I have just returned from my trip to Iceland where I was invited to speak at the Icelandic Health Symposium entitled “Who Wants to Live Forever?” and wanted to share with you some thoughts now that I have returned to the realities of daily life.
First and foremost, I need to express appreciation for what a fantastic job Gudmundur Johannsson, Ari Freyr and their team did putting on a first-rate conference that drew participants and attendees from all over the world. This would have been a major accomplishment for any professional event planner, but this was organized by a full-time Icelandic emergency physician who works in the busiest ER in the entire country. As a fellow emergency physician, I can attest that this is a superhuman feat. Well done Gudmundur!
Next, I just want to make brief mention of what an incredible experience we had in Iceland. Words fail to describe the natural beauty of the Icelandic landscape and the incredible openness and forthrightness of the people. We wrapped a full week family vacation into this trip and are so grateful that we did so. We did as many day trips as possible. One of the most memorable (and terrifying) was the Thorsmork Volcano hike. You can see what I mean by watching the first 1:30 of this video:
If you ever have the opportunity to visit Iceland, do not pass it up.
Now, on to the conference itself. Videos of all of the lectures will be up soon on Youtube, so I will just hit the high points for each speaker, and will announce on social media when the videos are available. But here is a speaker-by-speaker rundown.
Dr. Rangan Chatterjee
Dr. Chatterjee is a general practice physician with the National Health Service (NHS) in Britain. In his NHS practice Dr. Chatterjee sees approximately 45 patients per day and is continually frustrated by the limitations of this practice model. He escapes this model in his BBC One TV show Doctor in the House in which he lives with 3 different families for a month at a time.
In this setting Dr. Chatterjee is able to engender lifestyle changes which result in the reversal of chronic disease states. Encouraged by the experience, he also has started working privately one day per week seeing patients for 60-90 minutes per appointment in order to deliver more optimal care.
In his lecture, Dr. Chatterjee outlined his “4 pillars” for optimal health. These 4 pillars are Food, Activity, Sleep and Relaxation. With regard to Food a natural, non-processed diet is encouraged without any particular concern for macronutrient ratios (although low carb may be used as an induction diet for insulin resistant or stressed patients). Non processed foods stimulate a healthy gut microbiome, which in turn balances the immune system. A balanced immune system then optimally autoregulates body function leading to good health.
With regard to Activity Dr. Chatterjee hit upon myokines and also noted that HIT and HIIT both enhanced protein translocation (clearing out of old or mis-folded proteins) and caused mitochondrial age reversal. He also made a case for increased overall activity and prescribed replacing sedentary time with movement or sleep. He also recommended exercise “snacks” before meals to improve glycemic control.
With Sleep it was noted that sleep deprivation caused increased gut permeability which in turn led to increased inflammation from elevated cortisol, increased visceral fat and thus increased leptin and poor insulin sensitivity. Emphasis was made on good circadian hygiene, but the details were deferred to Dr. Panda who was to lecture later.
Finally, Relaxation via meditation was noted to enhance cognition and mental plasticity as well as to decrease cortisol and the inflammatory cascade that follows.
Dr. Chatterjee summarized his approach as “consciously changing your lifestyle to unconsciously change your biology”. To learn more about Dr. Chatterjee, or to order his soon to be released book, visit www.drchatterjee.com.
Dr, Lilja Kjalarsdottir
Dr. Kjalarsdotir (Dr. K) is a researcher at the University of Iceland whose work focuses on the metabolic underpinning of lifestyle and age-related diseases. Her lecture was “How to Make Your Cells Young on the Cellular Level”.
Dr. K opened her lecture by asking “if you were to lose 10kg of body fat, where did it go?”. The answer it turns out, by using the formula for cellular respiration is 8.4kg of CO2 and 1.6kg of water. She then detailed the flow of energy through glycolysis and then the mitochondria, citing the extreme importance of the mitochondria in metabolic health.
The essence of mitochondrial health is metabolic flexibility that is brought on by a suitable balance between the fed and fasted state. In the fasted state, fat metabolism predominates, relying on beta oxidation, and in the fed state, carbohydrate predominates via the respiratory chain. If one is in an overfed state, neither metabolic pathway is given a chance to predominate and thus metabolic inflexibility ensues. To quote Dr. K… “Nutrient overload suffocates the mitochondria”, and this is the state where most people exist.
Dr. K then delivered the good news that this is a reversible situation and can be achieved by diet, exercise and (early in the induction phase) use of L-carnitine. Exercise works by adding mitochondria and stimulating fusion/fission of damaged mitochondria and causing them to be cleared from the cell. This process is called “mitophagy”. Dietary manipulations include time restricted feeding and initial carbohydrate restriction to allow a long enough fasted state to entrain proper fat metabolism and initial carb restriction to diminish the relative overemphasis is the typical diet. L-carnitine is used because it is involved in shuttling fatty acids into the mitochondria and is typically deficient in the Western diet.
There was much more to Dr. K’s lecture. So be sure to check it out when it goes up on Youtube.
Dr, Satchidananda Panda
Dr. Panda is a research scientist with the Salk Institute in La Jolla, California who is the world expert on circadian physiology. He is the rock star of all things circadian. His lecture was “Daily Rhythms-The Master Conductor of Health and Disease”.
Dr. Panda opened his lecture by noting the remarkable increase in lifespan (age 47 in 1900 to age 79 in 2010) but noted that the technology that made this possible is also undermining healthspan such that many spend their adult years with some form of chronic disease.
With regard to these chronic diseases, ALL biologic function is tied to circadian rhythm. We all have melanopsin receptors in our retina that are not vision producing, but sense blue light and sets our circadian rhythm. It takes a brightness of about 10,000 Lux to set them off which, in a natural setting, is typically represented by morning light. Absence of this trigger results in depression, bipolar disorder, ADHD and vulnerability to PTSD. Light is thus a therapeutic agent. Depression can be effectively treated with 10,000 Lux for 15-60 minutes.
On the flip side, sleep is entrained by an absence of bright light and melanopsin stimulation. Thus, less than 20 Lux exposure in the hours before bed is needed to entrain a proper sleep pattern via melatonin signaling. Hence the emphasis on limiting screen time or using blue blocker glasses or apps such as Lux to limit such exposure before bed time. Dr. Panda is trying to set standards for exposure in architecture, building code policies, hospitals and even the international space station.
The most interesting portion of his talk is how circadian rhythm ties into to diet and the importance of time restricted feeding. If food is given at the wrong time, it has been found to override the circadian clock. Also, night time feeding results in excess fat gain because melatonin secretion inhibits insulin sensitivity making night time eating especially fattening.
With this in mind, Dr. Panda went back to the literature on caloric restriction and its effect on extending lifespan. When he retrospectively looked at these studies, he found that almost all of them also delivered the calories in a time restricted pattern. He then carried out studies in rats that used isocaloric feeding, but separated rats into free feeding groups and time restricted feeding. Lo-and-behold, the time restricted rats showed better metabolic health, and longer life span, suggesting that time restricted feeding may have been the life-extending variable.
Find Dr. Panda at www.panda.salk.edu
Dr. Bryan Walsh
Dr. Walsh is a licensed, board-certified Naturopathic Doctor with an interest in human physiology and nutrition who sees patients in his own practice and serves as Scientific Advisor at Lifetime Fitness where he designs laboratory panels and interpretation methods. Dr. Bryan’s Talk was “Mind Over Age-The Science of Thought Driven Physiology”.
Dr. Walsh’s talk centered on the profound effect that thinking and mindset has on our physiology and health. He noted the literature that supports that the placebo effect is an actual therapeutic effect that often accounts for most of a drug or intervention’s therapeutic benefit, and can often be exploited in isolation to achieve health benefits.
A battery of literature was offered to support the power of cognitive therapy and optimism in general. He demonstrated that mere optimism produces a lengthening of telomeres and pessimism shortens telomeres. In fact, longevity is promoted simply by having a positive self-perception in regard to aging. The studies he cited controlled for confounding variables, and in so doing, showed that attitude had a greater magnitude of effect than other more active interventions.
Dr. Walsh’s final message was on the importance of purpose. Purpose created a Eudaimonic (as opposed to Hedonic) sense of happiness defined by a fulfillment with life. Other states include self-acceptance, positive social relationships, personal growth, environmental mastery, autonomy and personal expression. When these elements are present in one’s life they seem to offer independent health benefits even in the absence of other interventions.
Find Dr. Walsh at www.drwalsh.com
Ben is a polymath of the fitness universe whose work can be found at www.bengreenfieldfitness.com. He is an experienced personal trainer and wellness consultant as well as author of “Beyond Training”, a New York Times Bestseller.
Ben’s lecture was “4 Hidden Variables That Are Stripping Years Off Your Life”. Ben focused on exercise (including avoidance of overtraining), light, water and stress control. The two areas that were relatively new to me were the importance of light modulation (refer back to Dr. Panda’s lecture). Ben uses various bulbs to ensure synchrony with circadian patterns, including use of red light bulbs in bedrooms and rest areas, blue light bulbs for office and gym, blue blocking glasses for evening screen time or software on computers/phones to adjust blue light exposure levels according to time of day. Also TV blocking screen and Near/Far infrared exposure.
With regard to water he discussed the importance of reverse osmosis filtering to remove contaminants in the typical urban water supply. Use of glass bottled water and using a Sport Berkey bottle for travel.
At this point, my pen ran out of ink for note-taking, but Ben said he would have his lecture slides posted at www.bengreenfieldfitness.com/iceland. It is not up at the time of this writing, but keep an eye out for more.
Dr. Diana Rodgers
Dr. Rodgers is a “real food” nutritionist and writer who lives on an organic farm in Massachusetts. She has written two books and hosts the Sustainable Nutrition Podcast. As an advocate of optimal human nutrition, sustainability, animal welfare and social justice, she offered a scientific argument for why a plant based diet might not be optimal for human health, and is not the obvious moral choice that is commonly portrayed. She demonstrated how proper animal husbandry, focusing on unconfined, pasture raised animal meat is not only ideal for human health, it is the best way to produce a sustainable and environmentally optimal food source. If this lecture is posted, be sure to watch it.
Find Dr. Rodgers at www.sustainabledish.com.
Who Wants to Live Forever? is one of my all-time favorite conferences. I learned more than I had even hoped. Watch for videos as they become available. I will give everyone a heads up when they appear.