Kenneth R. Pelletier, PhD, MD, joins Integrative Practitioner Content Specialist, Avery St. Onge, to discuss the new science of epigenetics and how it can be applied to create optimal health and longevity.

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About the Expert

Kenneth R. Pelletier, PhD, MD – is a Clinical Professor of Medicine, Family and Community Medicine, and Psychiatry in the Departments of Medicine and in Psychiatry at the University of California School of Medicine, San Francisco (UCSF) where he is Director of the Corporate Health Improvement Program (CHIP). Dr. Pelletier is also Chairman of the American Health Association, is a Vice President with American Specialty Health (ASH), and served on the Board of Directors of the Rancho la Puerta Resort/Spa. Prior to these positions, Dr. Pelletier served as Clinical Professor, of Medicine, Family Medicine, and as Professor of Public Health at the University of Arizona School of Medicine. Also, he served as Clinical Professor of Medicine at Stanford University School of Medicine; was Director of the Stanford Corporate Health Program (SCHP); and was Director of the NIH funded Complementary and Alternative Medicine Program at Stanford (CAMPS).  From 1974 until joining the Stanford University School of Medicine in 1990, Dr. Pelletier held a dual appointment as an Associate Clinical Professor in the Department of Medicine and the Department of Psychiatry, University of California School of Medicine in San Francisco (UCSF).

Transcript

Avery St. Onge: Hello everyone and welcome to the integrative practitioner podcast. You're on the go resource where we bring you closer to top industry experts through exclusive interviews with leaders in integrative medicine. I'm Avery St. Onge, content specialist of integrative practitioner, and today we're talking about the new science of epigenetics and how it might help us live longer. 

We're so happy to have you as part of this community of integrative health care professionals. If you're interested in learning more about our membership offerings and you can get access to exclusive content and networking opportunities, please visit integrative practitioner.com/join. 

For today's episode, I'm joined by Dr. Kenneth Pelletier. Dr. Pelletier is Clinical Professor of Medicine, Family and Community Medicine and Psychiatry at the University of California School of Medicine in San Francisco. There he is also director of the corporate health improvement program, otherwise known as Chip. His latest research focuses on the epigenetics of longevity, which is the topic of his presentation at the integrative healthcare symposium. 

Welcome Dr. Pelletier, thank you so much for joining me on the podcast today.

Kenneth Pelletier: Thank you for the invitation.

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Avery St. Onge: So to begin, can you just give me a brief overview of what you will be discussing at the symposium? 

Kenneth Pelletier: Well, the last five years, I would say maybe even the last three years has been an unprecedented interest interests bordering on fixation on extending life expectancy on longevity on how do people get to live to be 100 or more. And I use it as a kind of fixation is it's a niche. It's for those who have everything. The next thing you want is to live to be 100. That's the next prestige point in your life expect life itinerary. And that's both good and bad. But it certainly is a major national and even international trend. People are living longer, and they're living longer all over the world. So it is a major serious trend in addition to some of the more frivolous things that I'm sure we'll talk about.

Avery St. Onge: Okay. And then you're kind of framing this longevity talk around epigenetics. So can you tell me first of all, I guess what is epigenetics?

Kenneth Pelletier: Well, epigenetics the prefix Epi means above, or surrounding or encompassing the gene. So it's all the influences that impact the expression or suppression of the gene after it after the sperm and ovum unite. So epigenetics are all of those variables. Some of them are internal diet and stress and other factors, and others are externals are radiation exposure, glyphosate exposure, herbicides, etc. So it's all of those influences that determine whether or not a predisposition you have genetically that gets expressed or gets suppressed. And a lot of that is dependent on what we do day in and day out. Only five to 7% of what we experience as adults in terms of life expectancy, health longevity conditions, is monogenic, or what they call fully penetrant genes. The rest 9590 to 95% is dependent on what we do and do not do day in and day out that affects our gene expression.

Avery St. Onge: Interesting. And then what is the latest research telling us about epigenetics? 

Kenneth Pelletier: Well, there's there many different lines of research. Certainly the one area that that catches the most attention Are the dietary influences and those are huge, that's a big area. The microbiome is the intestinal tract, everything between the mouth and the anus. And that is the all the cells, if you will, that govern the activity in the body. So what we consume, the foods we consume when and the kinds of foods have a direct and profound impact on epigenetic expression. So you may have, as an example, a genetic predisposition to high cholesterol. But if your diet is such that it regulates and down, down regulates, if you will, the expression of that you'll have no problem. On the other hand, a person with the same genetic predisposition to high cholesterol, if they don't achieve a good diet, that will be given expression, it will turn into a major factor for heart disease. So diet is a major focus. Another is the area of stress. Stress has a direct and very powerful impact on epigenetic expression. If you think about it, all the cells in our body are are bathed in an ocean of biochemistry, that biochemistry undergoes a profound change when we're under stress. And when we're not under stress, we have what's called a catabolic functions predominate. So it's energy mobilization, it's a way for the body to meet the demands, get through the stressful situation and survive. Now that's fine. And we owe our survival as a species to that the problem is, when it goes on for too long, then we have just excessive destruction, we have byproducts from the excessive metabolism, etc. So it's a potential negative. And when we shift away from the catabolic function into what's called anabolic or regenerative functions, all that changes, and one of the easiest ways to do that is to laugh. And we can literally when a person laughs, or even smiles, the body immediately shifts from a catabolic to an anabolic from a destructive energy mobilization to regeneration, and cellular integrity. So it's a very delicate balance. But stress has a very profound influence other factors or you know, physical activity. Again, we've looked at athletes that express the genetics that are very predisposed to healthy aging and extreme longevity, compared to non athletes of the same age and the same level of physical activity, but not really, at levels of adequate exertion. So those are just some of the big factors. And as I mentioned, there are many external environmental factors. But those are the some of the big ones.

Avery St. Onge: Interesting. So when you when you're referring to diet, can you tell me about the specific influences of diet and nutrition on DNA expression? And, you know, what diet? Are you talking about? Like, what is considered good and what is considered bad? 

Kenneth Pelletier: That's a great question. But all of us are bombarded on the internet, or on television, every day with a diet of the day club, this diet is going to improve your mental function is going to have you living longer, it's going to give you a more vigorous sex life, whatever it happens to be, it'll make a promise that is false. Totally false. No diet can achieve that. So if we ask step back and say, Is there a diet that has clear scientific evidence over decades of having a positive impact on a person's health and longevity, no matter what their age, throughout their life expectancy, there really is only one diet, and it's the Mediterranean diet. And that's the diet characteristic again of the countries around the Mediterranean Sea. And it was initially discovered because one researcher from Harvard saw a gradient in heart disease from the Mediterranean, up to the Scandinavian countries where it increased as people consume more cheese and more milk and dairy products and lived in cold dark climates where it was negative relative to health status. And it's been more popularized more recently by Dr. Willett, Walter Willett at Harvard. And that diet is very, very powerful. Again, good data, good evidence and some of the characteristics of that diet are and we can talk a little bit later about the Blue Zones, is in mountain moderation or modification is associated With extreme longevity, so you have olive oil as the basis it gets consumed in the diet, it's essentially vegetarian based. They don't eat red meat, or even poultry, or because not because they're against red meat consumption. It's because they're poor. It takes a lot of money and a lot of land and a lot of resources to raise animals for slaughter. It's a very inefficient way to obtain protein in our diets. And so they tend to be lacto vegetarian, they do our they do our their pescatarian. They do eat fish. And we know from our studies that the Omega three content of fish, again is a very powerful antioxidant improves the metabolism in the cells and provides extra nutrients. The other that we can see in diets is there are superfoods. Superfoods like blueberries, as an example is a superfood. Fruit. There's no question about the fact high antioxidant content, vitamin mineral content, fiber, etc. So it is one of many superfoods. So by contrast, and ends with this, because they have the everything that we don't need and don't want as the white diet. So it's the white flour, white sugar, ultra processed foods, all of those are literally killers. It results in high levels of blood lipids, blood sugars, which can lead to pre diabetes and diabeetus. And even Alzheimer's has not been implicated with a high sugar diet. So there's everything we don't want to eat, and then all the previous items that we do want to consume more of that and the result is a longer life expectancy.

Avery St. Onge: And then specifically, how do these foods impact DNA expression like with the superfoods, does it positively impact genes and the fact that it like, expresses the good genes, as opposed to the bad genes?

Kenneth Pelletier: Yes, actually, there's, again, it goes back to the model of every cell in our body is bathed in an ocean, and that OSHA is affected by everything we eat, and everything we eat affects the cell directly. So as an example, about diet, the mitochondria is the ineffective sparkplug in a cell and governs energy metabolism and energy utilization of efficient use of nutrients in a cell. So when you have antioxidant foods, like as an example of blueberries, that has a positive effect on the mitochondria, such that it eliminates byproducts. So byproducts that accumulate in a cell as a result of normal metabolism is fine. But we're consuming a bad diet, those byproducts accumulate to the point of where it disrupts the function of the cell, and disrupts the expression, if you will of that cells, vitality, or the DNA. So that's an example of how an antioxidant has a direct effect on DNA expression. And it's the same for virtually every other aspect of DNA.

Avery St. Onge: That makes sense. We think a lot about unhealthy foods having a negative impact. But it's interesting to think about how healthy foods can actually, it's not just neutral, it actually improves your health.

Kenneth Pelletier: Oh, absolutely. Yes, there are. Like I said, there are super foods. There's no question about that. So you have the cruciferous vegetables, the cauliflower, the broccolis, the, the the the scallions, onions, garlic, all of those have definite antioxidant properties. They also contain micronutrients that are vital for a cell's function. So that's a category, if you will of superfoods. Another is simply fiber intake. In the United States, Europe, generally, we have much too low and intake of fiber, the microbiome needs fiber, we hear about prebiotic, and probiotic, and even post biotic consumption. The reality is that the amount of fiber that a person consumes on a day to day basis governs how well the microbiome is going to operate. The microbiome governs every aspect of the human immunity. So most of the immune cells originate from activity in the intestinal tract. So when we're consuming adequate fiber, we're influencing the nutrients in our body. Other factors we mentioned As with fish, you have high omega three content. Omega three is a powerful antioxidant. It also promotes elasticity of the arterial system. Elasticity of the heart reduces inflammation of the heart. So all of these foods, each of them has a definite positive impact. It's not just neutral. So if you eat this, you'll you'll be okay. These are ways to actually enhance our life expectancy, enhance our longevity.

Avery St. Onge: And then when you're talking about stress, obviously, there are a lot of different forms of stress. What, what kind of stress are you talking about? 

Kenneth Pelletier: That's a good question as well. There are basically there are many different kinds of stress, but they're really two basic forms. One is short term. And that occurs when the source of stress is immediate, identifiable and resolvable. So it's, you step off a curb, a car honks its horn, you jump back on the sidewalk, and your life is saved. And, you know, it doesn't feel very good. But you just saved your life. And we owe our evolution as a species to successful type one short term stress. The second type is the destructive form. It's the type two response when the if the immediate short term stress response continues for too long a period of time. So it's like if you have the accelerator on your car, just press to the floor after a while the engine just blows up. And that's exactly what happens to the body when we don't go through periods of cycling with sympathetic arousal followed by parasympathetic dominance or a trough if you will, compensatory period. That form of stress is the catabolic stress, it's extremely destructive. To every cell, it's destructive to our end organ systems, accelerates the heartbeat increases blood pressure activity, electrical activity in the brain hyperfunction, the irritable bowel syndrome, all of the conditions we see as chronic conditions really can be traced back to the excessive type two response. That's the bad news. The good news is, through meditative practices through stress management techniques, Pilates yoga, transcendental meditation, mindfulness meditation, we can practice and what we can do is when we know we're in a type two stress response, we can break that up into a type one stress response. So we get the high from it, which we like. And we need and we seek out many of our pleasurable activities are seeking a peak stress response, doing something dangerous or doing something a little on the edge, but we have to recover from them. And when we can learn to voluntarily recover, we can avoid the damage and derive the benefit.

Avery St. Onge: You touched on this. But can you tell me more about what Blue Zones are? And then the common characteristics within?

Kenneth Pelletier: Yes, Blue Zones are communities, physical sites around the world, I believe there are five to eight of them, that have been identified as sites where people on a regular basis live to be 100 to 110 years old. And that's that's kind of fat. Dan Buettner wrote a book on that called the Blue Zones and as a subject of a National Geographic documentary. So when we look with our research here at UCSF Med, we've looked at what we call the divine doesn't. And there are 12, common characteristics of virtually all of these blue zones. We've touched on a few of them so far, but just to go through them. All of them have a modified Mediterranean diet. They do eat fish, they don't eat red meat, again, they're not philosophically opposed. They just avoid the the steroids and the nutrients and the antibiotics that are characteristic of reared red meat. So they're pescatarian or purely vegetarian based for protein sources. They do smoke. I, I made that observation and published that a number of years ago, and the cigarette companies picked up on cigarettes quoting are not antithetical and the point is, is that when you see them smoking, they're usually little rolled cigars. And they they puff on them, they don't inhale them deeply. There's no fertilizer, no pesticides involved in the processing of the tobacco. So it's really a kind of social event, puffing, not deeply inhaling. So it's not really smoking as we know, smoking. They have a high level of regular physical activity. They don't have gymnasiums. They do don't have personal trainers, they're farmers. So they have to lift and bend and walk and stoop and stretch. So they do have these moderate levels of physical activity on a regular basis part of their life. They have strong psychosocial bonds, you have the cliche, it takes a child to raise, it takes a community to raise a child, well, it takes a community to raise a centenarian. So they do have very strong support for each other. If someone's ill, they take care of them. If someone needs help, they'll feed them if they need help their physical activities, they're taken care of. So there's always a strong social network. There also, the six of the Divine does it, they're sexually active, and which means they, they they, they touch, they hug, they celebrate. When you first get there, it's almost uncomfortable, because they're always touching each other, they're touching. And they are sexual into their 80s and 90s. But it's a bit more physical, they're more more touching. And we know that touch lowers blood pressure, we know it lowers heart rate and electrical activity in the brain. So it's, it suddenly feels good, it's good for you. Next is they have no fear of death. They don't strive necessarily to live to be 100 or 110. That's not their goal in life. Their goal in life is to live at optimal life. And there's no fear of death. In fact, very often, there's, there's Dr. Jim freezes a friend at Stanford, published an article call this the squaring of the curve, which is when people live for long life, the period between becoming ill and dying is very short. So it's a squaring the curve. They don't have periods of long lingering disability, and morbidity. Very often, they'll say, you know, we need to celebrate this weekend, I won't be with you on Monday. And sure enough, they usually die quietly in their sleep over the weekend. So there's no fear of death. Alcohol consumption, they consume a lot more alcohol than reconsidered re moderate in our culture. But again, it's like smoking, there's a difference between how we consume alcohol and how they consume alcohol. It's usually wine and beer. They consume it at breakfast lunch, middle of the afternoon, in the evening with dinner night before going to sleep. So it's consumed throughout the day in a social environment. There's very little alcoholism or intoxication, they'll they'll get high and tipsy but it's not getting drunk. It's not not active. They have appropriate, very good primary care that's very often overlooked in these descriptions of these communities. So and it includes very often indigenous medicine. So they'll use herbal medicines, they'll use in effect, what we call chiropractic or massage or AI or Vedic interventions. So it's good primary care, they don't have an MRI for a tennis elbow. These countries don't have an MRI. My favorite example is there are more MRIs in the city of San Francisco than in all of Canada. That makes no sense, whatsoever. Right. You know, so they're, they're spared, if you will, the wonders of modern medical technology. Last two, they do clearly have a genetic history. I mean, they have been, these communities have been in existence for decades, maybe hundreds of years. So there is a genetic predisposition to longevity. But as we've looked at, that is not a certainty. Studies of people that have long lived, grandparents and parents, they do not necessarily live a longer period of time, if they have adverse life practices. So it's really the, the it's like, if you will, the gene loads the gun, and the lifestyle pulls the trigger. Kind of a crude analogy, but the whole idea is that we have predispositions that it takes lifestyle to make that happen or not. And really the last, in many ways that may be the most important. They all have a sense of purpose. They're not necessarily orthodox ly religious. But they all have a belief in a universe that has a purpose. They have a purpose. And it's this sense of that their life is worth living for themselves, for their family, for their children for their offspring. And no one is made to feel useless. So the elders are the ones who decide finances. They decide allocation of food, they decide about marriages, they have a very critical function all the way through their lives. We did a kind of a sidebar, we did a study many years ago, of smoking cessation of Bank of America in San Francisco. And by happenstance, we were invited to go to Warsaw, Poland. And to do the same study and intervention, we went there. It totally failed. And we were perplexed at what is going on and worked so well. And then one of our Polish colleagues said, Did you talk to the grandmothers? We said, What do you mean, talk to the grid smoking cessation. And they said, Well, if the grandmother doesn't tell the family to stop smoking, no one's gonna stop. We went back, we engage the grandmothers got them to see the wisdom of it to promote no smoking, and then the program worked beautifully. So grandparents, the elders who are 100 to 110 years old, have a tremendous influence in the family, and then the community, not only is not allowed to feel useless, they are very functional, very important members of their society.

Avery St. Onge: Interesting. What I'm struck by most is that I feel like everything you said, is basically the opposite of particularly urban American society. So how do you propose, you know, someone changes the way they're living to that extent? I feel like we've kind of gone too far at this point, to go back to a more simple lifestyle, which it seems like that is the most healthy lifestyle. So, what do you envision happening to change these things?

Kenneth Pelletier: Great question. I mean, these cultures have been around for hundreds of years. So we're not going to snap our fingers and immediately assume that kind of a lifestyle. But you're right. It's a direct contrast. We started out the conversation saying we've become fixated on longevity. And we have, we're fixated on pharmacology on hyperbaric oxygen on young blood transfusions on extremes of biohacking of all kinds with pharmaceuticals, with drugs. And that's kind of a very macho, conquer death, live at all costs, assertive pharmacological approach, I'm hopefully I just don't believe in that. I mean, there are aspects of it, that are very good and are going to, in fact, enhance our health and life expectancy. But that's the wrong model. And the right model is where we have to look at ourselves as a culture as a society and make a difference. So National Geographic does have a program of actually identifying cities that would like to sign up for what they call Blue Zone communities. And they go in, they do assessments in the community, they say, here are the things you're doing well, here are the things you could do differently, and they try to change the entire community. So Should everyone living in it assumes a healthier life expectancy, and presumably a healthier longevity, but again, into two contrasting models. One is the slow, methodical development of a psychosocial base that gives rise to longevity. The other is a technological, pharmaceutical intervention oriented, very medicalized model, take rapamycin, and take this drug or that drug, and you'll improve your life expectancy go on extreme fast go on extreme diets. cold water immersion is the latest part. All of these have a value, but they are not categorically not any one of them going to lead to extended life expectancy. All of them might contribute some marginal benefit and value. But until the whole structure changes underlying the wisdom of these practices, we're not going to see expect, you know, we're not gonna see extended life expectancy of 100.

Avery St. Onge: So, for the average person who's trying to live a long life, do you suggest they just kind of simplify their lifestyle? Are there any aspects of that kind of modern technological approach that they should incorporate into their life that you think would be helpful?

Kenneth Pelletier: Oh, absolutely. There's so much we can do. If we looked at the divine doesn't, every single aspect of their life expectancy is possible for everyone to do right now. These are not distant communities. They've been around for hundreds of years. They exist right now. And there's so much we can learn from it. One is to improve our diet, eat organic foods to eat moderately to have periods in fact, have periodic fasting. These individual cultures they don't plan on intermittent fasting, they have feast they have fun Emmons their problems, crop failures, difficulties in raising enough food. So they go through cycles of intermittent fasting, whether they like it or not. So we can do that we can do intermittent fasting, we can improve the quality of organic foods for our diet, we become physically more active, we're a terribly inert nation, we sit in front of computers, and that's getting worse and all of the problems associated with that. So just going out and walking, we're not talking about running marathons or nothing about heroic levels, we're talking about taking walks around the block, walks around your neighborhood, getting to know your friends and family. Stress management, we can all develop more effective stress management techniques. So the toxic effects of the stress we're involved in on the daily basis don't have a negative impact, we get the high but not necessarily have to pay for the destructive impact of that. So those are those are all possible right now, today. All of us can do that. There's no, we can all care about altruism, taking care of others, social causes, if you will take care children, better care of animals in our environment, better care of the environment in general. All of these, again, we can do these things. You know, they're not extraordinary measures. And yet, the cumulative impact is to have a positive, Healthy Aging and Longevity.

Avery St. Onge: And I'm wondering how much do you think the environment is impacting epigenetics? Because, obviously, there are certain things you can do to prevent being exposed to pollution, but a lot of it is kind of out of people's control, right, depending on where they're living. What do you say about that?

Kenneth Pelletier: Well, genes, genes can be damaged, that you then change, your genetic predisposition at birth will remain unchanged. You can express it in different ways, but the gene basically remains constant, but it can be damaged, it can be damaged by radiation. It can be damaged by petrochemicals, by herbicides in the food, by extremes of heat and extremes of cold. So all of these things can damage the DNA and create illness and, and problems. Environmentally, we may not be able to avoid all of these things. Although we can certainly try certainly, we can definitely change the ingestion of herbicides and pesticides. Glyphosate is a hideously bad product. I mean, it is a known carcinogen. There was a study about six months ago, they looked at single cell organisms in Antarctica. And they found that every single celled organism in Antarctica had glyphosate. So we have poisoned the planet with a known toxin. So to not buy foods to not support companies that use glyphosate on their crops, and they're known, and we can avoid them just don't buy those products. They won't sell they'll have to meet change their farming practices. So that's a rather radical stance, but it's a way one of the time that we can make a difference in terms of diet. The other is, all the things we've been mentioning, are ways to not necessarily not immunize yourself in that sense of you will build a barrier around you in your environment, that's not possible. But a healthy, functional immune system, well nourished, exercise, stress manage, is relatively in, it's a lot more stable than we think we're not as vulnerable to these environmental impacts, as we think nor are we as invulnerable as we'd like to believe or the the processes in company was like to have this belief. So there are all things that we can do to not say immunized, but to balance out the potentially negative impact of the environment. 

Avery St. Onge: That makes sense. Well, those were really all the questions that I have for you today. Do you have anything else that you'd like to add?

Kenneth Pelletier: No, this has been actually a fun conversation. I hope it's been helpful. I think my last parting message would be that there are these two approaches, if you will to longevity. One is this pharmacological intervention oriented, masculine. Create drugs, procedures, machines, protocols that derive if you will, longevity, the other is a much more feminine, more supportive, more environmental. Let's create the preconditions for optimal health and longevity. We have examples. We're not talking about something that's theoretical these communities exist. We know they exist, they've been around. So there's a lot we have to learn from them. To me that is a much greater challenge to try to emulate and learn from them, rather than go a kind of down a biotechnology manipulation model. So my hope is that we choose to have a much more positive building environment. Build a caring, loving community among the people in that environment. And that will in fact, result in longer, Healthy Aging and Longevity.

Avery St. Onge: I hope that too. Well, thank you again, Dr. Pelletier, for joining me today.

Kenneth Pelletier: Thank you. It's been a pleasure.

Avery St. Onge: Thanks for listening. We'd like to thank Scott Holmes and Kevin MacLeod for providing us with our theme song. Be sure to visit our website integrative practitioner.com or send us an email at IPE editor at Def con.com. Remember to like and subscribe to our show. We'll see you next time.

Editors note: Transcripts are autogenerated.