Sharon Bergquist, MD (Host): Hello and welcome to the whole healthcare, A space
for Trustworthy science-based information on how you can live healthier longer.
Happier naturally.
I'm your host, Dr.
Sharon Bergquist at practicing Yale and Harvard trained physician and
scientists with three decades of experience specializing in chronic
disease prevention, longevity and human performance, and author of the
Stress Paradox, why you need stress to live longer, healthier, and happier.
Today's conversation focuses on defining.
Measuring and predicting how well we age.
A topic That is so near to my heart.
In other words, will you be able to live independently and do the things you love?
Aging well, as we know, isn't just about preventing disease
or extending health span.
We're gonna see that it's about extending function, how long we maintain the
physical and cognitive capacities.
Required for living Well, and I'm joined by Scott Fulton, who's an
internationally recognized redefiner in the positive aging space.
A researcher, author, and adult educator.
He teaches at three prominent universities on health span and aging.
He's a member of the American College of Lifestyle Medicine.
Sits on the prestigious True Health Initiative Council and is past president
of the National Aging and Place Council.
Coming from a diverse engineering research background.
He's known for translating complex science into applied evidence-based
preventive lifestyle medicine for aging.
Well, he's the author of Wealth Span and his latest book function.
Challenging around health span.
It turns out That
is the.
Scott Fulton: Thank you, Sharon.
I'm delighted to be back with you and thanks for the kind introduction.
Sharon Bergquist, MD (Host): It's my pleasure.
So Scott, I think you bring such a unique perspective to aging and I wanna start
by kind of asking you, first of all what you do and how you arrived at this
approach of looking at functional age.
Scott Fulton: I wear many hats depending on the hour of the day that you catch me.
in general terms, I'm really focused around educating everyday
people on what are the practical aspects of health that we can bring
forward, that really anyone can do.
And that goes to teaching at, so I teach at three universities.
around the country, one of them in-person.
I can't be in three different cities at once.
my course at Northwestern goes out to 50 schools around the country concurrently.
it's a great opportunity to reach out to adults who maybe didn't get the health
education, I didn't get it early in life.
and not to turn them into scientists, but really to help them understand some of
the gaps that we never learned earlier.
That doctors never learn in medical school that might apply to them, to really
apply to decisions they make around their health choices and their daily habits.
And really my approach is, my background's engineering, so
I'm all about what are practical solutions that we can adopt easily.
And so there are things that, that you can choose within a framework that
fit your priorities, that fit your culture, that really are the choices
that, I think if we listen out on the airwaves, we get into the minutia
pretty quickly in a lot of conversations.
And that's fine if you're ready for that level of detail.
But more about the foundation of how do you make sure you don't have cracks in
your foundation that you're not aware of.
You're kind of distracted by all the shiny, witty and clever
conversations going on out there.
And that's where, I see a big need out there.
And so that's really where I'm trying to serve.
Sharon Bergquist, MD (Host): I think That is so needed.
there's a lot of, you know, critique of the health system because.
Subspecialties work somewhat siloed, between the cardiologist
And the nephrologist.
But I see a lot of that same happening in the wellness space And in the
space of longevity in that some people are, promoting treatments
that are stacks of supplements.
Some people are putting forth, you know, hyperbaric chambers and infrared,
Treatments and there isn't that cohesiveness And the consumers are
left oftentimes just trying to piece together like, what do I really need?
How do I incorporate this wearable into the advice I'm
being given in this other space?
And it's creating a bit of that same siloing, where there isn't that
unity between what we're trying to do, how we're trying to accomplish it.
How did you get at function as such a core foundational concept?
Scott Fulton: It's a great question.
I wish I could give you a really succinct answer.
I think at the heart of it is I'm just interested.
In really good quality, large volumes of data, and not having any particular,
flag to wave around this, really around the whole health span issue.
'cause as you point out, there's so many people pitching different
nuances and totally different ideas.
I just am always searching for good quality data.
and my background being in engineering and research and my athletic background,
I think is a good example, right?
As a runner, I enjoy running, I enjoy a triathlon, but I know that I can follow
a training schedule and based on my running pace and my heart rate over a
number of weeks, I have some reasonable prediction of what my race time should be.
And if I follow my plan, I'll usually come very close to that.
and I kind of ask that question, well, why are we so all over
the map around health span?
We have people pitching ideas, but no one actually tells us these are
the, the metrics or the milestones that you can measure along the way,
the way we might think about pacing for a run, and again, you don't
have to be a runner to appreciate this, but the concept, it holds up.
I started to dig around and I've got a bit of a background in, accessibility
and disabilities, and I started to think, well, how do we measure those things?
And it just kind of started to ask questions that led me to functional
data and I started to dig into it.
There is enormous functional data and even within the functional, clinical
work, there are over 30 subspecialties.
The most comprehensive is geriatrics, but geriatrics isn't worried about
what a 40-year-old is looking like or a 50 or a 60-year-old.
So they're at the end of the cycle.
They're the most holistic.
And the younger you go, the more divided, the subspecialties are.
They're looking at the sports, injury, for example.
How do I get a pro athlete back on, the game field?
occupational therapists are certainly at play.
we look at development, from early childhood, use walking as a great one
because it's the most uniform across the lifespan as a newborn, we're
looking for when is that first step happens, around a year ly we're all
excited about that And we're kind of the doctors checking in on those things.
And once you get to be, you know, 16 or so, we don't even think about
those things anymore unless you're in the, school track and field.
We don't look at it again until you run into troubles walking much later in life.
Well, all of the scientists and clinicians out there have actually
been tracking all this data across a lifetime because they're trying to
benchmark what are we comparing to?
And so, so we have lifespan data around something as simple as
walking, And we know that we can characterize how you walk today.
What does that look like 10, 20, 30 years down the road?
And once I started to reach into that data, it just, came back to me with
so much information that we could start to bring to everyday life.
And it's more than one domain.
and I think that's, a key part of what I discovered in the course of
it too, is we're far too singular in the way we think about things.
Like even something like VO two Max.
Yes, it's a great indicator.
But it's not the best indicator.
It relies on correlation as much as many of the other things we hear about.
Sharon Bergquist, MD (Host): Maybe we should also take a step back
and kind of define some terms.
So what is health span?
What do you look at when you think of lifespan, And what is the role of.
Functional ability within that umbrella.
Scott Fulton: I think it goes back to your, opening comments,
which I think were so appropriate.
Health span.
We really have two definitions.
So there's the medical definition that really describes your disease free.
But when I talk to people out there on the street And in my
class, that's not their metric.
'cause they know that we can operate and do all the things we want.
disease may have some impact on that depending on where we are in the, the
cycle or development of a disease.
But we have lots of ways through medicine to be able to help people.
Like I could say hypertension, right?
So does hypertension slow people down?
Not so much.
It may have some complications if it's not addressed later.
So where everyone in, the real-world, I'll say outside of medicine views,
health span is, It's answered by the question I ask all my classes.
How long do you wanna live?
And almost without exception, as long as I can continue to do the things that I wanna
do and ultimately the things that I need to do, that's really, I think, the most
appropriate definition of health span.
That's largely gone unaddressed.
Sharon Bergquist, MD (Host): so.
Powerful because you know, we get asked that.
And what you bring to light, I think with introducing all the domains, which we'll
get into, is the predictive capability.
so much of what we're trying to do in healthcare, and I work a lot
around prevention, is the reason we test the blood biomarkers.
The reason we.
And test even VO two max, which as you mentioned, has gotten a lot of attention
is because we want to try and give people information as to whether they're on track
to age healthily, yet the predictive power of what we're trying to do.
Compared to some of the things that you introduce in your book, doesn't
quite have this, predictive capability.
So can you talk about this health trajectory, like the data we have
based on the things we can measure that can help people predict how
they're going to age functionally, being able to do the things they
wanna do for as long as they wanna do.
And I think That is such a.
Beautiful way to frame health span, define it and make that our goal.
Scott Fulton: I think there's two parts to that.
And so one of them, which I picked up on, a few years ago and I started
to bring in was like when we talk about, risk of, heart attack
or myocardial infarction, right?
We talk about in medicine around, well, here's the risk, Here's
your five and 10 year risk.
To the lay person that's really kind of, okay, so I have a risk, but I don't really
know what, to do with that information.
and even as clinicians, right?
It's hard to know, there's no certainty around it.
Just, and it's hard to differentiate your case from the general public.
And so if we think about function, because it's the
things that we do every day.
It's highly repetitious and it's highly predictive.
so if we think about all of the things that we do in the course of daily living,
we're really well practiced at it.
if I kind of think about that in terms of health span, it's more
about how intentional we are.
We do these things, but do we do them with intention?
And it's that intention that starts to change the trajectory.
And so if we think about, use walking as one.
but it could be some of the standard tests, like a, chair stand test is a
great example of how many times can you stand up and sit down from a chair
without using your hands for 30 seconds.
Boring, boring test, right?
So, you know.
clinicians don't get excited about doing unless you're in functional health.
But it reveals a whole lot because what it says is if you're already
using your hands at age 50, you've already required a dependency that
you're going to become more and more dependent on as you get older.
And so there's those physical things we can see, but also we
can measure it that example is how many times can you do it at age 40?
At age 50.
At age 60, yes, it will go down normally, particularly if you
don't do anything about it.
And we can follow that trajectory all the way through to the point
when you cross what everyone is most concerned about and no one
talks about is what's the threshold?
what number will it start to matter to me?
that's part of what I was trying to help people with too, is This
is the end point you need to be focused on and let's look backwards.
And the, And the engineer in me says, how can I reverse
engineer health and longevity?
We would all love to be able to do that.
Well, functional data is there that tells us exactly what we need to do and
when, whatever stage we're at in life.
Sharon Bergquist, MD (Host): So essentially what you're able to do
today in this example that you know how many times you can stand from a chair.
That can predict how well you'll be able to do it with very scientific
data showing per decade the rate of decline And what you can expect in
your seventies, eighties, nineties.
and depending on where you are today, what that trajectory is going to look like.
when we do a test like that.
obviously it's gonna help predict how well we can stand up from
a chair, but there's a lot more information in a test like that.
Can you talk about, well, what does that test, apply to in daily life?
Like, the other things that I'm gonna wanna do when I'm older,
what does sitting and standing from a chair, helped me predict?
Scott Fulton: Right.
So again, they seem so simplistic, perfect.
Question.
What are the things that tells us?
Well, it tells us mainly about lower body strength, So what's in
our quadriceps primarily are big muscles that we're using to stand up.
what is it about our mobility?
Our freedom to make that movement.
and particularly as we're coming down right, sitting down in a
chair, we've seen how that can be a challenge for people also from balance,
because everything isn't always laid out perfectly in front of us.
if it's the chair at home that we always are, go-to chair, we may understand that
quite well, but we're in a new environment and things are a little bit different.
Or we're trying to, get on a, bus seat or some other.
Place, you know, the bus is moving would be, there's another example, right?
It's in a dynamic situation and I need to be able to do that, safely.
the more that our mobility, our balance, and our strength are all working together
for us and cognitively, This is the other part that we tend to think about cognition
as our thinking side of the brain.
Well, cognition is involved essentially in our neuromotor.
response to the connection to say, how far away is that,
seat that I'm trying to get to?
And am I on path to hit that seat and I'm ready for it?
And maybe I'll use the bus example I'm holding a post to balance me.
Where should I grab that post?
What height?
When should I let go of the post to know that I'm safely gonna land on the seat?
So we take that and now we can apply it to things like going upstairs.
Again, things we do every day today, we don't give it much thought while the pace
that we go upstairs is quite meaningful and it's quite telling just the way,
standing up from a chair walking is.
So we know that at a, at certain levels or speeds that you go up upstairs,
our predictive of at what point is that going to be problematic for you?
So, it really kind of applies to anything.
Lower body is really what allows us to move around in daily life
in all sorts of circumstances.
That's, for most people, kind of number one in, in the health span department.
Lose the ability to move freely, in lower body strength and
ability, will be problematic.
So I'd like to know about that as early as I can.
Sharon Bergquist, MD (Host): you talk about function in five domains.
I think that's one of, again, the really unique things that
you bring forward because again, so much comes out in isolation.
Some people focus on VOT max, which really is one of the domains, or on grip
strength, which is popularized as well.
But you bring this all together under five domains.
Can you tell us those five domains And then, I'd love to also talk about
the synergy of why it's so important, to kind of do this in a very 360
way and, think of all these domains.
Scott Fulton: VO two max.
I'd say we would regard as the gold standard.
And I get an annual lab VO two max, so This is not a
bashing of VO two max at all.
It's really a recognition of that's only telling part of the story, and it's
more informative than all the other's, which tells you that all of these
other's are really just little nuggets.
the functional portfolio is really to say, well.
What are the nuggets that I can put together myself quite easily, And it's
really five domains When we think about function, there's strength in power, which
we kind of talked about already with the standing up, You know, climbing stairs and
things, You know, maybe you're a runner.
All or cyclists, all Those are kind of in the
strengthened power realm.
Sharon Bergquist, MD (Host): I'm a runner too.
Yeah.
Scott Fulton: And cardiovascular and recovery.
That's heart function obviously, and cardiovascular, heart and lungs, but
also that recovery after exercise.
So we've elevated our heart rate.
How long does it take our heart rate to come down?
That's another key indicator of functional fitness.
And then we move into the things that we generally pay less
attention to in everyday life.
mobility and balance.
Again, things we tend to think about.
Late in life, there's actually a lot we know about mobility and balance
earlier, so single leg balance is.
Probably one of the most familiar ones, how long you can stand in one leg at the
age of again, 40, 50, 60 is quite telling.
It doesn't suddenly magically get better and it doesn't fall off a cliff.
It's quite predictive, spinal rotation, your ability to turn and
look at things like we think about in.
In the car before we had backup mirrors or backup cameras, we had to turn our
necks around And we would notice with older, adults, real limitations.
that was part of why they had more accidents was they just didn't have
the ability to turn far enough to look behind and relying on mirrors.
the other is flexibility and structure.
that's things like, in terms of our ability to bend over simple things
like bend over to tie your shoes.
Right.
Pick something up off the floor and structure are the elements
of what's happening with our posture and our body position.
We've seen people that tend to kind of, curl over as they get
older, so essentially the walls are closing in around those people
And so we wanna find out about that early and do some preventive
measures and get them back on track.
Which is much easier when we know about it.
And then the fifth one is neuromotor and cognition.
And that's really, again, I touched on earlier, it's really
two ways to think about it.
One is how well is our brain communicating with our muscle and our, skeletal system?
Controlling our movements and our reaction time.
So one of the common ones people might remember is a ruler drop test.
Really, really simple.
Test drop a ruler and how long does it take to catch that ruler?
And we know that because it's gravity.
I simplified it even further and said, well, you can just do, you
know, so many inches or centimeters on a ruler, and that'll tell
you what the reaction time is.
Yes, it will slow down with age.
But how fast is it slowing down?
And then the other part of cognition, which I think is.
maybe the most interesting once you get the foundation in place is what's
gonna happen in later life to my brain in terms of what am I doing to,
drive neuroplasticity all through my adult years so that I've got cognitive
reserve And this, functional reserve.
You know, cognitive reserve is just one of the functional
reserves we wanna have in place.
Everything I've talked about is, is reserve, right?
It is for reserve that we need.
When we think about resilience, resilience is really what's
the reserve that you have?
And so that's the example there of people who have, plaques, in their brain,
which we associate with Alzheimer's.
They have no Alzheimer's symptoms.
And so we know from those, studies now that it's because they've been
really driving neuroplasticity all through their adult years.
And so they've essentially constantly generated new pathways for
information to flow through the brain.
It's not as quick as it was again when you were 40, but it's still high functioning.
And so that's really where it all starts to come together.
And we get into, To me, the whole part of this gets pretty exciting.
We get into dual task training where we start to do the body And the brain
together, and that's when we really we're into the gaming aspects of things
that people like to do with games.
Anyway.
Sharon Bergquist, MD (Host): You've mentioned some of the assessments and
I wanna kind of get into some of the other's because like you said, there.
Somehow they're simple, but so powerful And so predictive.
And you just mentioned the drop ruler test.
We've mentioned VO two max, the sitting and standing.
what are some of the other ones in these different domains?
People can do, and probably even more importantly, let's say we
discover we're in the 25th percentile And we wanna work our way up.
How do we begin that process so that we can improve how
we function as we get older?
Scott Fulton: so the way I organized.
The work was to realize, there's a lot of a ways to measure and if we're
going to rely on multiple metrics, which is a good thing, we need to
carefully select what those metrics are.
So what I came up with was, again, go back to the.
experts and look at what are all the standardized tests where
we have lots and lots of data.
So I didn't make up a single thing here on the data.
it's really all standard tests, over 700,000 test subjects that we followed
for over five decades to understand what are these, domains, but also I
organized them in a way that we could.
Put them into tears because it's too much to throw everybody all at once.
Let's start with what I call tier one, which is really the most informative, the
most, easily understood and easy to adapt.
And so that's things like so I talked about the chair stand, and
climbing stairs, a six minute walk test, one of the standard tests.
If you can walk for six minutes, there's information around that.
resting heart rate as you were just sitting here, that's informative
What a resting heart rate is.
single leg stand, I talked about that.
And gait speed kind of ties it in a little bit differently.
Again, there's some nuances here, where balance and mobility start to come in.
there's other things which are pure cognitive Tests, which are, one,
I call it the color card test.
And it's really this combination of, if you've seen a, an example of there's
a, word up there that's written in, green, but the word is red and you start
flashing these at people, How long does it take you to resolve what your eye
sees and your brain figures out, am I supposed to say the word or the color?
Simple, simple test to do, but because there's so much
data, it's quite revealing.
Things like, we add a, conversation to when we go for a walk.
So that six minute walk test.
Now let's start to introduce a conversation between two people.
So if you and your friend are, go out for a, daily walk together,
let's do it with a little intention.
Now let's start to talk about something that requires some
cognitive effort to resolve a problem you are working on or something.
Again.
How, much the walk slows down because cognition is requiring, or recruiting
too much of that neuromotor energy that you need to be able to do
something as repetitious as walking.
So all in all, there's I've got 44 tests that are these sort
of tests that people can do.
ultimately no one, I'm sure some will do, all 44.
The idea is find ones that are of interest to you, that you're curious about,
that you can do fairly easily, that will take you on to some other things.
so there's lots of places to explore.
Like a single leg squat test.
We talk about single leg balance, now try it, single leg squat.
So there's levels of difficulty as we go through.
So the second part of your question was, okay, so what, so I found out that I'm.
25th percentile.
Oh my gosh, This is terrible.
Well, so what I added in there was, because if it's not obvious, the
best way to practice it is to do some repetitions over the course of a day
and work on those lower body things.
So things like getting up from the chair, not using your hands are
going to help single leg squats, which are far more challenging.
So they all start to work together once you develop.
Really a, a very limited amount of awareness is all that's needed
and you start to become more intentional about everyday activities.
So the idea is you can see what 25th percentile.
I don't put 25th percentile in.
I start with median or 50th percentile.
'cause that's really where you need to be.
if you're thinking at all about health span, you've gotta at
least be at 50th percentile.
And then I've got two more.
I've got 75th percentile.
So you'd start to say, what do I need to start doing?
And there's some, again, recommendations around what people can do to
start to get to 75th percentile.
And if you'd like to get to 90th percentile, that's in there too.
So the idea is really to say, this isn't about an exercise routine.
You need to do.
For most of what we talk about in functional health, you'll get just
by being intentional around everyday activities you already do, exercise,
supplements that, And so if you wanna get to 90th percentile, yeah, you're probably
gonna require some exercise to get there is 75th percentile is you, your goal.
And you say, I'm fine with that because the outcome of That is pretty good.
Great.
So you've got some benchmarks to align with What you're actually doing
with what your expectations are, and that's really, I think part of what
I've tried to do with this too, is to match up expectations with reality.
Sharon Bergquist, MD (Host): And it's.
We should be doing, if we want to be able to function well, do the things
we love as we get older, instead of, starting some workout routine that,
we're just trying to move, which is, often very good advice, just move more.
But this really frames, do these assessments then if you're not on target.
Then, and I should add, what I love is these assessments are
easy, free, do at home, no cost.
I mean, This is just beautiful.
And if you're not where you are, then you know, the body works
in a use it or lose it capacity.
So you're losing this capacity, you've gotta use it.
So you're trainable ways to gain, better function in the
things that are gonna matter.
is there anything you would add to that?
Scott Fulton: I think what's surprising for people is because this isn't an
exercise prescription, it's the things you're already doing today, right?
No one says, well, I'm not gonna get up out of a chair anymore
because I don't like doing that.
Really, none of This is about that.
Sharon Bergquist, MD (Host): we don't balance enough on one
leg, we should do more of that.
Scott Fulton: that's the perfect example, right?
And I have a lot of athletic friends around me, who are well trained,
and some have MD after their name.
And we all are guilty of this, right?
We focus on the things where we're, we feel are, we're strong And that we're
competent, that people acknowledge and recognize for what we're good at.
That's great.
But that's not what's going to dictate your health span ultimately.
Sharon Bergquist, MD (Host): this really touches on what I think is
one of the most powerful messages you have, which is the blind spots.
And I think that's where you're going, where it's the weakest link that's gonna
hold you back, not your strongest suit.
Can you talk more about that?
'cause I think that should be repeated and, shouted from the rooftops.
Scott Fulton: Right.
Again, if you think about the messaging we get like, and again,
VO two Max is one of the ones we.
Here.
it's great to have strength, but it's also really easy to kid ourselves that because
we're strong in two or three things relative to our peers, that we're good.
because it's what I like to do already, We gravitate to the
things where we feel confident in.
The reality is, we all know this intuitively, but no one seems
to talk about it, is that's not what dictates your health span.
It will be the weak link.
And so you raised up balance as a great example, literally yesterday,
I'm getting rehab for my, torn, hamstring, and I'm listening to the
woman beside me who's not that old.
Talking about recent falls that she's had, and one was up in the middle of the
night and these are the, normal things that will happen in terms of the, trigger
will happen or the initiator will happen.
Whether you fall or not is really this reserve we talk about
that you already have in place around the different domains.
strength won't help you when you fall.
We can think of the bodybuilder.
these are extreme examples, but they don't necessarily apply to that degree.
Not noted for having great flexibility or balance.
So find a focus on, building strength.
Right?
That's great.
But don't think that compensates for flexibility and balance and don't
think that's gonna help you necessarily with your neuromotor and cognition.
Those are separate domains that will be benefited by all the other things.
So strength training will improve it on its own.
It's not enough.
And so what we wanna find out, And that was really what I said about to
do this, was to understand how would each of us find our own weak link.
We get all the advice around, you know, you should be doing more strength
training, you should be doing more cardiovascular training, probably.
Maybe that's not really where you need the most help.
It may be in some other area that really no one's talking about.
We'll, all worry about balance when I get older would be
kind of the self-talk we have.
So This is really a way to start to identify where are
your, blind spots or your gaps.
And thankfully, as we talked about earlier, these are the
easiest things to improve.
Because they're relatively low.
It's much easier to get to median and it's much easier to get to 75th than
if you're already at 75th and you're trying to get to 90th because you
wanna beat, you whomever you wanna be, the, you got a 10 K coming up.
And so it's this weak link, thing that we need to start to think about
it not as criticism of ourselves, but as an opportunity to invest in
our future, because those will be the most valuable investments we make.
And so your weak link is different than someone else's.
So listening to this generic advice around what we should be doing,
This is really a chance to stop and say, hang on, what's my weak link?
That's the only thing that matters is what's my weak link and how do I raise
it up And then find, what we would describe as the low hanging fruit.
These are the easiest things to fix once you find them.
But if you don't know where they are, that's the thing that will
creep up and, and catch you later.
Sharon Bergquist, MD (Host): I think that we're all susceptible
to that because we gravitate towards what we love doing, right?
If we love running, we're gonna have better VO two max, but
our balance and, some of the.
other functionalities can be very weak, And what I'm hearing you say
is you're better off trying to get to say 50 or 75th percentile across the
board in all these domains and trying to get into 99th percentile into one
or two, while the other's could be like lagging below 50 percentile.
Scott Fulton: Exactly and I'll use myself as an example, partly because
I'm going through rehab right now and I'm, being forced to do things
that I ordinarily wouldn't do.
have a very high VO O2 max.
I've had that for several years.
It goes back to my, Ironman training and I continue to have a high VO O2 max.
So part of rehab for this hamstring was, I've gotta do a whole lot
of single leg balance exercises.
Now, was I doing them before?
No.
Did I know about them?
Yes.
Not before I started to do the book.
But it made it very aware to me of all the circumstances where I'm on one foot
and don't even think about it, And the benefits now that I've done so much
training over the last several weeks, my strength when I say strength on
one leg, not muscular strength, but my strength in terms of competency and
ability to recover because I'm practicing and I'm doing complex movements, And so
I'm potentially falling all the time.
I'm catching myself.
And so that's part of what balancing is, is not so much how
much your balance is perfect.
It is what's your ability to catch yourself from falling.
And that's really that, kind of cliff.
And we talk about, the cliff as where is it and what's the fall
gonna be like if I get there?
And so how can I soften that?
however, it might look like to us, we wanna make sure that
we've got a good understanding of what That is and not have it.
blindside us.
'cause that's what happens, right?
We get blindsided with things like I had no idea.
And reality is we could have found that out decades ago.
Sharon Bergquist, MD (Host): And I think That is really a great point,
and I wanna conclude by having you help us put all of this information
in context of magnitude of what.
Ultimately moves the needle in predicting how we're aging.
So, as possible predictors, there are things like, my current
age is probably gonna predict how long and how well I live.
my body mass index may, my blood sugar, may, my blood
pressure may, and they all do.
But can you help us?
Put things in context in terms of magnitude because there are so many
things we could all be working on and we're told that we need to work on
all of them and it's all important.
but then it gets very hard to prioritize because, you could
be going in so many directions.
Can you help us put these functional assessments and working on our
functional ability in the context of what we already know are predictors?
Scott Fulton: if I were to think about it that way, maybe.
one way to think about it is, again, which I introduced this
concept of functional age, right?
Sharon Bergquist, MD (Host): Mm-hmm.
Scott Fulton: the functional age is really simply saying, where are you
now relative to your chronological age?
If your functional age is lower than your chronological age,
that ultimately is a great sign.
If it's that case in all five domains, that's a great sign as well.
starting to think about yourself as what's my functional age is again, a
different way of looking at health span.
It is a different way of looking at health and aging, and I think what
happens is because This is so relatable for people, it makes it easier to
start to pull in the other elements of.
health and wellness that we all talk about.
so will it improve my diet directly?
No.
Indirectly, probably, Because if I can see my functional performance getting better,
if I, get better sleep, if I eat a little bit better, and if I start doing this
walk and do a little more challenging.
I'm probably gonna actually have more success at losing a few
pounds that I've been wondering why they haven't just gone away.
And that's the simple thing of, you know, maybe I do a 30 minute walk, but my 30
minute walk has gone up by 5% in speed.
So I didn't mention that earlier, but great example would be just going by 0.1
meters per second, faster walking.
Which is about four inches, not big, is worth about 10 more years of health span.
what happens with this, what I've seen happen is that people look at health span
differently and they start to own it.
Because now it's around something I can get my hands around, and now I'm willing
to put some other things on top of it that before I tried and kind of went away.
This is now something you can build and take with you all the way through.
and it doesn't require a lot of ongoing maintenance.
Again, because it's everyday things.
You'll know how you're doing and you can do quick checks.
So I think it's really core and I think it's, I view it as a vital
sign that we've somehow overlooked and we've waited until far too late.
'cause that's what medicine is there for.
It's to catch us after we fall, not decades earlier.
it's really core to how people view health span and how they
view their current health.
Sharon Bergquist, MD (Host): Yeah.
And in a world where we're all looking at biomarkers and epigenetic
aging, and including myself, you know, This is such a great reminder
of, You know, our ancestors just.
Did and didn't have, gyms and et cetera, And what they did a lot of, they were
very good at, And that allowed them to continue doing what they were doing.
And, I love how foundational That is.
And that kind of revisiting in a very structured evidence way,
evidence-based way that you've pulled it together is really phenomenal.
So I, loved your book and tell us, Scott, where people can find you, where
they can find the book and get access to these 44 assessments so that they
can start doing them themselves at home.
Scott Fulton: the book is on Amazon.
You can either get Kindle or the paperback, And it's function, turn
your blind spots into strengths.
the easiest place to find it.
you can also learn about the book on wealth span.
That's Health Span with a w in front.
I've got a page devoted to function so people can learn a
little bit more about it if they didn't get enough information here.
everything I've done with This is to make everything accessible.
I've tried to make it really affordable for people, and engaging and make
it a really easy read for them too.
It's not a, big investment.
And the reading, most of the book is made up of all the tests.
One page is, here's the test, And the other page is, here's some
things you can do to get better.
Sharon Bergquist, MD (Host): Yeah, you've really done a tremendous amount
of work to make it so simple and distilled just so much information from
different specialties and distilled it to something that's so practical.
So thank you for doing all this work and, and thank you for the conversation.
Scott Fulton: Well, thanks Sharon.
I always enjoy any conversation with you, everyone we've had.
I've just thoroughly enjoyed, it's left me thinking of all the things
we could be doing and, and that's motivational for me and I, I really.
Appreciate all that you're doing.
It's, great service you provide And so thank you for having me.
Sharon Bergquist, MD (Host): Thank you.
Outro (Sharon): Thank you for listening.
I hope you enjoyed this episode and share it with a friend.
Until next time, do something to help improve your whole health naturally.
disclaimer: The views and opinions expressed in this podcast are those
of the speakers and do not necessarily reflect the views or positions
of any entities they represent.