>> Dr. Terry Simpson: We talk a lot about aging, aging with good health,

aging with a good health span and longevity. And

we talk a lot about supplements that don't work or

to diets that are rather silly. But today, the

biggest anti aging story isn't in a pill or a cold

plunge or a fasting app. Uh, it's in your

metabolism. And it starts with a class of drugs we

once thought were just for diabetes, the GLP1

receptor agonists, you know, Ozempic, Zepbound,

etc. These medications are now being primarily

used for obesity. And they're doing remarkable

things, not only reducing weight, but reversing

many of the diseases that travel with and maybe

because of obesity. And since obesity clearly

shortens your health span, it's not surprising

that these drugs are now being looked at as tools

to improve health. Spanish the years you live

well, not just lengthening a, uh, miserable life.

But it turns out there is much more to these drugs

than weight loss. These drugs have anti

inflammatory effects, cardiovascular protection,

reductions in stress physiology, and emerging

evidence they may delay cognitive decline. And

many of those benefits appear to be independent of

weight loss. So the idea that GLP1 drugs, and now

triple agonists like pitoutatride might represent

a new class of anti aging medicine isn't hype.

It's a serious scientific question. Even Peter

Attia, whose clinic focuses almost exclusively on

longevity and health span, has discussed using

GLP1 drugs at lower doses in select patients to

support metabolic health and long term health.

Spanish this week, Eli Lilly released striking

phase three data on their newest compound,

retatrutide, a triple hormone drug that isn't just

helping people lose weight. It may be resetting

the biology of aging. Today on 4Q, we're going to

make sense of the madness of Healthspan and GLP1.

I am, um, your chief medical explanationist, Dr.

Terri Simpson, and this is 4Q Fork University,

where we bust myths, make sense of the madness,

and teach you a little bit about food and

medicine. When we talk about longevity, we're

really talking about metabolic stability, blood

sugar control, lower inflammation, lower oxidative

stress, the ability of cells to repair. And GLP1

agonists touch all of these systems. They were

designed to mimic a gut hormone, the glucagon,

like peptide 1, which signals satiety and improves

glucose regulation. But over the last decade,

we've learned they do far more than lower

hemoglobin A1C and make diabetes better control.

They reduce systemic inflammation, they improve

mitochondrial efficiency, they lower oxidative

stress, and they improve vascular function. The

same biology that reduces appetite may also make

cells behave younger. Enter UH retatrutide. In

Lilly's Phase 3 Triumph 4 trial, participants lost

nearly 29% of their body weight over 70 pounds on

average, and saw UH major improvements in

inflammation, blood pressure, lipids and joint

pain. But weight loss is just the surface.

Retatutride targets three key pathways. There's

the GLP1 pathway, which reduces appetite and

inflammation. There's the GIP, which improves

insulin sensitivity and nutrient handling. And

this one adds a glucagon, which increases energy

expenditure and fat oxidation. If GLP1 calms the

system and GIP balances it, glucagon fights a

controlled metabolic fire, keeping metabolism from

slowing down as weight is lost. That's not just

slimming, that's metabolic rejuvenation. Let's

talk about inflammaging. Aging isn't just wear and

tear. It's driven by chronic low grade

inflammation, where gerontologists call

inflammaging. Inflammaging fuels heart disease,

strokes, type 2 diabetes, fatty liver, arthritis

and likely cognitive decline. In the Triumph 4

trials, retatutride decreased CRP, triglycerides

and blood pressure. Classic anti aging biomarkers.

Less inflammation means fewer senescent cells,

healthier blood vessels and better organ function.

Let's talk about heart disease and GLP1s. And if

you want to talk about aging, you have to talk

heart disease because nothing ages you faster than

a heart attack. Across multiple cardiovascular

outcome trials, GLP1 receptor agonist, which is

all these new drugs, have shown a 13% reduction in

cardiovascular death, a uh, 9% reduction in non

fatal heart attacks or myocardial infarctions. In

the so called leader trials, liraglutide reduced

cardiovascular mortality by 22%. Now semaglutide

and lugotide show similar reductions, enough that

the FDA now recognizes certain GLP1 drugs as

cardiovascular red risk reducing therapies in

patients with type 2 diabetes and established

heart disease. These benefits are not just about

sugar control. Turns out the GLP1s lower blood

pressure, reduce inflammation, improve endothelial

function. That's the cells that surround the

vessels, reduce oxidative stress and decrease what

we call RAS activation, which means at the

cellular level they protect heart cell muscles

from multiple forms of cell death and enhance

autophagy and mitophagy. That means the heart is

cleaning up old cells and old mitochondria. They

don't dramatically treat heart failure the way

SGLT2 inhibitors do, but they are safe and reduce

atherosclerotic risk. Avoiding a heart attack is

one of the most powerful anti aging interventions

and powerful ways to increase your health span.

People who live a long time aren't free from heart

disease, but what they are free from is heart

disease for a little while. Meaning healthspan

puts it off.

Now, let's talk about the brain. Let's be careful

here. GLP1 drugs do not reverse dementia. They do

not improve cognition once dementia is

established. Recent trials in people with

diagnosed Alzheimer's disease have shown no

meaningful cognitive improvement. And that's

critical for me to tell you that clearly the

promise of GLP1 drugs is prevention and delay, not

cure. And in large observational drugs, GLP1 users

had roughly 33 to 45% lower risk of developing

dementia compared with other diabetic drugs. The

2025 Journal of the American Medical association

of Neurology had a study that showed uh, a 33%

lower risk of Alzheimer's and related dementias,

especially in people who have cardiovascular

disease. Randomized trial meta analysis show a

real but m more modest protective signal stronger

than what we actually see with other types of

drugs. Mechanistically, GLP1s reduce

neuroinflammation. That's inflammation of the

brain. They improve insulin signaling in the

brain, they enhance vascular health in the brain.

They perform neurogenesis and they may reduce

amyloid and tau pathology. Age matters. The

benefit appear stronger when started earlier,

before neurodegeneration is established. But our

goal here is not immortality. The goal is to push

dementia far enough into the future that many

people never reach it. That's healthspan.

Let's talk about ultra processed food and brain

aging. This may be the real Ultra processed food

isn't a terribly difficult concept, but you

probably get the general idea. These foods hijack

the brain's dopamine reward system, increasing

wanting while reducing pleasure. They're soft,

fast, hyperpalatable and engineered to be consumed

before the gut can signal fullness. Ultra

processed food intake is linked to higher

inflammation, lower gray matter density, worse

metabolic health and faster brain aging. They

disrupt that gut brain access, damage the

microbiome and worsen insulin signaling in the

brain. GLP1 drugs are in many ways repairing

damage caused by a food environment designed to

exploit our biology. What about the Mediterranean

diet and alcohol? Well now, here's the empowering

part. If there is one dietary pattern with the

strongest evidence for protecting the heart and

the brain, it's the Mediterranean diet.

Vegetables, legumes, fruit, whole grains, olive

oil, fish. Minimally ultra processed food. This

pattern reduces inflammation Supports the

microbiome, um, improves vascular health and slows

cognitive decline. GLP1 drugs calm the biology.

The Mediterranean diet keeps it calm. And one more

hard truth, we've talked about this before.

Alcohol. The idea that alcohol protects the brain

has never been held up. Even moderate drinking is

associated with higher dementia risk, worse sleep,

hippocampal injury and increased neuro

inflammation. If your goal is to protect your

brain, thus alcohol is better. No, alcohol is

best. So what does this really mean now? Aging

isn't about the years, it's about systems. GLP1

drugs support metabolism. The Mediterranean diet

supports biology. Avoiding alcohol protects the

brain and the heart and the kidneys and the eyes,

movement and sleep. Lock it in. If we delay heart

disease, dementia and disability long enough, many

people will never live long enough to experience

them. That's not cheating death, that's winning.

At Healthspan. If you're thinking about GLP1

drugs, work with a qualified obesity or metabolic

health specialist. Not one of those peptide mills.

Avoid research grade compounds sold online. That's

lab reagent. That's not medicine. And if you want

to go deeper into longevity medicine and

Mediterranean eating, metabolic health and

evidence based anti aging, join us on the

Mediterranean Longevity Cruise. In August of 2026,

you'll have 10 days of real food, real science,

movement and conversations that actually matter.

Details will be forthcoming. This was written and

researched by me, Dr. Terry Simpson. And while I

am a board certified physician, I am not your

physician. Always consult your own board certified

physician and a registered dietitian before making

or starting any changes in medications and diets.

All things audio are from my friends at Simpler

Media and the pod God himself, Mr. Evo Tara. All

right everybody, have a good week. Hey evo. At

GLP1's the Mediterranean Diet and not drinking

help people live longer and think clearer. Are we

obligated to keep doing this podcast into our 90s?

I mean, maybe. And like also, what the hell else

we going to do, man?