Live Long and Master Aging podcast

Episode

184

Biohacking through the lens of longevity

Nick Engerer: Founder, Longevity Blog

BY PETER BOWES | WEDNESDAY APRIL 27, 2022

Every now and then we find a kindred spirit in life. In the field of longevity research, Nick Engerer, PhD, lives and breathes the healthy aging aspirations embodied by the LLAMA podcast. The creator of Longevity Blog is on a mission to optimize his wellbeing through self-experimentation and science-based interventions. Crucially, he is also driven to share his knowledge to help everyone make lifestyle decisions that promote good health and vitality. In this interview Nick explains his real-world goal of nurturing his longevity through a data-driven analysis of the latest research. He also discusses the power of exercise, the flexibility of dietary interventions and his belief that longevity breakthroughs should be accessible to everyone.

This episode is brought to you by Longevity Blog, where Nick Engerer simplifies complex topics to help you build a personalized and affordable approach to wellness through self-experimentation. Find Longevity Blog at nickengerer.org/llama – and join Nick in your shared quest for maximum healthspan.  

Connect with NickLongevity Blog | Twitter | Instagram | LinkedIn | Facebook

Read a transcript 

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“When you’re unwell, you want nothing more than to be well again. That is all you want. And when you’re well, the world is available to you and you can explore all the things you want to.”

Nick Engerer

Topics covered in this interview include

  • The longevity space and a “seismic shift” in how we approach health and wellness 
  • Developing a longevity mindset through personal and family health challenges
  • Why healthspan should be the main focus
  • Taking ownership of your health and body
  • Sifting through the rapid proliferation of health resources and interventions
  • How do I know what works for me? 
  • Why expensive health scanning can be valuable but also over-the top for everyday lifestyle improvements
  • The value of a completely free health questionnaire
  • Spotting familial trends and taking preemptive action
  • A proactive approach to preventative medicine
  • The value of a heart-pumping exercise regime, routines and regular walking 
  • The longevity space’s messaging problem
  • Diet: what works, what feels good – “food is en emotional experience” – and what’s going to promote a longer, healthier life?
  • Blood sugar monitoring
  • Cellular energy levels and nicotinamide adenine dinucleotide (NAD) –  ongoing research and self-experimentation
  • Why the pursuit of a better healthspan is a journey worth collaborating on

DoNotAge.org is offering listeners to LLAMA a 10% discount on its range of products – NAD boosters, Sirtuin activators, senolytics and more.Use the code LLAMA at checkout. Any health queries can be answered by emailing the team at hello@donotage.org

Affiliation disclosure: This podcast receives a small commission when you use the code LLAMA for purchases at DoNotAge.org – it helps to cover production costs and ensures that our interviews remain free for all to listen. 


This interview with Nick Engerer was recorded on February 24, 2022 and transcribed using Sonix AI. Please check against audio recording for absolute accuracy.  

Nick Engerer: [00:00:01] All of us in the longevity space. We’re talking about this, we’re interested in this. We’re all kind of biohackers. We’re all looking at data in our body, trying to optimize through the lens of longevity. How do I stay in health for longer to have better healthspan? And that’s a journey worth collaborating on.

Peter Bowes: [00:00:21] Hello again and welcome to the Live Long and Master Aging podcast. My name is Peter Bowes. This is where we explore the science and stories behind human longevity.

SPONSOR MESSAGE: [00:00:30] This episode is brought to you by Longevity Blog, where Nick Engerer simplifies complex topics to help you build a personalized and affordable approach to wellness through self-experimentation. Find Longevity Blog at NickEngerer.org/LLAMA where you can join Nick in your shared quest for maximum healthspan.

Peter Bowes: [00:01:05] So why does human longevity matter? Why are we striving to live as long and as well as possible? And what are we to make of the myriad tools that we have at our disposal to extend healthy lifespan? Questions that I know my guest today, Nick Engerer, wrestles with every day or probably almost every day. Nick’s aptly named Longevity Blog is a goldmine of information and a really fascinating insight into one man’s journey to optimize his own health through self-experimentation and research. Nick joining me from Byron Bay in Australia. Welcome to the Live Long and Master Aging podcast.

Nick Engerer: [00:01:48] Peter, longtime fan of the show. It’s an absolute pleasure to join you and your audience. You’ve accompanied me on many walks through the bush here in Australia, through, you know, taking in all the information, your podcast. It’s really helped mature my own views. So a pleasure to be a part of it.

Peter Bowes: [00:02:04] Well, likewise, your blog is fascinating, and we can dove into that. Just give us a little geography lesson for Australia. Byron Bay, whereabouts are you?

Nick Engerer: [00:02:12] Yeah, it’s actually the easternmost part of Australia, so it’s just up at the border between the two biggest states in Australia, two of the biggest states in Australia, Queensland and New South Wales. And it is a it’s actually a happening little town. It’s known for its celebrity appearances. It’s a surfer culture and it’s also centered in part of Australia where health and wellness are a really big part of the local business sphere. Between Byron up to the Gold Coast, this is where we have most of our skin clinics, most of the places where people can have plastic surgery, but also where they can go biohacking and try new technologies of all sorts. So I’m quite at home here in Byron, and it’s also one of the best places in the world to train for triathlon, which is a sport that I hope we’ll talk a bit about today.

Peter Bowes: [00:03:04] It sounds beautiful. It also sounds very Californian. You could apply all of those things to where exactly I am right now.

Nick Engerer: [00:03:11] You’re absolutely right, Peter. And in fact, I was fortunate enough to do well in the business space in my day job and be able to have the freedom to almost pick where I lived. My main company, Solcast, is based in Sydney and I travel there from time to time, but I could kind of pick where I wanted to live, did some exploring around and absolutely fell in love with it up here in the California like Byron Bay.

Peter Bowes: [00:03:33] And Solcast is the solar power industry that is in effect your day job.

Nick Engerer: [00:03:38] That’s right. So I did a PhD studying how the weather interacts with solar radiation and how that impacts the generation of solar energy and created with my co-founder James, a company that does solar forecasting where we predict how cloudy it will be just a few minutes ahead of time, through a few hours, through a few days ahead of time. And this is important for balancing supply and demand in an increasingly renewable powered electricity grid. And that’s a big passion of mine, is to create a future worth living in matched with longevity, which is maximizing the time and enjoyment that I and all my fellow humans get to spend in this beautiful world that we’re building.

Peter Bowes: [00:04:20] I can really see the synergy. So longevity, it really is a passion project like it is in many respects for me. I was just looking at the home page of your blog and it describes your vision which you’ve you’ve just encapsulated really. But you say you envision a future where we can catch disease early, where data drives our daily behaviors, like what we eat and how we exercise, how we live our lives, and the role of genetics. All of those different aspects, those little tenets you could say that go into building a full life, a full, hopefully long life. Can you tell us how you first latched on to longevity as a thing? What made you interested in the first place?

Nick Engerer: [00:05:03] I would say that coming to this concept of longevity as a thing was something that happened for me in around 2017 in terms of realizing and taking in information, doing some research went on a real deep dive around the technologies that are going to help us live better for longer. And to me, I saw not only a tremendous opportunity, but what I think will be a fairly seismic shift in how we approach health and wellness as a whole. And so while that was a focused year for me, where I spent a lot of time researching longevity technologies and forming a view for where I think those are going in in the very near future and in the medium term future. It really was something that I have always had a strong interest in. I’ve always had a resonance with looking out for health, for seeing others look out for their health. And I’ve had some very close people in my life have serious challenges with disease. And I would say that those are the most formative in terms of this view of the longevity future and my real interest of it becoming a passion project, as you’ve described. And, you know, when I was younger, my mom had some real strong challenges with her health, including a brain aneurysm that they found by chance that likely would have ruptured and ended her life prematurely. In my late twenties, my wife at the time and two of my close friends in the same year, all were diagnosed with cancer in their late twenties. This is very unusual for someone to have three people in one year. And as I went through those experiences in each case, the earlier the disease was detected, the more likely the outcome of being able to be healthy again was. And in each of those cases, you know, my mother’s aneurysm was found by accident through another procedure. My wife at the time was pregnant and they found that there was some tumors and some things growing. A long, complicated story. They found that out before she gave birth, thankfully, because she could have actually had some complications in birth where she could have lost her life. But they found this through scans. My close friend Erin, who I talk about in the blog, had a brush with colon cancer. And in all these cases, the earlier you define the disease, the more likely it is that the amazing plethora of technologies we develop to deal with disease are available to you. And the more likely they are to be able to cure that disease or to prevent it from having a life ending consequence. So early detection is key and that has been a very formative part of Longevity Blog. And in fact, I think we’ll go into some of that where you really look at the elements of technology that we can pull together to provide that early detection. That’s the starting point for what I call this longevity technology development moving forward, because we’re we’re at the point now where we can catch disease quite early, not only treat it well, but the earlier we catch it, the better we treat it.

Peter Bowes: [00:08:16] So it really is pursuing those interventions that can hopefully prevent those diseases, those very typical killer diseases of, well, not necessarily old age, as you have implied. These diseases can affect people at at many different ages. But big picture, the goal is to live as long as you can. This is why we use the phrase healthspan with full health, physical, mental health, to be able to enjoy life, to be able to enjoy those around you, to maybe share your wisdom of life as you get older with your successors, maybe your children, your grandchildren. And what certainly from my perspective, what it isn’t about, although some people confuse it, it isn’t about eternal life, it isn’t about living forever. That is interesting as a concept, and maybe it’ll come one day, but I don’t think it’s going to come in my lifetime or your lifetime. My focus is, is that healthspan. And if we can get to average age 100 rather than 79 or 80 as it is now, I think that would be a great thing.

Nick Engerer: [00:09:14] I love that focus, Peter, and it’s something that we both share. I think it’s the most important aspect of longevity, which I think there’s two major components of in terms of thinking about advancing longevity, and that is healthspan the number of years that we live healthfully and then there’s lifespan, the total number of years that we’re able to live of which we want the most of it to be healthy. And while I think there are some really exciting things in terms of extending lifespan and you know, there is a sect of people in longevity enthusiasts who like to talk about immortality and merging our minds with computers. And there’s all sorts of things that could happen in that space and we can stay open to them. The most valuable, the most practical, the most relevant part of this discussion is healthspan. And this is again comes back to why I’ve had such a formative experience in having people in my life become unwell, because when you’re unwell, you want nothing more than to be well again. That is all you want. And when you’re well, the world is available to you and you can explore all the things you want to. It’s an easy space to take for granted. But you don’t learn that lesson of how valuable that is until you have these encounters with mortality, with being unwell and healthspan is all about the quality of life that we can have and the duration of that quality of life. That’s where the most dividends are to be gained, and in fact, that’s where technology now is most relevant and is increasingly as we develop more longevity technologies, those will be focused on healthspan and this is why this is the most relevant part of the discussion. It’s something a passion both you and I share, and it is a focus of what I’m trying to do at Longevity Blog, which again, as you said at the beginning, is based on my own personal experience and my own experimentation, but really trying to do that in a way that helps others do the same so that they can form a view of what’s actually impacting Healthspan and how to personally invest in their healthspan as an individual. That is the most important part.

Peter Bowes: [00:11:33] Exactly. And the other clear message from what you’ve said already and from looking at the blog, is that we all need to be proactive and much more proactive in terms of our own health by looking at the options and applying them to ourselves. Because in the world that we live in, it isn’t going to come to us. We’re not going to. Acknowledging all the well-meaning doctors and health systems in the world, the proactive approach isn’t going easily to come to us without us working for it, is it?

Nick Engerer: [00:12:03] No. In fact, this is one of the most important fundamental aspects of what I call a longevity mindset. And it is the realization that your health starts with you and you must take ownership of it. No one is going to come do that for you. And I would say, adding on to that, not only once you start to view that journey as something that you’re responsible for, increasingly you are empowered on that journey. And what I think is really important in longevity mindset is moving the needle not just over the arc of life away from somebody else’s responsible to that to, ‘oh, I have responsibility’, but all the way over to ‘I can make a difference.’ I can make a difference in my healthspan. I can take ownership of my body. And it will mean that I can live more healthfully for longer. And not insignificantly longer. This is something that we can impact by 5 to 10 years. That is 5 to 10 more years at the end of your life, which is a very rich and rewarding part of your life that is often filled with grandchildren or great grandchildren and a real mature view in the world. And actually science, psychology science tells us are some of the happiest years of your life so this is what you’re working toward having that mindset of not only can I be proactive, take ownership myself, but that that will reward me. And the longer that I stick around, the more technologies will be there to help me stay. Well, that is the view that I want to help people embrace is see that not only are you responsible for it, but doing something about healthspan and being proactive about it in a smart way. You can really affect your healthspan that is now more possible than ever. And every decade you’re alive. Every year you’re alive, it’s becoming more possible to do even better. So it’s worth sticking around, as I say.

Peter Bowes: [00:13:57] Exactly. And accepting all of what you’ve just said. Many people may agree with you. But then the first question probably is, well, what do I do? And I suppose this is where your kind of work comes in the Longevity Blog and your own self experimentation. Others are doing the same thing because there are myriad, as I mentioned at the beginning, myriad interventions that we can apply to ourselves and some of which cost a lot of money, others of which of course are free. And much of exercise and diet, well diet isn’t free. But you don’t need to spend a lot of money, is what I’m saying, to make significant changes to your lifestyle. So let’s dive into what you’re trying to do and that is, I guess, sift through that information to find what works and what doesn’t work.

Nick Engerer: [00:14:40] Yes, this exact problem is relevant to everyone listening because what is happening as we gain more technologies that we can leverage for our health as that occurs, it’s a wonderful thing. More resources. There’s so many things we can already do from wearables to apps to personalized supplements to longevity focused clinics and doctors. But as that resource proliferation continues, which it will with an accelerated pace, there’s ever more options to you and. That means that all those options will then also be competing for your dollar with increasingly convincing marketing messages. And that’s the practice of good business. And many of the companies in this space are, you know, very ethical companies really actually communicating outcomes that are backed by science. Great company you talk a lot about is Amazentis and the Timeline nutrition brand with Urolithin A they are really bringing the science to a supplement but still that doesn’t mean that you should take Urolithin A just because the science is good, right? We have to take it all the way back to that individual aspect of this journey and figure out what works for you and also think through a lens of a broader strategy. I’d like to spend some time talking about this, which is not only what things work for me, but what things should I be working on first? Where is the place I should start with? Again, this expanding resources that are available to us ever more convincing science and marketing messages. This creates a really challenging landscape for the longevity enthusiast, the healthspan enthusiast, the regular well wellness warriors and people among us who just want to be well of what do I choose for me? So what I’m trying to do is set an example of how I’m doing that myself, provide some ways and some tools others can use, trying to help save people some money by going to these companies and saying, ‘Hey, give me the best discount you can on your product’, so other people can try it and see if it works for them, for them themselves. But doing this through a lens of knowing, where do I start?

Peter Bowes: [00:17:00] So in fact, Nick, you just anticipated my next question was going to be; Where did you start? And I think where you started perhaps is a good guide for the rest of us in terms of making these crucial decisions. It is quite a plethora of information. It’s a minefield if you’re going in from a blank piece of paper, isn’t it? So where did you start in terms of analyzing your own personal needs and the kind of experimentation that you’ve done?

Nick Engerer: [00:17:26] I started by going down what I call the premium health care route, so I went to the Health Nucleus, which is a longevity focused health clinic in San Diego, owned and operated by Human Longevity Inc, which is a company that’s really investing in this space, particularly on the genomics and genetics side of longevity analysis, but also in the analytical technologies to be able to scan your body with an MRI so full body MRI, check your brain, check your heart, look through your whole body and tell you whether or not there’s any cancer or any abnormalities in your body. And in fact, tying back to the example from my own mother, they would have detected that and that brain aneurysm risk zone. I think the proper term is an embolism. It’s like an enlarged part of the circulation structure in the brain. I have this beautiful 3D image of my vasculature in my brain that was taken from the Health Nucleus that shows all of mine is healthy. So I started by doing that and I was very fortunate to have interacted with the Health Nucleus twice. Now, first in May of 2018, which created some of the formative material for my blog, talking about that experience, interviewing their medical director, diving into the technology, going back again in January of 2020, just before we ended up in this travel shutdown from COVID. I luckily snuck that in and got to have another encounter with that clinic. And it’s an amazing place full of great people and good technologies that help me make some really important changes in my health, which again, will be some of the first steps I recommend to the listeners. But I don’t actually think that’s the right place for everyone to start, Peter. And the reason for that is it’s simply is outside the scope of most people’s budget.

Peter Bowes: [00:19:27] Yeah, I’m just going to make exactly that point that almost to play devil’s advocate here, that it sounds fascinating, it sounds very revealing potentially of your state of health. But for exactly that reason, most people probably can’t afford it.

Nick Engerer: [00:19:41] No, it’s a it’s a big ask, even for those who can’t afford it to fly to San Diego, stay overnight, go for a full battery of tests, do the follow up. The mental load of the concern about what happens if they find something is a real big barrier for all of these technologies. It’s a psychological challenge in all of these examples. And what is important to recognize is that, yes, that is expensive. That’s what I’m calling the premium route I started there. It was a great holistic check of the body, provided a good, solid, complete health check outside of a few potential cancers, esophageal cancer is a great example. They can detect almost anything. They looked at my metabolic condition. They looked at the brain, looked at the heart. This is amazing. But it costs at the time it costs a few thousand dollars. And now that program has actually gone to an annual subscription, which includes more technologies and has become, in order of magnitude, even more expensive. So it’s further out of reach than it was before. So there may be an opportunity for and I think this is a business opportunity and it’s something that other doctors in this space are working on. And in fact, it’s something that you and I might get to play with later in this year. And that is doing those longevity MRIs, full body scans with a longevity focused doctor outside of a fancy clinic in a regular hospital with some decent analytics that might become more affordable. But let’s move away from that one example and talk about where the listeners should start. This is actually something you could do for free, and I have a limited amount of resources on Longevity Blog that I will continue to invest in that help users get started with this.

Nick Engerer: [00:21:24] And the first thing that you should do if you want to think about your longevity and it’s completely free, is to fill out a health questionnaire on your family history. This is free. It will give you some great starting points in terms of what your own longevity risk is likely to entail. It won’t tell you everything. It’s not going to give you the complete picture. But if you build out a history of what has happened with your parents, your grandparents, your aunts and uncles related aunts and uncles, you will begin to see a picture of what may be in store for your own health. And this is not a holistic picture. It won’t capture all of your risk. But in many cases there will be patterns. And I will give you an example of a pattern that I saw in my own family and that actually came in to spinal health. So my grandmother, my mother and another related family member have all had, as they’ve aged, issues with cervical stenosis, which is a narrowing of the spinal column. And your nerves travel through the middle of your vertebrae and those vertebrae are growing more bone and shrinking its sinuses is referring to like almost a constriction which can end up resulting in nerve damage, the loss of function with example in the neck you can lose the ability to grab things, to feel things. And so I saw that there was a pattern. And so what I’ve done is then gone and worked with a professional. I went in, I have a chiropractor whom I trust. I wouldn’t say all chiropractors are great, but the one that I have, I have a great relationship with. He’s got a state of the art X-ray machine at his facility. We did an X-ray of my neck. We’ve created a care plan. I’m actually working on going from having a straight neck to neck with a more healthy curve in it through some exercises and things that I’ll put up on Longevity Blog later this year. And taking a proactive stance in this case could mean that in my case, I can avoid that issue, which builds up over decades. It’s a structural problem. It’s a limiting problem in terms of your function, which is really important to preventing frailty and staying robust into later age groups, because you got to be able to move your body, you’ve got to have good reflexes. You don’t want that that nerve circuitry to be constricted at all in that case. So here’s an example of looking at family history, pulling something out way ahead of time and knowing that’s in my risk profile. That is a longevity risk for me. How do I manage that risk? Talk with medical professional. Start thinking about it ahead of time. Many other examples could exist for the listeners, including things very common things like cardiovascular disease, seeing patterns and family of that type II diabetes developing later in life, knowing there’s a predisposition for that in your family, it’s completely free. It gives you the point where you should start because that’s that’s the low hanging fruit. That’s the most obvious thing. And it’s a place where you can make a real difference the earlier that you start.

Peter Bowes: [00:24:25] And it’s almost obvious, isn’t it, when you spell it out like that? And it’s probably there’s no surprise, therefore, that one of the first things that a doctor will ask you to do when you sign up with a new practice is to fill out a questionnaire. And I suspect a lot of people go into doing that questionnaire with a little bit of impatience. So we’ve got to get through all of these questions. You tick all of these boxes. But you’ve just beautifully explained the huge significance of that, and especially when it comes to those those big potential killer diseases of old age, like heart disease and like some cancers that just a little bit of awareness up front. And the fact that you’re the person that’s being aware and perhaps drawing your doctor’s attention to these things, perhaps before even they realize it could be hugely beneficial.

Nick Engerer: [00:25:10] This is a great what you just said is exactly the point, is that before your doctor even realizes it. Your doctor. There’s a lot of tension that can exist in the longevity space between people and their doctor because they’re frustrated with the system. They’re frustrated with how health care works. But a proactive person is not going to let that stop them from talking to their doctor and going and trying to get the best they can out of it. Because most doctors want to help you. Most doctors want to look out for your health. And particularly when you take something as practical as a health questionnaire, which is the next step you should do with the health questionnaire is go talk to your doctor and say, hey, look, I’ve identified in my family that there’s early stage cardiovascular risk, for example. I would like to be proactive on that. What can I be doing? Your doctor will support you, you know, they’ll be almost be amazed and so happy. Some doctors are happy to have that happen to them. I’ve had doctors that I’ve interacted with or other folks that I’ve known have gone and done this with their doctor. And their doctor is almost excited for or relieved to have a different perspective. There are this subset of people who are annoyed and say, Go away, don’t bother me until you’re sick. But there’s a lot more goodwill in that space than you than you might first expect. And this is a very practical first step that can help the system work for you. And that proactive mindset of doing it and trying to make the medical system that’s available to you work for you is also the place you can go next in terms of making your dollar go the furthest it can. You know,what blood tests can you get, what annual checks can you get that are covered by your insurance or by the Medicare program in your country? Real, practical, tangible longevity focus results can come out of this exercise. So it’s a great place to start.

Peter Bowes: [00:26:47] Right. And two of the pillars and I’ve already mentioned this, but two of the key pillars of good health are your diet and your exercise regime, or indeed whether you exercise at all. And I often say, you know, we could stop all of the signs now and just apply what we know about diet and exercise and its importance and its significance to our longevity. The challenge, I guess, is getting people to realize that and not just, oh, yes, I kind of know about it, but to realize it and then apply it to themselves so it can make some sort of practical difference in their lives.

Nick Engerer: [00:27:24] I love those two points and it follows on really naturally from the starting point because specifically exercise, no matter what risk you show up with in your longevity plan, your assessment of family history, the other tools that you can use to build out that picture like genetic risk profiling. I talk about a company Self Decode and they’re really actually breaking some new ground in terms of that personalized risk profile in genetic reports that can help you see different diseases and your risk for those longer term age related diseases like cardiovascular disease, neurodegenerative disease, metabolic disease. And if you engage with that and you start to form a strategy around how am I going to avoid or manage my risk or avoid those age related diseases as best I can? Exercise will be in there no matter what. Exercise is the most important thing we can do with our body. And it ties in really nicely to my first visit to The Health nucleus. So shell out, a few thousand go into the state of the art clinic, full body MRI, full blood panel, complete genetic sequencing, a bunch of other different things they get to engage with. Testing my balance, EKG to check my heart signals. What comes out of all of that when I meet with my Health Nucleus doctor to discuss the results? Oh, Nick, you know, you’re not doing enough exercise. You need to do more heart pumping, cardiovascular focused exercise. And that doctor, I write about this on Longevity Blog. She walked the talk. She was maybe late forties or early fifties, and she was fit as a fiddle. She came in that day and said, I just ran 40 minutes up and down the boardwalk here in San Diego before I came in to work today. I do that a few times a week and this is what you need to do, Nick. You need to get your heart pumping. A few times a week for 30 minutes, at least a few times a week. And the fact of the matter is, I wasn’t doing that. You know, I’ve gone to the state of the art clinic. I wasn’t doing that basic thing. So what do I learn from spending some shelling out these thousands of dollars? The most important, actionable thing I come away with. There was two things. One was working on my diet, which we’ll talk about. And but the first one was do more of that heart pumping exercise. And that later Peter changed my life. I have not – I’ve I walked away from that saying, if I’m serious about my longevity, I’m going to do that. And it was challenging for me to get into that space because I loved strength training, I loved lifting weights, but doing that for almost two decades now. And I love that side of the exercise. I really enjoy walking, I love going hiking. But is that heart pumping, that cardiovascular system training that I never really connected with, it felt like I had to go sweat it out in a heart pumping Zumba class or on the bike. All these things that I didn’t really like that felt fairly miserable to me. And the key for getting that development in the cardiovascular space was finding something, an exercise that I love or that I really like or enjoy and start doing. Start there. That’s what you’ve got to do. You don’t do the things that make you suffer and you don’t like. You won’t keep doing those. You’ve got to find the thing that you enjoy that can get that heart pumping goodness, as I call it, going to tell your heart to be strong and to get your body circulating more blood to through your whole body. So your vascular system builds up because this is how we deliver nutrition throughout our body and clear out waste. We have to have that circulatory air circulation system in our body to be robust, healthy, dilated, with a strong heart, to pump it for our longevity as a as a first principle, we need to have that. And so you can go to the most fancy longevity clinic in the world. They’ll come back to that very point. And you’ve talked about this in several podcasts, including a real advocacy for walking. And that’s where I say, if people aren’t doing anything right now, start there. Yeah, get walking. If you’ve got pain when you walk, go to a physiotherapist, fix that pain, you can do it. Get walking because walking can take you so far in that fitness journey because as soon as you can walk around the block, you can walk around the block twice and then you can walk around the neighborhood and then you can start walking up hills and get that heart pumping. And it becomes something that everybody it’s accessible to almost everyone walking. And that’s where you start.

Peter Bowes: [00:31:56] I couldn’t agree more, and I used to do a lot of triathlons, a did marathons. As I’ve grown older, I do fewer long distance, hugely energetic runs or bike rides. I still swim quite a lot, but walking is my thing. And the key to walking is to make it a routine so that you you don’t think about it every day, come to the point that you say, Oh, I haven’t done my walk yet. You basically get up in the morning and you do the walk. And in my case, it’s before 9 a.m., it’s before breakfast, it’s on an empty stomach because I find it easier to get up the hills that way. As you say, your heart is pumping, your heart rate is pumping, and you feel great when you get back. And because it’s part of your routine and admittedly having a couple of dogs in my case helps hugely because if you don’t go for that walk, there’s always someone there with four feet who’s going to tell you that you should and why it’s a good idea, but basically just get out. And you know the phrase ‘just do it’, it’s been used by others, but it is totally applicable to this. Just get out and walk and you feel great at the end of the day. And it’s so easy to get those ten, difteen thousand steps a day almost without thinking about it.

Nick Engerer: [00:33:05] It’s a beautiful illustration of this, and I can hear your enthusiasm for that in your own experience. And you’re right about the routine. It’s so important to get that into routine. And that, again, is at the basics. That’s that is at that fundamental level of what do I do first and what doesn’t cost me any money? Get walking. And you can take that so much further. If you’re someone like me who wants to go to the absolute optimum, you can you can take that as far as you want. I started with walking. It started turning into running. Then I started getting back in the pool like I did when I was younger. And now I’m a triathlete and it’s something that I want to take until I’m in those later decades of life because I see others doing it. They inspire me and it’s preserving a lot of function in the body, which is one of the primary things that exercise can do for you. I do think you need to add some strength training in there beyond just walking, particularly in the older age groups, because frailty is our is one of our biggest issues. Once we escape those age-related diseases, when we build a strategy that helps us avoid those we get into later life, our biggest issue starts to become frailty. And that is about the body losing strength and function because of not being used. If you use your body your body will stay strong. If you tell your body to be strong. It will listen. It doesn’t matter at what age that is. And there are some tremendously inspiring examples of this. I can’t remember the name of the woman on your show who actually documents these examples, but there maybe you can throw that in the show notes or you can toss it in now. But she was talking about how many people are out there as examples of what you can do when you’re older. Look to those people and be that person later in life. You can do it too.

Peter Bowes: [00:34:51] I agree totally. In fact, I probably had several guests making that exact same point, that there is a variety of different ways you can achieve these things and we’re all individual. I see the point that so many guests make that we’re all individual. We all respond to different types of stimulus, and it’s a matter of figuring out what is best for you.

Nick Engerer: [00:35:08] Yeah, find what you love because you won’t do it otherwise.

Peter Bowes: [00:35:10] Yeah, I couldn’t agree more. Find what is best for you. And well, you mentioned diet or I probably mentioned diet to start with as being one of the other key pillars alongside exercise. What have you done to try to figure out what is best for you? Diet is probably the most controversial area that I dive into in this podcast – maybe supplementation is as well. Do you have a meat heavy diet? You have a keto diet, you have a plant based diet. There are so many different variations on a theme. It’s absolutely bewildering, isn’t it, to most people as to what is the best diet.

Nick Engerer: [00:35:45] This is a great example of that marketing messaging problem in particularly because dietary strategies and diets are in such a mature phase. We have, you know, any diet you can think of, there’s a there’s a way to engage with that. There’s a person, there’s influencers who are doing that and they feel great. And there’s people providing anecdotes about how it changed their body and cured problems for them. It doesn’t matter which way you go, it’s the same. You can go fully carnivore, you hear that? You go fully fruitarian and eat just fruit, which is almost the complete opposite. You can find that you go to keto, you find the same thing vegan, vegetarian, the same messages, the same anecdotes, the same pitch that this is the best diet we need to back away from that completely. Because if you were to look at all those things and they’re all conflicting, what are they telling you? They’re telling you that there’s something missing here. And what I think is missing is that these anecdotes and these people who are advocating for these diets tend to be ones whose bodies have responded really well to that diet. There might be some quackery in there, there might be some misinformation. But if we go on the assumption that the people in this space are genuinely trying to share a message of what’s worked for them, they’re genuinely trying to share their view of the science and the view of dietary and nutrition guidance and what they think is best. And they have clients who has worked for that. All can be true at the same time, but it doesn’t mean it’s right for you. So how do you figure out what’s right for you? And this is a very interesting space for me personally, because I’ve tried I’ve tried all the diets. I’ve tried all the diets Peter. The only one I haven’t tried that’s been a fad recently is Carnivore. And it’s just because I don’t have any desire to do that to myself. I heard how Joe Rogan described his two weeks of carnivore switchover. No, thank you. But the main point coming out of this is that we have this individualization problem. How do you find what works for you that’s multifaceted. And I think we need to take a bit of time here to talk about how we might do that. And I know, Peter, I know you’ve done a lot of searching around for an optimal diet for yourself. I’m sure there’s an example there where you’ve tried introducing a food or you’ve tried a diet and you’ve been able to tell, you’ve been able to see in your body how it responds to doing one diet or another. I like to often ask people for an example of that from their own personal life. Do you have one you could share?

Peter Bowes: [00:38:21] What I would say to that is, I think the first decision you’ve got to make is what do you like eating? And there are certain things that we all just despise and couldn’t possibly contemplate that being our diet. And in my case, actually, you could say conveniently that has been meat. Even as a kid, I didn’t like eating a lot. We ate a little bit of meat, but not a huge amount. And that has continued throughout my life. And I’ve now got to a point where I better understand what I’m eating and the benefits, in my case of a of a plant, mostly plant based diet. It’s a mostly low protein plant based diet. So I’m getting my protein from from vegetables and from beans and peas, the legumes and eating minimal animal protein. A little bit of dairy in my case, I think is fine. I actually like dairy. That’s okay. I think you’ve got to enjoy your food with a certain sensibility about the big picture in what you’re consuming. But you can’t pursue a diet that you might think is good for you, that you’re actually going to hate eating. It won’t last. It just won’t continue. So I could give you a gazillion examples of foods that I just can’t stand eating, some of which are actually very healthy. I don’t really like garlic. I don’t like onions. They’re actually quite good for you, I think, in my understanding. But I could never eat a diet full of onion and garlic, so you kind of mold what you eat to what’s actually going to work, but then you figure out what those food items are, and then you can really drill into how much you eat when you eat, which is hugely important. I do do time restricted eating. I try not to eat beyond six or seven in the evening, get up in the morning, do my big walk without having breakfast and then spend a few hours during the day when I have my couple of major meals that works for me. It might not work for you.

Nick Engerer: [00:40:10] This is so wonderful, Peter, because it ties back to what we just talked about with exercise, which is where you’re going to start. You got to start with the things that you’re going to enjoy doing, the things you know you inherently like. And many of those things come out when you’re a child, like, I love swimming. One of the reasons I like triathlon so much, I did that when I was younger. Same concept applies here to diet. If you hate it, you won’t keep doing it. You’ve got to find what you like doing and you’ve got to find what works for your body. And a lot of that is a psychological benefit because food connects into our wellness on a level much beyond just the body. We are fueling the body. We’re providing the body with the nutrition it needs. But food is culture. Food is sharing with others. A food is an emotional experience and we have to acknowledge that. So we can’t be eating something we don’t like. We’ve got to love our food. We have to be nourishing our mind and our body at the same time. So, it’s important to start there. Now, there’s caveats to that because you might really like some foods, but your personal biology won’t be responding well to that and you might not be able to see. So for example, I’ve had to modify my own diet, which since you asked, I’ll just point out is a lot of different plants. I’ll talk a bit about the diversity of plants. If we have I have a second here, a lot of plants, a significant amount of clean carbohydrates because I’m an athlete and I have to eat actually four or five times a day. I eat smaller amounts to fuel my athletic training and then I eat meat, but I try to have lean red meat once a week and then need a lot of fish. Maybe eat some chicken and make sure I have meals that are fueled by plant protein alone. So it’s a limited amount of protein intake from animals. And I have largely eliminated dairy completely. And the way that I’ve learned that is through observing my body and seeing my body’s response. I love yogurt, I love cheese. But… 

Peter Bowes: [00:42:10] Me too

Nick Engerer: [00:42:10] I have had it and I love a nice, you wouldn’t like this one, but I love a nice, fatty, juicy steak as well. But if I eat too much saturated fat, my LDL cholesterol levels are too high. And that puts me in a risk profile that I’m not comfortable with. There’s a lot of conflicting views on saturated fat and HDL LDL-C or HLDL cholesterol in the diet world, but the evidence is resoundingly in the favor of managing your LDL-C level, particularly for people who have certain types of lipoproteins, which are the proteins being carried around in those cholesterol molecules, those cholesterol transporters that predispose them to cardiovascular disease. And you have to go beyond that panel to measure the number of very small particles and in particular, some that are known to be more dangerous. I talk about this in the blog, actually lipoprotein a is a genetic lipoprotein that predisposes people to early cardiovascular disease. And in my case, eating a keto diet through the levels of my LDL-C up very, very high. And they also meant that I was over the threshold for those very low density lipoproteins, those small lipoproteins that are particularly deadly in terms of cardiovascular disease development over time. So I have through blood work and some self information, talking with my doctor, being able to experiment with different diets and it’s actually a low saturated fat, meat inclusive, mostly plant a significant amount of carbohydrates that go up and down, according to my training. And a lot of very good fats like olive oil, macadamia nut oil, avocados that make up my diet today. And that was done through knowing what I like to eat, taking out some things that I do like to eat a lot, and reducing the number of times I eat those based on my bloodwork and knowing longer term, coming back to that longevity strategy where my risk appears to be my body seems to have high levels of LDL-C. It seems to. Meaning that over time I will have some exposure to the risk of cardiovascular disease, particularly the atherosclerosis, which is I won’t go into the details of that, but this is basically what’s happening in your arteries in terms of creating cardiovascular disease risk over time. So I have to manage that. So you’ve got to build a diet that you like that’s delicious for you that is supported by some evidence in terms of body metrics. Blood work is a great example. And then you also need to not eat too much, which I think is a fairly obvious one. We can note that in our own body mass index, but more importantly, not everyone will be gaining weight whose has an unhealthy metabolic profile. So keeping an eye on your blood sugar, which is something you can do buying a blood sugar unit off of Amazon or from your local pharmacy and testing your own glucose when you’re fasted in the morning to get an idea of how your fasting glucose levels are responding is another important aspect of that process. So it’s what you love, it’s data informed and it is maintaining the proper balance of intake to output.

Peter Bowes: [00:45:31] Yeah, I wore a continuous glucose monitor recently and the main conclusion at the end of it was that I probably didn’t need to wear one full time because everything actually looked pretty good. But it was fascinating just looking at the data and especially your your levels of glucose on waking up in the morning, which is a huge sign of your health, as in terms of your metabolism and how you you’re managing your glucose. We are running out of time, Nick. I suspect we’re going to do a lot more of these because we’ve only really just touched the surface. You’re hopefully going to visit California later this year. We will get together. We will, I think, do some video together on your latest exploits in terms of pursuing your own health. So I’m looking forward to doing that. One thing I just want to very quickly ask you about, and that is supplementation, because it is something we haven’t delved into in this discussion and I think we’ll talk about it in greater length in the future. But you’ve looked a lot at NAD and you mentioned earlier frailty and muscle health is one of the key issues as we get older and very often times the increased frailty of a human being is the beginning of the end in terms of their mobility and almost a major red flag of end of life, or at least that slow down that precedes end of life. Just tell us briefly what you’ve been doing with NAD, what its significance is and some of the experiments that you’ve carried out with yourself.

Nick Engerer: [00:46:54] NAD is referring to our cellular energy levels and in the longevity space there has been a very quick uptick in the interest of NAD precursor molecules and supplements that can help raise our NAD levels, which through that lens of thinking is something that can help us stay healthier for longer. And I work as an advisor to a company called Do Not Age. Alan Graves was a recent guest on your show and through collaborating with them, I’ve been testing different NAD boosting molecules, namely NMN and nicotinamide mononucleotide and nicotinamide riboside and then also doing blood tests of my NAD levels. And I’m most of the way through that experiment now. I’m trying a few additional options and I’ll be putting some results up on the Longevity Blog later this year, probably around June 2022. And what I’m learning through that process and working with the developers of that entity, testing technology, is that once again, everyone is different. So…

Peter Bowes: [00:48:02] Right,

Nick Engerer: [00:48:02] I’m not going to – release some results on that later. I’m not going to comment on those molecules directly. But it will be one of those things where, again, self experimentation is key, which is a theme on Longevity Blog is how do we run a self experiment? How do we know that the supplements we’re choosing are working? And I have as a part of my philosophy, an incredibly disciplined approach. And I will not take a molecule. I will not take a supplement unless I can measure its benefit. And that doesn’t mean it has to be quantitative in a blood test in a number. It can be qualitative in terms of how one feels, but particularly with how one feels. We’re very exposed to placebo effect, particularly for things that are boosting NAD because everyone knows that it’s supposed to boost their cellular energy. So they all tell you, Oh, I feel more energetic taking this molecule. We can’t rely on something that simple. We have to be a bit smarter about that. And the reason this is so important is because in the longevity space, if we’re going to add something to our stack, which is referring to the molecules and supplements you’re taking, you’re going to be doing that for decades. That is a significant financial investment. You need to know that that is working for you so that you can continue to justify that investment. So this focus on self experimentation and. getting good data points through a bit of research on how to measure whether something is working for you is absolutely essential to this journey. So I play around a bit with biological age testing on the on the blog. I’ve done that with some diet interventions. I’ve done that testing nicotinamide mononucleotide, which did appear to improve my biological age. And this whole idea of self quantification and the tools we have, like ordering your own blood test without a doctor, for example, some technologies like NAD testing, looking at another one where you can test your diet by breathing into a device called a Lumen device and using those quantification technologies to justify what you’re doing, how you’re making those changes, and to know that you should do them over the long term is absolutely essential to the supplementation process. So there’s a lot of examples. There might be something we could work through in more detail in future collaborations, because I think it’s important for your listeners to learn how to do in the meantime, I do have some good examples on Longevity Blog, as I just mentioned, that hopefully will help people start on their own self experimentation journey. Because I think all of us in the longevity space, we’re talking about this, we’re interested in this. You know, we’re we’re all kind of biohackers, we’re all looking at data on our body, trying to optimize and particularly in this community, through the lens of longevity. How do I stay in health for longer to have better healthspan? And that’s a journey worth collaborating on. So this has been a pleasure, Peter. Thanks so much for doing this with me today.

Peter Bowes: [00:50:50] It’s been my pleasure as well. And I wanted to raise that issue because I knew you were doing that kind of work and certainly looking forward to looking at the blog and looking at the data. And and you’re absolutely right. You need to delve into the data in some depth to fully understand it and then be able to apply it to your self. Likewise, Nick, I’ve really enjoyed this fascinating work that you’re doing. Looking forward to meeting you later on this year. We’ll talk more. And good luck with everything you do.

Nick Engerer: [00:51:14] Thank you, Peter. I’m sure we’ll continue to collaborate and share with your audience how they can personalize their own longevity strategy.

Peter Bowes: [00:51:22] And if you want to check out the details further of Nick’s Longevity Blog, I’ll put the details into the show notes for this episode of the Live Long and Master Aging podcast at our website LLAMApodcast.com. You’ll also find there a transcript of this conversation. The LLAMA podcast is a Healthspan Media production. You can follow us in social media @LLAMApodcast. You can contact me by direct message @PeterBowes. Do take care and thanks so much for listening.

The Live Long and Master Aging podcast, a HealthSpan Media LLC production, shares ideas but does not offer medical advice.  If you have health concerns of any kind, or you are considering adopting a new diet or exercise regime, you should consult your doctor.

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