InFocus featuring Dr. Chris Keroack

From the 22 News Plus studio, [Music] >> this is 22 News in Focus with Patrick Barry. >> Hello everyone and welcome to this edition of In Focus. I am your host Patrick Barry. We've got a fantastic conversation coming up for you today. If you're like me, I'm in my late 50s and I want to see 100 years old. I want to live to be 100. I ri my kids about it all the time, but I want to know I've lived to 100 years old. I don't want to be 100 in some vegetative state. So today's conversation, we're going to talk about longevity and living a long and healthy and vital life. Across the desk from me today here in the 22 News Plus studios is Dr. Christopher Carowak. He is the medical director with the New England Center for Functional Medicine. Dr. Carowak, thank you so very much for joining me. >> Patrick, it's always a great pleasure to have a conversation with you about anything, but today I'm very with you. longevity mid-50s I want to live a healthy strong life as well. So how I mean I let me refer let me back up a second. So going back in time my parents didn't think about longevity. It's like I my mother you know my grandmother lived till she was 80. That's my that's my number you know. Um that's a little bit different now. I joke that I say I want to live to 100 because my mom made it to 90 and a half. Um I live a much healthier lifestyle. My wife may disagree but I live a much healthier lifestyle than my mother did. I exercise. I don't smoke. You know, I I eat better than my mother did. 100 is really not out of the realm of possibility. So, I have to think that you in your profession and other doctors are looking at longevity, pardon the the pun, under a microscope. Uh very much so. And so, we think about sort of the past ideas about aging and aging was just an inevitable thing. I mean, realistically, it still is an inevitable thing. you know, even uh centuries and centuries ago when there was a much more mysticism in regards to that where your life was viewed as a candle that was going to burn down or a thread that was going to be cut or something like this. Uh and realistically, again, my mom, your mom, our parents, uh they did what they could, but they didn't think about these things. Um I might argue that as much as we're attempting to live a healthier lifestyle, I think what we get exposed to now is much greater than what our parents and our grandparents got exposed to as well. So, you know, there may be equal footing in terms of longevity. Uh, but what we're doing now is we're looking at it more as a science, not necessarily as a preventable component. So, immortality is not the goal, but really having many more much more life in our years than necessarily years to our life. Much more life in our years than years in our life. And so then we look at the component of quality versus quantity. Um and realistically the hope is to get both but quality is really going to be the destination the goal. >> Okay. So a couple of things I want to I want you to to answer for me is so how do I live to be 100? Is there is there a what's the uh the f is there a found is there somewhere something I can take something I can do to make sure I I am cognizant on my 100th birthday. So let's talk about like living to 100 as compared to living well to 100. All right. So >> so that's that is something called lifespan uh lifespan versus health span. >> Certainly. So even when you think about individuals who are in the intensive care unit and they're going to be on in they're going to be intubated on ventilators and and machines that keep their heart going and they're going to be in a vegetative state but they're technically alive and realistically that is not a life. that's not a life but I can keep them quote alive for 100 years and there may be some components in terms of helping individuals live longer but then dwindling as they live that is to say you know I don't have full mobility I wind up being confined to my house or I wind up in a nursing home where individuals are taking care of me and I live to be a hundred I don't see that as the ideal life even though you live to be 100 right >> very different storyline in terms of of having the health and vitality and the strength to go on vacation and climb hills and mountains and walk on the beach. >> We're not talking Mount Everest. We're just talking, you know, go to Maine and go for a walk through the mountains. >> And I think one of the biggest things is self-care, which is to say like I want to be able to be independent so that way I can my wife and I can take care of ourselves and not be a burden to our children, for example. Uh and equally cognizance, basically having a brain so I can recognize people, recognize situations and think. I think that when you lose mobility and independence as well as cognition, you don't have the life that you want. >> Okay? And so this idea about like how do I live to be 100? I'm in. However, I don't necessarily want to be dying at 100. I want to be living to 100. >> You're right. There's there's an old qual if you're if you're not living, you're dying or something like that. >> Well, so the big one that I always think of is get busy living and get busy dying. You know, and it's you're doing one or the other. And so the component is of longevity medicine is really get busy living. >> Okay. So, so let's talk about the medical side of it. So what are doctors and researchers looking at? I have to imagine it's within our bodies, various elements, cells or DNA or whatnot to determine how to live a more a longer life, >> a more active and more healthier life. And so really longevity medicine is looking at what goes wrong as we age, as our cells make copies of copies of copies. What goes wrong with the editing and the communication and the translations? So again, I have my original cells when I'm born and then who I am today is a copy of those cells and actually more like copies of copies of copies. So has the translation or the editing been okay or not? And realistically, proteins fold incorrectly. Genes fray at the end, mitochondria decay. And through um animals and organisms that live short lifespans, we've learned certain pathways that we can I hate to say manipulate, enhance is probably a better word, enhance, and we apply them to human beings to see if we can get more uh uh clearer conversations within our cellular mechanisms. >> Okay. So what are some of those creatures that live longer lives that doctors are looking at? >> Oh, so we tend to look at ones that live shorter lives. So think about the idea because realistically it' be wonderful to take a newborn and follow them for a hundred years, but that's not a research project anybody's going to fund. How about my dog? I love my dog. My dog doesn't live dogs don't live long. >> So sadly, what we tend to look at is molds, fruit flies, and worms because they tend to live days, okay, or even hours. And then we look at pathways to see if we can get a fruitfly to live 27 hours instead of 24 hours. There are some small studies that are done with dogs, cats, and sheep because again, realistically dogs will live about 12 years. >> But you have to remember the thousands upon thousands of dollars that are going to be going into these research project. And if you go year after year after year, >> right? >> Um there's two very interesting studies that were done with human beings. One is called the tame trial. That one's going on right now. And the other one's called the trim tile with two eyes. And there was sort of a concoction of medicines and hormones and peptides that were placed into certain individuals. And they found on average you could get higher quality and greater longevity for about 2 and 1/2 years. >> Okay. >> And we'll talk a little bit about those pathways and those medicines that might be quote some of the secrets. >> Fantastic. Well, perfect segue. We're into our first commercial break. We'll be right back after this. >> This is 22 News in Focus with Patrick Barry. [Music] This is 22 News in Focus with Patrick Barry. [Music] Welcome back everyone to today's In Focus. We're here in the 22 News Plus studio. Across the desk from me is Christopher Carowak, doctor uh of and director of medical director of the New England Center for Functional Medicine. Uh Dr. Carowak, thank you for joining me. Always pleasure. We're talking about living a longer life, but living a longer, healthier life. Um, one thing I didn't ask you in the first segment is, you know, we we talked about how our parents live versus how we live. And do you I I find, and I know I'm living a healthier lifestyle than my parents. Do you think it's generational that like my grandparents probably didn't live a very healthy lifesty you know to most recent years and then now us do do you think as we >> generations are learning more and being healthier to live longer >> so we or is it medicine that's >> so we like to think that medicine is playing a big impact but when we look at historical data The two major factors that I remember is public health. So honestly sanitation. So cleaning up waste and washing our hands seem to have a big impact on health and wellbeing. And then honestly penicellin. So you know many individuals in the 17th 18th and early 19th century were dying of infection. They weren't dying of heart disease and autoimmune diseases like you know or cancers. They were dying of infection. And so when we washed our hands and used antibiotics, we wiped out a reason that people were dying. You know, it's it's let me inter interrupt you there. It's funny. I was watching a scientist. He goes, "Think about pre-Ivil War. The average 50% of Americans were dead by the 50% of the population, global population was dead by the age of 50." >> Mhm. >> Okay. >> Mhm. >> 50%. That was pre-chemicals. You know, everybody ate organic, right? Because it was they didn't have anything, right? Everybody walked everywhere. >> Exactly. and and but um in childirth you know the the the physicians that would deliver the babies would do autopsies dead people then go and deliver babies and not wash their hands between the autopsy and delivering babies. So women had massive infections and they died in childirth as a result of these components and then civil war components with the with the with the disasters within the war. you know, a lot of the infections and amputations we, you know, people did what they could, but realistically the infection would lead to sepsis and then soldiers would die. Um um the concept of triage came out of that. But again, shifting from an infectious form of death to a chronic aging component. And so now the leading causes of death are going to be heart disease, cancer, and stroke. things realistically wearing out or clogging up or uh growing out of control, not an outside invader like a bacteria coming in and killing us or an outside invader like an animal in prehistoric times coming and killing us. Right. Um so I agree with you. I think that the situation has changed. We're much more mindful and alert, but the horizon is very different. We have a lot more technology. We have a lot more quote laborsaving devices that make us do nothing. Um, we don't walk, we drive. Uh, much of our food is is much more processed and packaged as compared to raw and organic. And it's sort of I think there's still a lot of things out to kill us. And if you're staying mindful about that, you can beat the system. >> Okay. All right. So, what are some like are there five things that we should always think about for living longer? >> Perfect. And so, yes, there are five things that show up over and over again in longevity medicine and they are much more common than you think. So there's the esoteric interesting things that we will cover and then there's the ground foundational things that really have to be in place. And so the top of the list really is nutrition. Um and it's a lot less than you think. So in the world of longevity, it seems as though calorie restriction and then we can argue whether or not skipping meals like fasting have an impact. Okay. >> So when there are certain signals in our body to grow or clean up and these particular signals respond to whether we're eating or we're not and when we don't eat when we calorie restrict there's this um there's this communication to basically start cleaning up dying or dead cells. So we get rid of dying and dead cells we keep the healthy and robust ones and we live longer. >> Survival of the fittest. >> Yeah. So not surprisingly when we calorie restrict or potentially fast we live longer. So nutrition plays a big role in that. Um second movement patterns and so your lung capacity and how much muscle tissue you have dictates how long you will live. So again if you >> sedentary inactive people have a shorter life >> a shorter lifespan. Uh third component is going to be uh how well you sleep. I know we keep coming back to this idea but sleep your sleep is a big anti-inflammatory antioxidant component and it also is how you organize the thoughts of your day. One of my favorite studies is um I think it was out of Colorado where they showed that uh the average amount of data points you have in a day is 35,000 data points, but you only need 7,000 of those data points and you have to have a filing system to get rid of four-fifths of them, right? >> And you file them while you're sleeping. >> So if you don't sleep well, you have a jumbled up brain. Um you also have a hot brain, an inflamed brain, and a rusty and oxidized brain. And then despite what a lot of people want to believe, eight hours is still really the target. Okay? So if you're getting seven or six, you're not going to live as long. Mostly because your immune system is going to be off and your cortisol system is going to be off. You know, it it's funny. 8 hours is I've heard that my entire life, right? But then as we age, I go, that's a third of my life unconscious. And so, and I I I understand what you're saying. We need more sleep. But on conversely, I'm going I don't have much time left. Correct. I want I want to live more, but it's by staying awake more, it's actually killing me. >> Yeah, exactly. And again, we're thinking about the idea of like, will we get more years? Possibly, but we'll have much stronger, healthier years if we wind up sleeping. Um, not surprisingly, stress management. So, type A people versus type B people, people who can filter their stressors, people who actually have methods to get rid of their stress. And then lastly, and this has a a 50% impact, is your circle of influence, your social network, your friends. >> Really, your friends play a huge role in terms of your longevity. And so I love to say that, you know, if you're the king of idiots, you're still an idiot, you know, and and and you are I can't remember, but you're the average of the five people you spend the most time with. And so the personalities of the five people you spend the most time with, you're the average of those five people. And if you have sort of joyous outlook on life um and a locust of control, the idea that you're in charge of your life, you have a potential for living longer. >> Okay. >> So optimist versus pessimist. >> Exactly. And so your friends influence that. You know, your friends also dictate a lot of your schedule, whether you're sleeping, whether you're exercising, what you eat, and what your stress levels are. >> Exactly. So, if you're if you if you have a group of friends that eats healthier or loves to I mean, I'm not when I when I say exercise, I don't mean going to the gym, going to exercise class, doing your your your boot camp or whatever it is, but if you got a group of friends that just likes to go for a walk, what and again, even starts young. So if you have a group of friends who want to get together and play Fortnite till 2:00 in the morning or whether they want to go out and play tennis at the, you know, at the at the country club, it's a very very different experience, you know. So it's funny you say that. When I was a teenager, I would go I my next door neighbor, we would go play tennis until the lights went off at a Westfield Park. >> Yep. And now it's much more easy to have virtual friendships and to basically uh lose time in a sedentary position on a screen. And again, I got nothing against video games and playing on a screen, but at the same time, when you are said and finished, >> there's a time and a place, >> right? >> Okay. So, >> the five things are going to be, so we're going to recap. It's going to be nutrition, uh, sleep, movement patterns, stress management, and friends. So, those are the five things that basically make the biggest difference. >> And you can start that now. >> Realistically, I think that, uh, sometimes it gets a little bit challenging from the social network point of view. You got to be relatively outgoing. The other ones I think are doable. >> But even still, you don't need to be that socially outgoing. You will meet people everywhere. I mean, you know, think about the places you go to most. School, work, home, right? Your neighborhood. So, you you're naturally going to meet people. You don't need to go out and join clubs to meet people and make friends. Just you start in your backyard. You start in your neighborhood. You're absolutely right. >> Exactly. So, those five key things that you mentioned, those are simple. those are not like high task, you know, high energy task >> and they almost seem unbelievable. And so in the in the medicine world, we tend to overlook them and we tend not to talk about them. We just assume that people know how to do this. Uh I found, you know, from seeing patients, it's it's not necessarily intuitive. Um and there has to be some form of responsibility and accountability to do these five things. >> Fantastic. We're up on our second commercial break. We're here with Dr. Chris Carowak. We'll be right back after this. This is 22 News in Focus with Patrick Barry. [Music] This is 22 News in Focus with Patrick Barry. [Music] Welcome back everyone to today's In Focus. We're here in the 22 News Plus studios. Dr. Christopher Carowak is across the desk from me today. And we are talking about longevity and living a long and healthy life. Uh Dr. Carowak, thank you so very much again for joining me. Greatly appreciate it. We talked about the five basic components, things people can implement right now to help them no matter what your age. You know, you you know, if you're our age and your mid-50s may add a couple months or a year to your life, but those are those are things you should probably start teaching your kids and grandkids >> realistic. And they're just they're kind of basic aspects that are often overlooked but have such an enormous impact on really all health outcomes. And so again, you get more quality in your years and realistically more years to your life. So you actually affect the quantity of your life as well as the quality of your life. >> All right. So uh there are a couple of other things that um we didn't touch on. I want to uh IGF-1. What is IGF-1? So there's a couple of markers that we know that basically determine your actual um biological age as compared to your chronological age. So it's the idea of like how young are you really based on these chemistries. So one of them is IGF-1 which is insulin-like growth factor. And so this is a signaling agent to make things grow. It sort of is under the control of carbohydrates and insulin. And so when you have components of IGF-1 and insulin, you might have aspects of what we'll call metabolic syndrome, pre-diabetes. And individuals who actually are less sensitive to their own insulin or more resistant to their own insulin have many more problems than individuals who are sensitive to their own insulin. >> Okay, >> this is a lot to do with body composition. So basically, again, we go back to the idea about exercise and diet. The more fat you have, the less longevity and quality you may have. The more muscle tissue you have, the less inflammation, the higher levels of quality you have. >> Okay, the next one, uh, mTor. So, mTor is a signaling agent for growth as well. This one's a little bit more focused on protein. This one has a really eloquent dance, for lack of a better term. So, mTor has been linked, higher levels of mTor has been linked to shut cutting your life short. So it seems as though if you activate mTor, you overeat, you actually may be cutting your life short. Uh and if you if you can control or downregulate mTor, you may be helping your life to live longer. Okay? Again, under the control of protein, but as we age, we need more muscle tissue. So you need protein for that muscle tissue. And so there's mTor on your muscle tissue. That's where it gets to be a little bit sort of eloquent. And so it's like, you know, the Goldilocks, you know, enough but not too much, right? And so again, this aspect of calories and choosing the right level of protein. So sometimes in athletic communities, it's this idea that you got to have a really high protein diet to basically do. We actually believe that high like pathologically high protein diets may be more detrimental than we think. And that targeted protein diet, so that way you get your needs met are going to be safer. >> All right, next up, AMPK. >> So AMPK is um a enzyme that basically is helps make the currency of energy. And so there's this something called ATP and you have AM and ATP and this is triphosphate or mono phosphate. That's what the TNM stands for. And AMK is a kynise Kynise that basically helps that stuff move along. So it's it's currency for your energy and it's kind of like your retirement plan. So your 401k in terms of your energy. Um this is going to be somewhat of the cleanup crew. So the more active components, the more ATP you have, the more mitochondria you have, the better your brain is, the better your heart is, the better your muscles are, the longer you live. >> Okay. And the last one is something called c sertuin. >> Sertuins are these special kinases that move a different type of energy molecule around called NAD. Nicotinamine adenosine di oh gosh, di uh diamine, I think, or diphosphate. So NAD is a hydrogen carrying molecule that uh moves energy around in pathways. Uh and the more NAD you have the more energy you have and technically the longer you live. So there's a lot of use of NAD directly or NAD substitutes to basically basically help these certuins and the NAD pathways uh become richer so that way you have more uh energy in your years. So, taking all of the information, >> damine, >> damine, taking all of the information that we've talked about today, >> it's overwhelming. So, should we talk to our primary care a doctor and explain say, "Hey, listen. this is what I've learned. You know, can I incorporate like the five the first five things that you mentioned, you know, your friends, your eating, everything in moderation, you know, those things are easy. But some of these other things, the IGF-1s, the mtors, the AMPKs, the sit certuins are those sound more medical side of it. >> So the sad part is I didn't learn any of this stuff in medical school. I didn't learn any of them in my residency. There has to be somewhat of a personal interest to discover these. So this is much more in the academic arena than it is the medical arena. But you know, all of us don't have PhD friends at UMass that we can go to and talk to about this. And I don't necessarily know if if I didn't have the special interest and I was doing primary care, I don't necessarily know I would know about these things to talk to my patients about them. I would feel relatively comfortable talking about these five foundational aspects. Uh but really where to go, I think you have to sort of seek out individuals who have a personal interest in longevity or functional medicine, which are somewhat linked. I don't necessarily feel that the western medicine model is there yet. However, I think the demand is going to be required. I think there's a carve out of individuals, Gen X's especially, that want to live higher quality lives than their parents did. And I think that the demand will actually occur. >> So, you mentioned western medicine, eastern medicine, like Asian medicine. Are they more in tune with >> longer living? So thinking about the friends that I have that I actually will go see in the world of eastern medicine or alternative medicine. So naturopathy, chiropractic, acupuncture, I have to admit I don't feel like they are wellversed in it either. Interesting. Um so I think they have a better handle on it from a foundational point of view. But these pathways of IGF-1 and mTor and and EMPK and certuins again partly same as you was just like as I was aging I didn't want to hurt as much and I wanted to breathe better and I wanted to move more and I was like I wonder if there's anything to about this and then you have to go into the pathways of of the PhDs who are studying worms and molds and fruit flies and sort of try to extrapolate that into human beings. >> Fantastic conversation Dr. Christopher Carowick. I cannot thank you enough for having this conversation. I I know I my goal is still to continue to live a long and healthy and happy life till I'm 100. I'm hoping that I join you with that happy healthy life until 100. >> Good see you. Thank you. >> This is 22 News in Focus with Patrick Barry. [Music]