1
SPEAKER_00
 that are not necessarily viewed as very tasty.
1
SPEAKER_01
Yeah, yeah, right.
1
SPEAKER_01
But they're more acquired over time and they become very tasty to you over time.
1
SPEAKER_01
So fasting has become this massive
1
SPEAKER_01
 more mainstream talked about thing, we were talking about this before, there's all these big fasting apps with millions of users, there's tons of fasting books, there's different types of fasting, there's water only fasting that you do for a few days, there's, you know, just
1
SPEAKER_01
 Calorie-restricted fasting, there's the time-restricted fasting, there's the fasting-mimicking diet, there are all these different types of fasting.
1
SPEAKER_01
Can you break down maybe the pros and cons of some of these that you've seen?
1
SPEAKER_01
Yeah.
1
SPEAKER_01
And which one is most effective for us?
1
SPEAKER_01
Or is it something we just need to try and see what works for us?
1
SPEAKER_00
 I would definitely say no to your last question, right?
1
SPEAKER_00
So, yeah, it's not about trying because it can do...fasting is like eating, right?
1
SPEAKER_00
It can do a lot of good for you or a lot of damage.
1
SPEAKER_00
 And so, I would say that you're starting to see lots of clinical studies and preclinical, so animal studies.
1
SPEAKER_00
And at a certain point, you put it together and you get a good sense for what works and what doesn't work.
1
SPEAKER_00
It doesn't mean it's not by no means final, but you get a good sense.
1
SPEAKER_00
So, I would say if you look at the daily type of fast,
1
SPEAKER_00
 What clearly works and is not associated with any negative effects is 12 hours.
1
SPEAKER_02
12 hours faster.
1
SPEAKER_02
12 hours of time-restricted eating.
1
SPEAKER_02
A day.
1
SPEAKER_02
Don't eat for 12 hours.
1
SPEAKER_00
Yes, I say 8 a.m., 8 p.m., stop eating at 8 p.m., and no more food until next day, 8 a.m., okay?
1
SPEAKER_00
So that, I would say, I've never seen a negative study about this.
1
SPEAKER_01
So if you eat, if you wake up, you eat between 8 and 8, you're good.
1
SPEAKER_01
 Don't eat before 8 a.m.
1
SPEAKER_01
Don't eat after 8 p.m.
1
SPEAKER_00
Yeah, so that's already a very good one Another one it now if you go to 16 hours, right say 16 8 You starting to see lots of benefit, but you start seeing lots of problems.
1
SPEAKER_00
What type of problems?
1
SPEAKER_00
Well,
1
SPEAKER_00
 First of all, gallstone formation, right?
1
SPEAKER_00
Gallbladder operation, gallstone formation, they double between the people that fast for 10 hours, the people that fast for 18 hours, right?
1
SPEAKER_00
Really?
1
SPEAKER_00
Yeah.
1
SPEAKER_00
So, just to give you one.
1
SPEAKER_00
Another one, study after study after study, and we've done the same study, but somebody has published it before, we get a chance to, people skip breakfast.
1
SPEAKER_00
Most people that go 16 hours will skip breakfast.
1
SPEAKER_00
 And the breakfast skippers tend to live less, have more cardiovascular disease, have more disease in general.
1
SPEAKER_01
Okay, wait a minute.
1
SPEAKER_01
Let me break this down.
1
SPEAKER_01
So for years I was always eating breakfast because I love breakfast.
1
SPEAKER_01
Then I heard about intermittent fasting where it's like skip the breakfast and eat at lunch and do the eight-hour window, right?
1
SPEAKER_01
But you're telling me now that the studies are showing that those that skip breakfast
1
SPEAKER_01
 are living less and having more problems than if you eat breakfast and eat within the 12-hour window.
1
SPEAKER_00
 No, if you just eat breakfast.
1
SPEAKER_00
Just eat breakfast.
1
SPEAKER_00
Eat breakfast against not eating breakfast, right?
1
SPEAKER_01
Gotcha, so just eating breakfast.
1
SPEAKER_01
What are the studies showing now between not eating breakfast and eating breakfast?
1
SPEAKER_00
Yeah, so the people that skip breakfast, they're living shorter with more diseases.
1
SPEAKER_00
Really?
1
SPEAKER_00
And then study after study after study, it's not one, you know, it's very consistent.
1
SPEAKER_01
Is this for people, you know, over 60 years old or 20?
1
SPEAKER_00
No, no, no, yeah, this is just looking at people, did they have breakfast or not?
1
SPEAKER_00
 And then follow, let's say for 20 years, the mortality of those that historically never eat breakfast.
1
SPEAKER_01
Are there other conditions around that where they were overstressed or they didn't have good relationships?
1
SPEAKER_00
 They adjust for most of it, but it's possible.
1
SPEAKER_00
But my point to those that say, well, maybe it's something else, it's not the breakfast keeping.
1
SPEAKER_00
Yeah, I say, but if it's so beneficial to go 16 hours a day of fasting, why doesn't it at least bring you back to normal life, right?
1
SPEAKER_01
Interesting.
1
SPEAKER_01
So why is breakfast so important?
1
SPEAKER_00
 Well, nobody knows, but it could be that it's setting up the metabolism, right?
1
SPEAKER_00
It's setting up the metabolism to be, you know, like we were discussing earlier.
1
SPEAKER_00
So if it's affecting the way you burn fat, if it's affecting the way your insulin functions, et cetera, et cetera, eventually you could be more prone to insulin resistance, diabetes, cardiovascular disease, et cetera.
1
SPEAKER_00
You don't need very much.
1
SPEAKER_00
And also the heart, right?
1
SPEAKER_00
So it could be,
1
SPEAKER_00
 The ketone bodies, this continuous high level, so when you fast, these ketone bodies, this is where the word ketogenesis comes from.
1
SPEAKER_00
These byproducts of fat are going up in the bloodstream, right?
1
SPEAKER_00
And also fatty acids, right?
1
SPEAKER_00
The fat themselves.
1
SPEAKER_00
And these can alter the way your heart works and the way your brain works.
1
SPEAKER_00
 So, we don't know, but it is possible that by having lots of that all the time, some of the systems now develop problems and improve.
1
SPEAKER_01
So, it's okay if you're doing a week-long fast or a three-day fast to obviously skip the food or have less food during breakfast, but you're saying skipping breakfast on a consistent basis has proven that it's not a good thing.
1
SPEAKER_00
 Yeah.
1
SPEAKER_00
I mean, obviously, nobody did an experiment where they say, well, let's randomize that 10,000 people and you skip breakfast and you don't, and let's wait 30 years, right?
1
SPEAKER_00
They cannot be done.
1
SPEAKER_00
But it's epidemiological study.
1
SPEAKER_00
So, you know, you look at the databases and you say, the breakfast keepers, you know, are they doing better or worse than the non-breakfast keepers?
1
SPEAKER_00
And they're doing consistently worse.
1
SPEAKER_00
And this is why you want to say, okay, if you want to do 16 hours, talk to a doctor, fine, it could help you.
1
SPEAKER_00
 do it for a month or two, but then find something else.
1
SPEAKER_00
Because it does have a beneficial effect, it can do lots of good things, but then eventually you don't wanna keep it for 20 years.
1
SPEAKER_00
So that's the sort of daily stuff.
1
SPEAKER_00
 Once you get to alternate day fasting and all that, I think it's just crazy stuff.
1
SPEAKER_00
I always say I have a difficult time asking people to go from four coffees to three coffees a day.
1
SPEAKER_00
So, if you go to someone and say, from now on, beside the potential
1
SPEAKER_00
 you know, long-term problems that we just discussed, right?
1
SPEAKER_00
So, if 16 hours does that, what could happen if you don't eat every other day, right?
1
SPEAKER_00
But beside that, just the feasibility, the fact that people are actually going to do this, it's just extremely unlikely.
1
SPEAKER_00
You're looking at one person out of 100, maybe they can
1
SPEAKER_00
 Not eat every other day, right?
1
SPEAKER_00
Right.
1
SPEAKER_01
What about one day a month for like I'm gonna do a 24-hour fast one day a month Is that yeah.
1
SPEAKER_00
Yeah, nobody knows right.
1
SPEAKER_00
Nobody knows the problem with that and this is why we My lab and my group has always focused on this developing this fasting making diet is that
1
SPEAKER_00
 So, in that one day, you don't quite get into the ketogenic mode, right?
1
SPEAKER_00
In one day of fasting.
1
SPEAKER_00
Yeah, in one day of fasting.
1
SPEAKER_00
So, you struggle because most people will not view that positively.
1
SPEAKER_00
I mean, you know, tomorrow or next week, I'm not going to have a day where I don't eat, right?
1
SPEAKER_00
So, it's a struggle.
1
SPEAKER_00
 you don't quite get, so you're hungry for that 24 hours, and you don't quite get into a fat, a starvation response mode.
1
SPEAKER_00
That's why we're saying probably the system, if you look at our history, right?
1
SPEAKER_00
 Most likely, we can't go back in time, but most likely, in the summers, we had the job to get fat, right?
1
SPEAKER_00
Fill up for winter.
1
SPEAKER_00
Lots of fruit, honey, whatever you can get your hands on, eat as much as possible.
1
SPEAKER_00
 And then the diabetes and prediabetes, the insulin resistance that then leads to diabetes, so insulin doesn't work as well, it was probably part of that process of making you store fat, put away as much fat as possible.
1
SPEAKER_00
So now,
1
SPEAKER_00
 you know, this can be activated any time of the year, right?
1
SPEAKER_00
Because people overeat all year long.
1
SPEAKER_00
And so probably, not probably, what we see now clinically is that when you do, let's say, five days of a fasting-mimicking diet, or it could even be
1
SPEAKER_00
 water-only fasting, you unlock that.
1
SPEAKER_00
You seem to unlock that mode where...and this is why the doctor that I was telling you about, you see him even using the longevity diet, but he's still not quite losing that insulin resistance until he does the fasting-mimicking diet.
1
SPEAKER_00
That changes, and you clearly see the slope of the glucose levels curve.
1
SPEAKER_00
And so,
1
SPEAKER_01
 And the fasting mimicking diet is around like three to five hundred calories a day type of thing, is that right?
1
SPEAKER_00
No, the fasting mimicking diet is the one for regular people is 1,100 calories on day one and then it goes to 800 calories on day two, three, four, five.
1
SPEAKER_00
Okay, got you.
1
SPEAKER_00
So it's 800 calories for the last four days.
1
SPEAKER_01
Gotcha, okay.
1
SPEAKER_00
 Yeah, so then the possibility is, considering that over 70% of Americans are either overweight or obese, now we're saying if you intervene a couple of times a year at least, and you remind the system we are not in summer mode,
1
SPEAKER_00
 Okay, let's go into winter mode.
1
SPEAKER_00
Let's burn these fats because we're no longer having to store them.
1
SPEAKER_00
Yeah, so that could be the trick of the five days versus, let's say, one day a month, which may keep the system confused and not sure, did we reach another phase here?
1
SPEAKER_00
Do we need to go now into a fat-burning mode or can we stay in the fat-accumulating mode?
1
SPEAKER_01
 So what's the difference between having the fasting mimicking process of five days?
1
SPEAKER_01
800 to a thousand calories Versus water only for five days.
1
SPEAKER_00
I've done it.
1
SPEAKER_00
I can tell you the difference I've done it one time with water only for five and I remember every day of it and
1
SPEAKER_01
 pain of it, you mean, or what?
1
SPEAKER_00
Yeah, to me, it was near torture.
1
SPEAKER_00
Really?
1
SPEAKER_00
And we knew that that was true when we did the, that I was telling you about the clinical trial, the first clinical trial in 2009, I think it was here, USC, on cancer patients, and we thought, somebody has cancer, they're not gonna argue with water-only fasting.
1
SPEAKER_00
They're gonna do it, right?
1
SPEAKER_00
Right, yeah.
1
SPEAKER_00
We were sure, the oncologists were sure, let's go, let's do it.
1
SPEAKER_00
 Nobody wanted to do it, right?
1
SPEAKER_00
So this is why we went to the government and said, we would like to develop a fasting-mimicking diet for cancer patients.
1
SPEAKER_00
That's where it comes from, right?
1
SPEAKER_00
So it comes from the refusal of cancer patients to- Who are like, I'm gonna eat no matter what.
1
SPEAKER_00
To do, yeah.
1
SPEAKER_00
It's just, it's a safety issue.
1
SPEAKER_00
There's lots of things in food that are important to maintain
1
SPEAKER_00
 high enough glucose level, high enough blood pressure, et cetera, et cetera.
1
SPEAKER_00
So once you remove it, I think people can do not only fasting, but probably in a specialized clinic.
1
SPEAKER_01
So if you go to a place... So it is effective.
1
SPEAKER_00
 It is a fact.
1
SPEAKER_00
If you're in a specialized clinic and you have... But watch out, right?
1
SPEAKER_00
Because again, as we were saying earlier, the devil is in detail.
1
SPEAKER_00
And if you go long enough, right, especially if you're extreme and long, then the body goes into another response, which is thrifty mode.
1
SPEAKER_01
 Drifty mode, so it stops burning.
1
SPEAKER_00
It keeps the fat.
1
SPEAKER_00
Let's say you go a couple of weeks without food at all.
1
SPEAKER_00
The body now has to intervene and say, we're going to be in trouble soon enough, right?
1
SPEAKER_00
We're not going to burn this.
1
SPEAKER_00
We're not going to burn.
1
SPEAKER_00
 And so now you could have, and we know this from long-term calorie restriction studies, you could have probably...nobody's ever figured out what it is, but it's called epigenetic change.
1
SPEAKER_00
So there's a switch that turns on and say, okay, from now on, and maybe for years, I'm now in a...
1
SPEAKER_00
 saving mode.
1
SPEAKER_00
I'm gonna save energy.
1
SPEAKER_00
So now if you, and this is why the technology is so important, right?
1
SPEAKER_00
So you wanna do all the things that we just talked about and don't, you wanna avoid all the bad things, right?
1
SPEAKER_00
You don't wanna get into thrifty mode.
1
SPEAKER_00
You wanna get into the ketogenic mode.
1
SPEAKER_00
You wanna burn the, start burning the fat.
1
SPEAKER_00
Keep that long-term and avoid the side effects, you know,
1
SPEAKER_00
 Yeah, so all of this even though people think it oh, yeah, it's an old thing people used to do it you see how The the purpose it was not to get to 110 years of age healthy Back 2,000 years ago.
1
SPEAKER_00
The purpose if you were lucky is make it to 50 years of age and have children So now everything changed, right?
1
SPEAKER_00
So now we can't just fast the old ways and we have to know
1
SPEAKER_00
 We have to be respectful of the tradition and what we learn from all these old practices, but at the same time, we have to bring in the science, the clinical trials, and say, okay, where do they match?
1
SPEAKER_00
What's the common denominator between all these things?
1
SPEAKER_01
So, who is the woman you said is 117 years old?
1
SPEAKER_00
Emma Morano is her name.
1
SPEAKER_01
Emma Morano.
1
SPEAKER_01
She's Italian?
1
SPEAKER_00
Italian, from Verbagna, Italy.
1
SPEAKER_01
Wow.
1
SPEAKER_01
 What are the main causes beyond diet of her living a long, healthy life?
1
SPEAKER_00
In her case, it was genetics, right?
1
SPEAKER_00
So, and we knew, I mean, you're never 100% sure, but you're pretty sure because when I asked her, tell me about all your brothers and sisters and your mom and father.
1
SPEAKER_00
They all lived old.
1
SPEAKER_00
 All of them but one over the age of 90.
1
SPEAKER_00
Oh my gosh.
1
SPEAKER_00
And the chance of that is one in a billion probably, right?
1
SPEAKER_00
Wow.
1
SPEAKER_00
So extremely unlikely that by chance a bunch of people in the same family, virtually everyone out of 10 people will make it to 90.
1
SPEAKER_01
So that's a genetic, that's a gene type of thing.
1
SPEAKER_01
What is the gene that she has or her family has and is there a way that we can trigger those genes in ourselves?
1
SPEAKER_00
 Yes, with nutrition, with the longevity diet and the fasting-making diet and a few other things.
1
SPEAKER_00
Yeah, so we've been following now for 15 years this population in Ecuador, and they're little people, right?
1
SPEAKER_00
So they're about three feet tall.
1
SPEAKER_00
No way.
1
SPEAKER_00
Three feet?
1
SPEAKER_00
Three feet tall, yes.
1
SPEAKER_00
And they're lacking what's called growth hormone receptor.
1
SPEAKER_00
 But why are we studying these people?
1
SPEAKER_00
Because if you remember our first discovery of the genes that control aging in microorganisms, it was in the same what's called pathway.
1
SPEAKER_00
So these microorganisms that live 10 times longer,
1
SPEAKER_00
 They are little, right?
1
SPEAKER_00
Yeah.
1
SPEAKER_00
And then the work by John Kapczyk and Andre Barkey here in the U.S.
1
SPEAKER_00
showing that the mice that have longevity, record longevity extension, they're little mice, right?
1
SPEAKER_00
With the same mutation in the same gene, the growth hormone receptor.
1
SPEAKER_01
Both of you, you and I are kind of tall though.
1
SPEAKER_01
Are we screwed?
1
SPEAKER_00
 No, no, not necessarily, because we know that we can intervene, you know, at different stages of life, right?
1
SPEAKER_00
So you can intervene, you can start a nutritional intervention or a pharmacological intervention on a, you know, mouse
1
SPEAKER_00
 at different stages.
1
SPEAKER_00
Of course, the earlier you start, the bigger the effect you see, but you can still get a lot of the effects later in life, especially if you consider the deaths from diseases, right?
1
SPEAKER_00
So if you switch your nutrition, even if somebody was 60 years old, they could still make a big difference.
1
SPEAKER_01
You could still extend your lifespan and reverse diseases at 60, potentially?
1
SPEAKER_00
 Yeah Almost for sure.
1
SPEAKER_00
I mean, I mean if you consider that yeah, if you consider cardiovascular disease and diabetes alone, I mean those you can truly Revolutionize let's say the chance of developing them or Having them progress based on a clear and strong change in your in your diet Wow What were the other factors beyond nutrition that you think are allowing her to live a longer life?
1
SPEAKER_00
 A big, big factor was Carlo Bava, her doctor, right?
1
SPEAKER_00
Big factor.
1
SPEAKER_00
Why?
1
SPEAKER_00
Because Carlo, the attention...and we saw that when I visited Monte Carlo and San Marino, you know, some of the places they have the highest longevity in the world.
1
SPEAKER_00
I realized that one of the major reason is that they have such a close attention
1
SPEAKER_00
 to the old person, right?
1
SPEAKER_00
The doctors do?
1
SPEAKER_00
The doctors, the medical system.
1
SPEAKER_00
So they, you know, for example, in Monte Carlo, if you're older, they can bring you the food at home.
1
SPEAKER_00
They have, you know, ambulances very close by.
1
SPEAKER_00
So they have a safety system.
1
SPEAKER_00
For older people?
1
SPEAKER_00
 for everybody, but for older people, that make sure that if you get a heart attack, they're gonna be there very quickly.
1
SPEAKER_00
Or they're gonna catch it early, or they're gonna give you the test, right?
1
SPEAKER_00
So, yes, that's how Carlo Bava was with Emma Morano.
1
SPEAKER_00
He made sure that she got checked, she got treated, he had to do some blood transfusion, I think he did them at her home, because she didn't want to go to the hospital.
1
SPEAKER_00
 So she would have probably made it to 100 on her own, but to make it to 117, I think it took a very inspired physician.
1
SPEAKER_01
 So it's regular checkups, it's prevention of things, it's not just going through life saying I'm fine, it's going to do a checkup once or twice a year and making sure blood levels are good and everything's good, is that right?
1
SPEAKER_00
Yeah, I think that having somebody follow your nutrition and have the right people follow your nutrition is key.
1
SPEAKER_00
Interesting.
1
SPEAKER_00
But at the same time, are you gonna get a colonoscopy or not?
1
SPEAKER_00
Are you...
1
SPEAKER_00
 gonna check your fasting glucose level, HbA1c, are you gonna, you know, if you have high blood pressure, are you gonna intervene strongly enough against it without resorting to drugs, right?
1
SPEAKER_00
So the idea is, I mean, as you introduce drugs, and the more drugs are in the system, the more the system now is gonna adapt, change,
1
SPEAKER_00
 And now each drug can cause another problem, right?
1
SPEAKER_00
So then ideally you want to try to keep everything working without drugs, which is very difficult to do.
1
SPEAKER_00
And that's why you need probably a team that helps you get there.
1
SPEAKER_01
Let's say you have unlimited resources.
1
SPEAKER_01
Let's just hypothetical situation.
1
SPEAKER_01
You've got unlimited resources or you've got a certain amount of money to dedicate towards a nutritional health doctoral team a year.
1
SPEAKER_01
 Who would you want to have on your team?
1
SPEAKER_01
Or what types of people should people be looking for on their team?
1
SPEAKER_01
Is it a nutritionist?
1
SPEAKER_01
Is it a specific type of doctor?
1
SPEAKER_01
Is it a trainer?
1
SPEAKER_01
What are those people that we should be looking for?
1
SPEAKER_00
 Yeah.
1
SPEAKER_00
So, yeah, so we're trying to do that, both in Italy and here in Los Angeles.
1
SPEAKER_00
And so, we have physicians that are in internal medicine, internal medicine doctors, and they are integrative type of doctors.
1
SPEAKER_00
So, they understand, they appreciate the
1
SPEAKER_00
 the integration with other interventions that could be, you know, nutrition, exercise, etc., etc.
1
SPEAKER_00
Then we like to have, at the clinic, dieticians that have higher degrees, right, the type of person that might focus on nutrition, might get a PhD, right?
1
SPEAKER_00
 And then, ideally, a psychologist.
1
SPEAKER_00
We don't have that yet because we're still small, but I think that would be very helpful.
1
SPEAKER_00
And then the collaboration, which we have, luckily, with lots of hospitals all over the world, right?
1
SPEAKER_00
So, in each case, we look for partners in, you know, usually we do clinical trials.
1
SPEAKER_00
 But our partners include MD Anderson, Mayo Clinic, Cleveland Clinic.
1
SPEAKER_00
And so as we develop protocols, clinical protocols, then we go to some of the leading hospitals.
1
SPEAKER_00
And usually the leading hospitals are very open.
1
SPEAKER_00
They like things that are different and they're looking forward or forward-looking.
1
SPEAKER_00
 And yeah, so I think that eventually it'd be nice that everybody had that, right?
1
SPEAKER_00
Everybody had the, so let's say you come to our clinic and then based on the problem, the clinic says, I think you should be treated by this oncologist or this cardiologist or this immunologist because they're probably the ones that are gonna work with the team in a way that
1
SPEAKER_00
 you know, minimizes maybe the drug interventions until you do need the drug intervention.
1
SPEAKER_00
For example, in cancer trials, it's all drugs, right?
1
SPEAKER_00
So it's fasting, vegan diet, plus the drugs.
1
SPEAKER_00
We've never seen any evidence that doing it without the drugs is gonna be helpful.
1
SPEAKER_01
How much of a negative effect does taking drugs consistently in your life affect the longevity of your life?
1
SPEAKER_01
Even a little bit of drugs, or medication, or a lot of drugs?
1
SPEAKER_00
 Yeah, nobody knows, right, because I don't know that there is any formal studies on this, but I think that the body is in a perfect equilibrium.
1
SPEAKER_00
Yes, harmony, yeah.
1
SPEAKER_00
Everything is perfect, nearly perfect, let's say.
1
SPEAKER_00
And so, for example, if you think about cholesterol, right, so now you have a statin, so this drug is now gonna block cholesterol synthesis.
1
SPEAKER_00
 Well... It's gonna cause a different problem, right?
1
SPEAKER_00
Yeah, is that good?
1
SPEAKER_00
Well, yeah, it's good because it's lowering your blood cholesterol.
1
SPEAKER_00
But at the same time, you have to ask the question, why were you making all that cholesterol?
1
SPEAKER_00
What are you trying to do with that, right?
1
SPEAKER_00
So the cholesterol is involved in making hormones, in building cells.
1
SPEAKER_00
So what happens when you block that, right?
1
SPEAKER_00
 Yeah, so then you have to consider lots of drugs are blocking things, and they're not necessarily blocking things in a sophisticated way, right?
1
SPEAKER_00
So, they're not...
1
SPEAKER_00
 Let's say, go after the cholesterol synthesis.
1
SPEAKER_00
Oh, I'm going to allow this type of cholesterol to be made, but I'm going to, you know, affect some other subtype, you know.
1
SPEAKER_00
Usually, they're pretty rough, right?
1
SPEAKER_00
Of course, you know, things are getting better.
1
SPEAKER_00
In some cases, there are more sophisticated drugs.
1
SPEAKER_00
 For example, those that are targeting the immune system, you know, they try to, you know, let's say somebody has an autoimmunity, the drugs are trying to go after only a subset of immune function, so they don't take away your normal immune function, but most of the immune
1
SPEAKER_00
 Drugs will say the chance of infections is gonna go up, and the risk of death from this and that.
1
SPEAKER_00
Yeah, so that means that when they were in the trial, they observed that the risk of certain diseases or infections went up, and it's not surprising.
1
SPEAKER_00
Now you're blocking something that is trying to help you, right?
1
SPEAKER_00
 that is also hurting you by, let's say, attacking your own cells.
1
SPEAKER_00
So, yeah, no matter what system you look at, what type of drug, you know, cancer drugs, right?
1
SPEAKER_00
Let's say immunotherapy.
1
SPEAKER_00
Well, that's so good, right?
1
SPEAKER_00
Because, you know, it changed the survival in several types of cancers.
1
SPEAKER_00
But then again, now some people are gonna have the immune system attacking
1
SPEAKER_00
 the normal cells, and so there's lots of side effects caused by immunotherapy.
1
SPEAKER_01
So I think that... So it's best to figure out what's the root cause of it, try to get to the root first before using the drug is what I'm hearing you say.
1
SPEAKER_00
Yeah, let's take the doctor that we were talking about earlier.
1
SPEAKER_00
So he's got diabetes, he's got hypertension.
1
SPEAKER_00
He had four medications he was on, you said.
1
SPEAKER_00
He had four medications, right?
1
SPEAKER_00
And he was gonna be on his way within, I would say, two or three years of having to inject insulin with the pancreas being, you know,
1
SPEAKER_00
 irreversibly damaged, right?
1
SPEAKER_00
So, right there, you see that what should have been done, you knew how to do it.
1
SPEAKER_00
Now you could say, well, lots of people are not gonna be able to do it.
1
SPEAKER_00
Well,
1
SPEAKER_00
 Of course they're not if they don't have the team.
1
SPEAKER_00
If they don't have the team, and we already see, for example, in Holland, we did a clinical trial, a multi-center clinical trial, where we did not have a centralized registered dietician calling people up.
1
SPEAKER_00
 and knowing the system and the compliance.
1
SPEAKER_00
So, the percentage of patients that did more than three or four cycles of the fasting-mimicking diet together with chemo went down to like 35%.
1
SPEAKER_00
When we do it with the dietitian calling you, then we're up 70%, 80%, 90%, right?
1
SPEAKER_01
 So you mean just the dietician calling you for accountability to check in once a week or once a month and saying, are you doing what you're supposed to do?
1
SPEAKER_00
How are you feeling?
1
SPEAKER_00
Here's what you can expect from this, right?
1
SPEAKER_00
How are you feeling?
1
SPEAKER_00
Did you eat anything else?
1
SPEAKER_00
Can I help you?
1
SPEAKER_00
Yeah, so that completely changes the ability and the willingness of a patient to do it.
1
SPEAKER_00
So I think one thing is to say to a patient, change your diet, and one thing is to say, don't worry about it.
1
SPEAKER_00
We got the team.
1
SPEAKER_00
 We're gonna help you, you know, and at the beginning gonna have lots of questions, lots of calls, and then, you know, after a couple months, you're gonna say, I don't want to talk to you anymore.
1
SPEAKER_00
I know.
1
SPEAKER_00
Yeah, I got it.
1
SPEAKER_01
I'm doing it.
1
SPEAKER_01
I'll check in less.
1
SPEAKER_00
I'm doing it.
1
SPEAKER_00
And now you have, you know, continuous glucose monitors.
1
SPEAKER_00
We use that on this doctor, for example, right?
1
SPEAKER_00
So, yeah, we were able to, you know, without him even seeing it, we were following his fasting glucose, adjusting to it.
1
SPEAKER_00
So, we will call him and say,
1
SPEAKER_00
 Okay, what did you do?
1
SPEAKER_00
Did you eat something last night?
1
SPEAKER_00
Oh, yeah, last night I had a big dinner.
1
SPEAKER_00
And yeah, so I think that the technology is a big help.
1
SPEAKER_00
So that, you know, just in also making it easier for the clinic to do the job.
1
SPEAKER_01
Did this doctor, was he obese as well?
1
SPEAKER_01
And did he lose a lot of weight in this process?
1
SPEAKER_00
 He was overweight.
1
SPEAKER_00
He lost weight.
1
SPEAKER_00
He didn't lose, it wasn't somebody lost 40 pounds, you know.
1
SPEAKER_00
He must have lost, I don't know, maybe around 10 pounds or something like that.