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237: How Chronic Inflammation (Even With Chronic Skin Issues) Can Drive Bio Aging w/ Dr. Kara Fitzgerald

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I find anti-aging to be this awful marketing device that oftentimes makes us feel bad about ourselves, but that's not what this interview is about! My guest today will discuss what exactly is bio-aging and how genetic expression plays a big role.

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android

My guest today, Dr. Kara Fitzgerald, ND, IFMCP, is the first-ever recipient of the 2018 Emerging Leadership Award from the Personalized Lifestyle Medicine Institute in recognition of her work on DNA methylation. As a leading voice in the intersection of nutrition, epigenetics, and aging, Dr. Fitzgerald’s work has been featured in media outlets such as Prevention, Fast Company, MSN, Everyday Health , and many more. Receiving her doctorate from National University of Natural Medicine, she is on the faculty at the Institute for Functional Medicine (IFM) and is an IFM Certified Practitioner with a clinical practice in Newtown, Connecticut.

Join us as we discuss all things bio-aging (NOT anti-aging skincare) and what you can do to influence your bio-age.

Did you know that the chronic inflammation of skin conditions could drive aging forward? Let me know in the comments!

In this episode:

  • Why skin issues are systemic and how the inflammation is being driven from the inside out
  • How gene expression influences quality of life and lifespan, health span, and diseases
  • How you can turn genes on and off
  • What are epinutrients?
  • What is the sweet spot for exercise to reduce aging?
  • A trick to help you turn the volume of stress down, which is a huge driver of bioaging

Quotes

“If we could improve biological age by a year, there is one estimate that it would save the country $38 trillion. And given that biological age is the biggest risk factor for all these chronic diseases, rather than siloing all illnesses separately, if we put our energy towards helping people age younger, keeping them healthier, we could by extension reduce risk for all of these illnesses.” [8:01]

“Epinutrients are nutrients that influence epigenetics and specifically DNA methylation, because that's where we just really hung our hat. So all of these epinutrients have some evidence of favorably helping with gene expression, specifically through DNA methylation. So we want… to bathe ourselves in sufficient methylation.” [25:36]

Links

Find Dr. Kara Fitzgerald online

Follow Dr. Kara Fitzgerald on Pinterest I Instagram | Twitter | Facebook

Order Younger You

Institute of Functional Medicine

Podcast: New Frontiers in Functional Medicine

Healthy Skin Show ep. 003: What's Causing My Chronic Itchy Hives? w/ Dr. Kara Fitzgerald

237: How Chronic Inflammation (Even With Chronic Skin Issues) Can Drive Bio Aging w/ Dr. Kara Fitzgerald FULL TRANSCRIPT

Jennifer: I'm so excited to have you back on the show, Dr. Fitzgerald, thank you so much for joining us again.

Dr. Fitzgerald: It's good to be here, good to see you.

Jennifer: I know and we're here today, because we're talking about your amazing book called Younger You, and it's huge, by the way, it's huge. It's a really amazing book and it's an amazing feat because… It's interesting, I've known you for so long now, and you've always been focused on how to help with methylation… You always had this interest in methylation, and we'll talk a little bit more about that, but thank you so much for sharing the knowledge in this book that you have because aging is something that we're all concerned about.

Jennifer: And just for everybody who's like, “Aging? Wait Jen, we talk about skin. What are you talking about aging?” Don't worry, because I think both of us here have a real aversion to the anti-aging movement in general. I think it might be helpful for my audience to just hear your thoughts on that, because that's not what this book it's frankly about. I find anti-aging to be this awful marketing device that oftentimes makes us feel bad about ourselves, but that's not what this is about, right?

Dr. Fitzgerald: Awesome. Yeah, that's a really good, important place for us to start. Yeah, so we all have a chronological age, the amount of trips around the sun as Davids and [Clare 00:01:32] says, the amount of birthdays we've celebrated, and we also have a biological age. We can't change our chronological age, but our biological age is how fast we're actually physically aging. If we have a burden of chronic disease, whatever that is, we're aging faster. In this country, relative to other countries, we're aging faster. What does that mean? I'll give you some statistics. In this country, our average life expectancy is just over 79 years, which is actually less than it used to be, we're losing… And of course COVID will influence it, but even without COVID influence, we're losing some of the gains that we made in life expectancy.

Dr. Fitzgerald: We're certainly better off than we were 100 plus years ago, but we're actually losing some of the gains. The final 16 plus years of our lives are spent in illness. On average, we've got two significant illnesses, we're on multiple medications, it's not pretty. Our life in those final years is spent in hospital, in skilled nursing, in medication, it's spent really compromised. So life expectancy may be extended, but health expectancy has not also extended along with life expectancy. And just think about, I'm an older first-time mom and I just think about all of the effort that I've made to build my career and so forth and what my daughter will inherit, and I definitely don't want it going to a skilled nursing facility, where I'm propped up on a pillow, kept alive, on multiple medications. That is so deeply unappealing to me, and putting a burden on her to have to care for me and compromise her life because of that.

Dr. Fitzgerald: So we need to do something. Not just the personal financial burden, but we're just heading towards bankruptcy as our population ages. Now, the biggest risk factor for all of these chronic diseases that we develop, is aging itself. Biological aging is the biggest risk factor for diabetes, for dementia, for cardiovascular disease and for cancer. So, can we actually do something about the rate of aging? Can we actually do something about biological aging? Anybody in our space, in the integrative medicine space, would say, “Yeah. If you live these principles, you should be getting younger.” Well, you in your space, see people turn around extraordinarily difficult skin conditions all of the time. And I will say, to bring this into skin, yeah absolutely, the inflammation of these skin conditions would drive aging forward so that inflammatory phenomena would be a pro-aging phenomena.

Dr. Fitzgerald: As you reverse them, we should also see that translate because you know that these skin conditions are systemic. Sometimes they're local. Once in a while you'll have something that you just need to address locally, but more often than not, you have to address the whole person, would you say that's true with skin stuff?

Jennifer: Absolutely, absolutely it usually is a systemic issue that the person and… It usually is the case, and as I see in my practice, that is often a huge problem where the mistake is made that it's just on the skin and in reality, it's a systemic issue and that the inflammation is being driven from the inside out. Yes, there's outside ways to address things, but we do need to work on the inside. So this really isn't about necessarily looking younger per se, right? This isn't about looking younger, this is actually changing something at… What would you say? Like a biochemical or a biophysiologic level?

Dr. Fitzgerald: Yeah. Yeah, both. You can change physically what you actually look like as you reverse biological age. We're in this new scientific revolution where we can measure biological age, and so because we can measure it now, we can start to see how different interventions influence biological age, and more and more and more of this science will come out and this will be more routine for us to think about biological age. I mean, I see maybe in 10, 15 years down the line, we'll probably have an aura ring that can give us biological age feedback, and will know whether something that we're engaging in is pro-aging or not. And not again, physically… Not the vanity piece, but cellularly, is this driving us towards a shorter healthspan, a shorter lifespan, like is this compromise…

Dr. Fitzgerald: Is this making us vulnerable to developing the myriad chronic diseases that we don't want? So we're talking about this is a very physical phenomenon, and I think we'll know. But the way that we measure biological age is looking at patterns of gene expression, so what genes are on and what genes are off. It turns out that how we live again, has a huge to say about what genes are on and what genes are off. You mentioned this to me earlier before we hit record, around, we always thought for our disease destiny, for our lifespan, et cetera, that it was all about our genetics, the DNA we inherited from mom and dad. What we know is that it's actually the gene expression, what genes are on, what genes are off.

Dr. Fitzgerald: It's the gene expression that influences quality of life and lifespan, health span, diseases, et cetera, and that is the interface of how we live, what we're doing and how it influences what genes are on and off. So my book is about a research study that we did using a diet and lifestyle program and its influence on this cellular aging journey, as witnessed through gene expression. So yeah, it's very foundational. Let me just give you just another statistic. If we could improve biological age by a year, there is one estimate that it would save the country $38 trillion. And given that biological age is the biggest risk factor for all these chronic diseases, rather than siloing all illnesses separately, if we put our energy towards helping people age younger, keeping them healthier, we could by extension reduce risk for all of these illnesses. So let me stop there and [crosstalk 00:08:31].

Jennifer: Well, here's a question for you because a lot of my listeners are dealing with chronic, some longstanding, you've probably seen cases of eczema where the person had eczema as a baby and they're they're now 40, 50 years old. So if someone is listening to this and they're thinking, “Oh boy, I'm doomed. I'm doomed. The doctor said I probably got these bad genes from my parents that are contributing to my skin issue, and I've been having this inflammatory issue for all my life.” Is there something, if you're able to slowly get the inflammation under control, are you able then to begin walking back this biological age? Are you stuck or is there hope for everybody listening?

Dr. Fitzgerald: I want to say a couple of things on this, let's go to this eczema person. Eczema is a modern phenomena, and maybe our parents and grandparents had it, but it's more about which genes are on and which genes are off. It's more about gene expression. It's more about us and how we're living, than about the hand of genes that we were dealt. I mean, think about 100, 200, 300 years ago, eczema, wasn't really a phenomena, it just wasn't so it can't be about genetic changes. I mean, it's more about changes to environment that influence genetic, really actually autoimmunity. So talking about psoriasis, really, or histamine, hives, et cetera. All of the conditions that you're dealing, that you're talking about, are phenomena of environment, lifestyle, et cetera, and much less so the genetic hand that we've been dealt.

Dr. Fitzgerald: I mean, just always go back in your mind, was psoriasis a big entity in the 1700s? Not to my knowledge. I mean, autoimmunity and certainly allergic disease are very modern phenomena. So if we can find our individual variables contributing to this, we should be able to turn around our skin condition. Because it's a systemic inflammatory condition, it is a pro-aging experience. And as we turn it around, as we get better, we should by extension be slowing down that aging process. I don't have research off the top of my head, incidents of eczema pushing biological age forward, but there is evidence in some of these other conditions, top of mind would be diabetes.

Dr. Fitzgerald: Like people who are diabetics are six to nine years older than their chronological age. But it also… Yeah, well, it's just, I mean, just think of the wear and tear over time, the chronic inflammation and then just the damage happening. But when you can reverse it, it also stands to reason that you can actually shave off more years. You can reduce biological age more significantly. So if you're older biologically to start and you correct the imbalance causing that older biological age, you should be able to bring it back in alignment with where it should be, or ideally even make it a little bit younger.

Jennifer: Yeah. I wanted to ask you about methylation because that was how I really came to know your work and you and Romilly, and your team has done a lot of research over the years on methylation. You talk about it in the beginning, I don't know, 10 pages or 15 pages of the book, repeatedly about methylation within the body cellularly, versus methylation with DNA. What do you feel is important for people to know? Because a lot of times they get hung up with just having MTHFR, that genetic snip, and they think that's all that really matters. But my sense from your book is that this is a lot bigger than just having one genetic snip.

Dr. Fitzgerald: Yeah, for sure. I became interested in DNA methylation, and that was where my focus was around the time you and I first connected. There's a lot of attention, yeah, in our field towards MTHFR, towards using high dose B… Towards pushing methylation forward, maybe diagnosing methylation cycle issues and trying to change it. My question, some years ago, was are we doing this in a way that's not helpful? And that led us, Romilly and myself… Romilly was our nutrition director at the time and now she's actually just written a book that will come out soon, I think in May. It's a great book on nutritional immunology, you have to have her on. It'll be awesome. Her book is just fabulous.

Dr. Fitzgerald: Anyway, used to be our nutrition director and so she and I designed this program for a food and lifestyle forward way to address methylation, because we had some concern around imbalanced methylate or the ways that we were approaching it with isolated vitamins as potentially harmful. Diet and lifestyle intervention is only favorable in methylation, there's no downside, from any angle that we were able to find in the literature. We did it with thinking about DNA methylation and balancing DNA methylation. So our study, we were given a grant by Metagenics, an unrestricted grant by a professional supplement company to see whether or not we were changing DNA methylation using our diet and lifestyle program. Our first extraordinary finding was beyond really our wildest dreams, not only did our participants tolerate and do well with the diet and enjoy the diet and lifestyle program, we were able to reverse biological age as measured by methylation.

Dr. Fitzgerald: I should back up and say… I should back way up, Jen. But so gene expression, going back to our whole conversation around gene expression, the field is called epigenetics, epi, above, genetics, the genes. And there's a number of different ways we biochemically regulate which genes are on and which genes are off. Our life and how we live our life influences what genes are on and off but our experiences are actually then translated to these biochemical marks that turn genes on and off. Chief among these is DNA methylation, so methylation is a major regulator of what genes are on and what genes are off. This is how we measure biological age, and this can help us see whether we're aging really fast or whether we're not. Is our bio age matched to our chronological age or is it going too fast, or is it nice and slow where we want it?

Dr. Fitzgerald: Our program was designed around optimizing DNA methylation. We hoped that we changed biological age, but I wasn't holding my breath on that. I was confident that we would change DNA methylation. I was confident our intervention was robust enough to favorably change gene expression, but would it actually move the biological age clock? It really hadn't been done. I mean, up until that time, there were only three other studies, ours was the fourth publication and the first one to show changes was a year long intervention using growth hormone, Metformin, DHEA, and vitamin D. It was a intense study for a long period of time.

Jennifer: And it was only done in men, correct? There was just male participants?

Dr. Fitzgerald: Yes. Well, I mean I have to say ours also, our study itself was only male participants as well and we can talk about that. I'm like… But it's just because of… I'll walk through why that was. I did not anticipate that we would be reversing biological age, certainly to the extent that we did. So as compared to the control group who didn't receive a treatment intervention, our participants in the eight week time got over three years younger. Which, it just got a ton of attention because it's never been shown before. It was new science.

Dr. Fitzgerald: My colleagues are very supportive and excited, Dr. Dale Bredesen, Dr. David Perlmutter, people who are real leaders in our field. Dr. Jeff Bland, who's been a long time mentor of mine, who continue to be very excited just because it was the first time it's been done and it will change… It's opened the door to diet and lifestyle interventions changing gene expression profoundly. We'll design studies with an eye towards what's happening with gene expression in a way that we never have before.

Jennifer: With that said, I do think it's fair because we have a lot of ladies that listen to this show, why is it that women aren't generally included? And could that mean that maybe the impacts might be more or less than what you saw?

Dr. Fitzgerald: More impactful? Yeah. I mean, I have the same annoyance on other studies, like why women aren't included. We've definitely been understudied in a way that's really offensive. In fact, my friend, Sara Gottfried, published a book, Women, Food, and Hormones, where she prescribes a keto diet specifically for women and you can't do the classic keto diet that's been researched because it's in men and our body physiology is different. And it is certainly annoying, so I share that irritation in the limitation of studies on women. And what I'll say is that our study was a pilot study. We had 20 people in our control group and we had 20 people in the study group.

Dr. Fitzgerald: The study was very expensive, we hired a clinical research center to administer and it was just rigorously done out at my alma mater university, National University of Natural Medicine, the Helfgott Research… Actually you know Helfgott, you just interviewed Heather Zwickey, so she started Helfgott Research Institute. So we hired them to run our study and they're just an amazing research institute and they do really high quality work. It's not cheap. It's not cheap and so we could only have limited numbers to be able to do it, financially.

Dr. Fitzgerald: If we had women… So our target population was middle aged, so 50 of 70, and that's because that's when we start to see the influence of aging pretty profoundly on DNA methylation, on gene expression, so we wanted to get right in there at middle age. And look, if we had included women in the population of 50 to 72, we would've had pre-menopause women, so women who are still cycling regularly, still ovulating. We would've had perimenopause, most of them probably, and we would've clearly had post-menopausal women. So again it's the complexity of the hormone picture that Sara talks about in her book, would've made our small population impossible to tease out what was happening, from the influence of different hormonal-

Jennifer: Impacts, yeah.

Dr. Fitzgerald: … pictures within our population. I mean, it's a disappointment, but it would've muddied our results and it would've made reporting on what we found difficult. So just given that men are endocrinologically relatively simple, we had to use them. We do have approval for a new study that we are recruiting for, this is a participant-funded study based in our app… We've got an app called 3YY… And this will include everyone, and of course women are there. I can speak from experience, I've been doing the program for years now and we've prescribed it here in clinical practice. So we've been using in women for years here and we see really great results.

Dr. Fitzgerald: Biological age has not been a huge tool we've used in practice, just simply because it wasn't available. These are new tools available to us, but I've been able to access mine and now they're becoming more available. So I can say in our clinic, and I talk about this in my book, we see it beneficial across the board and we layer it in. We use the principles of the program in any issue, so anybody presenting to us here in our practice will get some element of the Younger You program, into their prescription, their diet and lifestyle prescription, and women do fabulous with it. For me, my biological age has consistently been younger than my actual chronological age, and continues to be. So I think as we get more data and study women, it'll be awesome. [crosstalk 00:25:02] fabulous responders.

Jennifer: Well so you talked a lot about the things that you could do from a diet and lifestyle perspective, that I know my audience will be really interested in. You mentioned something in the book called epinutrients, which is probably a term that they haven't heard of before.

Dr. Fitzgerald: No one knows, yeah.

Jennifer: So what are epinutrients? I noticed you picked out some certain foods over others, so what are those special, I guess, epinutrient rich foods that you really love?

Dr. Fitzgerald: So epi, again epigenetics. So epi, above, genetics, genes. So these epinutrients are nutrients that influence epigenetics and specifically DNA methylation, because that's where we just really hung our hat. So all of these epinutrients have some evidence of favorably helping with gene expression, specifically through DNA methylation. So we want… Excuse me, sorry about that. We want to bathe ourselves insufficient methylation. As we age, we don't methylate as well so our total ability to methylate drops and it becomes disordered, it's just like it's messed up. It makes us vulnerable to all of the diseases.

Dr. Fitzgerald: I mean, it's like a raw deal, quite frankly. It's like a raw deal. You could look at DNA methylation patterns in somebody who's older and you could look at the same patterns in somebody with cancer and there are some shared imbalances. You can see how we become vulnerable to the chronic diseases of aging as we age, you can actually see it happening, and so we want to stop that. We just want to nip it in the bud, so we need foods that will help us methylate and that includes like beets and greens and seeds and nuts. It includes eggs for people who can tolerate eggs. I know in skin conditions routinely, there are problem foods that people have to avoid. I have two psoriasis cases and eggs were issues. I can think of two cases in my practice and eggs were massive deal breakers.

Dr. Fitzgerald: So you have to avoid what you're sensitive to, clearly, but you eat what you can eat. For people who are eating meat and are open to eating liver, liver is a methylation superfood. It's huge, you don't even have to… It's so rich, you don't even have to do it every day so if you can eat liver maybe three times a week, that would be great. We want methylation-packed foods. Shiitake mushrooms, Maitake, Enoki, even button mushrooms are good.

Dr. Fitzgerald: Then there's these other class of epinutrients that seem to direct where methylation happens. So you're not just pushing it out there willy-nilly, you're kind of directing the traffic. At least that's what we think was happening in what we saw in our study, and these nutrients are the beautiful polyphenols, the bright colors in all of our fruits and veggies, like quercetin or luteolin, or lutein, resveratrol in grapes, curcumin in turmeric, those beautiful catechins in green tea. Foods that we know are healthy, foods that have been used in traditional diets the globe over, forever. Turns out that they help with [crosstalk 00:28:20]-

Jennifer: It is really cool.

Dr. Fitzgerald: Isn't that cool? And probably their anti-inflammatory, their anti-cancer, their antioxidant, their detoxing benefits, I think may have to do, at least in part, with their ability to regulate what genes are on and what genes are off. So these together-

Jennifer: I also, you mentioned rosemary a few times in the book, what's the deal with rosemary?

Dr. Fitzgerald: Yes, here's my… I know. Rosemary's just a fun… Rosemary has something called rosmarinic acid, which is just fabulous, like all of the other polyphenols. I happen to love it and it's easy and it's fun, and so we've been calling it out as a great longevity nutrient, but curcumin is right up there, green tea. What I would say, research really suggests that we want what they call a combinatorial approach. We want each fork full of food to be packed with these beautiful epinutrients. There's a 30-page epinutrient appendix in the back and the most picky human on the planet would be able to go back there and highlight maybe, at least a dozen or more foods that they're already eating. So you can go and see what you're doing right and what you'd be willing to add. There is no reason why each meal in a given day, can't be packed with these important nutrients.

Jennifer: I want to ask, because this came to mind as you were talking and you're mentioning… I think the only animal product that you mentioned that was… Well you said eggs first, but then you also said liver. And so we have this whole movement, we'll just say a movement to people that do like more carnivore style eating and saying that plant foods cause you to hold on to oxalates and all sorts of things, and it's highly inflammatory. But yet here you have research showing that these foods actually reduce your bio age and help with DNA methylation. Do you have any response to somebody who has been thinking that maybe doing like Carnivore For Life is a better way? Any thoughts? What would you say?

Dr. Fitzgerald: I eat meat and this diet… We have a vegan version in the book, a vegan/vegetarian version for folks who are very committed to no animal product. So I definitely eat animal products. I was doing an interview in Iowa, in Iowa farm country and we were talking about… I was like, “I won't kick a really good steak off my plate once in a while,” but it is very plant-forward. This is very vegetable dense. Most of the food that you're going to be seeing on your plate in a given day, will be veggies and there'll be some limited fruits and then followed by proteins, and this could obviously be animal, and there's a decent amount of fat in it as well.

Dr. Fitzgerald: I am not aware of there being any good longevity data on a carnivore-only approach. I mean, it will help obviously put one into ketosis, it'll help with muscle, and blood sugar, in the short term, but we know that it changes the microbiome if we go too animal protein forward, there's fallout. And it's just, I think that the fallout limits its utility in the long run.

Jennifer: Yeah, I think that's interesting way to look at it, because I always think about too, the way that everyone says, “No, this diet's the best. This diet's the best.” And I just personally, I feel like there's so much research that shows that having a varied diet is really important, and that not one way of eating suits one person, but you can incorporate in a lot of these ingredients into different cuisines and utilize their benefits. But if you don't have some of these superfood type… I don't even like calling them superfoods, to be honest with you, but these epinutrients in your diet, you are limiting the ability of your body to have access to it. You're just not going to get them in if you don't consume them in those foods, it's just not possible.

Dr. Fitzgerald: For sure. Yeah, I mean the fallout from a carnivore centric diet is, I mean, it's just there in changes to the microbiome and ultimately just driving imbalances in other ways.

Jennifer: And a lot of inflammation, at least that's what I've seen in testing, there's usually a ton of inflammation, a lot of inflammatory markers are through the roof. There's a lot of inflammation and coming from the GI tract because of those changes to the microbiome, and having some of these… Like mushrooms are so helpful, like they've got beta-glucans, they're really good for the microbiome. They're great FODMAPs. There's so many great, wonderful things that… And beets are good for your liver and just so many good benefits to having a variety of beautiful foods in your diet that also bring a lot of color, and those intense flavors as well so it's great.

Dr. Fitzgerald: Yeah, that's right.

Jennifer: I wanted to ask you too about consistency because you have this whole thing, you were saying diet and lifestyle is now showing us that it can really move the marker here. But I used to be of the mindset that if I didn't have, for example, an hour to go to the gym, that I just wasn't going to go. And it wasn't until I basically couldn't walk because my back went out and I had a huge herniation in my lower back that I was unable to do long spurts of any type of movement at all, sometimes even just move from one floor to the next, that I had to take it down a step and focus on showing up consistently, but in small doses.

Jennifer: What I found was that my maybe five minutes of tolerance to exercise grew to 10, to 20 minutes, to 30 minutes. I was able just on focusing on being consistent to make more gains, than not showing up at all. Can you talk about the consistency piece in terms of maybe the diet, but also the lifestyle and the movement piece as well?

Dr. Fitzgerald: Yeah. When we're looking at gene expression, our habits will ultimately win as far as what genes are on and off. So consistently poor habits will bias our genetic expression towards something that's less favorable, pro-aging, pro-inflammatory, et cetera. Whereas consistently good habits appear to bring about the opposite. So I want to say that the good news is that, using exercise as an example, one experience of exercise, so going out and doing one activity, can change gene expression favorably. So it can, you can get some benefit from just one single experience. But the habit over time and it doesn't have to be crazy, you just have to get in there and do it. Our exercise prescription in the study was very modest, but that habit over time has the profoundly longevity-promoting anti-aging, chronic disease inhibiting, anti-cancer benefit. It's the habit over the long time that will allow, more and more genes…

Dr. Fitzgerald: So cell division is happening all of the time and those genetic patterns are either maintained or changed during cell division. So the better, more consistent habits we have, the better genetic information we're going to be passing down to cell division, after cell division, after cell division in our bodies, to hopefully make us biologically younger, reduce inflammation, reduce risk of various diseases. So habits over the long term will definitely yield the best benefit as far as biological age and longevity, and all of the good things that we want. But even just one, just starting on the journey is important as well.

Jennifer: It is, it is. So in terms of, you said you did actually require some movement in with this and you found that to be helpful, can you give us a sense of what that type of movement looked like?

Dr. Fitzgerald: Yes. Yeah, the research exercise in gene expression is just massive. I mean, it's anti-aging, it's just potently anti-aging. Too much exercise can be pro-aging so don't overdo it. You don't need to overdo it. Not exercising is very pro-aging, so it's a U curve. Too much exercise is pro-aging so you don't want to go from couch to crossfit, and not exercising is very pro-aging, both. So you want the sweet spot, the bottom of the U. In our study, we prescribe a minimum of 30 minutes, five days a week, doing whatever folks wanted to, and their perceived exertion should be 60% to 80% of max.

Dr. Fitzgerald: 60% of max is maybe a little bit of sweating, maybe breathing's a little bit heavier, but I can still talk. So you can go walk with a friend and chit-chat away, or go on a walk or a bike ride like I do. And sometimes I'll talk on the phone, just so you're not going crazy hard, and do whatever you want and just do it for 30 minutes. My mom gardens, that's her thing. Maybe she'll walk around the block and chat with the neighbors or something like that. In our study, a couple of the guys started walking to work because the study took place in the city of Portland, which is pretty walker-friendly, and just simple stuff like that.

Jennifer: That is helpful, I think that gives people some idea. I oftentimes think everyone thinks they have to start this enormous exercise program. And that was actually for me, physically too daunting. Like I said, it might have just been all right, I can do some bicep curls today and something simple and I wasn't sweating a ton, but I was getting a little warm and that was good. For some clients I'm like, “Look, could you do some slow flow yoga?” And do what you can do, maybe it's just walking up and down your stairs a few times and walking around the house and the block. I like that this is something doable for everyone so that it's not some massive time commitment, but it's also not expecting you, for those who have injuries and other issues, being able to be super active, they can actually do this. It's doable.

Dr. Fitzgerald: I would say we want to enter into this where we're at, just where we're at. Stress reduction is another huge piece, and same thing, we prescribed a little bit of a meditation to our study participants because meditation is very anti-aging, stress is very pro-aging. Stress is exquisitely, potently pro-aging. Stress is a major player with skin conditions as well, so anything we can do to turn the volume down on stress, is really essential. Sometimes for folks who don't meditate, I'll prescribe just like a one minute, or just some… I was talking to somebody earlier today who, when they're going in the elevator, which they need to do at their work, that triggers them to think about breathing and they'll do a couple of deep breaths during that time. And that's going to turn the volume down on stress, so we just need to start wherever we're at.

Jennifer: I like that a lot. Well, I will say that this is a great book. I will say that. The Younger You book is amazing.

Dr. Fitzgerald: Thank you, thanks Jen.

Jennifer: For those of you who want to see the cover, here you go. We're watching the video here. I honestly think that this is a great toolkit to be able to add in, again where you're at. If you can't do a particular food because you have an allergy or a sensitivity or something, that's fine. You just pick the things that you can do and integrate that in, and learn how to utilize these tools within your own daily life, to help support that biological… Or wait, it's not bio age we're doing… It's not chronological age, the bio age. We're helping to reduce our bio age-

Dr. Fitzgerald: It's bio age, yeah.

Jennifer: … so that ultimately the idea is to live a better quality life as we age. Because it's a big deal. Huge, big deal.

Dr. Fitzgerald: Yes. That's right.

Jennifer: But Dr. Fitzgerald, we'll put the links to how everybody can get a copy of your book, to your website. You've got a great podcast for practitioners to listen to as well, and I want to make sure that everybody can connect with you. You've got a great Instagram as well. You do a lot of really short, punchy videos with lots of information in them, for people to check out. But thank you so much for joining us today. I really appreciate you talking about your book and the research that you guys have found, and congratulations.

Dr. Fitzgerald: Thank you so much. It was really nice to connect with you today, Jen.

“If we could improve biological age by a year, there is one estimate that it would save the country $38 trillion. And given that biological age is the biggest risk factor for all these chronic diseases, rather than siloing all illnesses separately, if we put our energy towards helping people age younger, keeping them healthier, we could by extension reduce risk for all of these illnesses.”


Jennifer Fugo, MS, CNS

Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with women who are fed up with chronic gut and skin rash issues discover the root causes and create a plan to get them back to a fuller, richer life.


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