Hi everyone. Welcome to our Crowdcast number 38. 38 of these Q&A, live Q&A series. Pretty exciting. Welcome for those of you who are new to this event. Typically, I answer a variety of questions. The event's about an hour and a half long generally, and I typically do a deep dive on a few questions where This requires a little bit of background research and putting together some facts and reading the literature. And then I also do a variety of rapid-fire questions. So these are answers that I can give in a sentence or 2, or perhaps even 3 or 4. Please remember that you guys can always access these Crowdcast episodes, re-listen to them later on your private podcast feed. If you haven't gotten that private podcast feed, go to your dashboard, foundmyfitness.com/dashboard.

Make sure you download that so that you can listen to our aliquots, which we release weekly, re-listen to these Q&A series. We also send out an email with a timeline so you can rewatch the video on YouTube as well. I like to answer live questions in the chat as well. That's kind of the benefit of attending these live is that you get to chat some questions. So throughout the Q&A, I will look over in the chat and try to answer some questions. In fact, before I get started, there was a couple of questions about the microbiome gut test called Viome and what my thoughts are on the test.

And I've talked about this in previous Crowdcasts and I'll tell you that I don't think Viome— I don't think there's really any great microbiome test out there, maybe the Human Gut Project and that's— Only because it is run by the— one of the world-renowned gut microbiome researchers, Dr. Rob Knight, and they use most of the data for research purposes. So they will give you back some information regarding gut microbiome species, but they won't try to pretend that they can give you lifestyle factors, dietary, you dietary guidance to change anything. And that is where Viome really falls short in my opinion. The company is— the marketing has gotten way, way ahead of the science and I have yet to see anything accurate from that company.

So while you might get a little bit of information regarding the type of species of gut bacteria present in your intestines, I would say that's about all you're going to get. And what you're going to do with that data is kind of up in the air. It's like, well, I don't know anything. You know, you might not really know anything or what to do. And I certainly wouldn't go under the guidance of what Viome is telling you because it is completely marketing. And I haven't seen anything that suggests otherwise. So it is my opinion that it is not worth doing Viome.

So today we're going to start off with a couple of related questions that many people have submitted in some form or another, mostly because I've had a variety of science experts, health experts on the podcast that have talked about aging and longevity, and specifically Dietary protein intake and how it can affect the way we age. So a few years back, I've had Dr. Valter Longo on the podcast a couple of times. And in fact, he'll probably come on again. He's got some new, really interesting research on cancer and fasting-mimicking diet. And he's a real big proponent of low protein intake, and we'll talk a little bit about why that is.

But I think where the confusion has come in is recently I've had another podcast guest on, Dr. Stuart Phillips, who is a muscle protein synthesis expert, and also his work relates to aging and longevity. And he is sort of on the opposite end of the spectrum of protein intake as Dr. Valter Longo. And so there have now been a variety of people submitting questions to me about protein intake and longevity. So the first question I'm going to address specifically was submitted by Kim. And again, many people submitted this in some way, shape, or form.

So Kim says, can you address the conflicting evidence or advice about protein intake between Valter Longo, who recommends low protein intake for longevity, about 0.3 to 0.35 grams per pound of body weight, and Stuart Phillips, who recommends a higher protein intake for longevity, around 0.5 to 0.7 grams per pound of body weight, mainly since they are both interested in extending healthspan. So I'm going to be talking about grams per kilogram body weight because that's what literature talks about, and Stuart Phillips recommends around 1.2 to 1.6 grams per kilogram body weight, whereas Valter Longo is more on the low end of what the RDA recommends. In fact, even maybe lower, 0.7, you know, 0.8 grams per kilogram body weight.

So I think first and foremost, one of the most important things when looking at what these 2 different researchers are what they're researching and what they're communicating is the audience they're communicating to. With Valter Longo, he is really often speaking as a matter of public health. And what I mean by that is there is an epidemic of obesity in the United States. And he is really coming at this from a public health perspective that We've got overweight people, we have obese people, and that is accelerating the aging process. And they are getting way more than enough protein, they're getting way more than enough carbohydrates, they're getting way more than enough of everything in calories.

And so honestly, I think people that are overweight and obese need to focus on losing weight and not focus on their protein intake. They need to focus on losing weight, and there's a variety of different different ways to do that. Of course, fasting and caloric restriction being one of the most well-studied and well-researched ways, as well as there's other ways. For some people, carbohydrate restriction works. Ketogenic diets work for some people, not everyone. But, you know, at the end of the day, exercising and eating fewer calories is pretty much a gold standard for weight loss. I would say that sort of understanding that audience versus what Stuart— who Stuart Phillips is mostly talking to.

Stuart Phillips is talking to an audience that generally speaking is physically active and they are, you know, obviously interested in training, interested in maximizing their muscle protein synthesis, but he's also speaking to an aging audience. An aging audience that is battling sarcopenia or what's known as age-related muscle mass loss. And because there are 2 really main signals that basically activate muscle protein synthesis, one of them being protein intake, specifically essential amino acids. And even if we go down further, it's leucine, a very specific branched-chain amino acid. That is why Stuart Phillips sort of focuses on protein.

So the audience is important, again, and I think that first and foremost, considering who these different researchers are speaking to is important because then it kind of makes a little bit more sense. But I think second, we need to start to look at human evidence. And unfortunately, with human evidence, when you're talking about aging and longevity, you're talking about all-cause mortality or disease-specific mortality like cancer, for example, you're unfortunately going to be relying on observational data, which is totally riddled with confounding factors.

And, you know, at every step of the way, while there have been many, many different observational studies that have found lower protein intake is associated with a lower all-cause mortality and a lower cardiovascular-related or cancer-related mortality, this disappears when you correct for confounding factors. In fact, and I've talked about this many times, people that have no unhealthy lifestyle factors and eat more protein from meat, from meat and poultry and fish, they have the same all-cause mortality and the same cancer-specific mortality as individuals that are eating a more vegetarian or vegan type of diet that are taking in a lower protein content.

So I think looking at the observational data, we can infer that If you are unhealthy, if you are unhealthy generally being defined in the scientific literature as being overweight or obese, being sedentary, so not being physically active, smoking, excessive alcohol drinking, these are really factors that need to be taken care of before you worry about protein intake. So again, going back to if you're overweight or obese, focus on losing that weight first and then other stuff can be sorted out. First and foremost, if you're physically inactive, get active. Start exercising. Start moving. Very, very important. If you're smoking, you've got to quit. Quit smoking. You know, you shouldn't be drinking, you know, 3 beers a day. So those things need to be sorted out.

And in fact, if you don't sort them out, then science really does suggest that a lower protein intake may be beneficial because— you have an unhealthy lifestyle factor. So I think looking at the human evidence is really important. And again, you know, looking at the confounding factors is really important. But also the human evidence for muscle mass is important. And there's also observational data looking at muscle mass and mortality, and it's inversely related to mortality. So increase in muscle mass is associated with a decrease in all-cause mortality. And the opposite is true. When you have a decrease in muscle mass, there is an increase in all-cause mortality.

And because in order to maintain muscle mass, you need to consume essential amino acids, specifically you need to consume leucine, and we'll talk a little bit about why that is in a little bit. When it comes down to it, unlike carbohydrates, unlike dietary fat, which can be stored for later use, so you can store carbohydrates as glycogen, You store fat as triglycerides. Amino acids, they're used up. What you put in is what comes out. And there's no way of storing it, although you can break down muscle to get amino acids, right? So that would be muscle breakdown, the very thing we're trying to avoid. So I think, you know, understanding that Amino acids are very different than dietary fat and carbohydrates. You don't store it. And so you need a constant influx of it, right?

And when you think about protein intake from a recommended dietary allowance or RDA, it's the amount of protein that you need to ingest to replace all the protein and amino acids that your body loses on a daily basis. Okay? Most of that's also— a lot of it's lost as urine. The RDA for protein intake is 0.8 grams per kilogram of body weight. Now, this is where Stuart Phillips has really shed some light on the research that went into this. The research that went into deciding that number, 0.8 grams per kilogram body weight, was based on what are called nitrogen balance studies. Studies, which back in the day, they were used to trace things and figure out and quantify different things like basically figuring out how much amino acids you need to take in to replace losses.

However, as science progresses, we learn, okay, there's actually a lot of problems with that method, and they're including incomplete collection, overestimation of losses, and a variety of other problems. So what Stuart and other people have done, that's not just Stuart, there's a lot of different researchers that have done different stable isotope tracer studies. And what they found is that that 0.8 grams per kilogram of body weight actually is not accurate. What they found is that 1.2 grams per kilogram of— it's 1.2 grams of protein per kilogram of body weight that is actually closer to meeting that minimum protein intake required to replace all the amino acid losses in a day.

And from there, even 1.2 might be on the lower end, especially if we're talking about physically active people, certainly athletes. That goes up to 1.6 grams per kilogram of body weight. So there's a little bit of a sliding scale, 1.2 to 1.6 grams per kilogram of body weight. And, and that's where, where the number comes in with Dr. Phillips, is that his stable isotope tracer studies along with Other researchers have really found the RDA of 0.8 is just not really enough to replace all the amino acids we lose in a day. And when this becomes even more important and even more critical is in an aging population. Now, this is even where Valter sort of gives a little bit and he says, okay, as you start to get older than 65, you actually need to take in more protein.

He still isn't getting— he's not hitting the right level, but at least the concept is there. And, you know, the reason for that is because as we get older, we don't respond to leucine as well as we did when we were younger. So there's 2 signals for muscle protein synthesis: leucine, which is the amino acid, protein, right? And mechanical force from exercise. And those are the only 2 things that are going to stimulate muscle protein synthesis. So as we're older, we still have that mechanical force option. And so resistance training is highly, highly, highly important for battling sarcopenia and age-related muscle loss. And the other thing is, though, is the leucine intake, the leucine content from essential amino acids. from dietary protein. And we become— it's anabolic resistance.

We become like less— leucine is— there's less bang for your buck there with the leucine. And so you have to take in even more protein, even more leucine at that point to kind of get the same amount of bang you would get for a little lesser amount when you were younger. So with the aging population, even closer, you know, 1.2 grams per kilogram body weight sort of minimum. and going up to like 1.6, certainly in aging older people that are physically active, it's no doubt. Stewart showed that empirically, 1.6 is better. So that's really where my views have kind of changed. And now when we get into a little more mechanistic detail, this is where we always rely on animal evidence. And there's a lot of benefits to using animal evidence.

You know, maybe people have even criticized me in the past of at times being overenthusiastic about a certain type of animal evidence, and I'll admit to that. But, you know, so animal evidence, there are things we can do with animals that we just will never get with observational data, mechanistic insights, right? There's a lot of really important evidence, but that evidence has to be looked at under the lens of relevance to humans, how much it translates to humans, and then the bigger picture. What does the human evidence show, right? So there's these different sort of arenas of scientific evidence.

So with the animal evidence, there has been much effort and I would say buzz about low protein intake and longevity because when you restrict a rodent, a mouse, of dietary amino acids, it improves their healthspan. It improves the way they age and to some little bit of degree their lifespan. Now, when we're looking at the healthspan, I mean, things that are improved from low protein intake, increased insulin sensitivity, the animals become more insulin sensitive, they're less likely to get diabetes, they have a lower risk of cardiovascular problems, they're improved cognition and memory, They have increased thermogenesis. That's the, you know, the basically browning of fat and the ability to burn more fat even at rest.

These things, like, there are so many factors that regulate these things in humans. Insulin sensitivity. I mean, exercise. The biggest is exercise. You know, making sure you're not eating refined carbohydrates. Like, I don't think you have to Decrease your protein intake to increase your insulin sensitivity in a human. There are other ways to do that, right? Same with cardiovascular problems. Again, exercise, not being overweight, sauna. I mean, these are things that people can do that have been shown to improve cardiovascular health robustly, robustly in humans, in humans. Okay? I'm not talking about animals. You know, cognition, memory, again, exercise, a lot of different dietary compounds, again, just not being overweight or obese.

The thermogenesis is another one, exercise, cold exposure. There's so many different factors that regulate what little bit of benefit that decreasing protein intake in rodents gets you that I just find it Irrelevant, to be honest. I don't—I'm like, okay, well, great for the rodent who isn't going to be you know going out and running and lifting weights and isn't going to be going in the sauna and doing cold exposure. And you know they're they're getting a very controlled fed diet and they're not taking fish oil. Like there's so many things that humans can do to to to basically improve all those factors. And then here's the even more important thing is that animals are housed in a very sterile environment.

They're, you know, they're not being exposed to influenza or to SARS-CoV-2 or to rhinovirus or herpes or, you know, any other disease, infectious disease that humans are exposed to. They're in a very controlled sterile environment. They're fed a certain amount of food. They're not. I mean, it's they're not. It's it's it's a very different environment than humans live in. Okay, so humans as we age, we and this is where Stuart Phillips has really shed a lot of light, and I thought made a lot of sense where he talks about what he calls a disuse and disease event. We're exposed to these events that end us up in the hospital for a couple of weeks where we're no we're immobilized. We're not using our muscles. Okay, we're not getting that mechanical force stimulation.

And when that doesn't happen, our muscles start to atrophy. And it's a big problem. And I've witnessed it with my grandmother. Anyone with an aging grandparent or parent that has seen, you know, like even surgery, scheduled surgeries can precipitate this where, you know, anything that winds someone up in the hospital for a couple of weeks or even less, they're in the hospital and then they're immobilized for a couple of weeks even when they're at home, right? The trajectory that they experience after that is exponentially downward. They start to like have so many problems and age so rapidly. And a lot of that is stemming from muscle mass loss because protein intake is so essential for older aging people and throughout early adulthood as well, having building up a muscle reserve.

So that when you have that disuse event, you have a reserve. You have something there that's allowing you to to have a little bit of flexibility, a little bit of time to be immobilized, right? If you don't have enough protein intake throughout young adulthood, you're going to compromise that muscle reserve to some degree. You are. So I think I think knowing that animal evidence, while a lot of researchers like to cite. Animal evidence, and there's a lot of it, about, oh, it improves their healthspan, oh, they live longer. Again, at the end of the day, is it really relevant? Is it— I mean, increased insulin sensitivity, big whoop-de-doo. Like, is it really that relevant? Can we find other ways to do that without compromising our muscle mass? I think we can. I think we can.

And so I've really— again, I think it also just comes down to that public health perspective. You know, maybe a lot of researchers like Valter are talking to an overweight, obese audience where they're saying, okay, you need to lose weight and, you know, basically lowering protein, lowering all calories will get you there, is an important thing to keep in mind. And I think that, you know, Valter has done really impeccable research, specifically he's done a lot of animal research as well. But I think at the end of the day, there's a lot of nuance here. And again, Valter is not speaking to the same audience that Stuart is speaking to. And I think that That is also really important. And when it comes down to it, I think the defining factor here is actually physical activity, exercise.

And another question that was related was submitted by Merrilee. And Merrilee was talking about how Valter, again, is a proponent of lower protein intake. And she says, he also indicates that mTOR growth pathways in the muscle and in the rest of the body are not separated. For example, things that promote muscle growth may also promote cancer growth. All of these top— these are all top scientists. How do we reconcile these conflicting ideas? So to kind of just build upon what we've been talking about, we were talking about leucine and, you know, this branched-chain essential amino acid that is key for activating muscle protein synthesis. Well, it does it through one of the mTORC pathways. So there's 2 different mTORC components. There's mTORC1 and mTORC2.

And they both play a role in muscle protein synthesis and hypertrophy. They are pro-growth factors. mTORC1 is activated by leucine, essential amino acids, specifically leucine. mTORC2 is activated from, again, the mechanical force, this what you're applying when you're doing resistance training. So the combination of the two are really dynamite for muscle protein synthesis. And so what Merrily was talking about that Valter, you know, alludes to is that while mTORC is good for muscle protein synthesis, it also, since it is a pro-growth signal, it can signal to other cells to grow. And of course, those other cells could be precancer cells, cancer cells. And when that happens, it basically allows cancer cells to start to grow and grow where eventually a tumor can form.

So mTOR does play a role in cancer, but this is where, again, understanding mechanism is really important. And There have been a lot of studies where animals are transplanted with human tumor cells. So like, for example, breast cancer. They're transplanted into the rodents, into the mice, and then mice are fed a high-protein diet or a low-protein diet. And the mice fed a high-protein diet are activating their mTOR and the cancer cells are growing, and basically, it really accelerates tumor growth. And this is kind of where some of this, the idea that, oh, protein is bad. It's like we got to limit it because it can allow cancer cells to grow. And it does. It can. It's absolutely true.

However, it's important to keep in mind, again, one, feeding the mouse a high protein diet and not transplanting them with the tumors does not make them spontaneously just form tumors. Okay. The important thing, even more importantly, is Leucine activates mTOR1, mTORC1. Okay, that's true. But exercise causes branched-chain amino acids, including leucine, to be taken up into muscle cells. It gets out of circulation and it goes specifically into muscle cells. And what it does in the muscle is activates mTOR confined to the muscle. Okay, confined to the muscle.

This is one of the reasons why exercise also is is so beneficial for mood because branched-chain amino acids, when they don't get taken up into muscle, yeah, they're activating mTOR systemically, but they're also competing with tryptophan to be transported into brain. And so when you exercise, those branched-chain amino acids go into muscle. Leucine is going into muscle. It's not out in circulation and allows tryptophan to get into the brain to make serotonin. You know, that does a variety of things for cognition, for mood, for impulsive behavior, long-term planning, all those important cognitive processes. But more importantly is it gets leucine out of circulation and puts it in the muscle and specifically activates it in the muscle. So what do I think about protein intake and longevity?

I think protein intake and longevity, I think there's another key factor, and that key factor is Exercise. Exercise is so important if you're going to be taking in dietary protein. And I think that if you really care about longevity, what you won't do is just be, you know, sedentary and lower your protein intake. Because yeah, maybe you'll have a little, you know, you'll, you'll, by, by lowering your protein intake and being sedentary, you'll, you'll decrease a little bit of mTORC activation and lower your chance of You know, getting cancer, allowing cancer cells to grow uncontrollably, but you're not building your muscle reserve, and that is key for aging. And if you're taking in more protein and you're taking in enough to replace what you're losing and you're exercising, it's dynamite.

It's dynamite for aging, and that's, I think, the way to go. And so my perspective is I'm personally— and since I've been— since I've had a discussion and done a lot of reading and background research, For the Stuart Phillips podcast, I am 100% convinced that the the best thing I can do for the way I age is take in at least 1.2 grams per kilogram of body weight and to do more resistance training, which I have absolutely been doing. I've really been important about doing that since I guess it was you know June beginning of June when I when I recorded this. So, I'm now turning to the chat because that was a little bit of, again, my thoughts and rants. But I think I've covered a lot of, you know, important factors there.

And Chuck's talking about the Seventh-day Adventists who age better with lower animal protein. Again, going down to who we're comparing this to. In most of those studies, they're being compared to the average American that is sedentary or overweight or— they're not comparing Seventh-day Adventists to people that are physically active, taking in more protein, not eating refined carbohydrates, that are being— that are taking fish oil and vitamins and getting their micronutrients and doing the sauna. Yeah, okay, maybe again when you're talking about an obese— someone who's obese or overweight, or someone who's sedentary, or someone who smokes, or someone who drinks excessive alcohol, you know, then in that context maybe lowering your protein intake is good.

Or you can just not have that unhealthy lifestyle factor and then take in more protein, right? So again, that's been shown. So it's one of those things where people like to cite the Seventh-day Adventist data and it makes sense when you're comparing it to the standard American diet, to people that are overweight or obese, to people that have an unhealthy lifestyle factor. But what about people that— I haven't seen any of the Seventh-day Adventist data do the large comparison like some of these other big, big epidemiological studies that have looked at unhealthy lifestyle factors. And so my guess would be if you did that with the Seventh-day Adventist data, you'd see the same thing when you correct for any If someone has no unhealthy lifestyle factors, that protein intake doesn't matter.

And, you know, at the end of the day, I think that's pretty compelling data. So I think I've pretty much covered that, you know, and, you know, the thing that was also kind of interesting, and I see people sort of asking this in some form in the chat, is vegans and getting enough, specifically leucine, right? Because we're talking— when we're talking about vegetarian protein, we're talking about really getting leucine. Leucine is what is activating mTORC1 at the end of the day. That's what's— that's the— that is how the protein is stimulating muscle protein synthesis through leucine. Animal products are higher in leucine than plant products, fact.

So Stuart, when I asked him in the podcast, I said, well, what do you think about vegetarians, you know, and muscle protein synthesis and being able to, you know, basically stimulate muscle protein synthesis, stave off atrophy and stuff. And he said that his view has changed over the years, mostly because he thinks that if there is, you know, people that are following perhaps a vegan diet, they can be very thorough and calculated about getting the right types of protein, making sure the protein sources are high in leucine, as well as there's now supplementation. Like, you can supplement with leucine. You can supplement with a variety of even, you know, vegetarian or vegan protein powders.

Now, some vegetarians will eat egg whites, and I think that's the best if you're a vegetarian because egg whites are high in leucine. But again, so it just all comes down to having the knowledge, okay, I am a vegetarian, I am a vegan, I need— and I am also physically active. I need to make sure that I am getting enough of my leucine specifically. And in order to do that, I'm going to supplement with these powders. I'm going to make sure I'm getting enough of these different types of foods that are higher in leucine throughout the day. So I think that it is very possible, again, to stimulate muscle protein synthesis. It may be more work because you have to think about it a little bit more. But it's very— at the end of the day, it's very possible to do.

Deborah is asking about anyone finding a protein powder high in leucine. I've been using Thorne. Thorne's— their essential— their amino acid mix, which is kind of lemon flavored. And then I've been using the egg white protein from Julian Bakery, and it says paleo on it. And I use it in like my smoothies. I put it in my son's smoothies. It's pretty high in leucine as well. I think that like looking to third-party testing, making sure sometimes even people with big names that are— that you think are reliable, I'll just give you an example. Dave Asprey has a cacao chocolate powder thing. It's like collagen cacao and it's supposed to be really good for you. ConsumerLab measured the amount of polyphenols from the chocolate and measured the amount of contaminants.

And of a list of like 25 different brands of powdered chocolate. His was the worst. It had the lowest polyphenol content and it had the highest cadmium and lead. It was cadmium and lead or cadmium and arsenic. I can't remember, but it had the highest cadmium contamination levels out of all the different 25 brands. This guy claims to have the purest, cleanest supplements and products. Beware, just beware. Like that, you know, I would say that going to third-party testing sites is probably really important if you're going to start supplementing with a product. Thorne has— there's a lot of third-party testing on it.

I've also, you know, I've had researchers, scientists, friends that have tested a variety of things, a variety of their different supplements, and they're really pretty high quality, which is why I kind of turned to them. The Thorne product was— it was like amino acid complex or something and it's a powder. It's lemon-flavored powder and you kind of just put it there. They also have a chocolate and vanilla-flavored whey protein that has— I think it's sweetened with like stevia. It's pretty sweet. I do put it— I prefer the egg white protein powder which is unflavored for me, but my son who also again Growth signals during development are also important for activating IGF-1 in addition to mTOR, which again is important for height.

So I put it in his smoothies because any parent out there knows it's very challenging to get your kids to— kids are like carb lovers, you know, so getting them to eat enough protein and meat is often challenging. Okay, so I'm going to move on to the next question, which was submitted by Liz. Um, this is kind of a short, short answer question. Liz says, exercise is known to increase the number of mitochondria in muscle. So this is called mitochondrial biogenesis. I wonder if the recent discovery of mobile mitochondria in the bloodstream suggests a mechanism by which exercise affects neurodegenerative diseases like Alzheimer's or Parkinson's, and if so, which type of exercise could maximize the effect? There was a recent study that found functional mitochondria in blood.

The authors speculated that the function of these blood mitochondria was for cell communication rather than transporting to new tissues. Some have also speculated that mitochondria, they're from damaged tissues and it triggers inflammation similar to how extracellular ATP can trigger inflammatory processes. So it's possible that they do not come from damaged cells and they do replicate on their own in the blood. So that is a possibility. I would say there's no data to suggest that they can— the mitochondria can go into neurons or even cross the blood-brain barrier. But exercise does benefit those people with Parkinson's and, you know, in Alzheimer's disease. I don't know that it's— I don't think it's because of the mitochondria mechanism.

So really, Thanks for bringing this to my attention. I'll follow the research. It's certainly interesting to me. So the next question is kind of a big one. And I think it's one that a lot of people are interested because it has to do with NAD precursors. So the question was from Andrej. Andrej, sorry if I mispronounced your name. Andrej says, hi, Rhonda. I've been following you a long time and finally signed up for the membership. My topic suggestion is to discuss NAD in cancer, and he linked a paper which we read in detail.

And it basically—we're going to talk about what the paper said—but it was under—it was basically saying that potentially, you know, NAD could promote cancer growth, and that you know maybe there's a concern with taking these NAD precursors, or as David Sinclair calls them, NAD boosters like nicotinamide riboside or nicotinamide mononucleotide. So let's talk about a quick reminder what NAD+ is. It's an electron carrier that participates. It's a coenzyme in many different metabolic pathways. So one family of enzymes that consumes a lot of NAD+ are those that repair DNA, and this is called PARP. And anytime there is damage to DNA, that PARP enzyme is recruited. It moves to the site of the damage in your DNA, And it starts to repair that damage.

But the PARP needs NAD, a lot of it, to repair that damage. So when you have a lot of signals, so let's say there's a lot of— let's, I mean, obviously one would be you're exposed to a lot of ionizing radiation or something, right? Let's say you're undergoing cancer chemotherapy. You're constantly damaging your DNA to a very high degree. Your PARP is going to be— it's going to need so much NAD. There's just no way that NAD is going to be available for hardly anything else, honestly. And so, you're tired, you're lethargic, other things aren't working properly, right? So, it's really— it can be this NAD sink, right? It's a sink for NAD. Other obviously unhealthy lifestyle factors also increase DNA damage.

So, I gave you an extreme, but there's also just, you know, even normal metabolism and also being type 2 diabetic or insulin resistant and making your metabolism inefficient, you're leaking out more damaging oxidative-producing species called reactive oxygen species that are damaging DNA. So that also is just another example of chronically needing PARP activation and chronically causing an NAD sink inside of your cells. Now, let's shift to cancer. So how do cancer cells use NAD? Because this is the concern, right? So because cancer cells have a lot of DNA damage and other— they have a lot of cellular damage, they also have a real high requirement for NAD. And so a lot of cancer cells will increase activity of enzymes involved in NAD production so that they can survive.

And spread because they need NAD to do that. And so they start to increase their intracellular NAD levels inside of a cell. And that basically, you know, it can basically cause a lot of dysfunction with other enzymes and stuff. And so you start to increase different types of these enzymes like NAMPT is one. This basically catalyzes the creation of NMN from niacinamide. So your cancer cells will increase that enzyme NAMPT, which does it. And so when you have— when you're taking in niacinamide, you'll make more NMN. And that basically is what, you know, some cancer cells will do. Other cells then, you know, also upregulate some of those pathways for other reasons as well. And there's a variety of different ones.

There's another one that's upregulated called NMNAT, and that is the one that converts NMN into NAD+. So you'll have 2 different enzymes that are increased, one that's converting niacinamide into NAD+. Nicotinamide mononucleotide, and then another one that's then converting the nicotinamide mononucleotide into NAD+. And so these are increased in a variety of different types of cancers. So cancers are doing this. They're basically— so the concern is, you know, what if I'm taking in NMN, right, orally, I'm supplementing with it, and these cancer cells have increased enzymes that are converting that NMN into NAD+ so that the cancer cells can use it to have more energy to grow. And so it becomes, you know, that's sort of the concern.

There's a lot of, you know, cancer cells use NAD+ for their growth, you know, and obviously I think because of that, there is concern for nicotinamide riboside, which gets converted into NMN, and just taking NMN. Orally, how that could potentially, you know, if you have some precancerous cells, then you're also fueling those cancer cells, right? So that would be a concern. So the paper that was linked by Andrés basically said that, you know, scientists, while we have a really sophisticated understanding of the role of NAD in aging and also in cancer metabolism, there haven't been any trials that have manipulated NAD levels in humans with cancer or other diseases. And so, you'll find that the clinical trials that have involved any NAD precursors, like— and a lot of them have been NR mostly.

There's been one that I remember with NMN. You know, you're basically doing it in either healthy people. I think there may have been one with— overweight people as well. But you're not getting— you're not— you're certainly not doing it in people with cancer, uh, you know. So I think that would be a concern. Um, there's also a lot of drugs that inhibit those enzymes I was talking about that convert NMN into NAD, and it is associated with a better prognosis. So essentially inhibiting the production of NAD in cancer cells does kill the cancer cells, and it is people that are given drugs that inhibit those enzymes do have a better prognosis. So there, there is some evidence that you don't want your cancer cells to have uncontrolled access to producing NAD.

Um, there also is a lot of side effects with those drugs. Again, I mean, NAD is important for not just cancer cells, but it's important for all cells, right? So, so much like chemotherapy, which also damages normal cells, there's, there's terrible side effects with, with doing that. So the question is the NAD precursor treatment, um, you know, oral supplementation with NR, oral supplementation with NMN. This has become very popular. It's, you know, there's been a lot of— mostly based on animal evidence. There's animal evidence. Again, the animal evidence We've talked about this in the past. I have a video out there on NR, NMN, and NAD.

And the animal evidence, the levels are so incredibly high that there's no way that humans are going to get those levels from orally supplementing like they do with the animals. And we don't know that supplementing with the high of a dose as those animals are getting would even really be beneficial. So, you know, on the one hand, it's possible that supplementing with NAD precursors could be terrible or exacerbate cancer progression or, you know, possibly fuel precancerous cells. But on the other hand, you know, perhaps the NAD precursors are, you know, helping normal cells in a favorable way that's preventing them from getting cancer, right? Because NAD is required for repairing damage from— this enzyme PARP, DNA damage can lead to cancer if it's not repaired.

So it's kind of one of those things, you know, where I would still like to see more evidence. I'm currently not supplementing with them, as you guys know. So, you know, I think what the evidence— what the best evidence for NAD supplementation in cancer, what we have so far is, you know, the study, and I've talked about this in the past, this was in I think 2019. And there's been— oh, there's been some additional evidence in 2021 that was published. And injecting or orally administering NMN to mice increases their cancer-fighting natural killer cells, which is kind of— that's good to know that somehow the natural killer cell number was increased. Although it didn't increase them in aging or young mice. It didn't increase the cell number, it increased their activity.

So, it wasn't that they were having more natural killer cells, they were having more active natural killer cells. Sorry, I didn't communicate that properly. There was another study in 2021 that showed NMN combined with Lactobacillus fermentum reduced photodamage in skin cells. So maybe some relevance for skin aging, but there's a lot of other safe things that can be done for skin aging. There was a report where 10 healthy human participants were given intravenous NMN, and it did increase their NMN levels. There was no other biomarkers that showed damage, but they didn't measure any cancer biomarkers. I think there's really additional evidence that needs— we just need more evidence before really embracing, I think, NR and NMN supplementation. I know David's a big proponent of it.

You know, he doesn't— I haven't really heard him talk much about NMN and cancer. You know, so I'm just sort of keeping my ear to the ground and kind of listening and waiting for more data. And, you know, anytime new data comes in, trying to review it. But my thoughts are, honestly, I always sort of err on the side of caution. Other people like to be very experimental and they like to try new things that come out that could potentially be beneficial before the data really shows that they are beneficial and that they are safe and not— there isn't a trade-off. So those are really my thoughts on NAD precursors and cancer. Chris Moore is asking in the chat about My thoughts on dairy consumption and insulin resistance.

And I did cover this in a previous Crowdcast episode, which we will start having these sort of archived on the dashboard very soon so that you guys can kind of look through just even the chapters. But for now, you can go back in the YouTube channel, has chapters as well, or even in your private podcast feed or in the dashboard. There are chapters there, and so you'll see dairy consumption, insulin resistance. So you'll see that section there in one of those Crowdcasts. It was a few months ago. I can't remember off the top of my head which Crowdcast, but we went into great detail on that. So another question was submitted by David.

David says, hi Rhonda, any thoughts or recommendations regarding the recent interesting study that cereal fiber seems the most healthful And plant fiber such as from artichokes and asparagus can even be harmful in larger amounts. And David then linked a study. So the study that was linked investigated how 2 common forms of fibers— so there's inulin or long-chain inulin and another type of fiber, this arabinoxylan, and how those 2 types of fibers can affect the microbiome. It was a relatively small study. It was 18 participants. So the type of fiber that is from whole grains, so that would be the arabinoxylan, that's typically found in whole grains. And then the inulin or the long-chain inulin is commonly found in like artichokes or chicory root.

So the whole grain fiber is associated with a reduction in LDL cholesterol, which may explain why a high Fiber diet can lower cholesterol, but if you extrapolate from this data, foods that are rich in this whole grain fiber, they also may be better at lowering cholesterol than other fiber-rich foods. The long-chain inulin, which is again found in some of the plants like the artichokes, it's associated with a decrease in inflammation and an increase in short-chain fatty acid-producing bacteria like butyrate, which is really, really good for the gut and gut health and preventing intestinal permeability. However, at a really, really, really high dose, you can increase inflammation and liver injury. It's really hard.

It's almost like to get that really, really high dose is extremely challenging, but it can be done. Foods that are really high in inulin are, again, chicory root, as I mentioned, artichokes, garlic, and dandelion greens. So I would— as long as you're not just eating a single food diet where like, the only vegetable I eat is artichoke. I wouldn't be worried about getting like the highest dose of inulin. That has the opposite effect. So while, again, most inulin decreases inflammation and protects against intestinal permeability, if all you eat is artichokes, then you might actually have the opposite effect. And that's kind of what the study was showing, that at like just unbelievably high doses, it can be harmful. So David asked a question.

He said, which form of choline supplement crosses the blood-brain barrier? and is best for brain health? I had thought it was phosphatidylcholine, but I keep seeing recommendations for alpha-GPC or CDP-choline for that purpose. So a little bit of background inflammation— information. Acetylcholine, it's a stimulating neurotransmitter in the brain. Decreased acetylcholine activity on nerve synapses is seen in disorders of cognitive impairment like Alzheimer's. In fact, one of the ways that cognitive impairment is treated is by basically increasing the acetylcholine levels. And so, there's a couple of drugs that are used to treat Alzheimer's by increasing acetylcholine activity in the brain.

So, working off of this framework, supplementing with choline can provide building blocks for the brain to make acetylcholine. There's really no head-to-head study that compares all the different forms of choline supplementation. There is more evidence to support some over the others. The 2 that have the most evidence are actually phosphatidylserine and CDP-choline. So interestingly, phosphatidylserine There have been randomized controlled trials that show 300 milligrams a day can preserve cognition in elderly patients that have, you know, age-associated memory loss, cognitive impairment, and even Alzheimer's disease. So this is different than phosphatidylcholine, right? Phosphatidylserine is a different compound. CDP-choline is also known as citocholine.

There's a lot of different studies that kind of back it up. Most of them are in traumatic brain injury. There's a handful of clinical trials showing that 500 milligrams a day can prolong cognition in healthy elderly patients, as well as patients with cognitive impairment and Alzheimer's disease. There's really sparse evidence for other forms of choline supplementation, like alpha-GPC or even phosphatidylcholine. So I think, you know, managing expectations, you know, if you're trying to help a loved one or even if you're wanting to supplement for yourself, most of the studies show that it slows down the progression of memory loss compared to placebo. Very few patients actually see improvement from baseline. And in those patients, it still takes like several weeks or months.

So I think what I'm trying to say here is if we're talking about a healthy young person that's wanting a cognitive enhancement, it's hard to say whether or not supplementing with CDP or CDP choline or the phosphatidylserine is really going to do much for you. But maybe perhaps for aging grandma whose memory is not so good, it might slow her progression so that her memory doesn't Her memory loss doesn't progress so rapidly. I think there's a lot stronger evidence for that than for it's going to boost— I mean, it's a nootropic that's going to make me smarter. So with that said, there are some foods that are rich in choline.

Those include egg yolks, as we've talked about, fish eggs, so a lot of different types of caviar, including salmon roe, which I like, fish itself, shiitake mushrooms, soybeans, almonds, and actually most meat. L is talking in the chat about Consumer Lab reports, which I'll talk about in a minute. One of the questions was about canned salmon and heavy metals with contaminating spices and stuff. I'm very aware of it. It's why I've been so hesitant to use turmeric, different turmeric brands with my cooking. I really do like Consumer Lab. They do I would say I don't think they're really good at interpreting the science. Like, they try— what they're good at is third-party testing.

So they go to the standard grocery store or standard, you know, dietary supplement store, and they take a random sampling of a variety of products, of, you know, whether we're talking about canned tuna and salmon, or we're talking about spices, or we're talking about dark chocolate bars or hot cocoa mixes. They take all these and then they measure concentrations of active ingredients. They measure concentrations of contaminants. And I think that is where they shine. That is very, very beneficial to have that data.

What they've expanded on of recent is they try to then become a source of health information where they then say, oh, these are what polyphenols are good for, or, oh, this is what vitamin C— I have seen so much of their interpretation wrong with the science that I wouldn't go to them for getting health information. I would go to them for getting empirical data. That's where there's— that's their strong suit, not interpreting of the science. That's not their strong suit. Whoever they're hiring, whatever their— whoever their analysts are, I don't know that they quite have a great understanding of things. The next sort of long-form question before we get to the rapid-fire questions was submitted by Hillary.

Hillary says, my husband was recently diagnosed with high cholesterol and prediabetic level of blood sugar. His doctor suggested statins. I've convinced my husband to first give a 3-month trial to lifestyle changes. So Reduce refined sugar, starches, more veggies, more exercise, intermittent fasting, anything else? I believe this is very fixable. So first and foremost, obviously, I can sort of talk about some of the scientific evidence out there, definitely not medical advice, and, you know, talk about these things, anything, any type of lifestyle changes you're going to do with your physician before implementing them. Obviously, there is a risk of having high cholesterol. It does increase the risk of stroke, and it does increase the risk of having a heart attack.

I've talked about this before, and there, there's a website that you can go to to calculate your risk of having a heart attack over the next 10 years. It's called the ASCVD Risk Estimator Plus. So that's the American College of Cardiology. And you type in a bunch of things. I'm linking it here in the chat. We'll also link it in the show notes that we send out, but it's really sort of a good tool to use. So if the risk is greater than 7.5%, then, you know, that's where I think rather than just looking at cholesterol levels itself, you know, using this calculator to look at other factors that can help decide, you know, whether or not lifestyle changes, you know, or a statin, you know, that may be required, especially if there's like familial hypercholesterolemia or things, you know, a familial risk of having a heart problem, you know, earlier in life.

Some of the obvious things that were not mentioned that I think would be— are so obvious that they don't need to mention is obviously smoking. Smoking is one of like— people always think about lung— think about smoking and lung cancer risk, but smoking is like one of the biggest lifestyle factors that will increase the risk of having a heart attack. It's so bad for the heart. It's unbelievable how bad it is for the heart. Like, I would— like, you could just shovel in a bunch of saturated fat and it, you know, wouldn't have any of the effect that smoking is having on heart disease risk. Um, losing 5 pounds of fat, this, this will actually impact, impact, um, the other modifiable risk factors.

So actually losing 5 pounds of fat can lower LDL cholesterol by 5%, but it can lower the risk of a cardiovascular event by 25%. Um, so really that is important. Losing weight also prevents you from getting type 2 diabetes. When you start to have high levels of blood glucose that remain elevated, so you have a high HbA1c, that— so an HbA1c over 6.5% can increase the risk of having a cardiovascular event as well. So the other thing that losing 5 pounds of fat will do is it will decrease blood pressure, which by almost 5 points, which is also Has a profound effect on cardiovascular health and also brain health as well. So I think that a good goal would be to lose five pounds of fat, and so you can do that by optimizing dietary and lifestyle factors. We talked about caloric restriction.

If you are doing fasting, make sure you're getting enough protein because what people tend to do when they're fasting is they end up skipping meals, and then skipping a meal means skipping protein and getting that you know getting that 1.2 grams of dietary protein per day. Again, can be challenging to do if you're skipping meals. But on the flip side of that, if you're an overweight, obese person, maybe it's not such a big deal to focus on immediately until you actually start losing the weight and then focusing on optimizing protein intake. And then the exercise itself, you know, honestly, just having like about 2.5 hours of combined exercise per week is really ideal. And, you know, a lot of people talk about 10,000 steps every day and that's kind of what it sort of translates to.

You know, with the intermittent fasting, if that's a route that people, again, are going to take, you know, making sure you're eating the right foods within your time, within your window, right? So avoiding the refined sugary, you know, meals. And in some cases, some people can benefit from lowering salt, but that might— there's a lot of genetics involved in that. If you have done a 23andMe or AncestryDNA, run your report through our genetic report because we do give information on the SNPs that regulate blood pressure with salt intake. And then, you know, eating a lot of fruits and vegetables really is important for lowering cholesterol. The fiber really helps.

And that would be things like artichokes, garlic, oats, Flaxseed, apples, berries, romaine lettuce, that stuff really does help as well. And then, of course, maybe replacing some of the saturated fat with monounsaturated fat. So that would be avocados or olives or olive oil instead of so much butter, or polyunsaturated fat like salmon. I would stay away from vegetable oil. Vegetable oil is not really good, but polyunsaturated fat from nuts or from fish, like fatty fish like salmon. So those would be some of the things to try. Okay, so rapid-fire question. This was a top upvoted question from Caitlin. Canned wild Alaskan salmon.

Are there any concerns related to consuming canned wild Alaskan salmon compared to fresh or frozen with regards to the nutrient profile or safety of fish in this form. I started buying Kirkland brand, and this seems to be the easiest and cheapest way to get multiple servings every week. This is where I do turn to ConsumerLab for this sort of thing. According to their data, Kirkland brand wild salmon is very low in contamination metals like mercury, and it's got an average amount of EPA and DHA. So it wasn't like really on the low end. But it wasn't like the highest either. So there are— you can again look for ConsumerLab and see if you're looking for a higher EPA or DHA brand. But at the end of the day, cost is also an issue in this day and age.

And so I think the Kirkland brand is pretty reasonably priced. So, um, you know, the fact that it's pretty moderate amount of EPA and DHA and is low in mercury is, is, um, quite encouraging. In Life Force, Tony Robbins talks about a new skin cream called OS-01 by OneSkin. He said OneSkin's experiments have shown that this proprietary peptide can significantly decrease the level of senescent cells, reducing the age of the By several years at a molecular level, have you heard of this? And if so, what do you think? So I didn't hear about it until I looked it up, and apparently David Sinclair has talked about OneSkin as well. I looked at the ingredients. I will say, you know, it's got some good ingredients.

Like the biggest one that sort of differentiates them from like other brands that I like, like Cellbone. Is they have allantoin, but Cellbone has some products with allantoin. Allantoin is kind of, you know, it can really help, um, get rid of dead cells and, uh, replace— help stimulate replacing them with new cells. It's really quite beneficial for skin. I think it's way, way overpriced for what the ingredients are in it. I think that the proprietary peptide has really nothing to do probably with its effect on the skin, and a lot of it has to do with the other components in there.

And to be honest, I think the Cell Bone Neutralizer, which is what I use, is just as good, if not better, with respect— the way a lot of this stuff works, and let me just be completely honest with you, okay, is not by, you know, decreasing levels of senescent. Like, it's so hard to get some of these ingredients to penetrate deep enough to affect things on that molecular level, a lot of what they do is plump the skin up. And so while you're wearing the cream, it looks good. And when the cream gets washed off, you're not going to have— like, it's not going to look as good. Like, you're not going to be as plump looking and moist and youthful. So, but I mean, you know, I just— let me just say, I don't think it's worth it. I just think it's probably a lot more marketing.

And I think that some of the— a lot of the ingredients in the— in there is like, they're good, they're good ingredients, but I think you can get those same ingredients for a fraction of the price without all the marketing hype. Supplementation with hyaluronic acid seems to be gaining some hype at the moment for reducing wrinkles. The proposed benefits seem very similar to the benefits gained from taking collagen. What are your thoughts on supplementation with oral hyaluronic acid? Or also combining the two. So, um, I would say that I looked— I mean, really, there's just a couple of studies showing hyaluronic acid supplementation helps the skin. Um, like literally just a couple.

And in fact, the author of the studies show— show work— they work for a company that makes a hyaluronic acid supplement. So there's a pretty big conflict of interest Not that that's necessarily the deciding factor, but it sort of makes you raise your eyebrows a little bit, right? It's like, oh, there's 2 studies only, and both of the studies are from researchers that work for a company that makes a hyaluronic acid supplement. So maybe, maybe not. I don't know. Definitely hydrolyzed collagen is, you know, there's a lot of evidence. And I think it's pretty robust. Check out our hydrolyzed collagen topic page to learn more about that. I also think there's a lot of evidence about the polyphenols found in chocolate.

And this is one of the— that's one reason why I do take CocoaVia, which is a pretty concentrated cacao polyphenol supplement. It also increases vascular health and improves blood flow to the brain. And that's another reason why I do it. But so I do think that, you know, Hyaluronic acid supplementation, oh, maybe, you know, I'm not super enthusiastic about it. In your talks with the expert on moringa, so that would be Dr. Shad Fahey, you mentioned that he activate— that moringa activates similar pathways as sulforaphane, so that would be NRF2. Is there any reason to not supplement with both sulforaphane and moringa? I don't think there's any reason to not supplement with both, to be honest. Refrigerated probiotics.

So Jen submitted a question, says, what are the main differences between refrigerated probiotics versus shelf-stable products? And do you feel shelf-stable is better due to the theory that they would be able to pass the GI tract without being affected by, you know, different acids and stuff and heat from stomach juices? I can see a theory, a theory for, you know, an argument why that could be true. But when you look at empirical evidence, of course, there's the question of amount of bacteria. So just sheer concentration, right? And when it comes to sheer concentration, I haven't seen a shelf-stable product that compares to VisBiome numbers. So the 450 billion per sachet packet versus— A pill with maybe 10 billion.

So, you know, I think that there are a couple of things to consider there because maybe you'll have more survive, but when you're talking about, like, orders of magnitude more bacteria making its way through, that also makes a difference. So I think that there's other factors to consider in addition to being affected by stomach juices. What foods should not be paired with dairy because it blocks antioxidants? Does consuming berries with yogurt negate the effect? Making frozen treats for my kid that has kale and milk in it. I remember you once saying not to mix milk with cacao or chocolate. I would love to understand this better.

So yeah, there's evidence that there is a protein, salivary protein A, present in dairy that can sort of bind polyphenols from blueberries or chocolate or green tea and somewhat inactivate them. I, like, if I was making a frozen popsicle treat, I would use coconut milk or almond milk. I don't— at the end of the day, you're still going to get some of the polyphenols. It's not like you're not going to get any of them. So you got to choose your battles. If your child— getting dairy in your child is also important. It's a good amount of protein and fat and stuff in milk. So if that's the way they consume their dairy, then that's You know, it's a winner. I wouldn't, I wouldn't lose too much sleep over it, basically. You've said that you take pure EPA in the morning and pure DHA in the evening.

I take pure EPA from Metagenics but was not told to take DHA because of my family history of heart disease and have calcium in my arteries. Do you see issues with taking DHA? What am I missing by not taking it? I do take 3 to 4 grams of pure EPA daily. I have seen other health professionals recommend both DHA and EPA, and I want to be sure I'm on the right track. Yeah. So Stephanie, a prescription form of DHA and EPA is called Lovaza. It is a highly purified ethylester form of both EPA and DHA, and healthcare professionals prescribe it for high triglycerides and for improving cardiovascular health. So obviously, it's not detrimental to take DHA. It's a prescribed form of omega-3 that doctors are giving patients.

In fact, I've been trying to get— I encourage people that can get a prescription for it too because I think it's a very, very purified form. Of omega-3 DHA and EPA. It needs to be taken with food because it is ethyl ester form, which is not absorbed very well unless it is taken with food. But it's cheaper. It's like $20 for the bottle. And, um, and so I think it's cheaper than having to go out and, and find a purified form like Metagenics or Barlean's, for example. And which can be more costly. And also you have to do more work because you have to keep checking back to see if the batches are pure. The Lavazza, it's FDA regulated. It is the, you know, that is a regulated process where it is absolutely pure. And it's a really great option.

I think if people can talk to their healthcare professional and get it prescribed, I do think that is a good thing to do. If you could only choose one thing to do during your pregnancy, that would be? have the greatest positive impact on the baby, what would it be? I would say the supplementation with fish oil would probably be it. And specifically, 3 grams, 2 to 3 grams is what I was doing when I was pregnant. And I do think it's highly beneficial. But on top of that, getting the daily exercise, also getting enough choline from egg yolks, Enough, you know, like those things are important as well. But if I just had to choose one, it would be the omega-3. Stephanie asks about CoQovia. There are 2 products, one for cardio and one for memory. They have different ingredients.

I take the cardio one. So the really— there's a new one for memory and it does have a little bit of lutein and— but lutein, or maybe it was luteolin. They wrote lutein, but I think it might be luteolin. And has caffeine. I think the cardio one is the best because it, it's a little bit cheaper and it really has the same amount of the cocoa polyphenols or cocoa flavanols, which is like the most important. So, um, that would be, that would be mine. And then I take lutein— I mean, luteolin separately. You can get it from Swanson. Um, the, the supplement's called Luteolin, or another place that has it is Life Extension. And I have, I have both of these supplements. And the Life Extension one is called, I think it's called, um, Autophagy Renew.

It's like an autophagy stimulator type of supplement, but I really just take it for the luteolin, which is good for the brain, lowers inflammation in the brain as well. You previously discussed the benefits of older adults taking creatine to help maintain muscle. It would be great if you could discuss what kind of creatine is best for older folks, what form and how much. So the creatine really, I think, is for muscle function. And I started supplementing with it. I've noticed a pretty strong effect on my high-intensity interval training performance where I'm like rocking it better. I mean, I'm like, I'm getting exhausted. Later, so I really do think it's affecting my performance. Could be placebo, probably not. I take five grams a day.

I think anywhere between five to ten grams a day is is beneficial. I gave it to both of my parents. It's sort of like a lemon flavored drink. Sometimes I mix it with the the essential amino acids I was talking about from Thorn. Oh, I get my my creatine from Thorn as well. And I'll tell you that when you mix it, when you mix the creatine with the essential amino acids, it's really sweet because they sweeten it with like stevia. And it's like, whoa, it's like super sweet. So, you know, for me, I was like, well, I'm just trying to like get the biggest bang for my buck without having to drink multiple glasses of water. So I mix them together. So just beware. So Chad asks, hi, Rhonda.

This week there was news about a patient who used gene editing to lower their cholesterol via permanent PSK9 inhibition. Do you have any thoughts, concerns about CRISPR and gene editing as a way to solve many health issues on a regular basis? Chad, I'm so glad you asked this question because I just recorded a podcast we'll be releasing not this coming week, but the week after with like the icon, the legend, the man himself, Dr. George Church. He is absolutely just hands down, probably one of the most brilliant scientists, living scientists in our day. He was the first to show that CRISPR could work in normal human cells. He is the guy who initiated the Human Genome Project back in 1984. He brought the cost down, like, literally from $10 million to like a couple of hundred dollars.

He's the most, like, probably famous geneticist, living geneticist right now. He is doing amazing stuff. You guys are going to lose your mind for this podcast. I mean, science fiction is going to become a reality. I mean, an absolute reality. So, I'm going to save a discussion on this because I'm going to go into detail. I did actually, in the podcast, mention this very thing. So, CRISPR-Cas9 system is great for gene editing, but it also— the trade-off is it's inducing double-stranded breaks in DNA, which could cause problems. Base editing is another option. Base editing does not— it makes just a little nick. doesn't induce a double-stranded break. And base editing is what was used in the PSK9. It's, it's in clinical trials right now. And so, people are being injected.

So, PSK9 antibodies are available for treatment to people with hypercholesterolemia who do not respond to statins. And it lowers cholesterol, but in a very, very productive way that doesn't have all the negative side effects that statins have. However, it's an antibody treatment. You have to go in and get injected every 2 to 3 weeks. It's extremely costly. And if your health insurance doesn't cover it, so i.e., if you don't qualify because you've got to try statin first, and if you respond to statins, you won't qualify and your insurance will not pay for it. It is extremely expensive. And what that at the end of the day means is that really only, um, really wealthy people are out there getting it, right?

So, um, the benefit to this base editing is what's happening right now in trials is, uh, people are being injected with the, the, a certain type of base and base editor, which goes in and basically in the liver, it's going specific to the liver and it's snipping out, you know, some things and making it so that enzyme doesn't work properly. And what it does, it has the end result of lowering cholesterol. And the benefit would be this would be sort of like a one-and-done deal, so it wouldn't be as costly and might be more affordable, and certainly would be desirable because you don't have to go and keep getting your antibody treatments.

So, um, I wish I could just go on and on and on about all the cool stuff But I'm going to tell you, probably next Crowdcast, there's going to be people asking questions about the stuff we talked about. Everything from germline editing— germline means basically making edits in either the germ cells, so the sperm or egg cells, or at the embryo stage in a way that whatever— so let's say, for example, PSK9, instead of doing this in the adult in their liver, you're doing it at the embryo stage, or you're doing it in sperm and egg cells. And so the child then has that mutation where they're going to have lower cholesterol no matter what, and they're going to pass it on to the next generation and the next generation. So it becomes heritable, right? It's inherited from the parents.

A lot of controversy over that, of course, people's concern with designer babies and stuff. But we got into some really, I mean, amazing stuff in this in this podcast. It is definitely advanced. But, but I think it's, it's, you know, I think it's, it's advanced, but also understandable. So I'm super excited about, about that podcast. Linda submitted a question. What are your thoughts on red light therapy for improving skin appearance such as wrinkles, scars, redness, and acne? I would say that overall, there's some promising evidence Specifically for the skin, the red light therapy is sort of there's a lot of marketing that's gotten ahead of the science. It being like a panacea where it can just improve everything, and I say that the science doesn't show that yet.

But specifically, if we're talking about skin, there are a few studies that have shown that what's called photobiomodulation—it's also called red—it's red light therapy. It can improve collagen production and fine lines. The wavelengths that were used in those studies were 611. To 650 nanometers or 570 to 850 nanometers. The better results were shown with 570 to 850 nanometer wavelength. And this was a full face neck treatment. There was another study with red light therapy or photobiomodulation using LEDs. So these improved signs of photoaging including skin tone, smoothness, and skin clarity. So the LED device was actually— it was— there was contact with the skin, so it was applied directly to the skin. And the, the wavelengths that were used were 830 nanometers and 633 nanometers.

Um, I think it's very interesting, good news for some of these LED products. The distance, you know, so some of the stuff out there— I don't know that I've seen a product out there, consumer-available product out there, where you can contact the skin like I would say the majority of the scientific evidence and the human trials that have been done have done. So, you know, at the end of the day, while the science has shown improvements using red light therapy for skin aging, the, the, the methods are important. And sometimes when you change one component of a method, for example, the LED having contact with the skin versus standing in front of a red light and being, you know, X distance away may not have the same effect.

And so that is something to keep in mind when it comes to red light therapy, you know, and, and use of red light therapy with treating skin. So I'm looking at a couple of the chat questions before we have to say goodbye today. And people were asking about the podcast I was talking to you. It's not out yet. We're going to be releasing it the week of August 15th. So coming soon, really soon. And the podcast is with Dr. George Church. His name is George Church. He is a legend. I mean, I can't believe I was able to even get him on the podcast. It was like amazing. I had to work really hard to do it. But I'm just like super excited. It's not going to be out this week. It will be in a couple of weeks. Kenny is asking in the chat, what is an optimal serum vitamin D level?

So I've talked about this many times. I would say that based on all-cause mortality studies ranging from the 1960s to like 2013, a variety of studies looking at vitamin D levels and all-cause mortality show that really between 40 to 60 nanograms per milliliter is a sweet range for associations with lowest all-cause mortality. I typically like to go in between those ranges, like around 50 to 55 nanograms per mL is typically what I like to have for my blood levels as well. Where do I get my salmon roe? I get mine from Vital Choice, and I do the wild Alaskan salmon roe. Although I'll admit I haven't been eating it. I haven't been doing— I haven't eaten it recently. I've just been doing— I've been eating— I've been doing a lot of sardines because I've been experimenting with ketogenic diets.

And so I'm getting a lot of EPA and DHA from there as well as I supplement quite highly. I do a lot of— I really— anywhere between 4 to 6 grams a day is what I take depending on if I remember to take as much in the morning or not. So I do a lot of EPA and DHA, but I probably will go back to getting some of the salmon roe from Vital Choice. Well, that is— Tatiana is asking about identifying protein deficiency. And, you know, I think that would be a good question for next time for a deep dive. You know, off of the top of my head would say, you know, obviously like measuring muscle mass and, um, you know, seeing, seeing muscle mass gains or losses over time. But I do think that, that, that would be interesting to look into.

So if someone could submit that for the next time, that would be great. And all these questions that you guys are submitting, especially when you start linking a study and asking my thoughts, like there's no way I can give it, give you my thoughts in the chat because I have to look at the study. So please, please do submit your questions for next time. And again, I will go through the top voted questions. I try to look at all the questions. I also have some rapid-fire questions that I like to do each time. I like to do some deep dives. I like to try to cover as much as I can. So if I didn't get to your question this time, also please resubmit it. Just, you can go right, even right now and sign up for the next Crowdcast and submit it now. Early bird gets the worm.

I do like to look at the questions early, especially for the deep dive ones. Rapid-fire questions, I can kind of look at last minute. But if you have a question that you think is going to require me reading study, or if you link a study, or there's like a deeper dive, I would say try to submit that earlier because then it's more likely that I will Do a deep dive on it. So hope you guys enjoyed this this episode. We talked a lot about protein again. Any questions or follow-up questions you have, submit them next time. I do think it's an important topic, and I will try to get to them. Thank you guys so much for attending these, for submitting your questions. I learned so much from them. Thank you for all your support.

Please, if you guys enjoy these, if you enjoy the live Q and A's, if you enjoy the membership, the the aliquot podcast that we put out there. the Science Digest we send out, tell a friend, share it with people, share, you know, it always helps to kind of spread the information, spread the word. And, um, but I, I will see you guys next week. And, uh, major thank you for everything. I look forward to seeing you guys soon. Have a great month, and I will talk to you then.