 For me it's a real pleasure to be here with Mehmed Oz. He's of Turkish origin, I'm fully Greek as you can hear from that accent, and he's a surgeon, he's a television host, he is a bestselling author of six books, he's an amazing family man, his beautiful wife Lisa Oz is here, and has four children, and I'm over there. And she herself is a real talent, and four amazing children, so the fact that he believes in integrative medicine is also very much exemplified in the way he leads his life, and so we want to touch on all these things, and we want to focus on two things, one that we're both passionate about, and the other that I'm learning from him. I'm learning on both, but especially the second, the second is personalized medicine, the first is sleep. So let me start by asking you, how did you get so interested in making sleep one of your obsessions as a doctor? Well in heart surgery, which is my love of life besides my wife, which I still practice every Thursday, you are taught to operate on people's hearts without sleep, and you're taught that for a very specific reason. First off there's only a certain number of people who do heart surgery, so the ones that do it have to do a lot of it to become proficient at it, which means you have to stay up for long hours to do the cases, but in addition when you have complications it's usually the middle of the night, so you have to be able to make rote decisions, life changing decisions without that much sleep. So we were pushed always to be able to operate on one or two hours of sleep, literally you'd lie down in the gurney where the patient was brought in, sleep for 20 minutes to get up and do the operation at three in the morning, especially for transplants and the like. So I learned a lot about how sleep deprivation affected me, and I can tell you for everybody out there who says, oh you know what I can get along with four and a half, five, six hours, seven hours of sleep, five percent of us genetically have an ability to go with less than six hours of sleep and not pay a significant price for that. Everybody else, the mere mortals in the room, myself included, I know you were in that group, you know, 95 percent of us, must get around seven and a half hours of sleep, and the reason for that is interesting. The base state of the human mind is sleep. We're supposed to always be asleep. The miracle is that we wake up. Now so many of you are associated with people who never really wake up, but ideally we would all wake up for, you know, whatever many hours you think you need to be awake during the day, but for those hours that you're awake there are some delicate things that need to happen, otherwise you don't stay fully awake. And we now know, and this is well documented, that lack of sleep has correlated very clearly with obesity. And the reason for that, by the way, is the brain craves fundamentally four things. The brain craves sleep. We must sleep to be alive. We crave sex. Obviously you have to have sex to survive as a species. We crave water and food. So if you're not getting enough sleep, and you guys can figure out the sex issues, right, on your own. Now we're left with the only other way of coping is to either drink more or eat more. And classically the average person doesn't get their full amount of seven and a half hours of sleep. Men, by the way, need a little more. Men are needier, but you knew that already. But men need about eight hours. But if we don't get that, we will create carbohydrates. And carbohydrates, of course, and we'll talk about this when we switch to the personalization of health, for some people is clearly linked to deposition of fat, especially in the belly. And so it takes you into a place of obesity. In addition, lack of sleep is associated very clearly with high blood pressure. We believe it's correlated with cancer, autoimmune problems. In fact, the best treatment for a flu beyond any other therapy I could offer you is to be able to sleep because it allows your immune system to battle off viruses. And finally, it's correlated with increased death. And we know this from shift workers. People who work shift jobs who are unable to get into a circadian rhythm of normal sleep have a higher mortality rate. A classic example is light. We would see the sun go down. And as the sun set, our ancestors, because of the longer rays of light, would have their pineal glands. The pineal gland is located right behind the third eye in the Ayurvedic tradition. So directly behind there, there's a third eye that literally senses light. And it would sense radiation. And it would secrete melatonin, the supplement that we often talk about, which I'll come back to. And this supplement, which is created by the brain, would induce a deep sleep. So within two, three hours of the sun setting, you'd be very tired. You'd fall asleep. So today, we don't have the sun setting. We don't have those orange lights. We have bright blue lights. And this becomes a problem with the computer screen, blackberry television monitor, the bright light in your room. All these lights are blue lights, so they awaken you. This is so interesting because I know when I go into a hotel room now, I have this routine where I turn off the lights and then I get up again. And I have to cover about five to six lights. So what I do now is I travel with scarves, like that you can fold. And then I just go around and put them to cover the light. It's amazing the difference it makes. And some of this light, again, it's the visual light. But with cell phones, it's beyond that. So cell phones, obviously, have an electromagnetic field. And that energy disrupts brain waves. This is not naryfairy. This is real demonstrated proven. There was a large study done in Sweden on this. And the brain waves have to shift to take you from a REM light sleep to a deeper sleep. And it disrupts that transition. So even if it's not on and going off and bothering you, independent of all that, the cell phone frequencies will bother your brain's ability to go into deep sleep, restorative sleep. That's the sleep you need to feel recharged. So you have to move your phone to at least five feet away from your bed in order to get rid of those. And if you don't get the deep restorative sleep, that's your main source of growth hormone. And growth hormone is our vitality hormone. And when you appreciate how critical it is to be, not just being able to function the next day, but to create. When what is creativity? It's connecting dots that seem disparate that naturally wouldn't be put together to see things where others may not. It's the artist's mind, even if we're an analytic person, it's still there. So we lose that when we go to sleep. And so if you put value into that, we start to deal with two elements of that. One, we set our alarm clocks not for when we wake up, but for when we go to sleep. Because if you know you need seven and a half hour sleep, you have to go to bed seven and a half hours before you wake up or you won't get the numbers you need. But also you have to deal with the stress in life. They will often force you to awaken in the middle of the night. And people can divide themselves to those who can't get to sleep and those who wake up prematurely. But often that's driven by your brain processing, troubling things in your life. And because you haven't coped with it in your awakened life, you're faced to force those realities in your sleep. So now let us move from sleep to personalized medicine. First of all, is there something very specific that we can take away with us about personalized medicine? A little test, something we can all do before we go to the bigger picture? The way everybody here can go away with a little tip about sleep? I'll do a tip that might be valuable for everybody here. And I think it also reflects how little we would appreciate about our bodies and how we differ from each other. So we believe that what causes some of the obesity and some of the cancers that we see are our taste buds. Because our taste buds will naturally take us to eat certain foods more than others. But many of you haven't really checked your taste buds. You don't really know what kinds of taste buds you have. And so I'll give you a little test. Because you know if you're color blind, because you can see the lights, they don't change, and you figure it out because your friends say that was red, but no, it looked green or vice versa. So you know those little pink packets, the sweet and low packets with saccharin in them? Take one of those packets, mix it into a little bit of water. About as much water as you have a tennis ball amount. So it's two thirds of a cup. Mix it in there, swirl it around, and then just take a spoonful and put it on your lips and your tongue and taste it. If it tastes sweet, if it tastes sweet, it's different than if it tastes bitter. Bitter tasting people have super sensitive taste buds. They're called super-tasters. Because you're highly attuned to picking up tastes of items, you taste a little residue in the material with that saccharin packet. And that will make vegetables taste more bitter to you. You'll tend to be more sensitive to lots of foods and eat less of them. Because you eat less vegetables, people who are super-tasters are more likely to have colon pops, which is associated, of course, with not having the normal amounts of these wholesome foods. People who taste it as sweet are under-tasters. They don't really appreciate tastes as much. So they tend to eat more things to stimulate their taste buds. Because they desperately want those taste buds, the savory glands to feel like they're being awakened. So these are very simple examples of the personalization of medicine. This is going to shock you, will blow your mind. But 20% of the medical advice we give is probably wrong. Just because we are different from each other. Chemotherapy is probably the best of all examples. I actually jotted down some quick numbers I was walking in here. These are the number of patients who fail first-time use of drugs. 40% fail depression drugs. 50% fail arthritis drugs. 70% fail Alzheimer's drugs and cancer drugs. I have a whole list of these things. Almost any element you pick, we have high failure rates. And interestingly, this is a problem, of course, for the treatment of patients. As a doctor, I try to give you advice, but I have to give it based on how I think everyone responds, knowing that 20% at least that people don't respond. But you as a patient suffer because when I try to figure out what drugs to give you, I'm hamstrung. All the trials include people who for whom we know it won't work, which makes it more difficult to do it. For me, alternative medicine is the globalization of medicine. It's taking ideas that have worked in the Ayurvedic tradition for thousands of years in India, traditional Chinese medicine, South African medicine, and bringing it to the West as we take Western technologies there. Those are at their core, Ariana. Those are customized to you because you do trial and error. You try to do the therapy and then you see if it works and if it doesn't work. You don't try it anymore. That's how you customize to yourself. But are you getting resistance on the pharmaceutical industry with these messages? Because after all, part of what makes pharmaceutical companies derive huge products, derive huge profits from the products is the fact that they're available for everybody and everybody can use them. And you are saying that 20% at least of the people who are using them may be using the wrong thing. I'm not getting pushed back because there's a huge opportunity here as well. Think about this. It's clinical trial done today which costs tens of millions of dollars. There's partly expensive because you have to have a lot of patients in them. If you can begin to pick the patients for whom your drug really works well, you can do far fewer people because you distort the statistics on any trial if you have 20% or you know you're wasting your time. The problem the drug industry has interestingly is because they're making massive big investments in big products. The tests to figure out if you're sensitive are small itty-bitty companies. So you have this tug of war between these big powerful goliaths and these small little Daniels companies trying to make things that you know they're small businesses. No one wants to pay attention to them but without those businesses you don't get the big blockbuster drug. So we're seeing a seismic shift now in the pharmaceutical industry is they're appreciating the value both to human life but also the profit of making customized therapies come alive. So how do we make the connection between all these huge advances in medicine and personalized medicine identifying what really works for each person and the fact that millions are uninsured and cannot afford a lot of these tests that would clarify what is best for them? One of the biggest mistakes we make in assessing health is we don't appreciate what the most important and expensive part of healthcare is because the most expensive aspect of healthcare is bad healthcare. So let's take prostate testing and the same class for many things. So most of you may realize that we do a blood test for prostate-specific antigen. It's a chemical release from prostate cells when they're irritated. It's historically been thought of as a marker for prostate cancer. Men, if they live long enough, will get prostate cancer. If this is a well-documented reality 90% of 90-year-old men who on autopsy will have cancer of the prostate. So you do a prostate-specific antigen blood test. It's routinely done in men over the age of 50 or so. And then if it's positive you do biopsies, we put little needles in, those are expensive to do. You have to ultrasound the guides but then you've got to take the prostate out if you find abnormal test cells. We have a test now that tests for the four major genes that are correlated with prostate cancer. So I had the test done. These tests cost $200, they're not expensive. And so the test screens for many things besides prostate screens for breast cancer, screens for Alzheimer's, many things. So I don't have those genes. Now I could have also asked my family because my family history is a very cheap way of doing the same thing. So if you have a family member who's younger than 65 that has a problem, you need to know that because there's a chance you have those genes too. But if you wanna be more precise, now you do this test. So now here's my reality. If I get a PSA test, I'm not gonna let anybody go in there and biopsy it. I'm not gonna have prostate surgery almost for sure because I'm gonna believe that no matter what the PSA testing, which is a pretty poor test, it's the best we have but it's not a very good test. And no matter what that shows, I'm not gonna want my prostate taken out because you have to treat a thousand people for 10 years testing them all. For 10 years in order to identify 56 people to remove a prostate and you save one life after all that work. So why, that's such a foolish waste of money. All those testing, all those biopsies, all those surgeries to save one life where I could have identified that one person through genetic testing and then be hyper vigilant in surveying them and let everyone else go free. Think of how many fewer rectal exams we will have. Just imagine that. What we should insist on in healthcare is better value, not more of it. That's the big mistake we have made in the West especially. The cost of doing a DNA profile for you, Ariana, has gone from several hundred thousand dollars. Being impossible, frankly, 10 years ago to now being a thousand dollars. For a thousand dollars if I know everything about your genome and I can begin to pick out exactly where your weaknesses are. The concerning part about medicine and how we think about it is in all the countries where we debate healthcare finance, we think that the capitals of our countries with smart legislators and brilliant leaders will fix the healthcare challenges. They're not. It is impossible. You will not balance the healthcare budget in any major country if you don't fight healthcare where it has to be truly won. Which is not in the capital house. Not in the Senate, the legislature. It's going to be in the parliament. It's going to be won in your home. You win healthcare in the kitchen, in the bedroom, in the dining room. That's where you win the healthcare battle. So when you recognize that this controlling movement that allows you to appreciate how valuable, how special, how unique that your own body is, how magical it is when you really understand what's happening in there. When we abuse our bodies, we rule in that sacred relationship we have with it. And of course, if you can't take care of your own body, how can you take care of the people around you? So the big takeaway message is, give your heart a reason to keep beating and make sure that you pound on those important issues for the rest of your life. Thank you so much. Thank you for being with us. Thank you, Arianna.