Dr. Eric Topol shares a new vision for living longer and better
Dr. Eric Topol shares a new vision for living longer and better | The Excerpt
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Healthspan overrides lifespan or longevity
Dr. Eric Topol's new book "Super Agers" separates myth from fact in regards to living a longer and healthier life.
On a special episode (first released on May 8, 2025) of The Excerpt podcast: What if the second half of life could be just as healthy, active, and fulfilling as the first? Drawing on the latest science, world-renowned cardiologist and researcher Dr. Eric Topol challenges outdated ideas about aging and reveals how factors like exercise, sleep, social connection and cutting-edge AI tools can help us extend not just our lifespan—but our healthspan. Dr. Topol joins The Excerpt to share insights from his new book "Super Agers: An Evidence-Based Approach to Longevity."
Let us know what you think of this episode by sending an email to podcasts@usatoday.com.
Hit play on the player below to hear the podcast and follow along with the transcript beneath it. This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text.
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Dana Taylor:
Hello and welcome to The Excerpt. I'm Dana Taylor. In an era where aging is often framed as something to resist or reverse, Dr. Eric Topol offers a far more empowering vision. What if the second half of our lives could be just as vibrant and healthy as the first?
In his latest book, Super Agers, an evidence-based approach to longevity, the renowned cardiologist, researcher, and author lays out a bold data-driven roadmap to extending, not just how long we live, but how well we live. In addition to years of research, Dr. Topol has also been recognized by Time as one of the 100 most influential people leading change in the medical community. Dr. Topol, thank you for joining me.
Dr. Eric Topol:
Great to be with you, Dana.
Dana Taylor:
In the book you discuss the concept of health span versus lifespan. What's the difference and which one should people focus on to improve longevity?
Dr. Eric Topol:
Well, we don't really want live to 110 and be demented or have all sorts of other chronic diseases. But on the other hand, if we could live well into our 90s and have no chronic diseases, the big three age-related ones, cancer, cardiovascular, and neurodegenerative, that would be the goal. So I think most everyone would agree that health span overrides lifespan or longevity.
Dana Taylor:
You argue that genes play a surprisingly limited role in healthy aging despite decades of genomic research. What was the most surprising thing you learned from your study?
Dr. Eric Topol:
So some years ago we did a study we called the Wellderly, and we enrolled 1400 people, average age of almost 87, who had never had a chronic illness, an age-related disease. And we thought the whole genome sequencing was going to demystify everything. But as it turned out, we found very little. And so really the emphasis that has been put on our genes for healthy aging is misplaced. It's a small component, but there are many other factors, especially what I call lifestyle-plus factors, that appear to play the dominant role.
Dr. Eric Topol shares a new vision for living longer and better
Dr. Eric Topol's new book "Super Agers" separates myth from fact in regards to living a longer and healthier life.
Dana Taylor:
Well, you mentioned the profound impact of physical, regular physical activity, on health span. Can you elaborate on the types of exercises that are most beneficial?
Dr. Eric Topol:
Well, as a cardiologist, I would always advocate aerobic exercise. Like certainly you're walking and bicycling, treadmill, swimming, that sort of thing. But what has been really extraordinary in recent years is the data that supports strength or resistance training. As well as balance training, things like posture. But especially getting stronger as we get older, because our muscle mass is decreasing. And to counter that, to prevent frailty, to promote healthy aging, resistance training, which is advocated at least three times a week, is something that's really quite important.
Dana Taylor:
In an age of Ozempic and personalized medicine, how do you see the balance between behavioral changes and pharmaceutical solutions in promoting public health?
Dr. Eric Topol:
It's a great question, Dana, because the GLP-1 drugs like Ozempic caught us by surprise. Because, as I wrote in the book, for 20 years they were around for diabetes, but the people taking these medications with diabetes didn't have much weight loss. So we were misled. And now we're seeing not just the marked effects on weight loss, but also on many other conditions, even some not related to weight loss at all.
But the overriding thing is the lifestyle factors. The exercise, the types of nutrition and diet, and that does include our body weight, and also of course sleep. But then the lifestyle factors extend to things like social isolation, time in nature, exposure to environmental toxins like small particulate air pollution, microplastics, forever chemicals, and the list goes on. But we have an admixture where lifestyle factors are the most important, but now we have a drug class that came out of nowhere in recent years that is probably the most momentous drug class due to its reduction of inflammation. And of course is now being tested in Alzheimer's in people who are not even overweight.
Dana Taylor:
As you mentioned, sleep is super important in maintaining health. Can you explain the role of the glymphatic system in sleep and its impact on brain health?
Dr. Eric Topol:
Yeah, so the glymphatics, not lymphatics, are the drainage system for our brain, which gets activated during deep sleep, the slow wave type of sleep. And that deep sleep is so essential. Unfortunately, as we get older, it gets decreased in the amount of time. It tends to come in the earlier phases of sleep, interestingly, not... you think deep that it would be late in the night, but it's not the case. And we want to maximize that because that's the best way we get our brains refreshed and get rid of the stuff that's in our brain through the glymphatic system, which is a relatively recent discovery, that there's this elaborate system for basically pumping out these toxins from our brain that accumulate each day. So sleep health is far more important to prevent these age-related diseases than we'd ever really recognized before.
Dana Taylor:
You emphasize the role of AI in building personalized health forecasts. What do you think is the greatest opportunity and the greatest risk of integrating AI into preventative medicine?
Dr. Eric Topol:
I think this is now the next frontier. It's so exciting to see this starting to take hold. If you have all of a person's data, and now we have tests that can predict Alzheimer's over 20 years before it happens, and all three of the big age-related diseases take at least 20 years to incubate. So if you have all of a person's data, and now that includes things like organ clocks from a blood sample, these new proteins like PTOW 217 for Alzheimer's and so-called epigenetic clocks.
So the point here is that the science of aging has brought us all these new data types we never had before. So we can take a person and say, "You're not at risk for any of these three major diseases," or we can say, "Pinpoint, you're at risk for this disease," and say when. Not just that you're at risk. And so that gives us the ability to, with AI, it requires multimodal AI because it's billions of data points. But that gives us the ability to start to put a person under surveillance for that concern, that disease, and get all over it and prevent it. Something we've never been able to do in the history of medicine.
Dana Taylor:
I want to dig into environmental toxins because it's a significant concern in Super Agers. What are some common environmental exposures that people should be aware of? And how can they minimize their risk?
Dr. Eric Topol:
So this is something that's basically chasing our tails. We have all these new capabilities for promoting healthy aging and healthy longevity. But on the other hand, we're seeing increased exposure to air pollution, which is difficult to counter except for having air filtration in your home and being attentive to air quality.
Then the next, of course, is the problem with microplastics, et cetera, getting to every part of our body and especially our heart arteries and our brain, and implicated in conditions like heart attacks, strokes, and higher risk of dementia. So how do we get rid of plastics? That's hard. We can certainly reduce the intake of things that are in plastics. Don't microwave things that are in plastic containers, don't use plastic any way we can avoid it.
And that of course also applies to forever chemicals that are pervasive in so many things, where we unfortunately, Dana, don't have the national priority like they do in some parts of Europe and other parts of the world, to reduce the toll of these major environmental risks that are unfortunately mitigating the progress that we're making. So we can do some things at the individual and family level, but we also need things to occur at the national level.
Dana Taylor:
You explore the potential of personalized nutrition using AI in the book. How can AI revolutionize our approach to diet and nutrition for better outcomes?
Dr. Eric Topol:
So we don't know yet whether that will take hold, but it's a really intriguing prospect. And the point is we each metabolize the food that we eat, the things that we drink, totally differently. So if you and I had the exact same food, the amount, the exact same timing, one of us would have potentially a glucose spike and the other one would have no increase in glucose at all, and the same would be with other things like lipids.
So the point being is that if we can understand what is the uniqueness of each of us, and we can do that starting now with sensors and other ways like our gut microbiome, which turns out to be very important, then perhaps we'll get to a point where we can say, these foods are not good for you because they're potentially going to increase your progression from pre-diabetes to diabetes. On the other hand, these foods might help you reduce your risk of cancer. And so each of us has propensity for either benefit or potential hazard from foods, and so a lot of work is being done to decode all that. And the NIH has a very big study that's ongoing, and hopefully over the years ahead we might be able to crack the case. But it's still something that's a prospect and not a reality yet.
Dana Taylor:
Recent investigations have cast doubt on the validity of Blue Zones. These are parts of the world that have high concentrations of people living longer and healthier lives like Okinawa, Japan, for example. Some critics are suggesting that factors like unreliable record-keeping and potential age misreporting may undermine claims of exceptional longevity in these regions. Given your emphasis on evidence-based approaches to aging, how do you assess the credibility of the Blue Zones concept and what lessons should we take away from this controversy when identifying models for healthy aging?
Dr. Eric Topol:
Yeah, I'm so glad you asked about that because now we have to consider the Blue Zones as a real myth. The more it's been looked into very carefully, the absence of evidence for the healthy aging longevity in these zones of the world has never been confirmed. Poor records and inability to confirm the data about these people that were thought to be these special, exceptional, healthy agers is a real problem.
There's no question that we, as I present in the book, you know, a 98-year-old people who are completely healthy, never had an age-related chronic disease, but there doesn't appear to be any zone in the world that is special. There may be a cluster of people here and there like in Okinawa or Italy as was presented in Blue Zones. But it's been hyped up unfortunately to the nth degree, and it just lacks the substantial evidence to support it.
Dana Taylor:
Looking ahead, Super Agers discusses future possibilities for altering the aging process. What are some of the most exciting technological advancements on the horizon that could change how we age?
Dr. Eric Topol:
What excites me, and what I think is very different, is from this science of aging, that is we have all these clocks now we didn't have before. And so the near-term, one of those things we just talked about may click eventually, but none of them are there yet. And it may take years before any are shown to be safe and effective.
But on the other hand, we can now predict a person's arc of age-related diseases now unlike ever before, and it's just going to keep getting better. And that's why I think the science of aging brings us today a lot of exciting potential. Because if we can suppress the three age-related big diseases, the big killers, that's accomplishing a huge amount, that doesn't necessitate one of these elegant approaches to reverse aging. Instead of reversing aging, it's preventing the age-related diseases.
Dana Taylor:
Dr. Eric Topol's, new book Super Agers is on bookshelves now. Eric, thank you for joining me on The Excerpt.
Dr. Eric Topol:
Thanks so much for having me, Dana.
Dana Taylor:
Thanks for watching. I'm Dana Taylor. I'll see you next time.
And I'm going to do one quick thing. It's just for audio. Thanks to our senior producers, Shannon Rae Green and Kaylee Monaghan for their production assistance. Our executive producer is Laura Beatty. Let us know what you think of this episode by sending a note to podcasts@usatoday.com. Thanks for listening, I'm Dana Taylor. Taylor Wilson will be back tomorrow morning with another episode of The Excerpt.
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