Elissa Epel

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S: Telomeres, the protective tips of chromosomes play a key role in aging. Our everyday lifestyle choice affect our telomeres and telomeres in turn predict early disease and death. In this episode, you will glean important insights into how personality, mindset and lifestyle can accelerate versus protect us from premature cellular aging. Hi, I’m your host, Stephan Spencer. Today’s guest is Elissa Epel, a co-author of the New York Times bestseller, The Telomere Effect, along with her colleague, the Nobel laureate, Dr. Elizabeth Blackburn who discovered telomerase and the telomere’s role in the aging process. Elissa is an associate professor at UCSF. She and her team of collaborators found that the chronic psychological stress wears down the telomeres around a decade earlier than expected. Elissa has degrees from Stanford and Yale, and is the cofounder of Telome Health Inc. Elissa, welcome to the show.

E: Thank you, happy to be here.

S: Let’s talk about The Telomere Effect, your new book and about telomeres in general. Why should we care about telomeres? Why do we need to know about them and what do we need to know about them?

E: It’s a really good question. I’m going to say that if you care to understand how your body is affected by the things that we do every day and how aging is somewhat malleable and how we can change that over time, then you do want to do about telomeres, you want to understand them. They are one of many pathways of aging but an important one. Many people don’t care to know. That’s okay too. That kind of big diseases of aging look like they get us somewhat randomly because there’s genetics we can’t control but a lot of our aging really is about our lifestyle over the decades of our life. Even in childhood, we’re shaping our telomeres, we’re shaping our long term health trajectory. Some people, when they know and understand that we have these telomeres in every cell and that they’re being shaped by our habits and by little things we do because little things add up to have big effects over time. That can be helpful to people, that can be motivating or you can just not care or know about them. We felt compelled to tell the story of telomeres. We just knew so much by now after a decade of studying them and realizing that there wasn’t just health behavior which everyone already knows about but there’s all sorts of factors social, emotional, chemical, environmental, all these factors are associated with out telomere length and possibly shaping it, not just associations but possibly influences that we want to be aware of.

S: Basically, we have telomeres that kept the ends of our chromosomes and they get shorter as we age and the shortening of them is correlated with signs of aging and we want to try and slow down that process of the shortening of the telomeres. We want to do things that hopefully can even lengthen the telomeres.

E: Exactly, that’s exactly right. They are these caps at the ends of our chromosomes. They protect our genes. Because we’re such a long live species, they do wear out toward the end of life. When they get short, we get different dysfunctions happening in our body. We all have some old cells and cells with short telomeres as adults. It’s not just about you hit this old age and then your telomeres go bad. We come with different average lengths of telomeres in our different tissues in our blood and it does mean something about our health. For example, healthy young adults, they’re not close to getting a disease of aging, they’ve got decades on them but if they have short telomeres in their immune cells, it actually predicts that they’re more likely to get the common cold when it comes around. That’s been shown in this one beautiful study where people were quarantined in a hotel and they had rhinovirus, common cold viruses sprayed up their nose. The researcher, Sheldon Collins, asked, “Who gets a cold? How nasty is it? How quickly does it come on? Does it have anything to do with the length of you telomeres?” It did and that shows us it’s not just about the slow development of disease and aging, it’s also about how robust our immune system is.

S: How do you know the length of your telomeres and how they vary in different cell types? Could I know my length of my telomeres in my immune cells? Is there some test I can take?

E: There is, there actually is. It’s now commercially available. There’s a bunch of companies and you can. Do you want to know, Stephan?

S: Yeah, I do. I think more information is better. Peter Drucker once said, “What gets measured, gets managed.” How am I going to manage something I can’t even get any read out on?

E: I think there’s a couple ways to approach the testing. As of now, it’s new and it’s unregulated. We’ve done a few studies giving people their results here at UCSF. People, when they are short and they feel they’re already doing everything they can in their lifestyle including managing stress well, those are the few times when we find people are not happy, they’re distressed to learn they’re short. Not many cases like that, most of us can optimize, there’s always something that we can do better. We didn’t find it was upsetting for most people and we did find that those who tended to be short, who were told that they were short, they boosted up their exercise in the following year. That was something we found, we haven’t published yet but it does suggest, it is motivating, it is not too damaging to know. Just for the record, Liz and I have no relationship to any those testing companies. We don’t have a financial interest in testing. I think some people want to know and I think the only advice I’d offer is don’t take it too seriously. There’s variability and when we measure telomere length over time, we find it fluctuates a bit in people over the short run. Someone might be a short and that might be a little bit fluky and they might want to get it again. I guess the other piece is if you are short, the good news is that unlike a gene, this is malleable. That’s the beauty, it’s made of DNA but it is not coding for genes, it’s this protective, wound up long cap that you can protect better. This question of can we lengthen it, probably, it’s not like anyone’s ever proven that that happens in humans. We see that in these big population studies, the most recent was Mary Hulley. She found that in her big sample of adults who have stable heart disease over five years, a chunk of them did lengthen in telomere length. That group was less likely to die in the near future. That was a hint that there is some lengthening whether it’s actually per cell or just fresh new cells coming out of our immune cell stores. It does happen and it looks pretty protective and good for longevity.

S: That’s good news. How do we get tested? What companies are out there and what’s their price ranges?

E: That’s a good question. I think that these things change a lot. On our book website, we do plan to put up what the different companies are. Get on top of that at this moment in time but it does change. Every time I turn on my web browser, I see ads, they know that I’m interested in telomeres and I get tons of companies popping up in front of me. One is called Life Length, that’s the European company. One is called Telomere Diagnostics, that’s the Telo age. One is called Repeat Diagnostics. The prices range probably from $100 to $500.

S: Is this something that you would want to do once a year or quarterly, once every few years? What do you recommend?

E: I don’t have a data based answer, we just don’t know how quickly can change. If you’re doing something really intense like a residential retreat, we’ve studied residential retreats, people seemed to change within weeks and months. When we study classes that people take and really try to change their lifestyle and reduce their stress, we see changes is four months. If I were measuring my own, unless I’m going on some dramatic change plan, that’s probably not sustainable, I would probably say once a year is reasonable.

S: What do you mean by a residential retreat? They’ve had health issues and they go into a facility and stay for some period of time like a couple of weeks or months?

E: Yes, sorry to be vague. We do a lot of studies on stress management classes and some are weekly like Mindfulness Based Stress Reduction. There are these meditation retreats that you can go to for three days or a month. My colleague at UC [00:10:05] recently studied one that was month long residential retreat out here in Marine called Spirit Rock. That’s just one small study but that did hint that the people that in this retreat who were eating healthy food, they were away from the stress of the daily work, they were learning about their mind and having a lot of calm states every day. Not all calm, if you know meditation retreats, it’s not all fun, it’s kind of a lot of work to maintain focus and to be staying present and not to be following stories. These people who did the month long retreat did appear to have telomere lengthening compared to a control group who were also experienced meditators but they weren’t on a retreat. Retreats are super interesting. People get this opportunity to really unwind, or as I say, “Peel the layers of the onion.” How you go on vacation in that one week you might finally feel a sense of calm and equanimity and not be thinking about work and then it’s time to go home. If you have a bit longer, not that many people can take off and have no responsibility for weeks or a month but they really do lead to a lot of transformation. We did a study that was just one week meditation retreat, at Deepak Chopra’s retreat center in New York, San Diego. It was very interesting because we were wondering how much can people really change in their well-being, in vitality and their telomerase, the cell aging enzyme that protects the telomeres in just one week. The big problem is is it the meditation or is it really just the time spent relaxing? To try to really match people on that feeling of going on vacation or getting away from work, we brought people to the retreat center who were just having a bit of a vacation week. They’d be at the pool, they’ll take a walk, go to health lectures. The other half of the randomized sample actually sat in all day retreat learning mantra meditation and doing other reflection and self-growth activities. We really wondered what it’s like to be on vacation versus be learning this new skill. What’s your guess? At one week, who felt the least stressed?

S: I would guess the ones who were just hanging out by the pool.

E: They improved just as much as the ones who were meditating. It was dramatic. The reduction in stress and depression and increases in vitality, they were whooping 60%. People really have a chance to peel that onion, to really let go vigilance and teach their body new ways, recalibrate their nervous system and their level of busyness, busyness of thought. We found that for both groups but then we followed them up and the people who did learn the mantra meditation and particularly those who at early childhood adversity, that’s another kind of complicated but important thing about us as individuals, those people improved the most. Even almost a year later, they were still doing quite well in terms of their feelings of stress and depression. In the short run, sitting by the pool is just as good. In the long run, the meditators actually had learned a new skill that helped them maintain their mood better and manage stress better.

S: Interesting. Is the improvement that you’d get from doing a retreat market enough that we’re talking double digit percentage increase in length or something?

E: In terms of the telomere length, we didn’t see changes in that one week. We did measure telomerase and that was interesting. It did go up but not in those women who were randomized and we brought to the retreat center. There was another group of women I didn’t tell you about. They were already in enrolled in the retreat. They came with trained minds. They’d probably been there before. They knew exactly why they were going, what they were doing and they had a boost in telomerase that week and some different kind of patterns of gene expressions. We do think that these retreats, they’re not magic, they’re not going to cure someone who’s not skilled in this. It’s a commitment, you go, you learn, you practice it, you go again if you’re lucky and you can take retreats but people can do this at home too if they have a discipline and take a weekly class and try this at home. Not everyone’s going to like meditation or learn how to meditate so one of the things that we talked a lot about in our book is there’s a whole menu of things that you can do that we think are very, very similar in their mechanism, to put it simply, of slowing cell aging, of reducing stress arousal, of providing a real concentrative frame of mind, giving people an ability to focus their attention, have more time and engage in whatever they’re doing. It doesn’t have to be meditating. It might be a passion and a hobby.

S: What would be some of the things for people who aren’t really into meditating? Let’s give our listeners some specifics. I don’t really meditate that much. A little bit in the morning and in the evening just for a couple minutes, that’s it.

E: I’m going to tell you about two things. Let’s stick on the topic of what in this kind of basket of mind-body activities are the options and choices. I can tell you about the ones that we study. What’s common to these is as I said, this kind of a relaxed body state and a focused attention state in our mind. The different things that have been studied or things like moving meditation, that is Tai Chi and Qigong. There’s been several studies on Qigong which to me is so beautiful and how easy it is and how quickly you can feel the impact in your body of this. It’s just very slow, traditionally Chinese moving meditation. Actually, on our book website, on the very last page where I don’t think anyone noticed that yet but I put mind-body tips and there’s these two videos of Qigong, one is a vigorous wake up, it’s less than five minutes and the other is a calming slowdown that people can do before bed. They feel nice, they’re easy to do and the real question is can you make that a habit? Because if you can, that’s probably going to have a very good effect on your immune system, your mental health, eventually your telomeres. A couple of studies have shown that doing Qigong helps with the telomerase, the enzyme that boost telomeres. The other thing you asked me was what else that’s not necessarily in the mind-body category. One of the common ways that when we look at different things that reduce our acute stress reaction, when we’re feeling anticipatory stress or when we’re going to think of stress, we’re really, really absorbed through it. We feel threatened so our thoughts are being shaped by the threat. The thing that we’re not doing is thinking in a broad way, analytically, taking perspective on the situation and saying things like, “You know this isn’t going to kill me and how is this event going to affect me in five years?” Changing of perspective, changing the way we’re thinking about things to either prevent that stress response or get out of it in the moment. Those are the types of things that psychologists have been studying, there are all sorts of tricks of the mind that we can do to help us manage those emotional moment and stay in our wise mind instead of our emotional mind. We describe some of those in the book and one is called distancing, it’s time distancing, what I just mentioned to you by [00:19:12] and Ethan Cross and they have people just ask themselves when they’re reliving a really stressful moment or they’re in the thick of it, just step back and say, “How is this going to affect me in five years?” The answer is usually it’s not at all. Just does kinds of shifts of frame of mind. Another is watch yourself like a movie so you’re not just living through your thoughts and believing all you threatening thoughts. That gives people perspective.

S: Also, things that you can do to just reduce the amount of stress that you’re putting yourself under, of course, improve your telomeres and that telomerase level and so forth as well.

E: I think so but I think there’s a certain amount of engagement in life and social risks and activities. We’re never going to really eliminate stressful situations or reduce and if we did, life would probably be pretty boring.

S: Yeah, sure. In your book, you talked about studies about rats being put under stress and they’ll have less telomerase. Let’s talk about the whole stress side of things because I think people get a little too comfortable with being in high stress environments, constantly checking their email even when they’re on vacation and feeling like they need to be always available, putting themselves under tight deadlines, over committing, not being able to say no to their boss or to co-workers, these all can prematurely age you if you keep doing it.

E: That is what the data points to, yes. Some of the things that we know like the neurotic feeling of stress, doesn’t have much of an effect and most of us are pretty high on that type of neurotic stress. Having serious events, traumatic events, being a victim of violence, being a victim of chronic discrimination, child abuse, child neglect, all of these things appear to have larger effects than the small effects we see with hostile personality or pessimistic personality or scarring high on feeling of stress, those are pretty mild. They do show up as being significantly associated with shorter telomeres but the effects that we really want to think about is having more significance for our health and our transmitting short telomeres to our offspring are those severe stressors especially when they happen in early childhood. I think that’s something no one wants to hear because that’s the past and we can’t change that but we all carry around different levels of scarring, if you want to think about it that way. The good news with telomeres is you may have short telomeres because you had a lot of childhood adversity. The more advanced kind of adversity points you have like parents being alcoholic, being a victim, etc. The more those add up, the shorter your telomeres are, in general. The good news is that telomeres are malleable and that even if you’re short, you can maintain them and it’s about the maintenance. Maintenance is about what we choose to do everyday. Those are the little things that really do add up. These big population studies show that we can understand how telomeres are stable and longer in older adults based on habitual lifestyle habits. It doesn’t mean people are having an extreme diet, they’re not cutting out foods, they’re not doing caloric restriction, they’re just choosing a healthier diet over the years or they’re being a regular exerciser. They’re not running marathons but they are doing moderate exercise and that’s their habit. That’s how I think about the mind-body activity, that’s something we’re usually missing and if we can choose something, we have to find something we like and become addicted to, it has to be a positive addiction. You have to feel like you miss it or you feel bad if you don’t do it, just like an exercise addiction. That’s how I feel about yoga, I’ve gotten myself to that point where I need to do it a little bit at home or go to a class or I feel that kind of tightness setting in the withdrawal. That’s a good addiction that gets me to do it.

S: These habits or positive addictions. How would you recommend installing them? Do you have a favorite kind of app for your phone or something that helps you to establish a new habit or a website that you use or just an approach?

E: Actually, I don’t have a package or commercial program that’s helped me. What about you?

S: I use The Way of Life app which is very inexpensive, it’s for the iPhone. I don’t know if there’s an android version but it just basically is the concept of you don’t want to break the chain. Back when Seinfeld was in his earlier days getting going and he wanted to write a joke every day so he’d hang a calendar on his wall and then he would mark an X through the day when he wrote a joke and he didn’t want to break that chain of not writing an X because he feel like, “Oh, I broke the chain, I’m going to start over again.” Imagine in equivalent to that on your iPhone, that’s what The Way of Life app does. You can put in positive habits, negative habits so when you want to break a negative habit you reward yourself by marking it as like I didn’t do it this day and if you did do it, mark it as red and you just want a long line of green in a row for the positive habits. It tends to work for me. I just think that that’s a good way to get the ball rolling and then once it’s installed then it’s a lot easier to just keep doing it if you get a benefit from it.

E: And then you don’t need the app as much.

S: No, after 21 days, 28 days, something like that, it takes to establish a new habit, you can stop using the app. If you want to keep using it then that’s even more instead of like keep going with the habit but I found I’ve gotten new habits installed and then I don’t need to track them anymore.

E: Brilliant, it sounds like a really smart program. If you look at what the very basic science of behavior chains says you need, it sounds like that program has got those components. I like this word installation. How do you install the habit long enough so that it becomes a habit? We do give some golden rules of behavior change in the book just to help people realize there really are some, even if behavior changes so hard and you’ve kind of as a field given up a bit on the idea of people can lose weight long term. There are really good predictors of how you’re going to do. We’d lead people through that assessment of are you ready? Are you choosing realistically? Do you have that confidence rating that we know is like a crystal ball? Just asking yourself how confident are you that you’re going to do this behavior tomorrow or everyday next week. That is an honest answer that tells us if we’re going to do it, if our goal is realistic, if we need to change it. Those are some of the self-assessment things we can do and then I guess the other thing is the idea of if you’re going to commit time to something even if it’s five minutes, you decide where that is in your next day and you staple it to a behavior that’s already there, you already have to brush your teeth or you already have to commute and you implement the behavior so it’s attached to something that you know you’re going to do in your routine. That way, it’s going to come up, you can put it in your phone as a reminder to have protective time for myself, my yoga classes can’t be scheduled over, well sometimes I do schedule over but it’s the same idea of having reminders. When the trigger or the landmark behavior happens like commuting or being at a stoplight or first getting to work, it reminds you, okay, now instead of getting all kind of worked up to run the marathon of the day and do my to do list, before I start that I’m going to do this unwinding activity for five minutes. That can change your next few hours. Make them so that you have better concentration and you feel less stressed. Finding those periods in your day where you can either be really active or you need to restore your mind and body because you know otherwise it’s going to be a stressful period. Thinking through the day in a more granular way is what I think leads to those small changes that help stabilize telomeres over time.

S: As far as the idea of a habit, most people don’t realize that you can tease that out and there are actually three components that there’s the cue, there’s the habit itself and then the reward. If you want to break a bad habit, change the cue and then that doesn’t trigger the bad habit. For example, if every time you walk past the candy jar you want to take a candy and most of the times you do, the cue is walking pass the candy jar, pick a different one or take the candy jar and throw it out. It’s like sitting in front of the TV, if you sit on the couch, that’s the cue and that triggers you to grab the remote next to it and turn on the TV and binge on Netflix. Find a book, set it there that you really enjoy reading, put it by the couch, take the remote and put it in the bedroom in the drawer. When you sit at the couch, you’re not triggering the same cue, you’re actually grabbing the book instead of the remote.

E: Yeah, it’s brilliant. It’s that social engineering of our environment that we don’t give enough credit because think we can control things, control impulses but it’s like changing the options that we have is so much more powerful and lasting than just relying on willpower which is so depletable and flimsy and depending on if you got enough sleep and your emotional state and all sorts of other things, your glucose level.

S: Let’s talk about those things like your glucose level and your sleep and so forth. I’ve had Dr. Michael Breus on the show, we’ve talked about The Power of When which is his new book and chronotypes and all that. I’m curious, where does sleep fit into the equation for you?

E: Sleep is what we now think of as kind of a royal road to healthy longevity. It’s been ignored for a long time. It’s actually one of the most important restorative behaviors that we have, that we can do. We’ve been studying sleep in a lot of different ways, looking at not just how long you sleep but how much it’s interrupted and the quality of sleep. For telomeres, pretty much everything about sleep matters. Shorter telomeres are associated with snoring, sleep apnea, short sleep especially five hours or less, but six hours or less too, and worst sleep quality especially if you’re stressed, stress always makes things worse. We really want to think about how can we enhance our sleep? Not just go to bed earlier but really improve the quality of that experience. Boy, is it a struggle. Of course there are the temptations that keep us up but there’s now the phone that you can take into the bedroom or take to bed. That is definitely a sleep robber, a factor that impairs sleep. One, there’s the blue light exposure. People who uses screen instead of a real hard book tend to have sleep delayed at least 10 minutes. We know that that type of light shuts off the melatonin at a critical time when we want to be really increasing our melatonin. There are other things that happen if we go to sleep earlier and on time, we’re having more synchronized hormonal rhythms. That growth hormone increases, that’s so important to us as we age. That happens during sleep, that happens at night. If we miss that, because we’re staying up too late, we miss those early periods of growth hormone release. We miss the boat, you can’t make that up. Sleep is very interesting in terms of how it’s associated with the cell aging measures. Also, we think it’s a royal road to obesity as well. There’s been those studies showing if you really cut yourself short one night, you’re shifting yourself into a prediabetic state and into a state where you’re craving more carbs. If that is true over the long run, then many of us are shifted toward that state, chronically.

S: Did you see a correlation in any of your research of obesity and/or diabetes with shorter telomeres?

E: Yes. There’s been probably hundreds now of studies on obesity. What’s interesting there is the scale does just not reveal too much. Yes, the heavier you are, the tendency to have shorter telomeres. There’s this smaller weak relationship between BMI and shorter telomeres. It’s reliable and it’s shown up with med analysis but there’s so much variance. It’s not about your weight. It may not be even your adiposity but there are different things that weight is indicating about our health. Some of the things we think are really critical are how sensitive is your insulin? Is your insulin sensitivity really good? That’s something that just gets worse with age even if you’re lean. Glucose creeps up and insulin levels even if you’re not diabetic. That has been shown over the years, the more people increase on insulin resistance and these are not people with diabetes, the more they have telomere shortening. We also think that the abdominal fat is a big visual marker when weight is going to be important and have detrimental effects in our health. I’m sure you’ve heard lots by now but the intra-abdominal fat is the type of fat that’s releasing the [00:36:19] and causing more systemic inflammation through our body and affecting our liver health. We really want to try to have more of that well distributed fat. Fat is not bad, being overweight is not a predictor of immortality. We just know that even though it’s hard to believe and accept, it’s when you get to the really high levels of obesity that we see the real disease pathology set in but the good news for most Americans, that overweight itself is not the strong predictor. It’s really the thing underlying metabolic health, fatty liver in some resistance that’s causing all the trouble and the telomere shortening.

S: The abdominal fat, that’s the visceral fat. I remember some study, for every two inches you add to your waistline or to the abdominal fat, that increases your risk of heart disease by 25%.

E: Yeah. It’s a bad place to store. Inside, when you actually have really excessive abdominal fat, what’s happening is that those cells, those adipose sites, those fat cells, they get old, they get enlarged and those telomeres get short. Just like other age cells in the body, short telomeres mean more inflammation. Not all fat cells are equal. Those fat cells that have the shorter telomeres are more prone to inflammatory. Again, the telomeres giving us a clue that the cell age and if it’s promoting aging through the inflammation.

S: Let’s talk a bit about telomerase. Your co-author discovered this.

E: Right, with her graduate student Carol Greider, almost 30 years ago now.

S: She won a Nobel Prize for that?

E: Right.

S: It’s pretty amazing. You win a Nobel Prize for making a huge contribution to science. What was the shift in the scientific world when she discovered that? What were the implications result to that?

E: Back then, when she first discovered it?

S: Right.

E: I think the science grows very slowly and incrementally. The field of telomeres and telomerase has been moving along in the study pace but it did start for many years with yeast and with single celled organisms and lower level organisms. Researchers were able to map out and understand this cell aging system applies to all eukaryotic organisms, even these one celled organisms and people too. There’s this question mark of if the short telomeres can kill the one celled organisms, this Tetrahymena that Liz started studying, if you have short telomeres in your cells as a person, as a complex organism, is that really going to kill you? Is it really a pluck on the cell? There’s been this telomere hypothesis of aging for a long time. Then it became really easy to measure the telomeres in humans. We know that people who have a genetic disorder, rare genetic disorder, they don’t get enough telomerase. They do get diseases of aging early and they do die early. They develop very short telomeres. They develop anemia and other diseases where the cells that we need to replenish throughout life run out early. That’s a genetic disorder so then there’s this question, what about in normal people? Are the telomeres really important? Are they just shortening along the way, along for the ride of aging? Everything gets worse with aging. Telomeres really matter, they’re really causal. That’s a hard question to answer in humans. You can’t manipulate them and see what happens with humans but we, in the last let’s say maybe three years, scientists across countries have done these huge studies and they’ve been able to identify the top six genes that are contributing to telomere length. We can say I know this person’s genetic index and they tend to have long telomeres, genetically. Usually that’s partly about telomerase and partly about the proteins that build and stabilize the telomere. We can measure the genetics of telomeres and then say, “Does that directly predict disease because if it does, that is the closest we can get to showing a causal mechanism in humans.” Now there’ve been probably 10 studies showing that the genetics for telomere length directly predict greater risk of disease, heart disease, Alzheimer’s, and some other diseases. We know it’s important. There are lots of things, lots of different pathways of aging, it’s certainly not the only one and it’s particularly important because we’re so long live. In rodents, it’s never going to be important, they just start off life with these really long telomeres, never going to run out, they die of other things. Sorry, back to your question, did I answer your question?

S: Yeah, I think so. We now go to more the nutrition side of things like there’s certain specific things nutritional components here like the folate for example, I know you guys wrote about that in the book. There’s dieting in general, different types of dieting, I know you mentioned choleric restriction a little bit ago. I’m curious about intermittent fasting because I know there’s a lot of positive commentary about IF out there. Give me your thoughts about that.

E: Fascinating area, those are experiments that must be done because they can’t be done, we don’t have to wait and see how diet predicts longevity over lifetime. We’ll be dead by the time we get those answers. The intermittent fasting is interesting, no one studied that with telomeres. We did a study on caloric restriction, this was led by Janet Tomiyama who was [00:43:49]. She’s a professor at UCLA. She recruited people who were very devoted to caloric restriction. They were extremely lean. They’re blood sugar was very low, committed people, they weren’t just saying this. We tested their glucose in order for them to get into the study. We compared them to normal weight people and overweight people. We’ve really thought we’d see a difference. There are lots of biological differences when people do most fasting like that. They’re barely getting by in their calories. We thought we would see much longer telomeres and we didn’t. We saw telomeres that were very similar. Janet was about to publish that, we sort different cells and in one cell type, they weren’t just similar, they were shorter, not longer. We don’t think that the caloric restriction pathways is the way to go with telomeres. With telomeres, it’s really about nutrition. When you think about what are the things, the chemicals that shorten telomeres, you’ve got three major culprits. We have free radicals or oxidative stress, we have inflammation and certain foods can cause more inflammation and certain foods provide scavengers for the inflammations, the antioxidants, fruits, vegetables, superfoods and then there’s also the insulin resistance that we think is important. There we think about foods that spike insulin like liquid sugar, sodas, things that cause high insulin for short periods and high glucose. What we eat has a big effect on those chemicals on the whole chemical balance. Are we eating foods that are promoting a lot of oxidative stress in inflammation? Are we eating the foods that scavenge that? Our body makes enough of that naturally. We don’t want to be eating foods that increase those. We want to be having foods that are going to be reducing inflammation and oxidative stress and insulin and keeping those steady. It’s not that hard. There are no mysteries there. There’s a lot of diet that have been studied. We talk about the different diet stage in book and I want to put on our website all the nutrition points that we’ve learned from telomere science but they’re consistent with what we know from different dietary patterns across the world. For example, the American diet with a high meat and the high soda and sugars is really just shorter telomeres. It’s not just any meat, a few studies suggested that it’s not whole meat but rather processed meat that is associated with shorter telomeres, that’s pretty consistent also with what we know causes cancer. The World Health Organization has now listed processed meat as carcinogen. Anyway, thinking about what we eat every day and making it a habit to be having the whole foods and be avoiding the heavy meat and high sugar diet, those are probably the big things. There are certain nutrients that people have studied that are associated with longer telomeres like omegas, seaweed has a lot of omegas, black bean coffee is associated with longer telomeres, very happy to see that study.

S: You must be a fan of coffee then.

E: An addict, actually.

S: What would you recommend as far as supplements? The omega3, fish oil supplements and what are the things that would help with telomeres?

E: I think that is really an individual question. I think there’s a lot to be gained through nutrition, through eating whole foods and through supplements when needed but the supplement piece, I think we need better science so we can look at individuals and look at blood test and say, especially as people age, do they need supplements for iron and certain B vitamins, folic acid? Everyone is so different. If you supplement iron too much, it’s actually related to shorter telomeres, not longer telomeres. There’s a balance there and rather than blindly taking supplements, I wish there was a great ChLIA test and standardization for all of the nutrients and micronutrients that we need and there’s not. We go to a nutritionist and we get different answers from different ones but I would say that that’s a real individual question. I don’t have a great answer. Vitamin D, most of us are deficient in that, that’s a safe one to recommend.

S: What about for a women in pregnancy, what does she need to bear in mind in terms of giving her soon to be born child, his or her best shot at all. One telomere, one life.

E: That’s a good question I wish I had known, all I know now, earlier like when I was pregnant, we know that this is as huge critical period that both the mother’s mental health, nutritional state, level of obesity, all of these, they really transmit, they matter, they imprint unto the offspring. Telomeres are actually transmitted. Regardless of traditional genetics, if parents have very short telomeres, it’s likely that they pass this onto their offspring. But the good news is that other things like good nutrition and good mental health, a really healthy womb, we think those are really protective for telomeres. There have been studies looking at for example folic acid or certain hormones in the mom’s blood and that predicts from day one of life longer telomeres in the baby. This is a really great period where we can have a big influence on our baby’s health but also our health during pregnancy. Like you said, there are some particular things that are important to supplement like folic acid but that already happens through those prenatal multivitamins. The main thing to watch out for I think is toxic stress. We must protect pregnant women from major stressors during pregnancy. We know those have effects, lifelong effect. Potentially shaping trajectories in offspring and certainly the telomere study suggests that too. Moms who have experience major stressors during pregnancy, their kids when they’re adults tend to have shorter telomeres, at least in one study.

S: Got it. It’s not just about your childhood adversity if you’re going to end up with shorter telomeres but also while you were in the womb, was your mother subjected to extreme stressors.

E: Exactly.

S: I’ve heard about banking your stem cells as a way to protect yourself in the future. Let’s say that you end up with some horrible disease and you have some stem cells banked when you were younger, you could use those cells, our younger cells don’t have the impact to the aging and they are going to be much more effective at fighting that disease. Can the same be said about telomeres like can you bank telomeres while you’re young?

E: It’s an interesting idea. Can’t comment on that but I can tell you that the stem cells, part of the reason they’re so immortal or that they can go on dividing and dividing, they have really long telomeres and a high telomerase. Those are the cells with the highest levels of telomerase. They do very well when they divide whereas our more differentiated cells like our blood cells that have been around awhile, shorter telomeres, less ability to keep dividing, low telomerase.

S: Got it. I’m curious, have you considered getting you stem cells banked or have you got your stem cells banked?

E: I don’t know much about that, sounds intriguing. Stem cell science is certainly going to hold a lot of clues to both therapies as well as healthy aging.

S: I’m going to actually have one of the experts in stem cell therapy on the show here in the upcoming episode, Dr. Harry Adelson, that’ll be an interesting one. How do people find your book, The Telomere Effect, any other resources that you want to recommend for our listeners?

E: Yeah, sure. The book is on Amazon. There’s a book website and that is www.telomereeffect.com. There’s our research website at UCSF. We’ve been wanting to give people a chance to do some of the assessments that are in the book. In the book, there are more research grade assessments. On our website we have some what I’ll call knock offs, similar assessments but you can’t use research once publicly. We have chances to do these kind of quick crude tests on how pessimistic are you, optimistic, hostile, how much purpose in life you report. Those are all interesting traits that we’d have more less of, that we carry around with us and that have been associated with telomere length. If people take those, then let me know. I’ll put my email in the website, is it helpful to know this about yourself? We’re always looking for feedback. We don’t usually give people their results when they’re in our studies but I think that’s where everything is moving and should be moving which is awareness of our biological and psychological domains of health and how we can use that. Like you said, if you can’t measure it, you can’t easily change it. That kind of awareness is what we are wanting to help people with.

S: Awesome. You mentioned purpose. I’m curious, is there a strong correlation between your sense of purpose and your telomere length?

E: Purpose in life is a super interesting, important factor in healthy aging in general. Feeling more purpose is associated with lower inflammation. The one study that I was referring to is a small meditation study again by my colleague [00:55:45]. He found that the people who increased more in purpose in life tended to have a higher telomerase at the end of the retreat. The conclusion there is not that you need to go to a mountain and meditate, there are other ways of increasing your purpose in life. I guess the meaning in both every day and just our greater purpose is in a way that is more about love, relationships, giving. Those are the things that make people feel content and feel like they have purpose. Taking those types of questionnaires helps refocus us and helps us remember about what our priorities are and what matters to our fundamental human nature. Getting in touch with that can shape what we decide to do in that day and in our short and long term goals. Purpose in life is something that we have through life that can change. It can change around but it’s mostly something that’s highly correlated over time. We should look at it and think about it and make sure that we are living our full purpose.

S: I agree and I’m glad there’s some science to back up too.

E: Yeah.

S: Thank you so much, Elissa. Again listeners, the book is called The Telomere Effect. It’s available in Amazon and Barnes and Noble and everywhere else. The book website is telomereeffect.com. Also, check the show notes for this episode, the transcript and the checklist of actions to take all on The Optimized Geek website at optimizedgeek.com. This is your host, Stephan Spencer, signing off. We’ll catch you on the next episode of The Optimized Geek.