Dr. Michael Roizen Interview: RealAge and Living Longer

The short version: Dr. Michael Roizen, the Cleveland Clinic’s chief wellness officer emeritus and creator of RealAge, says the average man can make his body about 29 years younger than his calendar age through daily choices. His top six, in order: stress management, food, avoiding unforced errors like smoking, physical activity, brain health and sleep, and daily flossing to prevent gum disease. Supplements come in seventh. He’s 80, and by his own math his body is 55.

My full conversation with Dr. Michael Roizen.

Dr. Michael Roizen is 80 years old by the calendar. By his own math, his body is 55. After spending an hour with him, I believe it. He has more energy than most people half his age, and he is one of the people I most wanted on The 200 Year Life Project.

I first heard him speak at DaVinci 50, the longevity mastermind Kathy and I joined, which is run by Richard Rossi. Before we sat down, I asked you what I should ask him. This conversation picks up where that talk left off: what your RealAge is, the six things that matter most for how fast you age, why he flosses like his life depends on it, and the 36-a-day soda habit he had to be ambushed on live TV to quit.

Who Dr. Michael Roizen Is

Dr. Roizen is the chief wellness officer emeritus at the Cleveland Clinic and the man who created the RealAge concept. He trained in both anesthesiology and internal medicine, has published more than 185 peer-reviewed papers, holds 13 U.S. patents, chaired an FDA advisory committee and co-founded 12 companies. He has written or co-written about 25 books. Four were number one New York Times bestsellers, and he likes to point out that three of them knocked Harry Potter off the top spot on Amazon for a while.

What Is Your RealAge?

Your RealAge is the age of your body, as opposed to the number on your birth certificate. It started with a problem in surgery. Running cardiac anesthesia at UC San Francisco, Dr. Roizen found that the biggest predictor of how patients recovered was not their heart or kidney function. It was their age. So the question became: how do you make a patient 10 to 20 years younger in the two weeks around an operation?

Later, at the University of Chicago, one of his patients was Gary Becker, the Nobel Prize-winning economist. Becker’s work was about the “net present value” of investments. Dr. Roizen asked him whether you could do the same thing for health choices, and RealAge was born. It predicts when you will develop disability and when you will die based on the choices you make.

One example he gave: if everything else about you is average, a blood pressure of 150 over 90 makes you about 16 years older than 120 over 80.

According to Dr. Roizen, the average man can make himself about 29 years younger than his calendar age, and the average woman about 31 years younger, just with the choices available today.

The Six Things That Matter Most

I asked for his top five. He gave me six, in order of importance:

Stress management. He sums it up as “posse, purpose and play”: friends you can count on, a reason to get up in the morning, and time to have fun.
Food. What you eat, how much, when and how it is cooked.
Avoiding unforced errors. No smoking or vaping, and wear the helmet when you ski.
Physical activity. All four kinds, which I cover below.
Brain health and sleep.
Preventing gum disease. Floss or use a Waterpik-style device every day, and see a dental professional regularly.

Supplements did not make the list. All 18 supplements and medications he likes, combined, would come in at number seven. That is how much lifestyle matters.

Why Flossing Made the List

This one surprised me, although I have written before about how the bacteria in your mouth can end up in your brain. Dr. Roizen explained that the bacteria behind gum disease cause inflammation throughout your body. That speeds up the aging of your arteries, raises your risk of heart attack, stroke and dementia, and has been linked to joint pain, diabetes complications and miscarriage.

He once told Oprah on her show that she needed to floss every day. She turned to her audience and told them to do the same. He says flossing rates in America went up afterward, enough that a dental society gave them an award for it.

It takes less than a minute. He takes a battery Waterpik into the shower with him.

Coffee: Good News for Me

People tell me I am crazy for drinking four cups of coffee every morning. Dr. Roizen is on my side. He says up to four cups a day is beneficial for most people, with lower rates of Parkinson’s, Alzheimer’s, liver disease complications and several cancers.

The catch, he says, is that about 17% of people are slow metabolizers who do not get the benefit. His simple test: if one 8-ounce cup in an hour gives you a headache, an upset stomach, anxiety or an irregular heartbeat, coffee may not be for you. He often has 10 cups a day himself.

How a Man of 80 Exercises

Steps: he does not go to bed without 10,000.
Weights: twice a week, about 20 minutes each.
On non-weight days: a 4 to 5 minute plank, 50 push-ups and 50 sit-ups.
Cardio: three times a week for 48 minutes, with three bursts of high intensity. Why 48? He once captained the U.S. squash team at the Pan American Games, and the deciding moments of his matches came around the 46th to 48th minute.
Jumping: 20 jumps every morning before he gets in the car and 20 every evening when he gets out. He says 40 a day is where the benefit for spine and hip health tops out.

For my own routine, see my fitness page.

Supplements and Medications

Dr. Roizen says there are 18 supplements and medications that can slow the rate of aging. He named a few of each:

Supplements: half a multivitamin morning and night, vitamin D, coenzyme Q10, creatine and collagen or gelatin.
Medications: baby aspirin twice a day, colchicine, a statin, a PDE5 inhibitor and a GLP-1.

I microdose a GLP-1, so I asked him why it made his list. He said it changes how your body handles sugar in ways that slow heart disease, stroke and memory loss independent of weight loss, and he cited lower cancer and breast cancer recurrence rates. He was clear that these are conversations to have with your own doctor, and so am I.

Wear a Glucose Monitor, at Least Once

He thinks everyone should wear a continuous glucose monitor for a couple of weeks just to learn how their own body handles food. When he did, two grapes sent his blood sugar over 160. Grapes are now out for him. I had the same kind of surprises with mine. He also learned what I learned: a walk after a meal brings blood sugar down fast.

Soda, Sugar and Sweeteners

Dr. Roizen’s rule of thumb is no more than about 4 grams of added sugar an hour. A can of Coke has around 38. In his view, no soft drink should have more than 4 grams of added sugar, and the only sweetener he considers acceptable is leaf stevia. He says other sugar substitutes raise inflammation, and sugar alcohols increase clotting.

He speaks from experience. He was drinking 36 Diet Dr Peppers a day, delivered to his house by the pallet, until Dr. Oz and his assistant staged an intervention on live TV in 2010. He has not had a soft drink since. I used to go through a 12-pack of Diet Pepsi a day, and I thought that was bad.

What About Eggs?

I eat three eggs every morning, so I had to ask. He says egg whites are fine and one or two yolks a day are probably fine too. His concern is not cholesterol but inflammation from the fat in the yolk. The protein, he says, is excellent at any age.

The Cleveland Clinic Executive Health Program

He also described the Cleveland Clinic Executive Health Program: one long day, roughly 7 a.m. to 5 p.m., with an internist, an exercise physiologist, a nutritionist, a life coach, a retinal scan and up to five specialists as needed. You leave with a plan. He said it runs about $3,900 including labs, with specialist visits extra. He was speaking for himself, not for the Cleveland Clinic.

Why He Thinks We Will Live Much Longer

This is the part I was waiting for. Dr. Roizen says life expectancy in the developed world has gone up about two and a half years every decade since 1890. One of his patients was born in 1928 with a life expectancy of about 49 and is about to turn 99.

He believes there is at least an 80% chance of a breakthrough in reversing aging within about seven years, so that people can function at 90 the way they do at 40. Of 14 areas of aging research he follows, he says six have reached human trials.

Many people tell me they do not want to live a long time. He thinks that is because they picture being 90 and frail. That is not what he is describing. He means being 90 and feeling 40.

His New Book and Newsletter

Dr. Roizen’s new book is YOU: Getting Older, an owner’s manual for the later years that he wrote with his wife. It covers the medical side, including 40 things shown to lower dementia risk and the 18 supplements and medications above, plus the legal and family side: when to give up the car keys, what to sort out before a second marriage, and how to keep your kids from fighting after you are gone.

He also writes a free weekly newsletter on the latest longevity science you can actually use at michaelfroizenmd.substack.com.

He has agreed to come back on the show to go through the rest of the book.

What I Am Taking From This

Floss or use a water flosser every single day.
Keep the four cups of coffee.
Jumping: I was already doing 21 jumps every morning. Now I have added another 21 in the afternoon.
Keep walking after meals.
Keep working on purpose and friends, not just supplements.

You can see everything I do on my protocols page, my workouts on my fitness page, and my test results on my tests and stats page.

Live long and prosper,
Gary

A note from Gary: I am not a doctor, and I am definitely not your doctor. Everything in this interview is Dr. Roizen’s opinion and mine, shared for education. Several items above are prescription medications. Talk to your own physician before starting any supplement or medication, or changing your exercise or diet.