403 | The Real Factors That Effect Our Biological Age, Pain and Disease with Nikolina Lauc

[00:00:05] Welcome to the Optimal Body Podcast. I'm Dr. Jen. And I'm Dr. Dom. And we are doctors of physical therapy, bringing you the body tips and physical therapy pearls of wisdom to help you begin to understand your body, relieve your pains and restrictions, and answer your questions. Along with expert guests, our goal of the Optimal Body Podcast is really to help you discover what optimal means within your own body. Let's dive in.

[00:00:29] Guess what, podcast listeners? It is my birthday today. Yes, today is my birthday and I have deemed this month April ass and abs, if you have not heard. Now, this isn't about getting a six pack or building a bigger butt. No, this is about the function and getting down to the foundational level of how we connect to these areas so that we could feel so much better within our body.

[00:00:52] Now, you come to this podcast to learn, to understand, to feel something different in your body. And this is your opportunity to join us for just $20 this month. I am focusing on our Full Body High Intensity Plan, but for just $20, you can check out any of our 12 therapy plans that we have available.

[00:01:08] Now, I'm doing this plan because not only does it have power to help rebuild and reconnect in a very dynamic way within my body, which these HIIT workouts can be scaled for any level, and we lose power at twice the rate we lose strength as we age. So just so crucial to maintain, but we also have strength workouts. We have a ton of mobility this month, muscle activations, deep core coordination, so much that you're probably missing and not adding in.

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[00:02:01] This is such a complete program to really help us maintain how we feel and function in our body as we age. And I'm so excited to do this and continue to reconnect to my body this postpartum and feel so much stronger and powerful. And I hope that you join us. It's just $20. We're giving it to you for the first month. Use code OPTIMAL at checkout.

[00:02:24] That's going to get you $20 to check out any of our therapy plans we have available, but I am focusing on the full body high intensity plan if you want to come join me. That is gen.health backslash free trial. Use code OPTIMAL at checkout. Excited today to interview Nicolina Laus, who is CEO and co-founder of GlyconAge, a leading startup in the health tech and longevity space, whose technology has been developed with over 20 years of research and supported by $40 million in European grant funding.

[00:02:52] Utilizing the largest proprietary data set of human glycon, GlyconAge is pioneering advanced blood biomarkers for the prediction of age-related diseases. Recently raising a $3.7 million seed round, the company is endorsed by Hub 71, Mubadala's accelerator program. Nicolina is a serial entrepreneur with proven experience in scaling startups and leading growing teams.

[00:03:16] A Draper University alumni and Foresight Institute fellow last year, Nicolina was also recognized as the entrepreneur of the year 2023 in Croatia. Such a cool chat about how our biological age can actually influence mortality and be related to our health and longevity. Let's get into it. Nicolina, thanks so much for spending some time with us today.

[00:03:38] We've talked biological aging a couple times on the podcast, but really excited to dive into what you're all doing at GlyconAge and some of the cutting-edge research that you have related to it. Thank you for having me on. Really great to be here. So first of all, I think, you know, understanding what you guys do that's different in measuring biological age.

[00:04:02] Because as Dom said, we've had other people on the podcast that kind of have their own forms and tests of measuring biological age. So how is what you guys do at GlyconAge different? So you have to tell me how deep do you want me to dive into the science or aging in general? Okay, good. So we haven't yet settled on what aging is. And you have a number of these competing theories. And it could be that actually all of them are aging.

[00:04:31] It's just it's going to be a multitude of different things. And one theory is that we have a program. And I think potentially the other biomarkers or companies you spoke to use epigenetics as a way to measure aging. And this is more connected to this theory of that aging is a program that we can potentially reprogram. And at that point, we rewind the clock.

[00:04:59] The other theory is damage. That we do continuous damage as we live. And this accumulates. And that point causes disease and death. Our clock is connected to the damage theory. And it's predominantly around the immune system. So it's damage that you create throughout life. Part is being more predisposed to it. Part is epigenetics.

[00:05:24] So everything that's from when you were in your mother's womb to today, how your genes have been expressed. And the other part is behavior, lifestyle, everything that's kind of happening in your immediate environment. So that's called inflammation or this accumulation of chronic inflammation as we age. And we look at glycans.

[00:05:49] So these are complex carbs located on your antibodies, which would control inflammation. So they would be anti-inflammatory or pro-inflammatory. And then their balance as you get older would change. You would have more of these pro-inflammatory structures and less of these protective anti-inflammatory ones. And you have related events that would accelerate it. For example, menopause would accelerate it naturally.

[00:06:15] But it's really kind of different events in your life that would trigger it to go up. And then either you keep that or you can figure out what it was and turn back the clock. But it's something you have to look after throughout your life. Versus with a program, it's always good to kind of take as it's supposed to. And you can slow it down a little bit, but you can radically change it. Or we haven't yet proven that reprogramming therapy does that.

[00:06:42] Taking a quick pause from the interview to talk about one of the most important aspects of our health that not a lot of us pay enough attention to. And that's our hydration. Now, I'm not just talking about drinking enough water, but making sure we're replacing the electrolytes that we're losing naturally throughout the day. The weather is going to start warming up here. And especially in the summer when it's hot outside, we're losing sodium, magnesium, and potassium much more than we think we are through our skin when we sweat.

[00:07:10] That's why Jen and I use Elements electrolyte drink mixes in our water every single day to make sure we're getting back in the sodium, magnesium, and potassium. That helps with so many processes in our body. When we optimize our electrolytes, we can help with headaches, brain fog, fatigue, muscle cramps, even our sleep and our bowel movements. And not only that, it tastes so darn good that it's going to keep you coming back to your water bottle to make sure you're getting these vital electrolytes in.

[00:07:38] Now, with every single order that you make through our link, you'll get a free sample pack that gives you all of the flavors so you'll know which one you like the best when you inevitably come back and get more. Head to the link in the show notes. It's just drinkelement.com backslash optimal. That's drinkelement spelled out L-M-N-T dot com backslash optimal. All right, let's get back into the interview. So, it's this accumulation or this balance of the inflammatory markers in our body.

[00:08:06] And like you mentioned, you're kind of using a combination of a way of the genetics and the epigenetics where a lot of people I feel like we've talked to before have talked about how you can have complete control over this epigenetic factor and what you're surrounding your genes with and how they present. So, what's the balance? What's the balance of how much of this is genetically programmed into us

[00:08:33] versus how much can we control on the epigenetic or the environmental side? So, what we measure are post-translation modifications. So, they would change how your biology works beyond genetics and epigenetics, but they would incorporate genetic and epigenetic influences. So, it's a layer on top of your protein and all of our proteins are coded in the genome. So, this is like a direct translation from genes to protein.

[00:09:00] And then how your genes are expressed is changed through the epigenome. We did studies on twins to define how much of it is genetics, how much of it is lifestyle, and how much of it is epigenetics. And, of course, these are never perfect. And, you know, these measures are never perfect, but on average, it's about 40% genetics. Then 60% is epigenetics and environment.

[00:09:26] So, we can change about 60% of it and 40% of it is generally defined by our genes. That was when I heard you talk about that on a previous interview. That was probably the most shocking to me because we've heard that you can manipulate your genes a lot further. So, hearing that, you know, 40% is still controlled by your genetic, you know, makeup and how you were born

[00:09:50] and just the luck of the draw or not versus how much you can really control about 60%. What is dictated within that 60% that you can control? Like, what does that mean? Well, maybe this is in relation to aging. So, when we look at the aging clock, 40% of it is governed by genes. If we look at cardiovascular disease, cardiovascular disease in women, we see about 70% of that is defined by genes and 30% is what we can control.

[00:10:20] So, it's condition to condition. This is, of course, different. Now, what goes into the 60% in terms of what influences it? We can say that another 40% of it seems to be epigenetics. Which is your environment from, again, your mother's womb to the rest of your, you know, to where you are today. And then 20% of it is lifestyle. So, this is more small behaviors that you can influence.

[00:10:49] Now, these are all approximate numbers. You can find, and this is in a cohort. So, within these, we studied over 200,000 people. But in the genetic study, we mainly had twins. So, that was about 2,000 twins that were tracked over 20 years. And this is the percentiles we found for these twins. But if you apply to an individual, it could be entirely different. So, it could be that for me, 50% is genetics. 30% is epigenetics.

[00:11:17] And everything else is lifestyle. So, it's not, you know, in a study, we always say we're going to find this ultimate guideline that never applies perfectly to an individual. And we're actually now working on a way to calculate how much of it is genetic for an individual. So, when you get your results, we can say, hey, for you, this percentage seems to be genes. Wow. And this is what you can impact. So, I also want to grasp, like, the importance of this.

[00:11:46] Like, okay, I get my biological age back and it gives me a number. Why is that important? Or how can that be made important to someone? Like, does it relate to mortality if you have a much higher biological age? Is there, like, a correlation to mortality? Is there a correlation to when you might start developing other, you know, chronological diseases? This is, of course, clock to clock. So, I can only talk about our clock.

[00:12:12] And our clock is now, so it was invented in 2013 by my dad. This is quite a while ago now. So, we get to do a lot, you know, we did a lot of research in between to do these correlations with mortality, disease. And we've took it quite far. So, there's a study coming out in the next month on twins. In this Swedish research institute that had one of the biggest twin studies. And there were 600 twins tracked over 30 years.

[00:12:41] And they looked at acceleration on individual levels. So, if you have an accelerated glycan clock, on an individual level, it was highly predictive of mortality and also dementia incidence. And if you know what a hazard ratio is, the hazard ratio was 0.74, which is quite significant. And this is on the level of an individual. Usually, studies are on a cohort level. So, we say this predicts mortality on a cohort level.

[00:13:07] And we did a number of them before to predict mortality. And there was even comparison between the clocks. So, which clocks from the clocks we have used in research, which of them are the best at predicting mortality. And usually, the clock that's recognized the most as the best predictor of mortality is Steve Horvath's Grimmage, which is a mortality predictor. So, it's been modeled purely on mortality data.

[00:13:35] And they compared the Grimm clock with the glycan clock. And we were equally good at predicting mortality. So, that's quite interesting because our clock wasn't built on mortality data. So, it seems that its inflammation is very relevant to our risk of dying in the future. Keep in mind, it's not now. It's a risk. And you can live with risk for a long time. It just makes you more susceptible.

[00:14:02] And in terms of disease, we have shown that some of the glycans that are measured in the clock are even causal of certain diseases, like hypertension or Crohn's disease. And when we looked at general, so everything we measure in the aging clock, which are about 31 different glycan structures that would regulate this inflammatory process, that was connected to over 72 different conditions that have been studied so far.

[00:14:30] And the most interesting finding is not that they're connected to these diseases, but the glycan, we call them glycosylation signatures. So, there's this, glycans are complex carbs that you would, nothing to do with your dietary carbs or sugars. You manufacture these carbs to add the function to your molecules, and in this case, your antibodies. And they change, in many cases, up to 10 years before you develop a disease.

[00:14:59] So, if we look at rheumatoid dephritis, there's a certain glycan or the sugar pattern that would change 10 years before symptoms in the diagnosis. And then you have this accuracy level, or something called AUC, sensitivity versus specificity. And in this case, it was 92. So, in 92% of the cases, we can predict someone will develop rheumatoid dephritis 10 years before a routine clinical diagnosis.

[00:15:26] And that's also true for hypertension, for diabetes, for cardiovascular events. And it's very relevant to health in a way that we've shown in hard science. But now it's about how do we bring this to people and to healthcare, because healthcare doesn't yet know how to do prevention. So, when we give this tool to a regular doctor who's busy seeing patients with acute problems, they're like, Okay, great. Come back in 10 years. And then I will give you a prescription.

[00:15:56] But until then, I don't know what to do with you. So, I think this is really fascinating in terms of being able to even predict prior to having the diagnosis, which can be so powerful for so many people. But currently right now, how is that being measured? And how can people measure this? Is this, you know, do we see it eventually coming into more doctor's offices where insurance would be able to cover it?

[00:16:23] Or is it something completely out of pocket that only a few can really, you know, afford? Like, how accessible is this? And how do we really measure it? That's still a long path. You know, that's what's going to take a decade or more if you want to talk about when does healthcare actually pay for it. And then depends on, you know, which healthcare system around the world. So, it took us a very long time to do anything commercial with the clock.

[00:16:52] We kind of, you know, we could have licensed this out to another company that would do it for us. Or we could have done it ourselves. And we decided to do it ourselves. So, the original research institute and the team that was behind the scientific discovery is also the commercial team. I think that's actually an unusual but important thing to do because then the scientists who are usually stuck in the lab see real people's problems.

[00:17:19] And we kind of work together on how do you apply it so it actually benefits an individual. We started with the consumer tests because aging is not a disease. So, something that right now healthcare will never pay for. So, it has to be out of pocket. And that's a wellness category. So, we don't add any medical claims to it. Now, there's a number of different biomarkers and things which are measured with this wellness test that can be clinical. And that can be brought to the clinic for time.

[00:17:49] And that's something we started doing quite recently. So, we have these advanced reports which are for medical professionals. And they're similar to the early genetic reports where you give association with certain conditions. And out of these 72 diseases that were studied, we selected 14 that had the most robust evidence, highest cohorts, accuracy support.

[00:18:13] That we give now just to doctors this information of what could actually be driving this inflammatory process in the patient. It's not a diagnostic. So, they can't make a diagnosis based on it. But they can do other diagnostic testing to confirm something. And they can work towards prevention of something, especially if there's also a family history. So, at the moment, it's a cash pay test. It's not the same as the genomic tests.

[00:18:43] You pay for them generally out of pocket at this point. So, it's all private healthcare. And we work with about 1,500 private clinics around the world across over 60 countries at this point in time. So, it is available, but it's healthcare you have to pay for. And then in the long run, we're working towards proving these health economics.

[00:19:06] So, showing that if you utilize these biomarkers in a preventive model where you can identify people at risk and then put them on different preventive protocols, a lot of them which are based on the individual. So, it's you making these changes to actually prevent your own disease. It's not a doctor giving you a prescription. That in the long run, this saves the healthcare system money. But first, we need to show that people will actually apply this advice.

[00:19:34] And doctors giving it to patients will actually, or, you know, us giving this to patients will be beneficial. But we know that you can prevent them. For example, the lichen patterns that will predict cardiovascular disease respond to physical activity. So, if you identify that as a risk factor in someone, they could start increasing their activity load. And you can measure how well that's improving their markers.

[00:20:01] Or the markers that will predict diabetes respond to weight loss. And, again, you can tell somebody, hey, you don't have diabetes yet. So, we see changes seven years ahead of insulin resistance. You can tell them, Ian, you know, you're at risk within this period of time to have a real problem. Why don't you lose the weight now or work on it now before we actually have to put you on medication?

[00:20:25] So, maybe giving this information to the end consumer will help change his behavior. Because, right now, you don't really do anything until you have a diagnosis. And, actually, the best lifestyle improvement is seen after your first cardio event. Which, you know, if you survive, then it's good news. But if you don't, yeah, it's a bit too late.

[00:20:49] Well, and I think, and I'm sure that you've dealt with and discussed all of these frustrations about how we currently, in most countries, live in a reactive healthcare state where we're reacting to the major events. Like you said, a cardiovascular event. And that is what motivates people to make those lifestyle changes. Rather than, even if they had information, would that inspire someone to say,

[00:21:15] hey, you're at a very high risk of having a major cardiac event in the next 10 years. Does that even click with somebody? Does that even inspire them to make the change? And, like you said, like that's the type of work that you're doing right now. It just, like the paradigm shift that it would take to start to edge our healthcare system in that direction, I think is pretty huge. But one thing that we were talking a little bit before we came on about pain. And, you know, Jen and I are physical therapists.

[00:21:45] We talk with a lot of people about pain conditions, chronic pain conditions, especially when it comes to movement. And I know that you were discussing a little bit some research that you have coming out soon about how pain can relate to this biological aging. Yes. So, that's a published paper done a while ago. I put a link in our chat and I can share it for your notes later. Perfect.

[00:22:11] This was a study looking at, so glycans, it's not just about the age. It's more about the certain glycans that are measured or that would drive inflammation. And we looked at these glycans that drive inflammation in patients with chronic back pain and healthy controls. And we found that if you have chronic back pain, then you have a higher inflammatory load. And also, they looked at subtypes.

[00:22:37] So, there was a subtype of this degenerative disc where you had a scoring system of, you know, the more, the higher the score. And it didn't correlate as much with this degenerative disc score. So, it was more connected or either you can identify these subtypes of what's chronic inflammation and what's something else. But it was interesting that it wasn't so much about this concrete disease you can identify.

[00:23:07] It was more about this kind of underlying inflammatory process. And then maybe some other things that would be driving chronic pain. As you know, it's a symptom. And the cause can be very different person to person. And I absolutely love that this is a published paper as well that's already out and people can look at. And we'll have that linked up in the show notes as well. Because what that further drives on what we talk about here on the podcast is how multifactorial back pain is.

[00:23:35] And there's no just a movement that you can do to solve back pain. And there's no just MRI that will tell you why you have back pain. It is so much deeper than that. And like you said, there's so many reasons why people could be having this chronic inflammation. And a lot of times that is such a stress driver within the body, right? Can we talk about a little bit how stress, you know, plays a role in this chronic inflammation?

[00:24:04] And does that differ kind of from men to women as well? Oh, men to women, we don't know. We do know that if you look at immune aging or what we measure, there are significant gender differences. And for women, you would generally be more anti-inflammatory to men and you have less change throughout time. Men would age a little bit quicker than women on this scale.

[00:24:32] But of course, their clocks are customized to them. So we do personalize the clocks to gender. And then women would have this rapid acceleration in aging, perimenopause to menopause, even before they lose their cycle. So basically, their estrogen is declining. And then another natural event where we see women have acceleration that also goes down and they recover is pregnancy. Well, post-pregnancy.

[00:24:58] During pregnancy, they're more anti-inflammatory and you have this very special type of estrogen that's created during pregnancy. Their age would go right down, maybe even to the lowest number. But then straight after, as their hormones drop, then you see acceleration, which can also be about 10 years. And it stays until you stop breastfeeding because that's when the hormones start to rebalance. So there are some gender differences. We don't know how this relates to pain.

[00:25:25] Well, we do know that stress seems to be a more significant driver, even than menopause. And of course, it depends on the severity. So we did this study with 600 individuals diagnosed with PTSD and healthy controls. And we see that they're on average 15 years older than their age. And stress is something we've been recently doing more research.

[00:25:53] We were doing a PTSD study with Ukrainian soldiers. And that's not a published paper yet, but will be an interesting one. And we did 100 medical students during their first year of residency. That's just about to be published. And of course, you have many factors there. There's lack of sleep.

[00:26:18] There's poor diet, long working hours, high stress because lives are at risk and you've never done this job before. So I think this will be the highest, I can't yet tell you what it is, but this will probably be the highest acceleration in the clock that we see compared to some other things. So stress is a huge factor. It's impossibly hard to decode because it's very individual as well. But it seems to be more important than even natural bowel or events like menopause.

[00:26:48] Wow. Yeah, that's pretty eye-opening. I'm sure I would be very interested to see the study on the residents and how much their markers changed through that first year. I also know that you kind of shared a little bit with us about a personal story that you had that involved both stress or trauma and a physical pain that you were feeling. Can you tell us a little bit about that? Yeah, yeah, absolutely.

[00:27:12] I think that each of us has their own stories and it's really hard to find causes because usually when we measure these things, we measure them in our late 30s, 40s when we kind of start to think about aging. And I measured mine since I was 24 and I'm going to be 34 at the end of this year. So almost a decade, let's say nine years so far. And it's generally always been under my age.

[00:27:42] So and early on, and I was an entrepreneur for 15 years, so that comes with its own stress. But 10 years ago, it didn't seem to affect me so much. And I think in general, if I look at ups and downs in work, it didn't correlate with my clock. There was no acceleration, no matter how good or bad or stressful work was. And then the first significant acceleration I had was maybe two years ago now.

[00:28:10] And that was after a relationship breakup. My clock went up 10 years. And it's not the first time we see it. So usually this would be noise in our data. I remember a diet study we did five years ago of 3D nutritionists following a specific diet and all of them were doing well. And then I had two people accelerate and it was a pilot. So I emailed them and said, hey, what happened? You know, you age seven years. You're following your diet. What's going on?

[00:28:40] And then both of them said they got divorced, you know, not to the same person. But the woman replied saying, I just went for divorce. The man replied saying, I just went for divorce. And I was like, oh, OK, that's interesting. So that happened to me. And then I was also I was working with a psychotherapist at the time. And we discovered that that's probably connected.

[00:29:04] Well, there was a childhood trauma of abandonment because I was born when the Yugoslavian war started. And at nine months, at two years, they shifted me off to grandparents. It was like a five year war and, you know, pretty hard time to balance kids. And my parents had three kids in that period of time. And there were 20.

[00:29:31] Well, my dad was 20 and he had three kids before he was 25. So I ended up being left multiple times for good legitimate reasons. But you wouldn't understand that as a child. And that seemed to be a trapped emotion that came out when I would feel it as an adult.

[00:29:54] So and recently, so I've had shoulder pain for maybe 78 years now. I used to box and I thought this was a boxing injury that I just didn't heal. So I would try everything and it kind of got significantly worse this year. And I've tried from massages, acupuncture to biomechanics.

[00:30:21] I've pretty much tried everything to fix it. And then I realized that it would get triggered with certain things. Or also, again, when I would feel very stressed or abandoned. And I had a moment this summer where I couldn't sleep for two, three days because of shoulder pain. And nothing helped.

[00:30:46] So I did all the, like I had a little baseball that would help me and all kinds of things. Nothing helped. And then my brother came over for a day and a half. And my pain went away the next day. And I realized that it was completely psychological. And since I realized that, my pain has permanently gone away. At least for now. Well, we'll see.

[00:31:09] But it's kind of like when I can get to the core reason of something, it also seems to change my behavior. And I don't know if that applies to everyone. I think there's also lots about behavioral change that we still need to understand. I think there's different types, you know, how people respond to having or not having information. For me, the moment I understand the reason, I can change behavior. And this happened before as well.

[00:31:37] I had a period in my last year of university where I didn't sleep for six months. And then I read a book about a woman who didn't sleep for 14 years and went through everything that she tried. You know, all sleeping pills, different programs, anything you can do, basically. I mean, imagine if it was 14 years. Until she got in the end and realized the only thing that kept her awake was her mind. And everything she did was reinforcing that she had a problem.

[00:32:04] You know, that sleeping pill would reinforce that, you know, there's a problem. Or, you know, she didn't sleep well one day and the next day she was like, oh, maybe I'm not going to sleep well this year. This day and it becomes a chronic problem. I put that book down. I went to sleep. And I've slept like a baby ever since. So, yeah, I think there's this big part about our psychology that is really hard to decode.

[00:32:32] But for me, if I can get to this underlying why, it seems to change things. I 100 percent. And I hope that starts to light ideas up for other people of like, because it's that awareness factor and telling your mind what is to be true. Because a lot of times we're telling our mind if we're feeling pain, especially we're broken. Something's wrong. Something's this. But when we can actually connect it to what is the truth and where that's really coming from, you cut that, you know, that stress response.

[00:33:01] There's no longer a tiger chasing after me and I'm not broken. There's not something that's that needs to be surgically fixed or is wrong with me. It's just that I'm at this level of intensity or stress or trigger. And that's what's triggering my pain. And when you can connect those two, because I remember I did that. You know, I would get some shoulder blade pain. I got in a little accident. It wasn't a huge deal. But immediately my shoulder blade pain, you know, shot up and I can say, oh, because I got in the car accident.

[00:33:31] But I was like, oh, how funny. I'm stressed. And that's when I'm feeling the pain. And as soon as I acknowledged it, it went away. And as soon as and that happens every single time, if it it doesn't really come back at all anymore. And I think because similar reasons. Right. I acknowledge the pain. I understand where that's coming from. And if I can understand how to start managing my psychological symptoms and my stress, then I can start to reduce some of those pain responses.

[00:33:58] So it's really cool to be able to hear your story and your journey in that and and see how you're relating that back. And how much, you know, I think it's so great that you're able to talk with someone and get that psychological help as well in order to detect and decode what's happening on that deeper level. And that's, I'm sure, one of the factors that would go into longevity.

[00:34:24] And now when it comes to some of the people that you've seen, or maybe you guys have been able to test who are in their 90s and above, have you been able to see like, wow, this person, you know, chronologically is this age, but biologically they're testing way younger. Like, have you been able to see some really cool examples of people who are living a particular lifestyle in a particular way that's leading to these results?

[00:34:54] We did recently 50 centenarians in Italy and Costa Rica. And so the problem is we don't have enough of them to also customize their clock because their population ends at 95 and they're 100, 105 and more. But you would find individuals, so we can't always give them the exact number. That's something we're studying now so we can customize the clock to them.

[00:35:21] But we did have individuals who are phenomenally young despite age and they didn't have any diagnosed disease. So we had, actually the first person of the type that I met was my grandfather, grandmother's neighbor. She had, she has like a group of grandmas in her building and they socialized and we tested all of them at one point.

[00:35:46] And one of them is 96 and her glycan age was 65. And she has no diagnosed disease. Her only problem is she had an ear infection when she's young, so she doesn't hear so well. But she walks every day for hours. She travels to the coast. This is an eight hour bus ride. Swims. Eats mainly fish because she grew up on the coast.

[00:36:16] Completely independent. Writes emails to her daughter way too often. She's just very, maybe the lightest one of all of them. She would never complain. It's kind of like maybe mentally she's also in the best spot. But it's interesting how you can have somebody at 96 who doesn't have a disease.

[00:36:41] And on the other hand, you can have the average 65 year old who has a couple of conditions by that time. So there is a lifestyle factor. There's maybe some factors we don't yet fully understand, like psychology. And I think maybe to that point, maybe with chronic back pain, you need a psychotherapist added. Or maybe with every disease, you need a psychotherapist added.

[00:37:08] I think that's another possibility. Possibility. But there's many factors. And again, your mind influences your behavior. And if it's positive, then you're going to do these little things that will give you better quality of life. Well, if it's not, then maybe you're more likely to have negative behaviors.

[00:37:29] I think that everyone, whether diseased or no disease at all, should have some sort of psychological therapist on their team to help optimize our health. Because I think the more I learn about health in general, the more I learn that you can't isolate one specific thing. You can't isolate physical pain from the emotional stresses we feel, from the social interactions we have with people. You know, we're learning more and more. It's all combined.

[00:37:59] And it only makes sense to treat people that way. I think we heard you or saw something posted. That's kind of the flip side of this. When we think of the pinnacle of health, I think we often or some people might think of athletes, professional athletes. Oh, a professional basketball player. They must or someone like Tom Brady or someone. Tom Brady might not be a great example because he treats his body. Football.

[00:38:26] But he also treats his body very differently in how he trains and everything. But these people who are training and look like the pinnacle of health, you'd imagine, oh, they must have a really low biological age. Yeah, this was our first lesson commercially. And maybe even scientifically, we thought maybe the best way to optimize your aging is to go to the gym.

[00:38:53] So we had this idea that this would be a product applied in the gym. You would go start working with a PT. You would do your tests and it will make you younger in a couple months' time. But then we were seeing the same thing both in the trial and in practice where we had a thousand people in a study between 40 and 60, which went to the gym for the very first time. And they were trained by young PTs.

[00:39:22] They've been sedentary their whole life. And they put them on the standard gym profile training program. And we tracked them for a year and they kept getting older within this year. And it took us a very long time to convince the people who funded the trial to actually publish it. And then we did publish it because we did put it into context of a broader picture of different types of training profiles.

[00:39:47] And what we see is that if you are a professional athlete, so for your career, it's your primary income and different types of sports, your inflammatory profile is similar to that of a sedentary overweight person. So we compared sedentary overweight, never trained in your life, professional athlete. Same inflammatory profile, which means more inflamed.

[00:40:15] And then you had moderate exercise. So the people who exercise their whole life, a few hours a week, but nothing extreme. You're not going to the gym for an hour a day. And they had the best inflammatory profiles. Their glycan age was the lowest. And then we had this group of between 40 and 60 going to the gym for the first time. And they would see some acceleration, but nowhere near as a professional athlete.

[00:40:43] And then when you compare, you separate men and women, women have the worst profiles. So you look at the oldest scores. These are professional athlete women. Why we don't know. We don't know. I think that's a space that needs a lot of research. We did do another smaller study with bikini fitness. So they would start with a relatively healthy baseline. And then we had two sets, two arms at the study.

[00:41:13] Half just did training before they compete. So no dieting in between. And the other part did very low calorie diet and training to compete. And both cohorts get pro-inflammatory as they compete. So they have a significant acceleration. And then we followed them up three months afterwards to see if they recover. And the cohort that just trained recovers. So they go back to their healthy baseline.

[00:41:41] And the cohort that dieted and exercised at the same time, we call that energy insufficiency, they stayed pro-inflammatory after. And keep in mind, when we measure inflammation, this is something that doesn't change for weeks. So it takes you a few, at least the half-life is three weeks. So you'd need at least six weeks to see it change. So it's not the good inflammation from sports, where you train and it helps develop your muscle, but it's gone the next day or it's gone two days afterwards. It's chronic inflammation that's lingering there for a while.

[00:42:11] And if you look at, we did look at also gene expression and all the other immune profiles, and all of that was pro-inflammatory in the cohort, but also they would lose their cycles and they would lose bone density. And all of these things mimic aging. It mimics menopause. It mimics osteoporosis. So they are experiencing some type of accelerated aging on multiple levels from something that is supposed to be good for us. And of course, they look great,

[00:42:42] but is it worth the internal damage? I don't know. Maybe. Yeah. Yeah. I mean, and we've known friends who've lost their cycles for years based on how they were training and treating, you know, their bodies like not being professional athletes, but basically treating their body like professional athletes and how much of an impact that has, you know, biologically. It's just, it's shocking. Um, so what would you recommend to someone who's listening and saying,

[00:43:11] well, I have been pretty sedentary, but I want to get back to exercise because I hear how good that is for you. Like, what is the course that would be the most healthy for someone who wants to lose weight? So needing to be in a calorie deficit, but wants to also be, feel strong. So wants to get back to exercise. Like how can you more, you know, reduce that and that chronic inflammation and still be making those steps to, to starting to get healthy? What would you recommend?

[00:43:41] I think that's a very challenging question. It's probably very individual when we look at dieting. So we just look at caloric restriction. Uh, this does lower your glycan age. So we know that caloric restriction in general will knock down your age. When combined with exercise, we didn't do a big enough study combining both to say, you know, what works, what doesn't. But if I was doing it personally, um, I would try to do minimum training when I'm dieting.

[00:44:10] And I'll try to do more training when I'm, uh, not dieting. Um, and I don't diet period. So I think the load is very individual. What type of exercise load can you handle? And we have some professional athletes who are very anti-inflammatory. They're, they're the lowest scores. Although they go to the gym daily, but they're an anomaly. They're a rare occurrence. Majority of them would be, um, pro-inflammatory.

[00:44:37] And there has been this, um, so, um, meta review of all like the strength training studies put together to see what amount of strength training has the best impact on mortality reduction. And they identified that 90 minutes of strength training per week, uh, reduces all-cause mortality, uh, between, uh, 15 and 20%. But they also saw that if you do about three hours of strength training per week, this increases all-cause mortality by 10%.

[00:45:07] So somewhere within that range, and you have to see what's your optimal. And maybe we have some good case examples. There was, um, a lady working with one of the lifestyle medicine clinics, um, who had a high, high stress career, two kids, and then did HIIT training every night and came back 15 years older. So she was quite unhappy.

[00:45:32] Um, and then her doctor convinced her to change the HIIT training with yoga. And she did. And they followed her up two months later and she went down 13 years. Wow. So I think you have to customize your exercise to your lifestyle. And if you already have a high stress lifestyle, adding more stress with HIIT or intensive training is probably a bad idea. Well, in some other circumstance, it could be a great idea. Uh, we did a study of young men doing HIIT training.

[00:46:01] So average 35, but they were in a sports school. So let's say their body is prepared for, for training. Uh, they did 12 weeks of HIIT training sprints. So just sprints and nothing else added. And they all, um, got more anti-inflammatory or their ages went down. So young 35 year old already fit men. Sure. Do HIIT training, uh, daily if you, um, if you want to, but it, it, it should be very customized to an individual. And you have to see what load is healthy for you.

[00:46:31] And I think that you're hitting it on the head there with some of these examples. Like when a study comes out and says, okay, over 90 minutes seems to be beneficial to all cause mortality. That's the average of a large meta analysis. And that means that within that, there are probably people that would benefit the most from 30 minutes a week. There are probably people that would benefit the most from two hours a week.

[00:46:54] And I think that that's not what always comes across when the one headline from the study is, you know, put out in the newspaper. 90 minutes of strength training is the best for your body. Well, it was the best for the average of 20,000 or 30,000 people or however many they studied. So I do appreciate you bringing that up, that it takes a little bit of self-exploration in that.

[00:47:21] And I guess the last question, and you kind of touched on it a couple times, is like, how quick can we see change? And what do people do when, when you see the most drastic changes in their, in their glycan age? Like you said that one lady saw a 13 year drop, you know, in two months, you know, can everybody make changes that significant? Again, every case is individual.

[00:47:50] Come on, give me a straight answer. So the half-life is three weeks. That's a straight answer. So you need at least six weeks to see something. And this is, we usually do it in the study setting. Commercially, we recommend two to three months. So once you've started and some kind of change, wait two to three months, then see what type of impact it has on you. It depends again, what you're doing.

[00:48:14] So if it's something that requires more gradual long-term change, like weight loss, wait longer. So we see that unless it's this, unless you're overweight and you're doing this intense caloric restriction, we did a study with 800 calories per day on 700 people and probably not happy in this period. All of them when it became younger in this period, but all of them were overweight. So it depends on, you know, where you are.

[00:48:43] But we would say with weight loss, wait maybe a little bit longer, even six months after you've lost some weight. Because maybe you've lost this weight because you're exercising. And maybe, you know, there's still your body's getting used to the training. So don't be disappointed if you lost some weight and your age didn't go down after a few months. Check in a little bit more long-term. And we do see that when you check in a bit more long-term, you see more drastic change. If the cause is obvious, we identified it. You're doing HIIT on top of all the other stressors.

[00:49:13] Remove one stressor that's easy to remove. We can't remove the kids. We can't remove the job. Remove what you can and let's see what type of impact it has. If it's perimenopause or menopause, you're losing hormones. The moment we replaced them, we did studies with estrogen replacement therapy. In two months, you see a significant drop. Seven years on average. In six months, it continues to drop.

[00:49:40] So it is something that it's intervention specific. But then if you look at this, this is the immune system. So you're doing damage to the immune system. And it's not about, how would you say it? It's not aging in a visual way as we see it. It's something that you can't see or feel because it's this very low grade. We call it sterile systemic inflammation. It's not supposed to be obvious. It's not supposed to be immediately painful.

[00:50:07] It might cause you some pain in 10 years time. So it generally doesn't sometimes correlate with how you feel. And that's the challenging part. But if there's nothing changing in your life, and we track people longitudinally, on average, you age a year per year. So it could be that every year you test and you get one extra year. And that's also quite common. But that is kind of when nothing's changing in your life. You have the same pattern of living.

[00:50:37] So when I tested myself for this period, for eight years, I was getting the same age. I didn't get anything different. Every year I got the same age. Then there was a year where I could see a 10-year acceleration. And I can also see that go down. And I can see it go back up. So it depends. And I measure more frequently now because it's changing more rapidly. But on previous year, once a year was enough for me. And I got all the information I needed. It was going well. So it was so... Yeah.

[00:51:07] Yeah, that's... I mean, it's so fascinating. And I won't be testing for a long time because I'm about to pop in two months. And I know my biological age is... Well, now you'll be very low. But this is also fascinating. How can people go and test and figure out what their biological age is so that they can see what little things they can start to tweak in their lives and hopefully create some change?

[00:51:36] Yeah. So we are a commercial product. You can buy it online on our website. And each test would come with a consultation with our team of specialists. If you're buying as a consumer, we don't give you these scary disease associations. But there's a way for you to email that report to your doctor if you want to. And at that point, you can get access to it. So that's... And I would say so with pregnancy, you're younger at this period of time.

[00:52:06] You might be. For now. But sometimes we see... So we had recently one of our investors, actually. She's six months pregnant, got a very low score, but a very high cardio association, which could be connected to hypertension and pregnancy. Yeah. So it is relevant still. You know, there could be positive factors, but there still could be something there.

[00:52:35] So I think this will be relevant to even that. Although right now, you're artificially younger because of this special estrogen you get in your pregnancy. Yeah. Wow. Well, Niklina, I appreciate all the information that you came with. And I just got to say that anyone who wants to learn more, go over to the GlycanAge Instagram page. There's just like a ton of really cool information that you can read through. We didn't even cover supplements. I know you talked through anti-aging. I know.

[00:53:05] There's so much we didn't cover that we could have... We can look into or take on the Instagram. So go check out Instagram. If you're interested in getting the test, we will also have that linked up down in our show notes. And yeah, we appreciate you taking the time to chat with us today. Thank you. Thank you for having me on. I absolutely loved this interview with Niklina. I hope you enjoyed it as well. And please pass it along to other people that you know could benefit from the information she provided. I know we could have dove into so much more information.

[00:53:35] It really had like a three-hour podcast with her. She is just a wealth of information. But we're going to have everything linked up so you can dive in a little bit deeper to some of the studies that we talked about or just the website or maybe testing for yourself. But before you go, don't forget, it is my birthday today. Woo-hoo! I am officially 37. And as I step into this, we are working on something fun. So this is for Asinabs. That's what it's called.

[00:54:03] We are working on our full body low impact plan on Gen Health. This is my favorite plan. This is a plan I do all through pregnancy, all through postpartum, which I am currently in. And something that helps me really stay strong and feel functional within my body. We've had so many people go through it who were afraid to be lifting weights due to pain that they were experiencing and suddenly back in the gym. So it's really incredible the results that we've seen.

[00:54:28] And I hope that you really dive in with the community, get some accountability, and try this full body low impact plan. It goes into deep core. It goes into mobility and warm-ups. It's going to go into functional strength workouts that only take 30 minutes. It's not going to take a lot of your time. And we're going to focus so much on form because I do the entire workout with you entirely. And you're going to feel so much better in your body. I'm telling you. I absolutely love this plan. It's one of my favorite and it's something that we get the most feedback on.

[00:54:58] So I hope that you join us. The link will be below or just check out gen.health backslash low impact.