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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.
Dr. Weitz: If you’re looking for clinically useful insights, not wellness hype, then this is the place for you. Welcome to the Rational Wellness Podcast, the podcast for functional and integrative practitioners who wanna practice with greater clarity and precision. I’m Dr. Ben Weitz, and each week I sit down with the leading clinicians, researchers, and lab innovators to explore the science, lab testing, and clinical reasoning behind modern root cause medicine. This is a show focused on practical evidence-informed insights that you can actually use in patient care. Please subscribe to the Rational Wellness Podcast on Apple, Spotify, or YouTube. Please tell your friends and colleagues, and if you could give us a ratings and review on Apple or Spotify, we would certainly appreciate it. Finally, to access the show notes and the full transcript, please go to my website, drweitz.com. [00:01:00]
Today on the Rational Wellness Podcast, I’m excited to have Dr. Michael Aziz joining us to talk about one of my favorite topics, longevity. Dr. Aziz is a board-certified internal medicine physician, author, and broadcast media commentator. He practices at Lenox Hill Hospital in New York City. He spent decades integrating conventional and functional medicine with a focus on identifying and treating the underlying causes of chronic diseases. Dr. Aziz first became nationally known with his 2010 book, The Perfect 10 Diet, in which he challenged a number of prevailing ideas about dietary fat and nutrition, and his newest book, The Ageless Revolution, takes that thinking in a different direction.
Rather than simply treating the diseases that become more common as we get older, Dr. Aziz argues that we should think [00:02:00] about aging itself as a biological process that can be targeted therapeutically, which raises some fascinating questions, including what exactly is aging and which aspects of aging are modifiable? Today we’re going to dig into those questions and explore Dr. Aziz’s approach to ext- s- extending not just lifespan but healthspan. Before we do, I just wanted to let our listeners know that if they’re interested in making an appointment with me for functional medicine, they can visit my website, drweitz.com, and click on appointments and request an appointment at a time available, or they can call my office at 310-395-3111. Dr. Aziz, thank you so much for joining us.
Dr. Aziz: Thank you so much for having me, Dr. Weitz. It’s a pleasure.
Dr. Weitz: Absolutely. So is aging a disease?
Dr. Aziz: Some doctors are calling aging a disease, but I go a step further by calling [00:03:00] aging a syndrome, because a syndrome is a variety of diseases. So once we get old, we’re predisposed to multiple diseases, from high blood pressure, high cholesterol, heart disease cancer, dementia, and so on. So yeah, it’s more than a disease.
Dr. Weitz: Right. I think that one of the interests some doctors have in wanting to call it a disease is so it can be covered by insurance.
Dr. Aziz: Well, you know, the fr- in- insurance doesn’t cover it even,
Dr. Weitz: even- or at least so they can bill for it. Yeah. No, I know. I know insurance doesn’t cover it
Dr. Aziz: But aging is a disease because, you know, if you treat it as a disease, you can really have a longer life, and it’s the reason we get old is the cells deteriorate, and you have to preserve your cells. And you do that by a variety of thing, whether it’s diet, exercise, supplements, and as doctors, we can give medications to prevent the diseases from happening. I mean, it happens already with when you give somebody a cholesterol medication, when you give them a blood pressure medicine. You’re doing anti-aging [00:04:00] medicine. If you give them a vaccine you’re doing anti-aging.
Dr. Weitz: Yeah, and I would argue that if we treat aging, we’ll actually treat most of those other chronic diseases as well.
Dr. Aziz: Yes, absolutely.
Dr. Weitz: So if aging is a disease, what is the underlying pathology?
Dr. Aziz: So in 2012, scientists have discovered nine hallmarks of aging, and during the writing of the book, The Ageless Revolution, three more hallmarks were added in 2022. I talk about all of them in the book. I made it 10, but really I talk about 12 in the book.
And the hallmarks of aging is re- is really why the cells deteriorate, why they, why we get old, why the cells get damaged, and why we get sick and eventually die. And basically in the book, The Ageless Revolution, I’m throwing the kitchen sink on aging from every angle. So for every hallmark, there’s a weapon.
Dr. Weitz: How do we measure aging? Do you use a DNA methylation [00:05:00] test?
Dr. Aziz: You could do that, but also we must warn our listeners that, you know, some organs age faster than others. Somebody can have a healthy heart, but they have dementia, or they can have you know, their skin looks young, but they have heart disease.
So now we can understand that some organs age faster than others. So you have to take really a broad spectrum approach for aging on multiple levels.
Dr. Weitz: All right. So, in terms of testing your patients, is there any markers that you use to decide what their rate of aging is?
Dr. Aziz: confirmation test if you wanna do just the level of the the biological age of the person.
But, you know, it is costly. I think people have to start the right steps, and then eventually they could do another test in two, three years to see, to measure if the steps that they’re taking is making progress.
Dr. Weitz: Okay. So, what are the biggest accelerators of aging? [00:06:00]
Dr. Aziz: I think diet is a greater accelerator of aging.
We have such a poor diet in the United States. I mean, 50% of our diet is processed food, and that really can predisposes people to a variety of illnesses. That’s a big thing. And also poor sleep and stress are two big factors as well.
Dr. Weitz: Okay, so when it comes to diet, what are the factors that accelerate aging, and what are the factors that can decrease aging?
Dr. Aziz: So it has to come down again to processed food, refined carbohydrates. Sugar is very bad. Sugar is very sticky. It sticks to the blood vessels, stick to the cholesterol, and it cause glyca- you know, the, causes the glycogen to get damaged. So sugar is very bad. Also, seed oils are very bad. All the vegetable oils, the fried food, alcohol as well the chemicals, nitrites, which are very much in vogue with all the low carb and the keto diets that everybody’s now following.
You know, they’re eating, people are eating a lot of [00:07:00] processed meat. All that stuff accelerate aging. And then for outside, of course, the sun, smoking, of course. And I think we go back to stress as well.
Dr. Weitz: So when it comes to nitrates, I think some people have kinda rethought that given the fact that nitrates promote nitric oxide production.
Dr. Aziz: We’re talking about nitrites in foods. So nitrites in, like, in processed meat, bacon, sausage, hot dogs, that’s different, and that’s chemicals that the body cannot process, and eventually they lead to many types of cancer. And, you know, low carb diets now change to keto diets or ketogenic diets, and many people just think they’re losing weight, and they measure their success by how many pounds they lost on their bathroom scale, but don’t realize they’re also shortening their life by eating all those chemicals that are related to a variety of types of cancer from esophageal cancer, stomach cancer, colon cancer, and so on.
Dr. Weitz: Is there a way to do a keto diet and be healthy?
Dr. Aziz: Sure. So [00:08:00] I recommend in my first book, The Perfect 10 Diet, it’s really a balanced diet. It’s not a keto diet. I recommend more clean protein sources, so, like, poultry, seafood, beans eggs nuts. Those are good protein choices that can extend life.
You know, people who eat fish three, four times a week can live much longer.
Dr. Weitz: Okay. So, so you can follow a lower carb program. You just wanna make sure you’re not eating bacon and processed meats and, you know, s- some of the other foods.
Dr. Aziz: Yeah, that’s my big difference from all the other low-carb diets, Atkins, the South Beach Diet, and all those diets in vogue right now that many people follow.
And again, people judge their success by how many pounds they lost, but they don’t realize that they’re shaving a few years off their life by eating all those chemicals. Because it’s not just sugar that’s bad for us, it’s all the chemicals. It’s artificial sweeteners, it’s the nitrites anything that the body cannot recognize that-
So what [00:09:00] about fats? When it comes to fats what are the healthy fats? What are the fats we shouldn’t eat? There’s a lot of controversy, especially in nutrition and functional medicine world about whether or not eating red meat is actually bad de- depending upon the quality of the meat.
Is saturated fat really bad? Is high cholesterol really bad? Let’s get into that whole topic.
Dr. Aziz: So, you know, I don’t think there’s controversy. I think the problem is we have a lot of misinformation out there, and a lot of the misinformation came from the medical establishment itself, from the research sponsored by the soybean lobby.
So all, most doctors, I would say the majority, think that saturated fat are bad for us, but they’re not. They’ve been cleared from heart disease. So butter, cheese, coconut, cocoa butter, I cleared those types of fat from heart disease a long time ago. And I talk in my books about the Seven Countries study.
That was a study that we learn in medical school that’s a cholesterol [00:10:00] theory based. It’s the biggest fraud of the 20th century. The data that Ancel Keys collected was highly fraudulent. He cherry-picked the data. He omitted countries that eat saturated fat to prove his point that if you eat butter, you die of a heart attack and stroke, which is not true.
Because I talk in my new book that Switzerland, which is eat cheese fondue as a main dish, which is melted cheese, I mean, I think I’ve had that once in my life, have the longest lifespan in the world at age 90. So that is unbelievable. We also have Thailand, who eats coconuts, and they are fine.
And we eat, also we have the French with the f- you know, all the saturated fat, the butter, the cheese, the foie gras and all that stuff, and it’s called in medical literature the French Paradox. It’s not the red wine, because the Italians drink red wine and they don’t have the longevity of the French.
So I think saturated fat have been cleared from heart disease, but the one who sponsored the idea that if you eat saturated fat you’re gonna die of a heart attack is the soybean lobby. And as a result, you [00:11:00] know, many of the guidelines that doctors teach are that you have to buy your chicken and then cook it in vegetable oil and Mazola and Crisco, and it’s unbelievable.
Dr. Aziz: So- And I’m glad the, the, the country’s picking up on the danger of seed oils. So saturated fat are definitely okay you know, and if you don’t eat saturated fat, your body makes them. So, you know, when we gain two or three pounds, we don’t make, we don’t make you know, soybean oil.
You’re making saturated fat. Palmitic acid is a lung surfactant, is saturated fat.
Dr. Weitz: I would also argue that- Everybody’s eating a certain amount of saturated fat even if you don’t eat meat, even if you don’t eat butter. Even if you just have olive oil or avocado oil, there’s a certain amount of saturated fat in that.
There’s a certain amount of saturated fat in nuts, so even though they’re primarily not saturated fat, there’s still some saturated fat in all of [00:12:00] those.
Dr. Aziz: Animal fat isn’t really saturated. Animal fat is monounsaturated. It’s placed in the saturated fat by incorrect practice. So for example, poultry is about 50% monounsaturated fat.
The reason it because it depends upon their feed, but it’s 50% also saturated fat. So it’s just saturated fat is like cocoa butter, it’s coconut, it’s palm oil. So yeah, so, you know, goose fat chicken fat, animal fat is really monounsaturated, is not saturated. So that’s also another myth that we learned.
Dr. Weitz: So if somebody asks you what’s the best, i- if I wanna cook my eggs, what fat should I use to cook my eggs? Should I use butter? Should I use olive oil? What should I use?
Dr. Aziz: Of course, you should use butter because butter has a high burning point. Olive oil should not be heated at high temperature. You can saute some mushrooms for, like, five minutes, but not high…
It’s not a high-burning, that’s not a high-burning [00:13:00] oil. You wanna use a high-burning oil like maybe grapeseed oil for if you need to use if you need to cook salmon, for example. But you wanna cook with butter or coconut you know, but you don’t wa- Or goose fat.
Dr. Aziz: Or beef tallow.
Yeah, so satu- so saturated fats raise,
Dr. Weitz: I have to say, I’ve never had anybody on the podcast recommend goose fat. That’s a first.
Dr. Aziz: Well, you know, there’s RFK Jr., he wants McDonald’s to change from the vegetable oils. If you think soybean oil is good for you, that’s incredible, then you’re eating massive amounts of…
So that’s the problem with vegetable oil. They create free radicals, so they damage the cholesterol, and they also lead to the hardening of the arteries, and they also sometimes are hydrogenated, so they contain trans fats. And that’s why, I mean, look at the, look at our lifespan in United States.
It’s only 76. We use all this vegetable oil. If this saturated fats theory was true, we should have had the longer life than the French and the Swiss, but [00:14:00] we don’t. We have the shorter lifespan in the whole Western world. So this is all BS that was, were fed to us, and doctors kept repeating this information without thinking that maybe this information has been given to us by the soybean lobby.
Dr. Weitz: We’re also the most obese country on Earth
Dr. Aziz: Well, that has to do with the massive amounts of sugar. And you know what also, the other thing I talk about in my books, like who invented low-fat diets? Low-fat diets were invented by the McGovern committee. They were invented by politicians. It was not invented by doctors, and he was very influenced, the McGovern, he was running in Congress, and he was very influenced by the Pritikin diet, who was an engineer, he was not even a doctor, who believed that heart disease is caused by eating too much fat, and his diet was 90% carb.
So all the low-fat guidelines came from politicians and the USDA food pyramid, and before you know it, we started eating 400 calories more a day. We became obese. Diabetes became an epidemic. Obesity became an epidemic, and heart [00:15:00] disease did not disappear. Still the number-one killer for us.
Dr. Weitz: So what do you think about the vegetarian diet?
Dr. Aziz: So, you know, I’m also… I know I have opposing views to many doctors, but I redid my research because when I write a book, I really have to be a million percent correct before I give this information, and I think history proves that even with my first book I was correct.
A lot of the media now is talking about seed oils, and I was correct going on TV and going on national TV saying that butter is okay 20 years ago. So, vegetable vegetarians in general are okay, but the problem is I think if you’re a strict vegetarian, you don’t include animal protein, and you don’t supplement B- B12.
One, it could be end up missing a lot of protein, so you can end up losing muscle mass as you get older, and vegetarians in general are end up with a deficiency of B12, so they tend to have a very high level of homocysteine, which is the protein that builds up in the blood and can lead to being the cholesterol sticky.
So m- many [00:16:00] times vegetarian can have more heart attacks than people who eat animal protein. So if you’re a vegetarian, you really have to eat the right amount of protein for your body type. You can’t be just eating just small amounts, and you have to supplement B12, and you have to be on top of your homocysteine level.
Dr. Weitz: And you probably need to supplement omega-3, and you probably need to- Of course … supplement zinc and
Dr. Aziz: Yes. I’m glad you’re on the first page.
Dr. Weitz: So, if eating butter and saturated fat are not contributors to heart disease, what does cause heart disease?
Dr. Aziz: I believe that heart disease is inflammation. So I think when we eat massive amounts of sugar is very sticky, and it does the same thing like smoking, so it makes the cholesterol very sticky.
So there is a blood test that people can get. They can get oxidized cholesterol, and they can see how much of their cholesterol is really the sticky type. So cholesterol is important only if it’s sticky, and it’s sticky if you smoke, if you eat sugar, if you use vegetable oils. [00:17:00] That’s when it really becomes…
And, you know, the French have higher cholesterol than we do. We go back to the saturated fat. When you eat saturated fat, your LDL goes up, and your HDL goes up, but the type of LDL that goes up is the high, big molecule that doesn’t clog the arteries. The LDL made of small molecules of sugar is the one that goes under the intima of the blood vessels and can cause clogging of the arteries.
So heart disease is multifactorial, but I think processed food, again, and sugar, and vegetable oil and smoking all leads to this epidemic we have.
Dr. Weitz: So, small dense LDL you think is one of the main contributors to heart disease?
Dr. Aziz: Yeah, I mean, it, it’s been proven. I mean, you know, that’s why we have to do an advanced lipid.
We cannot just do, like… People concentrate so much on their total cholesterol, that’s useless, or their HDL. You have to do an advanced lipid. You have to do an oxidized c- cholesterol to see what your level of oxidized LDL and so on. And you also have to do the new blood test like lipoprotein A [00:18:00] and
Why don’t we go into testing? What is your ideal lab panel look like for a patient who sees you for longevity?
Dr. Aziz: It can become very expensive. People can do, like, 200 tests for every organ in the body. There is no limit. But to keep it simple, I like to check their hemoglobin A1C. I like to check their fasting insulin level.
I have to check sensitive C-reactive protein. I have to check liver function test to make sure they don’t have fatty infiltration of the liver, and advanced lipid. Right. That’s a good, that’s a good start.
Dr. Weitz: Okay. How important to aging is, you mentioned sugar and insulin resistance?
Dr. Aziz: Well, we have an epidemic of insulin resistance.
Sure. I mean, one fourth of the country has prediabetes. You check the sugar on hemoglobin A1C on anybody, it’s… A lot of people are prediabetic already, and we have interesting-
Dr. Weitz: But now that we have 30 million people on Ozempic, is that gonna [00:19:00] improve?
Dr. Aziz: I think Ozempic and Mounjaro are a game changer.
I think they are a good resort for someone who cannot lose weight, but I think people have to do the right step before they get on a GLP because a lot of side effects as well. They may not be eating enough protein. They may be you know, losing muscle mass, which is not good. They also may be not doing strength training, or they’re still eating, you know, one slice of pizza instead of three, so they could also lose muscle mass as they get older, which is not a good thing.
So it has to be done appropriately.
Dr. Weitz: So what are the side effects of GLP-1s?
Dr. Aziz: Well, there is three generation. There is a GLP-1, like semaglutide, Ozempic. There’s a second generation, like tirzepatide, the Mounjaro. And next year or in the next few months, Retta is coming, which is triple G that works on three hormones.
It works on GLP, incretin, and glucagon. So I think as you go to the next level, like the Mounjaro or the triple G, you get less side effects. But the most common side effects, of course, is people get [00:20:00] nauseous. If they do a massive dose the wrong dose, they don’t start slow, they can have vomiting as well.
Many people on high doses can have constipation, and then you have the rare side effects. I’ve seen some rare side effects as well, so from hair loss to-
Dr. Weitz: What, what kinds of side effects were those? Hair loss you mentioned.
Dr. Aziz: I, I think the most common is really people are just nauseous and they eat nausea pill or they’re constipated.
But that’s about it really. I think the rare side effects, electrolyte imbalance and all that stuff, that’s if they start at a very high dose and they don’t titrate up.
Dr. Weitz: Yeah. I’ve seen quite a number of cases of decreased GI motility leading to SIBO, which can be a real problem.
Dr. Aziz: Yes, of course.
Dr. Weitz: So how important is muscle mass and strength for longevity?
Dr. Aziz: It’s very important. You have to do that regardless, and especially with people on GLP now. We need- we lose muscle as we get older, and you need your muscle to you know, to protect your bones from fractures and for s- for everything. [00:21:00] So, I think we have to do more strength training, and we have to make sure that our muscles are getting…
we are not losing a lot of muscle mass as we get older.
Dr. Weitz: So in response to criticisms of, o- of seed oils you often hear a response like, “Well, seed oils are high in omega-6, and omega… when you substitute omega-6 oils for saturated fat, the risk of heart disease goes down.”
Dr. Aziz: So you need omega-6 and you need omega-3.
They need to be a ratio of 1 to 1, but you get your omega-6. So if I get a salad from next door, I get some corn or I get some peanuts on top of my salad, that’s how I get my omega-6. I would not get it from a, a small french fries from McDonald’s. That’s how you get your omega-6. And you know, and yeah, like I said, butter is fine.
No, no problem with that. I mean, we know the benefits of cocoa butter, dark chocolate. I mean, that’s out there. You know, the benefits of how cocoa butter, which is [00:22:00] a saturated fat, that the types of fat that you- chocolate you should eat, it melts in your mouth, and that’s why you see chocolate melting on a very hot day if you live in California because the melting temperature of cocoa butter is, like, 97, 98, so it- So you have to look for high-quality chocolate, not one made with hydrogenated oil.
Dr. Weitz: Okay. Are you a fan of coconut oil?
Dr. Aziz: Yes, of course. I love Thai food, and you can cook with coconut, and you can have coconut milk perfectly fine. It’s a medium-chain triglyceride that doesn’t raise cholesterol. It’s mostly used for energy. I mean, have you seen a person who, when you go to a Thai restaurant, have you seen somebody who’s overweight, a waitress who’s overweight in a Thai restaurant?
Dr. Weitz: I have seen p- I have seen patients who are consuming coconut oil a lot and saw a significant rise in their LDL cholesterol.
Dr. Aziz: Well, it’s a medium-chain triglyceride, so, the impact is minimal, and if anything, if it raises LDL, it also raises the HDL. So like I said, I think the problem [00:23:00] was was heart disease is seed oils.
All the information that were fed to us was sponsored by the soybean lobby. And then, you know, when you eat the, when you consume or you cook with seed oil, your cholesterol goes down, so it looks like you’re getting healthy, but really you’re more predisposed to heart attack and stroke because our cells are made out of saturated fat, our skin, our muscles.
So the, the, the seed oils, the body has to, the cholesterol has to escape from the blood vessels to make the cells more stable, otherwise our skin will fall off. So it looks like seed oil will lower your cholesterol, but it’s really a myth. It may be it will create free radicals. It will create f- oxidized cholesterol.
It will create increased risk for stroke and heart attack. Probably surprised talking to a guy like me. I’m like, you know, Atkins number two here without the processed meat. But- … but, you know, the information is out there. I mean, people can Google this information. They don’t have to take my word for it.
They can [00:24:00] Google the information. All I did is I did my homework of gather all the information to make things easy for the patients and for the readers. So they can read how the soybean lobby influenced the guidelines, how the saturated fat theory came, how the low-fat guideline came from the McGovern committee.
This information is out there. Now we have Google and ChatGPT. The- everything is online.
Dr. Weitz: So you’re c- you’re critical of the keto diet, but it sounds like a lot of the things you’re recommending is along the lines of a keto diet.
Dr. Aziz: I wrote the book, The Perfect 10 Diet, which is the balanced diet. It’s very similar to the Harvard Food Pyramid, except the Harvard Food Pyramid had seed oils at the bottom of the pyramid.
So can you imagine Harvard is telling us start your diet at McDonald’s and ended up at Burger King? Do you believe that? That was the Harvard Food Pyramid. I mean, the- that’s the g- I, I mean, how can you top Harvard? Right. But that’s the Harvard Food Pyramid. Soybean oil should be the base of a healthy diet.
So start your diet at Dunkin’ Donuts and make sure you end up at Burger King. I’m sorry. So [00:25:00] my diet is almost like the Harvard Food Pyramid, except the base of my diet, the types of fat that you should consume, is avocado avocados, coconut butter olive oil, anything natural. Anything that is fake, we- doesn’t belong in the human body.
Just, it just doesn’t make sense. The body does not know what soybean oil, the body does not know what nitrites are. I mean, the Mayo Clinic also has another… I think they had another book when my first book came, hit number one. Of course, I can’t compete with the Mayo Clinic. And they had also bacon-
and sausage. I mean, this is coming from the Mayo Clinic doctors. So that’s how you can get healthy. You can eat more bacon and sausage- … and seed oils, and you’ll live to be 100. You can just do like the blue zones.
Dr. Weitz: What do you think about whole grains?
Dr. Aziz: Yeah, I think perfectly fine. So you- you know I’m also, I’m against the Mediterranean diet, so now, like, you got the- You’re
Dr. Weitz: against the Mediterranean diet?
Dr. Aziz: So I- I had to learn a lot during the writing
Dr. Weitz: E- [00:26:00] even the low glycemic Mediterranean diet?
Dr. Aziz: Well, I’ll tell you why I’m against the Mediterranean diet. Well, you
Dr. Weitz: recommend eating fish, right? And-
Dr. Aziz: No, the Mediterranean diet, so first of
Dr. Weitz: all- And you’re in favor of vegetables I’m sure, right?
Dr. Aziz: Yes. So the Mediterranean diet, first of all, Ancel Keys, that was a big lie the biggest study of the 20th century. We talked about that. He cherry-picked the data. But the Mediterranean diet, when you-
Dr. Weitz: Right, but there’s been hundreds of studies on the
Dr. Aziz: Mediterranean diet- All right, but I’ve done- … the Freddie Med
I had a, I had an article in the New York Post where I do say what the problem the Mediterranean diet. The studies was done on farmers, and those farmers worked in the field 12 hours a day, seven days a week. So it has 11 to 12 servings of bread a day. If you eat 11 servings or 12 breads a day, you’re gonna be fat, and that’s why Greece is number five in the world in obesity.
So I recommend the French diet instead, because nobody eats 11 croissant a day. So I like the Mediterranean diet when it comes to the protein choices. Alcohol in moderation is okay, even though [00:27:00] alcohol could be a poison. But the massive amounts of bread is unsustainable for somebody who is sedentary, who doesn’t go…
So if you are, if you follow the Mediterranean diet, you better join Equinox and go 12 hours a day. You’ll be fine- … like those farmers. Otherwise, you’re on the way to become fat. And I think the problem is doctors also have become parrots. They repeat the information. So, you know, they tell you, “Oh, eat margarine.”
So they say, “Oh, yeah, eat margarine. It’s… Don’t eat butter.” So the Mediterranean diet, but they stop thinking that the Mediterranean diet has 11 servings of bread, and that’s massive amounts of bread. If I eat two pieces of bread, I’m already three pounds overweight.
Dr. Aziz: I’m, I would- I’m in favor of the Mediterranean diet, but please don’t eat 12 pieces of bread a day.
Dr. Weitz: Well, I would posit that there’s not one Mediterranean diet. There’s a French Mediterranean diet. There’s a Tunisian Mediterranean diet. Oh, no. The French, the French- There’s an Italian Mediterranean diet.
Dr. Aziz: Dr. Weitz, that’s because you’re a functional doctor. The French diet is supposed to be, oh, it’s the French paradox.
We don’t know why they live long. [00:28:00] No, I mean, the Mediterranean diet is really based on Greece and Italy, and that’s a diet that has massive amounts of grains. We talked about grains. I think grains are perfectly fine in moderation, two, three pieces of bread a day or whole wheat pasta or brown rice or wild rice.
Dr. Weitz: gluten, is sh- is gluten something that everybody should avoid?
Dr. Aziz: No, I think gluten intolerance or celiac disease is only one in 200, so if you have a problem with it, you should avoid it. But if you have no problem, no allergies, hey, eat the bread you want. And if you’re active, hey, eat five pieces of bread a day, six pieces of bread a day.
If you’re active and work out, that’s fine. Your body knows how to use bread and whole wheat as well, whole wheat grain and whole wheat flour. It’s just the
Dr. Weitz: massive- what about the lectins that we find in grains and in legumes?
Dr. Aziz: Who’s that doctor who’s always talking about that? That’s, Steven
Dr. Aziz: Yeah. It’s, I think it’s… I don’t know. No- … I don’t believe that. I don’t believe that. I think we have to look at those countries that live a long life, and the Mediterraneans are fine. But I will [00:29:00] tell you, the Mediterranean diet, when it was picked up as the healthiest diet, it was not the best co- the it did not have the longest lifespan.
I lo- I talk in my second book that the longest lifespan in, back in that time was Iceland. And I talk about, I know there was no ChatGPT, but there was libraries. Why didn’t people look this information? So the Mediterranean diet was picked up randomly, that it’s a healthy… Of course it’s a healthy diet, you know?
People in Hong Kong, it’s similar to Mediterranean diet. It’s also a healthy diet, but there are other diets also that are just as good or even better. I talk in my New York Post, I think if people Google this information, it’s, I th- I think if they put my name and the New York Post. I talk that the French not only are slim compared to the Greek, but also they have less colon cancer because of the calcium.
You know, they have more dairy. Their diet is more diversified. It has more organ meat than the Mediterranean diet. And when it comes to longevity, it also beat the Greek diet. So- They beat them by year and a half.
Dr. Weitz: All right. Is dairy [00:30:00] a good thing?
Dr. Weitz: Is dairy a good food to eat?
Dr. Aziz: So let’s talk about the research in dairy. I think the research in dairy shows that if you consume too much dairy… First of all, I mean, a lot of people are lactose intolerant, so, if you have two latte a day, that’s a lot. But I think that dairy consumption has been linked to maybe prostate cancer in men, too much dairy consumption.
But I don’t know if that’s true. Maybe it has to do with the fact that they’re giving cow growth hormones
Dr. Aziz: I like my dairy. I like my milk. I like my latte. I like my yogurt, full-fat yogurt.
Dr. Weitz: Okay. All right. So, let’s talk about hormones. How important are hormones for aging?
Dr. Aziz: So there are major hormones in our bodies, and we have minor hormones.
And as we age, the minor horm- Well,
Dr. Weitz: which are the major hormones and which are the minor hormones?
Dr. Aziz: The major hormones are are insulin thyroid hormone, cortisol. You cannot live one day without them. If you have no insulin, you [00:31:00] die. If you have no thyroid hormone, you die. But minor hormones start to decline as well.
That’s testosterone. That, the sex hormones. So I also talk in my books about replacing the sex hormone as we get older with natural hormones, with bioidentical hormones. You wanna have the testosterone of an 18-year-old. Women should replace their sex hormones with bioidentical hormones, not synthetic hormones.
And you know, that’s the benefits also of eating natural fats like butter and and, you know, cocoa butter and coconut that’s, they help with the production of sex hormones
Dr. Weitz: Which are made from cholesterol.
Dr. Weitz: All right. So, let’s see. So we talked about hormones. I know that you use peptides in your practice.
Why don’t we talk about peptides? What are peptides? How can they be beneficial?
Dr. Aziz: The research done on peptide was done in the Soviet Union in the ’70s. They were afraid Ronald Reagan is gonna throw a nuclear [00:32:00] bomb, so a lot of doctors in the United States and Europe don’t know about peptides. But peptides are signaling molecules, and they’re used in many countries that were under the Soviet occupation.
And so there are… The peptide tells the cells what to do. So people don’t know that insulin is a peptide, but insulin is a peptide. Before people had diabetes, they died, but insulin is a peptide that lowers sugar. The GLP are peptides, so when we eat, we secrete a hormone called GLP. It tells the brain we’re full.
So this injection, whether it’s semaglutide or tirzepatide, it’s a peptide that tells you’re not hungry. But there are different peptides that are not FDA-approved, and they are for a variety of reasons. So you have peptides for longevity, like epitalon that is used in Russia that prevents heart attack and stroke.
You have peptide like cerebral lysin. It’s used in Austria for people with dementia and people who had strokes. You have peptides to have better looking skin, like GHK copper. You have a peptide called BPC 157 for pain and inflammation. So there are different peptides, [00:33:00] even though they’re not here in the United States that are FDA-approved, but I’m sure we’re heading that direction, hopefully.
Dr. Weitz: Yeah, I think they’re gonna take a certain number of them and declassify them so they could potentially be made by compounding pharmacies, correct?
Dr. Aziz: They took them off the compounding pharmacies because peptides really are miraculous. They can help with many conditions. I mean, look how the GLP changed the obesity epidemic in America.
I mean, people couldn’t lose weight, and all of a sudden everybody’s taking a GLP and losing weight. So yeah, hopefully there are more peptides that can prolong life that come and that we have to get easily for doctors have to learn about them because doctors don’t know what peptides are.
Dr. Weitz: And you think they can play a role in longevity?
Dr. Aziz: I think the anti-aging revolution right now is happening from people on Instagram, from celebrities, from people with tons of money, and I’m trying to make anti-aging affordable for everyone. Okay. Because we talked about we’re getting a lot [00:34:00] of information that is wrong. I mean, we’re getting dietary information that was incorrect by the medical establishment from even medical institution like Harvard.
Then you’re getting the government banning peptides. Then you’re getting also, you know, l- just get a cholesterol check without knowing the oxidized cholesterol or advanced lipids. So we had a lot of misinformation, and if doctors don’t know about that, how the people’s health are gonna change?
So, let’s talk about the longevity process, the anti-aging process, and some of the other pathways, like senescent cells.
Dr. Aziz: So, senescent cells are the types of cells as we get older, m- more old cells accumulate in our body, and those cells don’t work. But not only they don’t work, they interfere with the function of the younger cells.
So I talk about them, think of like, a company that is very tech-oriented and a lot of old people who are not tech savvy. [00:35:00] Not only they don’t know how to use a computer or use ChatGPT, but they’re disruptive to the young people, so eventually the whole company fail. So you have to get rid of the senescent cells or the old cells, and one way to get rid of senescent cells or old cells is intermittent fasting, skipping a meal once in a while.
And if you have a medical condition like diabetes or you cannot, or hypoglycemia and you have to eat a lot, there are supplements to get rid of the senescent cells or the old cells. So like fisetin, for example, or quercetin or even a medication like low-dose naltrexone at four, 4.5 milligram to get rid of the senescent cells.
And that’s one of the hallmark that can make you live longer, and it had been shown in animal studies that when you get rid of senescent cells, you can live longer.
Dr. Weitz: Do you use any of those senolytics in your practice?
Dr. Aziz: Sure, I do. Yes.
Dr. Weitz: Do you have a particular one of those or use all of them or?
Dr. Aziz: I take, particularly I take fisetin as a supplement and I take low-dose naltrexone for some patients if they can afford it.
It’s quite cheap. It’s about $45 a [00:36:00] month. Right. But, you know, for people who are like, you know, worried about money, they can just get a supplement or they can just skip a meal.
Dr. Weitz: What do you think about fasting?
Dr. Aziz: So there are three types of fasting for our listeners. There is one type of fasting that you dec- you eat every day, but just certain days you decrease your calories, and that has not been linked to longevity.
There is 16 and eight, which is like you don’t eat for 16 hours and you eat only an eight-hour period. I like that one. So skipping a meal once in a while is fine. And there’s also fasting for a prolonged period of time, like for two, three days. I’m not a fan of that at all because, yes, you may get rid of of the senescent cells, but you’re also gonna lose a lot of muscle, and that’s not a good thing.
Plus, I don’t think life is enjoyable if you’re really gonna starve yourself.
Dr. Weitz: What do you think about the fasting mimicking diet?
Dr. Aziz: Is that the doctor, what’s his name? I forgot his name.
Dr. Weitz: him in- Dr. Val- Valter Longo.
Dr. Aziz: Yes, I talk about him in the book. I, I, they did animal studies.
I think what… He has his own [00:37:00] program, which is really about eating, like, soups and just, like, crackers. In animal studies, this has not been shown to prolong life.
Dr. Weitz: Eating soup and crackers.
He’s got a number of clinical trials out now
Dr. Aziz: I have to look into that, but the animal studies have not sh- I mean, I’m sure you get… I mean, they talk about, I mean, listen, if you lose weight, you’re probably gonna also drop your cholesterol, you’re gonna decrease the inflammation. But we don’t have human studies, so I think they’re short-term studies.
But in animal studies have not, they have not been proven to prolong life. Cutting the calories on mice certain days and give them normal calories certain days has not shown to prolong life.
Dr. Weitz: All right. When it comes to longevity, what do you think about NAD?
Dr. Aziz: So, NAD is a molecule that charges your mitochondria.
It declines with aging, so that’s why we lose our energy as we get older. I think it’s important. There are tests to measure the level of NAD in your body, [00:38:00] but we don’t have human studies. I talk about it in my book, that it’s a supplement that we probably have to take, but we don’t have longevity studies on it.
I, I share in my book, The Aging Revolution, all that I learned, whether from the supplements, the medication. I share the animal studies. I share the human studies. I share everything with the reader. This way they can take this information and implement whatever works for them.
Dr. Weitz: You like NR or NMN?
Dr. Aziz: So NR is a precursor.
It breaks into NMN, and then NMN is a precursor, breaks into NAD. I, I talk in my book that the studies have shown that if you take NR and NMN together, you probably would get higher NAD than taking the NAD molecule by itself because the NAD molecule may be too big. So maybe it’s better to take a precursor.
But there’s also some studies that people who took NR probably had a higher rate of breast cancer. We don’t know if that’s true or anecdotal. There are blood tests to check NAD level before you just take levels [00:39:00] blindly. But that’s, people have to decide if that’s the right supplement for them.
Dr. Weitz: What do you think about intravenous NAD?
Dr. Aziz: The, the studies show that it does increase NAD, but again, the molecule may be too big to enter the cells, so maybe it’s better to take the precursor.
Dr. Weitz: Okay. Even if it’s intravenous?
Dr. Weitz: Okay. Do you use a lot of nutritional supplements?
Dr. Aziz: So, I came up with my own supplement because I looked, in my book I have 20 supplements that have been studied for longevity, and they give them to all kinds of animals.
So we have fisetin, we have quercetin, we have NAD, we have alpha-ketoglutarate. So I talk in my book about 20 supplements that can extend life, and I talk about even some that have not been so much publicized, like, you know, vitamin K2 prevents heart attack, and we’re all deficient in vitamin K2, so I take vitamin K2 to prevent heart attack [00:40:00] and stroke.
Fish oil gives us four years of longevity. Vitamin D is the main reason we died so much during COVID. We had a very, we had 10 times more mortality of COVID than Japan and South Korea because our level of vitamin D was low and our immune system was low.
Dr. Weitz: Absolutely. I’m a big believer in all of those.
And omega-3 fish oil, I think you mentioned the benefits of that.
Dr. Weitz: You mentioned mitochondria, so right now to promote mitochondrial health, we have a number of newer supplements. What do you think about Urolithin A?
Dr. Aziz: Oh, that’s great. So for people who don’t kn- know what the mitochondria are the battery of our cells, and for them to function, they need a product called Urolithin A, and that’s only made in certain people who eat a lot of berries and a lot of berries in particular.
But some people are not able to make it, so some people, I take the supplement myself of Urolithin A because it protects the mitochondria. [00:41:00] Yeah, I like that supplement. It’s also mentioned in my book.
Dr. Weitz: Oh, okay. So which is some of the longevity interventions that you think are over-hyped and are not beneficial?
Dr. Aziz: We don’t have a lot of information on anti-aging for humanity in general. That’s why in my book I talk in general about we’re talking about plasma exchange. I mean, I looked into it.
Dr. Weitz: What do you think about therapeutic plasma exchange? I know Dr. David Haase,
Dr. Weitz: is doing it, and supposedly you can get rid of all these toxins.
He’s seen it reverse patients with Alzheimer’s and other chronic diseases.
Dr. Aziz: Well, it’s for people with autoimmune diseases, but we must know that the session is about $10,000. And for you to get two months extension of your life, you gotta do, like, five of them a year. So that’s totally insane. I don’t think that’s practical.
I just don’t think that this is really a, a good solution for people to live a long life. But I talk about other things in my [00:42:00] book. I talk about hyperbaric oxygen, which is possible that it can it can be beneficial for us to make more stem cells- Okay … which are the baby cells.
Dr. Weitz: You like sauna, cold plunge?
Dr. Aziz: Yeah, I like sauna a lot, and that’s from the Finnish study show that the men in Finland who uses the sauna three, four times a week have 40% less cardiovascular disease, so yeah, infrared sauna is great. And I also take Cialis, which is tadalafil, which is ED pill. And the study at Jama that just came recently about two, three months ago shows that people who takes, who take Viagra or Cialis have 30 to 40% reduction in heart attack and stroke because Cialis and Viagra also dilate the blood vessels, so it does the same thing like the sauna.
Dr. Weitz: What would you think about using nitric oxide supplements like beetroot?
Dr. Aziz: I’ve read some studies that it’s beneficial, but, you know, I am not sure if
Dr. Weitz: like- Be- because those also increase nitric oxide- Yes … production, which is how Cialis works.
Dr. Aziz: Yeah. [00:43:00] Yes. Yes. I take a daily Cialis, five milligram. It’s fine.
Dr. Weitz: Okay. So, let’s see.
Dr. Aziz: And we talk- I have to talk about the reduction of sugar. I also take metformin. Yeah. So metformin is a great anti-aging drug as well. Okay. So, you know, we have studies, human studies on people who take anything that drops the sugar, you get a halo effect of reduction in heart attack and stroke and dementia and possibly cancer.
And diabetics who take metformin, which is a diabetes drug, have less. They have a longer lifespan than non-diabetics. So I take metformin a gram a day.
Dr. Weitz: What do you think about berberine which has been shown to have a similar effect as metformin?
Dr. Aziz: Yeah, I talk about this also in the book. So, metformin, we have human studies.
We don’t have human studies on berberine, but if you take berberine, it does the same thing. It works on the AMPK pathway. You have to take it as dehydroberberine, not berberine, for absorption, and you have to take 150 milligram twice a day.
Dr. Aziz: The benef- and the [00:44:00] benefits of dehydroberberine, that you don’t lose the muscle like metformin.
So they say some people who take metformin, they don’t have so much muscle, which I don’t know if it’s, that’s true. It could be just because your sugar is a little low, so you’re not getting so much strength training that day. You don’t have that much power to do, like, 20 reps instead of 15. You know, 20, 15 reps instead of 20, something like that.
Dr. Weitz: Do you do you have a blood sugar target you like your patients to hit, like a fasting glucose level?
Dr. Aziz: I like the hemoglobin A1C to be below 5.6, so, you know, I want them not to be pre-diabetic.
Dr. Weitz: And- Is it better to be below 5.0?
Dr. Aziz: Well, the lower the better, as long as you don’t get a hypoglycemic episode.
Dr. Aziz: I’m trying to make anti-aging, You know, I’m not trying to make people like real biohackers like Bryan Johnson, and to make it like you do this- … and you do the plasma. I’m trying to give them simple tips of how to live better. So get rid of the bad habits, get rid of the [00:45:00] bad diets, get rid of the processed food, the chemicals, the seed oils, the vegetable oil, the trans fat, the artificial sweeteners.
Eat correctly. Eat a balanced diet. Cut the sugar. Do they need to drop
Dr. Aziz: No, but I think if they need to cut the refined carbohydrates. And they can eat as much bread as you want. If they wanna go to the Mediterranean diet and eat 11 pieces of bread, that’s fine with me. Just make sure you go to the gym at least four hours a day to to burn all that carb.
Dr. Weitz: What’s your recommendations for exercise?
Dr. Aziz: So, you know, there are three types of exercise. I think you have to do some kind of exercise, whether it’s aerobic, anaerobic. Definitely anaerobic and strength training as you get older, but the most impact on longevity, of course, is high-intensity interval training, but that’s very tough for people to do.
So I think once they get a clearance from the doctor that they’re healthy and they can exercise, they have to try to do some kind of high-intensity or HIIT, interval training at the gym. So maybe just get on the treadmill. They run for, like, two minutes, and then they can have to run so much that [00:46:00] they lose their breath for, like, a couple of minutes.
Or with weight training, they have to lift weights a little bit, but then you have to do it so much that, again, they lose their breath for two minutes.
Dr. Weitz: Is… What about heavy weight training? Is that important?
Dr. Aziz: I think that can predispose people to injuries. I think that’s only for bodybuilders. I think that’s for
Again, I’m not trying to make my patients bodybuilders. I’m just trying to make them live better and live longer. So, I’m doing a, basically giving them the right education to live better. But I’m not trying to make them, like, you know, superhuman.
Dr. Weitz: Yeah. Okay. I, I do think that heavy weight training is important if you wanna maintain your muscle and your bone density.
Dr. Aziz: Well, of course, but can everybody do it? That’s tough for somebody in their 60s and 70s. I mean, they have to go for higher levels of more pounds. They have to try to do that, but I think it’s tough as we get older.
Dr. Weitz: It’s tough, but I think it’s [00:47:00] still worth it. So, including myself, if we have this conversation 10 years from now, what do you think would be different?
Dr. Aziz: We’ll say, “Oh, my God, that guy was ahead of his time,” just like right here.
Dr. Aziz: that? That guy is ahead of his time. It was like we’re talking about peptides. We’re talking about things that nobody was talking about. So, you know, I think we’re still living in the Stone Age. I think a lot of- … doctors are
I really believe that. I think how many doctors are still, I mean, you know, we talked before we did the taping, but how many doctors are still giving patients low-fat diets or telling to use vegetable oils for their cooking or to eat, you know? Or, like, you have all those diets on the market that are New York Time bestsellers, and they’re recommending bacon and sausage and yeah.
And then p- people say, “Well, I lost weight.” Well, great, you lost weight, but you also possibly increase your risk for mortality or getting heart disease or cancer and so on. So I think this conversation may be a little crazy for some people to hear two [00:48:00] doctors talking about things that are not talked about a lot.
But I think right now is my new book and what we’re talking about, we’re ahead of our time because we’re talking about optimizing sex hormones with natural hormones, not synthetic hormones. We’re talking about peptides a lot of doctors don’t know about, and we’re still fixing the mistakes of the past about the low-fat guidelines and the seed oils and all that stuff, that many people are still stuck in the past.
I really wanna look to the future and hope to change how we age in this country.
Dr. Weitz: That’s great. I’m on the same mission.
Dr. Weitz: All right. And-
Dr. Aziz: Even though he did not agree with me on the Mediterranean diet. But you do see my point, right? 11 pieces of bread is a lot.
Dr. Weitz: Yeah. I’m not… You know, when I’ve heard the Mediterranean diet described, it didn’t necessarily include 12 pieces of bread.
Dr. Aziz: But I also talk about something else about the Mediterranean diet that is very limited. You know, we live… You live in California, I live in New [00:49:00] York. I wanna eat food from all over the world. I wanna eat French, I wanna eat Thai. So I cannot just have, you know, just, you know, octopus every day or just g- You know, I wanna eat Thai food, I wanna eat French.
I don’t think it’s practical, you know? So as long as you’re eating natural food, so if you wanna, if you like Belgian food, if you like French food, if you like Italian food, if you like Thai food, if you like Chinese food, you could do it as long as you’re avoiding chemicals, and as long as you know your food is cooked in a natural fat.
So I think just restricting it to olive oil is very impractical. You really… ‘Cause even if you lived in Greece, Greece is still a cosmopolitan country, and they have cuisines from all over the world. So you know, this, this study was done on farmers who did not know anything outside their little town. So I th- I don’t think not only it’s impractical, but I think the massive amounts of bread is just huge for all of us.
Dr. Weitz: Well, I think when it comes to Mediterranean diet, if you look at all the different studies, you’re gonna find that the different [00:50:00] studies describe it somewhat differently. And sometimes they just look at people in the United States, and they just have certain categories of foods that they consider part of the Mediterranean diet.
And if you sort of followed those parameters, if you eat a certain amount of olive oil, if you eat a certain amount of nuts and seeds, if you eat a certain amount of et cetera, et cetera, then it’s considered more Mediterranean, and that’s how some of the studies are done.
Dr. Aziz: Nuts and olive oil and fish is great.
I agree with all that. But I also wanna have cocoa butter. I wanna have butter. I wanna have coconut. I wanna have all types of cuisine.
Dr. Weitz: All right. That’s great. So final thoughts for our listeners?
Dr. Aziz: Well, thank you so much for giving me an opportunity to talk to your followers and to share my information with your audience.
And again you know, that was a great interview, so thank you so much for having me.
Dr. Weitz: How can people, how can listeners and viewers [00:51:00] get a hold of you, find out more from you, or visit your practice? Do you see patients remotely?
Dr. Aziz: Oh, yeah, I do. I have people calling me from all over the world now because my books have been, also been published in different countries and different languages.
But they can go to my website, michaelazizmd.com, or they can call one of the girls and make an appointment for telemedicine to help them with all their anti-aging needs or hormone replacement or peptides. But they have to do the right steps. They have to also get rid of all the bad habits because part of the anti-aging is 50% of what you do, I have no control of.
So people have to do the right thing when it comes to diet, sleep stress reduction, exercise, and then I can help them with the other part.
Dr. Weitz: All right. Great. Thank you so much, Michael.
Dr. Weitz: 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 [00:52:00] very much appreciate it if you could go to Apple Podcasts 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 wanna prevent chronic problems, and wanna promote longevity, please call my Santa Monica White 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.
