 Salam everyone Welcome to this event. We're throwing. We're really excited to have all of you On a topic that is I believe relevant to all our lives, which is a preventive approach to health care So inshallah, I'll start with some Quran and then Go with the bio with of my good friend Dr. Zeeshan Maan Afterwards, we'll give a presentation and then we'd really want this to be an engaging night for all of you So any questions you have specific general we'd be happy to take them and inshallah Would love any participation So let me start with Quran Bismillah Rahman Raheem Yeah, can I put away? Yeah, can I stay in a den of Sirat al-Mustakim? Sirat al-Ladina, I'm not I'm him. I'm a real maqdoob. I'm a member of the Lean I mean Alright everybody Well aside from being a doctor Zeeshan has a privilege of being my friend. So that's a that's a great privilege. He has but let me give you a short bio of Dr. Zeeshan Maan He is trained in plastic and Reconstructive surgery at Stanford University He also spent four years carrying out scientific research in regenerative medicine and stem cell biology at Stanford His research focused on both the biology of scarring and fibrosis and tissue Regeneration in the context of aging which is really relevant to today His work was supported by multiple competitive grants and and has resulted in numerous prestigious awards and the publication in over a hundred scientific papers before Stanford Dr. Zeeshan Maan was fortunate to go to King's College in London to study medicine straight out of high school After his medical school He obtained a master's degree in surgical technology in London and became a member of the Royal College of Surgeons in England and he is very passionate about regenerative medicine and and Melding it with plastic surgery to create a new paradigm of health care that combines preventative and medical approaches to health and longevity longevity with procedural and surgical Interventions to offer clients a holistic approach to becoming their best and healthiest self In addition to this Dr. Maan is married enjoys hiking and has two beautiful children So I'm gonna pass it over to him and inshallah we'll get started on the presentation and From there again, we'll leave some time for Q&A afterwards Assalamu alaikum everyone I'm I'm humbled by this opportunity to speak with all of you guys and ladies and to discuss a topic that as Nussar pointed out I have been passionate about for almost a decade I want to thank the MCC board and the organizers for making it possible for me to be here Making sure that the community was aware of tonight's discussion, and I also want to thank brother Nussar Agwitwala and Fuzzle Mogadidi for their help and making tonight possible I'm sure Fuzzle is very excited. I called him out by name. I Believe that the best approach in line with what Nussar already said is to turn this into a discussion so the goal of this talk is actually to Introduce a philosophy and perspective and to lay a foundation for that discussion The topic I'm here to discuss may be a little controversial, but hopefully not for most of you What I want to discuss is the problem with our current approach to health care in this country The reality is is that our current medical system is set up to treat people who are no longer healthy It reacts to the onset of disease to deliver what I would call sick care rather than health care and that's and that's because there's little to no financial incentive and Therefore attention paid to keeping people healthy and present preventing the onset of disease But let me start by telling you a little bit about myself and This slide was not designed by me or else my face would not be up on there My name is Zeeshan. I'm actually a product of this medical establishment. I was just referring to as pointed out I Figured out pretty early that I wanted to be a doctor and help people which is why straight after high school I did make the decision to leave the US and go into medical school in the UK at Kings College London It turned out to be a great decision for many reasons But most of all because that's where I met my wife who's now also the mother of my children Let me tell you that becoming a parent it really made me reflect on my own health and how Important it was for me to be able to actively participate in my children's life for as long as possible And of course it made me think about my parents and how I could help them stay healthy for as long as possible But let's let's continue the journey and please don't be too shocked by the next slide a Little over 10 years ago. I left the UK and I had the opportunity to come to Stanford University And train as both a regenerative medicine scientist and a plastic and reconstructive surgeon I can still remember during my interview for residency. I was asked to describe a memorable clinical encounter I told the story of a patient I'd met who had been burned and developed a severe scar contractor of the neck We removed the scar tissue and we used a skin graft to resurface the area This involves cutting away skin from another part of the body and moving it to the new area After our surgery the patient was finally able to lift their head up and look at the world While I certainly don't condone theft or gambling Robbing Peter to pay Paul is a central pillar of plastic surgery We take tissue whether it be bone skin muscle or fat from one part of the body to rebuild another part but not every patient who needs reconstruction has adequate donor sites or sources of tissue on the rest of their body and I always felt like we could do better in how we chose to pay the price for reconstruction and thereby also better serve our patients It was that belief that took me to the lab To see if there was something more that we could do beyond our current surgical armamentarium And it was my time in the lab that really transformed my outlook and my approach to health care It opened my eyes to the potential impact that innovation could have in people's lives. I Had the good fortune to join the Hague laboratory, which is part of the Stanford Department of Surgery It was an amazing environment. It provided an unrivaled ecosystem for asking any question you wanted There was a great culture of collaboration and a tradition of excellence Anything you could think of or need they had there available My mentor Jeffrey Gertner was a surgeon scientist and like many of those who straddle Medicine and scientific research he would often start with real clinical problems and work backwards from there And he believed in going after the biggest problems, which is why I spent my time studying aging and diabetes specifically how they impact our bodies stem cell population and the regenerative capacity When most people think about stem cells, they think of futuristic therapies What you may not know is that our bodies are full of stem cells and these stem cells are responsible for maintaining Our tissues and organs stem cells in your bone marrow are responsible for making all of the cells in your blood that deliver oxygen to your tissues That fight infections and keep you healthy that help your bleeding stop when you get a cut Every time our skin touches something or food passes through our intestine. We lose cells Stem cells make sure that the lining of our intestines and our skin is constantly being renewed and restored Whenever we exercise and we lift weights stem cells in our muscles are responsible for its repair and growth and These stem cells rely on signals that they get from their neighbors as well as the neighborhood they live in But when we get older changes occur not only in the stem cells and their neighbors But actually their neighborhood and these changes disrupt the ability of these cells to do their job When this happens the various tissues of our body lose their capacity for self-renewal Leading to a progressive loss of function into interestingly Diabetes has very similar effects to aging making it not only a disease that becomes more prevalent with aging But also one that appears to accelerate aging and age related issues as I built my understanding of the various mechanisms responsible for these changes I began to develop a framework for possible interventions that could slow down or counter the effects of aging and diabetes Now this also helps to explain why aging is a major risk factor for things like slow wound healing Decreased muscle mass and a host of other issues including what many call the four horsemen of chronic disease for Our community in particular Metabolic disease is a tremendous issue. This includes diabetes prediabetes metabolic syndrome X and all of the associated diseases that occur because of insulin resistance as sort of the root causal factor atherosclerotic disease which results in strokes and heart attacks is a huge player in the progression of aging related chronic disease unfortunately diabetes also contributes to this process and can Synergistically complicate our ability to stay healthy cancer It's it's the it's sort of one of the last areas except for the next one that I mentioned that we haven't really Had much luck in addressing other than Surgically and that's if we catch it early. And so early diagnosis and prevention are really sort of the key ways that we can tackle cancer nowadays and What is quite surprising is that many of the Lifestyle factors that doctors are now recommending and that in Islam has been recommended for a long time We are now seeing have direct links to the incidence and development of cancer as well as its progression and how aggressive it may be Finally neurodegenerative diseases, which is really the the big sort of black box that medicine has had trouble with This includes what's most? Commonly probably everyone thinks about which is Alzheimer's disease But it essentially means you have a cognitive decline over time Which can be caused by various things including strokes can also contribute to this process and what we now know is that? Things like glucose instability, which are a hallmark of diabetes can also accelerate the process of these neurodegenerative processes So it all ties back together so I Came to realize that my learnings from the lab were both Complementary but also clashed with my clinical training in plastic and reconstructive surgery Plastic surgeons operate on the entire body. We restore the ravages of time trauma and disease Regenerative medicines and natural extension of this and it's not uncommon for plastic surgeons who also Pursue laboratory science to choose it as their area of focus But I began to realize that my scientific endeavors were more than a way to improve What we're already doing surgically It actually offered the hope of a true paradigm shift where reactive medicine and surgery What I trained for years to do could and should be replaced by Preventing the consequences of age rather than treating them after they had occurred The heroic lengths that we go to to surgically restore form and function began to weigh on me I realized we were entering our patient's journey so late in the game that we were forced to take desperate measures to help them course correct Not to mention the significant financial burden this place is on the health care system The US system in particular spends five times or more to achieve the same health outcomes as they do for example In the UK National Health Service We've all heard that an ounce of prevention is worth a pound of cure and This concept is not totally foreign to the US health system Studies have shown that surgeries such as gastric bypass are worth paying for as they reduce the overall cost of health care and Insurance companies do pay for these types of things But when it comes to intervening even earlier perhaps to prevent the need for surgery There's a huge gap. Why is this the case? Why isn't primary care in this country focused on preventing age-related illness a large part of it is Related to money and the current structure of the health care system There's no diagnosis code for aging and there are no reimbursements for Interventions in the absence of a disease diagnosis. So what that means is until you have a disease There's no financial incentive to do anything to help you insurance companies also have very little incentive to spend any money on Preventive care because at the age of 65 Medicare takes over and they're not responsible for paying to treat the health problems that could have been prevented as For large hospitals and medical systems They make their money by treating diseases and performing surgeries and procedures So they have very little incentive to take a preventative approach. I mentioned the UK NHS earlier They're a little bit more incentivized to manage the health of their population because they keep the patient throughout their life Insha'Allah with the rise of Medicare Advantage, which some of you may be familiar with We may start seeing some interest from commercial insurance in implementing strategies that keep people healthy rather than treating disease after the fact As I considered my personal path forward in light of all this I was introduced to the emerging field of longevity medicine Actually, one of my colleagues from the lab who is now back home in Germany Brought to my attention that a few pioneers were starting to apply the learnings from the science of regenerative medicine To clinical practice including himself. He had set up a longevity center in Munich So this was a paradigm shift in health care. This was so exciting for me to hear about He was focusing on predictive and preventative approaches and it inspired me to also integrate cutting-edge research With clinical practice Of course people have been selling the fountain of youth for years And even now it's hard to tell the difference between snake oil and legitimate science-backed recommendations But he was applying many of the principles that we had learned together To cut through a lot of the nonsense and develop a pragmatic approach to maximizing health span What's health span? It's the portion of our lives during which we are free from disease and we have a good quality of life during which we have Afia Starting with this foundation. I began to seek out more knowledge from experts who are similarly grounded in the science and Understood how to evaluate it critically and please understand. I'm not here to say that I figured it all out This is an ongoing process where we regularly evaluate emerging research Needless to say I knew that this is not something I could do alone if I was serious about it So that's why I decided to build Afia health by focusing on multiple sources of real human data Things like your wearable data from an Apple watch or a Fitbit as well as measuring Predictive biomarkers rather than the standard blood tests that most primary care doctors use We seek to bridge the gap between scientific discoveries and tangible improvements in patient care Feeling good today doesn't mean that there isn't something brewing under the hood Our biology has so many fail safes and compensatory mechanisms built in Alhamdulillah that by the time you have external signs or symptoms of disease things have really gone wrong Our goal is to help people slow the biological effects of aging And prevent disease before it occurs through a combination of coaching Algorithmic and medical intervention our team has expertise in regenerative medicine and digital health based behavioral changes And we have three core pillars to our approach First we use predictive biomarkers rather than relying on the trailing metrics of mainstream medicine We create realistic action plans that integrate lifestyle changes evidence-based supplementation and targeted medication And third we provide accountability and support to ensure that people are achieving the goals they set out in their action plans So what's a predictive biomarker for our community? I'll focus on metabolic disease and diabetes most people Nowadays are hearing about the idea of pre diabetes something that happens before diabetes and Some more progressive doctors are actually intervening and maybe even prescribing you Medications such as metformin when you have pre-diabetes. I would argue that's already too late before you're pre-diabetic there are tests that can be done to identify the root cause of diabetes which is insulin resistance Insulin is a molecule released by our bodies in response to sugar It takes sugar from the bloodstream where it should not be and Puts it into our cells where it can be used to make energy. That's where we want it to be So insulin is a great thing our pancreas is make it so that we can eat food get energy and our cells can operate However, what happens over time when we have excess amounts of glucose in our bloodstream and we get Constant release of insulin is our body builds resistance to it When that happens the glucose is no longer going into the cell and it's sitting in your blood and that's when you measure it And you have a high blood sugar So what leads to insulin resistance even before insulin resistance you have glucose variability That's what leads to that insulin resistance in the first place And there are ways that you can measure that as well things like continuous glucose monitors that help you identify Which foods will spike your blood sugar you may have heard of high or low glycemic index foods? unfortunately, it's not the same for everyone and It's not just what you eat it can be the pattern of how you eat whether you have fiber before your carbohydrates and so being able to Monitor and measure that glucose variability in response to different foods different patterns of eating different patterns of exercise is a critical step in ensuring you never develop the insulin resistance that then leads to pre-diabetes and Diabetes and all of the other aspects of metabolic syndrome As I mentioned already we don't just do tests, but we take that information and we create personalized action plans We start by evaluating your health and life situation and we build from there the foundation of everything is sleep exercise and nutrition and You might be shocked at the nuance involved in that there are different types of exercise such as zone 2 or high interval training Hi, it's our high intensity interval training when it comes to nutrition. I already talked about the different patterns of eating the different styles We know in Islam that we should minimize how much we consume we should never fill our stomachs with food We should at most fill it with one-third food one-third water one-third air and this is directly in keeping with what science is starting to understand about caloric restriction and the benefits of that about intermittent fasting and the health benefits of that and Those are all aspects that are important to start with to build your foundation from and Then on top of that once you're ready There are other areas that you can layer on whether they be interventions that help mimic some of those Same pathways that get activated by sleep exercise and nutrition or medications that can help prevent the onset of diabetes Finally most of the time when we go to our doctors We get a laundry list of instructions, right and you're like, okay I've got 30 different things I need to do and then the next time you're there The doctors like did you do all of it and you're like, I don't even remember half of what you told me and Then it's your problem, right? It's your fault. You didn't follow the instructions. They in medicine We call that compliance and so the third part of the system is making sure that we Support you and are there to help you actually achieve the action items that we set out for you Even for those who are more aggressively trying to manage their own health a common paradigm that people talk about as being the CEO of your own health a Major hurdle in that setting is still the fragmented nature of health care from appointments with your primary care doctor To finding a nutritionist to check and get another fitness app and none of them are talking to each other So we wanted to consolidate all that care under one noof But we quickly realized that people need to actually be actively involved in understanding what Why and when and that's when we decided to build some technology and we created a personalized dashboard That aggregates your data in one place so you can easily evaluate how you're doing it also prevents your action plan and key Focus areas that way you don't have to worry about remembering what your doctor told you you get to see what you should be Doing alongside the health metrics that informed your action plan That way you can focus on your health rather than coordinating your care On the back end we're crunching all the data We use to not only guide your health journey, but also to develop novel insights and continuously improve our approach and What we're hoping is that it's not just going to be us But others doing this so that one day we can turn around show this data to insurance companies to the government and Get some coverage for this type of care. So it's no longer a Novelty item or something available to the rich to the few to the famous but something that we can consider a part of our society's approach to how we prevent disease I You know building something this ambitious can't be done alone and I'm very fortunate to have an amazing team around me Nancy my co-founder has a background that Includes project management at noom, which is a behavioral health platform focused on weight loss Some of you might have heard of an image in where she worked on the use of AI and health care Which is something we're trying to work on as well Amy Britton our director of wellness is a highly skilled and experienced nurse nurse practitioner with Expertise in genomics and precision medicine. She used to run a weight loss clinic and she's devoted to longevity medicine and maximizing health span Brandy is our Precision nutrition coach. She's also experienced in genomic precision medicine And she spent over a decade working in health and fitness after leaving the practice of law Dominic is my friend and former lab colleague. He's our longevity and advisor He's published over a hundred and forty scientific papers about regenerative medicine and aging and he's the best-selling author of two seminal German books on longevity and Daryl's our software advisor So if you have any questions left after today, or you want to learn more just sign up for our free trial And we'd love to talk to you But now let's get to the Q&A and so that I can actually answer some of the questions you may have about This new approach to health care Hello. Oh All right. Thank you. Dr. Zeishan for a Really informative discussion I know when I first Received I like to say it's the talk, right? You're like, oh man There's a there's a different way to approach this it's I don't need to wait till I start thinking back and so It was illuminating to me when I first had the the top or Well, I'll let you think maybe I'll pose a few to you I So in the oh, yeah, so the question was Whether we are using any tissue engineering or artificial skin At all and I'll answer the question in two different ways one is to say that yes in the hospitals and during my Practice as a surgeon. We do use regenerative medicine approaches. I would say probably the easiest Example would be in the context of a burn patient Who does has been we talk about burns in the context of total body surface area? and There are people who have burns that encompass 80 or 90 percent of their total body surface area I mean that's it's a it's a terrible injury and and for most people It's not survivable, but for the really young and healthy people they can survive this type of injury But then you're encountering a problem because the treatment for burns is to excise the dead tissue and then Grafft that area with the skin that's intact to take a layer off that will heal on its own and When you have so much of your body burn, you don't have enough areas left And so there is a procedure called cultured epidermal autographs where you can take a sample of skin from that patient and then In a lab expand it because the skin has basal stem cells in it and grow out sheets of new skin and then lay those down on top of the person, but Whether I believe Tissue engineering is something that today is a part of What for example we do it off your health or what I would be Discussing or recommending to anyone that's less so and this this is this is kind of It goes to a philosophical difference between stem cell researchers some people believe in what we call cell-based therapies and other people believe in Using signals to let your body's own stem cells do what we want it to do our bodies are full of programs and so the approach that we take it off your health and The sort of the sign I say that but really it's sort of the the underlying scientific grounding that I had the foundations I have are that Our body is such a well orchestrated machine built by obviously Someone who has way more knowledge than any of us and it's built to do everything that needs to happen All we really need to do is identify What is The instruction to start the innate programming to do what it needs to do and so that is the approach that we take so One of the things that happens is a Dysfunction in what we call like cell skills the abilities of cells to Use mitochondria to make energy the ability of cells to eliminate waste the ability of cells to replicate and so Targeting signaling pathways that can help Reverse some of those things which by the way fasting for example does a lot of the same stuff But you can also augment it and support it through other means that is how I would say we we use regenerative medicine. I Hope that answered the question without being overly technical All right any Thank you for the presentation so I don't know can Share with us some practical tips that we can actually take with us today as we leave this place to say here top three five things that everybody here can start to do to Have better longevity longevity and you know better health something practical and then the specific question I have is if you have some suggestions about somebody is Reach challenges with sleep All the nine. They don't live very well. So if you have some practical tips about Absolute the question was can you share some practical tips? I believe the request was three to five that we can take away today and specifically what someone can do who's having trouble with sleep and I'm excited you asked that second part of the question because one of the first things I was going to talk about was sleep The importance of sleep is undeniable and health in fact Everything else stems from that if you're not sleeping well everything else falls apart Your metabolic status your ability to exercise appropriately how you process food everything falls apart The risks of heart disease go up even cancer not sleeping enough doing shift work all of these things contribute to poor health outcomes and What I would say is sleep after Isha Wake up at fudger and stay asleep in between That's the ideal situation and what that means is you're in training your circadian rhythm to mirror the light and the dark cycle and You know humbler, that's what we've been told in Islam But actually in science is showing to be very very true in fact a recent study even showed that we need more REM sleep in winter compared to summer and funny enough the timings of Isha and Mugh and Fudger change to make you sleep more in winter and less in summer. So Sleep is critical The things that one can do to help with sleep. I can I what I'll do is I'll also afterwards share a link There's a professor at Stanford named Andrew Huberman he's a neuroscientist and He really focuses heavily on sleep and he has a sleep toolkit that you can look at for free online That gives a whole list of recommendations about what to do, but the basics are Sleep hygiene which means first of all try not to eat anything within three to four hours of your planned sleep time Try not to drink water within two hours of your planned sleep time Where you sleep should be a dark area. It should be cool So it should be a lower temperature because that's conducive to good sleep Avoid excess light near the time of your sleep There are things that you can do to help and train your circadian rhythm For example when you first wake up you should view visible light ideally outside Exercise fairly early in the morning. You can use your eating schedule to help regulate that as well because your gut contributes to your circadian rhythm People talk about things like blue light filter sunglasses at night, but that's I would say that's like way lower down the list Then some of the more basic things that I just pointed out It's also been shown that if you go outside and expose yourself to light at dusk then Excess light exposure at night has less of an effect as well So these are all sort of the basics that I would say to help with your sleep And then I would recommend the sleep toolkit And then when that's not working then there are other Areas to start looking into but I would start with that So that's one sleep which hopefully I gave you that's a tip to take away and also answers your question about sleep The next is exercise and My mom tells me that She was walking around cleaning the house and so she got enough exercise that doesn't count You know going up and down the stairs in your house also does not count What you have to do is you have to get to 80% of your maximum resting or your maximum heart rate That's what they call zone to which is sort of like a steady-state exercise It's like sort of the lowest level and that Type of exercise which should be achievable by almost everyone here, right? We're not saying like Go do high-intensity interval training and puke your guts out This is a type of exercise where you should be able to still talk Maybe not have a lengthy conversation, but you should be able to talk on the phone I know people who call others and talk to them to prove that they're in zone to and if you can spend 30 to 60 minutes doing this once or twice a week you're going to improve your insulin resistance By increasing the insulin sensitivity of your skeletal muscle. You're also going to improve something called your VO2 max The VO2 max is the maximum amount of oxygen you can consume because of aerobic exercise and that's something that goes down with age in everyone and Maintaining it has a tremendous impact on your ability to exercise and you're like well I'm not I'm not a health fitness freak. I don't care about that But we're not talking about like working out at the gym. We're talking about being able to walk up a flight of stairs being able to Run after your grandchild being able to do normal things There are people who get breathless and are unable to do normal activities of living And then there are those who can maintain their quality of life in their older age And that's linked to maintaining your VO2 max so Zone to exercise That's my second thing and then nutrition and This is a huge area because Everyone has a very interesting relationship with food You know, there are numerous from Jenny Craig, you know to noon to Fad diets to paleo to keto. There are so many options and Solutions and choices to take when it comes to diet because it is a challenging area but there are simple things that you can do such as The cadence of how you eat so eating slower Helps a lot because it takes about 15 to 20 minutes for your satiety center to kick in and tell you that hey you've eaten enough You're full. So if you eat slowly, you'll end up eating less when you're eating start your diet with fiber and What that does is it one it fills you up So it doesn't take as much food to feel full but second it blunts the release of glucose into your bloodstream as a consequence of your meal and thereby decreases glucose variability which leads to insulin resistance if You can get a hold of a continuous glucose monitor that would be ideal because not only will it show you that specific foods are Damaging for you that you may be shocked and surprised by one when my parents first started using the continuous glucose monitor They used to think all these foods were healthy, and they realized very quickly. No, no because their sugar shoots up and Number one culprit you think fruit is good for you. No unless it's like blueberries or Like a blackberry You should consider food to be a dessert especially bananas bananas are the biggest culprits Those will kill your sugar. So The other aspect of the continuous glucose monitor is that it gives you that real-time feedback and you're like, oh, I Ate this and look what happened. It's one thing when you're like, I'm just having one doughnut or I'll just have a slice of pizza When you see the immediate response That helps to change behavior. It's it's like We say in medicine is if you can't measure it, it doesn't exist, right? When you measure something then you can take an action and see it actually change it makes it more meaningful It means you're actually doing something so Yeah, I would say those are sort of some practical tips that you can take away. We can talk about other stuff too. Actually Donating blood it's fantastic for society and The evidence is increasingly pointing to the fact that it's actually very very effective in helping our health and keeping us young And it's sort of in line with What Islam says about hijama, right? so This is like the the best thing right when I was when I was young I used to love reading about science and Islam and as I went through medical school everything I learned I would be like Oh slum you about this already and now as I'm exploring longevity medicine and like predictive preventative care I'm seeing that all the things that we're starting to realize matter We already, you know, we were already told and knew about through the Prophet's holosome. So That is another thing you can do very easily There are some companies that are setting up which will do something called plasmapheresis where they take your blood out and put albumin in and they'll charge you money to do so But if you just donate blood You're helping society. You're helping yourself as well. I I don't believe I have the the expertise to answer that because There have not been any studies that I'm familiar with to compare blood donation or bloodletting which sometimes is called fasad with Hijama, but the Prophet's holosome recommended hijama specifically so There may be benefits beyond just the blood donation to it and I don't think I'm qualified to speak about that In the absence of studies comparing the two, but I do know that donating blood has benefits um Hijama might be harder to come about than donating blood as well is what I would say Yeah, too In regard don't I mean to some extent it depends. Oh, so the question was what is the frequency with which blood donation should occur and to some extent it will depend on the individual and Your co-morbidities and whether you have any health issues and how it affects you, but a Three-month interval is is Probably the most frequent that I would suggest in a sort of general sense It's a like them. Thank you so much for covering this topic. It's amazing. I'm kind of curious. What are your thoughts on? Ayurvedic Medicine and Chinese medicine and treatment through those Do you look at them as preventive or you know? Just kind of curious what your thoughts on that. I mean, that's a that's a great question and I think the majority of Medical doctors in the US would sort of be like that's kind of BS The reality is is that What what we call mainstream medicine is often called allopathic medicine and it's differentiated from What I would say is actually Which is the homeopathic medicine which has like zero foundation and then there's Osteopathic medicine, which is just philosophically different but not that different from allopathic medicine and then you have like Ayurvedic and Chinese medicine Allopathic medicine is defined by being nowadays by being evidence-based. So studies are done data is collected and Statistical tests are used and significance is shown that this intervention has this outcome with the appropriate controls There are things that were formerly part of Exclusively part of Chinese medicine or Ayurvedic medicine that once you do a study. They're now part of mainstream medicine and so What I would say is that when you have a thousands of years of tradition of something working We call that epidemiology where we just like look at you know What's happening in populations then there's likely is some benefit to it like now We know acupuncture has certain benefits when you think about Chinese herbal medicine The reality is is that most medicines are derived from plants and so there's probably some truth to it. It is probably less controlled It's less targeted less specific less refined but at the same time We also know that sometimes you don't want to be overly targeted Sometimes you want broader effects. For example, I'll give you Like I can use an example from our lab where we were studying Mechanisms of fibrosis or scarring and you might think oh who cares about scarring, right? But scarring on the skin is one thing you also have scarring on your lungs your heart your kidneys your liver So the skin is a model organism for all that anyways What we were doing was looking at different signaling pathways that lead to scarring and then trying to target them and It had some benefit, but what we realized is that there's so much redundancy in biology When we actually looked at some of the root causes which were mechanical forces that drove various different signaling pathways and Instead we just reduced Mechanical stress and strain It had a way more profound effect than any of those like targeted special medicines or whatever so that's just to say that perhaps there are some disease processes or pathways or Areas that may benefit even from a Like a plant or a medicine. I don't know, you know, but I do think we should still test it I think that untested There are dangers because there can be side effects and risks Hopefully that answered your question We have a online It's asked how many calories should one eat in a day? So the question from online is how many calories should one eat in one day? As few as possible eat enough to keep your spine straight, right? So You need to eat enough to maintain your health Ideally you would have a caloric deficit and so for each individual you would need to figure out like what are your What's your basal metabolic rate? What are your energy needs? So I would work with someone, but certainly I Would say the vast majority of people out there are not in a situation where they're gonna end up eating too little and almost everyone That we know could do with eating a little less And so if you can survive a fast during Ramadan, I think you know, it's not too hard So what I would say is a good way to help with that is time restricted feeding and So you can do things like for breakfast have just a glass of water or a black coffee and Then see how long until you have to have something There are different ways to tackle it, but I'm not gonna give you a hard-fast number I'm sorry, I walked in a little bit late maybe 10 minutes you were already with the slides So to my understanding you have an organization you've the Afia program and At the end you said that you were looking for people to sign up Is that yeah, I mean certainly if people are interested they can sign up Yeah, so I wanted to know that For a person like me I'm in my early 50s and My father and here all his brothers most of his brothers had Alzheimer's and If this is something that it's something that I'm very aware of you know That I might it might come down to me too. So if it's If somebody like me signs up for your program What would it look like for me in the coming months? What would what would I expect and I'm not Really asking specifically for Alzheimer's, but any any person who signs up for your program? What would it look like sure Yeah, I mean I didn't want this to become too much of a sales pitch Today, but I will answer your specific question about what it would look like if you worked with Afia Health and There we have We have like a HIPAA compliant digital infrastructure set up to onboard people and it takes you through programs But essentially what happens is we review your existing medical information We take it all in we review it and then we identify the Almost always the gaps in your blood work needed to properly stratify your risk and then we Perform additional testing such as a genetic test which can help evaluate your genetic risk for something like Alzheimer's we look at your risk for metabolic disease for heart disease and stroke disease and And then from there we formulate an action plan for you and This is delivered to you and then Then you have the ability to It's so a normal doctor visit is like a single consultation when you work with us It's like a dynamic ongoing consultation because there's the ability to message and get your questions answered and you have a Dashboard that shows you what you're doing what you're supposed to be doing where you are in your journey what your metrics are and then You retest and you see how those improve and then we make adjustments and then we support you We have like a health coach who interacts with you and works to make sure you're actually doing what you need to do to move the needle Yeah, and we can share like I mean I if I will share with sister I'm just the Some of our materials for people to look at if they want we also like we have a free trial So when you sign up it lets you learn about the process and everything And then there's some cards there with a QR code that you can use to look at it No, which is something that we hope will eventually happen. It's not covered by insurance, but there are others doing similar things and In Chala one day when we have enough data we can push for that. We have tried to So there are there are options out there that cost like anywhere from 50 to 150 K a year We we've really tried to make it affordable for as many people as possible and we run pretty lean So you can just check it out Concepts of this kind of if I understand a personalized medicine or customized dashboard that you work It's like the patient of one approach By signing up not only we do we get a sampling but you're trying to Build a data to change insurance policies Data outcome based medicine as I look at it Yes, it's gonna be a long slog. Yeah, just to be clear. It's not so I love that I know and yeah, you know again if it You're not only helping yourselves like in the black donation thing. You're helping the community by hopefully You know changing policies that that's a new goal. Yeah, that's the goal. I love that But there's one thing you actually created a problem for me Okay That sleep thing. I'm not looking to that side because that's the argument that often goes on between me and my wife I agree totally sleep is a regenerate process and unless Something really demands it Alaspana also mentions that he made the night for rest or Regeneration Yeah, that's right That's my understanding But I'm not gonna get in between a discussion between you Even naps are supposed to be good for you That's right And There's now they've written papers showing that if you have like a 10 to 20 minute nap it can Increase your focus your memory your performance for the next three or four hours Yeah, right Ask another question that you put it to in the talk You hear I mean as you guys You know I we we hope or I'm sure he hopes that you know you go home do some research on your own you're gonna see The term health span used and the term life span used and you alluded to that in your talk Can you just Elaborate a bit more on it. Absolutely. So Life span is How long you will be living and And the longevity community has a divide where you have a camp that is focused heavily on life span and there are Some people who I would say are Formerly very well respected come from very well respected institutions that Really have gotten on the bandwagon and on the media and have talked about living to 150 and maybe higher and That's not what we ascribe to and I the there the other camp is more focused on health span which means the portion of your life during which you are free from disease and Whatever your perspective may be on like, you know like maybe you know in Islam we say like your your your time is written, right and Perhaps you you know, like that means that you know, you can't change your life So that means that you also can't save a life potentially some people believe that others people Maybe have a different perspective on how exactly we should interpret The fact that your time is written already Regardless the one thing that we know for sure is that it is up to you to determine How healthy you are and what your quality of life will be during your given allotment of time In fact, it's a duty upon you to maintain your health to preserve your body It's a it's a trust given to you and it's your job to maintain that trust and so what health span means is Maximizing the period of time you're free from disease and people call talk about Squaring the curve because generally what happens is over time you have a gradual decline in the quality of your life Instead the goal is to keep it Great until the end where it falls off precipitously because of course all of us will have an end Any other questions? Okay Yes So you could focus simply on the prevention parts What happens if there are diseases already? active what Where does your type of service work best and where is your type of service? maybe not as productive Great question. So the question was a lot of what we've talked about is preventative and what happens if you already are experiencing health problems and The answer is it really comes down to the severity when you have like if you're a diabetic if you have end-stage kidney disease and diabetic retinopathy and Like a foot that needs to be amputated then obviously The mainstream medical system the health care system that exists is Fantastic at that. It's very very good at that However, if you have diabetes without those sequela then there are things that we can do to help you reverse the fact that you're diabetic And so it really comes down to where you are in the spectrum. So if you have disease there are still things you can do to Mitigate the risk factors for that disease progressing and actually turning back that disease. However, if you have an active cancer or Active disease that requires like hospital-based care, then that's what you should be doing like the the system is very good at treating that type of thing and so That would be sort of outside of our we can certainly and what we have done is we've found things and then referred people to the appropriate physician Yeah, awesome I had a question Which was talked about Sleep You've talked about Diet you've talked about exercise There's also a sphere of the community that Is interested in supplements could you talk a little about What role do supplements play and what's your philosophy on that within longevity? so We break things down into stages For a reason we what we have is like stage one is what we call the foundational framework Which is sleep exercise nutrition lifestyle factors optimizing those for a reason because If you're not doing that Then it doesn't make sense to take a supplement or a pill to try to Get around that you sneak to start with that, but once you have instituted those changes They don't have to be like oh you've mastered them all but once you've instituted those then there is a role for supplements for example for sleep Magnesium can be beneficial to help with sleep particularly in the Formulations that are more available. We can Talk more about that if you want There are supplements that Mimic fasting there's a whole class of them called fasting mimetics and what they do is they activate The same pathways that fasting does and those are beneficial There is a molecule that your mitochondria use to Generate energy. It's called NAD plus and there's a very big area of interest in how you can boost the level of NAD plus inside yourselves and There are supplements that are precursors to that that you can take that We have done, you know testing and shown increases the levels of your intracellular NAD plus so there is a role for supplements as a Another layer on top of sleep exercise and nutrition Thank you we are Have a few more minutes before we Dismissed does anyone have any more questions that I can walk over to Question about the exercise does the exercise the timing does the timing matter like if you exercise at the morning evening or at night Does make difference so for Sleep it can be beneficial to exercise in the morning Otherwise what I would say is whenever you can fit it in Really like I wouldn't I would start by just first getting the exercise built in and then You can see for you because what we've seen is that for some people Certain parts of the day work better for them And then you can measure different things you can you can measure things like heart rate variability to look at How stressful that exercise was for you how well you recover depending on the time of the day you can if you have a CGM Continuous glucose monitor look at how beneficial it was in blunting the glucose spike after a meal People find that if they go for a walk after eating, they don't get glucose spikes as much as they would if they didn't do that so I Would say start with just exercising and then there are nuances that can be built in but Everything I think it's like it's you know step-by-step. That's why we have the stages start with just Getting on the path starting to do something, you know show up and Then from there as once you've established that as a pattern a habit of behavior you can then add in those other bells and whistles question It is motivated by your talk What are Materials slash individuals you would recommend as they depart from today to continue their You know their journey their education Within this field and who should they be listening to? Well, we have a blog but apart from that There's a doctor Peter Atia who is very firmly in the camp of evidence-based medicine of health span and Doing things that Can meaningfully improve your quality of life and so he has a podcast called the drive You know, you can listen to that. I would an Andrew Huberman who I mentioned earlier has a podcast though I would All right Well, thank you one for the time tonight And Thank you everyone I