Superagers, statins, the latest cholesterol pill and the truth about heart disease risk | Dr Terry Simpson

Simon Hill (0:04)

Well, Terry, it seems our first episode was a big hit. I had many people from the community requesting that you came back, including my family. So I listened. I was a good boy and here we are.

Terry Simpson (0:16)

It's always good to listen to family.

Simon Hill (0:19)

In this episode, we're going to approach a little bit different to the first one. So the first episode, I would encourage people to go back if they haven't listened to it. We shared your story and we went into detail about your use of GLP-1s and your career working as a bariatric surgeon, etc. and covered a whole lot of other topics within that episode. Today, what I wanted to do with you, because you've become very well known on the Internet for this, is to discuss some of the new exciting things that perhaps we're seeing, to maybe get some things off our chest that we're seeing online, that are perhaps irritating or are pieces of misinformation that we would like to address.

Then we've also brought a few studies, new studies that we can go through, why they're interesting, exciting, and what are the take-home messages for the listeners. Why don't we start with the good stuff? Is there anything new or exciting that you've come across recently?

Terry Simpson (1:28)

Well, there have been a few things. I think probably the most interesting thing came out this last week when it was talking about the super-agers and these are people who are in their 80s, who haven't undergone any cognitive decline, but their brains are equivalent to people who are 20 and 30 years old. So they said, well, let's look at these people and see what their genetics are. Let's look at APO.

The APO-E allele is the one that we look at. If you have an APO-E4 or a double APO-E4, you have an increased risk, not complete risk, but an increased risk of developing Alzheimer's disease. If you have an APO-E2, you have a preventive. We've done a lot of dietary studies like the MIND diet, Mediterranean diet, showing that these people have decreased their incidence of cognitive decline. So this is an interesting group of people. They're in their 80s and they looked at them and said, let's look and see if any of them have better genetics than others.

Simon Hill (2:22)

Are these Americans?

Terry Simpson (2:23)

This wasn't done in Europe.

So already they have better genetics. The thing was, they found no relationship to genetics at all. So these people had sort of this equal distribution of the genes that we would think might confer an increased risk or a decreased risk. And we don't know why these people in their 80s are still cognitively functioning. Now, it didn't look at a lot of the lifestyle factors at all. It just looked at genetics. But I found that remarkable because you would think that we would be able to say and say, oh, I bet all these guys are ApoE2, and none of them are ApoE4. And it turns out that's not it. So we have these people, which gives people like me who are older than you, and you'll start thinking about this later, is you want to maintain your brain as long as you can.

And know that genetics is not your fate. In terms of that is, I think, remarkable and great.

Simon Hill (3:20)

So if you were to speculate, now zooming out based on the totality of evidence, what do you think explains their good brain health into their IDs?

Terry Simpson (3:30)

I think they're probably doing a few things right. Probably the basic boring stuff. They're probably keeping their blood pressure under control. They're probably taking medications to keep the lipids under control. They're probably eating a reasonable diet with more fruits and vegetables than the average person. And they're probably exercise and have a community. All those kind of boring things that are preventative in public health. I would say when we start looking at them, I would say that would probably be fairly high on the list.

Simon Hill (3:59)

You mentioned the MIND diet. If you had a couple of minutes with someone and they said, just quickly give me the recipe for the MIND diet, how would you explain that?

Terry Simpson (4:08)

So the MIND diet is a combination of two other diets, which is Mediterranean and the DASH diet. And briefly, it's increasing fruits and vegetables. So a person should have about 250 grams of fruits, 250 grams of vegetables a day, increase of pulses or things that we would call lentils, beans, decrease red meat, more monum and saturated fats like olive oil, whole grains instead of refined grains. And the MIND diet has sorted that out into a 15-point scale. So if you're perfect, you get a 15 And there have been two different studies looking at this. And guess how many people got perfect 15?