like your special subject. So what kind of things are there at the moment? And what do you think are future avenues for sleep to optimize? I actually think there's really mixed feelings about sleep tracking. And this is just anecdotal from people that I talk to. But one of the main reasons I wear a tracker, and I'm always wearing at least one tracker. Or at least one. At least one. I wear a smart ring all the time. By day, I also wear a smart watch. That's actually mainly because I can do payment on it. And until they bring it out in the smart ring, I'm still sticking to that. Oh, so you use that for payments. Yes, that's right. It's very easy when you're getting on the tube or bus, which in central London is a thing that I'm doing all the time. So I think the idea of tracking sleep to me is incredibly important because I like to see how that pattern is going and have a bit of a better representation than how well I think I've slept. Now, that's not to say the sleep tracking is absolutely perfect. I think of all of the tracking and I've done numerous experiments, again, non-scientific, just using these devices as anybody would. And the variation in sleep time and sleep staging is there a little. Now, Matthew Walker, professor who focuses on sleep at Berkeley in California. He's written a great book about sleep as well. I went to his lab and he showed me his sleep clinic, how it works there. that you have all of these wires attached to your head and you're monitored in this strange environment which I think would put you off your sleep anyway but he said you have a sort of night adjustment And he is disclosure here he is the sleep advisor for Aura Ring He said that Aura is 75 of what the sleep clinic is in terms of sleep, which actually for something that you're wearing on your finger is pretty good. Pretty good, yeah. And also it will measure in the same way consistently. And I think this is something important about the trackers that you don't want to keep swapping brands or comparing yourself with a friend using a different brand. because even though these days in terms of activity, the differences are pretty negligible, heart rate seems to match up pretty well across the brands, you want to monitor you against yourself yesterday, you last week, and it allows you to be able to do that. So in tracking your sleep, I think even if the data is a little bit out, it's really useful to see that pattern and see how things have affected your sleep. If you've upped your caffeine intake and you know it's had an impact and you see that in your sleep staging, as well as how long you've been asleep, it might push you to reduce it. I've had a triple espresso this morning trying to overcome my jet lag. And I know it's too much. I need to get back to my double. So it's really useful to be able to actually keep a long-term pattern of that. And one of the things that Matthew Walker said to me was that sleep pattern is seen to change 20 to 30 years before symptomatic dementia. So maybe one day we will reach a stage where it's not just about tracking your sleep, but using it as a potential diagnostic to raise the alarm bell that these changes are in keeping with those we see in people ahead of dementia. So you then go and investigate further. So in the longer term, I think there's real power as we collect more data, as we understand more correlations. And that's what's really exciting about this era of healthcare is that we are collecting uniform data built for purpose, collected for purpose to see how those correlations work in the longer term. We're collecting enormous amounts of data on huge swathes of populations in ways we've never been able to do through these devices. And sleep patterns, we're understanding a lot about what's going on all over the world. People in New Zealand are getting the best sleep. People in Japan are getting the poorest sleep. If you fall asleep at work in Japan, it's considered a mark of respect that you've been working hard. Do that in the UK, you'll get your P45. So there's really different attitudes to sleep. Amounts of sleep, weekend lions are a very European thing. And they're not necessarily good for us. We're better off to have a pattern where we're waking up at a similar time seven days a week. But you don't want to be deprived of sleep as a result of that. So these devices are allowing us to learn a lot about ourselves and a lot of population level. So for the people who may lose sleep over their lack of sleep, where this is really not a productive or good thing for them, Well, they may gain something from population level understanding. This isn't for everyone. And I think when it comes to anxiety over devices, sleep is probably the area that people may be the wariest. So for some, they might want to take their devices off at night's time, despite the power of being able to track. Yeah, I think there's definitely a lot to be said for being more intuitive about your sleep needs and whether you're well rested or not. I mean, I personally use my ring. I've been using it for like eight years now. and it's given me a lot of, I mean, when my newborn was born, he's 15 months old now, I just, I remember looking at my average heart rate and it literally just skyrocketed after he was born and like stayed like that for three months. So it went up for like 15%. Yeah, and that's the sleep deprivation you can't do anything about. For many people, there is sleep deprivation they can't do anything about. That probably did compound my anxiety around sleep actually at the time because I looked at the data, I was like, what can I do about this? Well, yes, when you know how bad for you it is to not get sleep, you're only going to feel worse about not getting it. And the devices will also encourage you as to when you should go to bed so that you are at the right point of your sleep cycle, at the point of the night, which is best for you. I met a load of people in California setting their alarm clocks to go to bed at night rather than to get up in the morning to get sleep right. But it's a real luxury being able to do that. I know, absolutely, yeah. I remember it saying, oh, you should go to sleep now. I'm like, yeah, but he's crying. Yeah, well, it's like all the baby tracking stuff, actually. your baby needs feeding your baby needs a nappy change i think you know you definitely know i actually tried a tracking device on rafael uh my son and uh it lasted like a night and i just took it off straight away because like anytime he moved the alarm would go off yeah was this one of the socks it was a sock it was a sock yeah yeah i forget the name of the brand now but i sent it back it just was not working for us because i thought it'd be really interesting data for us not not you know for any particular concern i just thought it'd be really interesting just to see like what his sleep waves are and whether we can actually monitor the sleep regressions and yeah because we had one at four months and um i mean generally he's he's been fine and we're very lucky and we're very sort of fastidious with his routine um but it just it didn't work and i was quite i was quite disappointed i was quite looking forward to just getting some data on raffaele and yeah well i can imagine like we collect data on us you've been wearing a smart ring for eight years. You clearly like data and you want it. But I've seen over the years, a lot of different devices, even one that analyzes a baby's cry to tell them what they are crying about. Yeah. And it was based on the data of thousands of babies' cries. And the idea was that even though all of our babies sound different, there was some sort of way that it was trying to correlate. There's so much out there. But I mean, I know as a tired new parent, which was a long time ago for me because I've now got a teenager but I know what it's like you're you're exhausted you're just trying to function you don't want to be setting up a gadget as well alongside yeah yeah yeah it's funny isn't it because I think sometimes I mean I love tech and I love data but I feel that it's taking us away from our traditional habits and our inner wisdom I mean I think I read this book called um uh why French kids don't throw food I read have you read it It's brilliant. I love this book. It's super funny. It's about this New Yorker woman who goes to live in France with her husband and she has a child and she's a sort of typical helicopter parent like I am, you know, always looking around and setting milestones and monitoring. and the French generally, this is a big generalization, a lot more laissez-faire and they go into the natural way of their child. And you can imagine by taking that approach, you naturally know what the different pitches are of cry that determine whether your child is hungry, your child has got a sore nappy. Like that's the sort of inner wisdom that I feel sometimes tech is taking us away from. Yeah, and the human instinct and the things that we want to do and we don't want to use tech for are equally important to recognize because the technology is there and created to try and help make our lives better and make things easier. But we've got to embrace the things we want to, the things that us as humans want. And that's actually something that I explore in the book as well, that it's all very well what is possible, but just because AI can do something doesn't mean it should. And we want to embrace the things that work for us. There was this lady who I met in one of the world's blue zones in California. I went to Loma Linda and I met 103-year-old Mildred. 103-year-old? 103. And what was brilliant about going to meet her was this was the ultimate human story. I'd come from visiting Brian Johnson in LA and going to see a whole load of scientists at universities across the US. The University of Southern California, Berkeley, Stanford. I had seen the absolute cutting edge of science. It was a program about brain aging that I was doing. And then I went to Loma Linda and it just happened that in my filming schedule, it was at the end of the week. And I got there and I was welcomed by this wonderful lady who made me breakfast and welcomed me to the community. They're Seventh Day Adventists. And for them, it's the duty of religiosity to look after their bodies. They are eating impeccably. I've seen what's on your shelves here. Theirs were very, very similar. Really healthy eating. They all exercise. They prioritize sleep. there are literally lectures taking place for the community on healthy living. Wow. And I'd gone to, first of all, interview 99-year-old Esther, and I had to wait for her to finish at the gym. So I was there. There was a singing, a group singing activity taking place whilst I was waiting for her. And then there was a lift next to me. The doors opened. There was a sign in the lift that said, only three walking frames at a time. And this really stuck with me because this community aren't magic. They're not superhuman. They're just aging better than your average Americans or average Brits. I'm saying America because I was in America. And they're living a healthier life for longer by what they're doing. But it's nothing wild and inexplicable. It's just slowing down the aging process a bit because they're living healthily. And then I went to interview 103-year-old Mildred. And the thing with Mildred was she'd had enough. She'd lost her daughter 30 years before. Her son was bedbound. And although she had no signs of disease and she was a sharp mind, every time she stood up, she was nervous that she was going to fall over. She didn't know who was going to come to her room to visit her next. And she was within an assisted living facility where she knew lots of people. And there was a real sense of warmth and community there. But it just went to show that this isn't everything. There's a really important human experience that goes beyond all of this. And it wasn't just a sense of community. It was also purpose. She'd had a very successful career. She was a doctor. She set up hospitals in Africa. She'd actually done a lot of important work over the years. And I just felt like she was feeling that that purpose was gone. And in her apartment all around, she's got all this memorabilia from her time in Africa. And it was really fascinating after a week of the cutting edge science, after going to see Brian Johnson, just seeing what it really means to be human and what it feels like to be 103. because we talk a lot about longevity and staying healthy for longer, but we rarely talk to people in those sort of years of their life about how it is for them. Yeah, yeah. I think that sense of purpose piece is super important and I think that sometimes gets lost in the technology conversation. I think that technology can definitely harness that. I mean, I met my wife on Bumble. Yeah, of course, it holds incredible power. Yeah, it's incredible. I mean, even, you know, like community events and Paddle, which is having a moment right now, has been for the last couple of years. you can book a court and meet some random people and play. So there's definitely ways in which we can harness technology to help us help with that sense of purpose. But sometimes it can take us away, like, you know, constantly obsessing over sleep data. Aside from wearables in that sleep space, are there any technologies that can actually just help us to get to sleep quicker outside of the supplement space? I mean, we were talking about melatonin before, right? where the melatonin doses are huge in the States and it's on prescription here. And when you told me you would start somebody on a 0.25, I was kind of breaking up those tens into tiny, tiny pieces trying to do the right amount. Because when I was using the Time Shifter app and you have this option, so you put in your flight details and I had a really crazy couple of weeks where I was a few days in New York, a few days in London, a few days in Sydney, straight back from an event in London 12 hours later. So I was determined to be as awake as I could be. And having put in my flight details, and you answer the question as to whether you're going to take melatonin or not, and it was telling me to take one milligram. And I was thinking, oh, that's tiny with my 10 milligram calories. But then you're saying even a quarter of that is what people would start on. Time shifter app. I need to download that. So that's the app that helps you get over jet lag or try to mitigate it. Well, yeah, it helps keep you in order, telling you when you need to prioritize daylight, when you can have caffeine, when you can nap. That's great. And when you've got a really fierce routine, but you need to be a good sleeper to be able to do it. That is one caveat to it. You need to be someone who can relatively sleep on demand. And I had a less successful trip with it recently, actually. I think when you're only a couple of days in places, you're not there for long enough to even adapt to the time zone. So in a way, it's probably easier than the nine days I've just spent in the US, where I'm still sproggling a week later. Well, you're doing really well. but yeah are there any devices that help you get to i mean thinking of um uh vagal nerve stimulation devices that are getting a bit more attention now within the scientific community so just for listening these are devices that you can either use transcutaneously so you just put it on on the skin or on the um over your neck um but there are some other implantable devices that are actually being uh used i believe one's just been approved by the fda for use in rheumatoid arthritis as a pain suppressant. So yeah, some of these devices, is there anything in that space that you come across? Yeah, there are wearable devices. I remember one that you wear in the daytime for 20 minutes a day to help trigger the brain reaction that will help you sleep later. So it's almost like you're practicing it. But this wasn't something that I could actually test and tell you how I thought it worked. Because first of all, I sleep too well. But when I've tested sleep gadgets and I've tested a load of them and I didn't test that one. I actually got an insomniac, Dom Jolly, the comedian, to test a load of stuff. And I tested various wearables that there was one thing that was a headband. There was another that was earbuds that plays music to soothe you off to sleep and it tracks your heart rate. So the music is kind of in keeping with how your heart rate's dropping as well as how you're going off to sleep. And so soothe you off to sleep and then can wake you up in a soothing way. But the problem is when I'm testing these devices, I'm so conscious of the fact I'm testing them. I sleep worse than normal because I'm worried it always come out my ear. I tested another one recently, which was to track snoring. You have it stuck to your neck and it came out of a university. It's got proper scientific papers to back it up. But first of all, it didn't seem to say stuck very well. And then I also thought, well, I need to be using another app to track my snoring because my husband just says I snore all the time. So it's actually quite difficult, I think, to test anything that feels remotely scientific in how well these work for somebody who sleeps pretty well. But a lot of these devices exist out there. And a lot of what can be done through vagus nerve stimulation through, obviously, we've got a whole world of brain computer interfaces happening as well, which is absolutely fascinating. But what I did test recently that I can tell you had a real effect was a pair of headphones that through stimulating the vagus nerve and vestibular makes you feel like you're tipsy. No way. Now, the real purpose is for meditation, but it has a demo mode. And I was at a health tech conference and I tried them on and we put them up really, really high. I had to grab hold of the man who was at the stand to avoid falling over. I don't drink alcohol, but I used to drink occasionally. so I know what it feels like to feel tipsy and I knew that's how I felt but the weird thing is the moment you switch it off you feel normal you're normal no way immediately really yes what's the company called uh brain oh I'm trying to remember brain something AI brain patch brain patch brain patch okay it's meant to be helpful for brain patch AI and then I took them on I was doing my slot on Lorraine on ITV and I took them in to get Lorraine a little bit tipsy. Really? On live TV? Yes. She did feel a bit funny. That's hilarious. So it's meant to be good for meditation just to get you into flow. Yeah. I mean, I posted this on my social media at a quarter of a million views. That was me just testing them at the show. But it was really, really interesting to see the effect it could actually have. I really felt that. There's another mode on it that gets you to you try and walk in a straight line and you can't. You walk to the left or right. Really? It just kind of controls you. Oh, my gosh. So it shows... All from vagal nerve stimulation. Yeah. It shows that they are doing something. And that's what's interesting about this demo mode, which isn't its real purpose, of course. Sure, yeah. But the idea of using it when lying down to do a bit of meditation alongside it, which at this tech conference I was at, I then got down on the floor and was trying, shows there's something there in the science. So these devices are existing. They are evolving. And I guess we will see how well they live up to the promise as they become more mainstream. Yeah, that's amazing. I mean, in that vein, is there anything around stress or anything to help with stress? Because, you know, we're becoming a lot more stressed as a nation. Stress has a huge biological component as well. We know that stress can trigger inflammation. It can affect our guts. And, you know, actually going back to some of the stuff we were talking about with regards to food and food intolerances, I think a lot of that can be psychological in origin, not to say that's all in people's heads, but the day to day stresses behind your computer, not moving, doing public speaking events. All these things can trigger things within your digestive tract that can be troublesome and people usually just look to food, but actually it can be, you know, stress related. Are there any elements around stress or? Yes. And different devices measure stress in different ways. And I almost feel like we haven't concluded yet which is the best way to do it. So you've got some wearables doing it through dampness on the skin. So assessing that as a sign of stress, others looking more towards heart rate and other factors. But there's also a company that I filmed with last year, Ellie Health, that does saliva tests to monitor cortisol. Okay, yeah. And there's a few companies that were moving into that space. So look, I would imagine in an ideal world, this is something you would do many times throughout each day. But obviously, in the interest of it being practical, and this something not being too much of an interruption to our lives or people won't do it at all. The suggestion from the company is that you assign a couple of days a month to doing it. And through those days, you'll do three or four readings in a day. So you will see on the app, your cortisol curve, which should be going up in the morning, going down later and seeing how stressed you are from those readings. From everything that I've seen from stress tracking, that was something that particularly excited me. That company is all about hormone tracking. They're now moving into progesterone. They announced last year, they've just announced testosterone tracking. So through these same methods of their test strips, they're not hugely expensive. Is it like a blood glucose monitor, like where you get the immediate result? Well, yes. So you do it with this testing strip that you put in your mouth and then your phone scans the strip. There's a code on it and everything. And the results will, I think it may take 15 minutes. I can't remember. The results will come up in your phone. And then throughout the day, you'll have those readings from four events, say. Wow. Because in my NHS days, we would only really do cortisol testing if we were suspicious of a cortisol producing tumor or another hormone event. And usually what we do is spit tests throughout the day. So we do four readings in the morning. Yeah, and that's exactly what this is doing. It's just bringing the ability to do it. But just in the home. Wow. So you're putting it in this little device and then you are scanning it to bring all the data directly into the phone. So which of these kinds of stress analysis is the thing that people really buy into long term and is proven to be really helpful? It's something that I think will gradually unfold because it is still very early for all of it. albeit it's been a few years since our wearables have started to assess stress and it can also that can be quite stress inducing yeah when i look at my data from my smart ring and i see that it tells me that i've been and it's normally very diplomatic oh i hate that yeah yeah it'll use phrases that you're you're engaged which i think one level under very stressed and so you see this data and you kind of think what was i doing at that point of the day what was causing it i used to have on my smart watch a function on where it would actually give me an alert and it would tell me to breathe. The weird thing was, I would realize when it said it that I was sort of, I was slightly holding my breath. I was either deeply in thought or in the middle of doing something. But look, some stress, there's a difference between acute and chronic stress, of course, and acute stress when we exercise or whatever is not bad in the way that chronic stress is. So this sort of analysis also takes a lot of understanding of the readings. And I think with all of this technology that we're using, we need to understand what that means for us and how relevant it is and what to not take notice of as well as what we should recognize as potentially a problem yeah i think with all of these devices the interpretation of the data is key because someone could look at a high cortisol level um for example as being a negative thing or like you know a suggestion that you are stressed as a negative thing but like you said there's good stress there's bad stress is how we respond there's certain people that actually thrive under that stress pressure i know anecdotally from the sort of uh the the stress um graph that i've got on my wearable uh i i can actually see when i'm off or on a holiday my stress level is actually really low wow and so it always says you know you're relaxed or whatever like you know you're almost good you're not getting stressed by 15 months you're old yeah yeah or there are peaks around uh feeding time um but you know on days where i'm working like the stress level is high but I don't see that as a negative thing. I think it's more that I'm engaged, you know, that politically correct. I was about to say that, the exact word engaged. Maybe there is some reality. I think so. I think, you know, without stress, you just, you couldn't engage. You need those stress hormones. They're very, very useful. But I think it's like, it should be pulsed through the day. It shouldn't just be constant. It should be, you know, periods of rest and downtime, which is why I think taking breaks and all that kind of stuff. I think if people could be nudged in that direction using some of these wearable devices, then it makes sense. But again, I think it's user-dependent, all this stuff. That's really interesting about Eli Health. I hadn't heard of that before. Eli Health, Eli Health? I think they Eli E E okay And I think when we look at the longer term as well with a lot of this and even continuous glucose monitors we starting to see devices emerge that aren't directly tracking the thing that they're looking at. So a continuous glucose monitor has this microneedle that's going into your arm. Well, there are also devices that are watches that are making the correlations using their algorithms between other vital signs and what readings that normally indicates. So this does mean that in the longer term, our wearables are likely to predict a lot of other data points to be looking at far more biomarkers than they are now, things that may seem very difficult to do in unintrusive ways. So I wonder how that will play out for stress, because it will be able to bring in more factors and maybe a greater understanding also of what the good stress is you pushed your body really hard in that spin class this morning and something that seems more like a longer term concerning stress because we're already starting to get this feedback in written information to us telling us a little bit more about the readings that they're finding and what it might mean and the apps have evolved so much in terms of that actually describing to us what's going on and what changes we might want to make yeah that's the ai bit isn't it well one of the smart rings i did an experiment of lots of smart rings at once recently and one of them had a large language model built into the app so you could use it as a chatbot oh nice and the speaking out loud to it unfortunately had some glitches that wasn't really working but you could type and you could ask questions about is the night that i slept the best last week the same as the day i did the most exercise interesting so you can maybe have those interactions i guess we're heading towards that probably we're actually becoming the norm for all of it because it's not wildly out there technology based on what we have right now. It's perfectly plausible. Yeah, for sure. It's like having an Apple health kit, but, you know, connected to ChatGPT or Grok or whatever. Great. That's epic. Let's bring it to activity then. I guess in terms of activity, a lot of these wearables are sort of like built for that with the advent of Fitbit and Garmin and apps that connect with those like Strava. But you mentioned right at the start of this pod, if exercise could be condensed into a pill, it would be literally like the blockbuster drug of forever, really, because of the benefits of exercise that are just so well recognized by everyone. But is there anything aside from wearables that encourage us to be more active out there that can mimic the effects of exercise? I think we all need to get moving as much as we can. And the difference between doing nothing and doing something is huge. And so encouraging people to make those steps forward, no pun intended, is really important. The 10,000 steps that our wearables are telling us to do is a fairly arbitrary number. It was actually born out of a marketing campaign for the 1964 Tokyo Olympics. It's not exact science that we need to do 10,000 steps, albeit it is good for us. So it's somewhere around 7,000 that a lot of the research is based on. There's even research for some older women based on around the 4,000 mark on the difference that it makes for various different health conditions. And we also know that doing different types of exercise is important. What cardio does for you is different to what weight training does for you. And you also should be stretching to keep supple. But obviously, all of this is just giving people another list of things that they need to do. So I guess a priority here is not overwhelming people with you must do this in something really extreme and they end up doing nothing. It's doing what works for them and habits and consistently doing it. So an activity tracker does help nudge people into doing it more. And the time that I really saw this was back in, it was around 2015. So it was fairly early days for activity trackers. And I'd done an experiment with four of the leading brands at the time. And I had these big clunky watches on doing it. And it was summertime, so they were showing. And people kept on asking me what I was up to. And actually the results back then, huge discrepancy between what they were reading, a 25% difference in the number of steps that one thought I'd done compared to another. One thought I'd burned 3,000 more calories in a week than another. And that wasn't the one that thought I'd done all the steps. So these differences were massive. And if you were trying to match up what you were eating to it, this was not great. And when I spoke to one of the CEOs of one of these big companies, he said to me, well, at least it's consistently inconsistent. So you can measure you against yourself last week. Just don't measure yourself on another device. and it was the greatest PR spin I ever had. That's a great PR spin. It was also true. And when I've done more recent experiments, the algorithms and the sensors have got better. Those discrepancies don't exist at all to the same levels. But the interesting thing at the time was when people were seeing I was wearing all these devices, every single person I came across who had one, which wasn't a huge number back then, told me how it had transformed their lives. It had got them walking. They'd lost a stone. There were always great stories about the difference it had made to them. Whereas anyone who wasn't wearing one would say, I'd explain to them how the data was going, and they'd say, well, there's no point then. They're not accurate. And I think this is a great marker of human behavior. The exact accuracy back then wasn't ideal. Now they are more accurate now, but it just goes to show it wasn't about that. It was about something that encourages you to change your habits. We're not all athletes. We don't all love sport. I was the one left over at school that no one wanted, where they pick everyone from team, they're left with me and they're like, oh. You know, it was devastating. And I still won't go to an exercise class now because this childhood trauma comes back to me. And I went to one, one well-known, I don't know what you would call it, interval training, I suppose. Oh, Barry's or something like that. I won't name it, but the person that was teaching the class was horrible to me because I was so incompetent. And I just thought, I'm glad you did that to me and not to someone who wouldn't otherwise exercise because I run 5k a day by myself quite happily I do my weights I do my Pilates class I do it all by myself I don't want to be involved with a group of people and we all do what is comfortable for us and if we can be encouraged that it doesn't matter if you're not good at team sports but if you do this for yourself you're going to see your resting heart rate go down you're going to feel more energy you're going to feel the benefits then that is something great the technology can drive. Yeah, I agree. I totally agree. I think, I mean, it's really bad that you had that experience at an interval training class. Yeah, it was. And what really upset me about it was that I came away from the class thinking, well, I don't care. I'll go and get on with my run and do my own thing tomorrow. But someone else could have not exercised anymore because of it. And that would have been a huge loss to them. Yeah, yeah, yeah. That's horrible. Well, in your book, you've talked about a whole bunch of other topics like you know cancer menopause um blood testing beyond what we've talked about here in in the food space and looking at specific proteins that might be um predictive or relevant for for those with a diagnosis of dementia what are you personally most excited by or interested in uh given all the topics that you you've covered in in hacking yeah there's so much because this is all about a direction of travel the future of health is that to be utterly transformed. Data has always been central to healthcare. You go back to Hippocrates era. And in whatever way healthcare data existed, it has been relevant. And today's iteration of it is incredible because not only are we collecting so much more data, but AI's power to learn from it, to unearth incredible findings, understand correlations, see those patterns, and better human health is phenomenal. So there's this huge bigger picture excitement that I have. But I think the area where we will see the greatest change as a result, and this is something that has been backed up by so many of the experts I've spoken to, is within cancer. Because there are so many variables, there's the location of the tumor, the stage of the cancer, the genetics of the tumor. Also, the person's genomics, the makeup of us as individuals. There is so much that makes each cancer risk and diagnosis different that the power of AI is absolutely incredible. to understand who we should be screening when. Genomics England is looking at not just who is at risk of what cancer, because we understand a lot of inherited cancer risk now, but there's so much more that will unfold. There's so much more that we will learn, so much that we don't know is genetic at the moment that we may discover in the longer term is. And they're also looking at not just who is at risk of what, but when. Why are some people getting it in their 30s and 40s? There will always be anomalies. There will always be the people who don't fall into any high risk category who could slip through this net of what we consider to be high risk to analyse. But hopefully, as we understand more, that will be fewer and fewer people. And when it comes to cancer treatment as well, we've always talked about survival rates because obviously survival is the priority. but for anybody who's been through cancer treatment anybody who has seen someone close to them go through it there's also a huge quality of life not just during the treatment but long term and that's something which is now being recognized more in clinical trials and it's something the precision medicine personalized medicine provides the power to do something about the ability to be able to hit tumors harder and damage the patient and the surrounding tissue less so that's something where AI understanding the target. So not only are you going to be able to find cancers earlier because you're screening the right people sooner, but you can treat it in more targeted ways and understanding the impact that treatment will have on the individual, knowing what side effects, what people are likely to get. And this is where going back to the idea of genome sequencing, this is the coming together of a lot of this. It's not just sequencing the tumor, it's sequencing the person because we'll understand more about what drugs, work for who and this is there's there's nothing wacky about this science this is real this is real and it's where we're heading and we are heading towards this creating much better more caring personalized effective medicine for more people yeah i completely agree i think the way we treat cancer today even today you know it's it's very broad strokes and it's really unpersonalized and a lot of different cancer and we're using cancer you know uh quite generally here but you know cancer is an umbrella term there are loads of different types lots of different morbidities and survival rates based on that but the use of uh genomic sequencing vaccines as well targeted vaccines actually we spoke to a patient uh last year who had one of the first personalized vaccines for glioblastoma glioblastoma as many people know have has a really poor prognosis she still fit well you know thriving it's incredible to see and she has a regular vaccine to essentially boost her immunity, literally, based on the specific cancer that she has. There's CAR-T therapy. There's just so many ways in which cancer treatment could be improved. Then one of the best things is screening in terms of earlier detection, because we know the later you find a cancer, regardless of what the cancer is, the worse your prognosis. So if we can get that sense early as to what type of cancer it is, how many cells are circulating around your body, that gives us the best prognosis for patients. So, I mean, you mentioned a whole bunch in your book, I think, grail testing. Yeah, TrueCheck, various other MRIs, which obviously aren't accessible to everybody. There's still a great cost issue. But a lot of the analysis that I've read from other experts on this, especially people who are working in the cancer space, oncologists and researchers right there is the we really need to know who is at risk and pick out the high risk groups better not just base it on age but understand more about risk because the cost of screening even these blood tests are still really expensive yeah so to be able to do broader screening we need to make sure we're screening the right people and i saw this recently i went to go and film in south hampton where a trial was happening on people who have been diagnosed with type 2 diabetes were having liquid biopsy blood screening tests for pancreatic cancer because they are a high risk group of a cancer with low survival rates. So if you're picking out one in 100, which I think may have been what the data suggested would be likely to exist, that could be absolutely transformative in terms of survival there if you were finding these pancreatic cancer cases early enough. and my father died of pancreatic cancer over 30 years ago and the survival rates have barely changed since then whereas so much cancer treatment has come a long way but it shows that there are different ways we can approach things and this screening program was doing was doing it for that high-risk population rather than the cost of thinking will we do it for a whole population because that that then rules it out you then get to this point where a healthcare system can't afford it. And we're talking about the UK where we've got a single payer system where it's not simple, there are different pots of money, but there are still some benefits to the NHS system compared to you look at the US where you talk about preventative medicine. And well, a healthcare insurer isn't going to benefit years down the line from the illness that they prevented because someone may have moved insurer. So there are a lot of challenges as to how we do this and how we get maximal benefit. And the cost of those liquid biopsy tests that can screen for 50, 60 different cancers, the cost of those coming down and the cost of the MRI scans coming down, we're already seeing Ezra launching in the US this year at $600. What's Ezra? Is that an MRI scanner? Yeah, that's one of the MRI cancer screening tests. And there are a few companies that do this and they test for a certain number of cancers. Each of them sort of varies in what it does. but they're still expensive in most cases, still costing a couple of grand. And you've got these really high-end preventative health screening things that are going up to, you know, eight, 10 grand for some people who can do these things to the extreme. But how do we bring this down to a level where people who are at the highest risk can be provided with this and it can really make a difference for everyone? Because obviously that's the question long-term, that this isn't just brian johnson and the people who can really afford it doing it yeah i agree i think on that subject of cancer one of the things that i'm getting a lot more interested in is the impact of the um exposome or pollution in general because there are things that are relatively controllable given you know financial means like diet exercise stress reduction social connection like all these things play into an anti-cancer picture but one thing that is quite hard to control is pollution we just had dr stephanie wright on the podcast she's an uh leads the imperial team looking at microplastics and what she was telling me about microplastics was really worrying because the the largest exposure in urban environments is actually from tires so when you're walking around on the streets because we've got so many cars going around regardless of whether they're electric or not though the tires that you know we have to change every few years or so because of wearing and breaking and stuff they're just shedding microplastics into the air that we're breathing every single day so there's so there's it almost feels like um uh farcical to even think about like putting an air pollution um you know filter in your office and that kind of stuff but i think incrementally things may um hopeful i'm glass half full kind of guy may have an impact so So in the arena of pollution, are there any things that you've seen, like domestic pollution more broadly, things that can maybe give us a bit of hope? Well, yes. I actually went out with a scientist a couple of times to test some of the air quality tracking devices that have come out over the years. Okay, yeah, yeah. So in my usual non-scientific testing, when I went out with a scientist, we went out in his vehicle with all of his full-size testing kit, And I had these sort of pocket-sized devices that were tracking air quality. And so one of them was particularly aimed at walkers or cyclists. And so it would take you the less polluted route home if there were alternative routes. And it was also bringing back all of the data to help map what the air quality was like in the area. And the fact that you could have the device with you all the time meant that you could track the air quality that you were exposed to, both indoors and outdoors, and see how that was sort of matching up throughout your days and weeks and what you might be able to do to make it better. What was fascinating to me this day was we went out, filmed by the Marylebone Road, a famously extremely polluted road. Yeah. And then we went just a few streets away to a little muse. And the difference in air quality in both my devices I was testing and his proper kit was absolutely enormous. And I thought it was really, really surprising actually. How, you know, I'm sure it was not like being in the countryside. Sure, yeah. But it was still, you weren't having to go that far for a huge difference in air quality. Then I did another experiment with him indoors. And it was really quite surprising how poor indoor air quality could be. Yeah. And then we tested a device that was meant to be purifying the indoor air quality. And this was all just quite interesting to experiment with and see what a difference you could make and see that you can make differences to what you're exposed to. But the reality is, are we going to stick to it? Are we really going to walk that other route home? Are we really going to cycle that other route? cyclists in a way may be more encouraged to take a different route if they are really aware of that air quality because they're right there by the cars on the roads. So there was that, which was one interesting thing in the air quality space. But talking of these wearable trackers, I then met a professor at Stanford, Professor Michael Snyder, who wears seven devices at all times to track everything. But one of them is an air quality sensor. Really? Or on him? on him. He wears it attached to his arm. And when I met him, he just got off a flight and he was very upset because one of the wrist straps for one of his trackers had broken. And I was always a good job of wearing all the others. And he was like, data, data, data. No, I'm missing the data from this. And I could totally understand, you know, somebody who's been obsessing over this sort of data and doing experiments, albeit not to his Stanford level. I got it. You don't want to be missing any of that data. It really messes with your spreadsheets. And so he has been identifying respiratory disease before any symptoms, sometimes before an asymptomatic COVID where there were no symptoms even emerging, but days before it would have been recognizable through any means in his experiments. These have been small studies, but through this data, he has built algorithms that have been able to identify it. So he is pulling into that air quality data. And as the years pass, I'm sure more scientists will come forward with their air quality data and how it's playing into it. So I don't know the specifics of what it means, but it's interesting to see it being used in these experiments and where that might go. Yeah. Yeah. I find that fascinating. And just like, so for the internal air filters, what are your thoughts on that? Are you pro, bullish? What was the... I think the results of them were varied. And I don't even know if the same brands exist now than when I did those experiments sort of eight years ago, because there were a couple that just weren't great and i think there was something that you would have in your bag but then it was in your bag so it wasn't me tracking there so well uh there was the wearable one there was definitely one that came out a lot better than the others okay so there's a there's a potential solution available out there yeah but it shows the technology can exist and be useful to some extent in a small form yeah yeah yeah we've started tracking our co2 in internally actually and just opening the windows whenever the co2 gets a little bit higher and actually i spoke to a sleep researcher who suggested I get a CO2 monitor for my bedroom because there might be periods in the middle of the night because I sleep with my dog in the bed and my wife, there's three of us in a relatively constrained room. So, you know, the CO2 is going to build up naturally over time and that can lead to micro wakes and sleep disturbances and all that kind of stuff. And, you know, I haven't seen an impact on my sleep tracking device, but I'm still doing it because I like seeing that the CO2 level is nice and low. But I think, yeah, there's definitely an evolution for these indoor air quality devices that either clean the air. The Ultra Human Smart Ring has their own air quality sensor. I didn't realise that. Yeah, that you can pull in the data from as well. Huh, OK. Yeah, so a lot of the devices are now starting to either sync with other platforms so you can pull the data in or having those add-ons for people that are interested in it. Yeah, yeah, yeah. Fascinating world. Well, you've gone through so much more in your book, Hacking Humanity, how technology can save your health and your life. I love it. It's great. I learned loads about the technology players in this space and how varied it is. So it's brilliant. Thank you. I really appreciate you coming on and telling us about it so much. And this has been great. Thank you for having me. Cheers. thanks so much for listening to this episode of the doctor's kitchen podcast remember you can support the pod by rating on apple follow along by hitting the subscribe button on spotify and you can catch all of our podcasts on youtube if you enjoy seeing our smiley faces review show notes on the doctorskitchen.com website and sign up to our free weekly newsletters where we do deep dives into ingredients the latest nutrition news and of course lots of recipes by subscribing to the eat listen read newsletter by going to the doctorskitchen.com forward slash newsletter and if you're looking to take your health further why not download the doctor's kitchen app for free from the app store i will see you here next time Thank you.