Longevity and Functional Medicine with Dr. Jeffrey Bland: Rational Wellness Podcast 415

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Dr. Jeffrey Bland discusses Longevity and Functional Medicine with Dr. Ben Weitz.

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Podcast Highlights

Dr. Jeffrey Bland is the Father of Functional Medicine. Dr. Bland has a PhD in biochemistry and he taught college biochemistry before going to work for the Nobel Laureate, Dr. Linus Pauling as the Director of Nutritional Research. Dr. Bland helped to establish science based nutrition, having worked to establish standards for evidence-based formulations, quality ingredient sourcing, and ethical manufacturing practices. Dr. Bland established the Institute of Functional Medicine as the premier educational platform to teach his science based approach to nutrition and lifestyle medicine that we call Functional Medicine.  Dr. Bland has also established the Personalized Lifestyle Medicine Institute and Big Bold Health, which he launched in 2018 in order to advocate for the power of immune-rejuvenation to enhance immunity at a global level. The website for Big Bold Health is BigBoldHealth.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

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Podcast Transcript

Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website, drweitz.com.  Thanks for joining me, and let’s jump into the podcast.

Hello, rational Wellness podcasters. I’m very excited today to be having a conversation with Dr. Jeffrey Bland, who I am a huge of for many years. In case you don’t know, Dr. Jeffrey Bland is the father of functional medicine, and all of us in the functional medicine community owe you a huge debt of gratitude.  Dr. Bland has a PhD in biochemistry. He started as a college professor and then he went to work with the Noble Laureate, Dr. Linus Pauling. As a director of nutritional Research, Dr. Bland helped to establish science-based nutrition, having worked to establish standards for evidence-based formulations, quality ingredient sourcing and ethical manufacturing practices that stand to this day.  Dr. Bland established the Institute of Functional Medicine as the premier educational platform to teach a science-based approach to nutrition and lifestyle medicine that we call functional medicine. Dr. Bland has also established the Personal Lifestyle Medicine Institute and Big Bold Health, which he launched in 2018 in order to advocate for the power of immune rejuvenation to enhance immunity at a global level.

My interest and passion for Functional Medicine derives directly from Dr. Bland for decades. I would go every year to the annual seminars that you would do for Metagenics. And I was an early subscriber to your monthly audio tape series long before podcasts were around, which at one time was called Preventative Medicine update.  I recall getting a cassette tape in the mail every month along with a cardboard card with summary and references, and I would put the cassette tape into my car and listen to Dr. Bland on my way to work or wherever else I was going. One thing I would always know is when I attended your seminars, I would come away with the neurons in my brain firing like crazy, but you would also include some story that would move me emotionally.  Okay, Dr. Bland, you have that rare combination of insane intellect with a deep sense of caring for humanity. I’m not somebody who’s a believer in religion, but over the years when I would have a conversation with somebody about their religion, I would often say that the closest thing I had to a religious experience was attending a Jeffrey Bland seminar.  So, Dr. Bland, thank you so much for joining us today.

Dr. Bland: Oh, my word Ben, I’m just truly blown away by that incredible and review of, you know, I’m not sure I deserve all that, but it’s just really it’s exactly what I’ve, I focused my life on is the way you’ve described my priorities and passions.  So I just really appreciate that acknowledgement. It means a tremendous amount for me. Thank you.

Dr. Weitz: Absolutely. So, I want to start by having a brief discussion about the state of functional medicine. I go to the recent Institute of Functional Medicine meeting. I’m so impressed by the quality of the program.  All the incredibly smart doctors and practitioners doing great work. All the patients whose lives have been changed, including my own patients. The success of the Cleveland Clinic Functional Medicine Clinic that was set up by Mark Hyman.  And I feel so positive about the state of Functional Medicine where it’s going, but then I notice that a part of the mainstream medicine community continues to see it as pseudoscientific and quackery, including Wikipedia.  Can’t we change that? In fact, there’s no Wikipedia page for Dr. Jeffrey Bland. Also witnessed the recent New York Times article entitled An Expensive Alzheimer’s Lifestyle Plan Offers False Hope Experts Say, which for me was quite upsetting and I’m sure even more upsetting for Dr. Bredesen. I, what do you think about the state of functional medicine?  I guess we just have to accept that it’s a disruptive, it’s a change in paradigm and it’s not gonna be easily accepted, but it’s hard to believe at this point that it’s not gaining wider acceptance.

Dr. Bland: Ben, I think you stated the dilemma or the paradox very well as to where we sit right now.  So the Institute for Functional Medicine and the functional medicine concept was initiated formally in 1990. My wife actually was the first person who kind of came up with the concept and it was, as a consequence of a couple of informational meetings that we had with a group of really innovative practitioners in 1989 and 90, that led to the start of this model, the systems biology approach towards thinking about upstream or root cause medicine.  And you know, at first, I would say going way back to that period of time, 35 years ago or 36 years ago, there was still emerging science that was supporting these concepts. So it was in an early stage of support with science of, I call cell biology or with understanding the etiology of chronic illness.  But that has really changed dramatically over the last 35 years. The science actually has kind of caught up with the. Concepts that we were teaching back at the early stages of this, and we were the first people to talk about gut dysbiosis, about leaky gut, about endotoxemia, about metabolic detoxification, about mitochondrial bioenergetics.  Those were all concepts that we developed and discussed in the early nineties that were considered maybe heretical to the way that traditional medicine had been thinking about how to diagnose and treat disease. Over time, these concepts got incorporated more and kind of, folded into certain of the traditional, more traditional medical practices.

So now if we look at the field of gastroenterology, for instance, and do a survey of the published literature in gastroenterology in 2024, you’ll see literally thousands of papers that use the term endotoxemia or use the term leaky gut or use the term dysbiosis. Those have become terms that got us in trouble when we started using them early on, that are now kind of, I don’t wanna call them mainstream, but certainly more, more commonly used within more traditional quarters of medicine.  So I think it takes a while for new ideas to be tested and see if they can be incorporated into the body politic of medicine. What I can say, however, is that the rate of change as to which concepts can be incorporated now is far faster than it was when we started, you know, 30 to 50 years ago. With the information systems we have now with artificial intelligence with podcasting and communications and internet and social media we really have a much faster distribution of information than previously, which accelerates change.  Now, I think the key when you accelerate change is that you don’t want to give over quality. You want to still have excellence. You still want to make sure you’re providing information that when people incorporate these concepts in their life, that they’re gonna be likely to have positive outcomes with minimum to no adverse side effects.  So we certainly want to be cautious in moving forward, but I think we have tested these concepts now enough, the functional medicine concepts, to know that they really deliver extraordinary positive benefits and outcome with little to no adverse side effects. And you know, I, I’m reinforced in that when I look at the studies that were done at the Cleveland Clinic, the functional medicine center of the Cleveland Clinic underwent a variety of different tests using traditional scientific evaluation of the treatment protocols against standards of care.

And then the question was how did they compare standards of care to these functional medicine concepts? And it I’m very pleased to say that the research that was published over the last few years in a trials demonstrated that in fact the functional medicine approach led to improved outcome in these patients.  It wasn’t that the outcome with standards of care was bad, it was just the functional medicine was better. And so I think we’re starting to lay down the tracks now of validated in the literature, even in top journals like the Journal of the American Medical Association, studies that demonstrate the proof of principle, demonstrate the concept really clinically works, and that the concerns that people might have had about, well, what if this, what if that, what about this adverse effect are really with practitioners in the art like yourselves, become really non-existent because the the skill in being able to implement these concepts doesn’t put you out into danger zones.  What it does is it allows you to leverage what we’ve learned about the cell and how it functions in ways that lead to improve function.

Dr. Weitz: Yeah. Well I also think there’s an issue with what is considered the highest level scientific evidence is a construct of a study that’s based on testing drugs. And that type of study where you just change one variable is not doable for lifestyle medicine.  And that’s one of the problems we’re up against.

Dr. Bland: Well, that’s another hugely important point I really want to compliment you in bringing that up. So we were one of the first groups, not the only, but one of the first groups to start using. This new model other than the double buying, randomized placebo control model, we started using what’s called the N of one model.  And the N of one model is where the patient becomes the internal control for their own outcome. And the reason that model is very valuable is it allows you to evaluate the effect of a complex intervention protocol where you’re changing diet, you’re changing lifestyle, you’re changing stress, you’re changing sleep patterns, exercise patterns, and you’re looking at how those things, when they’re controlled, influence single individual over time.  So you look at before and after. Now, why didn’t we do these studies before? Why weren’t they considered reasonable? The reason we didn’t do them before is that to do a lot of n of one studies, you have a huge data set of individual patient responses that requires huge amounts of number crunching in order to develop the statistics about how that would work in the average.  And we didn’t have the competing power until recently to do that. Now we have machine learning [00:11:00] capabilities and informatic capabilities on our own desktops. We have computing power that only supercomputers that were capable of doing it not too many years ago. So now we can start really implementing these n of one types of studies.

It really came out of, initially out of cancer therapeutics because as we all know, when a person is put on a chemotherapeutic program for cancer each patient is different. They differ in their type of doses and amounts of various medications they receive. And so each one is a study subject unto themself.  So that became kind of the start of the end of one studies, which we now can start using that concept into the feeling of lifestyle and functional medicine intervention. And when you use that, now you’re able to start publishing real demonstrably valid studies that use the patient or the individual against themself.

Start actually segmenting for individual responses. And you know, this whole field is built around personalization. It’s not medicine for the average, it’s medicine for the individual. So this concept is really related to the [00:12:00] frontier of personalizing care and how you assess personalized care in a group study procedure.

And I’m very proud to say that we’ve been kind of pioneering that model as we’ve done studies. And in fact, we have a study now at Big Bold Health that we’re just advancing. It’s eight, it’s an 850 person randomized placebo control trial. And what’s the fundamental model we’re using is an N of one trial in which each inpatient is tested against himself over the course of 90 days of intervention.  With a program to improve their immune system and then work doing it against a placebo group where they’re doing before and after as well. And then we will group aggregate the data, but we’ll have individual patient information that allows us to look at how people are actually responding, not just in the group, but at the individual level.  And I think this is the granularity and the specificity that probably most people would want to know exists when they’re going on to therapy. How does it relate to me, not the group, but me individually? How do I’m, how am I gonna respond?

Dr. Weitz: I think that’s amazing.  It’s clear that individualized personalized care is a medicine of the future, which is a concept that you and the functional medicine community have pioneered, and yet it’s still not being given credit for that.  But it’s clear that is we have to stop thinking of an effect of a drug that is negative as a side effect. That’s the drug. It will happen to you with your biochemistry, with your epigenetics, with your lifestyle.

Dr. Bland: I think you, again you’re saying some really important soundbites there that I think we we need to take very, IM important attention to the model that we built, the whole pharmacology of today around is a model that really grew out of the antibiotic revolution of the 1930s and forties in which we could find that there were these metabolites of mold.  Of certain fungi that would prevent bacteria from growing. And this led us to the principles starting with penicillin. That you could have a specific bug that was gonna be killed by a specific molecule and in this case penicillin. And so was the diagnosis could be the bug, the treatment could be the pill, and the outcome could be successful remediation of infection.  And so that, that led us into a fairly interesting binary and linear approach, thinking, okay, then let’s name the disease. We’ll give it a name by a certain diagnosis. Then let’s ask what are the principle factors in our body’s function that are affecting that disease? So we look for some kind of a receptor or some kind of an activity, and then we find new to nature molecule that blocks that particular function and uncouple that function for that particular activity.

And then we hopefully make it safe enough that people can take it without having a toxic reaction. And now we have an approved drug for the mass of individuals who [00:15:00] have that diagnosis. It doesn’t speak to the individual, it speaks to the mass of individuals with that diagnosis. So that is really, if you look, let’s just take one disease.  Let’s take type two diabetes. If type two diabetes was just one disease, that everybody that with that diagnosis has the same disease. We presumably only need one drug to treat it. But it’s not just one disease. It’s many different dysfunctions that we aggregate together that we call the same thing Type two diabetes.  And that’s why we now have 14 different drugs to treat diabetes type two or why lifestyle is even better than drugs because it hits many of those things simultaneously. It’s not just one shot on goal, it’s multiple shots on goal that lead then to the remediation of the problem at its cause, not just by uncoupling its effect.

Dr. Weitz: So let’s move to the topic of longevity. What do you think are some of the best ways to measure longevity and what are some of the most exciting strategies for promoting longevity?

Dr. Bland: So this is a really important front edge topic that, you know has been. Around in discussion for many decades, but is now really picking up momentum.  I recall in 1996, I can’t even believe this, when I was a professor, I wrote an article called The Biochemistry of Aging, in which I reviewed what was known at that particular time. The reason I did that is that I was working on vitamin E research in the 1970s, and it had been suggested that vitamin E as an antioxidant had some effect on the aging process.  So I got very, I. Interested in what is the aging process at the cellular level. And that led to collaboration with many different investigators back then that were studying the aging process from different perspectives. Now we’re at a much, I think more advanced understanding and we have what are called the hallmarks of aging.  These are the scientific discoveries. And depending upon who you want to listen to, there could be eight hallmarks of aging or there could be 10 hallmarks of aging. I think they’re even a couple people. 

Dr. Weitz:  I think we’re up to 12 now. Yeah. Yeah.

Dr. Bland: I think it’s 12. Yeah. So, these are fundamental biological processes that relate to deterioration of cellular function that we associate with aging.  And so the question is, if you were to treat each one of those 12 individually and get them to be promoted so they were functioning correctly, would you then not age and and live forever? The answer to that question is still open for discussion because we have been able to, in animal studies increase live life expectancy in animals by engaging in trying to modify these 12 hallmark of aging by up to 50% in some animals, even in in mammalian animals like monkeys.  There’s been considerable increase in life expectancy in longevity as a consequence of calvary restriction and certain types of medications and hormones like growth hormone that have been able to extend life in animals. We have yet to really demonstrate that in humans and in part that’s a consequence of the difficulty of studying humans that live much longer.

And so who’s going to study somebody for over 60 or 70 years under controlled circumstances and who’s gonna stay on the program for 70 years? So we do have some technical difficulties in under understanding aging at the the whole body level, however. We can study these individual components to the hallmarks of aging in a more short term way.  In one of those ways, which has gained favor recently is by looking at the, imprinting of our genes with things that occur over the course of living like toxic exposures ultra processed diets, too much stress trauma and chemical pollutants. They mark our genes, particularly of our immune system with marks called epigenetic marks that then are associated with the biological aging process.

And it’s been found recently. [00:19:00] Steven Horvath at UCLA started this kind of field now. It’s expanded extensively to many investigators around the world who are developing what are called these age clocks. These are algorithms that allow us to take the data that comes from the the pattern of the imprinting of our genes, and to analyze it numerically with computer assistance to actually determine kind of a functional age, I guess you’d call it a biological age.

And then see how that biological age tracks against that person’s age and birthdays or chronological age. It’s been found that many individuals who have say 55 birthdays when you do this type of study based on the way they’re living their life have a biological age that is much younger than their chronological age.

And similarly, we have found that people that have elected to lead lives in a different way. Their biological age is older than their chronological age. And then people have started to piece out what are those characteristics that are associated with younger versus older. And the simplest [00:20:00] one that we know for sure that’s associated with older is smoking.

Every study that’s ever been done shows that cigarette smoking actually leads to increased biological age by whatever clock, whatever biological clock you want to use. It always comes out showing that accelerates your biological age beyond that of your age and birthdays. We also know that excessive stress has imprinted the genes in the same way.

Now the nice thing about this, because it sounds like a pretty discouraging story, is that those marks that we put on our genes appear to be in the main reversible. So what we have put on, we can take off and put on new messages. And so that’s the the reversibility of our biological age through intervention.

And then the question, well, what is intervention? So then I go to look at the data on people that have a history of living a long life and being healthy. So we go to what Dan Butner called the Blue Zones. And the Blue Zones are [00:21:00] characteristics around the world like Sardinia and Costa Rica vba or the Philippines, and believe it or not Loma Linda, California. Right in the center of LA County, right. That’s a blue zone. So people say, hold it just a minute. How could people living in LA be in a blue zone that’s got pollution and stress and traffic and all sorts of stuff? How could that be? Well, it turns out that Loma Linda, if you know about the city is associated with a Seventh Adventist belief systems, and there’s a Seventh Adventist medical school there, Loma Linda Medical School.  And so these people believe in vegetarian diets and no alcohol and no smoking and minimal stimulants. And they live on average about six to seven years longer statistically than people that live across the street out of Loma Linda, but in, in LA County. So there is something about the way we eat and the way we live that plays a very important role in imprinting our genes.  So then we ask the question well. Let’s talk [00:22:00] about eating. What is it in their diets that are important? And this is a very big area of discussion, and my belief at this particular time is that if, and I just did actually a tour of the Blue Zones in the Mediterranean area. I went to Sardinia. I was in, I started with Portugal, went to Spain, went over to North Africa and looked at the North African Mediterranean diet, was went and went over from there to Italy and ended up in Turkey.  And so I had a chance to kind of look at the various dietary differences among the Mediterranean diet. 

Dr. Weitz:  Wait, boy, that trip must have been a huge sacrifice on your part for the sake of science. 

Dr. Bland:  It was, oh, it was horrible. You know? Yes. I, you know, we had to go really deep to sacrifices. Yes. So what I found and we’re we’re doing some research in this area and gonna publish some of these data, but.  One of the characteristics, not the only, but a major one, was that all of these cultures consume quite a bit of what I would call food of the rainbow, orange, red, blue, yellow foods. Now those are vegetables and fruits and it turns out that those foods are colored because they contain unique classes of phytochemicals that are called polyphenols and flavonoids.  There’s several thousand of these different plant derived materials and actually those re those substances are producing plants as their immune system. Plants have immune systems. They don’t have circulating white blood cells like we have in our blood, but they have aspects of the innate immune system in the plant, part of which is related to the presence of the building up of these protective polyphenols and flavonoids.  And it turns out when we eat those in our diet, we’re eating the immune system of plants and it bolsters our immune system. It communicates that, that effect over to our immune system. And we actually studied. The process by which are the the epigene genetic effects in our immune system are influenced by these food factors.

And we just published a paper in November actually from a human clinical trial used a, we used a [00:24:00] specific very high follow polyphenol food called Himalayan Tarry Buckwheat, which is being reintroduced into the United States just recently. And we found out that we could increase the the immune life span of immune cells by 47% by increasing the the polyphenols found from umay tery buckwheat.  So this was a major kind of breakthrough in our understanding of how diet can actually play a role at the cellular level in enhancing longevity and reducing advanced biological age. So I think this is at the frontier now. We get into stem cells and we say, well, what about stem cells? Well, let’s ask where the majority of our stem cells reside. They reside as hemopoietic stem cells in our bone marrow, and out of our bone marrow is derived all of our blood cells, well, their red blood cells and all of our white blood cells. And those hemopoietic stem cells can undergo injury over time as a consequence of exposure to bad diets and stress and [00:25:00] toxins.  And and that creates injury to those hemopoietic stem cells, what is called mutational injury. That actually damages the DNA, the chromosomes that make those up. And that leads to what is called this is a long term clonal, hematopoiesis of indeterminate potential. I’m just gonna abbreviate it. Chips, it leads to chips.

Dr. Weitz: There’s a Blandism, if I ever heard one.

Dr. Bland: Yeah. I’m not asking people to repeat that. So let’s just call it chips. And these chips accumulate over time at different rates and different levels. So a younger person, if they’ve got a lot of increased biological aging, has increased level of these chips, cells in their blood.  And these stick around and increase in number over time. And they’re like some people call ’em like zombie soaps. They tend to clog up and create inflammation. And so it produces what people call meta inflammation or inflammaging. That inflammaging is a process that characterize accelerated [00:26:00] biological aging, and that occurs when these cells accumulate in our blood and as a consequence of the effects on our bone marrow stem cells.  Now, the good news there again, is that just recently it’s been found that these chip cells can also be reversed to kind of cleanse. And that’s why we call it immuno rejuvenation. We can rejuvenate the immune system, we can reduce these kind of aged clinker cells and replace them with more naive functional immune cells.  So our body has the capability of getting off the ramp of immune aging and back on the ramp of immune rejuvenation, which then has effects on every cell of the body. ’cause the immune system is in, in every organ in our body. So. We are starting to transmit different information, younger information, more resilience and ability not only just to protect against flus and virus and bacterial infection, but actually to regenerate tissues because the immune system is involved with all sorts of processes of kind of recycling garbage material and building back [00:27:00] new cells and new tissues from the muscles to the liver, to the brain. So, this is, I think, a pretty exciting chapter in, in this whole feeling of this whole field of rejuvenation medicine.

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Dr. Weitz:  One of the big yin/yangs in the world of longevity science is whether we want to promote growth or whether it’s better to tamp those signals down. We know on the one hand, I. As we get older, we tend to lose muscle sarcopenia, bone osteopenia, brain function, immune function.  This can lead to falling and breaking a hip, which has a high rate of mortality. And there’s been a big push in longevity research and practice to use growth stimulating s signaling molecules like growth hormone, testosterone, a higher protein approach, and a focus on stimulating those growth pathways.  And in fact, the first paper that showed a reversal of epigenetic aging was conducted, was the Faye study, which gave patients growth hormone, DHEA, Metformin, vitamin D and zinc. However, there’s been an equally big push in longevity science to tamp down growth, to reduce mTOR and other growth pathways with fasting, a focus on reducing protein intake.  Dr. Longo has talked about the Laron Dwarfs in Ecuador who have no growth hormone and who have no cancer. Some people are using rapamycin, which partially suppresses immune function and reduces growth signaling. So how should we think of this or should we think of it as maybe like a toggle switch that we move back and forth?

Dr. Bland: Well, Ben, I want to compliment you. I think that was, drop the mic, what you just were stating that was really important news to use that cuts across many disciplines. And that. We could go on and on. So I’ll, I don’t want to diminish the significance of what you just said. I’ll just add a little bit to it.  I think you hit right into the heart of where I believe, and I want to emphasize I’m not omniscient, I don’t claim that I know everything, certainly, but from my now 50 years of experience in this field where I wanna reside at 79 years of age, and that is our body has native intelligence within our genes.  If we give our native intelligence the right information from which it can design its future, it will create an outcome that leads to a hundred plus years of good living. That is generally the case. And it will find, I wouldn’t call it a toggle switch, I would call it a rheostat. It will determine whether to turn up or turn down in, in what it needs to have in order to manage the stress or the the condition of that moment.

So at time other times, like for instance let’s use a simple-minded example. When we get sick, we generally lose our appetite. The body does that. Why does it do that? Because it has the inherent knowledge that by concentrating its energy on specific processes that are related to immune response and not using that energy for other things like digestion, which can eat up to 40% of [00:32:00] our energy in our digestive process, it’s able to really focus on then on the problems at hand.  So it has this intelligence, and then as we start to get better, our di our appetite comes back and it may be on recovery. After that we even are more hungry and so our body then will find the right resting point. The difficulty I believe we have right now is we’ve overridden based upon what’s going on in our society, the natural control points, the RTA that the body has, its native intelligence.

And we do so because we’ve laid the body into environments that then force it, sw sod one way or the other. It could be overly stress, ovary toxic nutrient deprivation. It could be related to xeno biotic exposure. It could be to too much alcohol, recreational drugs. It could be all sorts of variables.  And some of the 50,000 new chemicals had been indu introduced and in the environment that the body was not familiar with until the last 20 years. And all of those things then kind of [00:33:00] alter the ability of the body to maintain this resilience, this capacity to turn up and down as it needs.

So then we get into, in the medical world. Where people come in and they’re locked into a new form of homeostasis. It’s not the homeostasis of health, it’s the homeostasis of dysfunction. It could be the inflammatory cascade, it could be allergies, it could be di digestive micro gut microbiome dysfunction that leads to dysbiosis.

And those then kinda lock the rheostat into a specific position for which we then therapeutically need to do things to get ’em reset. It doesn’t mean we might put them on that forever. It might it might be that we need to have them onto a treatment program for some prescribed period of time to allow their native wisdom to regain that kind of native state of resilience.

And I think that’s what the functional medicine practitioner both is understanding and good at. Is designing a program that’s personalized to that [00:34:00] individual’s need that is, is capable of bringing ’em back into their own setpoint. And so that’s why I’m, if you look at the original publication in the New England Journal of Medicine on the use of growth hormone in each individuals, it was very encouraging and it talked about people improved skin elasticity, gaining muscle mass more energy.

They were sleeping better, so there was a rush to. Did everyone be on growth hormone replacement therapy? I was back in those days I said, but look very cautiously at this because continued growth hormone therapy has also been associated with dysglycemia and diabetes and liver problems and other side effects because the body’s not used to being as an adult growth hormone driven at for a long period of time.

So maybe it’s a therapeutic tool. It might be great to rebalance, but as a long-term application for, you know, something to make you 30 when you’re 70, I’m not sure that’s gonna prove out to be a good idea. And I think my [00:35:00] concern has been realized now over the last 20 years that these tools that we often have available to us might be best applied short term to get us back into balance so that our body’s native wisdom can then take over once again.  And quite honestly trying to be 30 when you’re 70 maybe is not a really good idea. Maybe we should be really a healthy 70. Right. And have the full virtue of being a healthy 70. 

Dr. Weitz:  What do you think about the protein argument?

Dr. Bland: Well, again, there’s another really strong example because I do believe that people that have been on the standard American diet, which if people often say is SAD, the SAD diet is a diet that has been imbalanced both for mi, both for macronutrients that’s protein, carbohydrate, and fat, and micronutrients, vitamins and minerals.  So we might then say that if we wanted to really improve a person’s health, we would want to address these imbalances that have occurred as a [00:36:00] consequence of the nutrient deprived diet. Now. That leads us to ask the question, how much protein do we need? How much carbohydrate, and what type of carbohydrate?  What kind of fat and what percentage fat? ’cause it’s not just the amount, it’s also the composition. So I think Gabrielle Lyon has done a tremendous job of helping us to understand that protein is a feature of our diet that is very important for fueling the body’s myocyte, the muscle cell. That it is protein that has to be properly balanced with regard to its cons, constituent of amino acids, the eight essential amino acids, particularly these branch chain amino acids.  So we think of leucine and isoleucine, but we also know that if you were to overdue leucine and isoleucine, it’s associated with dysglycemia and it causes insulin impairment and can lead to problems [00:37:00] with regard to blood sugar control. So I think that these terms that we’re using now are good for the professional.  What I’m concerned about is average people who pick up a book and don’t understand all the nuances and subtleties they then start introducing, you know, well I’m gonna take you know, 200 grams of protein a day because I really need to start building muscle. I. And they get emia, they get liver problems, they have a kidney overload, and they start then having adverse effects.  And they wonder why they don’t feel like they should when they read the book, it’s because they didn’t know proper balance points. And that’s why people like you I think, are so important in helping to introduce intelligent balancing of these principles so that we can use the tools in the appropriate way.

Dr. Weitz: Let’s talk about some of the innovations that you have established as some of the large levers that we can use to alter physiology and to help patients [00:38:00] make changes including the four R gut healing protocol, metabolic detoxification, mitochondrial support.

Dr. Bland: I think that when I look back now it’s hard to believe when I say this.  Actually, I did almost flummoxes me 50 years. I gave my first. Seminar for health professionals on metabolic health 50 years ago, last November. I remember that because I was nervous as heck. And it was the first attempt to try to explain these concepts to a health professional audience. That was 6 million miles ago of travel.  And I’m not exaggerating. I’ve traveled 6 million miles since then. Wow. And had the chance to be taught and learn from so many remarkable people around the world that I had the privilege of meeting and having in classes and getting to, to learn from. And of all of that, if I was to [00:39:00] distill down the things that I think I’m most proud of, the things that have stuck, I.  Continue to be developed and used. It’s the three clinical tools that you just described. And again, I don’t want to take individual credit for these were developed by myself and my colleagues over the, those periods of time. But I’m proud that I was involved with the groups. It kind of introduced these concepts into clinical practice.  The first you mentioned was the what we call gastrointestinal restoration program, which we firstly started off with four Rs and that was remove, replace, re inoculate repair. That was the mnemonic that we used for its introduction. And I can’t. Even begin to say how many hundreds of thousands of people have benefited from that program over the last well, we introduced in 1991, so that’s coming up 35 years, I guess.  And there, there are countless numbers of people that have valued from having this program introduced into life. 

Dr. Weitz:  And I have to say, in my practice, I treat a lot of patients for functional gastro GI issues, and that continues to be the backbone of our thinking about helping them.

Dr. Bland: Well, thank you. That’s very gratifying to, to hear that The second concept that we developed that I’m also proud of and again, I don’t want to overstate that we invented this, we were just part of the development of the process that we call metabolic detoxification.  Now, prior to that. There were many historical uses of detoxification programs by traditional healers and herbalists and nutritionists. And so, you know, it had a legacy history that goes way, way back prior to that. But I think what we contributed is to kind of delve deeply into what’s going on in the body when you introduce certain foods that we say help to detoxify.  And so we started looking at the family of enzymes in the liver [00:41:00] that were only discovered in the 1970s. I it was amazing actually, to me that was, we started to study this in the middle 1980s. That, that it was still a fairly new body of science. And these are called the detoxification enzymes that are present within our liver and other tissues.  And they’re members of a family of, over a hundred different genes that are called the cytochrome P450 enzymes. And I won’t get into all the machinations of it, but it turns out that this complex pathway of the ability the body has to get rid of bad stuff is genetically conserved across many animals, goes way, way back in, in phylogeny.  And it would only recently have been discovered and studied. And then we started asking the question, well, gee, what do nutrients have any effect on this series of processes in the body? And we came to recognize that the answer was yes. There were a number of investigators that were starting to look [00:42:00] at the genetics and the biology of how these compounds in food influence those detoxification enzymes.

And interestingly the field called pharmacogenomics was driven. By pharmacologists who wanted to know how drugs are detoxified because the same pathways that detoxify foreign chemicals that are influenced by nutrients are the same pathways that detoxify pharmaceuticals. So if a person had a genetic polymorphism of a gene called cytochrome P four 50 2D six, that was just one of the many.

Then it turns out that if you tried to give them an SSRI drug, they couldn’t properly detoxify and they were potentially able they’re potentially vulnerable to toxicity and even death by taking that drug because their body couldn’t get rid of it. So this field [00:43:00] of pharmacogenomics started to look at, wow, not everybody’s the same in the way they respond to drugs.

Maybe this is related to their ability to toxify. And then we extended that out into the nutrition field saying, now, hold it just a minute. Many of these cytochrome P four fifties, both what we call phase one and phase two detoxification enzymes. The conjugate enzymes are up regulatable through certain nutrients.

And so we started to look at what nutrients are they, and then we talked to look about the glucosinolate family of nutrients that come from cruciferous festivals, broccoli and cauliflower, Brussels sprouts, and cabbage. And those phytochemicals called glucosinolates in those foods get converted in the body into a series of compounds that then actually influence the body’s ability to detoxify things like Endo three Carbinol pH isobutanol sulforaphane.

These are known now to endo three. I think I, yeah, I said I three C. So these [00:44:00] particular compounds could be used therapeutically to actually enhance the body’s detoxification of foreign substances. And so we then started talking about endotoxicity. And that was toxins that come from inside the body like that microbial dysbiosis and exo toxicity, toxins that come from the outside world, like, persistent organic pollutants.

All of those go through the same pathways for detoxification. And then we developed a treatment program called metabolic detoxification. And I’m quite I guess proud of the work that was done because it raised the level of visibility of this important therapeutic tool, which I find very interesting that there are people that still criticize this concept.  I don’t think they’ve really studied, actually, what we have learned over the last 10 to 15 years about its biology.

Dr. Weitz: No, of course not. ’cause it’s been bastardized and people just put a few supplements in a box and say, if you just do this, then you’re gonna detoxify without the concept of the [00:45:00] changing the diet and modified fasting and a whole program that all fits together and is individualized for that person as well.

Dr. Bland: Exactly. So then that, well, by the way I just wanna say an aside from what you just said. So there’s a lot of concern right now about whether AI is gonna take over medicine and it’s gonna replace the health practitioner. And my thought is it will, it’ll only replace the health practitioner that’s either ill-informed or not connected properly to their patients.  You’ll never get an AI program that will sent relate to the patient like a, an informed, knowledgeable, experienced health practitioner can like you. That’s never gonna be replaced. What could be replaced is a person that’s not up to speed with regard to their understanding that’s faking it, that doesn’t have good rapport with their patient.  They probably can, their job can probably be done better by AI.

Dr. Weitz: Yeah, I mean, if there’s some total of your medical approach is that you look at a series of symptoms, a few lab tests, give a diagnosis, give the drug that’s approved for that diagnosis, then of course that could easily be done by a machine.

Dr. Bland: Yes. 

Dr. Weitz:  Thank you.

Dr. Bland: So that leads into the third clinical approach that I’m very proud of. And when I think back at the time I didn’t actually recognize that we were, I believe and I may be corrected on this, but I believe we were the first group to start talking about mitochondrial health.  Bioenergetics in this furnace of energy production that resides within cells. And it seemed very esoteric. And I did actually, I think the first published study on the role of dietary intervention on mitochondrial function in humans. And this was done in 19 published, was done in 1984, published in [00:47:00] 1986.  And the reason we did that study was that I had access to a new bit of technology through a colleague I had at the University of Oregon. And this was a five Tesla superconducting magnet NMR machine nuclear magnetic resonance machine, where it was big enough that a person could put portions of their whole body into this machine and measure aspects of cellular function.

So I. I recognize that one of the things that this machine could measure was the amount of a TP that was in cells. And a TP is the energy currency of cells. And the way it did that is that a TP by the name Aden and Tri Phosphate has the element phosphorus in it. And it turns out that phosphorus exists as an element in different isotope.

One of those is an isotope that has paramagnetic resonance capability. So you can actually use the [00:48:00] nuclear magnetic resonance spectrometer to look at the amount of phosphorus of a specific type, in this case, A-T-P-A-D-P, or a MP within cells in a whole organism in a, without taking a biopsy. So what we did is we had people stick their arm in this magnet in a special piece of equipment we had developed where they could exercise with their wrist, flex their muscle in their arm to exhaustion.

By just continuing to flex their hand in the spectrometer. And then we measured the depletion of a TP using this machine. So that gave us a kind of a energy biograph of that person based on that muscle group. We then had ’em go on to a diet that was regenerating diet in terms of high nutrient level, particularly antioxidants.

And we then retested that’s using the same test, their a TP recharge or deep discharge rate in exercise. And we found out that after 12 weeks that they [00:49:00] can almost double, or let’s call it the other way around, they can have the speed at which they lost a TP, meaning we would conserve energy in their muscle or it would take twice as long to go to exhaustion.

And so we published that paper and it was considered at the time such an esoteric, technology and therapy that I don’t think it ever got much to the light of the day was we couldn’t get a primary journal to publish it. So we had to publish it in kind of a secondary journal, and that never got the play of the day.

This was in the middle eighties. But now lo and behold, this this technology, phosphorus 31 N Mars spectroscopy is used kind of routinely for looking at mitochondria neuropathies. And now we start to see that this concept of nutritional rejuvenation of mitochondria is possible. And so we developed this in the early nineties as part of the IFM therapeutic tools.

We developed this what we call mitochondria resuscitation. Which was our third kind of clinical tool. How do you then [00:50:00] resuscitate the bioenergetic centers of the mitochondria? And those individuals, they were either depleted or putting high demand on their mitochondria, like heavy exercise, stress of things of that nature.

Now we have a way of intervening with this treatment program called mitochondrial resuscitation. So those are the three programs that I’ve been very proud to be involved with that I think have staying power.

Dr. Weitz: Your own personal longevity program. I’m just curious what interventions that you utilize.  We have a number of medications on the market. We, me, I mentioned rapamycin. Some people you use metformin off label. There are injectable peptides. We have hormones. We have many different strategies for supplements, NAD precursors. We have Urolithin A, we have methylene blue. We have all these different things.  I’m wondering, are there, which, which of these do you think are, do you take?

Dr. Bland: well, first of all, I think each one of those that you, me just mentioned, including stem cells and you know, cellular biology all have a role when applied. In the appropriate ways to the appropriate patients. Yeah.

Dr. Weitz:  And there’s even more advanced therapies like regenerative plasma therapy that Dr. Hasi talked about and things like that. Exactly.

Dr. Bland: So I would not discount any of those for me personally at 79. You know, I’m a have been for many decades now, a kind of a biohacker kind of guy as it relates to following my numbers.  And so for me, it’s all about keeping my physiological parameters within what I consider my functional range and what do I need to keep them there. I’m not looking for super, for performance. I’m not competing anymore in athletics. I’m still am. I would consider myself active in, in kind of non-competitive athletics.  So for me, I have, I can, as long as I stay on my program, as long as I eat a high [00:52:00] rainbow diet with high nutrients I take you know, and have taken for now decades a high potency multivitamin and multiple mineral supplement. I I take Omega-3 fatty acids in a form that has pro resolving mediators in them.  I take a pre prebiotic and probiotic and I try to eat a diet that is very low glycemic load that keeps my A1C around 5.3 or lower and keeps my H-S-A-R-P below measurable and try to stay within our body’s resilience to allow my body to find its its resting point. So I’ve been fortunate.  I think because I got into this, I. This conceptualization fairly early. I didn’t fall off the edge and have to do a lot of resurrection of of injury. And I think that, I really give my mother credit for that. My sister and I were raised with, you know, no white bread, no desserts, no sugar that, you know, we thought we were abused as children, but now we recognize she’s pretty smart.  And [00:53:00] so I think I got the good luck, my sister as well, who was three years younger as I, you know, she’s a marathoner and a snowboarder and all that kind of stuff in her seventies. So I think that we, it depends on where we are in this livestream as to how much we need to rejuvenate and what therapy is required.

Cool.

Dr. Weitz: Alright, so, I don’t want to use up any more of your time than we have already. I really appreciate it. Are there any final thoughts you wanna leave our viewers and listeners? I.

Dr. Bland: Well, I want to compliment you. I think you’re doing a fantastic job of describing this landscape in which we now live many options that we didn’t have available.  A lot of information that is really helpful in people constructing their own livestream to be more in charge of their health rather than the victim. I’d encourage people to really think the seriously about the fourth pillar beyond the three that I mentioned, which is what I’m spending all of our time working on now, which is this immuno rejuvenation concept.  I think we have under valued the resilience of our immune systems. You know, there’s only two systems in our body that speak to the outside world, 24-7, 365. That’s the nervous and immune systems and the immune system pick, picks up these signals and then translates to the whole body. Every organ in our body has part of the immune system.

So what we’re learning, and I, again, come back to this, start down the road here with the, understanding of these blue zones, that the immune systems of these individuals when they start looking at immune age are a lot younger than people in less controlled environments where they’re exposed to all sorts of junk.  And so this construct that we’re building, and that’s why I started Big Bold Health a number of years ago, and we just happened onto this 3,500 year old food that was completely absent in the American diet. I couldn’t even find it in the United States called Himalayan Toy Buckwheat that has 126 immune active nutrients that really have been found in the studies that we’ve done to date.

And we’re just turning this large clinical trial of [00:55:00] 850 placebo controlled subjects. To look at actually how Ucky influences the immune system in terms of its function. So I’d encourage people to really start looking at their immune system, and we see so much pre autoimmunity now. We see so much allergy.

We see so much gut inflammation and chronic low grade inflammatory conditions. And you know, precognitive dysfunction as it relates to memory effects and sleep and mood. All of those are in influenced by the immune systems activity. So I would encourage people to look at our big, bold health website or the jeff bland.com website, jeffreybland.com. Lots of materials there that people can learn from and learn more about their immune systems.

Dr. Weitz: I, I think for everybody who’s not quite following the importance of this is the immune system is crucial for healthy aging. As people get older, they tend to die from COVID, from the flu, et cetera.  And one of the things they looked at in some of these studies [00:56:00] on longevity is they look at what’s called thymic evolution, which is the thymus gland, which is one of the important parts of immune system tends to shrink with age. And maintaining that thymus gland, maintaining the integrity immune system is so important.  And I think we need to have a wider understanding of exactly what it means to promote a healthy immune system. I think there’s a tendency to think that the immune system is either up. Or it’s down, and if you have autoimmunity, your immune system’s too high. So we’re gonna use medications that just block part of your immune system, and that’s not the case.  The immune system’s outta balance. We need to have a more complex understanding of it.

Dr. Bland: Yeah, I think you said that beautifully. And it’s really interesting to me when you start thinking about the the immune system and how it defends us, that it’s actually reconstructing the body all the time.  And in fact, it’s of [00:57:00] all the the variable things that you could measure in terms of your prediction of your longevity, the data today suggests that the data says that the biological age of your immune system is the strongest predictor of your longevity of anything you can measure. So.  Affecting your biological agent for your immune system by doing the right thing is really important to live a long, healthy life.

Dr. Weitz: So, looking at blood markers, what are some of the things you can look at for immune function? I, is it mainly the CBC and white blood cells and lymphocytes and that balance?

Dr. Bland: Yeah, I think that’s a very good place to start. That’s a gross determinant. Also, you can look at salivary Iga. That’s a good kind of, measure of your mucosal innate immunity, which is the first line of defense that your body has. That’s another good one. You can look also obviously at your serum level of high sensitivity, C-reactive protein.  That’s another important marker. So you can actually put together a fairly simple panel of tools to assess the status of your immune system.

Dr. Weitz: Then the folks that offer the epigenetic testing for longevity, they also have part of that test that’s looking at immune aging.

Dr. Bland: Yeah. Yeah. There’s several companies that are doing that.  We’ve done quite a bit of collaborative work with True Diagnostic. That’s one of the companies that is off offering that from a blood spot analysis. So to me, this is the front edge of what a person might wanna know, and they, as they interrogate how their immune system is really working as their friend and not their fault.

Dr. Weitz: Great. And how can people find out about Big Bold Health? What’s the website?

Dr. Bland: Yeah it’s just www do big bold health.com or they can go to Jeffrey Bland, J-E-F-F-R-E-Y-B-L-A-N-D.com and lastly, I, you know, if a, if they’re really a geek and they want to have access to hours and hours of videotaped information, they can go to the Personalized Lifestyle Medicine Institute.  We have a whole library of of available information from clinicians. That, and that’s it. M institute.org or just Doug, you can just type in PLMI in your your search engine and you’ll come up with a website.

Dr. Weitz: That’s great. Thank you so much Jeff, and I look forward to seeing you again at the PLMI conference in October.

Dr. Bland: I you as well, Ben, and you’re doing a fantastic job. It’s been a privilege to talk with you today. 

Dr. Weitz: Thank you very much.

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Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcast or Spotify and give us a five star ratings and review.  As you may know, I continue to accept a limited number of new patients per month for functional medicine.  If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems and wanna promote longevity, please call my Santa Monica Weitz Sports Chiropractic and Nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine and I will talk to everybody next week.