Yuru Guo and Frankie Docker were Durham University students when they launched Hey! Food is Ready two years ago. 

They batted back ageist remarks about their ambitious plans - Yuru was 23, Frankie 19 - and got busy building an online platform that's thriving in the hyper-competitive world of corporate events catering. 

Their USP? Home cooks from across the world - immigrants, refugees, retirees and carers among them - making food magic to liven up lunch tables and party trays usually laden with soggy sausage rolls and beige sandwiches. 

What's more, their startup is a social enterprise. The platform opens the door to carefully vetted, certified home cooks to make some good money from their skills. 

And event participants often get to meet the cooks as they savour their creations. 

They've got more than 60 cooks on their books now from 40 countries, including Iraq, Egypt, Ukraine, Lebanon, Thailand, Greece, Portugal and South Korea. 

Yuru and Frankie won grants from Durham University and the Inclusive Innovation Award from the government's innovation arm Innovate UK. That distinction includes a £50,000 grant to develop inclusive innovations within their business. 

They'll be looking for investment soon in keeping with the maxim Yuru learned from her father: "Always dream big and make it happen".

Links

• Hey! Food is Ready
• Recent writeup in Portfolio North
• Yuru on Linkedin
• Frankie on Linkedin

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If you’re not already rolling your eyes and saying Nooooo Susan, I’ve maxed out on worrying about what to eat when, this fascinating conversation will make you think again.

Sally Norton is a nutritionist and public health leader from Richmond, Virginia raising awareness about oxalates,chemical toxins found in many plants. She suffered decades of ill health before discovering they were the cause of her misery. 

Why focus on oxalates when all plant toxins - lectins, phytates, tannins, glycosylates and goitrogens - can damage our gut and immune system? 

"What makes oxalates special is they're nearly impossible to remove from foods. They accumulate in the body and create long-term damage. They're tiny and get everywhere, messing up cells by stealing essential minerals and electrolytes and causing both physical damage and oxidative stress in cells and their mitochondria. The preparation methods used to disarm many of those other compounds, such as fermentation and high-heat cooking, don't adequately lower the toxic actions of oxalates. " 

"Remember too that the affected cells include our immune system, nerves and brain, glands and critical organs. By the time we reach 40, we all have some degree of a toxic load of oxalate compromising our glands, bones, brain, etcetera. They cause us to miss out on our potential for enjoying our lives, beyond our youth."

Toxic Superfoods, Sally's new book on oxalates, is out this month. 

Enjoy learning all about oxalates. No more heaving plates of spinach for me - just a handful or two! 

Links

• Sally's website
• Sally's book Toxic Superfoods
• Sally on Twitter 
• and on Instagram

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Regulars will know and adore the sharp thinker I’ve invited back on the show. It’s Dr Fayne Frey, crusading age-positive dermatologist and skin cancer specialist - my guiding light as you may have heard last week through my encounter with a malignant melanoma. Episode 49 is when you'll hear her style herself as "the ultimate wrinkle defender". 

Dr Frey's book The Skincare Hoax rocketed to the top of various Amazon sales charts even before it was out. In it she lays out how our sexist, ageist and lookist culture fabricates insecurities the skincare industry exploits. 

“Kindness matters. Health matters. Accomplishments matter. None of those things come in a tube or bottle.” 

And remember, she says, your top layer of skin is 20 layers of dead cells. No lotion or potion with a dollop of this vitamin or that mineral can penetrate it to do anything more than moisturise it and plump it up, temporarily. 

Tune in to hear her shoot down the cultural norms, marketing buzzwords and predatory industry practises that abound in the glossies and on social media. 

And if you're addicted to an intricate skincare routine of 10 steps and as many expensive products, you'll be fascinated by Fayne's pared down route to her healthy, glowing skin. 

Enjoy! 

Links 

• Buy The Skincare Hoax
• Discover Dr Frey's product selector tool  on her website FryFace.com
• Read her blog here 
• Fayne on Twitter 

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Eighteen months after the first of two operations to cut out a malignant melanoma, I’m happy to report the scar on my outer calf has smoothed out impressively; it’s kinda bumpy-wavy now, nicely faded. 

I thought it would never settle down. It resembled a shark bite for the first six months after the surgeries. I still can’t quite believe the dark brown splotch that suddenly appeared turned out to be malignant. 

I can’t rave enough about the first-class treatment I got from the UK’s National Health Service, the NHS. 

I’ve edited together the two skin cancer podcasts I put out last April - in the thick of the pandemic when I wasn’t sure what that thing was on my leg. 

And a couple of weeks ago I had a new patch of strange checked by a lovely skin cancer nurse. Not to worry, she said, but good I’ve seen it. 

Whew. 

So please heed the advice you'll hear in this podcast, even if you haven’t been baking on beaches and been that bit careless about sunscreen. 

Links

• How do I know if I have skin cancer? – Dr Frey writing for thedoctorweighsin.com
• Melanoma: What you need to know about diagnosis and treatment – Dr Frey’s article on thedoctorweighsin.com
• Dr Frey’s skincare education website FryFace.com – check out the Product Selector tool
• Fayne on Twitter

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The competition winners are sharing a £20 million pot of government money for design innovations to help us all as we age. All projects are either on the market or close to it and all have potential to scale. Competition leader Julia Glenn of Innovate UK, an arm of UK Research and Innovation,  is along to tell us more about how the winners were chosen and what's next for them. 

Who won for what: 

Lily Chow - Holly Health is partnering with charity Age UK's branches in the London boroughs of Lewisham and Southwark to develop a digital coaching service. It will improve the physical and mental health of older adults to slow the onset of chronic conditions.

Clara Sbraccia - KYMIRA through MISFIT is making a new smart garment bio-monitoring service to help Ida Sports create appropriate sports footwear to help women of all ages, and specifically older women, participate safely and more confidently in sports.

Afroditi Konidari - Tendertec’s FitBees, a service led by women, is integrating home sensors with smart garments to monitor people's activity. This is linked to a programme of community fitness for older adults, including those living with carers. 

Howard Blackburn - Yorkshire company Innerva is making power-assisted exercise machines more user-friendly for older people and the machines more readily available throughout the community. 

Ben Wilkins - Good Boost Wellbeing is transforming leisure centres into community musculoskeletal treatment hubs with artificial intelligence (AI) and gamified exercise monitoring in gyms and pools. Using gamification extends the service to more people by including those who are less mobile. 

Full scroll of winners here.

Enjoy!

Links 

• UK Research and Innovation (UKRI)
• Holly Health
• Kymira
• Tendertec's Fitbees
• Good Boost Wellbeing
• UKRI on Twitter
• Holly Health on Twitter
• Kymira on Twitter 
• Innerva on Twitter
• Good Boost Wellbeing on Twitter

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Animal foods are demonised. Biologically-dead, factory-made fare that’s poisoning our bodies - and draining health care budgets - is being promoted in the guise of planetary preservation. 

Where’s the truth? How do we get to solutions? How do we make the right healthy and ethical choices? 

My guest is long-time vegetarian Nicolette Hahn Niman, an environmental activist lawyer-turned-beef farmer who’s been touring her latest book, the second edition of Defending Beef, across the UK from her ranch north of San Francisco. 

We get into everything about the practise of regenerative farming, the environmental and health benefits of raising and eating grass-fed beef, and, in an interview first for Nicolette, discuss menopause and the challenges it brings to staying healthy and strong. Most of us need to take stock of our food choices and lifestyles at midlife, especially now that we're ageing differently. 

I know you'll find this as fascinating as I did. I reverted to being an omnivore after years of vegetarianism so we talk plenty about what needs to change to make the lives of animals raised for food a whole lot less miserable.  Nicolette joins other #RealFood advocates in saying "It's not the cow, it's the how."

Links

• Buy Nicolette's book Defending Beef 
• Find her on Facebook 
• And on Twitter 

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Much of that fakery has fed our disconnect with natural food production cycles and practices. 

And it’s left most of us in a food muddle - moral, environmental, nutritional.  

We latch on to our dietary tribe with conviction but what if our beliefs are based on a limited understanding of the evolution of global food production? And no understanding of how powerful multinationals control every aspect of it.

James Connolly is our guide to how we became the unwitting victims of a food system captured by big corporations driven by profit, not public health. 

"You’re taken out of the equation. The consumer has no real choices. They walk through the supermarket and think they’re getting a variety of products but really it’s wholly owned by about 13 multinational corporations that  control about 90% of our system."

He views the American capitalist system as “socialism for the rich” and farmers as “modern-day heroes in a feudal state, they have no control over their land, it’s owned by the bank”.

James questions how it has come to be that all so-called solutions to global warming take industrial capitalism as a given and nature must conform to it.

"Monoculture seems to be the biggest problem we have whether it's chickens, almonds or avocado farms... When you build a system based on that, you in essence have to destroy everything in that environment to grow the food. You have to bring in enormous amounts of resources, water...You build a system that has no resiliency other than excising this stuff from all different parts of the planet.."

James is a chef and Real Food advocate who transformed the food systems of inner-city schools in New York with his non-profit The Bubble Foundation. At no extra cost to the city's food budget, kids sat at round dining tables and helped themselves to nutrient-rich dishes cooked on site. 

He co-produced the documentary Sacred Cow, directed by Diana Rodgers, financed the marketing of Michael Moore's provocative Where to Invade Next (a must watch), and is producing Death in the Garden, a documentary promising a sober look at industrial civilisation, our "misguided attempts to resolve climate change", and how life always involves death. 

James is a voracious reader with an historian's head for facts and stories. You'll love this episode and want to read every one of his  desert island book picks. It was tough, but he managed to confine himself to just the five I asked for. 

Links

• Sacred Cow 
• Death in the Garden
• That Climate One podcast on Cowspiracy featuring Nicolette Hahn Niman, vegetarian cattle rancher, author of Defending Beef -
• Video highlights of Climate One debate about Cowspiracy doc
• James’ Top 5 reads:
• Ishmael by Danial Quinn
• If They Give You Lined Paper, Write Sideways by Daniel Quinn
• The Wizard and the Prophet by Charles Mann
• Shibumi by Trevanian
• The Tragedy of American Science by Clifford D Connor
• James is also an artist! Discover his work here
• James on Twitter 
• James on Instagram

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The messenger is my guest Jayne Buxton - journalist-author of The Great Plant-Based Con: Why Eating a Plants-Only Diet Won’t Improve Your Health or Save the Planet.

As you might guess, Jayne's been shot and trolled multiple times on the socials since her book launched three months ago (June 2022). But she's also been praised for her courage in stomping on the equivalent of the third rail of the nutrition wars between those who eat meat along with their plants and those who don't. 

"Somebody on Twitter likened the treatment of me to the stoning of a heretic. So that was interesting. But I have to say that hasn't been the entirety of the experience. There's been a lot of positive response to the book as well. A lot of people seem to have been waiting for somebody to open up this discussion and to bring a new narrative to the table because it's been far too one-sided for far too long."

We're bombarded with the seemingly incontrovertible message to reduce or quit consuming meat or dairy to stand a chance of saving our melting planet from imminent collapse. But that prevailing dogma is at odds with the facts Jayne found in her forensic search for the truth about the environmental and health impacts of food. 

Jayne stresses that she's not anti-plants or anti-vegan. She's an advocate of ethical, regenerative farming and real food to benefit human, animal and planetary health. Her sole - and fully-independent - motivation is to reveal facts and evidence to counter nutrition propaganda, sloppy journalism and the hidden agendas of powerful stakeholders. 

I've learned so much from this conversation and guarantee you will too. More learning to be had in the many links below. Enjoy! 

Links

• Jayne's bio
• Buy Jayne's book 
• Geosystem Science Prof ​Myles Allen​ of Oxford University on how current metrics exaggerate the warming impact of biogenic methane​
• and writing in Nature on same
• Soil ecologist Dr ​Christine Jones on soil biology and the role of ruminants​
• Real Food advocate ​Belinda Fettke on the influence of the Seventh Day Adventist Church​
• Seventh Day Adventist Church ​leaders writing about church influence ​on ​dietary policy
• Cult American livestock farmer Joel Salatin Ted talks Cows, Carbon and Climate
• "The chickens have a whole new salad bar" in 30 seconds - Joel interviewed about his mobile chicken structures 
• Jayne on Twitter

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Both ring truer than usual for guest Catherine Foot. 

She’s been a year in her post as head of Phoenix Insights, a new UK think tank set up to transform the way society responds to the possibilities of longer lives. 

It’s a workplace milestone fate served up with the kind of surprise we can all do without - a long recovery ahead after a freaky accidental stumble that has her  calling herself "a bionic woman...with Frankenstein scars".

You'll hear the full rundown of her ambitious plans for maximising social and policy impact in her new role, "my dream job".

"Funding is critical but my experience of working in the think tank sector is that everybody  needs to try these things for themselves and own the solution. You can't go around selling even the solution that works 30 miles down the road and expect them to doff their cap and say good then we'll copy that."

Central to her team's mission is finding ways to engage the public to open closed mindsets and influence behaviour: "Thinking about where people are and how to reach them is the perennial problem of social policy when trying to do something with working age adults". 

The hope is to spark many more living room conversations about longer lives. She aims to "break out of the delightful but cosy longevity bubble and begin to stretch our fingers of influence into the decisionmakers and policymakers who have yet to see ageing and longevity as their business. 

Links

• Phoenix Insights
• Catherine's moving Linkedin post about her accident 
• Her Linkedin post about the first year of Phoenix Insights (The Big Middle gets a lovely mention)
• Catherine on Twitter 

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The brilliant Catherine Foot on breaking out of the "cosy longevity bubble" - "We need to meet people where they are."

In this taster, why Greater Manchester is a stellar example of integration of public services to deliver the social support longer lives demand.

He's one of the world’s leading practitioners of neurofeedback.

Dr Hill age-stages his best bio-hacks to nourish and rewire our brains for peak performance. Meal-timing is critical, he says. As is getting enough deep sleep. And he tells us intermittent fasters we'd be better off shifting our eating windows to earlier in the day. 

He explains why kids shouldn't be allowed to play contact sports until their brains are finished developing:  "Half of all brain injuries are silent and have no symptoms. They show up years later as slowed processing, degraded quality of sleep and word-finding." 

He also tells us why loves the meditative power of Ashtanga yoga and performing West African drumming in crowds on mountaintops. 

Dr Hill is the founder of Peak Brain Institute, a global chain of "brain gyms" headquartered in Los Angeles. He holds a PhD in Cognitive Neuroscience from UCLA’s Department of Psychology, where he lectures in psychology, neuroscience and gerontology and researches attention and cognition. He's been  practising neurofeedback since 2003.

Notes

• How neurofeedback works to tune the brain to reduce stress, improve sleep and attention
• Types of brainwaves: “Delta is the heartbeat of the brain”  “Alpha waves are the idle speed” 
• Age-matched data sets are used to interpret brain maps
• How our brains change over the decades; consequences of the shifts that happen - attention, focus, speed of processing
• “You don’t want to diagnose off of this stuff, you want to come up with ideas and if they ring true, then you’re on to something” 
• “If you find things that are real, you can change them almost always. Understanding brains is hard but changing brains is not that hard”

• His academic and professional background in mental health that led to him setting up the Peak Brain Institute
• “We spent a year teaching someone to use a fork”
• How own struggle with ADHD (Attention Deficit Hyperactivity Disorder): “I was moving 9,000 times faster than everyone around me, chewing through books..I dug into everything”
• Was astonished by positive outcomes when he started working at a centre using neurofeedback

• What’s happening to the brain when sex hormones decline at perimenopause and menopause
• The reason you’re having brain fog and word-finding issues
• His take on the significance of estrogen decline, referencing the work of Dr Lisa Mosconi
• “Women have autoimmune stuff and most forms of classic dementia are not infectious diseases but metabolic diseases”

• The importance of deep sleep to banish brain fog and optimise brain health
• Why he says we’re doing Intermittent Fasting or Time-Restricted Eating wrong
  “The strongest cue for circadian rhythm is not light, it’s not when you sleep, it’s when you eat”
• “If you go to bed with any insulin that’s high, any blood sugar that’s high at all, you suppress growth hormone completely”
• How to properly measure ketones
• The benefit of movement before food every morning to burn off the cortisol - “it squeezes your liver and feeds you breakfast” - and glycogen that woke you up not call for more (by eating and flooding your system with sugar)
• Do low-key workouts in the morning and high-energy exercise in the afternoon when your cardiac output is best and your cortisol is lowest

• Impact of social media on brain health, especially for children
• "There's definitely an epidemic of childhood anxiety and sleep issues but there's no more ADHD than there was 50 years ago"
• Advice to parents of athletic kids who want to play rugby or football? "You shouldn't let your kids play contact sports.. non-contact is ideal until your brain finishes developing"
• The ecstasy of West African drumming on mountaintops and the meditative value of Ashtanga yoga

Links

• Dr Hill's Peak Brain Institute
• From Andrew's blog:  How to prioritise sleep for peak brain performance 
• Andrew on Twitter  

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Scottish writer Donna Ashworth translates our thoughts and feelings about life, love and loss into poetry that stuns in its simple complexity. 

Her beautiful words proved a salve for our battered souls and minds at the height of the pandemic. It was then that her precious poems went viral online. Her heartfelt musings were picked up by organisations as diverse as the UK's National Health Service, Amnesty International and Doctors of America. Celebrated actors recited her work, including Michael Sheen, Griff Rhys Jones and Vicky McClure. Her empathy, compassion and reassurance served as a beacon and blanket of comfort as we struggled under the weight of uncertainty and grief. 

This episode was a joy to make. Donna reads six of her poems for us, tugging at our heart strings as we go. She shares the astonishing fact that her artistry is not the product of endless tweaks and revisions. Her poems arrive overnight, fully-formed for delivery in the morning, her first drafts her final drafts. 

The six poems are copied below.  Not a chance you won't enjoy this one! Please share your thoughts on my website and subscribe to my baby YouTube channel (links below).  I'll get the video up in the coming days. 

Poems 

So Old  

You’re so old
they say
and I laugh
with a deep roar
rising up from my very soul
because how could that phrase
ever be anything
but magnificent?

She let herself go
they cry
and I smile
with every tooth in my head
because Mother Nature and I know
what a miraculous act
letting go
truly is.

You’ve changed
they say
and I am at once
completely fulfilled
and at peace
with my life’s purpose
because if I did not come here
to grow
then what was it all for?

Don't Prioritise Your Looks 

Don’t prioritise your looks my friend,
they won’t last the journey.
Your sense of humour though, will only get better.
Your intuition will grow and expand like a majestic cloak of wisdom.
Your ability to choose your battles, will be fine-tuned to perfection.
Your capacity for stillness, for living in the moment, will blossom.
And your desire to live each and every moment will transcend all other wants.
Your instinct for knowing what (and who) is worth your time, will grow and flourish like ivy on a castle wall.
Don’t prioritise your looks my friend,
they will change forevermore,
that pursuit is one of much sadness and disappointment.
Prioritise the uniqueness that makes you you,

and the invisible magnet that draws in other like-minded souls to dance in your orbit.
These are the things which will only get better.

History Will Remember When the World Stopped

History will remember when the world stopped
And the flights stayed on the ground.
And the cars parked in the street.
And the trains didn’t run.

History will remember when the schools closed
And the children stayed indoors
And the medical staff walked towards the fire
And they didn’t run.

History will remember when the people sang
On their balconies, in isolation
But so very much together
In courage and song.

History will remember when the people fought
For their old and their weak
Protected the vulnerable
By doing nothing at all.

History will remember when the virus left
And the houses opened
And the people came out
And hugged and kissed
And started again

Kinder than before.

You're Not Imagining It...

You’re not imagining it, nobody seems to want to talk right now.
Messages are brief and replies late.
Talk of catch ups on zoom are perpetually put on hold.
Group chats are no longer pinging all night long.

It’s not you.
It’s everyone.
We are spent.
We have nothing left to say.
We are tired of saying ‘I miss you’ and ‘I cant wait for this to end’.
So we mostly say nothing, put our heads down and get through each day.

You’re not imagining it.
This is a state of being like no other we have ever known because we are all going through it together but so very far apart.

Hang in there my friend.
When the mood strikes, send out all those messages and don’t feel you have to apologise for being quiet.

This is hard.

No one is judging.

I Walked

I walked with you today, I took the longer way.
I made some time to tell you all the things I didn’t say.
I spoke to you so softly and so often tears just flowed.
I let you know my secrets, the stories you were owed.

I gave you all my heart, as we walked the pretty way.
I cared not for my timings or the schedule of my day.
Instead I lingered back, picking flowers for my hair.
I showed you our old tree but this time I stopped and stared.

I walked with you today, I took the wilder path.
I reminded you of all the times your antics made me laugh.
I stopped to smell the roses, as I should have done before.
I seized that special moment and I wished and wished for more.

I walked with you today love and with all my aching heart.
I wish that I had not left it too late in life to start…
To start taking the long route, saying things I never say.
I’m sorry that it took me far too long to walk this way.

Remember Her?

Somewhere inside of you, there’s a little firecracker with her arms folded and a frown on her face.

She isn’t happy about all the times you said no when you wanted to say yes.
All the times you said yes when you wanted to say no.

She wanted you to buy the ticket.
She wanted you to take that trip.
She definitely wanted you to take that risk – the one that may have just opened a whole new world.

She wants you to remember what it feels like to run to the sea without a care in the world and splash and laugh till you ache.
To face the day without a fear in your heart and embrace every opportunity that comes.

She doesn’t understand why you won’t wear the bikini.
She doesn’t understand why you won’t eat the cake.
She doesn’t understand why you don’t let it go.
She definitely doesn’t understand why you accept second best.

Somewhere inside there is a little girl who wonders at the adult you’ve become..

She still has many things she wants to learn and so many people still to meet.
She still has food she’d like to taste and parties she wants to dance at.
She still has places she wants to visit and wonders she wants to stare at.

Somewhere inside you, there is a little firecracker – desperate to see more of this thing we call life.

Go get her, she’s fun.

***

Links

• Donna's website
• Her Facebook page
• Donna on Twitter

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My guests Bruce Hiland and Ted Kaufman tried but failed several times to call time on busy, high-status careers. 

They’re the authors of the book Retiring?: Your Next Chapter is about Much More than Money.  

They say figuring out what you're going to do is job one after you've sorted your financial future.  

To win at retirement, they say much more attention must be paid to planning how you're going to feed your mind, body, heart and soul. 

In their eighties now, Bruce and Ted decided to write their practical guide to the non-financial aspects of conventional retirement after hearing the frustrations of their contemporaries. Many had mistakenly thought ticking off bucket list adventures and hanging out with their grandkids would be enough to sustain them. There was little awareness of the fact we're living longer and in better health so need a plan for 25 to 30 years of freedom from full-time, all-consuming work obligations on someone else's clock. 

Ted is a former US senator from Delaware, Joe Biden’s former chief of staff when the president was a senator and head of Biden’s presidential transition. He lives between Vero Beach, Florida and Wilmington, Delaware. 

Bruce is a former management consultant and chief administrative officer for Time Inc.; he also lives in Vero Beach when he’s not hanging out with his family and savouring the natural delights of Middlebury, Vermont. 

Links

Buy their book Retiring?: Your Next Chapter is About Much More than Money

Bruce + Ted's blog

Contact them

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What does it even mean in 2022? 

We don’t retire these days, we shift gears, we make transitions. 

We keep earning if we need to (and most of us need to) while we grow our minds, feed our passions, soothe our souls and figure out how to give back - do something that matters to more than ourselves. 

Two fascinating guests join me on The Big Middle to talk transitions: gerontologist researcher and author Deborah Gale, based in Ascot, west of London, and  journalist and author Rich Eisenberg, newly UNretired; he tells us what that means from his #WFH office in New Jersey. 

Links

DEB GALE

The Age of No Retirement

The Purpose Exchange 

Robert Kegan on the Further Reaches of Adult Development, the video Deb said "blew my mind" 

Deb on Linkedin 

Deb on Twitter

RICH EISENBERG

Rich's new Marketwatch column The View from UNretirement  

Rich's podcast Friends Talk Money

Rich on Linkedin

Rich on Twitter

***

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The courage and resilience of Ukrainians is breathtaking. The images of the immense suffering of innocents pulverised by Russian shells in their homes and as they flee is horrifying. 

I’m betting you too are finding it harder than ever to manage your seesawing feelings of fear, anxiety, helplessness, anger and grief.  

The always inspirational Dr Andy Cope is back to help us find a measure of emotional balance. 

How do we square the guilt we feel as we witness Putin's barbarism from afar while striving to recover optimism and joy as COVID fades?

He says self-care is critical now. You won't be of any benefit to anyone else if your empathic distress overwhelms you to the point of incapacity. "You can't pour from an empty jug."

And beware what he calls "destination addiction" - kicking your happiness into the long grass of an uncertain future in an imperfect world. "If you're waiting for the perfect world in order to be happy.. you'll die waiting." 

Andy’s a Doctor of Philosophy with a PhD in positive psychology or, as he prefers, human flourishing. He’s written more than a dozen books and delivers keynotes and workshops on motivation, leadership and wellbeing across the world. His flagship programme is called The Art of Being Brilliant.

And brilliant sums up how we end this episode. Andy sends us off with one of his tried and tested proper hugs. Trust me, you'll want one! 

Links

• Andy's consultancy The Art of Brilliance
• His take on Putin's war on Ukraine - The Russian Revolution
• Our conversation last year about learning to "rethink your thinking" to ditch "the curse of mediocrity"
• Andy on Twitter

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• Music: “Beautiful Day” by Sahin Koc

Are they even comparable? And don't only a small percentage of men experience it? 

Questions I put to Dr Jeff Foster, a men’s health specialist here in the UK. 

We cover the men's health fundamentals - the importance of testosterone and estrogen, erectile dysfunction, cardiovascular disease, prostate cancer, turtle bellies, "moobs" (man boobs)  and more.

Dr Foster is the author of the excellent, practical book Man Alive: The Health Problems Men Face and How to Fix Them. 

Alongside his work within the National Health Service, the NHS, he's a co-funder of H3 Health, a private clinic in Warwickshire for midlife men and women. 

Loved learning from Dr Jeff. Video version up soon on my newborn YouTube channel. Do have a gander and subscribe - massive thanks if you do! 

Links

• Buy Dr Jeff's book Man Alive here
• Dr Jeff's clinic H3 Health
• Jeff on Instagram
• Jeff on Twitter

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A former renal and occupational health nurse, she's a tireless campaigner for better information and understanding of how to keep enjoying the many health benefits of sex no matter what life throws at you - illness, bereavement, menopause, relationship breakdown. And let's not forget age. Sam is all about blowing up the stubborn myth that sex has an age-expiration date. 

Sam advises health care professionals and gives talks to cancer and other charities when she's not running Jo Divine, the online sexual aids company she set up with her husband in 2007. 

The site has become a rich, public health service, an education hub about everything to do with healthy, consensual sex. 

And don't forget to use that 10% discount code for purchases from JoDivine.com from now through March 10th. The code is The Big Middle. 

Oh and there is a show and tell aspect to our chat. Video out soon (if it passes YouTube muster)! 

Links

• A sampler of sex education info and perspectives you'll find on Jo Divine:
• Breastfeeding and sex 
• Want Thrush? Use a bath bomb
• Menopause and Libido
• Winning Back our Sex Life after Prostate Cancer - a personal story by Elvin Box
• Sam on Instagram 
• Sam on Twitter
• Trekstock, the fabulous cancer charity for young adults Sam was to address that evening after our podchat

Piece in The Guardian about those Swiss sheds for sex workers (there is a laudable safety angle of course) I mentioned from 2013, when they were set up

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We got a measure of how hard in the latest from the UK's official recordkeeper, the Office for National Statistics. 

Vacancies are at a record high. There are more than 1.2 million job openings. But alongside that unprecedented demand, economic inactivity appears to be rising. Fewer older people are working; 180,000 fewer than before COVID hit.  

There are nearly as many vacancies as there are jobless of all ages. Employers are facing the tightest jobs market in at least 50 years. It's a taste of the demographic crunch I spoke about in my episode with Bradley Schurman if action isn't taken to retain or hire older people who want and need to work. 

A timely trip to The Big Middle archives now from  the summer of 2019. We hear about London restaurateur Jeremy King's trailblazing effort to attract older workers to the restaurant trade. Top gent who appreciates the soft skills older employees bring to his top tables. 

Links

• Article on ONS figures from People Management: Employers warned to expect challenges as vacancies reach another record high
• Corbin & King website
• Article in The Caterer: “Old dog, new tricks: why you should employ older workers”
• Article in The Telegraph: “Over 50s make just as good waiters and bar staff as hip millennials, says Wolseley boss”
• Piece on Jeremy on +50s jobs and advice site Rest Less UK
• Corbin & King on Twitter
• Photo of Jeremy by David Loftus

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What kills me is much of this advice - well-intentioned and variably valuable - rests on individual actions - what you must do to stay engaged, lit up with renewed purpose and zest for a longer, fully-examined life of quality and ongoing contribution to the greater good. 

Global context is missing. There’s scant attention to the big picture, the macro view of the demographic upheaval that - out of our personal control - is changing our world order. 

In 2021, China had its first population contraction since the Great Famine of 1959. And the US had its lowest birth rate on record. Japan’s population has been ageing out at an annual rate of 500,000. Cuba will join 34 other “Super Ager” economies by 2030

Bradley Schurman is a demographic futurist with an impressive record of achievement in sussing out megatrends.

His new book is The Super Age: Decoding our Demographic Destiny. We get into all of it here and then some - population ageing, collapsing birth rates, the folly of our artificial, post-war creation of a retirement class. It was then that older workers became a line on the bottom of corporate balance sheets, ripe for erasure. 

The opportunities of our unstoppable demographic transition are many but we've got to embrace them as a global collective, not recycle the gloom and doom narrative of social burden and resource wars. 

Enjoy this fascinating look at the shifting demographic landscape, one of the most pressing issues of our time. 

Links

• The Super Age
• Looking Toward the Future: Three Big Trends for 2022
• The Kids Are Not Alright (But They Are Going to be Just Fine)
• Bradley Schurman on LinkedIn
• The Super Age Twitter 

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This is The Big Middle, the podcast free-ranging around all aspects of messy, glorious life in the bigger middle. I loosely define that as mid-40s through mid-70s.

I found myself explaining the theme of this podcast a lot in recent weeks. Before I got sick, I had meetings with switched-on folk I'd have thought would have twigged to the fact we're in the midst of a demographic shift that demands a cultural and institutional revolution that's slow to come. They were surprised when I trotted out this milestone statistic from the World Health Organisation: there are now more over-60s in the world than there are under fives. That happened last year. By 2030, one in six of us will be 60 or older.  

The life model we've made is hopelessly ill-equipped to deal with this new reality. It was designed for 50 and 60 year lives, not the century the babies of today are likely to experience and the 80s and 90s we might be lucky to get. 

We jam everything into our first 50 years and then nothing's defined bar the fuzzy notion of retirement and, in your late 60s, state pension access. We haven't properly reconfigured our institutions and expectations to reflect longer lives in relative good health - relative to a century ago. 

I started this podcast three years ago to explore this cultural and structural disconnect. My first guest was Geoff Filkin, then the chair of the UK charity The Centre for Ageing Better. He'd written a manifesto for better longer lives. Lord Filkin has moved on to other roles advancing his manifesto but its themes remain central to the demographic upheaval of now and the future, despite the haircut COVID has given to global life expectancy statistics. My first question to him was about the nature and scale of that upheaval. 

Links

• Geoffrey Filkin’s Manifesto for Better Longer Lives
• Geoff's current role with the APPG for Longevity
• Centre for Ageing Better
• Old School: Anti-Ageism Clearinghouse 
• The Big Middle episode with Ashton Applewhite's Old School co-founders Kyrié Carpenter + Ryan Backer
• WHO global report on ageism

Even the chattiest in the changing room at my Aqua Aerobics class clammed up when it dawned that their voices would be online in podcast perpetuity. "Happy to chat, happy to share, but heavens no Susan, no way do I want to be recorded, even anonymously." Save for Sara and Teresa, two fellow Aqua Aerobics addicts here in my home patch of Acton Central, in the west London borough of Ealing. And my dear friend Barbs in Cape Town, home of my closest family. 

None is on social media. I wanted to sample opinion outside those echo chambers. None has read any of the worthy academic papers or articles from gerontolgists or longevity influencers on the importance of a growth mindset, purpose, acceptance, resilience, relationships. 

But in their commonsensical wisdom, they got there on their own. And you’ll hear they didn’t think for a second to take hormone replacement therapy; It just wasn't the done thing. Unlike my experience, menopause was barely a blip on their radar.

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Achieving that balance is no small feat in The Big Middle years. 

But functional medicine Dr Jay Wrigley has tried and tested ways to optimise the nutrition and energy bang you get from what you eat and how you live while taming those rambunctious midlife hormones. 

Links

• Dr Jay's website 
• His bio
• Dr Jay on Twitter
• Link to podcast with menopause specialist Dr Zoe Hodson 

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I’ve been exploring the black hole of nutrition in the medical education universe of late. Now, we’re going deep into the perhaps bigger black hole of menopause.  

Dr Zoe Hodson is on a mission of remedial menopause education and sisterly love she says is often exasperating. She kindly made time to speak with me on World Menopause Day (October 18, 2021) from her home in Manchester. 

We learn why testosterone is the mostly missing female hormone in the standard body-identical HRT mix, go into detail about the physiological and neurological rewards of modern, regulated HRT, share our menopause experiences, bemoan the reality of medical sexism, and rejoice that women have safe, evidence-based ways to improve their quality of life instead of suffering debilitating symptoms in silence.

Links

• Dr Zoe's profile at Newson Health
• Newson Health menopause + wellbeing clinic
• Balance menopause app to track symptoms
• Sign the #MakeMenopauseMatter petition 
• A bit about those GABA receptors Dr Zoe mentioned
• Book Zoe mentioned by Jane Lewis: Me and My Menopausal Vagina 
• Oestrogen Matters book by by Avrum Bluming MD + Carol Tavris PhD
• Professor James Simon on The Benefits of Body Identical Progesterone on Dr Newson's podcast
• Prof Simon's article on How the US Government and The Media Conspired to Convince Women That Menopausal Hormone Therapy Was Dangerous
• Professor Isaac Manyonda on Testosterone: the forgotten hormone on Dr Newson's podcast
• Dr Zoe on Instagram

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There are few who can emphatically state “that’s true” more than Tim Spector. He's a data explorer extraordinaire, a genetic epidemiologist who heads up his department and his ground-breaking Twins UK project at King's College London. 

Tim is one of the most cited scientists around, with research papers numbering nearly 1,000. He's working on his fifth book after his hot sellers The Diet Myth and Spoon-Fed: Why Almost Everything We’ve Been Told About Food is Wrong.

His work on the microbiome and identical twins has exploded current nutrition and energy models. It's exposed the widespread fiction of the standardized dietary guidelines - the ones governments and nutrition practitioners foist on us, the unwitting public, under pressure from Big Food manufacturers. They have the resources of medium-sized countries and control research money.

We covered plenty but not all. Please see the show notes for more details about his research into gut health, genetic disease markers, epigenetics and COVID19 symptoms. Trust me, you'll want to devour it all. It's fascinating.

<< Please view the information in this episode as only that; it should not be construed as personal medical advice. Go to your GP or family doctor for that. >>

Links

• Tim on Wikipedia - meatiest bio I could find with links to specific research we didn't manage to address
• That recent paper on sugar-dippers
• ZOE - the health science company Tim co-founded to measure individual food responses
• ZOE COVID Symptom Study app - a not-for-profit initiative launched end of March 2020 to support COVID-19 research.
• The PREDICT studies
• The Twins UK study
• Spoon-Fed: Why Almost Everything We've Been Told About Food is Wrong
• The Diet Myth: The Real Science Behind What We Eat
• That great Financial Times profile of Tim by Madhumita Murgia - July, 2021
• Tim on Twitter  I   Instagram

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My guests are #RealFood revolutionaries in the grassroots, global effort to stamp out the lifestyle diseases killing too many of us. The world over, they’re as respected as they are adored for their knowledge, energy, humility and contagious good cheer.

It’s the Unwins, Dr Jen, a clinical health psychologist, and husband Dr David, a general practitioner or family doctor. 

We talk about the wealth of clinical data they've contributed in more than a dozen peer-reviewed medical papers about their Real Food, drug-free approach to treating Type 2 diabetes and other lifestyle diseases. We talk too about their success in helping sugar addicts recover, the importance of what David calls a "diet of influences", and his sea-change embrace of social media. 

Jen's book Fork in the Road: A Hopeful Guide to Food Freedom and David's sugar infographics are essential elements of their work to help all of us enjoy optimal health for as long as possible. 

I put them on the ultimate power trip by appointing them Ministers of Public Health for The World with unlimited resources and full control. You'll hear their ideas for radical public health policy reform.

And because this is #TheBigMiddle, we learn about their transformational experience of the classic midlife reawakening and mind shift. They agree being older offers opportunities for continuous growth and learning that aren't seized upon and celebrated enough. 

Enjoy learning from these fabulous, generous, inspirational humans! 

Beware - there's feedback noise on the line that we valiantly tried to suppress but, hey ho, it insisted on gobbling some words. 

<< Please view the information in this episode as only that; it should not be construed as personal medical advice. Go to your GP or family doctor for that. >>

Links

• Dr Jen's website Fork in the Road. where you can buy her book 
• Dr David's profile on the Public Health Collaboration UK charity - both are founding, active members
• The full set of David's infographics downloadable from the PHCUK.org
• PHCUK.org scroll of the Drs Unwin wins! Note: Dr David's Norwood surgery in the Liverpool region now spending £58K a year less on diabetes drugs than is average for area
• Jen on Twitter
• David on Twitter

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Enter the grassroots organisations of the unstoppable Real Food, Low-Carb movement. 

In recent episodes of The Big Middle, we’ve met founders and ambassadors of the UK’s Public Health Collaboration charity. Now, we learn about the Nutrition Network, part of The Noakes Foundation of celebrated sports scientist Prof Tim Noakes. 

Jayne Bullen heads up the Network and is COO of the Foundation, the non-profit research arm headquartered in Cape Town but with a reach that spans the world. We also hear from Nutrition Network graduates Dr Andrew Oswari, a family doctor from New Jersey, and Frank Zweedijk, a Dutch osteopath. Enjoy! 

**Oh and that's my boycat Arlo - beauty huh? - in the photo. It had been all of 10mins without a snuggle so thoroughly understandable intrusion. Video coming soon for fellow cat crazies. 

<< Please view the information in this episode as only that; it should not be construed as medical advice. Go to your GP or family doctor for that. >>

Links

• Nutrition Network
• The Noakes Foundation
• Jayne's bio
• Dr Andrew Oswari's bio
• Frank Zweedijk's Facebook page (Dutch)
• Jayne on Twitter
• Andrew on Twitter
• Frank's KetoGroupBV has joined Twitter!
• Prof Tim Noakes on Twitter
• Public Health Collaboration UK

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Type 2 diabetes is a lifestyle disease we’re learning can be managed into remission by going low-carb - hat tip to Virta Health, UK Dr David Unwin and other primary care doctors across the world. 

Type 1 is for life. It always involves dosing insulin. 

But Dr Ian Lake, who has Type 1, says switching to a very low-carb [ketogenic] regime has helped him better manage his diabetes. 

He stresses that it's not for everyone, but wants it added to the standard care options offered by all physicians. 

Consider, he says, that 95% of Type 1s fail to reach targets for good blood sugar control. But on low-carb, 97% do. 

You may have heard of the remarkable Zero Five 100 challenge he organised in September, 2020. He, another Type 1 diabetic, and six others without diabetes, safely finished a fasted, five-day run-walk from Henley-on-Thames to Bristol - 100 miles on zero calories. There were no injuries and no problems with blood sugar control. 

Dr Lake has summed up his initial findings in a medical paper but, a year on, has his proof-of-concept research convinced others to rethink their Type 1 treatment protocols? We find out. 

<< Please view the information in this episode as only that; it should not be construed as medical advice. Go to your GP or family doctor for that. >>

Links 

• Dr Ian's website Type1Keto.com
• His paper on the Zero Five 100 project in the journal Endocrinology, Diabetes and Obesity: Nutritional ketosis is well-tolerated, even in type 1 diabetes: the ZeroFive100 Project; a proof-of-concept study
• Essential watch: Ian's presentation to the Public Health Collaboration 2021 conference
• Trailer for Zero Five 100 documentary in the making
• His tweet about Gina, a T1D who fared badly when following guidelines but reduced her insulin sixfold on keto
• Gina's experience in detail
• Dr Ian's blogs on Diabetes Management
• Dr Bernstein's Diabetes Solution 
• Ian on Twitter

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As we know, far too many don’t get a chance to stick around and savour The Big Middle years - loosely, mid40s through mid70s. 

Regulars will know I can’t bear all the angst and negativity around simply stayin’ alive to sample another day of whatever you make of it.

This episode from the summer of 2019 is a collaboration with The Liminal Space design consultancy and gerontology researchers at University College London. 

Sarah Douglas, who you’ll hear in a tick, says the glorious 'Unclaimed' installation is ready to be rolled out in your town or city - just let her know where and when. Her details are in the show notes. Enjoy! 

*****

You will love the learning and sharing and raw emotion in this episode of The Big Middle.

For this look at the big issues of longer midlife, I’ve teamed up with The Liminal space, a London design consultancy-cum-think tank. You may already know a space that’s liminal is one of transition and transformation, where what was becomes what next.

The studio teamed up with the Centre for Ageing Better and University College London to create Unclaimed, a quirky immersive installation about population ageing that had a great first run at The Barbican. Funds permitting, the exhibit will come out of storage for a tour of the UK and beyond.

The anonymous voices you’ll hear are the stars of Unclaimed, all 70 and older. But you don’t see what their owners look like or discover more about them than what they share. Director Sarah Douglas more than met the challenge of provoking deeper thinking about ageing without using images that might have reinforced ageist stereotypes. The Liminal Space team came up with a metaphor for all of life – a lost property office.

Notes

• Interview of Sarah Douglas, Director of The Liminal Space, about Unclaimed
• Montage of voices of +70s featured in audio vignettes in the interactive installation

Links

• Unclaimed – The Liminal Space
• Research of gerontologists at University College London of north Londoners interviewed for Unclaimed
• News coverage of Unclaimed
• Contact Sarah Douglas at info@the-liminal-space.com

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One of the many observations of Jonathan Rauch from our conversation about his book The Happiness Curve in December of 2018.

It's an upbeat listen that serves up surprises and positive perspectives in equal measure. I'm betting you too could use a small break from the deeply distressing news out of Afghanistan and the ongoing back and forth about how we manage living with COVID.

Jonathan has put out two more books since we spoke. We'll have him on The Big Middle soon to discuss his latest The Constitution of Knowledge: A Defense of Truth. As one reviewer put it, it's an antidote to the misinformation imperilling our politics.

Here's a replay of our episode about The Happiness Curve. Enjoy! 

****

Subscribers to The Big Middle will have heard just about every guest mention the U-curve of happiness. Along the life course, social and brain science shows the curve is happy-miserable-happy not, as you might have surmised, happy-miserable-more miserable until the end.

Perplexed when he had his own midlife slump, my guest went into deep research mode and wrote a book about it. American Jonathan Rauch is a print journalist of distinction – the best broadsheets, the best news magazines. The book, his sixth, is the hot seller The Happiness Curve: Why Life Gets Better After 50. I reached him at his home in north Virginia.

Hear what when:

• How the book grew out of his search for the cause of his inexplicable period of midlife gloom

“I knew it was irrational at that point and knew I had to start looking for answers. It was not depression.. It was a contentment disorder, completely normal, but I didn’t know that.”

• The surprising discoveries about the prevalence of the midlife slump borne of his study of global data feast around the subject of happiness

“People think this is supposed to be an invulnerable time of life but in fact it is a highly vulnerable time of life when we need more support, not less support.”

• I question finding that midlife slump same for both genders – what about the slam-dunk of menopause for many women?
• Dissatisfaction hits high-achievers hardest and happens when there is an absence of strife, leading to a rough transition

What seems to be happening… is a transition period from the values of early adulthood , which are focused on ambition and social competition …to the values of the later decades of life.. nurturing connecting, community – much better values to making human beings happy in life.”

• Contrary to popular belief, last several decades of life are the happiest, satisfying, fulfilling – “pot of gold at end of rainbow”
• What happens to our later-life brains to make us so happy?
• Stereotypes about 50 marking start of decline and grumpiness are all wrong and make midlife so much worse than it should be

“If people understood that 50 is the gateway to two, three, eventually four decades of healthy, emotionally-satisfying life, they wouldn’t feel that sudden pressure to be on top of the world and feel much better about ageing.”

• The nastiness of ageism bites hard just as we gain more emotional stability and tighten our focus on priorities
• The ‘Voyage of Life’ story as depicted by Thomas Cole, 19th-century American landscape painter – “surprisingly scientifically accurate”
• Of still bodies and busy minds, the opposite of the way we lived when we didn’t have time to think about whether we were contented or not with our lot in life
• The importance of real-life social connections, not “disembodied” on social media – “the bad effects seem to be swamping the good”
• How writing the book has changed his view of the future
• How the work of anti-ageism activist Ashton Applewhite has sensitized him to age discrimination across the age spectrum
• Advice for those on the cusp of their midlife slump?

“Time is on your side. As long as this slump can seem to go on – it seems eternal – but just when it seems like it will never end, that’s when it starts to end. And there’s actual science about why that would be the case. Be patient. Time will help you.”

Links

• The Happiness Curve: Why Life Gets Better After 50
• Jonathan Rauch website
• Jonathan’s opinion piece in The New York Times: Why Prosperity Has Increased but Happiness Has Not
• Jonathan writing in The Atlantic: How American Politics Went Insane
• Thomas Cole’s ‘The Voyage of Life’, National Gallery of Art video, Washington, DC
• Jonathan on Twitter
• Jonathan's photo courtesy of Stephen Voss

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Insensitive much, I thought. Then I dug around and found, she’s right. 

Worldwide, more than 200 million of us have some sort of thyroid malfunction. But when we start feeling brain fogged, tired, cold, fat and puffy, we often put our symptoms down to the stresses and strains of modern life. Or menopause. Or lack of sleep or exercise. But the root cause may well be undiagnosed or untreated Hashimoto's, your immune system attacking your thyroid gland, or hypothyroidism due to low thyroid hormones. 

Hashimoto's can strike at any age but is most often diagnosed between 40 and 60. It can affect men and children but it's eight times more common in women. 

This time on The Big Middle, we’re going deep on all things thyroid.

Elle Russ is  a thyroid troubleshooter who wrote the hot-seller The Paleo Thyroid Solution. She helps countless people get themselves out of thyroid distress, coaching international clients from her base in Malibu, California. She's also one of the hosts of the Primal Blueprint podcast started by Mark Sisson, a founding father of the evolutionary health movement.

There are so many important takeaways from Elle. Biggest for me after years of packing on poundage despite low-carbing and fasting is that hypothyroidism blocks ketosis. "When you have hypothroidism, you have a shitty metabolism. You don't have enough of fat-burning T3... Dietary paradigms meant for normal people with normal metabolisms do not work on a thyroid body."  

Nor, she says, does hitting the gym harder.

Have a listen if you've got hypothyroidism and are among the millions the world over not getting the answers and treatment you desperately need. 

<< Please view the information in this episode as only that; it should not be construed as medical advice. Go to your GP or family doctor for that. Best of luck finding a doctor specialising in thyroid issues. >>

Links

• Elle's website
• Fill this out for Elle's free thyroid guide
• Elle's book The Paleo Thyroid Solution
• That Primal Blueprint podcast Elle did with Dr Gary Foresman on perimenopause, menopause, HRT 
• The episode Elle referenced of her podcast Kick Ass Life: Keto In & Out. Do Keto. Not Forever.
• Janie Bowthorpe's thyroid education hub Stop The Thyroid Madness
• Paul Robinson's Recovering with T3 Facebook group
• Elle on Instagram
• Elle on Twitter

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He posted a tweet that couldn't be ignored - shirt off, belly out, it was a series of month-by-month side-shots of him starting from the summer of 2019. It was headlined Obesity and Type 2 Diabetes Can Be Prevented and Reversed. 

He might have called it The Incredible Shrinking Man. 

This time on The Big Middle, Eranda’s health recovery story and how he became an influential purveyor of healthy lifestyle education, hope and change.

<< Please view the information in this episode as only that; it should not be construed as medical advice. Go to your GP or family doctor for that. >>

Links

• That showstopper tweet
• Eranda's recovery story - 44 pages of essential reading!
• Public Health Collaboration UK website
• Eranda on Twitter

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Sam is a health crusader of the first order. Six years ago, he founded the UK’s Public Health Collaboration charity - a grassroots education hub that’s part of a global wave of people rising up against the dietary orthodoxy that’s making way too many of us sick. 

Sam rather impressively chose to make himself temporarily sick to prove all calories are not created equal - they differ in nutritional value and biochemical impact. 

Hear how the former fitness trainer and entrepreneur scoffed nearly 6,000 calories a day for 21 days at a stretch to test three dietary regimes: real food, fake food and vegan. A fascinating, inspirational guy. Enjoy!

Links

• Public Health Collaboration UK website
• PHCUK Real Food graphics
• Sam's biohacking overeating experiments
• Expert interviews Sam did for his Smash the Fat Fitness + Fat Loss Bootcamp website
• Sam on Twitter
• Am I the only one who hasn't heard of Footgolf? Looks FuN!

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The global numbers are, no surprise, falling after several years of stall and splutter. 

The last time they fell so much was 100 years ago, after the Spanish flu killed 20 to 50 million people. 

The extent of decline this time isn't knowable yet but the consensus is COVID will significantly cut into the current global average of 72 years, 8 months. The numbers now are much higher in the rich global north - an average 79 in the US, 82 in the UK. 

For all but the life extension radicals, the focus has shifted to healthspan - how long we live in good health - without the chronic diseases of lifestyle, genetic bad luck, and general physiological wear and tear.

On this episode of The Big Middle, what’s happening with healthspan? 

This is the terrain of my learned guest Dr Rupert Dunbar-Rees, the founder and CEO of Outcomes Based Healthcare, which he’ll tell us all about. 

Links

• Dr Rupert's bio
• Outcomes Based Healthcare
• HumanHealthSpan.com
• Piece in The Times about OBH's findings: "Fifth of people in UK [sic England] will suffer from poor health before age 30" - August 2018
• The APPG for Longevity's key reports "Levelling up Health" (April 2021)  and "The Health of the Nation" (February 2020) - see page 57 for Dr Rupert's paper
• Epidemiologist Veena Raleigh writing for The King's Fund - "What is happening to life expectancy in England" - April 2021
• Dr Rupert on Twitter

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We know longevity scientists are busy developing restorative treatments as they redefine ageing as a disease. 

It’s that medical model of steady decline that gallops to mind when we think of design for older people. It’s all panic alarms, stairlifts and mobility scooters.

Designers shoot past The Big Middle years, 40s through 70s, to dependency and frailty before death. 

The shiny new version of the UK's Design Age Institute is tasked with moving the design of products and services beyond the cliches and the stigma of growing old. 

Colum Lowe is its director. Georgie Lee is responsible for building community. We spoke in London. 

Links

• Design Age Institute
• This Age Thing
• Scooter for Life
• Colum on Twitter
• Georgie on Twitter

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The loss of a loved one takes the trauma next-level. 

How we cope is highly personal.

I, no surprise, have nothing to add to the explosion of advice out there about stress management and self-care and making it to the other side of The Awfulness intact, as unscathed as possible. 

But I’ve taken great care to find someone who does - someone with professional credentials with plenty to say that goes beyond the profusion of platitudes. 

Andy Cope calls himself the UK’s first ever Doctor of Happiness with good, scientific reason. I guarantee you will feel happier just listening to him. He sparkles. 

And if you act on his invaluable advice, you'll be on your way to shifting your attitude to achieve the happiness we all seek and deserve. 

Links

Andy's training and development consultancy The Art of Brilliance

Five minutes that might change your life 

Warning, tears may form when you watch Andy telling The Story of Jimmy's Diary

Pre-order Andy's new book The Happiness Revolution

Buy Andy's 'greatest hits' pick of all his books The Little Book of Being Brilliant

Andy on Twitter

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We learn about the life and work of biochemist Otto Warburg, the German-Jewish Nobel laureate who first proposed cancer as a metabolic disease. 

And we learn how the diet-cancer connection is now at the forefront of cancer research. 

This book has blockbuster movie written all over it - a gripping weave of history and science centred around an eccentric genius. 

Enjoy learning why!

Links

• Sam's Johns Hopkins bio
• Buy Sam's book Ravenous
• Sam's piece in Wired on podcast alum Nir Barzilai's groundbreaking work on metformin: Forget the blood of teens, This pill promises to extend life for a nickel a pop
• Sam on Twitter

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She implores us to do it every month. Pick a day and put it in your calendar. Scrutinise every nook, fold and cranny of our skin. If you notice any changes to freckles, moles or random spots, get in front of your family doctor or dermatologist without delay.

I'm only feeling confident about the outcome of the surgery to remove the melanoma that suddenly appeared on my calf because I wasted no time telling my GP about it. An excision biopsy is being done in a couple of days. 

Dr Frey's prevention essentials are a timely reminder to all to pay more attention to this part of our healthy living routines. Never, she says, scrimp on sunscreen. Go for a trusted, big brand with a four or five star rating and slather it on liberally for a safer summer in the sun. 

Cover photo: MBatty via Pixabay

Links

• How do I know if I have skin cancer? - Dr Frey writing for thedoctorweighsin.com
• Melanoma: What you need to know about diagnosis and treatment - Dr Frey's article on thedoctorweighsin.com
• Dr Frey’s skincare education website FryFace.com – check out the Product Selector tool
• Fayne on Twitter

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Long story short, a skin cancer specialist has declared a flat brown blob that suddenly appeared on my lower leg is likely a malignant melanoma, the deadliest form of skin cancer. How likely? 80% likely. Excision biopsy surgery is booked for the end of the month. I still can’t quite believe it. 

I’m that whiter-shade-of-pale, green-eyed Irish prone to sunburn. I’ve been careful in the sun as an adult, slathering on sunscreen, but that wasn’t the case in my teens. 

Every summer day was spent swimming, slathering on baby oil, baking to a golden crisp on the various sandy beaches of my hometown, Sarnia, Ontario. 

It’s at the southern tip of Lake Huron on the American border, roughly the same latitude and climate as New York City. Eggs are fast-fried on summer sidewalks. 

On this episode of The Big Middle, the why and what of melanoma - diagnosis, treatment, prognosis. 

Back on the podcast with her skin-cancer-specialist cloak on, dermatologist Dr Fayne Frey, the founder of fryface.com.. that brilliant skincare education hub we explored in episode 49.

Links

• How do I know if I have skin cancer? - Dr Frey writing for thedoctorweighsin.com
• Melanoma: What you need to know about diagnosis and treatment - Dr Frey's article on thedoctorweighsin.com
• Dr Frey’s skincare education website FryFace.com – check out the Product Selector tool
• Fayne on Twitter

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I’m delighted to spoil you now with none other than Ben Bikman, bioenergetics PhD, superstar scientist.

He is it when it comes to researching the role of insulin and fat cells in what he calls the Plagues of Prosperity - "The human race is eating itself into metabolic disarray".

He has his own obesity and metabolism research lab at Brigham Young University. 

We get into all of it - the Prof Ben Bikman motherlode and then some. He kindly goes off piste, giving me a hugely personal masterclass on menopause, pregnancy, puberty, miscarriage, estrogen and metabolic rates.

You'll learn:

• How insulin resistance is the root cause of modern chronic diseases
• "The key to metabolic flexibility is getting insulin sensitive and allowing the body to shift between [sugar-burning and fat-burning] fuels"
• Why we all need to care about our insulin levels, even in our 20s and 30s
• How insulin fertilizes fat cells and those secrete problematic hormones
• Why "hunger always wins"  if your get-healthier strategy is eating lots of carbs and counting calories
• Glucagon and why protein doesn't mean trouble if you keep your blood sugar low
• What fat and leptin have to do with infertility - "Fat is essential to human fertility"
• We also talk puberty, pregnancy, menopause, estrogen, metabolic rates, vegan ideology - "A purely vegan diet is incompatible with human survival" - and the "absolutely laughable and harmful" push to manufacture protein alternatives from plants and from animal cells - "I grow muscle cells in my lab.. that is a shockingly intensive process that involves a myriad of chemicals, hormones included"

What a guy. So much knowledge shared with so much clarity, charisma and humility. You'll understand why his students adore him and why you'll want to listen to this one more than twice. Enjoy! 

• Links
• Ben's new book Why We Get Sick
• Ben on "Insulin v Glucagon: The relevance of dietary protein" - from 2018's Low Carb Down Under
• PCOS in young women + mild insulin resistance
• Fasting respiratory exchange ratio and resting metabolic rate as predictors of weight gain: the Baltimore Longitudinal Study on Aging
• That "moment of weakness" Cold Cereal Lesson video
• InsulinIQ
• The Clean Label Project
• Ben on Twitter

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This is a story of professional ethics, motivation and agility that will inspire no end in this age of job insecurity. Pandemic unemployment is surging. More of us doing it for ourselves, setting up our own companies by default or design. We're repackaging and repurposing our skills and learning new ones to get off the soul-sucking treadmill of long commutes to jobs that no longer thrill or fulfil.  

Lucas Chambers is a dear friend and former colleague who took his shot at being his own boss seven years ago. He started a video production agency in Lausanne that he's grown into a tight team of 10. 

There have been many lessons along the way, some that run counter to the accepted wisdom of startup gurus. A pragmatist to the core, Lucas doesn't believe everyone can and should set up on their own. Critical to success, he says, is making sure there's a hot market for your wares. And surrounding yourself with the right people.

"We grew together as a team. They were motivated. They realised what they had - here's an opportunity not to have a job we don't like. And here's a guy who can perhaps make it happen for us. They made a lot of effort to learn, to get better."

I've worked with Lucas so I know a large measure of his success is down to his work ethic and personality; he's confident, charismatic and resourceful. If he doesn't know how to do something, he'll figure it out and deliver.

It was heartwarming - and not surprising - to hear how he protects himself against entrepreneurial burnout by giving his home life equal weight. Weekends are always for family and friends. Balance achieved. 

Links

• Smartcuts
• Showreel
• How big is that big green screen?
• Lucas on Linkedin

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This eager student got it while hosting the first podcast for Pro Longevity - the award-winning, precision nutrition service of Graham Phillips.

The retired University of Cape Town professor is one of the world’s most influential and energetic advocates of eating low-carb high-fat to halt the raging, parallel pandemic of cardio-metabolic disease. He’s reversed his Type 2 diabetes by restricting carbs and adding healthy fats after decades of adhering to standard dietary advice, heavy on grains, spare the fat. An ultra-endurance athlete, he'd been carb-loading to run marathons and teaching students to do the same.

Prof Tim Noakes is transforming the lives of countless unhealthy people the world over through his writing, talks and education and research bodies The Noakes Foundation and the Nutrition Network.

We agree with those who call Prof Noakes a "world resource". And he's as courageous as he is humble, having won a protracted legal challenge from organised nutrition in South Africa with unassailable scientific evidence.

“I got it all wrong for 33 years”

"Hunger makes you fat. Obesity is a disease of hunger."

"Sugar [addiction] and the industrial food diet is such a driver of obesity. You can control your cravings by getting rid of the sugar and carbohydrates"

"You cannot control your weight if you are eating four or five times a day. You have to be eating once or twice a day."

"If we can educate one doctor, it will have a massive influence on their patients and public health."

On my frustrating battle with menopausal weight gain: "I think a lot of people put on weight on this [#LCHF] diet.. Eating high fat is the problem. They need to up their protein [references the P:E regimen of Ted Naiman]... That's the only thing I understand at the moment...Makes sense to me that some people will benefit by eating a much higher protein diet and less fat but they must be satiated, that's the key.."

On one insulin-dependent woman's experience of glucose turbulence in pregnancy: "Her insulin resistance was very bad during her pregnancy - she had to inject insulin. The moment the placenta was free her blood glucose dropped out of the sky and she had to be put on a glucose drip for three days. So, what's going on?..There is so much we don't understand. We've kind of scraped the surface with what we can measure."

On large South African study of risk predictors of fatal COVID outcomes that"showed age and Type 2 diabetes - not tuberculosis and HIV Aids - were the only two factors that increased COVID risk by 8% to 12%.

On an imaginary, blow-out day of carb feasting? Prof Noakes has "reprogrammed my brain" and won't eat the pizza. It "tastes so disgusting." But Graham would binge on a family pizza for two, a sackful of corn chips, a family bucket of battered chicken fried in "carcinogenic seed oils", then feel wretched for days. 

Links

• Prof Noakes writing for Crossfit: It's the Insulin Resistance, Stupid
• Lore of Nutrition
• The Real Meal Revolution
• The New Atkins for a New You
• Tim on Twitter
• Graham’s website
• Graham’s coaching videos – Beating Coronavirus, Live Healthier for Longer, Avoid a Health Crash, Veganism, Type 2 Diabetes, Sleep + Stress
• Graham on Twitter

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She’s a serial social entrepreneur - founder and CEO of Longevity International, Collider Health and Collider Science. 

Writing a book wasn’t an ambition. But a publisher sought her out and, 30 interviews and 18 months later, 'Live Longer with AI' was off to the printers. And, imagine this, it was instantly picked up by the UK’s National Health Service, judged a must read for all staff. Every NHS worker is entitled to a free copy.

We talk about the role of data, government, business and academia in a post-COVID world we hope pays more attention to reducing health and social inequality, get a progress report on the work of the APPG for Longevity, and hear how Tina's gone from taking her shot to taking her place as a leading figure in the healthy longevity arena. 

Links

• Tina's consultancy Collider Health
• Tina's other consultancy Collider Science
• Latest project Science Question Time
• APPG for Longevity's Open Life secures funding for longer, healthier lives - Feb 2021 article in Longevity Technology
• APPG for Longevity's Business for Health
• Our unhealthy nation - Dec 2020 piece in The Lancet by APPG for Longevity's chair Damian Green MP, co-founders  Lord Filkin and Tina
• Buy Tina's book Live Longer with AI: How artificial intelligence is helping us extend our healthspan and live better too
• Okay, if you must, here too
• Tina Woods on Twitter

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Even the major makers of soybean, sunflower, corn and other seed and vegetable oils are quietly backing away from them, well aware of the biological damage they can do.

Tucker Goodrich has been sounding the alarm over the health risks of seed oils for more than a decade. He suffered 20 years of gastrointestinal torment and much - scary - more that mystified his doctors. So he dug into the medical science himself, eventually pinpointing industrial seed oils as a villain in his sickness puzzle.

Tucker's become a recognised world authority on the subject and I guarantee his Patient Heal Thyself story will blow your mind.

Quotes 

"The problem with seed oils is they ultimately break down to some highly toxic substances [oxidative stress process] - both when you're cooking with them - and in the body."

On debunking of key studies promoting the 'heart healthy' aspect of seed oils:"Is there another explanation for why we get heart disease other than this pathway that starts with seed oils and leads to oxidation of Omega 6 fats and consequent damage? There isn't. This is the predominant hypothesis in cardiovascular disease for why this is happening. But they don't say it. They just say take this statin and you'll have less LDL [cholesterol]."
 

On how ditching gluten and seed oils, decades after he quit sugar to prevent more cavities, caused him to "forget" to eat carbs: "All my extra weight just fell off...my pants fell to the floor...What happened when I stopped eating seed oils is that I lost my desire to eat carbohydrates. I forgot to eat carbs for a week...Subsequently, I discovered I can bring back the stroke-like symptoms if I eat whole wheat."
 

On how he'd been prone to breaking bones doing "stupid things" mountain biking and skiing, but broke none after ditching seed oils and gluten: "I'm like a rubber ball now...My healing capacity is up enormously...slipped and fell down the stairs of my ski condo.. later, I noticed a huge bruise ..but I just never felt it. It got weird enough that I was starting to look into whether I had leprosy. One of the symptoms of leprosy is that you can't feel your periphery."

"It turns out there's literature on this. These metabolic products of seed oils break down into things that can induce pain. There's actually a fellow by the name of Christopher Ramsden who did a study into reducing the use of seed oils to reduce headaches." 
 

On taking over-the-counter Omega 3, 6, 9 supplements:"It's roughly equivalent to giving a drowning man a glass of water...We eat too much Omega 6 fats. Nobody needs to have more. Just as with age-related macular degeneration, cutting Omega 6 fats will make it easier for your body to access the more beneficial Omega 3 fats."

You'll also hear

• How his Wall Street systems expertise, combined with his speed reading ability, helped him troubleshoot his many health  problems
• How neuroscience + obesity researcher Stephan Guyenet's work made the link between diet and dental problems
• Years of chronic diarrhea forced him to pack toilet paper wherever he went
• At 40, after 16 years with IBS, he had surgery for diverticulitis
• Dust, hay fever and other allergies disappeared when he quit seed oils and gluten
• Women in China who never smoked are getting lung cancer from inhaling carcinogenic fumes from cooking with seed oils
• The industry is reformulating seed oils to deal with the Omega 6 oxidation problem. Rapeseed and olive oil have fewer omega 6 fats, which are so unstable that they burst into flames when heated
• The surprising link to sunburn - you don't burn when you quit ingesting industrial seed oils
• Skincare products made of seed oils don't pose problems, as far as he knows, but "you want to eat your skin care, you don't want to slather it on your skin"
• How Tucker's fiancé stopped using seed oils, added animal protein to her vegetarian diet, and recovered from Fibromyalgia
• What fats are healthy to eat and cook with? Butter or ghee for him. And beware olive oils are frequently adulterated with seed oils. A jar of olive oil lasts him about a year.
• His unbreakable rules to optimise his health

Please consider the information in this episode as only that; it should not be construed as medical advice. Go to your GP or family doctor for that.

Links

• Tucker's blog 'Yelling Stop' - loads of interesting articles about seed oils, healthy living and barefoot running
• Tucker on Twitter 
• Neuroscientist Stephan Guyenet's website
• Want even deeper science on toxic seed oils? Here's Tucker with Dr Cate Shanahan on the Peak Human podcast

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"You can't join the dots unless you know what those dots are. There is a problem though in that once you've been bitten by this bug and once you understand that there is more to medicine than just prescribing a pill for every ill, it's really quite addictive because it works."

The wise words of my wonderful guest Dr Sarah Davies - a functional medicine practitioner who keeps one foot in the mainstream medical camp in the UK, also working within the National Health Service as a General Practitioner. 

We hear why she felt compelled to turn to functional medicine to find the knowledge and space to dig deeper - holistically - to treat patients. Why her clients thrive on whole food diets, breaking lifelong addictions to refined sugar and fast food. We learn why and how she treats autoimmune disorders and a host of others ills that defy easy diagnosis. And why inflammation and insulin resistance are the root causes of the scourge of modern, chronic lifestyle diseases.

We share a history of underperforming thyroid glands and of beating back serious bouts of Rheumatoid Arthritis (RA) by modifying our diets, eliminating gluten and other problematic foods. I was living in Geneva at the time of my RA diagnosis and followed the advice of my Swiss rheumatologist. I ended up taking progressively more toxic drugs over two years to slow the rogue attack on the cells that line the joints, making them stiff, swollen and painful. 

That standard protocol always suppresses - wrecks more like - the immune system. 

Dr Sarah, of course, knew better than to follow this treatment path. She investigated her diet as the probable cause of her RA. It took me longer to finally discover that, like her, I'm gluten-intolerant. Hers "vanished and never came back" when she changed her diet. It took me longer to reach the same, happy conclusion and suppress my symptoms. 

We close out this episode with Dr Sarah's advice on how to manage the extraordinary levels of stress we're all feeling. A good first step? Quit "doom-scrolling the news".

I hope you find Dr Sarah's insights helpful to you or someone you know. Enjoy and [encouraging tone] hope you'll share liberally!

Please view the information in this episode as only that; it should not be construed as medical advice. Go to your GP or family doctor for that.

Links

• Dr Sarah's website
• Dr Sarah's article on how to improve your gut health
• Dr Sarah's talk on Functional Medicine and the NHS at the Evolution of Functional Medicine Forum (2017)
• f.lux software to filter blue light
• 3-4-5 breathing to lower stress: breathe in for 3 seconds, hold for 4, breathe out slowly for 5
• Dr Jeffrey Bland (USA) known as the Father of Functional Medicine
• Dr Dale Bredeson (USA) recognised expert in the mechanisms of Alzheimer's and other neurodegenerative diseases
• Hypothyroid Mom
• TwinsUK – Kings College London Prof Tim Spector’s landmark nutritional PREDICT study on twins

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Thankfully, a global movement to expose it and end it has become an unstoppable force. As more of us live longer and age differently - rejecting the dominant 'old is awful' narrative - more of us are embracing the cause. We find like-minded people and a vast store of inspiration and resources at online education hub Old School, the brainchild of anti-ageism activist Ashton Applewhite. Hear her 2018 turn on The Big Middle here.

This time, we meet Old School's co-founders, therapist Kyrié Carpenter and gerontologist Ryan Backer. We hear how the anti-ageism movement is taking off, about Old School's exciting collaboration with the World Health Organisation, why members of the ‘successful ageing' brigade don’t feature on the site, and how they, in their 30s, swap age shame and denial for acceptance and pride. Kyrié calls herself a Crone in Training; Ryan an Older Person in Training. 

Oh and we briefly talk hair. Will I ever join others in seeing hair dye use as a badge of dishonour in the battle against ageism and sexism? I doubt it but you never know, ask me again in 10 years. 

Links

• OldSchool.info
• Old School on Twitter
• Ashton Applewhite's website
• Kyrié's website
• Kyrie writes for and is Managing Editor of ChangingAging.org - the online platform of influential geriatrician-cum-thespian Dr Bill Thomas
• Kyrié on Twitter
• Ryan's website
• Ryan on Instagram
• Christina Peoples' gerontology blog Gero What?!
• Ashton's Age Against the Machine interview with Kimberlé Crenshaw

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Eat real food. Ditch sugar. Avoid ultra-processed rubbish 'food'; it's addictive and keeps you hungry. Manage your stress with sleep and exercise. 

That's the topline advice of Graham Phillips, The Big Middle's resident metabolic science guy. 

He laments what he sees as a systemic failure to focus on the root cause of many COVID19 deaths - metabolic syndrome, the lifestyle cardio-metablic diseases already killing millions every year. 

"You would assume only the adaptive immune system is the bit that works against COVID19, that unless we've either been infected or had a jab, there's nothing we can do. But that's not true.

The immune system is multilayered and your first line of defence in your immune system is the mucosal lining of your gut and your nasal cavities. And guess what looks after your immune system? Your microbiota, your bugs. So if you eat healthy food...you'll be far more resistant to the infection."  

Links

• Graham’s website
• Graham’s coaching videos – Beating Coronavirus, Live Healthier for Longer, Avoid a Health Crash, Veganism, Type 2 Diabetes, Sleep + Stress
• Graham’s blog: What is ultra-processed food? 
• His article The Personal Touch in Pharmacy Magazine – Oct 2019
• TwinsUK – Kings College London Prof Tim Spector’s landmark nutritional PREDICT study on twins
• Public Health Collaboration UK
• DietDoctor.com
• Graham on Twitter

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Graham Phillips is back on The Big Middle in his coveted new role as resident Metabolic Science Brainbox. His knowledge runs deep and he's also a seriously nice guy. Isn't it fabulous he's coming on as a regular now, two months after his first outing as a guest? Listen to episode 64 to catch his debut. 

This pandemic has shown that lifestyle diseases that set us up for the worst COVID outcomes are within our power to avoid. If we know how. 

Prepare to learn all you need know about strengthening your immune system to survive an encounter with The Virus. 

Here's a sampler from our conversation:

"80% of your immune system is in your gut"

"Your microbiome is your second brain"

"95% of your supply of serotonin - your happy hormone - is in your gut, not your brain"

"The state of your microbiome is your destiny, not your genes"

"We have 100 trillion bugs in our gut but only a few more genes than a banana"

"Just two nights of bad sleep will cut the efficacy of the winter flu shot by half"

"Before you get your COVID jab, make sure you get a couple of nights of good sleep"

"Look after your gut bugs and they'll look after you"

You'll also hear more about the lifestyle changes I made to all but win my battle with autoimmune attacks Rheumatoid Arthritis and Thyroiditis that struck at menopause. The heavy drugs I took for the RA certainly did a number on my immune system. 

Next week with Graham, how to survive COVID by optimising your metabolic health. 

Enjoy and go well... 

Links

• Graham's website
• Graham's coaching videos - Beating Coronavirus, Live Healthier for Longer, Avoid a Health Crash, Veganism, Type 2 Diabetes, Sleep + Stress
• TwinsUK - Kings College London Prof Tim Spector's landmark nutritional PREDICT study on twins
• Graham's blog: What is ultra-processed food? 
• His article The Personal Touch in Pharmacy Magazine - Oct 2019
• Graham on Twitter

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• Website with help from designer Emanuel Draghetti
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Canadian entrepreneur Wendy Mayhew wrote a How To book to help you weigh up the risks and rewards. And we meet three over 50s who went for it and wish they'd done it sooner, all featured on her Wise 50 over 50 awards list in Canada. She joins me from my old student stomping grounds in Ottawa. 

Links

• Wendy's website,, where you can buy her book
• Wendy's article in The Globe & Mail newspaper Older entrepreneurs are worthy of support, too
• Wendy on Twitter
• Lisa Hallsworth, founder of Rillea Technologies
• Lisa on Twitter
• Linda Peers, founder of The Cultured Coconut
• Linda on Instagram
• Jacques Cantin on Linkedin, founder of D Givre (no website, in R&D phase

 Support The Big Middle 

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But as he coped with challenging physical reminders of his ageing self in his late 60s - hips replaced, back surgeries - gerontologist Thomas R. Cole wanted to know more about the road ahead. He sought answers from a dozen men of immense privilege, exemplars of the 1930s through 1950s American model of masculinity and achievement.

His hand-picked group - many now gone - included Denton Cooley, the first surgeon to implant an artificial heart into a human; George Vaillant, the former research director of the famed Harvard Study of Adult Development; Paul Volcker, the former head of the Federal Reserve; philosopher Dan Callahan, co-founder of The Hastings Center, the world’s first bioethics research institute; Hugh Downs, veteran TV broadcaster and creator of The Today Show; and Ram Dass, his generation’s foremost American teacher of Eastern spirituality.

We talk about their guidance, which features in Old Man Country, Cole's book of rare intimacy and insights into what it’s like to live so long having prospered due to privilege as well as effort. What happens to high-profile men when they step out of the limelight into "the province of retirement — a barren place often marked by an absence of wealth, prestige and personal meaning."

Old Man Country is Cole's "autobiographical field report" too - a poignant account of his own search for what eluded his father, who ended his life when Cole was just four. 

Links

• Tom's profile - Director, McGovern Center For Humanities & Ethic, McGovern Chair In Medical Humanities at the University of Texas
• Buy Old Man Country
• Tom's piece about his book for Next Avenue
• Buy The Journey of Life: A Cultural History of Aging in America, which was nominated in 1992 for a Pulitzer Prize

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Had things gone to plan, you’d be hearing an answer from a friend I’ll call Beth, 52, mother of three and desperately sad. Her eldest, now 32 and flying high as an oncologist, never calls, never visits and openly tells her father, sister and brother she has no interest in having a relationship with her mother. 

Was there a cataclysmic rupture in their relationship - an event Beth can identify? She says no. Has she tried every which way to get her daughter to open up, tell her why she’s being shunned? Yes, says Beth. She’s also suggested they see a therapist. Not even a no to that one. No response. 

Coming on The Big Middle, anonymously, was too hard for Beth. Her life is cloaked by heartache and confusion. 

This is a little-reported flaw in the fantasy 'Happy Families' social script we’re all fed. The advent of The Big Middle years doesn’t mean there’s less drama and more love and respect in both directions. 

My interest in this is born of comments from Beth and two other mothers of grownups. In the past year, all surprised me with “Susan, I wish I’d never had them. They couldn't care less about me. I only hear from them when they want something.” 

I know why they felt they could share that with me without judgement. I love kids but never felt in a hurry to make my own. That ambivalence held through a succession of international jobs, miscarriages and the cancer death of my beloved in my mid-40s. It’s harder to share the dark reality that your kids have abandoned you with friends living that Happy Families fantasy of enduring mutual love and support and so much fun had by all whenever you’re all together. 

That’s my springboard to take a wider look at the flaws in that social script. Our guide is Rachel Melville-Thomas, a child-psychotherapist of 30yrs experience in the US, UK, France and Switzerland. 

Links

• Rachel's website
• Rachel's profile
• Rachel's advice in The Guardian's Ask Annalisa Barbieri - 
  Our relationship with our 32-year-old daughter has broken down
• Rachel's input in BBC report on estrangement from perspecitve of adult children - Why it's OK I'm not seeing my family this Christmas - 
• Rachel's advice in The Irish News - Ask the Expert: How is our divorce likely to affect our children?
• Rachel's article for Huff Post - Parents and Teaches Must Do More for Children's Mental Health 
• That piece in Bustle - 7 Things You Don't Owe Your Parents
• Rachel on Twitter

For decades, thanks to the corporate capture of the food sector by vested interests, we've been popping pills to treat but not cure chronic diseases - many rooted in our subsistence on ultra-processed fakery marketed as food. Many of those diseases strike in The Big Middle years, mid-40s - mid-70s. 

Like a growing number of the world's leading scientists and medical professionals, my guest is working tirelessly to wean us off the received wisdom that fat makes us fat, a calorie is a calorie, and when you eat doesn't matter. 

The UK's Graham Phillips is known as The Pharmacist Who Gave Up Drugs. He's getting spectacular results with a new coaching service for people in metabolic distress: personalised nutrition and lifestyle tweaks based on biometric data and blood sugar monitoring.

He also sees a bigger role in disease prevention for community pharmacists, the unsung heroes of the COVID crisis. 

Links

• Graham's website
• Graham's coaching videos - Beating Coronavirus, Live Healthier for Longer, Avoid a Health Crash, Veganism, Type 2 Diabetes, Sleep + Stress
• Graham's blog: What is ultra-processed food? 
• Graham's opinion piece Abandoned on the NHS Front Line in Pharmacy Network News - Apr 2020
• Graham's article The Personal Touch in Pharmacy Magazine - Oct 2019
• Graham on Twitter

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"None of us know where it's headed; it's an uncertain pattern we're facing, an uncertain future and I think there''s a lot of fear out there but there's also quite a bit of opportunity. I'm seeing some glimmers of hope out there and ways that we're going to shift our workplace and the way we approach our work. But there are all kinds of opportunities coming up through this with this new world we're facing and I think of it as work transformed."

Our guide Kerry Hannon, author, speaker, work, money and personal finance expert. She taps into the zeitgeist of our rapidly ageing, rollercoaster coronavirus world for The New York Times, The Los Angeles Times, PBS Next Avenue, Money, US News & World Report and many more. 

She’s called on for comment by major and minor broadcast media, delivers keynotes, and writes books - 13 so far (a 14th was custom for a private client so not available to us).

Last year, she gave us  Never Too Old to Get Rich: The Entrepreneur’s Guide to Starting a Business Mid-Life and, just out, Great Pajama Jobs: How to Land a Job Without the Commute.

Links

• Kerry's website 
• Kerry writing in The New York Times - Aug 2020 - With Virtual Reality, Caregivers Can Become Patients
• Kerry's opinion piece for MarketWatch - July 2020 - As Trump and Biden trade age insults, older workers suffer
• Kerry for PBS Next Avenue - Dec 2019 - Social Media Tips for Midlife Entrepreneurs
• Kery writing in The New York Times - Aug 2020 - Keeping a Dream Alive During the Pandemic
• Kerry and The Big Middle alum Marci Alboher, VP Encore.org - Apr 2020 - on Andy Levine's podcast Second Act Stories
• Kerry on Twitter

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I’m partial to the new science around the ancient teaching of the healing power of fasting. I’ve followed a relaxed low-carb-medium-fat-no-sugar way of eating for the past five years. It's how I’ve  suppressed a couple of autoimmune disorders this way - Rheumatoid Arthritis and Hashimoto’s, an attack on the thyroid - that arrived with menopause. That’s my N = 1 experience, of course, not to be construed as medical advice. This episode is not that. 

If you’ve explored fasting as you look to optimise your health, you’ll know my guest by name and reputation. Megan Ramos is co-founder, along with Dr Jason Fung, of the Toronto clinic Intensive Dietary Management and The Fasting Method programme. There's an exploding online community around what they do, helping countless people recover from metabolic illness. 

Links

• Megan and Jason's Toronto clinic Intensive Dietary Management
• Jason and Megan's site for The Fasting Method
• 'Practical Fasting': The Use of Therapeutic Fasting in a Clinical Setting - Megan highlighting the inequality around access to healthy, real food in her speech to the 2019 Low Carb Down Under event in Australia
• Therapeutic use of intermittent fasting and ketogenic diet as an alternative treatment for type 2 diabetes in a normal weight woman: a 14-month case study in the British Medical Journal - June, 2020 -authors Charlene Lichtash, Jason Fung, Katherine Connor Ostoich, Megan Ramos
• Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin in the British Medical Journal - Sept 2018 - authors Suleiman Furmli, Rami Elmasry, Megan Ramos, Jason Fung
• The Fasting Method's free Facebook page 
• Megan on Twitter

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A period of self-reflection and stock-taking is necessary if you find yourself in an existential twist, as so many of us do. But isn't there a point when you have to get on with things, plan your next move and actually make it?

My guests, Judy and Adrian Reith, have decades of experience as, respectively, parenting and executive coaches. Now, they're sharing their expertise with The Big Middle cohort. They've written a terrific book to help us fine-tune our priorities and options and get to the action stage of our midlife transitions. It's called Act 3: The Art of Growing Older. I hope you enjoy discovering it as much as I did. It may be just what you need to shift your attitude and take yourself in a new direction. 

Links

• Judy and Adrian's website
• Their virtual book tour Zoom sessions 
• Judy and Adrian on Twitter

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Coronavirus unemployment crisis could flatten a generation

The unemployment dam is about to break - manufacturers warn of bloodbath

I’m using unemployment benefits to buy my insulin 

That last one applies to many unfortunate souls in the US, where easy access to healthcare is tied to having a job, unlike here in the UK of mostly free, universal health care.

My guest is superstar economist Pavlina Tcherneva. Her new book The Case for a Job Guarantee is generating headlines that include the words radical, bold and absurd. 

But is it shifting the ideas of policymakers in a pandemic world that's already seen nearly 10-trillion dollars worth of state intervention? Are any governments on the verge of testing the idea? Is it gaining the support of the public?

Pavlina makes her case for public service work for all who need and want it in this episode of The Big Middle. 

Links

• Pavlina's website
• Pavlina's latest book, Jun 2020 - "The Case for a Jobs Guarantee"
• Pavlina's Op-Ed in The American Prospect, June 2020 - "Controlling the Viral Spread of Unemployment With a Job Guarantee"
• Her piece for Foreign Affairs, July 2020 - "A Job Guarantee Costs Far Less Than Unemployment"
• Her piece for the Institute of New Economic Thinking, May 2016 - "A Global Marshall Plan for Joblessness?"
• Pavlina's interview with Brian Lehrer on WYNC, June 2020 - "Jobs, Guaranteed"
• Pavlina on Twitter 

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Everything’s in flux - what jobs will survive four months of the forced shutdown of supply and demand. That's never happened before. 

There’s no end of speculation about the magnitude of the unemployment surge ahead. There’s no recovery-path consensus from economists - how could there be? COVID has exploded all the certainties and models of yore.

The pandemic’s impact on older workers is being tracked by the fabulous Stuart Lewis, founder and CEO of the digital jobs and advice site Rest Less UK, a partner of The Big Middle. 

He warns Chancellor Rishi Sunak is distorting the labour market with his temporary youth jobs scheme, sabotaging the survival efforts of overlooked jobless over50s.

What's the right crisis response to surging unemployment and financial precarity for all ages? 

We hear the heart-rending stories of long-time jobless Maura and Steve, both living on a knife edge but, somehow, battling on to try to beat the ageism odds and get a job, any job. 

Links

• Rest Less UK Summer Statement reaction news release warning youth Kickstart scheme could leave at least  660,000 over50s dependent on Universal Credit benefits for a decade
• Rest Less UK research reported by Amelia Hill in The Guardian, June 2020: UK reports rise in over-50s struggling to pay for necessities
• Ipsos MORI and the Centre for Ageing Better research, June 2020: Lockdown could leave next generation of retirees poorer and sicker than the last 
• Stuart’s blog for the International Longevity Centre UK: Why aren’t more people talking about the impact of longevity on the workforce?
• Rest Less website
• Rest Less on Twitter
• Rest Less on Facebook

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In this episode of The Big Middle, I’m in hot pursuit of some new hot spots of innovation - positive pandemic impacts. 

I find plenty in the healthcare innovation sector.

"I have certainly seen in the fields of diagnostics, therapeutics, vaccines, surprisingly rapid progress and an ability to remake the rules to some extent.”

My guest, our guide to healthcare innovation, Professor Richard Barker of Oxford University and King’s College London,founder and CEO of New Medicine Partners and the startup Metadvice, a renowned expert in biotech, population health, precision medicine, diagnostics, informatics, and Chair of the Health Innovation Network - what that is and does, as we go.

Quotes

On "surprising" pace of change:

"I have certainly seen in the fields of diagnostics, therapeutics, vaccines, surprisingly rapid progress and an ability to remake the rules to some extent. We have seen scores of diagnostic tests approved by the FDA or notified bodies in the EU. 

We've seen 1700 or more clinical trials set up for promising and indeed unpromising therapies and we've seen vaccines being produced or at least developed and trialled in the world and all of that in the last three months."

On importance of embracing data for personalised, precision healthcare:

"We're deeply schizophrenic [about data collection and use] ..We've got to move, and I would love to see this happen in my lifetime, to the situation where patients feel not just a sense of responsibility about their health but also a sense of being able to control their own health data - not just what's in their electronic medical record or their Fitbit or their diabetes remote monitoring or whatever it is - and that way it just simply reinforces people wanting to do the right thing with their own bodies."

Links

• The Health Innovation Network 
• Richard’s books
• New Medicine Partners 
• Metadvice 
• Sweatcoin - an app that rewards your steps
• APPG for Longevity
• Richard on Twitter

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My first distinguished guest is variously described as a visionary entrepreneur, billionaire master investor, bad boy of Brexit and emerging markets, skilled spotter of global trends, accomplished author and generous philanthropist.  

Jim Mellon is founder of the Burnbrae private investment group, which has interests in a number of industries. His most recent ventures include co-founding Juvenescence, a company investing in the development of therapies for ageing and the diseases of ageing, and Agronomics, which invests in the nascent industry of environmentally-friendly and cruelty-free foods. He's also co-founder of The Longevity Forum, a non-profit bridging the gap between longevity science and society.

We talk philanthropy, longevity, biotech, the shocking turn of events in the US, whether we’ll hit reset on the crises in inequality, capitalism and climate in any meaningful way, why China will have to reinvent itself, best future career and investment bets, why government intervention is needed to overhaul Big Food - we agree sugar is poison and should be taxed like cigarettes - and how his values and investment moves are inseparable: “I want to make a positive impact in some of the areas I'm interested in."

Quotes

On how COVID crisis underscores urgency of research into prevention of  age-related killer diseases: 

“The sick and elderly are extremely vulnerable to something that comes sideways to get them. If we could boost their immune systems, which are very compromised by the fact hey’ve got all these diseases and that they’re old and their immune systems have been compromised by age, we put them in a much stronger position to resist the ravages of pandemics.”

On President Trump’s chances of winning a second term?

“Who knows? Donald Trump pulled a rabbit out of a hat last time. He probably knows his audience better than Joe Biden knows his audience and he’s absolutely ruthless in the pursuit of power. But...as you rightly pointed out, the US is on fire at the moment and this is something in my lifetime I have never seen - this is incredible. The world’s most advanced society...has the greatest level of inequality in the history of the world, which is evidenced by all these riots. It also has a very patchwork response to the pandemic - not a good response - and it’s got erratic leadership. It’s a very difficult situation.”

On best future career and investment opportunities:

Don’t follow the obvious trends. Don’t go develop an app. Don’t become a doctor or lawyer because those professions will be replaced by technology in the relatively near future. Look at the meta-thematic trends we have at the moment: number one is environmental change, and they’re all linked together, number two is food….and number three is the science of longevity in biotech, in healthcare, in the provision of empathetic services to older people. Those will be the three key areas of great career and entrepreneurial development over the next 10 or 20 years. And that’s what I would recommend anyone who’s starting now to do. Don’t go with the old status quo, go with the new.”

Links

• Jim Mellon donates £1 million to Oriel for Aging Research - Longevity.Technology May 2020
• The Burnbrae Group
• Jim's virtual Master Investor talk April 2020 - Reflections from a small island
• Interesting write-up of latest partnership forged by Juvenescence 
• Read one of Jim's six books? 
• Jim's Master Investor investment, media + events company on Twitter
• He's not on Facebook "a time-wasters' charter" or the others 

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I sincerely hope you're settling into a rhythm that nurtures you and yours. 

Solitude-seeking weirdo that I am, I'm mostly finding it manageable - surreal, yes, unsettling, too, but not enough to send me over the edge. 

Beautifully deafening birdsong, marathon sunrise walks, huge WhatsApp chats with family and friends, Zoom events galore and - not virtue-signalling, promise - but some shopping runs for my older neighbours and helping fill the boxes at my local food bank. I know I’ve got it much easier than many. Grateful for that. 

The rough-and-tumble of recent years has done wonders for my resilience, my capacity to maintain a steady state of sunny side up. My guest is the same, a realistic optimist who chooses to find reasons to be cheerful. 

Suzanne Noble is a serial social entrepreneur who excels at acting on her steady stream of practical, good ideas. She likes solving problems. She doesn’t waste time mulling pros and cons. She spots a needs gap and goes for it. Quickly. That, as we all know, is the hard bit. 

Her latest enterprise is Silver Sharers - finding compatible house mates for over50s, very much part of Generation Rent. Her Advantages of Age Facebook community and business academy is thriving, ditto an app called Frugl I’ll be asking her about. 

Down the line from about five kms down the road from me in west London, I reached Suzanne at her home in Kilburn. 

Quotes

"Moving into the social enterprise space.. I only recently recognised that had I set that business up with a completely different structure, I could have run it very nicely as a not-for-profit. I was chasing big money from venture capitalists and angel investors who couldn't see the long-term value in it."

"Finding a place to live when you're older, perhaps with like-minded people, this is not a transitional type of accommodation.. there's a whole different kind of criteria the comes into play."

"One in five people over 50 are renting now.. and that is going to go to one in three by 2040. ..Many, many people here [UK] and in the states are renting. I think we're going to see that trend become more prevalent ...unaffordable housing is a problem in every major city in the world."

"With every startup, you have to just decide you're going to go for it... I'm just about getting on with it."  

Links

• Silver Sharers
• "Silver Sharers: the site helping older renters meet their match" - Amelia Hill in The Guardian, Jan 2020
• Advantages of Age website
• Advantages of Age FB Group
• The Age Advantage - Sonia Zhuravlyova for online mag Positive News, Oct 2017
• "I've put my career on hold to try and help musicians earn a living" - Suzanne on her Corona Concerts Facebook page in London's Metro, April 2020
• Suzanne singing the dirty blues on YouTube
• Suzanne on Twitter

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Her groundbreaking book Elderhood: Redefining Aging, Transforming Medicine, Reimagining LIfe was named a Pulitzer Prize finalist the day before we spoke. It was already a New York Times best-seller, praised as a landmark work laying bare the structural faults of society and healthcare systems that fail the old.

Dr Aronson teaches medicine at the University of California in her home town of San Francisco, where she makes house calls alongside her hospital work. 

We talk about her writing, why we need to embrace elderhood as a life stage as we do childhood and adulthood, why 'elder' is the perfect replacement for 'older adult', the "self-defeating hypocrisy" of ageism - exposed anew in the response to the COVID-19 crisis - and how COVID-19 infection can present differently in elders. 

Quotes

"How we treat older people tells us almost everything we need to know about what's wrong with modern health care."

"We've set up a health system that recognises kids and adults and not elders. We've also set up a health system that really values technology but not people. And it's all part of this larger change that's harming medicine, old people, health care and society."

"We so often think that the only life that has value is the optimal one and that's insane because it means 99.98 % of us are losers the whole time."

Links

• Louise's profile at the University of California at San Francisco
• Elderhood entry on The Pulitzer Prizes site
• Get your copy of Elderhood here
• Louise's newly-released TEDMED talk "Embracing elderhood as a stage of life" 
• "Age, Complexity, and Crisis — A Prescription for Progress in Pandemic" - Louise's latest in The New England Journal of Medicine, April 2020
• "'COVID-19 Kills Only Old People.' Only?" - Louise's opinion piece in The New York Times, March 2020
• "Coronavirus reveals just how little compassion we have for older people" - Louise writing in Vox, March 2020
• "Ageism is Making the Pandemic Worse" - her piece in The Atlantic, March 2020
• "The New COVID-19 Symptoms to Watch For" - older adults can just seem 'off', Next Avenue, April 2020
• Louise on Twitter

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The coronavirus pandemic has introduced all of us to the concept of flattening the curve. We stay at home to help stop the spread of COVID19, helping preserve critical care resources so rationing won’t mean the virus that mostly kills old people kills old people who might have survived if age was factored out of triage calculus.

We are far from flattening the virus curve on ageism.

Early on, when the messaging from China and Italy was that this disease mostly kills old people, the poisonous hashtag boomer remover cropped up on social media. We shuddered at a UK columnist’s casual reference to a potential upside: the cull of the elderly who are economically dependent. We heard the lieutenant-governor of Texas urging the old to sacrifice themselves to minimise economic damage, to take one one for the team.

And only now has the UK government been hammered into paying attention to the reality it ignored - the virus is ripping through residential care homes it left to fend for themselves. The UK's social care sector has long been Cinderella to the National Health Service (NHS), deprived and in chronic crisis.

Is care being denied higher-risk old people even before pandemic peaks overwhelm resources?

Even more so than usual, are old people being treated as expendable?

Questions I put to Margaret Morganroth Gullette, prolific author, scholar, influential culture critic, expert in age and ageism and, I’m honoured to say, a friend of this podcast.

She says decades of government neglect, deep-rooted inequality and ingrained age bias have set us up for avoidable deaths of the old and the poor that will amount to "crimes against humanity".

She worries that her seminal message that we are "aged by culture" is being lost in a resurgence of the ageist decline narrative of later life. It will be a struggle, she says, to silence the pandemic narrative that old people are expendable in a crisis.

"Ethical triage even in crisis care should focus on the individual's medical condition, not the sociological category."

"Bias in triage decisions is a worldwide danger to the vulnerable."

Links

• Margaret's profile Brandeis University
• Margaret's essay "Avoiding Ageist Bias and Tragedy in Triage" - online magazine Tikkun.org Apr 2020
• Margaret's piece "Ageist 'Triage' is a Crime Against Humanity"- LA Review of Books Mar 2020
• Her latest book "Ending Ageism: How Not to Shoot Old People"
• "Rapid Expert Consultation on Crisis Standards of Care for the COVID-19 Pandemic" from the US National Academies of Sciences, Engineering, and Medicine - Mar 2020
• Sheri Fink's “The Hardest Questions Doctors May Face: Who Will Be Saved? Who Won’t?" - The New York Times - Mar 2020
• Margaret's piece in The Atlantic - Losing the American Dream of Progress: Getting Fired at Midlife
• Ezekial J Emmanuel article in The Atlantic 2014 - "Why I Hope to Die at 75"
• Margaret on Twitter

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I am not dissing the many purveyors of lockdown lifestyle advice - much of it is good to excellent and surely necessary but enough already is my feeling, confirmed by a straw poll of friends and family.

We each have our own way of adapting to this global trauma.

Since my cold meant I had to stop doing shopping runs for lovely high-risk neighbours, I slipped back into my old news junkie ways, incessantly scrolling, falling down bottomless Twitter tunnels for hours.

My trusted news sources - Reuters, the BBC, the New York Times, the FT, the Guardian, the Economist, Next Avenue, Channel 4 news - are covering every conceivable angle - the facts, first-person accounts, sidebars, explainers, roundups of all the remarkable stories of kindness displacing selfishness. Bar the corona and ageism show I’m working up now that I’m feeling better, I don’t see a coverage gap that needs filling by The Big Middle.

Virus news overload is hitting many, driving up anxiety levels. Instead of this rush to displacement activities, more busy-busy hurry-hurry but now indoors and online instead of out there in the world we shut down, surely, alongside the explosion of lockdown advice, we need to make time to process what’s happening. We need to sit with it. We need to just be and reflect instead of engaging in what feels like competitive lockdown hyper-production and self-optimisation.

This invisible menace presents a real opportunity to check our behaviour, to figure out how we can sustain the extraordinary displays of selflessness we’re seeing, to figure out how we can live in a kinder, gentler, more equitable, more compassionate way.

For the foreseeable surreal future, there will be no shortage of existential questions without clear answers. Future episodes of this podcast will focus on some of these questions.

To this week’s guest. Dr Linda Fried is a renowned geriatrician,epidemiologist and Dean of the Mailman School of Public Health at Columbia University. I was thrilled to speak with her for The Longevity Forum at their flagship event here in London last November.

Dr Fried’s message then is even more pertinent now. The longevity revolution, she says, presents us with an entirely new stage of life and figuring out what to do with it is the design opportunity of the century.

Links

• Dr Fried's profile at Columbia University
• Dr Fried on how to adjust daily routines during pandemic
• Dr Fried video explainer of her “Rethinking (Y)our Longer Lives" course at Columbia
• My other inteviews for The Longevity Forum

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For now, I'm keeping this a virus-free zone. There is more than enough essential daily listening and learning to do from official and trusted media sources. And so many qualified professionals are offering excellent psychological and emotional support and coping strategies as we brace for what’s next.

This time, it's my interview with longevity legend Dr Nir Barzilai, Director of the Institute for Aging
Research at New York's Albert Einstein College of Medicine, discoverer of the first ‘longevity gene’ in humans. He's poised to begin - as soon as $75m worth of pledges materialises - a five-year clinical trial exploring the rejuvenation properties of metformin, the generic Type 2 diabetes drug.

We talk about his work to realise the promise of targeting ageing with metformin and other next-generation drugs - arresting it, reversing it, instead of treating the many specific diseases related to it. Dr Barzilai says we're not far off from seeing applications to "erase the scratches of ageing", unlocking a healthspan dividend that will drive down treatment costs to the benefit of all.

Next up soon, my Longevity Forum interview with Dr Linda Fried, Dean of the Mailman School of Public Health at Columbia University. She says designing our new life stage, the extra years we‘re getting in what I call The Big Middle - is the design opportunity of this century. This global pandemic certainly adds an unexpected design element into the mix.

Links

• Nir's profile Albert Einstein College of Medicine
• Nir's Institute for Aging Research
• Is metformin the key to living longer? - Oliver Franklin-Wallis writing in The Times Magazine Dec 2019
• The detailed science of metformin as a tool to target aging - Nir and others in Cell Metabolism 2016
• Great feature about Nir's background and work - 'The Man Who Wants to Beat Back Aging' Science magazine 2015
• The Longevity Forum 2019 agenda

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She's a member of the steering committee of ARCH, the University's Ageing Research Collaborative Hub. I first met her in my work for the All-Party Parliamentary Group for Longevity - she's a strategic advisor for the group and wrote a key paper titled the Economic and Scientific Case for Therapeutic Intervention in Ageing for the APPG's action plan, out last month.

I was delighted to interview Prof Cox about her work on the biochemical mechanisms of ageing at the second annual Longevity Forum in November. The Longevity Forum - as you may know - is the brainchild of Jim Mellon, of the biotech incubator Juvenescence, Dafina Grapci-Penney, Managing Director of Greentarget PR, and podcast alum Prof Andrew Scott, the London Business School economist who gifted us and countless governments with the longevity policy bibie that is The 100 Year Life. Their forum has become a must-attend ideas exchange for the world's leading longevity scientists and social scientists. Lucky me, I got to talk stem cells, cartilage regeneration, zombie cells and the much-pursued longevity dividend with Prof Cox.

Links

• Coxlab - Prof Cox's specialist website showcasing her and her team's work in the biochemistry department of the University of Oxford
• Prof Lynne Cox on Linkedin
• Prof Cox's paper in the APPG for Longevity's key report The Health of the Nation: A Strategy for Healthier Longer Lives - pp 72-80
• Excellent interview of Prof Cox by Longevity.Technology: her ideas about researching ageing and the need for tighter integration between academia, spin outs and drug development

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Science is pushing ahead, making impressive strides in preventative and regenerative medicine to achieve parity in healthspan and lifespan. That parity is at the heart of a sweeping strategy unveiled in the UK by a cross-party group of politicians, scientists, academics and public health experts and advocates - the All-Party Parliamentary Group for Longevity. For details, have a listen to the episode with Tina Woods, the APPG for Longevity's co-leader. As their head of communications, I get to meet and interview so many game-changing pioneers in healthy longevity.

If you're not among those pioneers on the science side, I guarantee your mind will be blown by the transformational work with stemcells and vaccines being done by Wayne Channon - a physicist, tech and life sciences entrepreneur I interviewed for the APPG for Longevity a few months ago. He's the chairman of Cells4Life - the UK's largest cord blood bank - Stabilitech Biopharma and a number of other biotech companies. He’s a strategic advisor on the APPG’s science and business boards and a corporate sponsor of the group.

Off-mic, as we chatted about bringing our earlier interview to The Big Middle, I asked Wayne how he feels about his work.

“For the first time in medical history Susan, ​stem cells are allowing doctors to actually repair or regenerate new tissues. In the past, medical science just tried to keep you alive until your body could self-heal, if indeed it could. I have run bigger companies but none more rewarding than Cells4Life - we are actually saving lives."​

As COVID-19 tightens its grip on the world at large, have a read of a blog Wayne wrote on the Cells4Life website. He explores whether umbilical cord stem cells could be the answer to stopping this infectious coronavirus, saving lives.

More thought food from legends of the longevity space in the weeks to come: Biochemistry Prof Dr Lynne Cox, a specialist in the molecular basis of ageing at the University of Oxford, Dr Nir Barzilai, Director of the Institute for Aging Research, Professor at Albert Einstein College of Medicine and discoverer of the first 'longevity gene' in humans, and Dr Linda Fried, Dean of Columbia University’s Mailman School of Public Health and a leader in the fields of epidemiology and geriatric medicine.

Links

• Wayne's profile and info page Cells4Life
• Wayne's stem cell blogs
• APPG for Longevity's key report The Health of the Nation: A Strategy for Healthier Longer Lives - February 2020
• Cells4Life on Twitter
• Wayne on Twitter
• What Wayne does in his spare time - very cool
• Wayne on the dressage circuit

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• Music: “Beautiful Day” by Sahin Koc

When I stumbled upon the work of my guest, New York dermatologist Dr Fayne Frey, I did that thing where you read something insanely good that jibes precisely with your thoughts on said subject - you punch the air and shout yaaaaaaasss - must get her on the pod.

What I read was her column Making the Case for Inexpensive Skincare Products on an online site called 50Plus Today.

My interest in her and all she does grew when I clicked into FryFace.com, her skincare education site. This is where she helps us, the bewildered victims of the dodgy bits of that Skincare Industrial Complex. With scientific and medical rigour, she strips away the BS and helps steer us to the best, safe, affordable products to put on our precious skin.

I’m more than a little bit in love with Fayne now and bet you will be too. Enjoy!

Disclaimer

Specific products are mentioned as Dr Frey-approved. Neither of us has any financial links to any of the products named in this episode. Dr Frey's FryFace.com is an independent and impartial organization with no financial interest relevant to any products mentioned on it and referenced here.

Links

• Dr Frey’s skincare education website FryFace.com - check out the Product Selector tool
• Her column Making the Case for Inexpensive Skincare on the site 50Plus Today
• Fayne's article on evidence-based site The Doctor Weighs In - Skin Care Products: Are you Being Deceived?
• Her OpEd piece on NBCNews.com - Pricey Anti-Ageing Products Cannot Reverse Time
• Fayne on Twitter

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It remains a primary risk factor for chronic diseases and impairments. But your biological age - the state of your physical self - is determined by your environmental and social context, your lifestyle history and habits, and your genes. It's measured by a battery of biomarkers - things like cell viscosity and grip strength.

Sir Muir Gray is a human billboard for the disconnect between birthdays and biological age and the power of exercise of mind and body to maintain good health at every age - 70s through 90s too.

He’s one of the UK’s leading medical figures - a physician, Oxford University professor, public health expert and innovator. He was knighted in 2005 for services to the NHS, the UK’s universal care National Health Service, and currently holds a half dozen jobs and advisory roles. He's also written seven books - Sod 70! is the latest and blows up the old = frail narrative society keeps dishing.

Sir Muir says knowledge is the elixir of life: "Clean, clear knowledge is the equivalent in this century of clean, clear water in the 19th century - it's a public health service, people need access to it. Knowledge is the enemy of disease.'

As well as people arming themselves with knowledge - advocating for their own health - he wants empathetic doctors writing knowledge prescriptions alongside those for social therapy and drugs.

We speak about the power of conquering stress, volunteering that's intellectually challenging - not just filling time - why we’re genetically mismatched to our environment, and why cliche gifts for the elderly like shawls and slippers merit tossing on a bonfire. Instead, he says, give resistance bands, free weights or lease them a treadmill or a stationary bike, preferably equipped with Virtual Reality if getting out of the house is an issue.

Links

• Muir's University of Oxford bio
• Analysis published in The BMJ (British Medical Journal) by Scarlett McNally, Muir, Anna Dixon and others: Focus on physical activity can help avoid unnecessary social care
• Muir’s recent article in The Daily Mail - You're never too old to be as fit as a fiddle!
• Muir’s Live Longer Better website and links to his seven books, including the latest Sod 70! The Guide to Living Well
• His YouTube channel Live Longer Better - new so much more to come
• One You app from NHS - Take the One You Quiz
• Muir on Twitter

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There’s a smattering of songs pushing back against ageism and generational differences - think "End of the Line" from the Traveling Wilburys and "Living Years" by Mike + the Mechanics.

But, until now, there has never been a song about age discrimination by employers and recruiters.

On this episode of The Big Middle, we meet Australian singer-songwriter Kelea. Her poignant ballad "Dear Sir/Madam" is surely a contender for theme song of the growing, global movement to expose ageism in all its demeaning forms and end it.

I reached Kelea, who is Kelly Gardner off-stage, at her country home near Perth.

Lyrics Dear Sir/Madam

Thank you for your interest in our company

We received your life summarized in a one-page CV

We regret to inform you, you were unsuccessful

You were one of many, just not the best we’d hoped for

We couldn’t help but notice a few minor holes in your application

And your choice to stay at home lack of Y chromosome gives us hesitation

Not quite suited to our political agenda

But we wish you well in your future endeavours

And the lines beneath her eyes

Earned from mothering a child selflessly

Count for nothing when they’re blinded by an under-35 policy

Dear Sir/Madam

Thank you for your 35 years with our company

We regret to inform you of your redundancy

Payment enclosed with some great referrals

You were one of many and it’s nothing personal

Yes the umpires pick their sides in a game of high school popularity

There’s a man with a briefcase on a bus and out of work age 53

So I’m sitting and I’m staring hesitating at a box marked date of birth

Please fill in this application so our algorithm works out what you’re worth

Yours sincerely

Dear Sir/Madam, Dear Sir/Madam

Links

• Kelea's website
• "Dear Sir/Madam" video
• Kelea profiled by Richard Eisenberg on Next Avenue
• Kelea on Twitter
• Interesting read on Pacific Standard news site by Tom Jacobs: "The Prevailing Stereotypes of Old Age in Pop Music"
• Frank Sinatra performing - prepare to swoon! - "It Was A Very Good Year"
• Neil Young singing "Old Man"
• Lukas Graham's "7 Years"
• The Traveling Wilburys with"End of the Line"
• Mike + The Mechanics singing "The Living Years"

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When you set a Google news alert for life expectancy s I do - it’s a core issue of The Big Middle - you can’t help but notice an uptick in the number of articles about it. The headlines are all variations of UK and US life expectancy stalls are worse than most other rich countries.

We’re still living so much longer than ever before - 81 is the UK average, 79 in the US. The average was 69 in both countries as recently as 1950. Over the last century, every generation has been living ten years longer than the one before.

But you can get lost in a fog of numbers and percentages and projections in the growing crop of articles about the slowing pace of life expectancy gains. And the clashing opinions from influential pundits on why it’s happening.

In search of clarity and context, I speak with Simon Szreter, a Cambridge University professor of history and public health. A self-styled egalitarian, he's a global leader in making sense of historical public health data.

He says we've been here before, several times. In England, average life expectancy fell from 43 years in the 1500s to the low 30s in the 1700s.

History teaches us, he says, that universal healthcare and education are among the interventions that matter when it comes to life expectancy, not high levels of GDP per capita. The European Union has a higher life expectancy than the United States, with 40% less income. Prof Szreter says the fact we've been labouring for decades under the illusion of capitalism has "brought us to this absurd position of sitting on a melting planet waiting for the next carbon-using toy."

Quotes

On GDP as key driver of life expectancy gains in UK+US: "[History] shows us that simply relying on economic growth to deliver widely-distributed good health to the population is not good enough. It has to be accompanied by government policies that address how to use that economic growth and wealth. If you simply leave it to the free market to decide, inevitably...some people will get left by the wayside, some will self-harm, some will become extremely poor and some will experience premature immortality and that’s what we’re seeing right now.”

“Economic growth creates wealth and resources but the big question is who’s getting them and how are [they] being used. Are they being cashed out in Lear jets and yachts and investments in enormous blocks in London and Paris and New York - where sometimes people don’t even live -...or is it going into people’s lives...funding their education and training and enabling them to function in this society sufficiently and earn a living.”

“We need policies where we’re all in it together.”

On the climate crisis: “..biggest problem facing the world”
“..requires the kind of response that governments found possible when faced with global fascism in the late 1930s and 40s.“
“They found it within their political willpower to come together and tax themselves heavily and fight this dreadful threat to their existential survival. We have exactly this threat now. It needs that scale of response. And that kind of response is a world away from free markets and libertarianism and free choice and requires a whole level of coordination and integration from citizens and governments working together.”

On social care: “We need a system to provide good quality social care which accepts that it’s expensive but the alternative is a kind of lottery where old people are scared that they’re going to bankrupt their families and sell their house and deal with themselves when they don’t know what’s going on.”

On education: “Every single citizen should have three years of government-funded educational training post secondary school at any point in their lives.”

Links

• Simon Szreter’s profile University of Cambridge
• Prof Szreter is co-founder and editor of historical research site History & Policy
• Simon says the policy recommendations he made in his first H&P policy paper in 2002 are even more needed now
• Economic anthropologist Jason Hickel’s opinion piece in The Guardian, Nov 2019
• Journal of the American Medical Association Nov 2019 report Life Expectancy and Mortality Rates in the United States, 1959 - 2017
• Reporter Stephen Castle’s NYTimes piece Aug 2019 Shortchanged: Why British Life Expectancy Has Stalled
• Simon Szreter, Hilary Cooper, Ben Szreter - joint winners of inaugural economics prize of think tank The Institute for Public Policy Research for their paper Incentivising an ethical economics: A radical plan to force a step change in the quality and quantity of the UK's economic growth

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Or should I be calling it the science and economics of mission-driven healthspan extension by the eradication or damage limitation of the diseases of ageing?

My guest is certainly a man on a longevity mission of scale and awe.

Russian Sergey Young says he’s determined to make longevity affordable and accessible to change the lives of one billion people. He's set up a $100-million fund to get the job done.

We talk about his route into the exploding longevity industry, his ambitious mission, his deliberate strategy to grab headlines with - arguably - far-fetched proclamations, why he’s against immortality, his fund’s investments, the longevity science and innovation that most excites him, and how everyone in the industry needs to better communicate their goals to engage policymakers and the public.

Links

• Sergey's personal website
• Longevity Vision Fund website
• Sergey interviewed by Longevity.Technology Oct 2019
• AI expert Alex Zhavoronkov's piece for Forbes Feb 2019 - Longevity Vision Fund: Fueling The Longevity Biotechnology Boom We've Been Waiting For
• News release of LVF's most recent investment in organ regeneration biotech LyGenesis
• Sergey on Twitter

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I used to spend far too much of my early mornings jumping on and off trains to get to a TV news desk in an open-office incubator of noise and stress and rolling deadlines. Now, I swim most mornings after going hard with underwater weights at aqua aerobics.

Making this podcast, teaching and wearing my other job hats means I’m still staring at screens way too much but my work place is anywhere and everywhere; my schedule is mine to make. It's comparative bliss.

It’s the kind of bliss at the core of Hoxby, a global, online talent hub that’s up-ended convention to create what its founders call a world of work without bias.

Those founders are Lizzie Penny and Alex Hirst, who join me from their homes - their digital work spaces - in Bristol and Wiltshire.

Links

• Hoxby website
• Forbes piece on Hoxby by Jon Younger - The Hoxby Collective: Putting Heart And Soul Into The Freelance Revolution
• Alex on burnout - Linkedin
• Centre for Research on Self-Employment report - The Freelance Project and Gig Economies for the 21st Century
• Hoxby vlog Workstyle Freestyle
• Lizzie on Twitter
• Alex on Twitter