Extended Conversation: How To Live Forever With Dr. Sanjay Gupta

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This is Gavin Newsom.

And we continue with Dr.

Gupta.

I want to talk in, Sanjay, because you've been, I mean, you've been one of the great thought leaders and written so much about longevity.

And you talk about nutrition and health and some of the remarkable breakthroughs that are just, they seem just shockingly common sense.

I mean, just sort of foundational, just leading with common sense, eating well, sleeping well, hydrating,

you know, socialization, et cetera.

But you've been writing particularly about some breakthroughs and some examples of real successes as it relates to longevity and wellness that give, I think, distill a sense of well-being, at least to people like me, that with an aging grain population, that we should be more optimistic than I think some of us have painted the future.

With what we know now,

not any new medical breakthrough or some big development, I think we could greatly, greatly expand life expectancy and health span.

That's a term I'm sure you've heard, but health span versus lifespan,

the number of really functional years you have left.

I think the data has become very compelling on this.

I think anecdotally, we've known this for a while by looking at other countries around the world and saying they spend a lot less.

They do pretty simple things.

They walk to, you know, their meet friends as opposed to driving.

They eat right.

They eat fresh foods, healthier foods, they sleep well.

Some of the healthiest communities in the world have

either non-existent healthcare systems or very, very small health care systems.

So, and that's that's that's heart disease, that's dementia, that's diabetes, all at a fraction of the rates that we have in the United States.

They don't have anything that we don't have.

It's happening to us is not because of what we're not doing, it's because of

what we are doing to our bodies.

But I'll tell you something interesting, Governor.

If you talk about longevity overall or aging sort of as a construct,

What scientists will say, including Eric Topol, who you may know in your state,

aging is really made up of several different things.

It's not just revolutions of planets.

It's how well your immune system is working, how much inflammation you have, how much something that you have known as senescence, how many cells that are in a senescent stage.

There are seven different things like this that you can sort of think about that actually make up aging, that will determine your health span,

far more important than your genetics.

We can control many of those things.

We can improve our immune function, we can decrease our inflammation.

We can decrease senescence.

And there's all these different ways to do it now that have great data behind that.

There are certain medications, and I'm not hawking any medications here, but like something like metformin, even, which is something that's gotten a lot of attention.

Nils Berzeli, who's a longevity researcher out of Sinai, will say metformin is probably the closest thing we have to targeting all these different cardinal issues of aging, which I find really, really interesting.

I wouldn't call it a breakthrough.

I would call it a recognition of what aging really is, what is really happening to the human body, especially as we get older, why our function decreases, and what can be done about it.

You're quite right.

It comes down to the big three: how we nourish ourselves, how we move, and how we rest.

But, you know, there's more nuance to it now based on a lot of the data people like Eric and Nils are collecting.

And at the core, I mean, you've, you know, you've written about, I mean, when it comes to inflammation, obviously sugars, issues around dairy,

meats.

I mean, what's, I mean,

are you solidified in that sort of core sort of understanding that limiting, obviously, sugars seems to make a lot of sense.

I don't know if everybody's familiar with dairy as a component concern.

And then we can have the great meat debate.

as well.

But are these sort of, are these foundational in terms of addressing, particularly issues around Alzheimer's and dementia?

I mean, I know Dean Ornish is out here in Sausalito.

California has been pushing a lot in that space.

What's your sense on the basis of all your research and work?

Well, sugar I'd put into its own category, like I think you're alluding to.

Sugar is toxic.

I mean, I did a piece for 60 Minutes years ago called The Toxic Truth, and it was all about sugar.

And it is remarkable to me what sugar does to the body.

Our bodies just don't know how to process the amount of sugar that we eat nowadays.

It basically hits our liver like a tsunami.

And I think what's surprising to people is that because the body can't handle all that sugar, it churns out these byproducts, which are typically what are called LDL particles, low-density lipoprotein particles.

You would typically think my LDL is going to go up because I ate a cheeseburger, which is true, but it might go up even more.

from a sugary drink.

That's how toxic sugar can be to the body.

So sugar I'd almost put into its own category.

But I think with regard to the other things, dairy and even meat, I do eat meat.

I'm not a total vegetarian.

I hope Dean's not listening because he's, you know, he's vegan, but I think it really has to do with how those foods are processed.

It's all the other junk that's added to a lot of those foods that I think make them really problematic and increase inflammation.

What Dean was able to show,

and I thought it was fascinating, was that going on a vegan diet was greatly associated with decreasing inflammation in the body and in the brain and could if if it could stall and potentially reverse Alzheimer's disease

that that was a big deal I mean people once you get diagnosed with dementia it is a downward spiral from there on out he was able to show that you could at least stall it if not reverse it by simply changing diet and increasing activity as well but diet was the big thing um and

we've anecdotally sort of known this to be true, but I think he was really able to show this.

And I think that's, that's certainly made me reconsider my eating.

So I've cut back on meat, but you know, I, I, um, we, you know, I got three teenagers.

You gotta, you gotta balance your life with what you know.

I mean, if we were gonna live forever, Kevin, if that was a, can I call you Kevin, by the way?

Please do.

Hey, bye.

If there was a possibility we could live forever, that immortality was attainable, I might live my life differently.

But I think you got to balance your joy with

your lifestyle.

And

I'm a very healthy guy.

I exercise every day intensely, but also take long walks with my wife and my dogs and stuff like that.

So I have more moderate activity as well.

Eat healthily.

Don't eat sugar.

at all.

Don't drink alcohol.

Alcohol is terrible.

I mean,

why do we, well, anyways, but the...

I'm in the wine business, you're talking to the wrong guy, but I completely appreciate your point.

My guess is when you drink wine, and I have

drank wine and I can appreciate its virtues, but do you not, do you not get a terrible night's sleep?

I mean, I trap my sleep now.

If I have a this works against my personal interests, I'm not going to say no.

Okay.

I would have gotten sugar.

And of course, there's a byproduct of the wine as well.

But by the way, are you a coffee drinker?

Everybody's got, is it mushroom coffee?

People are in, what's going on with coffee?

Should I be drinking coffee?

Yeah, I didn't know about the mushroom coffee, but I don't know.

Everyone's saying you should try mushroom coffee.

I don't know.

I'm asking you.

I like coffee.

So I, you know, it's a funny, funny thing is I really did not drink coffee up until a few years ago.

And it was for no particular reason other than I just didn't like the taste of it.

I, I, um, it was unusual because most surgical residents and medical students, they, they start drinking coffee, you know, sort of, you know, early 20s and it becomes part of their lifestyle.

I just never liked it.

But during the pandemic, actually, is when I started drinking coffee, I was waking up at 4.30 in the morning every day and working until 11.30 at night, you know, for a couple years in a row.

And my wife actually introduced me.

to this coffee.

I don't know if I were allowed to talk about brands, but I really like this.

It's called Purity Coffee.

And it's pure coffee.

It's just, it's got none of the additives that we were talking about.

It's

pesticide-free.

And to me, it tasted really clean.

When I drank coffee in the past, it always felt like I could almost taste the aftertaste to it.

And this was just a really good coffee.

And then I started really doing a deep dive into coffee.

And I think, you know,

it's associated with all these different health benefits,

cardiac, dementia, inflammation overall.

So I drink a cup a day, sometimes two cups a day.

And

I think it's been really good for me.

All right.

Well, I mean, as the guy who's got a few cups behind him, in front of him, on the sides.

Is it just black coffee or what do you drink?

It's just black coffee.

I'm not adding any of that cream, any of that nonsense.

Don't add that.

And it takes a little bit to get used to the taste, I think, of just the black coffee.

But once it's there, you add that.

Once you're there on the other side, you can hold strong.

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How worried should I be about this fluoride movement now?

We're seeing, I'm in Utah, Florida.

There's big debates in Louisiana, other states to take fluoride out of the water.

Where did this even come from?

How important is it?

I read in the past one of the great success stories in the last half century in terms of just, you know,

give me your over-under on fluoride.

Yeah, well, so this is what I appreciate about podcasts like this, because there's a nuance to this, and you can actually get into the nuance a bit.

Fluoride in really high doses can be problematic.

It can cause something known as skeletal fluorosis.

I'm talking about ingested fluoride.

So you're taking it into your body through usually through water.

It can cause skeletal fluorosis, which can make your bones and your skeleton weak.

It can cause dental fluorosis.

I don't know if you've ever seen Governor people who have white streaks in their teeth.

Yeah.

Sometimes that is a dental fluorosis.

That's an indication of high fluoride levels.

And I think most recently and interestingly, there's been concerns about neurotoxicity.

There were studies done, all of them outside this country where fluoride levels are much higher than the United States, where they showed that moms, for example, during pregnancy, if they had high fluoride exposure, their kids later in life, it was associated with a lower IQ.

So that was obviously concerning.

These are hard studies to do and there was some, you know,

getting the methods right on these studies is challenging, but I think there was enough of a concern about that for people to really start paying attention.

To give you a little bit of context,

the levels that we're talking about are at least twice as high as the levels in the drinking water in the United States.

So quite a bit higher.

And in medicine, we always use this phrase, the dose makes the poison.

Things in any dose, just about anything in a high enough dose could potentially be problematic.

But it's, you know, it definitely gets people's attention.

What I would say when you talk about the fact that it's touted as one of the greatest public health achievements of the last century, I saw that as well.

And I think that there's a kernel of truth to that.

But the nuance is that most of the data that exists on the benefits of fluoride exists before 1975.

1975 was a timeframe when dental care became much more widely available and fluoridated toothpaste.

So prior to that, fluoridating the water probably had an incrementally a much bigger benefit than it does today.

So

it doesn't provide as much benefit.

I think it's low risk because the levels don't get as high as they used to.

They don't get as high in the United States, I should say, as they do in other countries.

But it's also lower reward.

So fluoride today, lower risk, lower reward than it used to be.

Iceland does not fluoridate their water.

England does not fluoridate their water.

Israel does not fluoridate their water.

In Iceland, the kids all do twice a month fluoride rinses.

In England, interestingly, they fluoridate milk.

So it's not water.

So you're fluoridating milk.

They're like, we don't want to put it in the water supply.

But kids, you know, who drink milk, they should still get their fluoride.

That was sort of their thinking.

Calgary in Canada, they stopped fluoridating their water back in 2011, I believe, but then brought it back.

because cavity rates went up.

And there was a new study that said in the United States, how much of an impact it have to take fluoride out of the water?

And they said it could potentially be 25 million more cavities within the next five years, 50 million cavities within the next 10 years.

So

I think we need better dental care overall.

And this is almost a policy discussion.

I think people, it's hard to get dental care.

It's hard to get dental coverage.

But I think if we had fluoride rinses, if kids got better dental care, then I think the incremental benefit of fluoride goes down even more.

Secretary Kennedy's been talking about fluoride for a long time, heavy metals in general, but fluoride in particular for a long time.

And, you know, as with these other things we're talking about, there's a nuance to it.

I don't think it's as big a public health issue now as it was 50 years ago, 60 years ago,

and we can even model how much of an impact it would have.

But I think it really speaks to the fact that we need better dental care overall.

Boy, I really appreciate the nuance of the response.

And just look, it goes to, I think, our frustration just generally as consumers and as people that

just

are so desperate just for the facts and a deeper understanding.

And you talked earlier about the politics and these binaries and how everything is seen through a political lens.

Just the larger issue of misinformation.

I mean, you know, obviously COVID seemed to expose a lot of that stress and anxiety.

And, you know, obviously our politics has been, I think, profoundly shaped sort of post-COVID framework.

And I think in some respects, significantly so, obviously, with RFK as HHS secretary in terms of healthcare policy today.

What's your, you know, as you reflect back on, you know, your

own

experience

living through sort of helping us all through the pandemic experience and COVID.

How do we get back to the kind of platform that we need in order to row in the same direction as a country to be prepared again, my gosh, for another novel virus moving forward where we're not at each other's throats, we're not talking down to each other, past each other.

Help, give us a sense of how we get back into the trust and truth space.

You know,

I think it's tough for sure.

And as a medical reporter, you know, I think I have a really front row seat to how this has all sort of unfolded.

I'd say one thing just for historical reference is that if you go back and you look at the 1918 flu pandemic, that was a time when obviously we didn't have cell phones, social media, you know, rapid sort of spread of information, but there was still a lot of distrust overall of basic public health recommendations.

There was a fair that was supposed to take place, I believe, in St.

Louis.

and or maybe in Philadelphia.

Philadelphia and St.

Louis were the two cities.

One city said, how can we possibly do a big fair like this in the middle of a pandemic?

And the other city said, We don't think it's a big deal.

We'll do the fair.

So they took it on, and they had 12 times the rate of flu deaths as the city that chose not to do it.

Point being that there has been this skepticism that I think exists just in human nature forever.

And I'll go so far as to say this, Governor:

maybe some of that skepticism is necessary.

You know,

I think that, you know, if we look at human beings like organisms,

some people just have their antennas raised really, really high.

And I think when your antennas raised really, really high, two things happen.

You see things that aren't there.

You just see things blurry off in the distance and you think that there's an attack coming and it's not coming.

But on the other hand, sometimes you see things before everyone else does as well.

And so I think there are people whose antennas are raised really high who are just concerned citizens.

I think there are, you know, shit starters who sort of fall into that category as well, but not all of them.

It's a heterogeneous group of people who are who are going to be resistant to basic public health measures.

It's a much more diverse group of people than I think I realize.

That's one thing.

I think with regard to misinformation and even disinformation, purposeful misinformation,

I think my largest concern right now is that we're getting to the point,

and I hope it changes, and I'm optimistic.

I'm an optimist, I think it will change, but I think right now we're at a point where nobody believes anything.

Yeah.

I was talking to my youngest daughter, this is about a year, year and a half ago, and I was very close to Senator John McCain, and she showed me some meme on TikTok or Instagram or something about John McCain.

She knew that we were close, and

especially after he had his brain tumor and things.

And this was a funny meme, but it somehow suggested that he was alive and that his whole death was a hoax, right?

Crazy, crazy stuff.

And I said, hey, Soleil, okay, funny, right?

But you know, that's not true, right?

And she said, yeah, it's here on Instagram, whatever.

And I said, yeah, but you know, it's not true.

And she said to me, governor, she said, I don't think any of this stuff is true, dad.

And it really got me thinking, like, what happens to a generation of people that grow up without a locus of trust?

I mean, forget who they trust.

I, I, They should trust you.

They should trust me.

They should trust experts.

I think I really do believe that.

But maybe they don't trust anybody.

And I think unless you can touch somebody, unless you know somebody personally,

you don't really trust them anymore, which I think

is really problematic.

And I think that's where we're headed.

It starts to hyper-localize suspicion of everybody.

And I think that's where we're headed.

So I think for me, as a reporter, instead of constantly combating misinformation, which is like playing whack-a-mole

all day long, just continuing to try and put out good information and explain things in a way that is accessible to people and

leans into the nuance and the uncertainty of things.

As a country,

if the question you're asking is about preparing for the next pandemic, I would say the precautionary principle is important.

And

that is how we do many things in our country.

We have more than a dozen aircraft carriers right now that are circumnavigating the globe and they're keeping us safe.

We don't pay a lot of attention to that.

It's not something we have in the forefront of our minds, but they're out there basically displaying the precautionary principle.

A virus is a national security threat.

We saw what it did to our country.

If we're able to apply the precautionary principle at a policy level, so things just go into effect, as opposed to Seattle's doing this, and New York is doing this, and Alabama is doing this, and Florida's saying we're not going to do any of that.

And it was just a mess.

Instead, if we actually applied the precautionary principle as a country, treated it as a national security threat, which it is, I think we'd be much better prepared.

But, you know, right now we're in a position where you have people who believe COVID was a hoax, the entire thing.

So we have some work to do, I think, before we get there.

Because I think, you know, there were obviously mistakes we did make.

There was lessons that we do need to learn.

And there were decisions that need to be reconciled going forward.

And I think if we're in denial about that, then we're not going to build that level of trust moving forward for those that feel very, very differently.

No question.

And I think, you know, one thing that I think was a real learning point, I think,

as doctors, if we're...

you know, recommending, I was in the operating room all day yesterday, you know, taking out brain tumors and doing things like that.

We know that it leaves a toll on people to do that, to recommend chemotherapy.

We know the impact of that on their lives.

we think that the benefit is that it could cure their cancer but we know it's going to be it's going to be tough sledding for them for a while how do you convey that at a societal level you know closing schools the impact of that you know that was tough on my kids you know so so to to really i think be very mindful of the the um the the impact I'm not saying the the decisions are wrong, but being really mindful of the impact of those decisions on people, it's tough.

As doctors, I think we're a little bit more trained toward it because we have to look at risk-reward for everything.

But I think assessing risk and balancing that reward as a country is hard.

And I think that gets back to where we started: this precautionary principle.

We don't know.

Let's be cautious.

Let's be careful.

Let's not accelerate around the blind curves here.

Let's hit the brakes a little bit.

And I think that's

still to me that still makes sense.

Final question.

I'm curious, you know, you speaking of sense, speaking of risk, speaking of trust,

where are we to make sense of AI and medicine?

We're seeing just runaway costs in healthcare.

It seems like every other industry has found efficiencies.

Every other industry costs seem to go down.

It seems like more technology is introduced to the healthcare sector.

Our costs seem to go up and up and up.

Is AI overhyped overhyped in terms of medical expenses?

Is it over-hyped in terms of research and discovery?

Is it underhyped as it relates to imaging benefits and just sort of super capacity to address chronic disease and solve for some of life's great evils and cancers?

I think it's going to be magnificent, ultimately, what AI can do for healthcare.

It's going to need guardrails,

but I think even those are, you know,

very trainable.

I I mean,

there's great companies, one of them out of California called Open Evidence, where you're already starting to see, like for me, I'll give you an example.

A guy comes into the office with back pain and leg pain and has got a herniated disc in their lumbar spine, the lower back.

Do they get an operation?

Do they not get an operation?

I could ask 10 different spine surgeons and maybe get 11 different answers.

AI could look at 9 billion pieces of data within a fraction of a second and said, here are 50,000 other people who are just like the person you're describing.

And here are their various outcomes based on evaluating their medical records and doing this all in a de-identified way.

My residents are already walking around talking to their phones as they're walking into a patient room to figure out the best approach to

whatever ails their patient.

So it's already changing.

I think

I sat on the subcommittee for AI for the National Academy of Medicine, and I think one of the things that really struck me as we were creating these

guardrails was this idea that we still have to think of AI from a trust but verify sort of model.

It's wildly effective at finding breast cancers, for example, on mammograms, but sometimes it errs wildly as well.

And, you know, these hallucinations, as people call them.

I think they're already starting to get better about that.

I think it's going to, you know, we've been talking about big data, you know, for decades now.

AI is actually going to be able to make sense of that big data and I think make it valuable for patients.

I'll tell you a quick anecdote.

You know, if you've been to the hospital lately or a clinic and you got a letter from, you know, sort of summarizing your care, it probably was generated by an AI platform.

That's interesting.

And most of, and when they, when they blinded these letters and they compared them to actual letters written by doctors or nurses and then gave them to random people, what they found was the AI letters were often referred to as more human, the human letters, which I thought was.

Is that the state of doctors?

Is that the quality of?

I think if you said to me, hey, you know, my daughter's going to get married, you know, in July, you know, and I'm really excited about that, but you're here for your herniated disc.

I may have deprioritized that information, whereas an AI platform may have listened to that and said, hey, governor, I hope the wedding went well with your daughter.

And, you know, just these human touches.

You had these moments where humans were looking at these AI letters and they were pausing at the moment that they read these human touches.

And it was almost like humans learning from machines how to be more human, I think.

So

I'm bullish on AI.

I think one thing about new technologies is that there's always a disparity in terms of haves and have-nots when they first come out.

Before mammography, black women and white women had similar rates of breast cancer.

After mammography, breast cancer rates went down overall, but much more so for white women than black women.

We see those disparities with AI already.

So we have to address disparities, make sure this is very available and accessible to people.

But I think it's going to change healthcare.

We're going to come up with new treatments and the right clinical decision-making much more quickly as a result of AI.

In 30 years, you're still doing brain surgeries or is a robot doing them?

No,

I'm still doing them.

You'd be proud.

You know,

I say this as a brain surgeon who always carries around a brain with me.

I got it right here.

I don't know that a robot is yet able to fully grapple with three and a half pounds of the most enigmatic tissue in the known universe.

I still think humans have to do that.

Eventually, we may get there.

But right now, I just think the...

you know, the dexterity and sort of the types of operations that we do.

But look, in cardiac surgery and prostate cancer surgery, you have Da Vinci, you have robots that have been doing that stuff for a while.

We'll get there.

I'll be retired, I think, by that point, hopefully.

I don't know.

If you keep to your wellness program, you're going to be fine.

You've got to be like you, governor.

Hardly, hardly.

I'm going to watch, okay.

I already have my instructions on my meat consumption.

And yes, I'll acknowledge.

I'll acknowledge the.

Can you be in the wine business and not drink so much wine?

No, I mean, that's an issue.

I mean, it's an objective issue.

But I shouldn't be, I can't be promoting, well, maybe I should be promoting my businesses.

Apparently, that's not an issue anymore in this country.

Jesus.

Hey, can I ask you what's going on with you real quick?

Like, what's up after

Sacramento?

Well, it's sure as hell ain't going to be medical school.

I have no capacity there.

But

it's to be determined.

All of it to be determined.

A time of profound uncertainty.

And I'm just trying to, you know, I'm trying not only to not get fined today, but not get arrested tomorrow in the next few months.

It's crazy what's going on in this country.

But I will say, though, on a serious note, just, you know, it's also remarkable how

just trying to just absorb what's happening with healthcare policy.

We didn't even get into Medicaid cuts.

We didn't even get to the broader issues associated with the quote unquote reorg at HSS

and all the cuts to, you know, just people out there promoting vaccines, HIV

issues and treatments.

I mean, this is

a lot going on, and it's hard to absorb just 100 plus plus days in.

I know.

And as a reporter, I mean, just every day there's something new and it changes.

It's so ephemeral.

Like you get all ready to report on it an hour later, it's different.

But, you know, keep fighting the good fight.

You know, I think certainly as reporters,

information matters.

Good information matters.

Fewer people are consuming it.

You know, we're well aware of that.

Right.

It doesn't mean we stop trying.

You know, keep asking.

Oh, well, I love what I mean, to your point.

I mean, I made the point earlier, but your podcast is fabulous.

And it's great to see you out there doing, especially with the just those sort of short clips where you're answering those tough questions, but doing with the kind of nuance.

I thought, and I mean this sincerely, your response on the fluoride is just something we don't hear.

And it's hard to have a segment that is that comprehensive because it just provides a different level of appreciation for perspective on this.

It's not just as simple as yes and no, huh?

It's not.

And, you know, I'm a dad, you know, I mean, first and foremost, and a husband, but a dad, you know, who think like I do put myself in the position of those people who are the honest skeptics.

I'm an honest skeptic, you know, most scientists are honest skeptics, I think.

And I think that, I think that, that helps, you know, would I do that for my kid?

Would I do that for my mom?

I think it makes it there.

You go.

No, it's, and by the way, we had the exact, I remember that conversation you mentioned with your wife.

Do we do all of the shots at once?

Yes.

Or do you, you face, I quite literally had that conversation with four kids four different times.

We concluded all four times.

Let's just get it done.

But it's a legitimate sensitivity.

I wouldn't call it quote unquote hesitancy in the sort of weaponized sense, but just human.

And you have to acknowledge that perspective.

I don't mock those people at all.

I mean,

there are people who mock them.

That's not going to work.

I mean, maybe that's the number one thing about misinformation.

The mocking doesn't, that doesn't work.

It just

creates tribes and politicizes it even further.

So, try not to do that.

God bless.

Couldn't agree more.

Hey, I really appreciate you taking the time.

This was fabulous.

Thanks for all you do, and keep doing what you're doing.

You're a bright light in this darkness.

And I appreciate you taking the time.

Means a lot coming from you, Governor.

Thank you.

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