▶ 0:19:02>> we will now come to order. I want to thank all of you for being here today. Remember this committee -- some of us are grandparents dynamic grandparent. Living a long and healthy life is something that is very important to me and all of our members on this committee but having more time with our loved ones is only half the issue.
▶ 0:19:25My hope is to focus on today -- expanding the number of years we live but also our health spans and the number of years we live free of disease or disability. Trying to make sure we have none of those. It's no secret we are facing significant health issues our country. Americans are plagued by preventable chronic diseases, cancers, and other illnesses. Heart disease, cancer, diabetes are the leading causes of death and disability in the united states.
▶ 0:19:57Six in 10 americans have at least chronic disease. At least one chronic disease. Four in 10 have two or more chronic diseases according to the cdc. Healthy life choices should mitigate and completely prevent these onus is. Start any time in her life and you can change your life. I believe the american people will make smart choices.
▶ 0:20:22Ahead of every hurricane season, when families understand the dangers of inaction action, they make the decision to do what is best for themselves and their loved ones. With hurricanes, we say preparedness days lives and it does. Just having information is not enough. The american people are being underserved in both categories of education and action. Too much of the conversation around health is reactive.
▶ 0:20:51We spent a lot of time of talking about -- and not about how to preventable diseases in the first place. There is a huge amount of research showing how americans will live longer, healthier lives -- to put these best practices in place. That is what today's hearing will be about, turning research into action that improves the health and wellness of americans so we can all enjoy living longer, healthier lives, and spend our senior years enjoying time with family.
▶ 0:21:21It is time to put a lot more focus and action on wellness and prevention. As our witnesses will discuss, it is not too late for anyone, even our seniors, to start making informe choices to leave -- choices to lead healthier lives. I look forward to working with rk junior and mama oz to create a healthier country. The issue of longevity is something our country should be more focused on. When americans live healthier lives, health care costs come down.
▶ 0:21:50The chronic disease as I mentioned before are eating driver submit -- of america's annual health care costs according to cdc. We are all fiduciary as of the american taxpayers and when we can do something that helps people live healthier lives while saving taxpayer money, everybody wins. I look forward to an insightful discussion on how we can take for generations to come.
▶ 0:22:16Let me turn it over to the ranking member, senator gillibrand.
▶ 0:22:21Senator Gillibrand: Thank you. We all want to live a long. Longevity bring the wonderful things like opportunity to spend time with her family, to travel, and continue to thrive, ensuring we remain healthy as we age is our utmost importance. Today, we will hear from four witnesses who represent four components of healthy aging. Research, nutrition, exercise, and medicine.
▶ 0:22:47Senator Gillibrand: We all know that we should eat a healthy diet, remain active, seek inventive care, and avoid habits that contribute to disease. As we will hear from Dr. nosal, so many macon's don't have access to stable housing, financial security, or lockable community's, so we need to address some of those challenges.
▶ 0:23:06Senator Gillibrand: We also know that these factors, often called social determinants of health, are often key to understanding how we can then allow for people to make those healthier choices. Although structural barriers make it hard to achieve health at any age. Congress has to do more to ensure that all people are able to meet their basic needs so that they can learn how to optimize their longevity and their health.
▶ 0:23:34Senator Gillibrand: It is why I have introduced the strategic plan for aging in the last congress. This bill would provide states with critical funding to transform the infrastructure and build communities that meet the needs of older adults and future generations. I would address -- it would address everything from housing to health care to food insecurity to make sure these systems are able to support our aging population and I am proud my home state of new york is in the process of developing a strategic land. These are positive steps to helping older adults achieve longevity.
▶ 0:24:05Senator Gillibrand: We are all aging, which is not in and of itself a disease but a natural process and we have a duty to ensure all americans can age well and age gracefully. I look forward to hearing from witnesses. >> thank you, ranking member gillibrand. I would like to welcome our witnesses here today. Before we introduce our first witness, I would like to ask each of you to be mindful of our limited time here today to keep everyone's opening statements to five minutes. First, I would like to introduce Dr. rhonda patrick.
▶ 0:24:37Senator Gillibrand: Dr. patrick is a scientist and health educator recognized for her leadership in nutrition, aging, and disease prevention. Dr. patrick earned her phd in biomedical science, conducted her graduate research at saint jude children's research hospital. He completed her postdoctoral fellowship at children's hospital oakland research institute, and has also conducted research on aging at the salk institute for biological studies. It is Dr.
▶ 0:25:01Senator Gillibrand: Patrick's goal to encourage the wider public to think about health and longevity using a proactive, preventive approach. As the founder of life fitness, she shares insights on aging and disease prevention with her own unique brand of scientific rigor , engaging millions through her website, youtube channel, where she has a combined following of more than 2 million people across the world. Dr. patrick.
▶ 0:25:26Dr. Patrick: Thank you. My name is rhonda patrick. I am happy to be here today and is this just an introduction I am doing or is this my opening statement? >> we are glad you are here. If you want to do your opening statement?
▶ 0:25:42Dr. Patrick: Yes, so we have to ask ourselves if we can call ourselves the greatest nation in the world while 70%, nearly three out of four adults are overweight or obese. While we spend about 18% of our gdp on health care, more than any other nation, yet we rank 55th in life expectancy. Our children are getting type 2 diabetes at unheard of rates. This is not just a health crisis. It is a cultural crisis. Obesity is not inevitable.
▶ 0:26:12Dr. Patrick: It is not an act of god. It is something that can be prevented. It is a choice that has been compounded by bad habits over time. It is reinforced by a culture that is -- that does not foster good decision-making and self-discipline. We have created a culture where these difficult truths have become personal attacks where physicians are afraid to talk about a patient's weight because it is too taboo.
▶ 0:26:40Dr. Patrick: If we cannot have a conversation about obesity, how can we ever solve the obesity crisis question market is associated with 13 different types of cancers. It takes between three to 10 years off of life expectancy. It damages dna, causes double-stranded breaks to dna, and it fundamentally accelerates the aging process. It is the possible difference between our nation and the longest lived nations. We are overfed but undernourished.
▶ 0:27:13Dr. Patrick: About 60% of daily total calories consumed by the average american come from also processed foods. These foods are caloric rich, nutrient poor, they do not increase say tidy so people do not -- satiaty. People are incentivized to eat unhealthy and they activate the dopamine reward pathways in our brain, causing addiction, so this trifecta of no state
▶ 0:27:44Dr. Patrick: This trifecta of no st -- it spirals us into this process of poor health outcomes and runway health care costs. Overconsumption of calories is not the only problem. The food we eat is supposed to provide us with essential vitamins and minerals that run our entire metabolism. Omega-3, so about 80 percent to 90% of americans have low omega-3 levels. We now know that low omega-3 levels have the same mortality risk as smoking.
▶ 0:28:12Dr. Patrick: Vitamin d deficiency, easily corrected, vitamin d gets converted into a steroid hormone that basically runs about 5% of our protein in the human genome. Everything from immune function to brain function to cancer, very important, easily corrected. Magnesium, half the country does not get enough that museum from their diet. It is essential for over 300 enzymes in the body including repairing damage to our dna. Dna damage is happening every day.
▶ 0:28:40Dr. Patrick: It is not something you can see in the mirror, that you will know about on a day-to-day basis, but it is what is -- it promotes cancers or decades later, it rears its ugly head. But the real problem is simpler. We actually need to start thinking about physical inactivity as a disease. We now know that it carries the same mortality risk as smoking, cardiovascular disease, and type 2 diabetes.
▶ 0:29:06Dr. Patrick: Yet when the average american reaches age 50, they lose about 10% of their peak muscle mass by the time they reach age 70. They are losing 40% of their peak muscle mass. This is not just about looking strong. It's about physical independence and survival. Higher muscle mass is associated with a 30% lower all cause mortality. Grip strength is actually a better predictor of cardiovascular related mortality.
▶ 0:29:32Dr. Patrick: The number one killer in the united states that high blood pressure yet nobody talks about it. Strength is also associated with a 42% lower dementia risk and yet we think of resistance training as an add-on come as a luxury. It is not. It is a fundamental pillar of aging.
▶ 0:29:48Dr. Patrick: It increases muscle mass, muscle strength, and bone mineral density so fractures are a death sentence between 20% to 60% of americans that have a hip fracture die within one year and yet resistance training can lower fracture risk by 30% to 40%. This is preventable. We have the information. We have the data. We need to take action.
▶ 0:30:11Dr. Patrick: And resistance training, exercise, getting the right foods are the most important things that we can do to prevent disease and make a difference in our country. So thank you. >> thank you. Next, I would like to introduce Dr. eric verdin, the president and chief executive officer of the buck institute for research on aging. The world's only research institution singly focused on the biology of aging.
▶ 0:30:37Dr. Patrick: He has insights into age-related diseases before they start. He received his doctorate of medicine for the university and completed additional clinical and research training at harvard medical school. He has published more than 210 scientific papers and was more than 15 patents he held faculty positions at the university of brussels, national institutes of health, and the institute for medical research he's also a professor of medicine at the university of california san francisco. Dr. verdin.
▶ 0:31:08Dr. Verdin: Good afternoon, chair scott, ranking member gillibrand, and members of the committee. Thank you for the opportunity to speak today. As chair scott mentioned, my name is eric verdin and I run the institute for research on aging in northern california. This is the world leading research organization on the biology of aging. Our mission is to eliminate the threat of chronic diseases by addressing the inching process itself.
▶ 0:31:38Dr. Verdin: Over the past century, public health advances in medical breakthroughs have nearly doubled the lifespan. This incredible success has come with a number of challenges. We live longer but not healthier. The end of our love lives -- long lies is characterized by a diseases including outside nice, parkinson's, heart attacks, strokes, cancer, osteoarthritis, degeneration.
▶ 0:32:06Dr. Verdin: By the time an american reaches age 65, most have at least one chronic disease of aging and 70% have two. We call these conditions the chronic diseases of aging. Our current health care system is focused on treating these conditions when they occur, not in preventing them in the first place. This approach is expensive, inefficient, and ultimately ineffective.
▶ 0:32:32Dr. Verdin: The cost of managing these illnesses is actually staggering . Increasing as our population ages and places and unsustainable financial burden on our health care system, our citizens, and their families. In the 20th century, we dramatically reduced deaths from infections, from heart disease, and from cancer, extending life expectancy in the process, but progress is slowing.
▶ 0:32:59Dr. Verdin: Even if we cure cancer tomorrow, the average lifespan will increase by less than three years. The reason is simple. The aging itself and its associated complications continues unchecked. Aging is the greatest risk factor and main driver for these chronic diseases of aging.
▶ 0:33:20Dr. Verdin: The good news is that we now know from research from the past 20 years that aging can be slowed and we have preliminary evidence that it can actually be somewhat reverted in some cases. Thereby extending healthy lifespan and delaying disease in animal model systems. There is not a single reason why these findings should not apply to humans as well.
▶ 0:33:45Dr. Verdin: By focusing on aging and its mechanism, we can compress the illness associated with aging so that in our later years, they are spent in good health. The economic and public health for of a shift from a reactive health care system to a true preventative health care based on our understanding of aging are enormous. Studies suggest that delaying aging will generate trillions of dollars in economic gains, reduce medical costs, and increase productivity.
▶ 0:34:15Dr. Verdin: Just as vaccines and antibiotics revolutionize medicine in the past, aging science is the next great frontier in preventing -- in preventative health care. Science is at a turning point and as policymakers, you will play a critical role in ensuring that we realize its benefits. Investing in aging research must be a priority. The nih should increase funding on the molecular pathways of aging with a new fss on translating discoveries into human applications.
▶ 0:34:47Dr. Verdin: We also need a much greater focus on lifestyle interventions. Nutrition, exercise, sleep, stress management, and social connections. These variables account for more than 90% of our lifespan and should be an essential part of our health policy and research. We must also rethink how we allocate health care dollars. Right now, we spend trillions on treating diseases after they arise.
▶ 0:35:16Dr. Verdin: A shift towards prevention would be far more productive. And effective. The fda needs clear guidelines for aging targeted therapies. Biotech and from a companies are investing in this field but without a defined regulatory pathway, progress is slowed. Finally, we need stronger public-private collaborations.
▶ 0:35:43Dr. Verdin: Translating discoveries into real-world application will require coordinated efforts between industry, government, and revelatory agencies. This is a pivotal moment. The 21st century has the potential to witness one of the most profound medical breakthroughs in history. Not just treating age-related diseases but preventing them. The goal is not just to extend lifespan but to ensure it is -- the entry years are spent in health, dignity, and independence. I applaud the committee for recognizing the urgency of this issue.
▶ 0:36:13Dr. Verdin: Aging research is at an inflection point and with the right policies, we can transform public health for generations to come. I look forward to working with you to make this vision a reality. Thank you. >> thank you. Now, I would like to recognize ranking member gillibrand to introduce her witnesses. >> Dr.
▶ 0:36:36Dr. Verdin: Sarah is a physician who practices at a federally qualified health center in the south bronx. She is also the president-elect of the american academy of family physicians. Thank you for being here, doctor. >> thank you so much. Chairman scott, ranking member gillibrand, and members of the committee, thank you for the opportunity to testify today. My name is sarah nosal. I am a practicing physician in the south bronx.
▶ 0:37:06Dr. Verdin: As the president-elect, I am honored to be here today representing more than 130,000 physicians and student members of the aafp. I work at the institute for family health, a network of federally qualified health centers with more than 27 locations across new york state. I am proud to be a family physician. In my office, I have the honor and privilege of taking care of not just patients but families and communities.
▶ 0:37:35Dr. Verdin: Mass month, chairman scott laid out his priorities which identified four aspects of someone to be well. Having the physical health, financial security, a safe community to live in, and family and community support. Each of these are rooted in the very fundamentals of family medicine. I have practiced for more than two decades in a community that ranks last for health outcomes in new york. My personal patient panel approaches nearly 90% medicaid beneficiaries.
▶ 0:38:04Dr. Verdin: A typical patient of mine presents with cane in hand, living with hiv, diabetes, hypertension, chronic kidney disease. Patient tailored counseling on diet and exercise is something I do in every visit. Unfortunately, while I talk about the importance of eating healthy, whole foods, the reality is most of them are often out of reach financially or otherwise inaccessible to most of my patients. This is only one of the health-related social needs that impact them.
▶ 0:38:33Dr. Verdin: A lack of stable housing, reliable transportation, safe places to exercise, and financial security also make it difficult if not impossible for my patients to afford medications and even make it to medical visits. Research has consistently shown that health-related social needs can worsen health outcomes. On more than one occasion when I have asked a patient why they were not taking the insulin as I directed, I would learn that they did not have electricity in their apartments for the last few weeks when they fell behind on rent.
▶ 0:39:03Dr. Verdin: Patients at our rural clinics -- patients with walker's face four flights of stairs. Many experience food insecurity for which the snap program is a lifeline. Congress can strengthen to ensure it better serve those in need. However, that alone will not solve my patients challenges pride while diet and exercise are important to health and wellness, we cannot ignore that many communities are designed with them out of reach.
▶ 0:39:33Dr. Verdin: Food and exercise can only be medicine if they are easily accessible. As a family physician, I recommend a healthy diet and working out but it is up to you, our elected leaders, to ensure the resources are in place to fill that prescription. Congress must support promising, innovative policies to address health related social needs such as expanding medicaid coverage for reimbursable services.
▶ 0:39:57Dr. Verdin: For example, some states have used existing medicaid authorities to provide medically tailored meals to whole households, not just the eligible beneficiary. This recognizes that a food insecure parent will often give their meal to a hungry child rather than feed themselves. Many of my younger middle-aged patients are caregivers for young children and older relatives.
▶ 0:40:19Dr. Verdin: Any reforms that affect their health care coverage may impact employment, their ability to help their mother make rent, to take their grandma to the laundry mat, or contribute to any productive meaningful way in the community. Insurance does not help patients if there is no access to care. Committee health centers provide care to those in underserved areas and are often the only accessible care setting for many. Chc's have a significant economic impact and are incredibly efficient in terms of health care spending.
▶ 0:40:49Dr. Verdin: Further, many are training the next generation of family physicians through the graduate education program. Our system has multiple family medicine red is -- residency programs. They have the highest success rate of any program for retaining residents in communities with need. Unfortunately, they rely on a patchwork of inconsistent, temporary federal funding. Right now, both programs are only funded through march 31.
▶ 0:41:22Dr. Verdin: To support and improve the quality of life for all patients and in all committees, I urge congress to make long-term funding for chc's and the thc gme a priority. In closing, thank you again for this opportunity to testify and I look forward to answering your questions. >> thank you. We do have one more witness coming but he has had some trouble so he will be here just a few minutes so we will go ahead and go to questions and I will start. >> thanks, olivia, for being here.
▶ 0:41:53Dr. Verdin: Dr. patrick, our health care system is broken. Reactive, not preventative. How do we get more longevity focused care into mainstream medicine and what is standing in the way? >> well, I think that the most important thing that we can do right now for longevity medicine is actually move more and I think the federal exercise guidelines are sort of out of date, to be honest. We do not focus at all on resistance training. It says two days a week. What does that mean? To be honest, people might start doing bicep curls.
▶ 0:42:25Dr. Verdin: I mean, there is not information there. You need to give people specific information, actual information. Resistance training, ok, well, you can do 15 minute -- seven or 815 minute workouts throughout the week and that is as good as doing 345 minute workouts in terms of gaining muscle mass and strength. So giving some more specifics in terms of types of exercise -- also compound lifts. You want to make people be physically independent.
▶ 0:42:53Dr. Verdin: You want people to be doing squats or you want them to be doing, you know, rows or deadlifts, things that are multi-joint and I think exercise snacks is a big one. There is nothing in the guidelines about how people can get exercise benefits by doing these short bursts of physical activity. Tons of research coming out on this. We are talking a recent study showed doing 10 bodyweight squats over a 7.5 hour workweek was better at improving blood sugar regulation then a 30 minute walk.
▶ 0:43:24Dr. Verdin: I mean, that is like 2.5 minutes a day. There is also tons of evidence coming out on these unstructured exercises which can be recommended. These are the kind of things that you take the stairs instead of the elevator or walk briskly instead of taking a car to work.
▶ 0:43:41Dr. Verdin: And there have been studies showing that people wearing these accelerometers are able to reduce their cancer mortality by 40%, the cardiovascular-related mortality by 50% if they are doing nine minutes a day of these unstructured snacks where they are taking advantage of everyday situations to get physically active. It does not cost money to do bodyweight squats. You don't have to have a gym membership. That is one important way that I think information can be improved and more targeted.
▶ 0:44:13Dr. Verdin: >> thanks. What is the most important breakthrough in aging research we should be paying attention to and how can we use it to actually help people live healthier, longer lives? >> there has been an explosion of our understanding of the biology of aging. In particular, the identification of what we call molecular targets.
▶ 0:44:38Dr. Verdin: We now understand that targeting unique molecules can actually have a profound effect on the whole aging process and on the associated disease. I also want to expand on what rhonda talked about, this idea of lifestyle factors. We talked about exercise but there is a group of lifestyle factors that we all know about. Nutrition, physical activity, sleep, human connections, that are really the critical determinant of your longevity.
▶ 0:45:06Dr. Verdin: Actually, more than 90% of our longevity for most people is determined by the way we live. What is really important is to know also each of these variables are stackable. If you are eating well, you are going to live longer but if you actually exercise on top of it, you are going to live even longer and if you have good human connections, you are going to live longer. Today, most of us in this country could expect to live to 90 or 95 in good health if we were to do everything right. So that is today.
▶ 0:45:39Dr. Verdin: And there are communities within the U.S. who live today close to 90 years old on average and I can guarantee not all of these communities are optimized in terms of doing everything. Right now a nation, as someone who studies aging, I am struck by the lack of knowledge of some of the things that we know are conducive to good health are not actually implemented and I am going to add one last point about exercise.
▶ 0:46:09Dr. Verdin: A 15 minute walk in the morning and at night will lead to a reduction of heart attack, stroke, cancer, many -- all of these diseases of aging by 40%. That is 30 minutes of walking every day. And I defy anyone, no matter what their lifestyle is, to tell me they do not have the time to walk 15 minutes in the morning and 15 minutes at night.
▶ 0:46:33Dr. Verdin: This is the type of information that people are not aware of and it could have profound effect on the health of our population so I am really passionate about lifestyle. Next will be of course the additional interventions at the research is pushing forward but for me, the foundation has to be these lifestyle factors. Drugs that target the aging process will come in the future. We are working on them.
▶ 0:46:58Dr. Verdin: There are promising leads but they should not be a replacement for reestablishing a healthy lifestyle yet ourselves and in the population at large. >> thanks. Questions to ranking member gillibrand. >> thank you, Mr. chairman. How do you say it? You said it perfectly at the beginning. >> I love that.
▶ 0:47:28Dr. Verdin: So sometimes, there's barriers to the things that we know are needed for longevity. Healthy eating is one. Obviously, there's barriers to affordability. Barriers like food deserts when it's not easy to get your group -- get to a grocery store and sometimes, it is just mobility if you are at a building and you are not very mobile and cannot walk to therocery store and you don't have a car, it is hard to get on the bus. The many barriers.
▶ 0:47:56Dr. Verdin: But one of the barriers I want to talk about with you is the nutritious aspect of it. A lot of people don't even know what is nutritious. Our doctors don't really study it in medicine. It's not common knowledge in culture. It is not well-known what is nutritious and what is good for you.
▶ 0:48:17Dr. Verdin: So one of the things that you talked about in your testimony, a four-year nationwide pilot program through medicare to provide medically tailored meals to eligible medicare beneficiaries with diet impacting conditions. This is innovation. We know that a medically tailored meal for somebody with diabetes is going to be a truly healthy for them. It will have a lot more fruits and vegetables in it. It will have whole grains.
▶ 0:48:47Dr. Verdin: It will have lean proteins. It will have no processed foods. So medically tailored meals really is pretty powerful. Can you talk about that a little bit and how could we implement it as she is one of the barriers? >> thank you so much. I am a practicing family doctor. I was seeing patients this weekend I saw a patient who I really wish this was one of the services I was able to prescribe her as part of her medicare coverage. She gave me permission to share her story.
▶ 0:49:17Dr. Verdin: This is a woman I have taken care of for quite a number of years and has done a really great job at being physically active to the best of her ability. She uses a rolling walker with a chair. And she has really well-controlled hyundai ability -- diabetes. As well as it can be controlled, reduced her risk of complications, and then came in this weekend saw me and her diabetes was fully uncontrolled. I asked her what was going on and she said she -- her apartment had moved.
▶ 0:49:45Dr. Verdin: Previously where she lived, she knew where the local soup kitchen was and the food pantry. She used her snap benefits, as I work with my patients to use their snap benefits for fruits and vegetables and use resources that are -- get those other foods there but save your benefits and you can get some extra incentives.
▶ 0:50:04Dr. Verdin: But this is really a patient who cannot find in her community where she is the resources to have that healthy meal that she needs that will be part of her remaining well and full and the idea that I could have prescribed her an appropriate low-calorie diabetic diet full of plant forward protein and foods would be a complete difference in her entire life.
▶ 0:50:32Dr. Verdin: I agree with this because the ability to move and to eat the end have access to those nutritious food resources, this could be groundbreaking and life-changing for our older adults. And this can be done right through our health centers, right through our community health centers that are in the depths of the communities where we can do this for the whole family and prevent the outcomes. I don't need to take care of people in a state of disease.
▶ 0:50:56Dr. Verdin: We are ready and willing and able in our health centers to care for communities that we know their risk is greater but our ability to provide these medically tailored meals will change both cost and outcomes in that community. >> along the lines of impediments to access to nutritious meals, we have snap benefits and snap benefits, you can go to the grocery store and cook whatever you want but for older people who are not cooking as much anymore, again, who cannot carry the two bags of groceries of all those fruits --
▶ 0:51:29Dr. Verdin: It and whole grains they are going to then cook appropriately to eat, what do you think about the idea of being able to use snap benefits for congregate meals or organizations like meals on wheels that deliver hot meals? Is that a way to get over some of these barriers to the nutritious or medically tailored meals that people need?
▶ 0:51:46Dr. Verdin: >> it would be tremendous if we could both increase funding for snap benefits -- I can tell you they don't meet the needs even right now, but the kinds of creative programs I know that we have done where I live where we have been able to increase funding for fruits and vegetables.
▶ 0:52:06Dr. Verdin: Sbut my elderly patients often have nutritional deficiencies because they are insect eating things that come in a bag or a box which are my top list of things I tell patience to try to not eat but that really is not feasible or possible for them. It would be astounding if they could actually use those benefits and have that kind of food delivered at their home. It would be life-changing. >> thank you. I would like to recognize a last witness. She has some travel issues so we are glad you made it.
▶ 0:52:36Dr. Verdin: Dan is an explorer, national geographic fellow, and the award-winning journalist and producer, new york times best-selling author and founder of blue zones. The term blue zones was first coined by dan in 2004 and refers to areas with high concentrations of centenarians, individuals who live to be over 100 years old. His team uses research to highlight and promote specific lifestyle habits that are tied to extended longevity and vitality. Thank you for being here. We look forward to hearing your presentation.
▶ 0:53:05Dr. Verdin: >> [indiscernible] >> my goal over the next four minutes and 54 seconds is to convince you that most of what we think works for healthy aging and longevity is either ineffective or just plain wrong. I know most of you know these statistics but we are spending $4.9 trillion on health care per year. About 85% of that money is spent on people with chronic conditions.
▶ 0:53:37Dr. Verdin: Most of them are avoidable chronic conditions. Another $300 billion on exercise and diet programs and then another $42 billion on antiaging industry -- an industry that has failed to produce even one intervention that has been shown to stop, reverse, or slow aging, so if that does not work, what does?
▶ 0:54:00Dr. Verdin: 20 years ago, working with national geographic and a team of demographers, we found five areas in the world where people are living statistically longest. Something called the danish twin study established that only about 15% of how long we live is dictated by our genes. 85% is something else and the reason we find that something else among these five populations who are living about 10 years longer at middle age. Our age.
▶ 0:54:26Dr. Verdin: The reason they are living 10 years longer is because they are avoiding the diseases that foreshortened americans live and are bankrupting us in many ways. What are they doing? Well, I -- none of them are dieting or exercising or running down to latin america for stem cell treatments.
▶ 0:54:49Dr. Verdin: Every time they go to work or a friend's house or out to eat, they are getting 8000 to 10,000 steps per day mindlessly. The cheapest and most accessible foods for them are peasant foods. They are whole grains, tubers. The cornerstone of every longevity diet in the world is beings. They are eating about one cup of beans per day. They are not spending time on facebook.
▶ 0:55:18Dr. Verdin: Instead, they are spending time in face-to-face conversations, living in extended families, connecting with their neighbors. They have vocabulary for purpose. There is an idea. Purpose. We know people have a sense of purpose, live about eight years longer than people who are rudderless. They manifest their purpose usually in family but also with religion.
▶ 0:55:38Dr. Verdin: We know people show up to church or temple or mosque and live about four years longer than people who don't show up at all. So taking this insight where people are living their longest, because they tried. It's not because they pursue longevity. We tend to think that health is the result of a pursuit in this country. Actually, it in series. It is the result of an environment makes the healthy choice the easy choice.
▶ 0:56:06Dr. Verdin: We are not relying on our mothers to make the right choice and then sending them out into an environment where 97 out of 100 food choices are bad. About 15 years ago, working with aarp and the university of minnesota, we set out to manufacture blue zones by working with municipal governments where you could get policy done to help them decide on policies that favor healthy food over junk food and junk food marketing.
▶ 0:56:33Dr. Verdin: To favor the human being over the motorist, to favor the non-smoker over the smoker and to certify all the restaurants, grocery stores, workplaces, schools, and churches who agreed to optimize their designs and policies so that people are knowledged into moving more, eating better, and socializing more. The proof is in the pudding.
▶ 0:56:56Dr. Verdin: Our very first town, we saw a 30% drop in health care costs amongst city workers in two thousand nine. In the beach cities of california, we saw about a 25% drop in obesity in the 10 years we were there and in fort worth, texas, they themselves reported about a quarter of a billion dollars in health care cost savings after the five years we were there. We succeeded not because we came in telling people what to do, came in with an agenda.
▶ 0:57:24Dr. Verdin: We simply came in with policy options and place options that made the healthy choice the easy choice. We set people -- we set americans up for success. Right now, our food environment and built environment sets people up for failure. We have about 25 times more fast food restaurants then we did in 1980 when we had one third the rate of obesity that we have right now.
▶ 0:57:50Dr. Verdin: So the big idea I would ask you to think about is shifting the focus from changing people's behavior and individual responsibility and setting americans up for success by designing our cities so the healthy choice is not only the easy choice but the unavoidable choice. >> thank you. >> I live in naples, florida. >> that's right. We have a blue zones city in naples and jacksonville, florida.
▶ 0:58:20Dr. Verdin: I salute them. >> let me turn it over now to senator johnson. >> Mr. chairman, very good hearing. Very interesting testimony. I held an event at the end of september with rp junior, with Dr. casey means who had written a book that interested me, talking about metabolic health. An awful lot of testimony here relates to that in some way, shape, or form. I think two of the most significant parts of that testimony, Dr.
▶ 0:58:47Dr. Verdin: Chris palmer is a psychiatrist who does a lot of work in terms of nutritious -- as it relates to mental health issues he said they don't want to know the root cause of chronic illness. Dr. casey means talked about in her medical education, they could spend an hour talking about nutrition. You are talking about trying to design a city for the right food choices but again, what are those right food choices question record think it is becoming pretty obvious and I think that is one of the questions that I have for Dr.
▶ 0:59:18Dr. Verdin: Patrick. We have known about this for quite some time, right? I mean, the food pyramid was marketing. There is nothing scientific about that. It was a marketing deal. We have gone to seed oils. The problem that we have as a consumer is again, you have all the books out there and all these different theories. Who do you believe? It's a very confusing thing unless you just go completely simple.
▶ 0:59:46Dr. Verdin: All whole foods, no ultra processed food, try and approach it that way. Dr. patrick, just kind of comment on that. >> well, I do think that going whole foods and trying to reduce your ultra processed foods as much as possible is the way to go. And I think we have a lot more information now than we did, you know, 30, 40 years ago. We know these ultra processed foods are not causing satiety.
▶ 1:00:15Dr. Verdin: They are activating the -- the addictive reward pathways in our brains. That information is a little more in-depth but I also think some of the information on why do we eat? If we have nutrition in primary and secondary school, definitely medical school, you are right. I mean, one class in nutrition is absurd. I mean, if we can start educating at an early age children why they eat, what are they supposed to get from their food question of why do you want to eat leafy greens?
▶ 1:00:43Dr. Verdin: What happens if you don't get magnesium? What is cancer? There's even some data out of japan. They have that program in japan where they have in primary schools nutrition education and they have shown longitudinal studies that people who were educated with nutrition in childhood are much more likely to eat healthy, nutritious later in life. >> part of the problem is our medical establishment. They call it rockefeller medicine, based on pharmaceuticals.
▶ 1:01:14Dr. Verdin: It is awfully appealing. All we have to do is get a shot or take a pill and we are going to be well. When we think probably the exact opposite is true. 85% of our spend is on chronic illness. It is about preventing that chronic illness. You talked about the basics. Right? Nutrition, exercise.
▶ 1:01:37Dr. Verdin: Not necessarily -- and then all of that, there's all kinds of different opinions on types of exercise but being active makes sense, getting good sleep, stress management. All those things make perfect sense. How do we break through? How do we be educate our doctors? How do we reeducate our public policy here?
▶ 1:01:59Dr. Verdin: One thing we could probably do is with our snap program, not allow certain foods to be purchased, highly ultra processed, the ones that we are pretty convinced are not good for you. I mean, that would be a good switch, wouldn't it? >> thank you for the question. First, let me completely agree with you on the idea that the foundation has to be there. Lifestyle factors and the drugs should only come on top.
▶ 1:02:28Dr. Verdin: A subset of the population that is at increased risk of accelerated aging. That being said, there is something that is happening in the aging field which I think is going to allow us to work through the noise that you described. Which diet, paleo diet, ketogenic diet? Atkins? People are completely confused and the same about exercise p had what are you supposed to do? Is it strength training, is it yoga, is it endurance?
▶ 1:03:00Dr. Verdin: Aerobic, anaerobic? People throw up their arms in the sky and say I don't know what to do. Same about sleep. How much should you sleep? The whole field of aging is in the process of developing these biomarkers of aging which allow us to measure and to predict the effective interventions in the long term so instead of doing a clinical trial, right you would take a group and do strength training and another one to flexibility and follow them for 30 years to see what happened to
▶ 1:03:30Dr. Verdin: Them. These markers allow us, within a much shorter period, within one year, to actually detect a signature so there is the promise that developing -- they do exist. And I think we need support to be able to actually test these interventions against one another so that we can actually make the best prediction to people in terms of what is really the optimal way to actually live and optimize your health. That is where the field is.
▶ 1:03:59Dr. Verdin: Again, there is a bottleneck in terms of the funding. These are not cheap studies but they could have massive implications in terms of public policy recommendations, in terms of what is the optimal way to exercise question marks I mentioned the point of, you know, walking 30 minutes a day. That is already good. It's a 40% reduction. Can we get to an 80% reduction by adding another modality? To what degree are these interventions going to be individual?
▶ 1:04:26Dr. Verdin: So that is a whole other field -- a whole other area to study. >> thank you, Mr. chairman. >> senator husted. >> thank you, Mr. chairman. I appreciate the testimony and the thoughts, the conversation. You know, I listen -- you can read -- it's exercise, diet, lifestyle choices. If we just made better decisions and more active on those things, we would drive down costs.
▶ 1:04:56Dr. Verdin: We would improve quality of life. I heard a lot of talk about longevity. It is not just the number of years but the quality of those years that also are almost immeasurable in terms of their value, in terms of your productivity, your joy, your ability to contribute to your family and community if you have those things.
▶ 1:05:16Dr. Verdin: And I was also thinking when you were talking about the access to it, I was also thinking when you live in a high crime neighborhood how much harder it also is to be active and to live a healthier life. So I want to ask any of you who has a thought on this, what about this -- our technologies? They seem to be driving isolation and idleness.
▶ 1:05:46Dr. Verdin: And as we look at the difficulty we have had as americans are getting healthier even though we know all of these things, is there evidence that you have seen about how our technology is driving isolation or idleness that would affect our health in a negative way versus a positive way? I'm interested if you have any thoughts on that. >> I have thoughts on the opposite.
▶ 1:06:09Dr. Verdin: I mean, so most of us have an apple watch or fitbit or some sort of wearable device where we can get -- measure our heart rate. We can -- resting heart rate during exercise. A lot of different health parameters and yet, I think there's a lot of regulations there that don't allow those devices to help give us medical advice.
▶ 1:06:34Dr. Verdin: We have ai coming out with -- I mean, ai has now been shown to be as good or better at predicting, you know, disease and illness and looking at all of the articles and contribute to that then physicians are. And yet we cannot use that information, that health information for anything, and it seems like it is something that would be very useful. >> let me challenge you a bit on that. I agree that those things are valuable.
▶ 1:07:04Dr. Verdin: I am not sure that most of us have those things. And I read in the last couple of years that the average prisoner spends more time outside a day than the average child.
▶ 1:07:21Dr. Verdin: And I am just wondering, you know, when you read things like that and you see the amount -- the way that social media is affecting particularly young people and fewer of them are participating in sports, it seems like from the very beginning, that we are getting children off to the wrong start as it relates to this. I see some heads nodding. Others have thoughts on that? >> as a family physician, I take care of people.
▶ 1:07:50Dr. Verdin: Pregnancy, newborns, small children. I get to see great-grandparents and the entire family. I think it is an interesting perspective across technology. I'm also the chief medical information officer at my organization so overseeing the rollout of our electronic health record and patient portals in english and in spanish. So I am right with you. I really worry about my young people in school. When I am seeing that kids in my practice, I find out what sports they are doing.
▶ 1:08:17Dr. Verdin: How much physical activity is in their fiscal activity question on how often do they have recess question my particularly for young people and it's a little different for adults about obesity and weight, for young people, it really matters, the activity level that they are doing, and we have models where schools will not have cell phones during the school day and you will get rid of your cell phone at the start of the day and get it back later. But I am not seeing.
▶ 1:08:39Dr. Verdin: With that the kind of investment in making sure we have that funding in education, the teaching staff, and the supervision and expertise to make that physical activity possible there. And that is a wonderful place for prevention. I want to come to the other part of technology for our older people -- older adults.
▶ 1:08:56Dr. Verdin: Our rural communities that don't have broadband access, who cannot communicate or take it vantage of things like telehealth which are critical when we are following up complex medical issues or preventing falls and trying to make sure we keep our older adults safe, that it is actually really critical that only that we have infrastructure that makes access possible but our isolated older adults helping and teaching and finding ways both to connect with your physician and with your community, that there is
▶ 1:09:28Dr. Verdin: Investment there as well. >> no doubt, we made a lot of progress on telehealth. Other thoughts? Yes. >> may be I can add something. As a parent, I clearly have seen, and I think all of us who have children have seen the effect of portables on social isolation and physical inactivity so I do not know, as a scientist working on aging, how to solve this problem area clearly, there are other countries who have regulations
▶ 1:10:00Dr. Verdin: That limit the use of these portables had iphones and so on bright younger individuals who are obviously more vulnerable. One thing to note is that these are the formative years where critical habits are formed that would last a lifetime. Just wanted to amplify also the point about wearables.
▶ 1:10:22Dr. Verdin: Wearables, I agree with you, today, they are a subset of the population that is generally more well-to-do and able to afford it and more interested in its health. I can see the day changing where wearables are going to be part of the tools used by physicians, especially in areas that are remote in combination with telemedicine for increasing the health in those populations that might be more isolated and might
▶ 1:10:53Dr. Verdin: Not have access to everyday physicians. So the wearable technologies are rapidly accelerating. They are actually, I predict that within the next five years, they will be valuable, recognized medical tools in terms of assessing your rates for chronic disease simply by measuring your movements, looking at your blood sugar, looking at all series of variables I see. Your blood pressure and so on.
▶ 1:11:21Dr. Verdin: I think they will become important tools and with their democratization, we can expect the prices to go down and the value to go up so I think this is something, if I were a regulator, that I would keep my eyes on as a potential changing factor in the landscape of medicine. >> thank you, chairman scott. Senator.
▶ 1:11:46Dr. Verdin: >> first of all, to our panel and our great witnesses, I did not have the opportunity to hear you. But I am sure that we are all singing from the choir. That is all there is to it. You know, I have got to say justice. I am from west virginia. West virginia has surely got some really tough issues going on.
▶ 1:12:13Dr. Verdin: To say the very least, we are the third oldest state in the country. You know, we have a life expectancy of 72.8 years, which is the second lowest. 20% of our folks in west virginia are 65 and older. You know, we do have affordable housing in west virginia and that helps a bunch.
▶ 1:12:44Dr. Verdin: But we have got risk factors like you cannot imagine, whether they be social isolation or the risk of falls. You know, they could very well be food insecurity, the lack of broadband, transportation issues, or medical care issues, and obesity. Obesity absolutely the worst of the worst.
▶ 1:13:10Dr. Verdin: Now, I don't look by any stretch of the imagination, but I am trying real hard. Between babydog and I, together, we continue to try real hard. I have lost 55 pounds and I am really proud of that and I have got a long ways to go.
▶ 1:13:28Dr. Verdin: Now, babydog, in subscribing to the same theory that I am subscribing to but for those of you that know her, she is a little brown, 62 pound watermelon, and she is a little bulldog that she absolutely loves everybody. But let me just tell you just this. In west virginia, we do have some things that are going on that are really, really neat stuff.
▶ 1:13:54Dr. Verdin: We have the fact that we are a community, and it is so important, absolutely from the standpoint of family and community, it is so important to our seniors. I just think about this beautiful little girl who is here and everything and if you could tell me her name, please. Addison?
▶ 1:14:22Dr. Verdin: Well, addison, you are absolutely, spectacularly beautiful and I will promise you if you will look up online or whatever babydog and look up just know how much she would love you, too. But I tell everyone, and I tell you this just speaking from my heart just speaking from my heart, I tell you that, in many ways, we are here for addison.
▶ 1:14:50Dr. Verdin: Not only are we here for all of those of our seniors, all of those of our aging, but we are here for addison, because some way, somehow, we've got to change the path of what we are doing today.
▶ 1:15:08Dr. Verdin: For that reason, and I don't want this to be such a political issue, but for that reason, that is why I will vote for rfk junior, because I believe he is at least trying to bring more awareness to all of us. In all honesty, there are so many in my state that need help in every single way, but more than anything, we need knowledge.
▶ 1:15:42Dr. Verdin: We need to step up. I will never forget my dad saying just this. He was trying to figure out where to build a road, and really and truly, he kept listening to engineers all around him, and finally, the lead engineer's name was kirby, and he looked at kirby and said, "kirby, I don't know what the right answer is, but this dad- gum well ain't it."
▶ 1:16:14Dr. Verdin: Now, if you think about just that, what we are doing in america today is not it, and we've got to do better. We got to do better for all of us, for myself, believe it or not, for babydog, but more than anything, for addison. Addison, thank you for being here. Thank you so much, Mr. chairman. I you will back to you.
▶ 1:16:42Chair Scott: Thank you. Senator moody.
▶ 1:16:48Sen. Moody: Thank you. I'm only three weeks into this tenure, and I noticed that we set around a lot, so thank you for being here today. Thank you, chairman scott, and ranking member gillibrand, for holding this hearing.
▶ 1:17:06Sen. Moody: Not only on this aging committee but those who may be watching and hearing the information around the country, I agree with senator justice, becoming more aware and making sure that others in our state are aware is an incredible first step to making america healthy again. Thank you for taking the time to be here. I know it is not always easy to break away from practice or travel another state across the country could I really appreciate it. I know some of you are residents.
▶ 1:17:34Sen. Moody: I am the newest senator from florida. I know some of you are my constituents. I'm grateful. One of the things that I think our long-standing, reactive approach to health care needs is we spend more money than we probably need to. I was most fascinated by your work, Mr. buettner, some documentaries you've worked on, I recommended my own parents watch those.
▶ 1:18:03Sen. Moody: I'm fascinated, I'm from a state that is growing exponentially. There are new communities being built. Those going back and think about how to address their existing communities. I was taken with some of the statistics you included within your written testimony, some of the places you've worked who have reported annual savings.
▶ 1:18:26Sen. Moody: Cities reported not just a drop in their physical bmi but an actual drop in cost to their city. I think it was in minnesota, 30% of their worker health care cost since they started.
▶ 1:18:43Sen. Moody: I was just wondering, in terms of existing communities that are trying to go back and reconfigure or new ones you are working with two to build the city, highlight health and community, healthier options. Have you done a study that shows how much might be saved versus what the in pot -- input to a cost to a community or city might be?
▶ 1:19:12Mr. Buettner: [inaudible] I've got to turn it on. [laughter] so if you drop the bmi or the rate in the city of a million people, it saves about 19,000 heart attacks over time. The average heart attack cost about $120,000.
▶ 1:19:32Mr. Buettner: So you don't have to have a big movement to make a big difference, but essentially what I'm pitching to all of you guys is the notion that we tend to think in silver bullets. There's going to be this one magical intervention that's going to save us. Meanwhile, we are surrounded by what I call silver buckshot's, the small nudges in default. It iso slow-moving.
▶ 1:20:03Mr. Buettner: -- it is slow-moving. But city governments, municipal governments can move in a hurry. A mayor and city council in coordination with the business community can get a lot done. We do it in jacksonville something called a complete street policy. You know you can raise the physical activity level of a an entire city by just building street so they invite pedestrians?
▶ 1:20:30Mr. Buettner: They invite people to socialize, they invite cyclists instead of just cars. That does not cost any extra money. Once every 77 years, a street needs to be redone, and you can just as easily rebuilding for humans and cars rather than just for cars. So it is see and clearly. We know there's a clear correlation between the number of fast food restaurant permits and the obesity rate of a city.
▶ 1:20:57Mr. Buettner: If you live in a neighborhood with more than seven fast food restaurants within a half-mile of your home, you are about 35% more likely to be obese than if they are fewer than three. In the hands of a city councilmember, they may decide, well, our children's health is more important than another burger joint, and make the changes appropriately. Billboard advertising.
▶ 1:21:19Mr. Buettner: We know two identical neighbors, and one neighborhood has billboard advertising and the other one does not come of the neighborhood with billboard advertising has about 15% higher bmi. So what we try to do is rather than telling cities what to do, we show them the evidence, we give them about 30 different policies and age of smoking, environment, and food, things that cost them nothing, and we ask them, would this be effective for you? Would this be feasible for you?
▶ 1:21:49Mr. Buettner: And if they say so, then we help them get it done. The wrong thing to do is to come in and say there's a silver bullet. The wrong thing to do is to come in and tell people what to do, but when you show them the evidence, america is smart. There's a lot of very smart mayors and city council people who are tired of seeing their children grow up overweight, tired of seeing their neighbors died prematurely of heart disease and type two diabetes. And this is something we can act on right and now.
▶ 1:22:18Mr. Buettner: I guess the pitch for the federal government is to think about empowering designing cities for health rather than continuing to look for just a silver bullet.
▶ 1:22:30Sen. Moody: Thank you, chairman. , again, chair scott: thank you, senator. We hear a lot about diet and exercise, encouraging stronger communities and healthier lifestyle, what can we do?
▶ 1:22:47Mr. Buettner: The name is buettner.
▶ 1:22:52Sen. Moody: I started out. I apologize.
▶ 1:22:56Mr. Buettner: No problem. You guys are important. [laughter] well, believe it or not, it is encouraging people to eat at home. Every time we go out to eat, we consume about 300 more calories than we would at home, and those calories are going to be laden with sodium, ultra processed food, and sugar. You can control the calories when you live at home. We think about educating people.
▶ 1:23:22Mr. Buettner: One of my fellow testifyers here had a good point about teaching children how to cook at home. For national geographic, I studied a place in finland called nor karelia, and they brought it down by 50%. How did they do it? They brought it down by changing the environment.
▶ 1:23:51Mr. Buettner: One of those was using church basements to teach mothers how to cook with plants rather than just with meat. That is an approach that works. If you take a person who is getting zero physical activity and get them to walk 20 minutes a day, you raise their life expectancy by three years.
▶ 1:24:16Mr. Buettner: There's no pill, no phmaceutical in the world that will raise life inspected the -- life expectancy by three years. If you get people to go from zero to 20 minutes, we can achieve that by designing our street and sidewalk so it is easy for people to go to grocery stores, easy for people to pick up their coffee, easy for kids to walk to school. It is a very simple solution. It is within our grasp, and it can potentially cost nothing.
▶ 1:24:41Chair Scott: Thank you. I will now turn it over to senator alsobrooks. By the way, I have to go to a budget hearing, so I will turn it over to senator lee. I thank each of you for being here, and I love what you are doing.
▶ 1:24:56Sen. Alsobrooks: Alright, thank you so much, Mr. chair, and ranking member, for hosting this important hearing today, and thank you so much as well to our witnesses who have been here. Advancing research on healthy aging is key to helping the seniors live longer lives. And congress must be sure, I believe, that we take action to improve the quality of life for our seniors. My first question for Dr.
▶ 1:25:25Sen. Alsobrooks: Verdin, as someone who has worked at nih and continues to engage in aging-related research, would you speak to the role of the national institute on aging and inventing -- advancing research on longevity and health care?
▶ 1:25:40Dr. Verdin: Thank you, senator. I came to this country 42 years ago with a suitcase and a medical degree from belgium. I was attracted at that time by what I knew at the nih, the vision, and the medical research enterprise that had been created in this country. And I must say that I never looked back one bit.
▶ 1:26:08Dr. Verdin: I became an american citizen, made this country my home, and still at this point, the whole institute focusing on the biology of aging. I think the nih has been instrumental in creating what has been called the crown jewel of the american come from it -- american government, and quite frankly, the crown jewel of all biomedical research organizations in the world.
▶ 1:26:39Dr. Verdin: The U.S., thanks to the work in support of the nih, has created the best biomedical research institute. Remarkably, every dollar that is being invested in the nih yields two dollars of economic output, which is a remarkable outcome for our society.
▶ 1:26:56Dr. Verdin: This has yielded countless cures that has put millions of jobs, created a whole new industry, a whole biotechnology industry, and has given the usa leadership position in the world to still attract the very best to come to research and conduct their careers here. So I think, from a personal point of view but also for the country, I think the output from the investment in nih has been nothing short of remarkable.
▶ 1:27:25Sen. Alsobrooks: I could not disagree with you, Dr. verdin. I agree, especially with your characterization that it is the crown jewel. Would you say that right now, nih, as you may know, is subject to a number of cuts that have been proposed. Would you say the cuts to nih funding threatens the progress we've made in research on the aging brain, and alzheimer's disease and dementia research?
▶ 1:27:53Dr. Verdin: Dramatically so. And I do worry about the institute that I direct, and I worry about the leadership position that we are in. Right now, it is in a comfortable position. We are leaving by far, every other country in the world. China is making great strides in terms of really pushing into biology. A recent j.p.
▶ 1:28:19Dr. Verdin: Morgan meeting in san francisco, about a month ago, saw a very strong presence from china, and we are going to be really pushing the leadership position, that we are going to be missing new opportunities, to develop new treatments, especially in the field of aging, and that we are going to be basically losing a lot of jobs. There's no way around this.
▶ 1:28:45Dr. Verdin: From a personal point of view in terms of the institute that I drive some of these cuts actually come to affect the way we have seen them. We will have layoffs. We will have a difficult time, a difficult road ahead. And I think this will be replicated across the whole country, red and blue states.
▶ 1:29:05Sen. Alsobrooks: I agree. Thank you so much, Dr. verdin. Just real quickly, my time is winding. I want to ask Dr. nosal, regarding research and preventative care, actually the question I want to ask you about is about marginalized communities and federal research funding that helps make significant advancements in understanding aging and age-related diseases, and how can nih ensure that aging
▶ 1:29:36Sen. Alsobrooks: Research includes diverse populations, particularly for historically marginalized communities? I know that is a long list. Whatever you have to say is helpful.
▶ 1:29:47Dr. Nosal: It is critical, for individuals, black and brown individuals, that how they are impacted and what needs to be done to really prevent the heavy cost of care in the future is different because of the dynamics within the community is that we are in.
▶ 1:30:05Dr. Nosal: Research into connections with faith-based organizations, connections with communities, and we really see that, those are opportunities within communities like mine that aren't being leveraged for research. What we know, trust in the community, we can make those benefits to help out comes across.
▶ 1:30:26Sen. Alsobrooks: Thank you very much.
▶ 1:30:30Sen. Alsobrooks: Ranking member gillibrand --
▶ 1:30:34Sen. Moody: Ranking member gillibrand, I heard you had a few follow-ups.
▶ 1:30:37Sen. Gillibrand: I really like what you talked about, that you were talking to cities and communities and leaders about much more of a strategic plan for what they could do for the health and well-being of their citizens, and what I really liked about your approach, it was no silver bullet, it was not even silver buckshot, it was, you have to do all these things. And you mentioned transportation, making sure people can walk, walkable cities , so they can ride bikes.
▶ 1:31:10Sen. Gillibrand: I would imagine as part of that, you would want some kind of mass transit or public transit, so an older person can actually get somewhere. Because an older person might not be able to walk for a mile or long distance. Did you talk to them about access to fruits, vegetables, whole foods?
▶ 1:31:26Sen. Gillibrand: Like if you go to the bronx today, a food desert in some areas, where it is not accessible to get to a grocery store, you might be able to get to a bodega or a corner store, but you might be charged, I don't know, two dollars for an apple, you know, it is so expensive. It is not accessible and affordable. Did you look into those types of barriers as well? Did you make recommendations?
▶ 1:31:51Sen. Gillibrand: Because I have legislation to incentivize us to build grocery stores in food deserts, so that we can get those quick fruits and vegetables across the sites. And did you hear my conversation with Dr. nosal about using the federal benefits that we do have better? You know, we made the change in s.n.a.p. To make it easier to use the s.n.a.p.
▶ 1:32:18Sen. Gillibrand: Benefit at a, what do you call them, like a farm fair, you go into a farm stand, to be able to buy the foods and vegetables directly from the farming, better for farm, better for people.
▶ 1:32:36Sen. Gillibrand: Usually they use it, instead of eating by yourself in front of a television as an 85-year-old, you can go to the senior center and have two meals a week that are, get with family members -- community members. Do you have thoughts on that too?
▶ 1:32:51Mr. Buettner: Yes. So we have worked in 70 cities, and I have learned that every community think they are different in that they are all alike. So what we have done, we have boards of academic advisors, and we compile, we called in policy menus, in food, built environment, and tobacco.
▶ 1:33:14Mr. Buettner: These menus are evidence-based, and there are usually 30 different policies that have worked elsewhere at creating a healthier eating environment and more physically active community , in a place where it is a little bit harder to smoke. In other words, they have improved health. We measure with gallup, so it is not just anecdotal. We take a well-being index metric at the beginning. And then in order for us to come in, the city council and the mayor have to pledge to go through this consensus process.
▶ 1:33:43Mr. Buettner: We go through every one of these menu items, every one of these policies, and we score it for feasibility, can we get it done in this community in five years, and for effectiveness. Do we believe it is effective? So do I believe that taxing so this will lower the amount of sodas that children will drink? Yes. But if you lead with that, you will often be shown the door. But we keep it on the menu, so they discuss it.
▶ 1:34:12Mr. Buettner: So with each of these areas -- we have 30 or so policy items -- it's hard to mess with s.n.a.p. You can sometimes sell the idea of a pilot program, but s.n.a.p. Come as you know, is a federal program.
▶ 1:34:28Sen. Gillibrand: Well, we are the federal lawmakers.
▶ 1:34:31Mr. Buettner: We love you.
▶ 1:34:33Sen. Gillibrand: So when fighting a farm program, we can make it better, more accessible, more usable.
▶ 1:34:38Mr. Buettner: Let me take you to jacksonville, florida, and I can show you some opportunities for the s.n.a.p. The bottom line is, trying to come in and tell people what to do does not get you far, but showing them how they can be successful within the parameters of what is important in their city, you can get a lot done. And it is a different way of thinking about things. S.n.a.p., you know, my big criticism is it allows people to buy the same food that is making them sick.
▶ 1:35:05Sen. Gillibrand: So ideally, you would like nutrition dollars to be on education about what is nutritious?
▶ 1:35:12Mr. Buettner: Teaching people how to cook with whole, plant -based foods.
▶ 1:35:20Mr. Buettner: You know, we have done this before. A healthy 100-year-old who lived to be 100, you have to know what she ate as a little girl. 155 dietary surveys done and five blue zones over the past 100 years, and without a shadow of a doubt, they are using mostly whole foods, about 90% whole grains, garden vegetables, tubers, nutes, and beans.
▶ 1:35:51Mr. Buettner: And showing them how to make it taste delicious. You cannot guilt them. They have to want to be that more.
▶ 1:35:56Sen. Gillibrand: Our most successful food banks in new york are the ones that have cooking classes.
▶ 1:36:01Mr. Buettner: Bingo.
▶ 1:36:03Sen. Gillibrand: They can teach the whole family how to make these vegetables that they may not have ever seen, they don't have recipes for, and that has been very effective. Also, along the lines of our earlier conversation, teaching pediatricians and even prenatal doctors, providers, when they get the pregnant woman into say when you have your baby, this is the best nutrition for you, this is the best nutrition for your baby. Teaching it right away.
▶ 1:36:31Sen. Gillibrand: Again, you have the benefit of exercise every day in our schools, and nutrition education. Helping the next generation for sure. Thank you so much, all of you. This has been an excellent hearing. I think we had a very lively conversation about ways to improve, and I just appreciate you, madam chairwoman, for hosting us, but all of the contributions you make to today's discussion.
▶ 1:36:54Sen. Moody: All right. Thank you again for being here. The committee hearing is adjourned. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap.org]