Episode 81

Published November 19, 2024

In this conversation, Dr. Kara Fitzgerald discusses the intricate relationship between epigenetics and longevity, detailing her journey into the field, the design and outcomes of her Methylation Diet and Lifestyle Program, and the implications of biological age versus chronological age. She emphasizes the importance of personalized interventions and the role of environmental factors in gene expression, while also exploring various lifestyle changes that can positively impact biological aging.

Dr. Fitzgerald and Dr. Smeaton also explore:

• The impact of lifestyle changes on biological age
• Recent studies on aging patterns
• The significance of hormonal health, especially for women
• How small daily changes can lead to significant improvements in health span
• The importance of DUTCH testing in understanding hormonal patterns and its relevance in aging discussions

Key Moments

00:00 Introduction to Epigenetics and Longevity

06:08 Designing the Methylation Diet and Lifestyle Program

11:57 Understanding Biological vs. Chronological Age

18:10 Personalizing Interventions for Optimal Health

24:04 The Future of Epigenetic Research

32:33 Understanding Aging and Its Accelerators

41:44 Surprising Changes to Impact Biological Age

Transcript

Jaclyn (00:01.432)

Well, it's nice to have you back, Dr. Fitzgerald on the DUTCH Podcast. Thanks for joining me today.

Kara Fitzgerald (00:06.201)

Absolutely, it's always good to be with the amazing DUTCH team and of course you, Jacqueline.

Jaclyn (00:12.104)

We have so much fun. So I'm excited today to talk about like really your bread and butter and your passion and the thing that really lights you up, which is kind of the connection between epigenetics and longevity. Now, how did you end up stumbling into this area of interest and really igniting your passion for it?

Kara Fitzgerald (00:30.201)

Yeah, I love talking about that question because it came in a really kind of a roundabout fashion. mean, we were, it was around 2013, 2014 when I really started pondering and diving into the literature around epigenetics. was just, you know, crossing my desk, dropping into my email a lot. And I noticed a little resistance to...really wanting to get into it. It's dense science. There's a joke that says, if you don't understand it, just tell them it's epigenetics. was just, it's and I actually used that in my slides for a long time. It's dense, but it felt really important to read and think and swim in the pond of the science of epigenetics through a functional slash system slash naturopathic lens.

So I'll just define that first and I'll continue with my story. So epigenetics is everything above the gene. You everything that's regulating what gene is on and what gene is off, know, and there are, you know, hundreds of different biochemical marks that can influence the activity of gene expression. And it's an extraordinary conversation in and of itself, just thinking about that. But when I first dove into it, a lot of the science was around epigenetics in cancer. So cancer very efficiently taking over gene expression from the host and, you know, turning genes off to promote cancer growth, cancerous growth, excuse me, turning genes on to promote cancerous growth and turning genes off that inhibit cancer. And that really stopped me in my tracks around, could anything that we're doing in functional medicine be influencing gene expression through the window of epigenetics. And at the time, and still, the epigenetic mark that is most reliable, like we have the best labs around it, most research is published on it, is something called DNA methylation. When there are a lot of methyl groups on the promoter region of a gene, it basically blocks that gene from being transcribed.

Kara Fitzgerald (02:49.881)

Conversely, when there are few or no methyl groups on a promoter region, that gene can be turned on. And we have enzymes to maintain methylation. We have enzymes to remove methylation or add methylation, de novo, new. So thinking about cancer was our first entry. My dear friend and colleague, Romilly Hodges, is the director of our nutrition programs, or she was then.

She's doing other work in our practice. And she and I were talking a lot about this during those early years and decided that we could design a program, a diet and lifestyle program with an eye towards optimizing epigenetic expression, specifically DNA methylation. Kind of, you know, sort of, it's funny to think about it in hindsight, sort of somewhat cocky, I don't know, thought that we could just get in there and really build sort of forkful by forkful activity by activity, know, something designed to really sweet talk DNA methylation. But we thought that that would be the, you know, the best and perhaps safest way to support, you know, optimal gene expression. So we did, we created a diet and lifestyle program. We started to use it in practice.

You know, it's a well-designed dietary pattern really by any measure. It's, you know, it's low glycemic, it's anti-inflammatory, it's a little bit keto leaning, et cetera. It's a healthy dietary pattern. And then we layered an exercise, you know, stress management through meditation and just kind of built this program based on our read on the literature. We are, the question after that, as we started to use it in practice became, are we actually moving the needle on epigenetics? And at that time, you couldn't just send somebody out to Quest Lab to look at gene expression in that way. And so it was really a cool gift that Metagenics sponsored a study. They actually gave us an unrestricted grant. So that means we were able to design it, the content, that what we did is ours, and we were able to conduct it.

Jaclyn (04:48.834)

Right.

Kara Fitzgerald (05:09.559)

you know, a randomized controlled clinical trial on looking at gene expression in a healthy population. So our first entry into it was really thinking about, you know, cancer and the other chronic diseases of aging, less so than aging. And the reason was that epigenetic age or the era of epigenetic clocks was only starting and especially the idea that we could move the clock.

Jaclyn (05:35.438)

Hmm.

Kara Fitzgerald (05:38.467)

that we could favorably augment, you know, biological age or epigenetic age is measured by one of these clocks. I mean, that just simply hadn't been done in humans at the time of our of our first blush on this. So I was pretty confident that we were going to influence gene expression. And again, I look back and maybe chuckle a little it seems kind of cocky, but it just you know, our read on the literature and a lot of the literature back then was in vitro and cell studies, but still it was

You know, we just designed it through the best lens that we had and our best read on the literature. But anyway, we got this grant. Yeah.

Jaclyn (06:14.84)

to stop you though. It's not cocky. This is the scientific process. You see what's out there, never been done in humans, and you create a scientific hypothesis. So please accept that reframe because I don't think it's cocky at all. I think it's amazing.

Kara Fitzgerald (06:24.793)

It's pretty, I mean, it really is, it is incredible. And yeah, perhaps that's not the right word for it, but it's funny to look back on it and see where we are now some years later. So in 2016, we released a white paper on it. We called it the Methylacin Diatin Lifestyle. We released a white paper on it.

We had clinical data that we could lower homocysteine with it. We could see people clinically respond and have improved symptom control, et cetera. Homocysteine, which was our surrogate marker of methylation, know, homocysteine sits right there in the center of the methylation cycle. We could see that drop in people who really stuck to the program. So we had some hint that it was doing something. We could see cholesterol drop and so on and so forth, inflammatory markers. So we were getting that information clinical practice. But we embarked on this study. We launched it in 2018. know, again, knowing we were going to have the tools to look at the clocks or the clock, was a single clock at the time, but really not holding my breath that we would see any movement on it. But during the course of our study, even though was an eight week intervention, it took us over a year to recruit healthy, a healthy cohort because we wanted to look at middle aged men, who were healthy at baseline and that took a while to get that group. And the reason that we chose that group is that we wanted to try to capture the aging phenomena not influenced by chronic diseases. And it just, yeah, it took some time. And, you know, middle-aged being 50 to 70, if we had women, and this is a pilot study, so we had 40 people in total.

Jaclyn (08:05.63)

That makes sense.

Kara Fitzgerald (08:18.937)

2020, if we had included women in this cohort, the waters would have been muddied by the range of pre-menopause to post-menopause. And we'd struggle with teasing through the hormone influence in such a small cohort. We did come back later and we can talk about it. And we released a little group of case studies, a collection of case reports in women. And hopefully we'll get to just research a larger cohort and include both sexes, a broader study population. But anyway, that's what we set out to do. It took a while to do. And during the time our study was running, the first paper was released to show biological age reversal as measured by the epigenetic clocks in humans. And this was the father of the epigenetic clocks, Steve Horvath. And Greg Fay was the first author on the paper, the principal investigator there. So those guys together released a year, a paper on a year long intervention with growth hormone and a handful of other things in a group of nine men. And they showed a biological age reversal over two and a half years at the end of that study. And it was, it was ridiculously exciting, you know, so it was very, very, very exciting, like anybody who was paying attention to this field, you know, it was the first, it really, really was.

Jaclyn (09:36.514)

Mm-hmm.

Kara Fitzgerald (09:45.113)

to see that that had happened. And it made us excited about knowing we were going to be able to look at the clocks. But again, we're talking about an eight-week diet and lifestyle intervention, not a year-long intervention using growth hormone injections among other treatments. anyway, we moved through the duration of the study and then started to crunch our data. And again, just...you know, it took our breath away. You know, when we saw that we had slowed biological age, as measured by the Horvath, the first generation clock, there's many clocks now in our study group as compared to the control group by over three years. I mean, it was just extraordinary. And then we could actually see the within group. So our study group at baseline as compared to follow up also got, you know, significantly younger. yeah, it was...

It was a big deal.

Jaclyn (10:46.518)

It's a huge deal. mean, just to reiterate for listeners, this is an eight week intervention, really like non-pharmaceutical. And that's what I think is so great. And if you want to read more about the study and about the work, Dr. Fitzgerald has a book called Younger You. We'll link to it in the show notes. I actually use this all the time and I give it to my patients for fertility because fertility is one of the earliest signs we have of aging in the body. And I've found that so much of the work that you've done is very relevant.

Kara Fitzgerald (11:06.169)

Nothin'.

Jaclyn (11:15.384)

to couples that are trying to conceive, especially if they're like over 35, really. That's a huge, it has big implications for fertility. So that's like my manual for them as far as what to do, diet and lifestyle. So, but I would recommend taking a look at it. And so let's talk just briefly about the intervention because this was an eight week intervention. Like you said, it's not a long-term study and to have three years biological age or not biological, yeah, biological age reversal after an eight week intervention.

Kara Fitzgerald (11:25.407)

Awesome. That is awesome.

Kara Fitzgerald (11:33.741)

Yeah. Yeah. Yeah.

Jaclyn (11:45.12)

I was truly shocked. mean, I'm sure you were too, but that's more than I would have expected because I would anticipate that you could get results like that, but that it would take longer to achieve results like that.

Kara Fitzgerald (11:46.862)

No.

Kara Fitzgerald (11:57.145)

Well, yeah, that's right. First of all, let me just, I just have to say on the fertility work that you're doing, I'm thrilled. I didn't realize you were using our intervention in your practice. And we talked about, I talked about fertility in the book and preconception planning and all of that, and even tweaked the macros a bit because it is, you're absolutely, you're.

It's the most important time where you really want gene expression to be happening as perfectly as it possibly can. So gosh, thank you. I'm thrilled to hear that. Okay, so yeah, the intervention.

Jaclyn (12:25.198)

Mm-hmm.

Kara Fitzgerald (12:40.929)

it first of all, I think what we're starting to see. So let me just say this was the first of its kind study and we did get a lot of attention because of that. was conducted in humans, first randomized control study using a diet and lifestyle intervention and looking at gene expression and looking at the epigenetic clocks. Since then, more and more studies have come out, you know, using diet and lifestyle interventions in humans and looking at epigenetics. It's just extraordinary. It's so exciting to, you know, be right in the middle of basically the, you know, the birth of a new science. It's extraordinarily exciting. I think that the take home is, and I should circle back and nuance the conversation around the clocks because the clocks have evolved and, and some scientists would argue that we need to go back and do our intervention using the newer clocks. we want, we will absolutely, I want to do that more than anything and use, we used saliva in our original specimen. Now we see that we should have, you know, used blood as our specimen, but we didn't know that at the time we were working with the best knowledge. You know, we started building this and designing the study in 2017.

Jaclyn (14:02.956)

Mm-hmm.

Kara Fitzgerald (14:06.073)

So there are things that have changed and it would be fabulous to put our intervention to the test under the modern abilities. The abilities have changed over a handful of years. It's extraordinary. But the idea is that environment is influencing gene expression all of the time. And a huge aha for me was that every single nutrient on a fork can be an epinutrient.

Jaclyn (14:15.746)

Right.

Kara Fitzgerald (14:35.577)

can be sweet talking DNA, sweet talking gene expression. And we could build brick by brick using our best read on the literature, what we think that optimal fork fall would look like. so everything you're ingesting is a complex interplay of compounds, some yet to be identified. There's this whole field called nutrition arm called the dark matter, is yet to be even defined. But we know the polyphenols, the various phytochemicals, the vitamins and the minerals, all of this, they're interacting with each other. They're being acted upon by our microbiome, by our digestive juices, by our stress status at the time. There's so much complex interaction for the whole journey. And then once absorbed is just potent regulator of gene expression. And I really, really came to appreciate the power of that. And then when you layer onto that exercise, these, you know, exercise is an epineutrient. It is. When you look at gene expression, you can see what exercise is doing looks like you know, a really fabulously designed meal in some ways, you know, it's, it's really, it's rather remarkable. Sleep similarly has these favorable kind of sweet talking effects on the epigenome and stress reduction sort of taking care of balance, you know, experiencing a balance, balanced amount of, of, of stress rather than, you know, stress kind of running our show.

All of these things influence gene expression in extraordinary ways. so it makes sense to me that we would have the ability to change things in a strong way. our original hunch really kind of bore fruit in our intervention.

Jaclyn (16:45.166)

Well, of course, it completely makes sense to me because we're not random victims of disease, right? There's a process biologically that happens and we are part of an ecosystem and community of all the things that we're exposed to and our body's constantly and very brilliantly adapting to our environment, right? So I love how you word that. It's like every fork, every bite of food becomes either helpful or harmful. And it allows you to really

Kara Fitzgerald (17:12.761)

Yeah, that's right. That's right.

Jaclyn (17:15.138)

change the way that you look at your food. And I love your social media feed because people take pictures of their food and like tell you all those epi- epi-nutrients that they're eating so they can get a pat on the back that they had beets today or whatever that food is that they're talking about. And so it's really wonderful because I think it changes the perspective of food from being something that you blindly do because you're hungry and you need to eat to something that's a lot more intentional and thoughtful that's about nourishment.

Kara Fitzgerald (17:24.483)

Yeah.

Kara Fitzgerald (17:41.515)

Yeah. And by design, we didn't want to include vitamins in the intervention. Not that I don't prescribe them in practice, not that I don't use them all the time and take them myself and have prescribed to my family and so forth. So I'm not anti-vitamin by a long shot, but we really wanted a food forward approach. know, probably, of course, you know, because you've read the book that I'm a huge fan of liver. don't cook it very well. Yeah, I wouldn't eat any liver that I cooked, truth be told. But you can get liver caps now, and so I'm a huge fan of liver caps. If you can cook liver, if you can make yourself a nice pate, go for it, it's awesome.

But liver is a multivitamin mineral complex in a food matrix. And so that's what I'm getting at here. This food matrix, this extraordinary complex interplay of compounds that we evolved to be exposed to, our microbiome evolved to have this information and then modify it and create these really sophisticated, extraordinary postbiotic compounds. So we just evolved with this kind of information versus isolated bioidentical compounds and superphysiologic amounts. And really leaning into that and testing that, plus the lifestyle components, not only made the most sense, but just really seemed the correct way to go.

Jaclyn (19:18.914)

So I want to step it back and for maybe listeners who are newer to this concept, can you help us understand the difference between chronological age and biological age?

Kara Fitzgerald (19:29.018)

Mm hmm. Yeah, sure. So chronological age is the number of birthdays we've celebrated and we can't do anything about that. Try as me might. My sister has been 29 at her birthday for the last, I don't know, 20 years. So chronological age, can't change, but biological age is the rate of physical aging. So basically the

Jaclyn (19:41.528)

haha

Kara Fitzgerald (19:55.441)

the wear and tear on the body. we can do, know, our biological age can be trending in step with our chronological age. can be faster than our chronological age, or it can be slower than our chronological age. There's kind of a cool paper that came out, I want to say maybe 2015 or thereabouts. The group that created one of the cool, actually a third generation biological age clock published this earlier where

They asked individuals to look at a handful of photographs of faces and to determine age. And what they discovered is that we're basically hardwired to see when somebody's aging faster. So the point is that when people look older, they probably are biologically extraordinarily enough. evolutionarily, perhaps we're hardwired to see that.

We want to stay with the healthiest in the pack. So some of us are indeed aging faster and we can see that reflected in their appearance or in their body habits and how they move, cetera, et cetera. And some of us are aging slower. And the extraordinary science that we're onto now, headlong onto, is being able to measure this rate of biological aging using a variety of tools and the tools, it's just an extraordinarily active area of science right now. It's really, really exciting. At the forefront are the tools using epigenetics and specifically DNA methylation. So there's a lot of epigenetic clocks these days, capturing the rate of aging through a variety of parameters. So, you know,

Jaclyn (21:45.132)

Now, what do those typically measure? They measure like how much methylation is happening in those promoter regions or could you, I mean, this might be getting in over our heads. I might've asked a question that's taking a little bit too deep, but at a high level.

Kara Fitzgerald (21:58.539)

Yeah, so they are looking at it's no it's beyond specifically, they're, they're not just limiting their investigation to promoter region methylation. There's about, I think, at last count something like 30 million methylation sites on the DNA, there's a lot. And so they can identify either sites of methylation or you know, absence of it. So sites of methyl groups or absence of methyl groups in certain regions of the DNA that correlate with chronological age, with health, with disease status, with, you know, smoking history. mean, they can capture DNA methylation imprints around a variety of parameters and then create a clock based on you know, those methylation imprints that they've found and then test them across different age ranges, you know, different ethnicities and so forth, the different, you know, gender cohorts and just massively kick the tires of these patterns to see whether they are, you know, reproducible and effective. And so to that end, we've created, there's quite a few clocks that have been created using variations of this. And these clocks can predict morbidity and mortality more reliably than chronological age alone.

Jaclyn (23:35.018)

It's fascinating. There's so much cool work being done in this area. Now, you'd mentioned some of the things that slow biological aging. You'd mentioned sleep. You'd mentioned food. You'd mentioned movement. Are there other things that are, well, I'm sure, well, there are vitamins that have been tested that affect methylation or like curcumin and turmeric, for example. There's like so many downstream inflammatory changes. And when you combine that with methyl donors, you can get a lot of benefit. But what other interventions really move the needle in your experience.

Kara Fitzgerald (24:11.683)

Let me see. So there's actually a paper that just came out. It's a preprint. It still has to go through peer review, looking at 51 different interventions and the ability to impact. Yeah, but it needs to be interpreted with some nuance. So we know that if you investigate a population with a certain condition, if there's a crime.

Jaclyn (24:25.474)

Very cool.

Kara Fitzgerald (24:40.889)

Chronic diseases accelerate biological age and really well established is diabetics. So if you study a cohort and you're able to control blood sugar and lower A1C, et cetera, through using metformin or diet and lifestyle interventions, you should be able to see at the end an improvement in their biological age for sure.

So depending on cohort, I know one of the most responsive was a group of HIV individuals with HIV. And so they saw pretty profound biological age reversal with their drug intervention. However, in healthy cohorts, I think we're still teasing it out. Diet has been shown beneficial. Caloric restriction has been shown beneficial.

I, know, exercise has been shown beneficial. I think there's some caveats around that. I mean, there's, there's a push in the scientific community to move into using these next generation clocks. So I think rapamycin has been shown to beneficially move the needle on clocks.

Vitamin D deficiency has been demonstrated in a handful of publications to actually accelerate biological aging and then treating with vitamin D has shown a beneficial influence on biological aging. Let me see.

Jaclyn (26:09.41)

Hmm.

Kara Fitzgerald (26:27.321)

I think the Dissatinib-Quercetin intervention has shown, know, showed benefit in bio-age reversal. There, yeah, there is, and the literature keeps growing. I'm, you know, I apologize because I'm working from this pre-print that just was released. So, but yeah, there's a slew of literature and more is coming out all the time.

Jaclyn (26:35.608)

There's a lot, a lot of options to choose from. Yeah.

Jaclyn (26:53.838)

Yeah, can practitioners choose the best things for their patients? I it seems as though the lifestyle interventions are a no-brainer to implement. Beyond that, are there better ways to determine what might be most helpful for someone?

Kara Fitzgerald (27:10.713)

That's a great question. So I would say that, you know, now that I've done this research, I'm attracting a group, you know, my patient population now I would describe as sort of biohacking leaning. wasn't always, I had sort of, had a kind of a workhorse functional medicine practice for many, many, many years, but now I'm getting more biohackers and they're coming to me on all of the kind of sexy, you know, vitamins and minerals and accessory nutrients and practicing high intensity interval training and rucksacking and all of this other stuff. Cryotherapy or cold immersion, et cetera, et cetera. And that's awesome. And it's great. And I do think that there's science around all of these to varying degrees to engage in. But we always need to treat the individual first.

This does not supplant using a good functional medicine lens, know, taking a good history and getting whoever that human being is sitting in front of us onto their optimal diet and lifestyle pattern and to and optimizing their nutrient levels using exactly what they need stepping outside of the literature, the literature, social media. It's super sexy and engaging. And a lot of people really want to take the latest thing getting, that, that influencers are talking about. But we really want to just get into balance ourselves. So do we have profound allergies? That's an inflammatory burden. That's a pro-aging phenomena. So if you've had these profound allergies that you haven't rectified yet, or if you've got a mercury burden because you're eating a ton of fish, you can have a whole, or if you've got some degree of inflammatory bowel disease, actually, know, IBS or let's say just whatever our collection of imbalances and it can be the continuum up to inflammatory bowel disease. But if we're not addressing those and trying to layer in these longevity interventions, we're really not going to see extraordinary turnaround. So we need to deal with our own reality first and then from there layer on these additional interventions or layer on some of them concurrently.

Jaclyn (29:28.75)

Mm.

Kara Fitzgerald (29:29.593)

The clock that we're using now that we're really pretty excited about is called the pace of aging. And this doesn't give us a chronological age, or excuse me, it doesn't give us a biological age. So if you're 40, doesn't, you it's not gonna say that you're younger or older than 40. It gives you the rate of how you're aging in that moment. And so a rate of one is consistent with chronological age, greater than one is accelerated rate, less than one is a decelerated rate. And so we obviously wanna be less than one.

And that's a pretty fast responsive clock. So you could get that at baseline and then you can track it with your functional medicine interventions and then with the longevity interventions and you can get it pretty regularly. We can link to a spreadsheet that we use that's standard chemistry biomarkers. Anybody can input their data. Any clinician ordering standard chemistries can use this. And this will also give you

Jaclyn (30:01.698)

Mm.

Kara Fitzgerald (30:25.901)

a biological age and one of the clocks, one of the called the phenoid clock was based on this particular calculator. And so that's available and you can, and that's super cheap relative to buying a DNA methylation clock. So there's, yeah, so there's a handful of tools.

Jaclyn (30:38.222)

That's great.

What makes it really accessible, like any patient that's doing blood work can even conventionally could get access to this type of information. That's awesome.

Kara Fitzgerald (30:46.679)

Yeah, super, super easy. And so then you can start to track how you're responding, be your own N of one and see what interventions work for you. There's a lot of individualization that needs to happen for sure. Not everybody should be on metformin, not everybody should be on rapamycin, not everybody should be eating one meal a day, et cetera, et cetera. As we all, know this in naturopathic slash functional medicine and it's absolutely true. And so if we follow our own,

Jaclyn (31:00.59)

Mm.

Jaclyn (31:09.367)

Right.

Kara Fitzgerald (31:16.343)

rate of aging, can design an intervention optimal for us. And actually, let me just say, in our practice, so before we started to research our intervention in our clinical practice, we do take the tenants of the Younger You program and individualize them for the human sitting in front of us. So that every fork full of epineutrients is, you know, is day rigor for all of our patients, but the design, the ratio of what epineutrients are on that fork will change from person to person.

Jaclyn (31:19.8)

Get it.

Jaclyn (31:44.142)

That's awesome. But one of the things you said before around like social media, there obviously there's a lot of talk around lifespan and health span and healthy aging. And we absolutely see all of the trends, know, the intermittent fasting, the sauna, the cold plunges. And what I really like about what you said is, you you have all of these things that could potentially add benefit that do have science in a lot of cases. And yet you start with the fundamentals when it comes to the Younger You program. And I just want to call that out because I think sometimes, you know, as a society, like if you're going to invest in something for your health, you know, if you're going to get a cold plunge tub for outside of your house, but then you're going to like not sleep enough, be really stressed, party, drink, you know, and not eat well.

Kara Fitzgerald (32:33.35)

Or you've had really refractory, small, know, small bio bacterial overgrowth that you just haven't, you know, remedied or whatever it is. Yeah. I mean, it's just, it's common.

Jaclyn (32:44.47)

Yeah, so you gotta start at the beginning, right? Start at the beginning and then like the cold plunging is like the icing on the cake, but it's not the cake, right? So I love that you have this focus in your program on what's gonna move the needle the most for people. Yeah. So I wanna ask you about a study that came out earlier this year, cause when I saw this, I thought about you immediately and I'm really excited to get your perspective on it. It was published in Nature and the study looked at aging, which we always generally considered to be a linear process. You you get one year older every year. But what the study saw, I'm sure you came across this, but that there were a couple of clusters in our lifetime where periods of accelerated aging occurred. So was 44 and 60 is what they'd seen where there was almost like these key substantial changes in dysregulation in our different molecular markers, immune regulation, carbohydrate metabolism, all these things seem to kind of like cluster around aging. Do you have any perspective on that or thoughts on that when you saw that study?

Kara Fitzgerald (33:51.531)

I think it's really interesting. I think it'll be kind of neat if I don't I don't know that I have any relative revelatory thoughts on it other than

Jaclyn (33:53.782)

Hahaha!

Kara Fitzgerald (34:03.449)

What are my thoughts? I would say that that's, you know, it was a small cohort, so it needs to, it definitely needs to be substantiated in a larger group. you know, and, and the study, so the study has some limitations around it that I think have been, you know, fairly critiqued and they should take it. It's a really cool, interesting idea, maybe not cool, but especially if you're 44 or 60, but it's an interesting idea.

Jaclyn (34:32.078)

I am 44, I'm 44 right now and I was like, gosh, that hit hard.

Kara Fitzgerald (34:33.697)

Isn't that funny? Isn't that funny? Great. Great. But see, that's well, except that except that this is just this is looking at, you know, some population average. So again, you absolutely have the power to not be engaging in that in that way. And you know, everyone in these studies where they're looking at these, you know, the the mean everyone's an out, you know, everybody's basically an outlier. And then they're all, you know, that the average at the end of it looks, you know, looks at these two peaks. So I think that it's an interesting first blush at capturing when we might have these leaps forward in aging and it may direct how we treat people during these times. But I think that a lot more research needs to be done in it.

Very interesting, but a lot more research needs to be done. again, I really, I just, stand by that if we're doing the work that we need to be doing, we can really push against being, you know, as much of a victim to these, if these two data points actually bear out in larger studies, you know, I think we have the possibility of really pushing against being a victim of those.

And let me, I'll just say one other thing about this. And we do have a baked in life expectancy that we're starting to, I think these studies and other studies like this, we're starting to tease out what that looks like, how that expresses itself. So we get at best case, humans get to live to 120. And I do think some of the core science is, getting into and touching upon what that looks like and why that is. So maybe this is a piece of that puzzle.

Jaclyn (36:35.93)

I think the last question I have for you, you know, because we're the Dutch test and we love hormones, is how do hormones play a role in biological aging and is that a consideration for women that they need to be thinking about when it comes to like long-term health?

Kara Fitzgerald (36:41.208)

Yeah.

Kara Fitzgerald (36:51.649)

Yeah, yeah, absolutely. think that one of the revelations that has really, the revolutions, revelation that has really come out of this movement towards focusing on longevity has been a much-needed attention towards women's health and especially around perimenopause, post menopause, know, is especially around our hormones. I mean, and especially sort of rebounding and recovering from the Women's Health Initiative misinterpretation. No question about it. Hormones play a huge role in not only quality of life, but in our rate of aging. We know that menopause is a massive age accelerant, unfortunately, and that in fact, it may not be appropriate for...women to just simply allow that to occur, you know, without considering HRT. I think there's a place for HRT for a lot of us. I also think we have a good, good, good, good toolkit to minimize the symptomology and the problems associated with menopause if we're not going to do hormone replacement therapy. But yeah, hormones are incredibly important, you know, maintaining them, supporting robust and appropriate metabolism. you know, just...something that any practitioner working in the longevity space or functional medicine space or naturopathic spaces is thinking about and looking at. So yeah, you guys are in the right place.

Jaclyn (38:25.326)

Fabulous. Fabulous. Great. Well, I thank you so much for joining me today. It's always fun to talk with you and learn about the work you've done and the work you're doing. And I just always appreciate your perspective, Dr. Fitzgerald. So thanks so much for being here.

Kara Fitzgerald (38:38.957)

Thank you. Nice to be here.

About our speaker

Dr. Kara Fitzgerald, ND, IFMCP, is engaged in clinical research on DNA methylation using diet and lifestyle interventions developed in her virtual and in-person functional medicine clinic. She published a consumer book, Younger You, and a companion program based on her ground-breaking eight-week study that resulted in a three-year reversal of biological aging.  

Dr. Fitzgerald is a faculty member at the Institute for Functional Medicine (IFM) and is an IFM certified practitioner. She regularly lectures internationally and is the host of the podcast New Frontiers in Functional Medicine.  

Show Notes

Learn more about Dr. Kara Fitzgerald and check out her book, Younger You.

Follow Dr. Kara Fitzgerald on Instagram @drkarafitzgerald.

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