Dr. Kay Durairaj 0:14
Well, hello, hello, guys! You're listening to Beauty Bites with Dr. K, Secrets of a Plastic Surgeon, and today's podcast is going to be amazing. I have one of my good friends and mentors. He's an icon in esthetics. This is Dr. Mark Tager. He's a physician, an author, a healthcare communicator, and he is an integrative esthetics educator. I would say he literally has helped bring this term integrative esthetics into prominence in the last couple years. His work focuses on personalized nutrition, nutraceuticals, skin health, regenerative medicine, and the gut vagal skin connection. So he's helping medical professionals improve speaking and on camera presence. He's also CEO of ChangeWell, and he previously launched a little laser, the Fraxel laser. So he's helpful in the building and technology and the launch of Fraxel. He was an executive at Reliant Technologies for years, and currently he's co-founder, vice president, and co-chair of the Vagal Nerve Society. Now, this is an organization dedicated to advancing education about vagal nerve science, and it's something we don't know enough about. And I'm going to have so many good questions for you today about that. Welcome to the podcast, Mark.

Speaker 1 1:28
Hey, Dr. K, it's a pleasure.

Dr. Kay Durairaj 1:31
I am always thrilled to learn from you. I recently we did an all day conference in Vegas. That

Speaker 1 1:37
was great at

Dr. Kay Durairaj 1:38
the esthetic show, all about integrative esthetics. And you've written a book. You've written two great books. So this one is "Feed Your Skin. Feed Your Skin Right.

Speaker 1 1:46
That's the right is the most important word. Right.

Dr. Kay Durairaj 1:49
Yes. And that's going into its second edition launch. And then this one, which I love, which I think everyone who's interested in doing an integrative esthetics practice should get it as their bible. Integrative esthetics: Your roadmap for success. Yeah,

Speaker 1 2:03
thank you.

Dr. Kay Durairaj 2:03
Yeah, so that that's impressive in and of itself. How on earth do you find time to write two books? You know,

Speaker 1 2:09
there's something I I love writing. This is my this one's my 12th book, and I find that the actual act of writing for me is very centering. I get up early in the morning. There's no distractions, and you know how

Dr. Kay Durairaj 2:24
early? How early? I

Speaker 1 2:26
get around four, 430. Oh my god! So

Dr. Kay Durairaj 2:28
that's crazy. I'm so jealous of Euphoria. But I go to bed early. I go to bed early. So,

Speaker 1 2:33
but you know the interesting thing is, if you were to really define meditation, so I define it as when you and the act that you are doing are one, and time is flying, you're meditating. And for me, writing in the morning is a meditation.

Dr. Kay Durairaj 2:50
It's interesting because you can perceive on your own when your brain is in that zone of clear thinking, and it's not all the time. No, it's not. Yeah, but maybe you've trained yourself to be all the time on at that hour, it it

Speaker 1 3:02
just tends that that is what works with my biorhythms. That's when I'm at my most creative and my most focused. However, it's different for different people.

Dr. Kay Durairaj 3:14
Interesting. Now you talk a lot about describing beauty as an inside-out process that you've got to have the inner workings functioning correctly to reflect outer health and beauty. Can you explain what internal factors are causing skin to age poorly like that? No,

Speaker 1 3:32
I think you know better than almost anyone that if you do the same procedure on two different patients, and one gets an incredible result, and the other one doesn't. And you say, "Well, wait, I did the same thing, and the answer and the difference lies in the health of their tissue. You know, we spend close to about 180 billion dollars a year on topicals, things that we're smearing on our faces, and our necks, and our arms, and other places, and when you think about it, right now as you sit here, any place from five to 10% of your blood flow is going through your skin. Wow! So if you think about the delivery of nutrients, of antioxidants and vitamins and minerals and other important cofactors. That is beauty. That is the essence of beauty from within. So that's where the nutrition piece fits

Dr. Kay Durairaj 4:32
in. And people just put so much crap in their bodies too, and they don't think twice about ingesting, you know, yeah, we junk food and highly processed foods and chemicalized foods.

Speaker 1 4:44
So the sad diet, the standard American diet, is indeed very sad. And you know, one of the issues. I mean, folks take in over 100 pounds of refined sugar every year, and it's hard to get people off of that. And one of the things that I found really can be helpful is, just like hemoglobin A 1c, in which the sugar molecules attach to the heme, in this case sugar also attaches to collagen, and it glycates it. And when collagen glycates, that collagen becomes stiff and brittle, and then we get those lines that appear in the cross hatching. So the the same person who maybe wouldn't be as interested in dropping sugar for their hemoglobin A 1c might possibly, and we look we all look for these motivations, be interested in the fact that that glycated collagen, the half-life for that is about 10 years. So when you glycate your collagen, it stays that way for a long period of time. So we we really and and I advocate that one of the most important things that physicians can do, any kind of clinician, is to teach people to read food labels and look for the amount of hidden sugar that's in food. It's it's amazing. It's a huge

Dr. Kay Durairaj 6:09
thing. I recently started wearing a glucose monitor, continuous glucose monitor, which you can buy over the counter nowadays. The Stello is available to consumers, and it's fascinating because it teaches you the cost of food. Like you quickly learn. Like I cannot have a Starbucks sugary drink. I don't need that. I cannot have a number again because like I never knew that just eating crackers or you know pita chips was going to be so bad for me. So now I'm all about protein. All about really thinking: Is that sugar worth

Speaker 1 6:40
it? Yeah. The other thing that I I think that's difficult is the concept of fiber, because you know fiber is the food that the good bacteria eat in your gut to produce those short chain fatty acids, which by the way go to the skin, and the neurotransmitters that work through the vagus nerve, the brain, and if you think about it, if you've ever tried to get about 30 grams of fiber every day, it's work. I mean, it's hard, but you are nourishing your gut and the back, your healthy microbiome and your skin when you do that, so I think that that's a it's a conscious effort. I think it's a little harder. It's harder, in fact, than doing protein, than kind of calculating. Okay, how much protein am I getting? How much fiber? There's not

Dr. Kay Durairaj 7:34
like a good fiber calculator out there. I think you kind of just have to look at charts and figure out what does an apple have, what does a broccoli have. You know, exactly.

Speaker 1 7:42
I mean, I I think a lot of it is about four to five grams per serving. So you know, your oatmeal is four to five grams. You throw some walnuts in there, a handful of walnuts, four to five grams. Some chia seeds. So you can get a 1012, gram breakfast fairly easily, I think.

Dr. Kay Durairaj 8:02
That's that's a good goal, a motivation to have that because I think fiber and vegetables maybe even comes sometimes before protein because then you can get your legumes and your various beans and things that give you protein anyway while adding fiber. Sure,

Speaker 1 8:16
and the other thing you know, I I've really gotten into gardening in my advanced years, I'm a gardener, and I love it. I've got a big garden, and I go out in the morning and I look at all the different colored plants, and I think to myself, these plants are really smart. They're all these different colors because they are trying to protect the plant from the harmful rays of the sun, so that when you eat these plants, these richly pigmented plants. You are actually taking in the antioxidants, and they actually have a protective effect. It's not huge. It's not like sunblock, but it's maybe the equivalent of an SPF of three or four. So you you think that they're doing that for the plant. They could do it inside out for you.

Dr. Kay Durairaj 9:04
So true. And then you get the benefit of forest bathing, which recently I was reading that plants and trees in the forest emit phyto molecules that you actually breathe in and give kind of a restorative resting effect. So if you wonder why you feel calm after going into nature. There's a reason. Yeah,

Speaker 1 9:23
and the also there's also research showing that they have sounds. They put out sounds. Yeah. So vibration. If you think about, yeah, this is very California of us. I like it. But we can let's do vibes. Let's you know we're in California, SoCal. Let's talk about the vibes. And and I think you know as science has begun to look at and investigate the elements of well-being, we have to really keep in our minds vibration. So we're sitting here right now, and you can measure the rays, the vibrations coming from our heart. With a sophisticated electromagnetometer, three feet, three feet away. So right now, if we are within six feet, we're bouncing off of each other. Well, we're bouncing off, but we also have the opportunity for resonance. Yeah, and resonance is that very special moment when you're you're in sync, when you know we see it in the in the therapeutic relationship, when you're making eye contact and you're you know you're you're right there with your patient. So so this is this concept of resonance, which takes us to heart rate variability and takes us to the vagus nerve. Wait,

Dr. Kay Durairaj 10:40
do you think there are certain people that emit vibes that you perceive as your body does not align and they're anti-frequency with you? That must be because sometimes you just see a person in a room and you just know that they're not your person.

Speaker 1 10:53
Well, I have a whole nother system on that. That some years ago I created. I wrote a book called Transforming Stress into Power, and what we did was we looked at personality traits. We had been teaching my colleague and I at Myers Briggs for a long time, and we found that certain types of people were stressed in certain kind of ways. Now, the way I explain that is for anyone out there who has more than two kids. This is your test. Okay, here's your test. Let's assume they came off the same manufacturing production line. With which statement would you agree? Oh, my two kids are so much alike. What stresses one isn't what stresses the other. I I have to deal with one differently than the other. You know, I kind of like this one. I love them both, but I like this one. We vibe better. Would you say that, or you just say, wait a minute? Who are these two kids? They're night and day different, and I think there are unique aspects of personality, type, and temperament that that and those folks vibrate differently. They are relationship people, much more in tune to the feelings and needs of others. Logic people, very analytical and sequential. Creative people, ideas, possibilities, grounding people, focus. So I think there's there's some overlays there. It all comes it comes back to there's some vibrations on top of a base of type and temperament and personality, and then your ability to manage the workings of your internal autonomic nervous system, the parasympathetic system. Peace, rest, relax, digest.

Dr. Kay Durairaj 12:40
That falls right into what I want to check about next-the vagus nerve. So, basically unheard of, and thought to just regulate breathing and you know baseline functions of digestion, like you said. But honestly, does so so much more than that. It touches

Speaker 1 13:00
every organ in the body. It is the largest organ nerve in the body. It is called the the vagus because it wanders. So it goes like a vagrant. Like a vagrant, it goes out the brainstem. It goes into the to to the. There's a little branch. It goes to the ear, but the the majority of it is found right there, right where you feel your pulse. It runs in a sheath with the carotid artery. Exactly. It is. This is the important piece: is that 80% of this nerve is afferent. In other words, it is sensing information from your gut, from your heart, from your spleen, from your liver, and feeding that up to the brain. The brain then modulates those those signals via the vagus nerve. So this is this large feedback loop. So 80% up, 20% down. It touch it in the heart. It's responsible for slowing the heart, dilating the lungs for breathing, it is responsible for peristalsis, which is this nice, excellent movement of the gut that moves food through the body. It it goes down and as far as the the pelvic organs, but it it touches every every single part of the body. Now, what's interesting about the vagus nerve? You know, most of our our autonomic nervous system is not under our control, but we can control certain aspects of our parasympathetic system, and that is the ability to slow down our heart rate, reduce some of the stress that that's coming in our body. You know, I think that anybody in healthcare today will recognize that many of the patients who come see us are. Wired and tired. I mean, they're wired because of the the frantic looking at their phone, all the inputs. They've got way too much stimulation, and they're tired because let's face it, a lot of folks are not sleeping.

Dr. Kay Durairaj 15:14
Right.

Speaker 1 15:14
So they they don't have the ability to tap into the rest, restore, digest component of the vagus nerve.

Dr. Kay Durairaj 15:24
How do we reset that for ourselves? Because I think you're right. We are wired and tired, and even if I want to rest on the weekend, it does take a while to let the cortisol wear off.

Speaker 1 15:35
Yeah, yeah. So, I mean, 50 years ago, I wrote about deep breathing being first aid for the for stress, and it's still and it still it hasn't changed. I mean, the the number one thing you can do is breathe. The

Dr. Kay Durairaj 15:53
474. I like the four seven. I like 478.

Speaker 1 15:57
There's also box breathing, but 48478. is in for four through the nose, hold for a count of seven, and out the mouth for a count of eight. And you know, I think this is, by the way, a great thing for practitioners to do with patients. They, oh, Doctor K, I'm, I, I was caught in traffic. I'm so sorry. I'm, I'm half an hour late for our appointment. I don't didn't mean we. Yeah. Best thing you can do say, I get it. Let's take a minute. Let's be here now. Let's center ourselves. We'll have a. We'll both have a better experience. I mean, so it's so

Dr. Kay Durairaj 16:34
funny because I do that with patients. I'll tell them I need to do three big breaths with you to bring your blood pressure down because that literally does and helps for less bruising, and but also puts us in a calm mindset, like able to accept the beauty. Yeah, and

Speaker 1 16:48
able to sort of relax and and be there. So I think that's a that's a piece of. Now there are devices. The two non-invasive methods involve either auricular, which is a small little branch of about 1,600 fibers in the ear, but the main one has to do with the we call transcervical, and there's a device called true Vega, T-R-U-V-A-G-A, and it's excellent. You can the protocol very simply is usually two two-minute stimulations. Have you tried

Speaker 2 17:21
it?

Speaker 1 17:22
Oh, I use it all the time. Really, not just try it. That's why you're so calm and grounded. Well, along with you, I'm excited, but but often, you know, it is. It's a great device. It's wonderful for bedtime. You know, a lot of folks they they get they either can't get to sleep, or what happens is they wake up at three in the morning, two three in the morning. So this is a is a great device. You do about two two minute stimulations very simply. Is there's no pain associated with it, and and studies have shown that it's it's really good for focus, concentration, and sleep. There's another. So the device that I'm most familiar with is Tru Vega, and it's a non-invasive device. You just put it up to the neck. It works with a little app, and it's two two-minute stimulations. I tend to do it first thing in the morning to focus me again. My wife uses it at night to help her sleep. It's it's wonderful for that. There is a another device that that the same similar technology that is FDA cleared from migraines. So it has a. This is a Truvaga has a 14-year history of development with enormous amount of research behind it and multi-million dollars. So that's a simple thing. You can just get that online.

Dr. Kay Durairaj 18:51
Do you need a prescription?

Speaker 3 18:52
Nope. It is. It is. I think it's like

Dr. Kay Durairaj 18:54
two, $300. Yeah,

Speaker 1 18:56
several $100, but it's well worth it.

Dr. Kay Durairaj 18:58
There's a new device I was reading about that works on the auricular branch of the nerve. That's like a cutaneous little in the ear stimulator. Have you heard about that? The

Speaker 1 19:06
challenge about all the auricular ones is you have to have that on for 2030, minutes because it's just a tiny small fiber that goes to the vagus. Where here you've got 160,000 fibers. You got you know a small percentage of that in the ear. So this is the superhighway, and that's why the the transcervical or through the neck, through the skin of the neck, is I think the best.

Dr. Kay Durairaj 19:36
So if you have a dysregulated vagus nerve and you're chronically wired, what kind of symptoms are you going to have? You're going to have poor digestion, poor nutrition.

Speaker 1 19:46
Well, you will have poor skin. You will have poor digestion. You will also here's something I want you to hold on to, and this is really important. So, you know, we know that curcumin and ginger. And omega-3 fish oils all downregulate inflammation.

Dr. Kay Durairaj 20:06
Yes. Okay.

Speaker 1 20:06
How do they work? They work via stimulating the vagus nerve through something called the inflammatory reflex. So what happens? Remember, we talked about the fact that 80% of the vagus is afferent; it's picking up signals. So, you've got inflammation. You've got these little molecules called cytokines, TNF alpha, and things like that. And the vagus nerve is picking up on that and going to the brain. Now, the same time, things like curcumin and ginger, and to some extent boswellia and other herbs and fish oils, they work via that same thing. They send help send the messages up to the brain, and they go back down from the brain to that body part, often the spleen, to downregulate, calm down, chill the mast cells that are responsible for perpetuating the inflammation. So this is the inflammatory reflex, and increasingly, what we are learning is that many of the modalities we use, many of the therapeutics, work via this anti-inflammatory reflex, which is really powerful. And and I'll tell you another little factoid for those of us who like little factoids. The gut produces 80% 90% of the serotonin and the the GABA and these brain neurotransmitters that are essential for mood, for mental acuity, etc. Those neurotransmitters that are produced by the good bacteria in the gut do not cross the blood-brain barrier. They they just don't go via the blood vessels to the brain. They work by tickling again the vagus nerve to get to get this this response to get this this anti-inflammatory response. So I think that and and the neurotransmitter responses that we want. So I think that's a another central feature of how this nerve is kind of wired into a lot of stuff.

Dr. Kay Durairaj 22:20
So interesting, and the centenarians who live to be 100 years old, when they look at their guts, they all have like a high population of certain bacteria, maybe related to diet, but those happen to be bacteria that produce more of this. We

Speaker 1 22:35
call those the commensal, the OGs, the O, the really the good guys like Acromansia, for example, and and what we really have that is such a shame is we have an epidemic of two things for the gut. One is leaky gut, which is the separation of the the cells that line line the gut. And by the way, we have seven layers of skin cells. We only have one layer of cells lining our gut. And you think about that. I saw that

Dr. Kay Durairaj 23:09
in your lecture the other day, and I was like, that stuck with. I

Speaker 1 23:11
mean, that one

Dr. Kay Durairaj 23:12
layer of cells. It's like, what kind of insane engineering project is that? Everything bad comes in through the mouth, and then leaks right into the system. Exactly,

Speaker 1 23:21
and you know, when I believe it or not, when I was trained, we were taught that these cells are glued together. Yeah, and in reality, it was watertight. Watertight in the late 70 s, the Japanese researchers found it. No, you can get a leaky gut. You can get increased penetration through these these junctions. So now what now what happens? What that means is that undigested protein fragments, little the the wrappings of gram negative bacteria, get into the system, and they travel, and they travel to the brain. They travel to the knees. They travel to the skin, and in some places they're like a mimetic. In other words, let's say you get a little protein in the foreign protein in the bloodstream goes to the knee, and it sort of looks like it could maybe fit into a cartilage. I know this is a simplistic way to think about it, but what happens is it gets in there and it doesn't quite really fit, and so we have an inflammatory process taking place. So there's that, and then there's the dysbiosis. Dysbiosis is when you have a disproportionate percentage of bad bugs in your gut. Now we all have the bad bugs. I mean, but if you've got a disproportionate, then they are crowding out the good bugs. They're putting out more of these potential lipopolysaccharides, these little toxins that can go into the bloodstream. They are they're crowding. Running out the good guys that are making the neurotransmitters and the acetate, propionate, and butyrate, short chain fatty acids, which are critical for health, for the organ health, and for skin.

Dr. Kay Durairaj 25:13
So interesting because you, if you change the gut biosis, you can change the whole organism, like these

Speaker 1 25:19
exactly

Dr. Kay Durairaj 25:20
incredible studies that show elderly rats, when given the gut flora of a young rat, yes,

Dr. Kay Durairaj 25:26
will transform into a younger organism.

Speaker 1 25:28
Well, there's the the whole movement of fecal microbiome transplantation. Yes, I mean is when you think about that and you go back to these studies where you take again the the fecal matter and you transplant that, and you get this incredible change. Now, what we do know here's the good news here because I don't think we're all going for fecal transplants anytime soon. Diet will change the microbiome.

Dr. Kay Durairaj 26:01
Consistently good. three four months

Speaker 1 26:04
actually in a short period of time, but you need to maintain it. But you can actually get changes. You'll changes within weeks 334 weeks. So the goal, of course, is the maintenance. So you can do that, and then you know. I think we, if we get the sugar out, get the fiber up, you start leaning on the fermented foods, on the kimchi and the sauerkraut. I mean, sauerkraut goes doesn't go on a hot dog at my place. It goes on eggs in the morning, which is a great way to get. Oh, that sounds good. I mean,

Dr. Kay Durairaj 26:41
I have to try that.

Speaker 1 26:43
I had that this morning with a little homemade potato salad my wife ate.

Dr. Kay Durairaj 26:47
Love it. Well, yeah, that I think the idea that people have that they can take a probiotic pill and fix things does not work because that just kind of flips us right through if you haven't built the forest for the bacteria to live in. It's a

Speaker 1 27:01
piece. I, it's it's not just one thing. It is you lean on the fermented foods, you increase the fiber. I'm a big believer in probiotics. I like the spore based ones because they survive the harsh GI tract. There's a company called Microbiome Labs, and they have a product called Megaspore. The other thing that we're learning, and I think this is fascinating, is that we used to think, "Oh, it's a probiotic. I need millions of millions of colonies, billions and zillions, and and and and what we're seeing now is that there's an increased knowledge and awareness of specificity, so there are specific strains of particular bacteria that do certain things. So, for example, microbiome labs. I know they have a sleep product and a coping product, and they have these specific strains of bacteria that have been really well shown to calm things down or enhance cognitive function

Dr. Kay Durairaj 28:10
or create more happiness, the oxytocin. Yeah, yeah.

Speaker 1 28:14
I just did a produced for the Vagus Nerve Society. We did a series on women's health and the vagus nerve, and I had the opportunity to interview and produce a piece by Sue Carter, and Sue Carter is the oxytocin expert in the world. Period. End all end of discussion. One little thing stuck with me, and this is the tip. and And I was always thinking myself, why are we talking about people drinking more water, drinking more water, drinking more water? You're not getting enough water. You need water for your skin. It's essential for the oxytocin release.

Dr. Kay Durairaj 28:50
Really? Why? Yeah. Because of the whole ADHD. Yeah,

Speaker 1 28:53
exactly. So I think to myself, okay, I'm going to drink more water now, so I can be happier.

Dr. Kay Durairaj 29:01
That's interesting. Okay, that's not good because I don't drink enough water. Yeah, but I'm not like a person who chugs water. You could

Speaker 1 29:09
be. I could be happier. You could be happier. I have something to work on.

Dr. Kay Durairaj 29:14
Oh my goodness! Well, I love the idea. There's that lactobacilli rootary that. Yes. If you have that, it creates apparently more oxytocin, more happiness for you. Yeah, I've been I've been taking that, so maybe that'll compensate for lack of water. Drink the water too. Okay, I gotta talk about peptides because at your integrative esthetics day, peptides are they're all the rage. There's so much demand to learn it. What are your thoughts on peptides right now? Like we dove wholeheartedly into peptides for a while, and then we've-I think that our thinking is changing.

Speaker 1 29:48
I'm going to actually defer to you on this, and and we did this panel together, and I thought that your take on peptides was so spot. On right now, it is the wild, wild west. This is 500 billion, a $500 million going to a billion dollar industry. There is so much confusion there. An example: you go online and say, "Well, we I only take research grade. Oh gosh! I mean, just think about that. It says it is not for human consumption. Really, these these things. So that that's scary. You don't know where it's come from. You don't how it's been manufactured. You don't even know what's in it. So I think that we've we've we've got a land grab here in which you've got some good, legitimate, wonderful compounding pharmacies doing some good work, and you've got everybody else trying to grab money on this. As a practitioner, I mean, I would I would turn to you on this and for your take because I thought your take was brilliant. My concern is that we never we don't know the consequences of these, and there may be consequences that we can't even imagine, or there can be consequences that, for example, you know you've got a peptide that is increasing Vegf, which is an which is a growth factor for vascularity, and if you had a small tumor that is invading blood vessels, okay, and you're doing this peptide, you know that worries me. That worries me. So I would turn to you. I'm going to stop here and say, Doctor K. Let me. I'll become the interviewer. Doctor K, you are an expert, and you just gave some great talks at the esthetic show on peptides. So, what is your recommendation for practitioners and patients?

Dr. Kay Durairaj 31:56
Well, you know what I think. I love the idea that we want to have optimization, human optimization of performance and strength, and like maintain our 30-year-old health. You know, love that. But then, like you, I want I want a practitioner who's going to be so super thorough that they give me a whole screening before starting me on anything because

Speaker 1 32:17
absolutely the

Dr. Kay Durairaj 32:18
the enemy of good is better. I'm running good right now. If I inject something and I don't know the ingredients and they're not vetted, they're full of heavy metals potentially. Potentially, it's water. Some of these products are sold and you find that there's no peptide in them. So I think all those things that you have to check a full blood panel. You need biomarker testing. We need to know if you're full of inflammatory markers, if you have cancer markers, have you had a mammogram? Have you ever had a colonoscopy? Because like, there's so many of our patients out there that haven't done the basic testing, but they want to go for the peptide, and like, you might have a breast lump, and I didn't check your breast, and here we're gonna feed it some VegF producing peptides, angiogenesis and BPC 157. Like, and looking at the studies that are out there, there's not a lot of human evidence, not much. I'm sticking to FDA-approved peptides for the moment, and I might try things on myself one by one after I've really read about it. But I'm really gonna do the homework for my patients because I owe that to them to do no harm first.

Speaker 1 33:22
We really must stress great assessment and assessment. Screening and assessment first.

Dr. Kay Durairaj 33:32
Metabolomics, like what's going on in this person's profiles, their genomics. Have you checked them for gene deficiency, gene errors?

Speaker 1 33:40
I think this is, you know, I, I'm in the process as we speak of reworking a gene test for skin, skin and hair health right now, and and this to me is is such an important area, because I'm just giving a personal example. I disclose a little bit. So my vitamin D level, left to its own devices, is 18.

Dr. Kay Durairaj 34:03
Yeah, very normal. Which is very, very, very napthorn.

Speaker 1 34:07
Exactly, it's, and it should be 60. You know, 6070, So why is that? Because I have the genetic SNIP, the single nucleotide polymorphism, a genetic variant, that doesn't allow me to hydroxylate the vitamin D in my liver, which is the physiological process of tacking on a hydroxyl group, which is essential to make it active. So does my son. So does my daughter. So here's where personalization comes in, and I really have a problem with some doctors who say, "Oh, you don't need vitamins and supplements and such and such. You get everything from your food, really, please. You don't because they haven't seen what people eat every day. But the other piece is, you know, I've just experimenting with myself. I have to take about 7500 units of vitamin D a day, and you say, "Oh my goodness, that's so much to say to stay at 60.

Dr. Kay Durairaj 35:09
Really?

Speaker 1 35:10
Yeah. So it's it's because I'm not hydroxylating it. So interesting. So so we can learn these these kinds of things. We learn about for the skin the extent to which we break down our collagen? Are we faster or slower? Pigmentation, the tendency towards scarring with acne pigmentation, barrier your the the the essence of your skin barrier for water loss. So I think that's another piece of it. So all of those labs and genetic testing, and if you go one step further, you're into epigenetics, and which is much more malleable. And you know, people ask me to explain epigenetics, and everything that you do, your thoughts, your childhood experiences, the food you eat, the air that you breathe, the stress that you carry, turns on or off genes. One of the studies that that really moved me to consider the power of lifestyle, because you know, here's what I can tell you: there's no way that as a practitioner I can out supplement a patient's crappy diet. He can't do it. And I was touched by a study that Dean Ornish did some years ago in San Francisco. He took men with prostate cancer, Gleason six, a certain kind of score. Half of the men had just watchful waiting; the other half had his protocol, which was meditation and exercise and eating well. And the results were staggering: that the men who had watchful waiting went on, many of them had needed their prostates taken out, whereas the lifestyle group had did very very well. So I just think that you know. Here's the other problem: is we all know that the power of lifestyle, the power of exercise. I mean, you want to raise your nitric oxide to protect your endothelial health. There's really only one thing that really does it, and that's exercise. Nitric oxide obviously is a piece of that, but but this is that's a the amount of fat you take in, the number of calories. So we the challenge, of course, is that practitioners don't get reimbursed for lifestyle. It's pretty hard. I mean, if which is I think the rush to peptides. In fact, because peptides, there's science there. I'm not going to belittle the science. Everything is a pro and a con, okay. But it's a lot easier to sell someone an injection or a pill than it is to help them go and improve their lifestyle, what they eat, because these are deep ingrained behaviors. They're tied to emotions and childhood upbringing, and and but when you see someone who embraces wellness and they start exercising when they haven't done it, they start eating well, they start doing a centering practice, meditation, yoga. You see this incredible transformation in them, and and that is, that's the most rewarding part of I think this lifestyle movement, wellness, healthcare.

Dr. Kay Durairaj 38:49
It's amazing. If you are a person who's listening, if if there's a consumer out there listening, what are like three things that they should incorporate from the biohacking lifestyle and supplement world and top three things because I don't know if you make a list of 20. I love this

Speaker 1 39:07
question because you know this book

Dr. Kay Durairaj 39:08
right here. This book had

Speaker 1 39:10
answered four questions that that I've I've gotten from the beginning of time. What should I

Speaker 4 39:15
eat?

Speaker 1 39:16
What supplements should I take? What topical should I apply? Right there. And what procedures should I have? And everyone says, "Just give me the one. Give me three answers,

Speaker 5 39:24
and

Speaker 1 39:24
I have one answer for you. It depends.

Speaker 5 39:28
And

Speaker 1 39:28
so we think a little bit about. We go back to the assessment and the biomarkers, and taking that great history, understanding the the timeline of that individual, figuring out, you know, doing starting the negotiation, figuring out where in fact people are in their in in their contemplation of change. Are they? I'm well. I'm fix. I love Texas. I'm fixing on doing it. Well, does that mean you're doing it or you're not doing it? Are you committed to doing? I'm fixing on it. I'm fixing to change. I'm fixing to change my diet. I'm fixing to start exercise. So I think there's a process now. It is unfortunate that the biggest wake-up call comes at a point of crisis, at a point of injury, the heart attack, the death of a loved one, when people sort of get shaken up, and go back and reflect, and they now have a new openness to looking at their health and well-being. Now I have to say something good about GLP ones because I was really not that keen on them initially, but as we see that people develop this locus of control, and they're beginning to see these changes in a rapid fashion, they actually start exercising more, and then they're they're being more active, and they're out and about, and many of them are changing their dietary patterns, so I think that success breeds success. You know, and and I do like the fact that for many folks who struggled and struggled and struggled with with weight and and satiety, this is pretty helpful.

Dr. Kay Durairaj 41:18
I think it gives them motivation to see a new version of themselves, like you know, that they didn't know was possible or fixable.

Speaker 1 41:25
You know, how do you look into the future and see that possibility? And and what does that look like for you? Can you create in your mind and your heart a vision of yourself being alive and vibrant and energetic and and healthy and trim and fitting into your clothes, if you can put that into your mind, and I think the GLP ones have actually helped do that, because now people look in the mirror, they they they see a that they've got a sense of control, they see a possibility that wasn't there before for them,

Dr. Kay Durairaj 42:04
and the entire anti-inflammatory benefit that a

Speaker 1 42:07
lots other resetting

Dr. Kay Durairaj 42:09
of the mTOR and cell cycle, and so many other great benefits. So yeah, I think they've been game changing. Yeah,

Speaker 6 42:15
has

Dr. Kay Durairaj 42:16
your definition of let's just end with looking back in your career. This aging beautifully means something different to you now than it has in the beginning of my career. This is

Speaker 1 42:25
really interesting. I'll share with you a personal story. So, you know, I I've been doing this for 50 years. I just put a little LinkedIn post of a picture of me when I started the Institute of Preventive Medicine in in Portland, Oregon, and back in 1976, and I saw patients for an hour at a time, and I taught Monday night yoga, and you

Dr. Kay Durairaj 42:51
did, yeah, I did. That was great.

Speaker 1 42:53
So I start, you know, you look decade by decade, and it's interesting because you know, as I go out into the the world that we're in with these conferences, I see a lot of my buddies, and we're sort of all there's a cohort of us that are aging, hopefully well, and we share these you know sorts of things about how are you doing, how are we doing. So what will I recommend? I'm going to do a couple of things. I rarely do this. I normally say it depends, but I'll give you three answers. Okay. One is I think attention to understanding body composition is critical. Okay. It is. It is not weight. It is body composition and muscle mass. So you can go right here in LA and get a DEXA scan for 75 or $100, and know not just your bone density for osteoporosis, nosteopenia, but it will tell you your percent body fat, your muscles, and how much muscle you have. So muscle is the key metabolic fuel. It is also a produces hormones. It produces myokines. These myokines go to your brain and make you HAPPY. So that's a good thing. So the first thing I think is is really understanding body composition. I think the second is, you know, we're faced with so many opportunities and choices of food every day. You got to be disciplined. I mean, the healthiest people I know are the most disciplined. You just no thanks. You know, occasional drink, never eating to the point of being full. As you age, cut your food in half, share it with somebody else. I mean, you just don't need the the caloric thing. And the third piece is, and this is interesting because in this book, in the last chapter, you meet my my 15 year old Maltipoo, who since passed, and and it's really sad, and it's a story of resonance. You know, with with heart energy touching and breathing, and so I. This is terribly personal, but so I went to my doctor because I have a doctor. I you know I have to have a doctor too. Everybody should have a good one. I said I have a question for you. Can you keep me going for another 17 years at least? He said, "Yeah, yeah, we can do that. We can get you, you know, to your mid 90s. I said, "Okay, thanks. And I went out and bought a dog, a little puppy. I bought a I bought a little another little Maldi poo recently, just 72 hours ago. Oh,

Dr. Kay Durairaj 45:40
that's so exciting!

Speaker 1 45:41
She's probably home right now, chewing up all sorts of stuff in the house. So, you know, the the idea here for me is that there's a there's a high touch, high resonance. Not made

Dr. Kay Durairaj 45:52
me tear up. That's so cute. You're gonna stay alive. Yes, 95. I predict. Okay, stay with that multi crew. Just

Speaker 1 46:00
just to get, so I think you know the sense of of being loved and loving. I have a wife 40 years. It's different. 41 years. Your dog is different. My dog is different. But of course, my I will share the secret of being married for 41 years. Yes, honey, you're right. I'm sorry. I'll never do it again. That's part one. Part two. Part two is I travel about half the year, so I've only been home 20 years of it. So, but those I think you know. Look, if you look at what is psychological hardiness, what does it mean to be mentally resilient? Perceived sense of control, a willingness to reframe problems as challenges, a sense of commitment, so that you and what you are doing are one. There's no, I value one thing, I do a second thing, that you don't have that. And the fourth one is connectedness. So, the puppy, her name is Cayenne because she's real peppery looking. She helps me with connectedness. My wife's got I got the commitment stuff down. Challenges, you know, I've solved enough business problems to know that it's just another problem. And for me, control is putting one foot in front of the other for exercise, moderating my diet, being in control of my breathing and my parasympathetic nervous system, I can turn it on at will. I can improve my heart rate variability, which is a measurement of of vagus nerve tone. So those are the kinds of things I think about that model of the C's again, control, challenge, commitment, connectedness. So that's the inside game of longevity, I believe,

Dr. Kay Durairaj 47:50
and aging beautifully. Yeah. Yes. Like a really honestly good advice from the heart. I I hear you, and I think also having passion because you are passionate about this teaching and writing and your industry. I

Speaker 1 48:07
believe that people ask me. A lot of my colleagues say, "Well, why do you do all this stuff? Why aren't you retired already?

Dr. Kay Durairaj 48:14
Yeah.

Speaker 1 48:14
And my response is, everything that I do enthuses me. So I would, you know, I ask people all the time, are you getting excited by what you're doing? Is there passion there? So I love to be in a room where people burn with passion. Now it may not be the passion for the same thing that I burn for, but I think that's an essential part of human drive and behavior and and and healthy longevity. I mean, I intend to stay passionate about stuff at least 17 more years. I

Dr. Kay Durairaj 48:51
love it. Oh my gosh! Well, we're going to lecture on a lot more stages. You got it. Yeah, my pleasure, Kate. Thanks so much, you guys. This has been so powerful, motivational, educational. It's all the things you need in a good podcast. Where can people find you, Mark? On all your hands. You know, you

Speaker 1 49:06
can hit me at DRM Tager. That's the easiest place. My books are on Amazon. For if you're professional, hit me up on LinkedIn. That's pretty good. Yeah, I do a little TikTok stuff reluctantly. I mean, I can dance, but I don't. Make you do a TikTok now.

Dr. Kay Durairaj 49:22
You know that, right? Oh my gosh! But that's

Speaker 1 49:26
that's the easiest way to get to me. And LinkedIn and Instagram, those are both good.

Dr. Kay Durairaj 49:31
Amazing. Well, I always say surround yourself with people smarter than you and better than you who motivate you. Mark is one of those people. Ah,

Speaker 1 49:38
thank you.

Dr. Kay Durairaj 49:38
That's it for now, guys. I hope that you were motivated. Stay energized, get focused, disciplined, and I think that life is ours to seize. We're gonna age beautifully.

Speaker 1 49:50
Amen.

Dr. Kay Durairaj 49:51
That's it for now, guys. Stay beautiful. Don't forget to find me on my Instagram. It's Beauty by Dr. K D R K A Y, doing amazing things with people's faces. Wellness, longevity, the whole picture. Trying to be a role model for all you guys out there, and finding great colleagues to bring you knowledge. That's it for now, guys. Stay beautiful.

Transcribed by https://otter.ai