Top Foods That Delay Menopause: According to the Doctor Who Reversed Aging by 3 Years | Dr. Kara Fitzgerald

Dr. Brighten: [00:00:00] Welcome to the Dr. Brighten Show, where we burn the BS in women's health to the ground. I'm your host, Dr. Jolene Brighten, and if you've ever been dismissed, told your symptoms are normal or just in your head or been told just to deal with it, this show is for you. And if while listening to this, you decide you like this kind of content, I invite you to head over to dr brighton.com, where you'll find free guides, twice weekly podcast releases, and a ton of resources to support you on your journey.

Let's dive in delaying menopause. Is it possible that we can actually delay menopause with new therapies coming available? 

Kara Fitzgerald: It's something that is on the horizon, uh, for real. Mm-hmm. So the possibility of ovarian rejuvenation or just maintaining more youthful ovaries, uh, is something science is really, really focused on right now.

And I'm bullish. Uh, on this [00:01:00] being available to us. I don't know. 10 years? Mm-hmm. Maybe less. I mean, it's extraordinary. And if you think about the implications of delaying menopause, if you think about our ovaries functioning longer, a lot of us immediately say, oh great. I can have a kid when I'm 70, which you know, isn't.

Wildly appealing for many of us. But think about it more broadly beyond just the idea of reproduction. Think about having these hormones available for brain health, having estrogen available for brain health, for bone, for heart, for skin, I mean. Every single organ in our body is influenced by our, over our ovarian fitness.

So the possibility of maintaining that fitness for longer is extraordinary. I mean, ultimately for us, for women, it will keep us younger. I mean, it's really a biological age, uh, technology, [00:02:00] you know, beyond just ovaries because they're so influential for, um, for us, uh, in totality. Mm-hmm. 

Dr. Brighten: I appreciate you framing it that way because immediately when we start talking about delaying menopause, firstly, there's women who hate their period.

Hi, you should be on, you should listen to this podcast. We can help you fix that. But there are women who are like, why? Why would I want to be in my reproductive years longer? And as you said, it, it keeps us younger. The next argument people have is, well, why should I be chasing beauty standards? It's not about beauty standards as you just framed.

Yeah. It's about your heart. It's about your brain. It's about keeping you younger at a cellular level. So what is ovarian rejuvenation? 

Kara Fitzgerald: People are grappling with it from, you know, all corners and research is happening in a variety of different arenas. The way that I'm thinking about it and the way that it interests and excites me the most is this idea of using yamanaka factors.

Mm-hmm. Have you covered [00:03:00] them? No, not at all. Okay. 

Dr. Brighten: This is totally new. So define it for us. Okay. So that everybody's on the same page. 

Kara Fitzgerald: Yeah, absolutely. So Yamanaka factors are proteins that, um, can change gene expression. Actually, they're. Th they are used, they're, they're heavily involved in basically building a baby, sort of controlling the expression of DNA and, and guiding, um, you know, cell division and cell definition, uh, in, in utero and utero development.

Uh, so Yamanaka. You know, discovered these or isolated these four factors. Uh, won the Nobel actually with, um, with another individual whose name is escaping me, unfortunately. So, but the name is Yamanaka because he's given credit for, for discovering these and. Uh, more importantly, seeing that you could apply Yamanaka Yamanaka factors to a somatic cell, so a defined cell mm-hmm.

And reverse it back to [00:04:00] a pluripotent stem cell. So you can take a defined cell, a skin cell, a heart cell, a you know, a brain cell, et cetera, any cell type, apply these yamanaka factors and basically turn back the hands of time to, um, pluripotent stem cell status so it can become any stem cell. So let's say for example, you take a, a, a brain cell and you apply these yamanaka, it becomes this pluripotent stem cell, and then you can really turn it into, you know, any other type of self.

So that was his original work, but science scientists have since, uh, been working with Yamanaka factors in all sorts of capacity. So, and, and turning back the hands of time in a limited way. By the way, there are problems with, um. Using those, what they call inducible stem, pluripotent stem cells. Uh, they're associated with cancer.

Like there's all sorts of mischievous happening around, uh, turning back the hands of time all the way to ground [00:05:00] zero. Mm-hmm. Uh, so now scientists are learning how to stop the action of Yamanaka factors, um, and turning back time a little bit. Mm-hmm. Uh, actually, you know, can be decades, so it can be pretty significant, but not bringing back things to pluripotent stem cell status.

And this is safer. Uh, and it's just ridiculously interesting. So, um, a lot of biohackers, a lot of, you know. Longevity enthusiasts have been paying careful attention to Yamanaka factors with this idea that we could take a cocktail of them and turn back the hands of time. And so, you know, you're 50 now and you want to be 20 and you could just sort of shoot back a cocktail and, and become 20 again.

That's been, uh, kind of the big fantasy I think around them. Uh, but in fact what will, uh, probably end up happening, probably be able to be translated to humans [00:06:00] is applying them to distinct cell types and changing the age of cell types. In fact, right now, uh, using Yamanaka factors in skin mm-hmm. You know, applying them via microneedling or something like that is actually jumping through FDA hoops.

So that will probably be the first application that we have access to as humans. Um, if that's able to pass and. By the way, that's headed by VI Victoria Sebastiano in his lab at Stanford. And, um, he's been on my podcast, uh, a couple times and he'll be on our masterclass and I know we're gonna have some information on that masterclass.

And so if you wanna get the latest on what's happening in that arena, you know, just jump into the masterclass. It's, it, it's free. Uh, but I'll be talking to him about that. And he's also, uh, uh, well versed on Yamanaka factors for ovarian rejuvenation. So we'll be touching on that as well. But to get back to that conversation, uh, we need to think about using these [00:07:00] yamanaka factors in organ systems, you know, isolated organ systems, isolated cells.

So the next one, you know, so the next logical place to think about is, you know, what, what organ could really leverage the body as a whole. And you know, in women, it's obvious the ovary. Mm-hmm. So when we think about really, uh. Biological age reversal broadly, the ovaries are a logical place to go. Mm-hmm.

So yeah, we can couch it as delaying menopause, but really we're thinking about real, you know, uh, delaying aging, delaying the phenomena of aging itself by maintaining ovarian health, ovarian youth for a longer period of time. 

Dr. Brighten: I mean, it's the thing, you know, for people who are listening, they might be like, why is this the hot area people are researching?

And it's because there's such a disconnect. It makes absolutely no sense in the evolutionary paradigm that we have to live essentially a third or more of our life without these hormones. I mean, when you think about. [00:08:00] Uh, what the lack of these hormones are doing and how we go into menopause. And without these hormones, our critical organs start rapidly aging.

Yeah. What I'm curious about is how would these factors be delivered? Are we talking about they'd be injected into the ovaries like we're seeing with like ovarian PRP or, you know, is there a different way that they're delivering these? I 

Kara Fitzgerald: don't know that that's been established yet. Mm-hmm. I mean, right now they're not, they're, they are not in human studies, so they're doing them in organelles, you know, it's totally preclinical data.

Yeah. 

Dr. Brighten: So 

Kara Fitzgerald: the way that they're delivering them is, um, you know, they're using viral vectors and mm-hmm. Um, I, I would, ima I don't know if it would be, I mean, probably it would be injection, I mean, that seems to be most logical. You really have to control the length of exposure. Mm-hmm. And the delivery. I mean, everything has to be spot on, but, um.

Yeah, I can't answer that with any degree of sophistication because it's [00:09:00] preclinical and you know, I'm, uh, I'm an enthusiast in this arena. I'm not actually a bench scientist doing it. Totally. 

Dr. Brighten: Well, when they get a little further, we'll have you back and we can talk about that. Yeah. Yeah. And for people, you know, when you say viral vector, for people to understand that viruses hijack our DNA to be able to replicate themselves and in science, we've been able to hijack.

The virus to get it to insert the DNA that we want to be replicated into cells. And so that's one delivery method of being able to do this. 

Kara Fitzgerald: Yeah. And I'm not, and I'm not certain whether that is how they're doing it. Um, and then you have a hard stop, and so there's different drugs that are being used to stop the action of the Yamanaka factors at an appropriate time.

Mm-hmm. But I'll cover these things in the masterclass. Yeah. You know, actually these are good questions. Definitely 

Dr. Brighten: link to those, uh, to the masterclass so people can get in further with that. What are your thoughts about rapamycin? I mean, that's like the new hot drug, something 

Kara Fitzgerald: that we're using now. Yeah.

Yeah. 

Dr. Brighten: Well, I mean, it's still, I think the, the trials are supposed to conclude soon, [00:10:00] either the end of this year or next year. I had, um. Dr. Amy, who goes by the egg whisper on, and she's been using it in reproductive medicine to extend the longevity of the ovaries to produce healthy eggs. Not just naked eggs, but healthy OID embryos being created.

But I'm just curious if you've seen research on that. I think that, 

Kara Fitzgerald: um, I think rapamycin, particularly in the dosing structures that are being used, and I know that there are, uh, you know, human trials. Uh, now, um, you know, and there's some preliminary human data, and of course there's a ton of preclinical data, uh, demonstrating efficacy with rapamycin, I think in the dosing structures being used, which is about, you know, on average maybe six milligrams a week, uh, which is modest and, you know, without side effects, without the concerns that we confront normally when we're using them, uh, with transplant patients.

I, I think it's entirely reasonable. You know, I think ra rapamycin is, is, [00:11:00] is promising. 

Dr. Brighten: Mm-hmm. Are there other things that women can be doing that's accessible to them now if they are wanting to, you know, whether it's delay menopause or, you know, just bathe in the goodness of their own hormones and support their ovarian health?

Kara Fitzgerald: So thinking about, uh, maintaining biological youth or reversing biological age or slowing the rate of biological aging and, you know, with a lens towards ovarian health. Um. We wanna be thinking about, uh, interventions that we have now and, uh, that have some evidence for efficacy. And my area of focus has been looking at diet and lifestyle.

Mm-hmm. Um, so there's, there's an idea, there's a concept of a longevity bridge, which was coined by Sergey Young, who, uh, is a longevity fund. Uh, he maintains this pretty cool, pretty sophisticated longevity fund [00:12:00] where they're investing in a lot of these technologies that will be available to us in, you know, the coming years.

Uh, but he talks about this longevity bridge. These are things that we can do now that, that are evidence-based that will keep us younger so that we may harness these tools to come, such as ovarian rejuvenation. Uh, and I'm a big proponent of diet and lifestyle interventions that. I've published on and others have published on that show.

We can slow, uh, the rate of aging as measured by epigenetic clocks. Using these tools as a foundational intervention, uh, as our pathway to maintaining youth or achieving, you know, a younger biological age, I think is essential and we can apply this to ovarian health as well. Mm-hmm. 

Dr. Brighten: When you talk about biological age, why is that more important than calendar age?

Kara Fitzgerald: Yeah, so calendar age is the number of trips. You know, [00:13:00] we've, we've traveled around the sun, you know, the number of birthdays, the number of candles we've blown out, uh, and there's really nothing that we can do about it. And it's becoming less and less important now that we can measure the physical rate of aging.

Um, and we have some ability to control that. Uh, you know, it's a whole new paradigm and that is ultimately the most important piece of information that we can have. The rate of our aging, you know, the actual amount of time we've spent here is really less important. Uh, so. Yeah, so biological age, the tools are growing and evolving at an exponential rate.

For us to be able to measure that and to be able to apply interventions to slow it, uh, and be able to improve it, you know, via, via, you know, different tools. And I'll talk about my area of focus. Um, yeah, this is the, this is an exciting time in medicine, an extraordinary time in medicine, in functional medicine and longevity medicine.

It's extraordinary time in science. [00:14:00] We're really leaping forward here. Mm-hmm. Um, so. Attention on biological age I think really trumps chronological age at this point. 

Dr. Brighten: Yeah. And I think, you know, as you're talking about this, I think about the golden girls and um, I think I'm older than like the youngest golden girl now.

And we look at that and it's uh, it's something where, okay, so I'm in my forties now and I remember thinking like forties is so old. Not just because, you know, I was a teenager but into my twenties thinking like forties is so old. But I look at how people function now in their forties. Yeah. I look at how I'm like, I don't feel old.

I still lift weights. I still do all of these things that I've been doing for years. Yeah. And so much of, you know, what we're seeing now, you'll see people attribute to like, we have better skincare. It's 'cause we don't get those short bob haircuts. And it really is because. We've seen advancements in the science around biological age and the education that people have, the information people have that they can get access to.[00:15:00] 

I wanted to find exactly what biological age is and then I wanna start talking about some of your research because it is incredibly cool and accessible for people. 

Kara Fitzgerald: Yeah, yeah. So let me say, just entering into this conversation here, um, yeah. I was delivering a conference yesterday. You and I actually, you were, you were at the same conference.

Uh, and I showed a piece of research on centenarians. They're clearly, so they're, so they're calendar year is a hundred plus. They're super centenarians. Their calendar year is like a hundred. And I think makes you a supercentenarian. Uh, and on average these guys are, they, these guys have biological ages of, you know, in their seventies.

Mm-hmm. So I joked with the audience yesterday that, you know, 100 is the new 70 to your point. I mean, there's this incredible sea change in the possibility of, of, of who and what we can be at any age. Mm-hmm. I mean, we really don't need to slow down. And the [00:16:00] Golden Girls is funny. I mean, you're absolutely right.

It's kind, we look, it's so antiquated at this point, at how old they were when they were so young. Mm-hmm. It's funny. So biological age is the rate of physical aging. It's the rate of our cell age, you know, the, the individual cellular aging, the organ aging, uh, and the rate, you know, and we can apply that.

You know, phenotypically or how we look or how we feel, uh, which is exquisitely important. Um, I think there's uh, there's this sort of, there's this illusion of being old. There's a mindset that's important that people can fall into, and I think. The golden girls were sort of in that space and, and we're moving away from that.

You know, I'm old age X makes me old, therefore that knee pain, uh, you know, which might've been from a poor, poor position when you're doing some squats or whatever you [00:17:00] attribute to being old or thing X happens. It's because I'm old. There's a fatalistic attitude, or there has been a fatalistic attitude that I think we're confronting and transforming in society and it's really exciting and it's really empowering.

So scientifically biological age is the rate of physical aging. We can measure it. Total body, we can measure it down to the cellular level or the organelle level. We can look at the rate of mitochondrial, a aging, et cetera, et cetera. And then there's also this mindset that comes with the aging journey that we can absolutely confront.

Mm-hmm. You know, I remember my mom saying to me, oh, you're getting old because thus and such is happening. And I'm like, mom, I am not buying into that story. Yeah. I am not interested in buying into that story. And I think for all of us, I really, you know, advocate. If that's your story, if that's your self-talk, I'm old, so I'm not doing X, Y, and Z.

That we absolutely have to confront that actively. [00:18:00] 

Dr. Brighten: Mm-hmm. This whole, uh, paradigm shift in science also challenges the lazy medicine answer Yes. Of you are just getting old. Yes. You're a woman. Yes. You're getting old of course at this way. Amen. You should just 

Kara Fitzgerald: accept this. That's absolutely right. Lazy medicine.

Absolutely. And I, and lazy us as well. If we accept that, you know, we accept that as our fate. Mm-hmm. Oh my gosh. You know, I'm not gonna do X, Y, and Z because I'm old now, or I can't push my body in this way because I'm old. Yeah. It's definitely something we have to confront. 

Dr. Brighten: How can someone measure their biological age?

There's 

Kara Fitzgerald: a, there are a lot of tools available to us these days, so, and they're affordable, so there's a continuum of tools. I. We created, um, for my book, younger You, we created a questionnaire using the best, the best science. So, so, so somebody could access the, the questionnaire in the book or go to my website, which I know that you'll link to, uh, dr kara fitzgerald.com.

There's a free version [00:19:00] of this. Uh, the reason, so we, we built the quiz to make something available free. We built it on our, you know, our best read of the literature. So we put some effort into it. And since then, in the years that, that, that have passed, we now have a cohort of over 70 individuals who've.

Taken our quiz and did a blood test. They used the pace of aging, which I'll talk about in a second. So they used one of the best, um, blood tests for measuring biologically. So we had both data sets and we found that there was a significant correlation between our quiz and this test. So in fact, I shared it with the developers of this test, the pace of aging, and they were excited about it.

They thought it was really cool that our quiz, you know, was, was correlative. Uh, so the quiz doesn't supplant using the blood test. The blood test, the pace of aging test is, is, is certainly better and it's one of the most respected tools out there. Um. But an easy free [00:20:00] way to start would be to just take this quiz.

So that's thing one. Uh, and then we've got a plethora of, of blood tests where we can actually measure, uh, something called DNA methylation. The pace of aging blood test, or the variety of tests out there look at most commonly something called DNA methylation. Mm-hmm. And DNA methylation is falls in the, under the, the field of epigenetics.

And epigenetics is, uh, the study of how genes are expressed. DNA methylation is one of the key biochemical marks that influences what genes are on and what genes are off, uh, over the course of our lives from really. In utero onto, uh, centenarian or however long we live, there are predictable changes to DNA methylation consistent with biological age.

Mm-hmm. So we use this measurement, uh, to be able [00:21:00] to define biological aging, uh, rigorously. So epigenetic clocks are, uh, an exciting science, uh, available to us, uh, that we can use to measure the rate of aging. So aging. So that would be my next step. You can actually buy these clocks. You can buy just the pace of aging, which I love.

Um, and we can link to information about that. It's reasonably affordable, uh, and people can get an accurate estimate of how fast they're aging. This particular clock won't give them a number. Uh, everybody wants to be younger, so it won't give them a number. We can think of it as a speedometer. It will give them a rate.

If they're aging at a rate of one, they're aging consistently with chronological age. If they're over one, they're accelerated aging. If they're under one, which is where we wanna be, they're, they're aging at a slower rate. The developer of this clock, one of them, uh, Dan Belski I podcasted with. So if there's some super geeks out there in your audience and they really wanna drill down on what this clock is about, they can, they can [00:22:00] tune into that podcast.

Um, there's a whole rejuvenation Olympics built around the pace of aging. The dunin pace of aging is the full name of, of this particular clock. Um, Brian Johnson, who a lot of people know, famous biohacker investing two a million a year in his, uh, in his bio age status, uh, started this rejuvenation Olympics.

And there's a board of individuals participating, trying to get that, uh, their pace of aging as slow as possible. Mm-hmm. Uh, the really cool thing is number two on that board is this amazing badass woman. Uh, Julie Gibson Clark, who, um, is using our, our program, so a simple diet and lifestyle program. And she's number two on the leaderboard, so she's yeah, just affordable interventions.

You do. She's a middle-aged woman. She's actually a single working mom and she's just, she's a badass and she's using simple, simple tools to do it. 

Dr. Brighten: That's amazing because, uh, immediately [00:23:00] when you talk about Brian Johnson, people are like, I don't have like millions of dollars to throw at my health every year.

So, you know, you've actually shown in clinical trials to reverse biological age by a significant amount in a relatively short period of time. Yeah. Tell us how that's possible. Yeah. Yeah. That's cool. 

Kara Fitzgerald: Yeah. Thanks. Um, so we designed a diet and lifestyle program to specifically sweet talk, DNA methylation.

Mm-hmm. So we wanted to sweet talk epigenetics. You like whisper into the DNA? Yeah. Basically. What, you know, using our best read on the science, what can we eat, what can we do to optimize DNA methylation? Uh, and so we'll talk about a variety of foods and we've, since actually we just published in 2025, a couple of months ago, um, an investigation in what aspects of the dietary pattern did the heavy lift [00:24:00] on bih reversal?

Mm-hmm. Uh, so. The diet is keto leaning, so it's a little bit higher in fat. There's a decent amount of protein we want people to hydrate. There's a gentle time restricted structure, 12 hours on, 12 hours off. Uh, heavy in veg, heavy in green, meg, cruciferous, uh, and a host of different polyphenol compounds. Um, what else?

Coffee is legal. We want people to avoid. 

Dr. Brighten: Coffee's my favorite. I know, I know. And it's a really important polyphenol. Yes. 

Kara Fitzgerald: Uh, we want people to do some green tea if they're into it. Um, just a whole variety of polyphenols that we outline and that I go into in detail in my book. Um. What else are we doing in this dietary pattern?

Uh, olive oil, avocado, um, coconut oil. If coconut oil works for you. Avoid dairy. Avoid grains for the eight weeks. Um, no alcohol just for the eight weeks. [00:25:00] Um, and legumes are out just for that eight week period. So that was the dietary pattern. We had people exercise as well. We wanted people to do, you know, to sleep well.

So we offered them sleep hygiene tips. Um, we had a meditation intervention, just a really simple breathing exercise. Uh, a probiotic and a greens powder. People worked weekly with our nutrition team. And then we had a controlled group that didn't do any intervention. Uh, so eight weeks in that, uh, diet and lifestyle or not.

Uh, and we showed using the a first generation hor, uh. Biological age clock that I can talk about in more detail if you're interested in it. Uh, using that particular clock, our participants got over three years younger as compared to the control group. Hmm. And when we looked at our participants at baseline as compared so compared to themselves after eight weeks, they got over two years younger.

So it really, they, yeah, they moved the needle significantly on biological [00:26:00] age as measured by epigenetic clock using this eight week intervention. It was the first of its kind study, so it got a, it got a lot of attention around the world. It was the first randomized controlled study looking at biological age changes, uh, using a diet and lifestyle pattern.

Um, so yeah, needless to say, it was pretty life-changing for me and I ended up. Sort of stepping out. I'm usually somebody who's educating other professionals and kind of behind the scenes a little bit. But I ended up publishing this book for regular people and doing a lot of interviews and stuff like that.

And it's been a fun ride. Uh, but it just, it's, it's important to put this information out there. I. The cool thing is that since that publication in 2021, there is a lot of data coming out looking at diet and lifestyle in humans, just corroborating what we found. Um, and so this year we published, uh, a due paper analyzing what did the heavy lift, and it was the polyphenol compounds, these uber dense polyphenol compounds.

That was 

Dr. Brighten: gonna be [00:27:00] my question. 'cause I was like, listen, you're taking out dairy, the French are gonna be calling you. Yeah. Like there's gonna be people who are gonna be like, I don't wanna give up these foods. But yeah, it sounds like the most, well, let's define what are these polyphenols? So for people to know what, because we, we set coffee, we talked about green tea, but what are they really, and why are they so powerful?

Yeah. 

Kara Fitzgerald: So. I, I should more broadly, we can talk about phytochemicals in general. Mm-hmm. Polyphenols are a specific type of a phytochemical, so a compound found in plants that have a very specific structure associated with them. Uh, and these guys, sweet talk gene expression, they sweet talk epigenetics and specifically they can sweet talk DNA methylation.

So we packed our dietary, uh, program with them. There's almost three grams a day of these polyphenols in the diet. Mm-hmm. It's actually higher than any really any other research dietary [00:28:00] pattern. Looking at DNA methylation or is ours is the highest when we quantified it. Um. But other, other dietary patterns in humans are really, you know, badass and we're just seeing this explosion of new data.

So they don't, um, sort of increase methylation DNA methylation, but they arrange how DNA methylation is happening, um, as we age. And the reason that we can predictably measure aging, looking at DNA methylation, is that we start to, it starts to change. It starts to become negative. In fact, um. I mean, it really kind of stinks.

In fact, the, my original interest in DNA methylation and using a dietary pattern was when you look at cancer, when you look at DNA methylation in the tumor microenvironment, um, you can see that the tumor microenvironment is able to take over DNA [00:29:00] methylation turn genes on that push cancer forward, turn genes off that protect us from cancer.

That was sort of my original aha motivation around building this diet and lifestyle intervention. It was before we knew that humans could reverse biological age or change by the rate of biological aging. Um, and when you look at the aging methylome or DNA methylation in the aging population, it looks like that cancer microenvironment.

Mm-hmm. So as we age, we start turning on genes we don't want on. We start turning on genes that drive disease forward. We start to turn on genes that drive inflammation forward, that, that make us vulnerable to metabolic disease, to cardiovascular disease, to dementia, to cancer. Most classically cancer, that's where the most research is.

Um, and then we turn off our protective genes. It's really crazy. So you can measure this along the journey of aging. When we're younger, we can [00:30:00] control, like we really have more say over genes, gene expression. Uh, and as we age, it really becomes sloppier. Mm-hmm. Um, so. We can look at foods that will support maintaining a more youthful pattern.

And that's these polyphenol compounds, they're incredibly powerful. They dictate what gene they can really dictate strongly what genes are on and what genes are off. It's incredible. Um, polyphenols can help re-express the all important tumor suppressor genes. So those genes that protect us from developing cancer, those genes start to become, uh, become off.

They're inhibited as we age, but these polyphenols will turn them back on for us. Um, the pro-inflammatory genes, they can help inhibit expression of those. So polyphenols just seem to be these. Badass compounds, if you will, that can help optimize gene expression towards something more [00:31:00] youthful. And that's what we saw in our study.

We saw, yeah, go ahead. Yeah. 

Dr. Brighten: I wanted to ask, how did you ensure that people were following the diet and the lifestyle and how successful were they and actually sticking to this diet for eight weeks? 

Kara Fitzgerald: Yeah, that's an awesome question. We selected eight weeks because we used, so we designed this program long before we actually researched it, and we used it in clinic practice for many years.

In fact, in 2016, we presented it at the Institute for Functional Medicine and made it available to professionals there as a, as a white paper. So we made it. We made it available early on to our functional medicine peers, um, and had a lot of experience in clinic practice, so we knew people could adhere to, you know, a pretty rigorous eight week structure from our own experience in clinic.

Um, but they have a lot of support. We have a nutrition team, you know, they're just getting all sorts of support. We have recipes, we just support them in sourcing ingredients, et cetera, et cetera. Uh, when we were given a grant, an [00:32:00] unrestricted grant to study it in the clinical setting or the clinical research setting, um, we had our nutrition team right in there working with them in the same kind of way, you know, helping them source ingredients, helping them with recipes, you know, just helping them build their lives around being able to do the dietary pattern.

So it worked. Mm-hmm. We have, we have really high adherence. I think the other piece was that, um. It was a randomized control study, so we limited the amount of information they had about what we were doing, but they did understand we were doing something kind of cool. Yeah. Kind of special. It was a first of a kind study, you know, looking at epigenetics, looking at gene expression, and I think the participants got that enough where there was some like background excite excitement around doing something new.

But without question, I would say the secret sauce and the success of our ADV intervention and the high adherence rate came from having, you know, nutrition coaches and making that a requirement. Mm-hmm. They couldn't opt out of that. 

Dr. Brighten: Okay. [00:33:00] When it comes to the foods that you eliminated, so alcohol seems like an obvious one, but grains and lagoons and dairy, how important do you think it is for people to have those removed from their diet?

Ongoing. So, 

Kara Fitzgerald: by the way, it wasn't perfect. Our adherence was high. In fact, my co-principal inve in, um, investigator Ryan Bradley. He was, he was relatively convinced we would not get high adherence. 'cause it is a pretty rigorous intervention. And so he was sort of studying how we were gonna make that happen.

Mm-hmm. And it was another shout out to our nutrition team, but we didn't have 100% 

Dr. Brighten: adherence. So it's pretty cool. The only way for people, I want people to know, the only way to do that is to actually take these people, lock them away and that you make all their food for them. That's right. That's right.

And then it would be completely artificial. Right. Because then it's like, well, what does it what? What happens when I lock you in a hospital and only feed you this food? Yeah, that's right. 

Kara Fitzgerald: That's right. That's exactly right. [00:34:00] So we probably had somewhere in the neighborhood of about. 80, you know, 80% adherence and it kind of depended.

I mean, we wanted people to eat liver liver's a a, a methylation superfood. And we could talk about why it's basically a multivitamin in a food matrix. That's, that's why it's so important. Do 

Dr. Brighten: you have to eat it or can you supplement with it? 

Kara Fitzgerald: Well now, you know, we didn't at the time recommend supplementation.

I just wasn't aware of it. But yeah, now a hundred percent, yeah. Okay. So just take capsules. 

Dr. Brighten: I wrote a book, gosh, what was that like 2013, I think my first book, which is on postpartum health. And what I actually recommended, this was before people had liver capsules available, is you actually get the liver from the, the butcher.

You chop it up into small pieces, you freeze it, so it's a pill size and then just swallow it. That's so smart for women to do it. And that's what I was using my practice back then with women because That's awesome. I'm also like. My kids, they'll eat liver me. I'm like, Hmm. Because they didn't grow up with this.

But I'm like, I will freeze it and I will swallow the liver. Awesome. I will make that happen, but I'm curious. That's awesome. You know, so that's me. You know? That's super clever. [00:35:00] That's really clever. I am like, seriously, I'll bastardize anything because I'm lazy and I don't, I'm, I'm like, ew. No. Okay. How do, but I know this is good for me.

Yeah. So, 

Kara Fitzgerald: yeah. 

Dr. Brighten: But we see that there's liver capsules now available as supplements. Yes. So that's my question. Does someone have to eat the liver or No? No. You need to take the supplements. Yeah. Go with the 

Kara Fitzgerald: sub. Absolutely. Just, you don't want 'em to be def fatted. You just want those freeze dried liver capsules and, and we can get really clean source liver capsule.

They're not super pricey. A hundred percent. We would've used capsules back then, had we known. Mm-hmm. But we didn't. So we gave I 

Dr. Brighten: don't think that, yeah. I mean, they're relatively new, uh, incoming available. 

Kara Fitzgerald: Yeah. Yeah. And I think, I think that there were some. Encapsulated organ meat products, but they were d fated and then you lose vitamins.

But anyway, yeah, I just, I wasn't sensitive to them, but now we have capsules go with capsules a hundred percent. It's easy. I mean, that's how I take it. I'm with you. I'm, uh, I like a good pate every once in a while, but I'm not gonna eat pate weekly. Yeah, 

Dr. Brighten: yeah, no. If I'm like hanging out in [00:36:00] Paris, then like, you know, gimme the old fall that day.

Fall because like, here, it, it's, legal goals are the best you can get. Like even steak tartar, I'm like, yes, I will roll with it there, but thanks anywhere else in the world. And I'm like, no thanks. 

Kara Fitzgerald: Yeah. Um, so adherence wasn't perfect, but we did have a high degree adherence because adherence, because we had that additional support.

Um, it's an eight week intervention. I think people really need to understand that this isn't for life, uh, in the us. Dairy tends to be inflammatory in the us. Um, you know, grains, they can be inflammatory. And, uh, we really wanted to control glycemic cycling. Mm-hmm. This is a, this is a, this is a keto leaning intervention.

It's not a keto, it's not a ketogenic diet's, keto leaning. Mm-hmm. Triglycerides dropped. Triglycerides are. You know that change is a, suggests that there was some ketosis, some background, gentle background, ketosis happening. Ketosis is anti-inflammatory and supportive, et cetera. Anyway, [00:37:00] so we wanted that.

So we pulled the grains out. Legumes we pulled out for a couple of reading reasons. One, again, we wanted it to be keto leaning. Some individuals eating, uh, a lagoon based diet aren't, are gonna have a harder, harder time achieving a little background ketos. The other piece is, is that the American gastrointestinal tract really frankly kind of sucks and a lot of people don't tolerate legumes, um, until they do a little bit of basic gut work and kind of clean it up.

So we pulled the Gomes out for the eight week intervention. We wanted the dietary pattern to be as well tolerated by as many people as possible. Mm-hmm. And then, you know, and alcohol doesn't support DNA methylation, you know, unfortunately alcohol is not great for a lot of reasons. So we pulled alcohol out and, you know, there was one, at least one guy who.

Continued to eat his grain every day. Um, I think somebody reported that they had alcohol a handful of times, et cetera, so it wasn't perfect adherence, but we still achieved those [00:38:00] numbers, which is awesome. In addition to reversing biological age, people lost weight. Their triglycerides dropped their LDL cholesterol drop, total cholesterol drop.

They significantly increase circulating methylfolate without taking any, you know, B vitamins. So we achieved our goals without perfect adherence, which is important. After the eight week time, people can transition back. You know, people can have a drink if it's appropriate for them. If dairy is, is, is, is fine for them.

Not a deal breaker. Go. I'm a huge fan of legumes. I think they're wildly important and you know, if the gut can tolerate them. By all means, you know, resume consuming legumes. We might actually do a study in Mexico. Hopefully we will. Um, and probably we'll include legumes 'cause that's such a fundamental part of the dietary pattern here.

Mm-hmm. And I think people do better with them generally here. 

Dr. Brighten: It's also interesting as you're talking about, um, doing a study in Mexico. 'cause as you're talking about this, I came across recently research on blue corn and white corn in the antioxidant capacity in [00:39:00] there. And what's so interesting is that we're looking.

So when I say corn, I'm not talking about GMO Iowa Corn. Yeah. In Mexico, they were the very first country, I believe, to tell Monsanto to jog on with their GMOs because they're like, corn is so important. I mean, yeah, culturally, I mean for people to know there's a goddess of corn and there is a baby God kernel of corn.

Like that is how important corn is to Mexican culture. But what was interesting is the way that Mexicans actually process their corn traditionally liberates the nutrients and then adding lime, which is what you do when you eat a taco, if you're eating a taco, right. Um, actually helps protect these, some polyphenols, these antioxidants that are present in there.

And it's just fascinating to me because when you look at how people traditionally eat in their culture, you actually find that there's ways that one. They have been supporting, you know, the, the food in being able to liberate [00:40:00] nutrients and being able to get the best antioxidant capacity, but also the way that they've been eating culturally fits so much with their body.

So, as you were saying, I mean, frijoles, that's a staple of like a Mexican diet, so it would make sense that you include that. 

Kara Fitzgerald: Yeah. 

Dr. Brighten: You made a comment about dairy being inflammatory in the United States, and I know people are already running to the comments right now to be like, say more. What does that mean?

So can you explain more about that? 

Kara Fitzgerald: So Cain, you know, or certain Cain structures, there's a handful of different Cain structures seem to drive, well, not seem, drives a pro-inflammatory kind of phenotype in, you know, in many of us in the US and actually probably, you know, the world over, we seem to, our immune system kind of picks up that protein relatively commonly, uh, and sort of tags it as something not helpful.

Mm-hmm. Uh, we see dairy being associated, I mean, you know, from, from early [00:41:00] infancy driving, um, atop the atopic presentation. So eczema, uh, potentially asthma, I mean. I certainly was taught, and there's plenty of experience clinically, that it was path mnemonic for ear infection. So basically if you're a kid and you're getting a lot of ear infections, that's a classic sign of being reactive to dairy.

Mm-hmm. Um, there's milk colitis, which is common in kids. So this is, you know, this is developing colitis in response to, you know, cow's milk. Um, what else? Migraine headaches have been associated with dairy reaction and on arthro various inflammatory arthritis, including rheumatoid arthritis. Um, what else?

Uh. Individuals with autism frequently have dairy intolerance. So I would say on and on and on. Dairy is, uh, a bad actor in the us. It's possible that raw dairy or uh, cleaner source dairy is better [00:42:00] tolerated by some. But you know, I think of all the foods that are being regularly consumed. Um. Some of the proteins in dairy are just really a problem for a lot of individuals.

Mm-hmm. 

Dr. Brighten: I actually met with a reproductive immunologist who is based in Spain. He's an older gentleman. He had to be in like his sixties, maybe close to his seventies. And when I met with him, first two recommendations he gave me is eliminate gluten and eliminate dairy. And I was like, it is so interesting that you say that because this is something I've been talking about for like over a dozen years and I have been called a quack and crazy and all of these things.

Yeah. And I'm like, in the United States, this is just not regarded as something you do if someone has autoimmune disease. And he was just like, and that is why you guys are so sick and your healthcare is so far behind. And he's like, is it the one thing that's gonna be triggering everything or causing problems?

And everyone, he is like, no. But there's enough evidence there. And in my clinical expertise, this is something if you have immune system dysregulation Yeah. You need to [00:43:00] remove. Yeah. To your point about autism, what's really interesting. Is it came across research on autistic individuals. These were nonverbal children who, what they found in this research, and of course we need more studies to understand it fully, is that dairy was triggering an autoimmune condition to their methylation pathways.

And the way to circumvent that while you remove the dairy was to actually bring in folinic acid. That's right. And I've seen other researchers say, fortifying our food with folic acid. Great for pregnant women. We wanna, we wanna prevent spina bifida potentially harmful for our neurodivergent children who are having methylation issues.

Yeah. Have you seen researcher on them? Yeah. 

Kara Fitzgerald: Yeah. Abs Absolutely. Yeah, for sure. And you can measure those antibodies in clinical practice. Yeah. And yeah, it, so the. The, the oxidized folic acid, so the synthetic folic acid that we use in fortification, um, they're not able to activate and um, it [00:44:00] can block central nervous system uptake of the natural folates, um, including methylfolate or folinic acid.

The various vi for sure I have seen that clinically and we can measure the antibodies and, uh, dairy can promote the development of those auto antibodies. So, yeah. 

Dr. Brighten: Yeah. Um, what was interesting in that study is these kids became verbal again, and I. Like, I'm not saying this is like absolute, but I want somebody, whoever's listening to study this because I have a hypothesis just based on observation and what I've seen in the research that potentially why we are seeing.

Autistic expression of symptoms may be more heightened, may be the fortification of these foods with folic acid. And so, as you were saying, it's actually blocking their ability to use the folate, use the B12 to actually run these processes, not only in their brain, but [00:45:00] the detox systems. Yeah. And when you look at autistic people in general, they tend to have issues in their detox capacity.

Yeah, for sure. So the clusters of genes that go together, you know, they cause or they're correlated with. Increased inflammation, immune system dysregulation, nervous system dysregulation, and we can see poor detoxification. And so when I start thinking about the fact that, you know, we've got kids who, you know, they start restricting eating, they have sensory sensitivities, their diet is really limited, then they're getting processed foods.

Maybe they're getting, um, you're getting a multivitamin that has folic acid and then they're also eating a piece of bread that has folic acid. And we haven't really explored that. And what tends to happen is that we put one initiative in place for public health and we're like, we did this one thing and it's super great and we're saving people.

And we're like, yes, we love that. And we never go forward to think about the consequences in the rest of the populations. And that's not to say that like, we should stop fortifying food. Like [00:46:00] obviously this intervention has been helpful, but at the same time we have to ask the question like. Is not best for everybody going forward.

Yeah. 

Kara Fitzgerald: 100%. I completely agree with you. I think it's incredibly important. In fact, I talked about it in the book, um, specifically for pregnant women, uh, avoiding the, you know, synthetic folate. Mm-hmm. And it's, and, and, you know, it's pretty easy to do if you read labels. So folate is important, but get a bioidentical form of folate, and we can do that pretty readily, like folinic acid or methylfolate, uh, rather than folic acid.

So if it's, if it, if, if, if it says folic acid on the label, that's your clue that it's a synthetic, uh, form and it's harder for the body to activate it. And yes, in the case of some individuals with autism, uh, it's cerebral folate deficiency actually is the name of the, um. Is the name of the condition that can present as autism because there's no, uh, [00:47:00] absorption, there's no uptake, there's no, uh, folate is not able to get into the central nervous system because of this autoimmune process.

Uh, and for them, folic acid can absolutely be toxic. Mm-hmm. 

Dr. Brighten: Oh, it's so interesting that you bring up the folic acid, uh, for pregnant women. This is such a hot debate. And what's so interesting to me is that I will see ob GYNs who are like, no folic acid. There's no reason for methylfolate. There's no reason for anything else.

And when I was pregnant, my last pregnancy, I'm 40, my, uh, maternal fetal medicine specialist was like, are you taking folic acid? I'm like, no, I'm taking methylfolate. She's like, good. I don't wanna see any of my patients on folic acid. I go to my regular ob gyn who's, you know, also involved with the pregnancy and she's like, why are you taking methylfolate?

You need to get on folic acid. And I'm like, I'm in to default to this expert here who also understands my thyroid better than you do. But there is such a disconnect in this. And the big reason is we studied folic acid and the outcomes in pregnant women. [00:48:00] But we don't wanna repeat that because we don't wanna repeat it with methylfolate because like the, the potential of harm, right?

It's an ethical issue. We don't experiment on pregnant women and so we're not gonna see those studies again. Although I'm like, we could because there's lots of women opting in to methylfolate and chew, choosing not to like take folic acid. So we could look at those outcomes. We certainly have the retrospective data to be able to understand that, but.

I think where people need to like pause is to actually understand nutritional biochemistry and to understand that going folic acid and then going methylfolate, like down that line. If we're giving you methylfolate, like we're skipping a step, like you're going to get there, hopefully, eventually. Like that's the plan.

But you know, it's, it's something that with so much resistance because people are like, well, there are no studies, and I'm like. Okay. But also I don't think you actually understand nutrition if this, if this is the only argument you're bringing. 

Kara Fitzgerald: Yeah. [00:49:00] You know, it's cheap. Um, it has a really, it's very stable, um, folic acid.

Um, yeah, I just think the bio, the, the biochemistry isn't really well understood. It, it takes more energy to activate it, to actually convert folic acid into a bioidentical folate that the body can use. Some of us don't do it as efficiently as others. Um, so there's all sorts of mischief and at this point, we just really don't need to use a synthetic form.

So, yeah. And it's toxic for some of us. Mm-hmm. 

Dr. Brighten: Who are the people that it's toxic for? 

Kara Fitzgerald: I mean, I think if you eat a, have a, have, you know, any kind of genetic inability to activate folic acid, you wanna avoid it. It's probably, it probably isn't toxic for you. Um, but it's just gonna be less effective for you.

Uh, it might inhibit some of your ability to make the more active folates that the body uses, uh, people with [00:50:00] cerebral folate, um, deficiency for those individuals and they can present with the characteristics of autism. Yeah. For those that population folic acid is, you know, is, is, is a no-no. 

Dr. Brighten: And how would someone know if they have that condition?

Or how would a parent be able to know, this is not truly autism, this is actually a folate deficiency. 

Kara Fitzgerald: You, so you can measure those antibodies now. So I, I would go to a doctor who's versed in it, and it would, that would probably be somebody who's, who's got an expertise in working with individuals with autism, um, who's been trained in functional medicine.

Uh, and those antibodies can be measured, you know, fairly readily. Mm-hmm. 

Dr. Brighten: We've been talking about pregnancy, and pregnancy has been shown to age us at a biological level. Can you talk about that? 

Kara Fitzgerald: Yeah, that was an interesting paper that got a lot of attention. So, pregnancy as a pro aging thing. Well, you know, pregnancy is like a pretty intense journey.

So, uh, it makes sense to me that during that process that, you know, measuring, um, [00:51:00] biological age using the various collects that they were using, you might see an uptick in action. Uh, but the cool thing is, is that, you know. Women reverted back to their, their previous biological age after giving birth, especially if they breastfed.

Um, sometimes I think that women who gained weight and didn't lose, so if, you know, depending if they had a healthy pregnancy, if their dietary pattern was decent, um, they could and they breastfed. They just rebound back and they rebound well and strong and as they should, as we should, right? Uh, but you know, if you gained weight and you haven't been able to lose it, or if you adopted, you know, less of less healthful dietary patterns, I think you can put yourself into a, a pro aging, um, state, uh, and then make pregnancy perhaps can start that journey.

So I think, um. High stress events [00:52:00] as pregnancy, you know, certainly is at, at certain points in time can be pro aging, but ideally only for a short period of time. Certain scientists like Matt Kalin will argue then, therefore, it really isn't pro aging if you rebound and I think that. That's fair, that's a fair argument.

Um, but I also think it's interesting, I, you know, as measured using the, the biological age clocks, it appears to be pro aging. So I, I, for me, I don't have a problem looking at this short term, pro aging phenomena and then just ensuring that we rebound back. I mean, for me, I don't, the semantics, I don't, I don't really get caught on, but we know surgery can have a short-term, pro aging, uh, effect.

Certain illnesses can be short-term pro aging. Um, a high stress experience can be short-term pro aging. Uh, but in the best of all worlds, we get through it, we get to the other side, and then we rebound back. Mm-hmm. 

Dr. Brighten: What about breastfeeding? It's helpful in reversing that. 

Kara Fitzgerald: Helpful. Yeah, exactly. Yeah. So in that particular [00:53:00] study, breastfeeding was, was awesome.

Dr. Brighten: Did they say why or, or what it was about that? I wonder like, 'cause you're bathing in so much oxytocin, right? Yeah. Yes. Um, which that's like for sure. I always am like oxytocin sees CORs. Cortisol is just like, sh quiet over there. Like, I'm doing my thing now. I 

Kara Fitzgerald: think, I think that's, I think that's probably a good guess.

I don't know if they teased out the mechanism, but that's fabulous. Yeah. Because stress, cortisol is phenomenally pro aging. Mm-hmm. I mean, short term, again, it's beneficial, you know, we need it. Yeah, absolutely. For survival. Um, but that chronic grind of stress is. You know, gasoline on the fire of aging.

Mm-hmm. It's potently pro aging. 

Dr. Brighten: What other things are people doing with their nutrition and their lifestyle that's aging them more rapidly? 

Kara Fitzgerald: Certainly, you know, following a standard American diet, a standard American lifestyle is, is wildly pro aging. You know, it's wildly pro aging. Mm-hmm. You know, we've extended lifespan, you know, through heroic interventions, through drugs and surgeries, et cetera.

So we're living longer than we were maybe a couple hundred [00:54:00] years ago. Um, but we're not living better, you know, and we spend the bulk of our final decades sick. I mean, on average, you know, most of us have, um, multiple chronic conditions. Most of us are on multiple drugs. I mean, our final years living, um, we live in poor quality health.

Mm-hmm. I mean, it's just, it's really heartbreaking. Um. I think the promise of this new science, the science of longevity, is that our genes don't dictate our fate and we really sit in the driver's seat of how well we're going to live. Mm-hmm. How well our health span, how robust a health span will be. Um, and I think science is tinkering a little bit with, um, lifespan and, you know, our lifespan humans really is about 120 max.

But I think, um. A, I think science will allow us to actually achieve that more readily with some of the tools and [00:55:00] using diet and lifestyle interventions, which will, will never be, we'll never be able to, um, drug away a poor diet or poor lifestyle habits. But I think if we combine some really good science and we continue to lean on, um, the dietary patterns, the exercise, et cetera, sleep, et cetera, you know, stress managing our stress, we'll be able to have this beautiful health span along with a longer lifespan.

Dr. Brighten: Are there supplements that you've seen in the research that can also support that? There 

Kara Fitzgerald: are supplements that have awesome promise that I'm incredibly bullish on. I'm really excited about, uh, ULI a, it's a prebiotic compound. Um, so it's coming from a polyphenol, again, going back to these plant. Compounds.

Um, the po polyphenols from berries, from pomegranate, from certain nuts and seeds, uh, can produce this compound. Um. [00:56:00] These, well, this handful of compound called alleg, the alleg acids. And then our microbiome will act on these compounds and produce something called uli. There's a handful of different ULI thins, and of all of those, ULI a seems to do the heavy lift, uh, physically and really supporting mitochondrial health.

Hmm. And there's cool, cool data on your lith. A, um, in supporting muscle mass in supporting mitochondrial fitness in rejuve, in rejuvenation. Autophagy. So rebuilding healthy mitochondria, supporting the clearance of poor functioning mitochondria, and then the development of new robust mitochondria. They've looked at euro lith a in the context of biological age clocks and have demonstrated in human, this is actually all human data that, um, you can shave a couple of years off biological age using your liase.

So I'm, I am super bullish on that compound, and I think it's incredibly cool that its [00:57:00] origin is from plants, from these plants that have mm-hmm. These, um. Allergic acids, tannins in them and, you know, were acted upon by the microbiome. So just going back to polyphenols, and I wanna just give another shout out.

There's this whole field of study in phytochemicals called, you know, it's not field of study. There's this, this, this term called dark matter of nutrition that recognizes, it sort of reflects on, uh, the fact that we don't understand a lot of these phytochemicals. Mm-hmm. There's an in, there's, there's just.

Hundreds of thousands of them, and they work together and they interact and they're super powerful. And we evolved with them. We evolved with our microbiome, um, changing their structure, making them bioavailable to us and our, you know, and our, our, our cells, our organelles evolve to respond to them and they sweet talk, you know, gene expression, DNA methylation.

[00:58:00] So I think more and more will understand that these compounds are incredibly important. So there's uli a, um, there's curcumin compounds I think are, that are important for all of us to be using. Um. Green tea. If we're not green tea drinkers, it's probably worth it for us to consider, you know, just an encapsulated green tea because EGCG is such a badass polyphenol.

Um, I'm a huge fan of Himalayan Tart buckwheat. Mm-hmm. Uh, we can cook with it, or again, you can take it encapsulated form because it. Packed with a ton of these all important polyphenols. And then there's some exciting science on immuno rejuvenation using Himalayan tery buckwheat. You know, we can't escape fish oil.

Fish oil is incredibly important. There's a whole subset of compounds from fish oil called, um, pro resolving lipid mediators. These are really important anti-inflammatory players. If we have enough of those omega threes in our lipid membrane, [00:59:00] we, and we're healthy, we can make these specializing pro resolving lipid mediators.

But if we've got an inflammatory process going on, sometimes we don't make them as efficiently, but we can buy them, we can buy these SBMs. I think those are really, really important. Uh, we need to be taking care of our microbiome and we, we can do that most effectively with a good dietary pattern. There's a huge place for, uh, fermented foods.

Um, there's a handful of probiotics out there now that I'm bullish on. I'm a big fan of Akkermansia. Mm-hmm. Um. People who live long and well have a lot of akkermansia in their gastrointestinal tract. They, and it's just, um, it supports intestinal barrier structure and, uh, supports producing GLP. So it, you know, it helps us with appetite and craving control, et cetera, et cetera.

Um, so those are a handful of compounds. I'm bullish on magnesium. Always. Always, yeah. For everything. So. 

Dr. Brighten: Yeah, no, [01:00:00] that's a fantastic list. And it's something that, so I've been in the nutrition field for over 20 years and I have said over and over and over, like everyone is focused on macronutrients, micronutrients, and we're gonna figure out that we actually didn't understand food whatsoever.

And so as we look at supplements, yes they're important, but there are compounds that Yeah. Are married together within our food. Yeah. That interact in ways that we don't even understand. Hundred percent. And it's so exciting 'cause we're now just on the cusp of starting to understand that like huge food isn't just fuel, it is information about your environment.

Modulation of the microbiome, you know, as you were talking about one strain of probiotic and all the benefits of that. And people right away are like, how do I supplement that? How do I get that? And if you're not eating the diet that we talked about at the start of this, like, good luck. Yeah. Take all the pills you want.

But that's like, you know, having barren soil and throwing seeds on there and thinking anything's gonna grow. 

Kara Fitzgerald: Yeah, absolutely. Yeah. And speaking of Akkermansia, yeah. We can support [01:01:00] our own endogenous amania with polyphenol dense diet. Going back to those pomegranate, it's the pomegranates that make your litan a, I mean, it's, we're so interconnected and you're absolutely right.

I mean, a well-designed fork full of salad. Has contains thousands upon thousands of compounds. They interact with each other, they interact with our digestive juices, they interact with our microbiome. They're completely transformed and, um, turned into something different that our body th absolutely thrives on, including gene expression and including, um.

You know, gene expression is looking at biological age. So yes, it's wildly important. And to your point, we're just beginning to tap into it. I mean, I love, I love the term dark matter of nutrition because it really underscores the fact that we don't get it. Mm-hmm. But we are starting to, I think it's new technology, you know, the fact that we're able to look at, uh, lots of different [01:02:00] compounds more readily, and, you know, layering on AI to be able to interpret all of these interactions, you know, will certainly help us begin to, uh, tap into what's happening.

Mm-hmm. A cool project that I, that I did, um, was to look at the genes. In our study, we could see that we changed methylation on well over 600 genes. Uh, and I was able to take that list and overlap it in other studies. So the direct trial looked at a Mediterranean dietary pattern and Himalayan artery buckwheat, they released a trial.

And so I looked at all of it to see if we were influencing if any of us were influencing shared genes. And sure enough, we were so these polyphenol dense dietary patterns, um, we were all kinda dancing in, uh, a Venn diagram. There was some overlap, not everything overlapped, but it's exciting to begin to kind of look at that.

And there's only going to be more and more and more of that where we're able to just [01:03:00] really exquisitely get in there and understand, um, how these different dietary patterns are overlapping and how they influence health. 

Dr. Brighten: Are there things that women who are wanting to conceive or are currently pregnant that they can be applying?

Because as you've been talking about genetics and epigenetics, certainly what you do during pregnancy, it's not just about your longevity, but babies as well. Oh my God, yeah. That's such 

Kara Fitzgerald: a good question. Um. We, so aging begins at the time of conception, actually. And if you want to design a healthy baby, of course you want your egg and sperm to be as exquisitely healthful as possible.

And when we're thinking about gene expression and DNA methylation, um, there needs to be a precon, a very intentionally designed preconception journey that's as important for the man as it is for the woman. Like both players are going to be contributing. Huge pieces of information to this offspring they're going to be building.[01:04:00] 

So I would, I argue for using the dietary pattern we used in our study as a preconception program with a few tweaks. Um, in fact in the book I created a whole dietary pattern with the macros. I tweaked to the macros a little bit, um, for preconception conception, for pregnancy, for the postpartum period, because it's that important.

So these polyphenols that we're talking about, this methylation dense diet that we're talking about is essential for, for preconception, for pregnancy, you know, for the postpartum period. Mm-hmm. Yeah. All of these nutrients are wildly important because we want our offspring to have as healthy DNA, um, gene expression as possible.

Um, and we can do it, we just wanna set them up. Right. Um, we can see. Challenges in pregnancy. Um, we can see challenges in infancy that [01:05:00] can push aging forward in an unhealthy way. Uh, and this information, using this food as information can really kind of help optimize it and change it. Mm-hmm. 

Dr. Brighten: I love that.

And that's super empowering and I love that you emphasize the male factor as well. Yeah, because here even, you know, in this day and age we. Still see fertility clinics that are like, let's just focus on the woman and saying nothing about the sperm and not looking into that. So it's so important for both to be on the same page.

Yeah. I wanna shift gears. I wanna talk about brain health and specifically Parkinson's disease because we know that environment and lifestyle can shape your risk for Parkinson's disease. Can you talk to us a bit about what people should know if they have a family history of Parkinson's disease and what they should be doing to help with prevention?

Kara Fitzgerald: Yeah, that's a really good question. And we could even more broadly look at neurodegenerative diseases, you know, um, you know, including, um, cognitive impairment, [01:06:00] Alzheimer's. Mm-hmm. Um. So the gastrointestinal tract, like there's more and more, there are more and more studies coming out, really implicating some of the, um, dysbiotic microbes, actually some of the compounds that they can produce, uh, influencing the development of Parkinson.

In fact, you can see that inflammatory bowel disease tends to track, um, with Parkinson mm-hmm. As a, as a precursor, um, condition. So GI health, I mean, a really, a full functional approach. There's, you know, there was just a study released not too long ago looking at the toxins in a, you know, on a golf course, um, being associated with increased incidents in, in, in Parkinson's disease.

So, so toxin exposure, certainly chronic toxin exposures. Um. And those would, those, those are pesticides and, and, and chemicals of that nature, but, 

Dr. Brighten: and is that pesticides? So we heard about the golf course. Yeah. There's people who, like the Central Valley of California is like a hotspot for so many health [01:07:00] conditions.

For people who don't know, that's where we grow a lot of our food. Is it also consuming pesticides? The pesticides that you come into contact with your food? I think it's across the board. Mm-hmm. 

Kara Fitzgerald: And I think metallo toxins can play an issue in there. So fish with a lot of mercury, for example. Um, or being exposed to lead, which can bioaccumulate in lead, you know, lead saturated soil, can bioaccumulate in the food grown.

Mm-hmm. Or, you know, lead that's in, uh, an old home. Um, that tends to be a more common source in kids. Uh, but if you're rehabbing an old home and you're ex and you're, you know, you're pulling down some of that paint, likely you're being exposed to lead and you need to check for it. I, you know, so toxins more broadly is something that we absolutely have to be thinking about, uh, regardless of where the exposure is coming from.

So, is our water clean? Is our air clean? You know, what is the pollution like in the, in the environment we're living in, in the city? [01:08:00] Um, yeah. What kind of pesticides are being used? What's, what is the quality of the soil that our food is being grown in? Um. You know, the quality of fish that we're consuming.

Unfortunately, toxins are a thing that drive disease, drive aging actually to, you know, to, in keeping in that theme will drive disease forward. Um, and we need to be looking at them at least annually. Mm-hmm. So for me, for my patients, for my family, um. An investigation into a broad investigation, into toxin exposure is something that we'll do at least annually.

And if something is identified, you know, then you need to track it, find exposure, source, remove it, do detoxification. If that's indicated, you know, until that thing is cleared. And, you know, one of the cool things. So it need be quite as overwhelming. If you've got a good clinician helping you in this process, it needn't be horribly overwhelming.

Um, the dietary pattern that we [01:09:00] researched, any good healthful dietary pattern is going to have built in nutrients that are detoxifiers that are gonna help keep the body clean. Mm-hmm. So if you're eating right, chances are already, you're doing a lot right to protect your yourself from the toxins that you're inevitably exposed to do your best to get organic.

But just anecdotally, recently I had, for the first time in my life, I've been measuring my, my toxins, um, my body burden of toxins for, um. For, you know, the bulk of my adulthood, I did my postdoctorate training in a lab, and so I had ready access to being able to measure 'em. So for many, many years never had lead, uh, until recently.

And so clearly there was some sort of an exposure source. The first thing I did was to measure my daughter's lead to make sure, uh, she wasn't also being exposed to it. Yeah. She was negative completely. There was no lead identified. So, so I knew her Halleh. I know, right? I know, I know. Hallelujah. So, but that ruled out, you know, paint in our house, [01:10:00] um, that ruled out water being an issue that ruled out the foods that we were sharing being an issue.

So I had to look, it was something ex, you know, exclusive to me, and I think it was some root vegetables that I was getting from a source that I was less sure of. Mm-hmm. Um. So measured, did some detox, uh, continued to track, it changed some of the, some of the places I was buying my food. And you know, now it's gone.

But it was interesting, you know, and I posted on, I, I actually tracked online with it and people followed me and there was so much fear around it, but I'm like, look, you guys, this is the first time I have a history of labs. I know this isn't something I've been tracking with. So it's not, it's, I, I can get rid of it.

I can find the exposure source, I can eliminate it, I can get on with my life. You know, I don't have to have a lot of anxiety around it. 

Dr. Brighten: Mm-hmm. Um, people are gonna wanna know how you're testing this, how you're measuring this because you go to your regular old PCP. Yeah. And they're gonna be like C-B-C-C-M-P.

Yeah. Maybe you have to beg for a vitamin D, but they're not running these types of labs. 

Kara Fitzgerald: [01:11:00] Yeah. And it's easy. So the best way to measure metallo toxins, lead, arsenic, cadmium, mercury is through blood. Mm-hmm. Insurance will cover it. Basic standard insurance will cover these markers. You just need to ask your doctor for 'em and really insist on it and get them annually.

Mm-hmm. Now, some of the compounds we're talking about, pesticides, um, uh, plastics, et cetera, are derivatives from plastics. Those are a little bit more sophisticated. You won't be able to get those necessarily. I mean, in fact, some of the standard laboratories, like Quest does have a couple available, but they're a little bit tricky.

Um, going to some of the so-called functional labs mm-hmm. Like vibrant or, um, mosaic is probably your best bet. So going to a functional medicine provider, integrative provider of some kind, um, will be able, you'll be able to access those labs. Mm-hmm. 

Dr. Brighten: When it comes to neurodegenerative disease like Parkinson's, [01:12:00] Alzheimer's, the cognitive decline that, you know, people are told you're just getting older, do you believe there are things that people can do?

We've, we've talked a bit about prevention, but to actually start reversing those symptoms through nutrition and lifestyle. Oh 

Kara Fitzgerald: yeah. 100%. Absolutely. And we're getting more and more sophisticated labs, um, to identify neuroinflammation earlier and earlier and earlier and earlier. Mm-hmm. So we can see those changes actually.

Even MRI, um, two really cool podcasts, one with, um, Hans Ryman, who is a co-founder and, and chief science officer at Neuro Code. Neuro Code is doing awesome laboratory work in early ch seeing early changes to neuroinflammation. So that's a cool podcast people might be interested in. This is your podcast?

This is on my podcast. We'll link to these episodes. Yeah. So we can link to that. Yeah. Yeah. And another really cool podcast is with, um, Owen Phillips, who is the co-founder and chief science officer. [01:13:00] At Brain Key. And Brain Key is using AI technology to interpret MRI, um, in an incredibly sophisticated and really interesting way.

And again, we can pick up, um, perturbations much, much earlier than a standard brain MRI. Both of those are cool, like our tools are becoming more and more and more refined, and it's a super exciting time in medicine. Um, as you'll, as you'll hear if anybody listens to the podcast, I, I did with Hansman, you know, he, uh, talks about Dale Breen's work.

Mm-hmm. So you know who Dale Breen is, of course. Um, and his recode protocol turning, turning around cognitive impairment or inhibiting the onset of dementia in a POE four people. Mm-hmm. Um, so the promise is there, you know, early intervention can, um. Shut down the development of these conditions, even when the genetics are pre are, are present.

Mm-hmm. [01:14:00] So I'm, it's, I'm very bullish on a, our ability to measure and pick up these changes earlier and earlier and earlier. And b you know, some of the interventions that we have at the ready and again, we're looking at diet and lifestyle. In fact, the drugs, um, you know, used in in Alzheimer's are. Uh, you know, they're just not particularly effective.

Mm-hmm. Um, Parkinson's is a little bit different. Obviously having access to dopamine and keeping dopamine around when the Parkinson's symptoms are present, um, is important, is an important part of therapy. There's some cool research happening around Parkinson's disease and using glutathione. Actually David Perlmutter has done amazing work in that arena, um, using diet and lifestyle interventions to, uh, gut work, uh, because there is this microbial association mm-hmm.

In Parkinson disease, um, there's some cool work happening in that arena, you know, that people can get their hands on. 

Dr. Brighten: [01:15:00] Mm-hmm. So if someone's listening to this right now and they're like, I have a family history of Parkinson's disease, what are some actual things that they could put into place? So you mentioned like gut health broadly, so you know, if you have gut symptoms, definitely get that checked out, but are there other things people could be doing?

Kara Fitzgerald: Well, you know, I would have to say if, if I came from a family with a history of Parkinson's disease, I would wanna work with a functional provider. Mm-hmm. I mean, it would be that simple. You wanna do a full systems approach and make sure that you're dialed in across the board, you know, what's your vitamin D status?

Let's look at gut health. I mean, it's pretty hard to escape, um, having some kind of gut imbalance living in the US at this point in time. Mm-hmm. Uh, so some intention towards gut health has to happen. Uh, what's your dietary pattern? Are you eating the optimal dietary pattern for you? Um, you know, again, the toxins exposure, like we've talked about already, uh, we want, you wanna do a broad sweep there [01:16:00] and just make sure that, um.

You're eliminating those toxins that might be present and that you're just inhibiting exposure to, to new ones. And you can do this within a, within the context of a sane life. Like you don't have to be really obsessive about it. You can live a good life and take care of yourself in this arena. But I would do it with a functional medicine provider.

If you need to have somebody whose insurance covered, um, you can find them. More and more, uh, functional providers are taking insurance where, and I would probably go to the Institute for Functional Medicine and look there for a provider in my area. Mm-hmm. Um, and you know, and start there. Our dietary pattern where you were focusing on biological age.

Um, aging, by the way, is the biggest risk factor for the development of all of these disease diseases. So I think if you need to do something on a super budget, you know, and you don't have access to a functional provider, grab the book and, you know, start to eat nutrients. Mm-hmm. You know, just. [01:17:00] If, if the idea of changing your dietary pattern causes anxiety, uh, go, there's an appendix in the back of the book, a 30 page appendix of epi nutrients.

Start there. Go the, go back there with a highlighter and just highlight everything that you're already eating. 'cause you're already doing a lot, right? And see what you can add, you know, and then slowly begin to incorporate some of the other elements of the dietary pattern into your life, you know, until you're doing it.

I mean, that would be a simple cost-effective, doable way to bring, you know, healthy, uh, habits into existence in your life. And you know, the life of your loved, the lives of your loved ones. 

Dr. Brighten: Epi nutrients. Some people have never heard that before. Can you explain that to people? Yeah. 

Kara Fitzgerald: EPIs Epi Nutrition. So these are nutrients that we know ex influence gene expression.

So they influence the epigenome. The epigenome again, is that, um, biochemically active part of above the [01:18:00] DNA. So the DNA we can't change, it's what we got from mom and dad. Um, but we can, we. Actively change the expression of our DNA through epigenetics. Uh, so nutrients are known to be able to influence gene expression, and there are a lot of nutrients.

In fact, we could argue that, you know, toxic foods, the pro-inflammatory foods could be nutrients in a negative way. Mm-hmm. You know, they'll allow, uh, pro-inflammatory genes to be turned on, et cetera. So we wanna be eating those. Awesome healthful nutrients. Um, and just really making sure every fork full of food that goes into our mouth is providing that information for optimal gene expression.

Dr. Brighten: Mm-hmm. Well, this has been a fantastic conversation. We are gonna link to all the things that you said today, but thank you so much for taking the time. 

Kara Fitzgerald: That was great. Really great. Good questions. 

Dr. Brighten: Thank you so much for joining the conversation. If you could like, subscribe or leave [01:19:00] a review, it helps me so much in getting this information out to everyone who needs it.

 

If you enjoyed this conversation, then I definitely want you to check out this.