Join us for a fascinating conversation with Dr. Michael Snyder, Professor of Genetics at Stanford University and Director of the Center for Genomics and Personalized Medicine. Dr. Snyder shares groundbreaking insights into aging, discussing how major changes occur in our 40s and 60s. Learn about the future of health monitoring, including wearable devices that can detect illness pre-symptomatically, and the potential for genome sequencing before birth. Discover how strength training, continuous glucose monitoring, and other interventions might shape the future of personalized health and longevity.
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The Future Of Personalized Health – A Conversation with Michael Snyder
Hi, everybody. Welcome back to the Futurist Society, where, as always, we are talking in the present but talking about the future. Today I have a very special guest that I’m very excited to speak with, his name is Dr Michael Snyder. He’s a professor of genetics at Stanford University, as well as the director of the Center for Genomics and personalized medicine.
Thank you so much for being with us, Dr Snyder. I know you’re starting a lot of companies and I’d love to get to talk to you about the different things that you’re doing in the private sector, but let’s talk about the public sector for just a second.
Study Results on Aging
You recently just published a really influential paper that’s making the circuit of people like myself that are interested in this kind of thing. You’ve noticed that aging happens in two real hot spots in our timeline. It happens in the 40s and it happens in the 60s. And I just want to kind of get to the basis of, from a genetic standpoint, why that happens, so we can all understand and hopefully prevent some of these things from happening. So can you tell us a little bit more about that research paper?
Sure. So what we do is we profile people really deeply, meaning we’ll take their blood, their urine, even their stool samples where we study their microbiome. Which you may know, has a lot of bacteria that are very, very good for you. We literally make 135,000 measurements every time we sample someone.
And we’ve been doing this on a group of 109 people now for about 10 years or so. And so basically, by doing these detailed profiles, we can see what’s going on. How they change. We can also compare across different people. And what most people expect is, as you get older, you just gradually see these changes that occur. But what we discovered is that it’s not so simple as that. They’re really bursts of activity, meaning in your sixties and in your forties, you’ll see a lot of changes occurring. It’s not just, you know, a linear change, so to speak, there’ll be these dynamic periods.
The one in the 60s we expected. Disease risk, we know, goes way up as you hit your sixties. Your immune system declines. That’s why you get vaccinated, for example, for COVID and influenza.
The one in the 40s was quite a surprise to us. I wasn’t necessarily expecting it, although in hindsight I think it makes sense. People do injure themselves and other big changes do happen, at least anecdotally. But we can see this in incredible detail, meaning we’re kind of pulling the curtain back, if you will, on exactly what’s going on as you age. And we can talk about that a little more if you like.
Yeah, so I, I want to dive into just the measurements themselves, because I know you’re an expert in genomics, but also omics in general. I had an opportunity to read the paper and there were just a lot of words that I wasn’t familiar with. And you know, I say this as somebody who kind dives into the anti-aging literature on a regular basis. So for example, lipidomics, right?
Like, what are you measuring when it comes to lipids? Are you just measuring cholesterol? Are you measuring the different lipid molecules? And how does that correlate to aging?
Yeah, great question. So we’re measuring about a thousand different lipid species. LDL and cholesterol is one of those things. HDL is your good cholesterol, as you may know. LDL, your bad one. But we’re also measuring lots and lots of other lipid species, many of which are important for things like energy metabolism, all sorts of things.
But we go beyond that. So that’s the so-called lipidomics, your profile lipids. But we’ll measure your metabolomics, meaning all your metabolites. Proteomics, all your proteins. Transcriptomics, all your RNA molecules. We’re literally measuring as many molecules as possible out of your blood, out of your urine. Then we also measure the microbiome–we measure your gut. Believe it or not, we’ll measure your skin, your tongue, even your nasal microbiome. We’ll measure all these things to get a better picture of what’s going on.
So one way to look at this is if your health is a thousand piece jigsaw puzzle, we’re trying to measure seven or 800 pieces, whereas we would argue in medicine today, you measure five or six pieces.
We’re just trying to get a much, much clearer picture of people’s health. And we do this over time. I’m one of the participants, we’ve been profiling me for over 14 years now. And another group of people for about 11 years – 108 people or so.
We’ve been doing this for some time. And again, it’s not only just to see what’s going on, what their health profile looks like, but how it changes over time. And that’s actually how we could look at what’s going on for aging. We could see, you know, how people are aging.
If your health is a thousand piece jigsaw puzzle, we’re trying to measure 700 or 800 pieces. In medicine today they measure 5 or 6 pieces.
One of the things we discovered, by the way, is that everybody ages differently.We call it ageotypes. So some people, their top pathways that’ll be changing will be their cardiovascular system, we call those cardio agers. There’ll be other people who are a bit metabolic. Immune systems, different systems can age at different rates in different people. And so we call these ageotypes and we actually can measure this.
The information is actionable. That is to say, if you’re a metabolic ager, you should probably watch what you eat and also exercise. If you’re an immune ager, maybe you keep your immune system up by eating garlic and turmeric and things like that. So there’s very specific, actionable information.
That’s something that’s interesting that I didn’t know about. I looked at aging as kind of this ubiquitous type of situation that happens to you based on DNA methylation or… I’m sure you’ve heard of David Sinclair and his like information hypothesis of aging, that the CD gets scratched and over time that’s something that leads to all of these buildups of different pathologies.
That being said, it sounds like what you’re presenting is something a little bit more tailored to the individual. And I guess my question to you is, if we’re trying to prevent that from happening to the individual, how in depth do you have to go from a testing perspective? And also, how are you getting the different comparisons from someone who’s healthy versus someone who’s not?
Yeah, great question. Well, we profile people while they’re healthy and while they’re sick, but for the aging process we’re just focusing on the healthy time points. We’re very interested in what happens when people get sick, but that’s sort of a separate question.
When we’re trying to see aging, there are really two aspects. One is the fact that everybody is aging a little bit differently. I suppose that could fit a little bit with the Sinclair hypothesis. But really, the way we think about it is maybe a bit different. Imagine your car. Well, your car, you know, gets older over time, but some parts wear out first. Your transmission or brakes (Hopefully not), but you know what I’m saying? Different parts can wear at different rates. That’s how we view aging. That for different people, different things will wear out first. If you can catch that, you can actually try and fix it, keep people healthy.
That is the mission of our research, to keep people healthy basically until the end of their lifespan. You may or may not know that people’s health span is 11 to 15 years shorter than their lifespan, meaning they’re living their last decade of life unhealthy. And we want to change that.
We want people to live healthy lifespans basically all the way out to the end and then just pass away quickly, something like that. Probably extend the lifespan in the process. And so by doing this deep data monitoring, we can follow what’s going on and basically catch things even before symptoms happen.
People’s health span is 11 to 15 years shorter than their lifespan
In fact, in the first part of the study, that was the goal. It was to see, can we use these big data technologies, sequencing people’s genome, doing these deep measurements to be able to catch disease before it happens? And we did. We had 49 major health discoveries from 109 people in the first three and a half years of this study. So nearly half the people learned something pretty important about their health, in some cases life saving, all before they had symptoms.
Pre-Symptomatic Detection
Can you give me an example of that?
Yeah. We caught someone with early lymphoma. That was picked up by imaging and some blood markers. Two people with pre-cancers you may be familiar with called MGUS and smoldering myeloma. And you’ll monitor those folks more carefully now that you know that. Two people had serious heart issues. One was picked up by genome sequencing and another by wearables.
I forgot to say, but we do a lot with wearables. You can see all my smartwatches…
Oh my God. You got two Apple watches. Wow.
No, it’s a Fitbit and an Apple watch. And then the one from my company, SensOmics. An Oura ring and I normally wear a Garmin–that one broke. I normally have hearing aids, I just lost them recently, but they also measure. So we make all kinds of measurements around people. Part of it we’re evaluating technology, but part of it we’re using it to do health monitoring.
No one technology found these for these 49 major health discoveries. Sometimes it was imaging, sometimes it was genome sequencing. For example, we had someone with a BRCA mutation with no idea and so they’ll get screened a lot more now that they know they have this. And some of this was, as I say, a big deal.
This heart issue was a very, very serious case where it turned out a young guy had a heart defect. He had no idea but it was picked up by the genome sequencing. We saw there’s something in this gene that says he might be at risk. And it turns out his father died of a heart attack in the sixties. So we think that this is likely the culprit.
So these deep data profiles, again, they show you what’s going on. And these are all found again before people had symptoms.
So the other aspect, that we started talking about, was the aging. The fact that we’re following people over time, we can see how they’re aging. People are aging differently and they can act on that. Meaning the metabolic agers, when some of them found this out, they basically started exercising more or lost weight and that improved their metabolic health.
We have spun off a company on this, it’s called Iollo. They actually do an at home test or at home sampling. You put a little on prick on your arm and you actually mail in blood and then they’ll measure 600 metabolites. And from those metabolites, they basically do a deep profile on you and follow 20 different wellness categories. Things like oxidative stress, inflammation, heart health. And they also follow your biological age in each of these categories.
You can actually see if your biological age is older than your chronological age, meaning you’re older than you should be. But it’s more than that, they can tell you the exact categories that are shifting. Like you have too much oxidative stress or too much inflammation or your heart age is older. And they can give, now with AI, very specific recommendations because you can pull in information. Based on your profile, based on your lifestyle and tell people recommendations. And it’s not just exercise more, eat better. There is that aspect. But it’s like if your oxidative stress is off, well, you should eat more blueberries and less of these other things. So it can get very, very tailored.
And I do think that will be the future of health, having people adopt healthy lifestyles.
Implementing Personalized Healthcare
I love that you’re talking about the future of health because I always wonder how that’s going to be implemented. Everybody’s saying it’s going to be more testing, it’s going to be data analysis, it’s going to be early intervention. But I was wondering what you think the future landscape is going to look like from a deliverables.
Is it going to come from companies, like yourselves, that biohackers like me send in my blood? I’m interested in this stuff. Or is it going to come from your primary care physician? And now we’re going to incorporate this battery of testing that otherwise was not available to us.
Because you know, I feel like right now we have a sick care system, not a health care system. And I would love for primary care physicians or somebody else along those lines to take up that baton, but I don’t see that happening on a regular basis. Based on your company and the circles that you run with, which way do you think it’s going to go?
Yeah, great question. So first of all, 100 percent agree with you. We have a sick care system, not a health care system. And that’s what motivates us, to measure people while they’re healthy and catch disease early.
So unfortunately, because our system is broken, the whole financial incentives are not aligned. Meaning people tend to only go to the doctor when they’re ill. There’s no incentive to keep them healthy. And we’ve got to change that.
So the way, in my mind, this is going to work is we do a lot of research academically to discover what we should be measuring–you know, what kinds of tests are useful, which ones aren’t. And then we spin off companies.
Academics are great at discovery, we’re great at proof of principle. We’re no good at scaling. Many of us think we are, but not really. If you look at any one of my companies, they would just smother any academic lab because they take an area and they just totally crush it. They do really well at it.
So over the years I’ve learned this and we’ve spun off a genome sequencing company. If you get cancer, you want them to sequence you. It’s called Personalis. They don’t do direct to consumer though so that would be an issue, but they do work with academic centers.
And then we spun off, in this work I was just describing, the company called Q Bio that does deep data profiling on people. It does a medical version of this– what we do cost millions of dollars, but they streamlined us to find the most important tests. And they also do whole body MRI.
Now, this is interesting because if you talk to any physician today about if you should do a whole body MRI, 100 percent of the time they’ll say absolutely not.
I mean, I don’t know. I’m a fan, I’m a physician. I’m a fan of them, so I think that that idea is changing.
Yeah, you are the exception.
Well, I think there’s the old guard of people that have this idea, which I do firmly believe, that you should only order a test if it’s going to change your decision making. But then there’s a whole other group of people who are now… I wouldn’t say it’s a large majority, I would still say it’s a small percentage of people like myself that see the errors in the healthcare system and healthcare delivery… why not get an MRI.
Chasing down abnormal findings can be a problem in and of itself, but if you have a healthy dose of skepticism and you’re able to not get really anxious about every abnormal reading… like, personally, I’ve done it. Both my parents passed from cancer. I’m very hypervigilant about this stuff. So, I’ve done it myself. I wouldn’t say that it’s a hundred percent, but I agree with you, it’s the majority of people.
99.9 percent. My take on it is overlapping with yours. Which is to say, you should assume you have nodules. Everybody does. I have nine of them. I’ve had 19 whole body MRIs in the last eight years, and I know exactly where those nodules are. And I’m a 100 percent believer in this because the issue isn’t do you have nodules, the issue is do you have any growing nodules.
The only way you know that is through longitudinal profiling. So we need to do the longitudinal profiling. And in fact, the flip side of this is, if you do get cancer and you’ve never had a whole body MRI and you see nodules, you won’t know if they’ve metastasized. And so I would argue you need this just to know your baseline so that if you ever do, you know, hit an unfortunate situation where you do get cancer, you need to know this.
This happened to a friend of mine, you may have had a similar experience. He woke up one day and actually couldn’t move his arm and then got a scan and it turns out he had a big tumor on his spine. They took him in and, literally that day or the next day, they did an operation and cut it out and recovered it. But then, as a follow up, they did a whole body MRI and they saw three more nodules on his spine. But they didn’t know if they were there to begin with or they had metastasized from that first one. There was no way to know because he never had a baseline.
I think it’s real. That’s a big theme of our work. Get your healthy baseline, whether it’s MRI or all these measurements we’re talking about, so that you can see these shifts. Which, as you know, is not so well incorporated into medicine today.
Yeah.
But going back to your original point, how’s this going to roll out? Again, nobody pays to keep you healthy so you have to pay out of pocket to get these healthy measurements.
There was no way to know because he never had a baseline.
But I’m hopeful that what will happen is that, as we do spin off these companies…
So I mentioned Iollo that does this metabolic profiling, gives you a health profile from metabolites. We have another one called January AI that does CGM. As you know, this is a huge problem in the United States. Almost 10% now are diabetic and 33% are pre-diabetic, and 90% of those will become diabetic within five years. And so the diabetes endemic is worse than the COVID pandemic yet we just kind of live with it. It’s just getting worse and worse and worse.
The CGM, meaning continuous glucose monitors, they’re really powerful because they measure your glucose so you can see exactly what is going on. First of all, do you have glucose dysregulation? But, as you may know, different people spike to different foods. So some people will spike their glucose to bananas, others to pasta, some to white bread, some to brown bread. It’s all over the map. And you can measure that with a CGM and then it’s very easy.
So in the lab we’ve done a lot of research and now there’s a company that can basically see these profiles, and they have a 32 million food database. They can actually make a recommendation. Meaning, from four days of training data they can say these foods spike and these foods don’t, you should be eating these kinds of foods from this 32 million food database and avoid these.
And it works. People improve what’s called their time and range, meaning less spiking of glucose. And they even lose weight in the process. That wasn’t a goal, but it turns out they do because they’re eating better and better managed.
We think these new technologies can be very, very powerful. Right now you do have to pay out of pocket for them. So that company, January AI, and these different companies, that’s their goal, to keep people healthy. I’m hopeful that as people show they are effective, they will move into the healthcare system. So I think it will happen. It’s just going to be a slow process.
I hope you’re underestimating the speed at which it’s going to roll out because I’m on the verge of doing all this stuff. Like I wear an Apple watch continuously. I was this close to pulling the trigger on a continuous glucose monitor just for myself a few months ago. And I just haven’t followed up with it, but I’ve done the MRIs and everything…
Can I, can I interrupt? Continuous Glucose Monitors, if you try one, you’ll never eat the same. They are so eye opening. I’m not kidding you.
I’ll give you a story here. I was talking to a New York Times reporter who said, “Mike, I thought I was eating the healthiest lunch every day. I had salmon on salad. What could be healthier than that?” And then he wears a continuous glucose monitor. He suddenly discovers he’s spiking through the roof after that. And guess what it was.
The salad dressing.
The salad dressing.
Yeah.
And it had sugar in it. In hindsight, a lot of the stuff is obvious, but you don’t realize it while you’re living your normal daily life, doing your normal things. Salmon on salad must be healthy. And so all he had to do is leave that off, which he did after wearing the monitor, and he’s got the healthy lunch he was looking for.
And that’s true for me. I have a continuous glucose monitor. First of all, I’m type 2 diabetic, which is pretty predicted for my genome sequence. I got it after a nasty viral infection, actually. So we think it’s a combination of genetics and environment. But what was interesting, after putting on a glucose monitor, I ate a pulled pork sandwich and my glucose went through the roof–350. I’m showing this friend of mine and he says, “Mike, everybody knows pulled pork sandwiches have sugar in it.” Well I didn’t know that. In hindsight, it was pretty obvious, right? They’re a little bit sweet, so I should have figured it out.
Everyone who wears one of these things goes through the same experience.
So what do you do? That brings me to my next kind of reasoning: what are you doing in your own life?
I can tell you that, you know, as someone who’s interested in it, there’s certain things that I feel fit my lifestyle. There are certain things that I might be contemplating, like the continuous glucose monitoring, but I haven’t pulled the trigger.
Wearables
First off, I want to start with the wearables. You have a number of different wearables and what is the reasoning for all of them as opposed to just one? And then also, you know, what does your diet look like? What other interventions, other than MRI and continuous glucose monitoring, are you doing?
Yeah. Well, the wearables, the reason I wear so many… as I say, and even wear hearing aids that are normally sensors as well… is that I’m evaluating technology. So, you know, the average person needs one, but we’re trying to figure out what’s the optimal resolution.
I don’t know if you know, but from our research we discovered that you can tell when people are first getting ill from a simple smartwatch. It’s actually when I first figured out I got Lyme disease, of all things, because my blood oxygen dropped and my heart rate went up. I went on to get tested and sure enough. And that was pre-symptomatic, I didn’t have symptoms. I did get them after a day, sort of off and on. But what alerted me was my smartwatch and my pulse ox I was wearing at the time. Now you can actually measure blood oxygen right on your smartwatch.
Then we went on to show that you could tell when people are getting respiratory viral infections–this is all before COVID, we published this in 2017–because your resting heart rate jumps up. It’s a very sensitive measure when you’re ill. And so then when the pandemic hit, we actually showed we could detect COVID this way. We went on to perfect algorithms.
If you want that’s a research study you can join it’s https://innovations.stanford.edu/wearables/. It’s an alerting system, you get a red alert when you have a jump up in resting heart rate–too high for too long. It means something’s up. It doesn’t mean it’s COVID because it turns out workplace stress can trigger these things too. There are other things that can trigger it, but respiratory viral infections for sure. So we think these new technologies can be very, very powerful for detecting illness.
How do you tell when you’re ill now from respiratory viral infection? Well, temperature. You put a thermometer in somebody’s mouth, and that’s a 300-year-old concept that works only about half the time for COVID, right? Because half the people don’t get a fever. So it’s a really Byzantine way to do things.
We should be doing new technologies. Resting heart rate turns out to be a very sensitive measure when things are off. And so we think that’s going to be very, very powerful to incorporate. And you can get that right off these simple commercial grade wearables.
These new technologies can be very, very powerful for detecting illness.
So again, we have that running, you can join our study. We’re trying to perfect this because I know we’ll be able to tell the difference between mental health stresses which can trigger red alerts versus respiratory viruses. Because all we need to do is bring in respiration rate, things like that, that we weren’t doing in the first study. So that’s why we’re continuing these studies.
The point out of all this is that these wearables are powerful because they’re measuring you 24/7. It’s all passive monitoring. If something goes off you can see the shift, you just need an alerting system, which we built.
The other measurements we make are more stochastic, meaning you have to give samples. We do sequence people’s genome once and for about 8 percent (it varies from 8 to 10 percent of people) we see actionable information in terms of things that people should know about from their genome sequence. Those numbers are going to get higher and higher as we learn how to interpret genomes better.
As I mentioned, in the cohort we were studying, somebody had a heart defect that was revealed from the genome sequence. Another person was at risk for certain kinds of endocrine cancer. It turns out they actually had early thyroid cancer that was predicted from their genome sequence. Other people were misdiagnosed. Some people in our study were thought to be type two diabetics. One’s a MODY diabetic, which is a different kind, and they were on suboptimal medication for years. So the point out of all this is that the genome sequence was powerful, but these other measurements were powerful too. Imaging and the molecular measurements picked up things that we didn’t see.
In general, multiple measurements can tell you stuff. And this company Q bio, I mentioned, that does the whole body MRI and other measurements, they show that same thing about a lot of people who learn something important early. They caught some with early ovarian cancer, prostate cancer, even early pancreatic cancer that was picked up with MRI. You know, that’s almost never discovered early, and that was done all by these deep data profiles, all pre-symptomatically.
So again, you get this very complete picture of people’s health before they have symptoms, and it alerts you that something may not be right. Let’s go do a follow up test and see if that’s something to be concerned about or not. So I do think this is the future.
Some aspect of it still has to occur in a doctor’s office. You’re not going to do a whole body MRI in your house, because those are big machines, they’re million dollar machines. But there are simple things like smartwatches and micro sampling, where you take these little drops of blood and mail it in. That will be the future, we think. And it makes a lot of sense. Why, when you’re healthy, do you go to a doctor’s office? To get measured. You’ll still need some of that, but you could do a lot of it at home and you can measure more frequently so you’re more likely to catch illness before it happens. That’s really our philosophy.
But it’s primarily all self-directed, right? You’re in it, you see the advancements happening, so you do it for yourself.
I was hoping and honestly I’m even contemplating doing this myself, is having some sort of service that is a quarterback, you know like a physician. Now that they have these functional medicine physicians that are out there, which are up on some stuff, but honestly, I tried it and it was like really pushing testosterone replacement and stuff like that. Which is great for looking good and feeling good and all that kind of stuff, but I’m primarily focused on longevity.
Yeah.
Moving Beyond Monitoring
I know that that’s something that your research is specifically delving into. I’m at that 40-ish transition point and I want to know, other than testing, what interventions would the expert tell me of things to do. And it sounds like it’s just like living a healthy lifestyle and getting all the testing and trying to optimize that. Would you agree with that?
A little bit. I think you can go beyond that, especially as we pull more and more data and with AI based algorithms.
At some level, what you say is true. Live a better lifestyle. And it’s true, most people don’t get enough exercise, don’t eat well, and don’t sleep enough. These are big issues that are out there.
I would like to say that we don’t even know at a molecular level how a lot of these things work. There’s a lot of push from our lab and other labs to better understand this so we can get people to live better, healthy lifestyles.
So maybe returning back to the beginning of the conversation, one of the things we discovered by looking at people in general is that we saw these big changes in the 40s and 60s. The changes we saw in the forties were skin and muscle changes as well as lipid changes. And so I think they can direct you. Obviously if your LDL is going up, sure start watching what you eat, but you can keep an eye on that.Maybe go on statins a little earlier now knowing this information–they’re pretty safe drugs, as you know. So this is the kind of information.
Now, why are these changes occurring in the 40s, like for muscle and such? Well, I think it’s because people have been living a fairly unhealthy lifestyle. They get more sedentary as they hit their 30s and into the 40s, and I think that’s what’s going on. We don’t know that for a fact, but that’s the speculation.
So I’m a big believer in exercise. But even beyond that, I’m a big believer in strength training, believe it or not.
Yeah.
So going back to what I do, I lift weights every day. I’ve heavy days and light days, and the idea there is to keep my muscle mass up. You make all these really important hormones when you exercise. Mitochines, things like this. And in the 60s, this is really essential. Muscle mass goes down. Sarcopenia, I’m sure you’re familiar with, loss of muscle mass.
When people lose their mobility their health just plummets. It’s really important that you keep your muscle mass up. And you get that through strength training, actually, more than you’ll get through endurance exercise, aerobic exercise. So, I’m a big believer in strength training throughout, but especially as you hit your 60s.
Then some other changes we saw, by the way, in the 40s were alcohol metabolism, caffeine metabolism, things you might want to keep an eye on.
Yeah, that caffeine thing, man, that’s going to be tough. But yeah, the alcohol, I’ve given that up a long time ago.
Okay. Yeah.
I wanted to just double click on your exercise recommendations because that’s something that Peter Attia talks a lot about. He’s focusing on metrics like your VO2 max and stuff like that. What metrics are you looking at for yourself? Is it just overall strength or is there anything more specific?
Well, VO2 max is the number one predictor of lifespan, you may know that. So I definitely keep an eye on that, I get that measured twice a year. I kind of measure everything, as I say, through what we do in the lab and also through these companies like Iolla with oxidative stress and inflammation. I think these are big deal. Keeping your inflammation down is really, really important because it does lead to cancer and such. And you really want to keep your immune system up if you can.
In your 60s, that’s one of the big changes we saw. It was expected, but we could see it in detail. We saw, you know, your ability to fight viral infections goes off and such. So it’s really, really important that you eat, I think, anti-inflammatories. Going back to what I do, I take a lot of supplements, antioxidants of various sorts.
I also do something, and this is more through reading than through personal experience, but I do beetroot extracts which keeps up your nitric oxide. I don’t know if you know this, that’s really good for your microvascular system and keeping your endothelial function up. Keeping your blood flow active is a very, very big deal, we think, both for cognition and for general health overall. So I take that every morning. I have no stake in this one, I am conflicted on everything else I’ve been telling you about, but I take these Berkeley Life’s every morning – it’s this nitric oxide producer, if you will.
That’s great.
I take quite a few things and vitamin D3. Oh, and my omega 3s–fish oil and equivalents thereof. So yeah, that I take twice a day.
Reversing Aging
We’re getting close to our time, we talked a lot about the near future, let’s talk about the longer future. We’ve talked a lot about prevention, let’s talk about intervention.
Especially with genetics, there’s all this buzz about Yamanaka factors and, you know, reversing the clock. How do you feel about that? And what do you feel is the most promising?
Yeah, great question.
Well, one aspect of the future is I think people will get their genome sequence before they’re born so that you will be able to predict risk. I think this idea of deep data health monitoring, a lot of which will be done at home, will become a reality. So I’m still a big believer in prevention.
But as far as reversing aging, I think you can obviously prolong your health span by all these lifestyle things we’re talking about–through exercise and nutrition. How about reversing aging? I’m actually a believer we should be able to do that. I think we should. You know, some people say everybody born today should live to be 100 and I think that’s probably true.
Can we reverse aging? I’m a believer the answer is yes. It’ll require some engineering, a lot of technologies which we can’t yet do, but let’s start with some simple things.
So your mitochondria gets damaged as you get older and older and all your cells, some tissues more than others. So we’re going to need to swap out mitochondria. But you can do that, the technology does exist. It hasn’t been done yet as a routine procedure for people, but it probably will be done. So that’s one of the things you’ll need to do.
Now one of the other areas you brought up are these Yamanaka factors. These are factors, as the audience probably knows, that can basically kind of make stem cells, rejuvenate cells. And that is one angle. That will have to be done in skin first to see safety, because you don’t want to turn things into cancer. That’s the big concern. That’s the balance people want to watch out for. So I think that is possible.
I think a lot of people are working more on compounds. The equivalent of that, so that they’re not irreversibly genetically modifying cells. That would be hard to get rid of, but if you can use small molecules to do this, that’s a big deal.
Another big deal are the senolytic cells. Our cells are programmed to divide roughly 40 divisions and then they poop out, and that process is called senescence. And that actually causes a lot of damage when that happens. And a lot of people think that the way to live longer is to get rid of these senescent cells, and then also maybe stimulate stem cells to grow more. So there are companies forming around (anti senolytics they’re called) these compounds that are meant to wipe out senescent cells. I think that’s probably promising as well.
I think it may take a combination of rejuvenating your stem cells… which we should be able to do, we should be able to generate our own stem cells. I happened to save them for my daughters from the umbilical cord blood, back when they were born eons ago. People laughed at me and now I’m kind of happy I did it because, you know, they’re natural stem cells for my kids. I hope they never need them, but if they do need them, they have them there in supply – not many, but enough. Hopefully you don’t need many… Anyway, so stem cells we may need, getting rid of the senescent cells, and we’re going to need to fix our mitochondria. So these are some of the things that we’ll need to do. And there may be a whole bunch more, as well.
I’m hopeful we can do those things in the future. It may not happen in my lifetime, but I do think it’s quite possible. Kids that are born today may have the potential to live forever. That’ll lead to all kinds of social issues we’ll have to deal with. Meaning, you know, what do you do with an overcrowded planet and all that sort of thing? Obviously, the solution there is to go to other planets and that has its own challenges.
Kids that are born today may have the potential to live forever.
I’m an optimist in general, as you can probably tell, minimally though, right now, I want to improve people’s health span and let them live long, healthy lives.
That’s awesome. I love the optimism because I feel like it’s permeating outside of genetics and it’s something that’s really exciting to see as an outside observer. As it permeates into the rest of the culture, I think that people will just get more and more excited about it.
Man, what like an awesome time to be in biotech, right? Like it’s such an interesting time.
I live in Cambridge, Massachusetts, right next to MIT, you can see the MIT dome in the picture right behind me. And there’s a Marriott right across the street from where I live, and there are always genetics and biotech conferences that are happening. And a couple years ago, there was so much buzz about Juan Carlos Belmonte and his Yamanaka factors reversing aging, that when he spoke at this conference, the fire marshal had to be called in because there were too many people at the conference. They had to kick people out.
There’s really a lot of buzz about all the stuff that you guys are doing and kudos to you for being on the forefront of it. So thank you so much for speaking with us and telling us a little bit more about how we can better our lives.
Interests and Motivation
I am getting to the end of our show today and I wanted to ask the three general questions that I ask all of my guests.
There’s obviously a lot of inspiration right now but, when you first got started, what inspired you to get into your field, especially genetics? I feel like it is such an interesting and niche kind of science, over the past few decades we’ve seen like this explosion of interest, but you might’ve been around when it wasn’t as interesting and so what drew you to the field in and of itself?
Yeah, great question. I guess the way it started was when I got my PhD… I’m about to date myself… but people used to study genes and proteins one at a time. And it’s kind of, you know, clone the gene, get your PhD. That was really a major effort.
So when I started my lab, initially at Yale, it was basically to look at all the genes at once. We launched the field of systems biology by trying to study everything involved in a biological process. And then I moved to Stanford, 15 years ago, where we wanted to apply that to medicine. Let’s look at all the components that might be important for your health.
So take the systems view… and genetics is part of it by the way, a very important part, but it goes beyond genetics. It’s measuring all these other things. Epigenetics, as I’m sure you know, is, we think, just as important as genetics. It’s also actionable – there are things you could do because your exercise and the food you eat does affect the way your genome plays out.
That was really what launched this idea of trying to use big data to understand initially biological problems and now to try and improve human health. And that’s really what I guess drew me into the space.
That’s great, man. Thank you for sharing that. I feel like, as an outside observer, it’s drawing me more into the space too. The genetics department is really doing a lot of amazing things at Tufts University, where I teach, and it’s something that I like hearing about as a passive observer, so it’s really cool to hear about from your perspective.
Next question is, where do you see genetics in 10 years? Because we’ve talked a lot about the near future, we’ve talked about the far future, but realistically 10 years is the timeframe that I always like to ask all my guests that are in this field because you probably have an idea of what is capable with the current science.
So do you think that we’re going to be able to change our mitochondria at that stage? I don’t know. Do you think that we’re going to be able to have stem cells that are readily available to us? I’m not sure. So, from your perspective, what do you think is really realistically doable in 10 years?
Yeah, it’s a great question. I’m a bad gauge of time, like I guess we all are in science because some things take longer and some things move faster than you can predict.
I’m a believer that people will get their genome sequence before they’re born. Will that be in 10 years? Maybe yes, for a subset probably yes.
On the issue about mitochondrial transfer, I don’t think we’re that far away. And I don’t think it’s a matter of changing people’s mitochondrial DNA, I think you’ll swap out their entire mitochondria because that may be easier. There are companies doing that sort of thing.
On the issue about stem cells, again people do some level of this now, but it’s kind of done in a very uncontrolled fashion. People go abroad to get these stem cell injections, this sort of thing. It’s not well controlled, so we don’t know. But I think in 10 years, probably there will be some levels. I certainly think skin regeneration–there’s a lot of activity there now, and that’s how things will start.
So the thing about the aging field is it’s hard to directly study aging because nobody can wait 20 years to see if something works or not. So they pick extreme conditions. Like for the mitochondrial cases, they’ll cure mitochondrial diseases first as that’s easier to do and then, in the process, show you can improve things and then that’s how I think it’ll sweep into the longevity field.
Then skin you’re allowed to do a lot with. We replace skins, people put toxins on their skin all the time, Botox and things like this to improve their epidermis. We can argue if that’s a good thing or not, but the point is that you can rejuvenate skin because it can replace itself.
I think that’s a way to get these aging therapies going, show they have utility. I think some level of this probably will start coming out in 10 years. It might be more stem cell than Yamanaka factors per se. Again, people worry a lot about the specific genetic alteration, so it’ll have to be either small molecules or RNA as a way to change things.
I do think as far as fixing tough diseases… like sickle cell, that’s happening now, just starting to… so I think for some of these very difficult, rare diseases that debilitate people, especially the blood diseases, that’s going to probably be routine in 10 years. Using CRISPR and such, because there you’re only just replacing people’s blood cells, you’re not modifying their germline or anything. A lot of stuff is just starting to happen. There’s a few hundred trials running right now for CRISPR experiments. I lost count of it, last I saw, it was like 250. There might be 500 different trials running now.
Stem cell trials, they’re starting to happen. They’re going to, I think, hit some of these neural debilitative spaces first. Parkinson’s and things like that, that really need these treatments very badly.
Yeah. I think that I’m seeing like the beginning trickle of a lot of these advancements. I never would have thought in medical school that we would cure sickle cell anemia, right? But it’s available. It’s such an interesting time to be alive, really, and not just because of what’s happening in genetics.
These breakthroughs are happening across the board. You know, there’s breakthroughs that are happening in AI. There’s breakthroughs that are happening in robots. There’s breakthroughs that are happening in biotechnology in general, with vaccines and everything like that.
So that brings me to my next question. Outside of genetics, outside of health optimization, what’s something that you’re interested in that you can’t get enough of? Where you’re seeing a news article that is not in your field specifically, but you’re really interested in. Whether it’s like space travel or any of the other things.
Just to give you an example. For me, it’s robotics. I can’t wait until I have a humanoid robot that’s able to clean my dishes and do my laundry and stuff like that. So I’m always clicking on those clickbait advertisements whenever I see something like the new Tesla bot or the new BYD robot that’s coming out.
What’s really interesting to you?
Well, like you, I do like robotics and the idea about the human robot interface in particular, because I think we will become hybrid entities in the future. I mean at some level we are, people wear pacemakers and things like this, and I just see that accentuating.
It’s not exactly my field, but I think I like the idea about people, you know, who can use their brain waves to actually make motion. That’s pretty incredible when you think about it.
Believe it or not, we do do some space research.
I like the whole idea of integrated systems in general. And I know you might argue it’s just an extension of our work, but the idea that you would have smart fridges and smart toilets that will interface with you to help… “You’ve hit that fridge and you’ve eaten…”
[Dr. Awesome laughs] My fridge is going to fat shame me. It’s like, “Hey man, you’ve had enough cake, okay. Sit down.”
Have a lock on it. You can build these more integrated systems. We already do some of it already, right? The lights go on when you go into your room and go off when you leave it. We could do that so much more than we do now, I think, and have a lot more happening.
I’m a data guy. So I think that just using all these data types to go way beyond what a human brain can comprehend, to pull data to better manage people’s health and lives in general, I think is pretty cool. So, yeah, I guess I am interested in integrative systems at scale.
That’s awesome. I look forward to that day too. You know, I think that all of the extra little administrative things that are happening in the background in 2024 should be handled by some sort of integrated system. So I really look forward to that.
Honestly, thank you so much for being with us today, Michael. I really appreciate speaking with you and you sharing your insight with us. It really gave us an optimistic view of the future that’s going to come for all of us.
And thank you to all the listeners who are tuning in on a regular basis. As always, please like and subscribe. And follow Michael and all the companies that he’s with.
And if you’re having a good experience with, you know, finding out health information, let me know, cause it’s something that I’m interested in.
Thank you everybody! As always, we will see you in the future. Have a great day, everyone.
Important Links
About Professor Michael Snyder
Michael Snyder is the Stanford Ascherman Professor and the Director of the Center of Genomics and Personalized Medicine. Dr. Snyder received his Ph.D. training at the California Institute of Technology and carried out postdoctoral training at Stanford University.
He is a leader in the field of functional genomics and proteomics, and one of the major participants of the ENCODE project. His laboratory study was the first to perform a large-scale functional genomics project in any organism, and has developed many technologies in genomics and proteomics. These including the development of proteome chips, high resolution tiling arrays for the entire human genome, methods for global mapping of transcription factor binding sites (ChIP-chip now replaced by ChIP-seq), paired end sequencing for mapping of structural variation in eukaryotes, de novo genome sequencing of genomes using high throughput technologies and RNA-Seq. These technologies have been used for characterizing genomes, proteomes and regulatory networks.
Seminal findings from the Snyder laboratory include the discovery that much more of the human genome is transcribed and contains regulatory information than was previously appreciated, and a high diversity of transcription factor binding occurs both between and within species. He has also combined different state-of–the-art “omics” technologies to perform the first longitudinal detailed integrative personal omics profile (iPOP) of person and used this to assess disease risk and monitor disease states for personalized medicine.
He is a cofounder of several biotechnology companies, including Protometrix (now part of Life Tehcnologies), Affomix (now part of Illumina), Excelix, and Personalis, and he presently serves on the board of a number of companies.
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