41. Can We Live Better, Not Just Longer? Feat. Andrea Maier.
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Andrea Britta Maier (00:00)
How long can we optimize the health of individuals that they are physically capable, mentally capable and socially capable to be part of a very pleasant life? I think that's most important. It's not about lifespan. It's not about can we reach the age of 120, 130. Can we improve the quality of life, the physical ability and mental capacity of individuals as long as possible?
Mizter Rad (00:01.171)
Hello, beautiful humans. You know what's crazy? In 1913, humans lived, averaged, only 34 years. Today, we're hitting 72 years. That's more than double. But here's where it gets interesting. We're facing something totally new in human history. See, we just hit 8 billion people on Earth in November 2022. But here's the plot twist.
We're not really worried about other population anymore. Instead, we're dealing with what experts call population aging, and it's happening super fast. Think about this, by 2050, and that's just about around the corner, by the way, we'll have as many people over 65 as under 15. Almost 5 % of all humans will be 80 or older. And this, as you may imagine, is creating some real challenges.
Who's going to support all these retirees? How do we handle increasing healthcare costs? And most importantly, how do we make sure that these extra years are actually worth living? This is where my guest today comes in. Dr. Andrea Maia is not just talking about these challenges, she's actually solving them. She went from being a traditional geriatrician to founding Singapore's first evidence-based longevity center called Qi
Longevity. What makes her work unique is that she's not just focused on making us living longer, she's focused on making us living better, using precise measurements of how each organ in our body ages. When you think about it, we're in this fascinating moment in human history where declining fertility rates, increasing longevity and huge groups of people entering older age are completely reshaping our society.
The question isn't just about living longer anymore. It's about living better. And that's exactly where we're going to explore today. Dr. Maya, welcome to VigetesD. How are you?
Andrea Britta Maier (02:16.664)
Thank you so much for having me. You pronounce my name very, very good. The salutation in German is also good, but I'm at the moment in Singapore.
Mizter Rad (02:28.381)
Singapore. All right. That's amazing. That's amazing. Yeah, I saw you in the Seller City Conference in Berlin. I'm generally based in Berlin. Right now I'm not in Berlin, but I speak a little bit of German. Maybe that's why I have an okay accent.
Let me start with something that blows my mind, Dr. Maya. You talk about having clocks for each organ in our body. Like my liver could be younger than my heart. Can you explain this to me like I'm five years old? What do you mean by that?
Andrea Britta Maier (03:04.942)
sure. But first, please call me Andrea. That's easier for this interview. So every second, we are
Mizter Rad (03:07.983)
Andrea, okay. That sounds good.
Andrea Britta Maier (03:18.538)
or even every millisecond, everybody listening at the moment is aging. And while we are using our body, that's nothing else than aging, we are accumulating damage. And the response to that damage can be very different in different people, but also within your own body, it can be very, very different.
And coming back to your question, so why is a clock, which is nothing else than a quantification of how old you are biologically, how much damage somebody accumulated is different between all different organ systems. It's very easy because every organ.
We have beautiful organs in our body. Every organ which is aging is aging differently. That's the reason why we need different clocks measuring how much damage occurs and how well the organs are functioning.
Mizter Rad (04:21.308)
So if I understand correctly, when you say clocks for each organ, you mean like having sort of KPIs or indicators for each organ and track those indicators on a regular basis?
Andrea Britta Maier (04:34.88)
Yeah, you could call them key performance indicators, so KPIs. We can measure now what this states.
of functioning is of an organ but even of a cell but to make it much much easier maybe first of a body. So think about you, you have a certain chronological age, you went to school with your friends hopefully but they were like-minded, people also had to go to school at your the same roughly the same age.
These people now can be biologically older or younger. Say you went to school when you were a kid, it was very, very similar how you look like now at the age of 50, 40 or 30 or even 70.
all these individuals who looked nearly the same, especially think about babies, they are now very different. And this is because there is a difference between the chronological age and the biological age. So the chronological age is still the same. Somebody is still the group of individuals who went to school together. They are still now 70, 50 or 40, but the biological age can vary hugely. Think about somebody is 50.
Mizter Rad (05:57.447)
And it varies. Yeah. Now go ahead, please.
Andrea Britta Maier (06:00.349)
That person can be 42 or can be for example 60 at the age of 50. And that is dependent on how the body reacts to the aging process, which means to the constant stress we are facing while using our body.
Mizter Rad (06:21.395)
Okay, interesting. so I guess it has to do a lot with sort of like the biological structure that each individual has, but also the environment in which each individual lives, I guess, in this case, if you compare two individuals that are kind of on the same chronological age, but on a sort of different biological age, it can be because they want
person's biological structure, let's say, or their body, the way their body functions biologically, is different from the other guy, but also because that person lives in a place that maybe is more stressful or in a more stressful, constant stressful environment and so on.
Andrea Britta Maier (07:12.524)
Yeah, so now you're asking, okay, why is there such a big difference sometimes between the biological age and the chronological age? Why is not everybody aging in the same way? And that has three different components. The first one is your genome. So what kind of genes you got. So if you can blame your father and mother, actually. So that's more...
What kind of quality of your body did you actually get? What kind of risk factors did you get via the genes? That's roughly 20-25 % of the risk to die or to either if you want to be positive in life to survive and to be well functioning.
So genes is one thing, then the usage is another thing. So the usage means what is your lifestyle? How much risk do you take? An example, do you smoke? Very likely if people smoke that they are biologically older.
If somebody is not meeting the WHO criteria of 10,000 steps, very likely that that person is older. If somebody has overweight because of excess of calorie intake.
very likely that that person is older. If somebody is exposed to lots of stress, yes, very likely that that person is older. And the third one is maintenance. So how good are you to deal with the stressors, not only mentally, but also within the cells, sort of physically, biologically? So how good are you to repair, for example,
Andrea Britta Maier (09:04.932)
the accumulation of the damage. How good can you actually polish all the wrinkles out of your cells? So it's really the genes. What did you get from your parents? What's your starting point? What do you do with this? And how good are your repair mechanisms and dealing with stress? How resilient are you?
Mizter Rad (09:10.845)
Yeah.
Mizter Rad (09:31.091)
And when you hear, like nowadays is very, the longevity topic, I would say is a hot topic. And a lot of people talk about all these longevity treatments. Are those treatments sort of focused on those three components that you mentioned? Is there a component of within those three that is more, let's say where.
where funding is being funneled more that is more important, that is more advanced in a way.
Andrea Britta Maier (10:03.29)
Yeah, that's a good question. So if we are talking about genes, we can do gene editing. But that's very complicated because we have a huge amount of genes and we cannot change all our genes. So CRISPR-Cas, for example, where we are fixing one side of a gene is very unlikely to work in the next coming five years for the aging process because we need so many genes while repairing, while
cells are dividing. So that's at the moment quite unlikely. However, we are using and measuring what kind of genes somebody has for risk prediction, which means to estimate the likelihood if somebody has a disease later in life or how long somebody is likely to live. So that's how we use the genes.
If you're looking at what do we do with the body, how do we use it? There is a huge potential for interventions. So I already told you if somebody is smoking, it's likely that that person is biologically older. So the intervention would be to stop smoking. Okay, that's not an easy one. It's many people. Yes. Yes. So
Mizter Rad (11:15.621)
Easy.
It's not an easy one, yeah, I understand.
Sounds easy, but maybe not.
Andrea Britta Maier (11:26.698)
It seems that it's not easy. I never smoked a cigarette in my life. I really dislike also the smell. anyway, that's an intervention where somebody can lower the biological age. Another one is excess of food intake. If changing the diet, it's likely that...
Mizter Rad (11:35.206)
smell.
Andrea Britta Maier (11:51.052)
via, for example, the gut microbiome and making the pancreas, which is also an organ in our body, or not exposing them to so much food that the biological age is lower. So there we not only have a lower number of calories as an intervention, so eating less, actually, but also we have an intervention what somebody should eat. So what is the ideal diet for a certain person based on
their needs and their needs are based on the genome, based on the environment, based on the microbiome, so how many bacteria and what kind of bacteria somebody has. So a huge amount of variables influencing what kind of food somebody should actually take. Physical activity is the same if somebody is being exposed to less amount of physical activity.
We use the term sedentary lifestyle. If somebody is moving more, so more endurance training, more strength training, balance training, it's likely that the biological age is going to be reduced. Same for sleep, stress and all the other factors. If you're looking at how you are repairing the damage, they are especially repurposed drugs. So drugs and supplements come in.
Mizter Rad (12:53.158)
Right.
Andrea Britta Maier (13:17.07)
where we understand the mechanisms of what's going wrong or well in a cell that we can actually facilitate the process during the aging endeavor. And think about removing senescent cells. So senescent cells are cells who accumulate in a body who stopped replicating, so they cannot replicate anymore. And they are just sitting, maybe not just, but they are sitting in our body.
and very likely negatively influencing our aging trajectory and their risk to develop it related diseases at later life. So by removing this kind of trash, very often these senescent cells are called the trash cells or the zombie cells. If you remove them, then you might have a lower biological age that has to be proven in humans, but it already works in animals. So that's an example of senolytics. It's called
Mizter Rad (13:54.029)
Mm-hmm.
Andrea Britta Maier (14:13.272)
where you could, with an intervention, then help the body to repair itself and to clear up the mess.
Mizter Rad (14:20.295)
What is it called again? Sorry.
Andrea Britta Maier (14:22.286)
Senolytics is senescent cells, so old cells removal. So think about, many people know cancer is the accumulation, so really the replication of cells which should not be there, replicating, replicating, building that tumor and you're removing that with, for example, chemotherapy or radiation, same principle, but then absolutely other drugs.
Mizter Rad (14:23.686)
analytics.
Mizter Rad (14:30.374)
Okay.
Andrea Britta Maier (14:52.2)
is for senescent cells, senescent cells accumulate, you don't want them at certain stages in life and you are removing them with the drug and they're risk clear up the environment. It's sort of cleaning session.
Mizter Rad (15:07.079)
Hmm. Okay. Interesting. Interesting. let me take you somewhere else for a second. In my hometown in Columbia, I have my Tio, my uncle, my uncle is 90 years old and he has never taken a supplement in his life. He eats raw garlic before breakfast every day. He sells three crosswords every day and he walks everywhere.
And I can tell you he's sharper than many 60 year olds I know. When you hear stories like this, how do you balance all this advanced longevity technology with this simple traditional approaches that seem to work well?
Andrea Britta Maier (15:50.83)
Yeah, let me go back one step. So if we are talking about interventions, we are talking about changing the environment where you live, changing your lifestyle habits in the environment where you are living, speaking about supplements, speaking about drugs.
These are the four very important pillars which change or could influence the aging trajectory and therewith improve the biological age. The story you just told is actually capturing already two of them. That's the environment. It seems that he is able to walk around in...
in a certain environment which is assumably pleasant to go from one place to the other. So there is an intention to actually to walk and it's a pleasure to walk. Secondly, Yusai is mentally active, he does puzzles etc. and he eats well and because of the environment he might also move very well.
which means this is lifestyle. This is just a summary of a very good lifestyle, very often seen also in the blue zones, where people very often live in rural areas, villages, where there is social connectivity, where the environment invites people to be physically active, where you can enjoy gardening and where...
there with the stress level very likely is also limited compared to more urban sites. So these are the fundamentals to keep the biological age low. Additionally to that, there are new therapeutics. This can be supplement, this can be repurposed drugs, this can be other interventions.
Andrea Britta Maier (17:58.626)
physical technological interventions which can lower the biological age. But I think for me very importantly the basis should be right. We should provide individuals when they are living in environment to age gracefully in an environment which is stimulating mentally but also physically.
Mizter Rad (18:19.891)
So how do you guys at Chi Longevity, and specifically how do you see a country like Singapore doing this on a macro, on a national level? And what is your contribution as a founder of this longevity clinic in Singapore to that bigger goal as a country? I would like to understand more what
why you're there, why is Singapore important in this field, why are they doing right, and how do you think this will help the population in the decades to come?
Andrea Britta Maier (19:03.086)
So these are two questions. So first of all, longevity clinics very often work on micro level because it's about one individual to optimize the health of a person in a certain circumstance. Secondly, what you are asking is the macro level. How does it fit into the strategy of Singapore?
Let me start with the micro level. So I founded the Qi Longevity, which is a private clinic for health optimization, which is a healthy longevity medicine clinic and healthy longevity medicine is being defined as optimizing health.
and increasing healthspan while antagonizing aging processes across the lifespan. So what does it mean? We want to optimize for an individual the health that somebody is better and also feels better, so mentally and physically, and increasing the healthspan, which means the health of the duration in good felt and objectively measured good health.
while really targeting the aging processes. And that's what we just discussed. measuring how old somebody is biologically, why somebody is aged or not aged or biologically younger compared to the other one. So what can we target? And then with interventions and in the longevity clinic at CHI, we are targeting the four pillars.
It's the environment, it's the lifestyle, it's the supplements and it's the drugs.
Andrea Britta Maier (20:51.85)
and applying that to that individual level, individual based on the individual needs. That's very important because we started this conversation with the question, okay, why is everybody aging so differently and why are the organs within our body, why are they aging so differently? Which also means if everything is different, then you need different approach how to tackle that.
So that's what we are doing at Qi Longevity. We opened the second clinic in Singapore and now we are expanding throughout the world to really bring the concept of evidence-based medicine into different countries to be available for many more people. Very importantly is that it is evidence-based. Evidence-based.
Mizter Rad (21:42.631)
What does that mean? Can you explain us what that means exactly?
Andrea Britta Maier (21:46.242)
Yeah, evidence-based means that everything which is applied in clinical practice is proven in humans. What does that mean? Very often we do research in animals. Think about a little worm or think about a fly, a fruit fly, or think about a mouse. Think about monkey research. But all these very important
Mizter Rad (21:59.485)
Yeah.
Mizter Rad (22:03.069)
Right.
Andrea Britta Maier (22:15.502)
in a certain way, experiments does not mean that if it works in a worm, that it's going to work in a human. Because not only that the genes are very different in a worm, there's lots conserved, but we are different. think everybody will agree with that.
Also, the environment a worm or a fruit fly is living in is quite different from where we are living in. So we cannot translate one-on-one everything we found in fundamental research using animal models, using in vitro studies where you are just taking cells into the lab and culturing them. This is not in a one-on-one transferable to humans.
Evidence based, so does not mean that we transfer the animal models to the humans, but we want studies in humans. We want the proof.
that whatever we apply is first of all being tested in humans and secondly, it's successfully tested so it works in humans. That is either that a test to measure the biological age has been proven to be valid. So if you're getting a result saying you are 53 instead of 60, that was an accuracy that you are really 53 and not the next day that you are 70. So there should not be
the variations. So it has to be accurate. You want to know that what you get is actually usable in clinical practice in terms of the tests.
Andrea Britta Maier (23:52.898)
But also you want, at least I as a physician, I only want to prescribe anything where I know that this is actually proven to work. If I prescribe physical activity, I know it works because there have been so many studies and proven evidence that if somebody is more physically active,
having just 1000 steps compared to 9000 steps without any disease, that this is better. I nobody would argue that this is not the case. So we have proven interventions which really work and especially in the lifestyle domain but also in the environmental domain. If I would ask you to sleep in a very noisy environment, I can tell you that your sleep quality will be worse compared to
having a very nice relaxing environment and you are sleeping there, it's very likely that your sleep quality and your sleep duration is much much better.
So these are proven interventions you can actually immediately apply. Then there are interventions where the evidence is less prominent. Think about supplements. Which kind of supplements are actually proven to work in humans and not only in humans, but in which humans? course, if it's proven in a 30 year old, it might not be proven in a 60 year old or a 90 year old.
If it's proven in individuals with cancer that it works, it does not mean if you don't have cancer that it also works.
Andrea Britta Maier (25:33.984)
So here we really have to see where is it, has it been tested in humans? Does it apply to that individual you are seeing as a physician in clinical practice? And how much can you extrapolate that it might also work in that population? And the evidence in terms of supplements and repurposed drugs is much, much less compared to lifestyle interventions or environmental interventions.
So here we really have to learn. And at Qi Longevity, we really apply only the interventions where we know it has been tested.
in very good designs in humans and we apply that to our patients in clinical care. So that's really the essence. We don't do anything which is not considered evidence-based. It has to be tested in humans, it has to be had a good effect and we need to know in which population it has been tested.
Mizter Rad (26:36.529)
Hmm.
Andrea Britta Maier (26:38.19)
So that's the micro level.
Mizter Rad (26:39.151)
Interesting. That's the micro level. Now what's the macro level? Because I think maybe there is an overlap there as well.
Andrea Britta Maier (26:49.002)
Yeah, so Singapore is a very exciting environment. Singapore is young nation. We have many ethnicities. Chinese, Malay, Indians are the most prominent ones. We went from an aging population to an age population and we will in 2030 be a super age population.
What does it mean? The percentage of individuals being 65 years and older is increasing hugely, significantly. 25 % of the population in 2030 will be 65 plus. So that's a huge amount of individuals, which means you need by in super age population, you also need youngsters because somebody has to work.
So being a super, nearly a super age, now an age population, this is paralleled with a very low fertility rate. So the number of children being born is very, very low under the, absolutely under the replacement rate. So for each individual, we don't have the same individual back being born.
which means that we are accumulating even faster aged individuals, older individuals, which means that to keep the economy running and Singapore running, there is a problem. There are two solutions or there are more, but two main solutions. First is you are increasing the fertility rate or
you are keeping people healthier for longer, that they can work for longer and that they are active in society for longer. So very often worldwide we think 65 is the age where you have to retire. Can we actually improve that to 70 or 75 or think about scenarios to 100? I don't know. That's absolutely not in reach.
Andrea Britta Maier (29:11.311)
Can we imagine a world where we can be very active because our mental capacity is maintained, our physical capacity is maintained, and people love to live and there is hopefully also to work. So Singapore is facing an aging society and is facing that low fertility rate.
So it is acting on it very, very significantly. While, for example, bringing preventative measures into place via Health CISG, that's a nationwide program where family doctors are now assigned to individuals, really taking care of the health very proactively, talking about lifestyle interventions, talking about environmental interventions.
to keep people as healthy as possible. It doesn't mean that the ones I exclude who are not healthy, who already have a chronic disease, but I think the most important thing for that group is not having a next disease. Think about a person who has diabetes or hypertension. How can we prevent that that person is staying relatively healthy and not having a stroke or
have has cognitive decline and having dementia in the end. So how can we optimize the health of our entire population? So that's what we are doing at the National University of Singapore. We are providing or try to provide bringing lots of solutions towards the table. So we do many trials where we
not only investigate the biological ages of the population, but also how to lower the biological age of individuals. For example, while giving supplements or drugs or lifestyle interventions to really gain the evidence towards standardization, how we can optimize the health of individuals. So there's lots of research, sort of research and development R &D involved. And once
Andrea Britta Maier (31:35.05)
it's effective, then the government can decide to implement it nationwide towards family practitioners, towards other medical specialties to integrate it into their public health strategy, etc.
Mizter Rad (31:53.189)
Okay, let me share something personal here. I've spent thousands of euros, dollars treating my gastric problems in the last 20 years, but nobody ever made money from teaching me how to prevent, talking about preventive personalized medicine, how to prevent it in the first place. I always got like pills and gastric.
neutralizers of my gastric acid, even though that's probably the worst thing I could do, I finally discovered. Anyway, I see this pattern everywhere. We pay for the cure, not for the prevention. And now you're talking about personalized, if I understood correctly, a more personalized preventive medicine. So how does preventive medicine actually make business sense? Because we of course live in a business world where people
want to or have to or would like to make money and that's okay but it kind of looks like the system is designed for something else, for keeping us sick in a
Andrea Britta Maier (33:00.814)
Yes or no, if you're looking at the GDP, the gross domestic product on different countries, that's a huge amount. So it varies from 6 % in Singapore to more than 13-14 % in the US. So it's huge. So we are paying a lot for keeping us in a diseased state. And you're right.
only a very tiny percentage is going to prevention. But many governments and many people now understand that this is not sustainable because the percentage of GDP being spent for the conventional model, which is a great model, by the way. So let's do not say that the sick care is bad because the sick care keeps us alive.
Maybe it doesn't keep us healthy, but the sick care is keeping us alive. And that's what many people want. Also with a very good quality of life and very often. So people understand that that has to change and we have to add something. I wouldn't replace it at this moment in time, but I would add something. Very often we say, OK, everything has to be prevention. Well, that's not true because people still will get sick.
And we need that. So we need the sick care, which is not health care in that terminology, because it's not health. But sick care has a very, very bad connotation that it's very, very bad and it's like rubbish. It's not true. I'm very proud to be a sick care physician. But we have to add some because we are learning and we learned in the past 10 to 20 years not only how to measure the aging process,
but especially also how to intervene. So now there is a shift and the realization that something should be added. And some of the governments really understand this. Four weeks ago, so in November, the Department of Health of Abu Dhabi signed
Andrea Britta Maier (35:18.348)
the first scope of facilities for Health and Longevity Medicine. And there was sort of approved Health and Longevity Medicine as a entity within the medical system. And the first clinic was approved and certified by the Department of Health in Abu Dhabi. That's a huge milestone for the entire world. Because
Mizter Rad (35:43.121)
Why? Why is that a milestone?
Andrea Britta Maier (35:46.584)
Healthy longevity medicine clinics do not on paper, I would say, exist in the system. And there was no scope, there was no regulation, there was no summary, there was no description of what people would receive in such clinics. And secondly, who should work there, what it actually is. Now we are defining that and we did that work where the Healthy Longevity Medicine Society
where I'm the founding president of it, really driving to be able to write standards, guidelines, and there was built quality in the field that we can in the end democratize the way how we optimize health of individuals. So that's a huge milestone. So we are there that there is lots of talk, but also no action.
to bring it into the medical system. There was also eventually financial allocation will change. Will that be done overnight? No, absolutely not. We have to prove that the way we are working is not only clinically effective, which means that we are making people biologically younger, we are preventing age-related diseases.
So all the things we state that this is actually the case. And secondly, that this is cost effective. Which means, that's coming back to your original question, we have to make sure that the investment in prevention is actually useful to save money.
Or at least if we are not saving money, the investment has to be in such a state that we are getting a return.
Mizter Rad (37:43.699)
Yeah, at least it needs to break even, I would say. So we're not making a loss.
Andrea Britta Maier (37:52.163)
Yes, we are investing and we are getting something back which might be differently quantifiable. And I will give you an example. Very often we say if we have sick people, we are treating them with biological, so very expensive drugs. We say, okay, we spent X amount to save X amount of lives.
So we are quantifying it what we want to spend, especially in public services for healthcare. So now imagine that you have a healthy individual, that healthy individual you are spending money on, but what do you actually get back? So you don't know if in 20 years you are preventing that disease, maybe in 30 years, and maybe it's never. So it's very, very difficult to quantify because you have to look into the future.
what that is and it's not the near future, but it's decades. And very importantly now is thinking differently about the quantification of how we value what prevention actually is. So we should not just looking at healthcare costs, but we should also in return look at, for example, productivity.
Mizter Rad (38:53.307)
Right, generations, yeah.
Mizter Rad (39:18.483)
Mm-hmm.
Andrea Britta Maier (39:19.194)
long can somebody work? How happy is somebody? If somebody is happy it's very likely not only that that person of course is physically able to work but also spend money in society which is actually yes. So these new models have to be defined how we quantify that it's not only
Mizter Rad (39:39.333)
in the economy. Yeah.
Andrea Britta Maier (39:48.835)
effective from a clinical perspective, but especially cost effective.
Mizter Rad (39:54.543)
So it doesn't make sense to say that the longevity field is not about making us live longer or forever, but rather making us live as long as possible, as good, as healthy as possible, as productive as possible, to put it in economic terms also.
Andrea Britta Maier (40:08.919)
Yeah, it's called
Yes, so it's all about health spend. how long can we optimize the health of individuals that they are physically capable, mentally capable and socially capable to...
Andrea Britta Maier (40:30.478)
to be part of a very pleasant life. think that's most important. It's not about lifespan. It's not about can we reach the age of 120, 130. I think it's a discussion which is not as relevant as can we improve the quality of life, the physical ability of a mental capacity of individuals as
as as possible.
Mizter Rad (41:04.025)
Interesting. You know, I was listening to Dr. Gabo Mate, I'm sure you know who he is, recently. And for those that don't know who he is, he's this amazing trauma expert who is actually, I would say, 80 years old now. And he said something that made me think. And he believes that our obsession with living longer is actually coming from a place of deep social anxiety, that we're so afraid of death, that we're missing out on really
living. And I wonder what you think about this. Are we maybe too focused on the number of years instead of how we actually live them? Do you think that the industry is a bit, or part of the industry is a bit skewed toward that part that could be a bit dangerous if we focus on that?
Andrea Britta Maier (41:55.15)
think there are different aspects. For an individual, think it's a quality of, at least for me, it's a quality of life also for group levels. I think if you want to get the attraction of an attention of different stakeholders, as for example Aubrey de Grey did 20 years ago, stating that we will live forever,
That gives attention and awareness. But it doesn't mean that this should be the goal for our industry. And yes, a part of the industry is hunting to live forever. There are cryonauts out there who want to be defrosted at a certain time. I think this is at least for me, but maybe I'm not too visionary.
This is not the goal
Mizter Rad (42:53.331)
Well, it's not about being visionary or not. It's nice that you tell me how you feel about it. That's what I'm looking for here.
Andrea Britta Maier (43:00.91)
I'm very, very happy to be 300 years of age if I have a very good quality of life. I can walk, talk, and I can socialize. Very happy to live very long. And that's the end game. But it's not about the number. And 300 will not happen in my lifetime.
Mizter Rad (43:18.755)
Mm. Mm.
Andrea Britta Maier (43:26.634)
If I can reach the being very active, I would be very happy.
Mizter Rad (43:26.982)
Yeah.
Mizter Rad (43:31.633)
Yeah, no, think 300 is a bit too over the top. you know, there's this other guy on the opposite side now of Gabo Mate, Brian Johnson. He probably also know who he is, who spending about $4 million a year trying to make his 46-year-old organs look like or function like 18 years old. And I believe he's taking about 111 pills in a day.
And he calls things like eating a cookie an act of violence against the body, which is kind of funny. But I want to get this right because I know you're a doctor and you're focused on research. From a medical perspective, do you think this extreme optimization is helpful or are we maybe crossing into dangerous territory here when you talk about taking hundreds?
11 pills a day. Is that sending the wrong message or the wrong hope?
Andrea Britta Maier (44:30.99)
So first of all, there is an individual right to make own choices how to treat the body. So that's very important. And I think that the individual right to treat your body as you want is especially there if it's being done while there is enough education and there's a shared decision making. So if somebody is educated what somebody is doing and makes that decision.
to do one or the other, I think it's fine because this is our freedom. This is our freedom of choice. So that's the first thing. Is it the right messaging? So I'm very happy for Brian Johnson to do whatever because it seems that it's an informed decision and that's his choice. So I absolutely value that. The question is, is it the right messaging for the field?
So now we are not talking about an individual choice, but now we are talking about biohackers who are influencing the field. And there I think the messaging can be quite dangerous because there are very often followers.
and the followers occur because somebody is going to do one or the other. Very often they don't have the shared decision making model because they don't have the physician where they can actually bounce back their ideas and their thoughts. Shared decision making is very often used in the terminology where you have a healthcare professional, you as a patient client or whoever you are that's individual
you are bouncing back your ideas and you are coming together to a conclusion and that shared decision making. Very often individuals do not have that and they have limited and I think a skewed amount of information which can also be misled and misread in posts etc.
Mizter Rad (46:25.139)
Mm.
Andrea Britta Maier (46:41.358)
So here it becomes a little bit dangerous and it becomes especially dangerous not only in terms of the way of communication, but if there is the third part, if there is a financial incentive behind it. And I think then it becomes really dangerous. I personally, I liked the first one, one and a half years what Brian Johnson was doing.
And even I liked him as a like on LinkedIn and Twitter, etc. because he was informing in a way the population.
with what kind of diet to do, being physically active and really showcasing so nicely that our body is so flexible and wonderful and can react. Like if you see photos before and after, very different. So really showcasing the beauty of our body. But then it went very extreme, with applying stem cell therapies, applying
Mizter Rad (47:31.101)
Right.
Andrea Britta Maier (47:47.768)
getting the blood or the plasma of the sun, et cetera. So very extreme things which are absolutely not proven in humans. Coming back, absolutely not evidence-based. And then the next stage, and then taking lots of supplements and also promoting the supplements.
and then becoming with the blueprint very commercially. So it's not really that good anymore and education, but now it's a product. And of course it's smartly done, well done, very good from a business model. So that's the reason why I think it can be harmful for the field because it went...
I would say through channels now to miss communication or part communication and to that financial incentive behind it.
Mizter Rad (48:44.627)
Definitely. Interesting. Interesting that you touched this topic of bouncing ideas or thoughts or experiences with people that maybe know more about you, in some cases maybe a doctor and so on. Because I see from my experience as well for a while, I realized I was tracking my physical activity on the phone. I did some CO2 recovery tests to measure my nervous system recovery every day. And I even had a food diary on my
on my phone and app. And I thought at that point, well, I'm basically being my own doctor. I don't need to go to the doctor anymore. Then my father on the other side, on the other hand, he would never do this because he's from a different generation. He trusts. He likes to go to the doctor to the praxis and talk to the doctor. And he knows it's the same doctor for 30 years. So looking 50 years ahead, do you think and taking the example of
the extreme example of personalized individualistic self sort of reflecting kind of medicine that Brian does and or my simple example that I just talked about. And you look 50 years from now, do you think we'll still have this human connection with doctors or do you think it will become more sort of like individual, egoistic, egocentric with the help of AI, maybe on machines or robotics?
that each individual will kind of diagnose themselves. How do you see that happening?
Andrea Britta Maier (50:14.446)
So first of all, think we should not have the view that only doctors and physicians are shaping the body. I really would like to highlight that personal coaches, health coaches, dietitians have an equal role or even a more important role.
So in optimizing the health, so it's not dependent on physicians. It's always the paternalistic or maternalistic physician view, which I do not have. I am a physician, yes, but I love what others do, which is complementary from what we do. I can tell you the physicians have the least influence on patients or clients in changing their lifestyle. It's not the physician, it's the health coach.
And it's really that friend that made the trusted source of changing habits. So it's not the physician, I would say. Will it be in 50 years just the AI robot? Maybe, but I think it will always be through research, which at least is human guided.
And it's not only physician guided as said, but it can also be guided by chemists or biologists, et cetera. the entire idea where somebody has to guide full stop. And very importantly, whatever is happening in 50 years time, that person or individual or even if it's I...
AI individual, I don't know how we call them in 50 years time. I think we just make sure that the quality of the provision is good. And we do that with the best ethical framework, including
Mizter Rad (52:01.596)
Yeah.
Andrea Britta Maier (52:17.834)
in taking into account safety, for example, and very importantly, that that knowledge transfer. So there was enabling informed decision making.
Mizter Rad (52:33.541)
Yeah, you know what's really fascinating? I've had the opportunity in the Mr. Rat Show also to talk to indigenous leaders, spiritual leaders who see death as just another part of existence, like breathing or sleeping. They actually embrace it as part of our life's natural cycle. But then when you see a lot of people spending millions trying to avoid it at all costs,
It's kind of interesting that kind of dichotomy. So let me be here like a kid and ask you, why do you think we're so afraid of death in modern society? Because it was not like that for, according to history for many years. If you read, you know,
Andrea Britta Maier (53:26.51)
It's not so much afraid, I think it's exaggerated because we are talking about it. think people are afraid of this. If you ask me, are you afraid of death? I wouldn't say I'm joyful that I'm going to die. No. Is it fine that I'm going to die? Yes. But I don't know how this is going to happen and how my last minutes with my last breaths are going to be. Yes, I'm afraid to be in pain, etc. Yes. Very importantly is...
Mizter Rad (53:51.795)
Mmm.
Andrea Britta Maier (53:55.288)
turn it around, think people now imagine that there could be a life with a better physical and mental condition. And that's very often the driver of coming to clinics, because we now imagine, hey, we are seeing ourselves in the mirror, we have no photographs, we see ourself back, like from 10, 20, 30, 50 years ago, we say, hey, what happened with our body? And with the knowledge we now have from
research that we can not only measure it, but we can also intervene. I think that's the reason for, I would say, the hype also in our field that many consumers understand that there might be solutions. So they understand, hey, I can interfere.
They want to interfere because they want to feel better. have the means to interfere. So they have the money to spend. And there was there is a huge consumer drive in our field, which was absent 20, 30 years ago, because 20, 30 years ago, we had not much understanding of the agent process. We were not able to measure it. And yes, we knew that lifestyle interventions are important. But if you're looking back.
the history of the understanding of how bad smoking is. Like 100 years ago everybody was, many people were smoking. I still remember that we are not allowed to smoke now inside of rooms or in trains or even airplanes. So imagine that you are now embarking into an airplane and everybody is smoking. Like 40 years ago, very normal.
Mizter Rad (55:36.819)
That would be normal, yeah. It's the same in China. mean, you go to a bank in China and people are smoking inside of the bank. That was 10 years ago. Maybe it changed already,
Andrea Britta Maier (55:45.516)
Yes, yes. So I think there is so much knowledge accumulation. People now understand. I think also the investment not only to survive and to have a job, et cetera, but in yourself is really changing. Like we value our private life. You can have private life or you want private life, a pension, for example.
and you want to do other things. Think about now the third generation university. That's something new. Like you are 70 and you decide you're going back to the university. Think about dating apps for seniors. Even the word senior is not being used anymore, but for the...
Generation being 80, 80 year old people now are dating, which is, I think also happened 100 years ago, but now it's much, much more there because our lifespan is increasing and our healthcare system is so good that we don't have to die per se. So everything we are talking about is not only because of sanitation and that was not having infectious diseases.
but especially because of the very enormously important, glorious sick care system. Now we can enjoy life even with diabetes or with hypertension and even we can recover from a stroke. Not possible 60, 70 years ago. Now we have the potential to stay healthier for longer and be rigorous in our activities.
the course of this celebrate the sticker system for a second.
Mizter Rad (57:31.379)
Yeah, it was not my intention to make it sound like the bad boy of the neighborhood. you understand what I mean with both systems kind of pushing away each other. At least it looks like they don't correlate or fit. But from talking to you, I understand that it is a transition and that it's OK that it is like that.
Andrea Britta Maier (57:37.068)
No, no, no.
Andrea Britta Maier (58:00.27)
Yeah, and imagine like 60 % of the 60 year olds have at least two chronic diseases now at this moment in time. If we would shut down the sick care system, that would be a discussion. So don't do that.
Mizter Rad (58:17.181)
That would be a problem. Well, before we end, Andrea, how can people learn more about your work at Chi Longevity or at Singapore University? If someone is listening and wants to get involved in longevity research or in the topic of longevity, what do you think is the first step they should take?
Andrea Britta Maier (58:41.046)
I would say the first step individually, think about yourself, what your biological age is. That's the first starting point. Measure yourself and even if you're just measuring your weight and the trajectory of your weight. So think first about yourself based on your mental and physical state.
If you want to learn more and also from a professional level, have webinars. We have the NUS Healthy Longevity webinar, which is on air every Thursday.
So that's a show, it's all available online. If you just Google my name, you will find lots of information. If you are tracking societies like the Health and Longevity Medicine Society, you will find lots of information. And I would say just reach out. We have many educational activities at the NUS Academy for Health and Longevity. We have...
talent incubators, have intensive courses, have conferences we organize. Very importantly is just be curious, but always open-minded because there many voices around the field and
Andrea Britta Maier (01:00:07.584)
I think valuing every voice is important, but also then distinguishing what is evidence, what is not so much evidence, what is a voice shouting versus whispering, I think is of huge importance. And make up your mind where you stand.
And once you have knowledge, I think you can apply as you would if you would be a client with a physician, inform decision making and see what you want to gain in life professionally and individually for your own health.
Mizter Rad (01:00:43.517)
Beautiful, Andrea, it was a pleasure to have you in the Mr. Rat Show. We finally made it and I'm very happy about it. I really appreciate your time and until next time.
Andrea Britta Maier (01:00:55.928)
Good. Thank you so much for having me.
Mizter Rad (01:00:58.811)
Until next time, beautiful humans, stay curious, question everything, and maybe, just maybe, start treating your body like it could be around for another 100 years. Hasta la vista, ciao.