TIP 049 | Angiogenesis

TIP 049 | Angiogenesis

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Angiogenesis: Piecing the Health Puzzle Together with Dr. Will Li

I couldn’t be more excited to have Will with us. For those of you who were able to figure out who he is, you know that we have Dr. Will Li with us. Will, thanks so much for coming on.

It’s a pleasure, Jon. Thank you.

For those people who didn’t Google you or try and figure out who you are, what is your name, title, your company, some of the achievements that you’ve had. Tell us about yourself.

I’m Dr. William Li. I am a physician and a research scientist. I’ve built a career working on ways to improve health by thinking outside of the conventional box. I got my start at Harvard. I studied biochemistry, so I’m a real scientist who spent the first half of my career in the biotech world. I was focused on a process called angiogenesis. I started a nonprofit organization called The Angiogenesis Foundation where I’m the CEO. We started in 1994, so we’re going onto 25 years of an incredible journey and adventure and exploration into how do we conquer disease and how do we capture health by looking at common denominators. I started in Pennsylvania where I grew up. My mother’s a pianist and artists. My father’s a scientist, a biomedical engineer. I was inspired by science, which logic is the way that I navigate and the practice of medicine, which I’ve trained in internal medicine is all about putting together the pieces of a puzzle of someone’s health or sickness and trying to figure out what’s going on.

So many times, when we use science to solve problems, we wind up hitting this proverbial brick wall and that’s where I’ve been able to kick in some of my creative side and find solutions around the brick walls. That’s what gets me up every day and helps me navigate is how do I find new ways to conquer diseases. Angiogenesis is the process of blood vessel growth or how the body grows blood vessels. It’s a common denominator of both health and disease. What’s amazing about blood vessels is that it’s a 60,000-mile system of channels that deliver oxygen and nutrients to every cell in our body. We now know it’s connected to our immune system. It’s connected to our healthy gut bacteria. It’s connected to how our DNA behaves. It’s also even associated with our body’s ability to regenerate.

The Angiogenesis Foundation has set out on a mission. In Star Trek, it was a five-year mission. We’ve toppled that, so we’re on to our 25th year of trying to find new ways to explore the conquest of disease. We were fortunate and productive to be able to develop 32 FDA approved new medicines or medical devices for diseases ranging from cancer to diabetes to vision loss or blindness.

I want to break this down a little. I know that you’re used to it because you’ve been working on this for 25 years, but I’m going to start us back at the beginning of what you were talking about. You’re looking at blood vessels and you said that our bodies have 65,000 miles of blood vessels.

It’s 60,000 miles and what’s amazing is the sheer extent of our circulation. You’ve got the big blood vessel, which comes right out of your heart. That’s the biggest piece of plumbing in our body called the aorta. These vessels get smaller and smaller and smaller until the tiniest blood vessels in our body are called capillaries. They’re finer than a human hair, and yet our blood cells that deliver oxygen can squeeze through these and they drop off that oxygen and keep literally every cell from our head to our toe able to be alive. If you were to take all the blood vessels from the big ones to the tiniest ones, pull them out of the body and line them up end to end, you’d form a 60,000-mile string that could wrap around the earth twice. That tells you how important the circulation in the body actually is. My work is trying to understand everything I can about how this system keeps us alive or in some cases brings us to the brink of death.

TIP 049 | Angiogenesis

Angiogenesis: In this day and age, there’s no reason to lose your vision and go blind from these causes because that’s the power of these breakthroughs.

What I love about this is that our blood is traveling just as far as I have to earn gold status with my airline. That’s pretty impressive. You just have to go around the world twice. You said that throughout your work produced 32 FDA approved drugs and devices. Among them, you’ve worked on blindness?

Angiogenesis or blood vessel growth is important for health and disease. In health, our blood vessels do their job perfectly, which is that they transport material through fluid, or blood, from point A to point B and reload up with oxygen and continue doing the same thing over and over again. There are certain organs like our eyes in which blood vessels have to be under strict control. The eyeball is like a marble. In order for lights to be seen, for us to see anything, you need to be able to shine and image from outside of the body through the front of the eye, the cornea, through the lens, out through a crystal clear jelly-like mass in the back of the eye, and then it hits our retinas, which then transmit that image to our brains. If there is any problem with blood vessels, if they leak, if they bleed, if they grow abnormally, you suddenly block the ability for light to get through, number one. Number two, the bleeding or the leaking can destroy or rip up the retina, which is that nerve layer.

Think about having a flood from your bathroom that seeps underneath the carpet. Suddenly that soggy leakiness destroys the carpet and that’s what can happen in the most common causes of blindness, like age-related macular degeneration, which is the most common cause of blindness over the age of 50 in the developed world or in diabetes. There’s a horrible complication of diabetes called Diabetic Macular Edema or Diabetic Retinopathy in which blood vessels grow like mad in the back of your eye and literally robs you of your sight. Out of our field of angiogenesis has been a remarkable identification of the smoking gun proteins that go haywire in these common causes of blindness due to blood vessels. What we’ve been able to do is to help coordinate the efforts of researchers, doctors, industry leaders, and government regulators to successfully develop. There’s now three and in the next couple of years, there’s going to be more treatments that when you put them into eye, it can block that smoking gun, knock out that protein, dry up the leakiness, and cleaning up the leaking sink and getting that carpet back into shape. It can halt blindness in its tracks. In about 30% of people or so, you can reverse vision that has previously been lost. You can take somebody who’s legally blind and can’t drive and put them back behind the wheel of a car.

This is what I love about contemporary scientific breakthroughs. The last time we’ve heard stories about giving sight to the blind, it was stories from the Bible. Now, thanks to incredible research and investment by companies, we’re able to fundamentally shift the quality of people’s lives dramatically. It’s absolutely amazing. I really congratulate you and your team and the researchers and companies that you work with because that’s an amazing achievement.

If we look around us and our society, someone we know is elderly, whether it’s a parent, a neighbor, a friend, or perhaps looking at ourselves in the mirror and we’re over the age of 50. We should be going to our eye doctors to get our annual dilated eye exam because that’s the best way to catch this condition early, so we can treat it early. In this day and age, there’s no reason to lose your vision and go blind from these causes because that’s the power of these breakthroughs.

While we’re on the topic of preventative care, over the years of research, I’m sure you’ve developed best practices or made some insights into things that could improve the quality of the average person’s life. What have you come away with besides like don’t eat unhealthy foods? What kind of impact have you seen in and results?

The first thing that we realize is that the body is absolutely amazing. There are secrets to the body that we have yet to unlock, but the ones that I’ve been focusing on is how the body heals itself. We tend to think about health and prevention as the absence of disease. When someone asks you, “How do you know you’re healthy?” The answer usually is because, “I’m not sick.” The absence of something is not the answer to health. Health is your body firing on all cylinders in terms of its defenses. What I’ve been working on is starting from my field of angiogenesis or blood vessels, which is a defense system of the body, feeding every cell, making sure it’s nourished, getting oxygen everywhere, and not having too many blood vessels and not having too few, but just the right amount. That is one defense system and there are other defense systems that we’ve discovered as well that are interrelated and closely tied.

For example, we regenerate. It’s amazing to think about this because when I was growing up, we were told that starfish regenerate, salamanders regenerate, but people don’t. We now know that human beings do regenerate and what we can do to help slow down aging and repair ourselves is to push those buttons in our defense systems, so that our health is supported by regeneration. Another area that’s amazing is the healthy bacteria that grow on our bodies. There are trillions of bacteria that grow on our bodies, a lot of them in our gut. What we’ve discovered is that these bacteria form an ecosystem that talks to our immune system and talks to our brain and talks to our blood vessels. All these years, in the past decades that we’ve been, as a doctor, writing antibiotics and trying to get rid of this cold and not pneumonia and treat this and treat that, we have, perhaps, been unknowingly wiping out key members of our ecosystem that defend us and prevent us from getting diseases, like cancers. It’s a whole new world about defending our body through the microbiome.

This is a critical idea. We’re used to thinking of ourselves as a person or an individual, but it seems that we’re more of an ecosystem that has millions of foreign entities interacting within it. Is that accurate?

The question is if they’re really foreign or if they really are us. Your interest in behavioral psychology is very much influenced by our bacteria, which then prompt our brains and our organs to secrete hormones like oxytocin, the hormone of love, which is responsible for closeness and social interactions. Our research has looked at a single bacterium called Lactobacillus reuteri that, in a laboratory, can help the brain to release more oxytocin. Even if you put it into drinking water.

TIP 049 | Angiogenesis

Angiogenesis: Those things that we have ignored or maybe even thought were bad for our health may in fact be good for our health.

Is this going to become love potion number nine? Will I be able tell my friend that next time him and his girlfriend go on a date, they should put it in there to fall in love with each other?

It gets even more profound than that because the Lactobacillus reuteri has been studied by veterinarians and animals and looking at their mating behavior. Those that have these bacteria, if they’re males, wind up developing larger testicles, higher sperm counts, and more sex drive, so you can pass that on to your friend.

What makes a man a man is a bacterial infection. I remember hearing this crazy statistic that something like only one out of ten of the cells in our body are ours in the sense that they carry our genetic material versus all the other cells in our body cohabitate.

This is when we thought we knew everything. The science is still actively moving. It is true that there has been a 1:10 ratio of human to bacterial cells that’s been cited, but in point of fact, the latest scientific research shows that we’ve got probably about 37 trillion cells in our body and about 39 trillion bacteria. It’s about 1:1. The number is less important than recognizing how profound we are influenced by what is around us and what is inside our bodies. Those things that we have ignored or maybe even thought were bad for our health may in fact be good for our health.

I remember as a child, I would keep getting ear infections. My mom would have to take me to the doctor then doctor would prescribe antibiotics. Speaking to other doctors since, they said it might have seemed like the right thing to do at the time, but all those antibiotics may have done some serious damage to your body and your microbiome. Is there accuracy? Not that I’m suggesting that people don’t take antibiotics. They’re a very important part of our modern day medical process, but studies have shown that they’re excessively over prescribed and often completely unnecessary.

It’s even more profound than that. It turns out that when we were in the womb growing in our mother’s belly, that’s where we start getting our bacteria from the mom in the fluid in which we’re bathe in the womb. When we’re born through the birth canal as opposed to going through cesarean section, going through that channel, our mom squeezes healthy bacteria into our nose and our mouth and coats our skin. When we breastfeed, which not everybody does, there’s new knowledge that we had that we never even imagined was possible, but that there are signal sent at the end of the pregnancy in the mom’s colon that tells the bacteria to take an a cellular uber over to the breast and they park themselves by the breast ducts. When the baby starts to breastfeed, it injects the healthy bacteria right down into the baby’s intestines themselves.

This whole idea that we’ve evolved to have many ways to pick up good bacteria has caused us to reexamine, “What about all the sanitation? Are we being too clean?” Nobody wants to go back to the Middle Ages where we had garbage and feces all around us. That led to the plague, small pox, typhus, typhoid, and all kinds of terrible diseases. Some of the work I’m doing is to look at common denominators of health defense systems and the microbiota or the bacteria inside our body play a critical role along with our blood vessels, in our immune system, in our stem cells, and our DNA repair. There’s an undiscovered country right under our skin that is the next great human expedition in a 21st century.

I’m really in awe of this and I love this topic because after speaking to a slew of doctors that are experts in the field, there may be correlations that were completely unexpected to having caesarian. Doing a C-section, because it doesn’t expose the child to the same bacteria, then it could have long-term effects on immune system development, digestion and we know that that has a direct tie to everything from the way we think all the way through to how healthy we can maintain ourselves. I’m super fascinated to see where this field of research goes because the introduction of certain bacteria or enzymes and so on may lead to dramatic changes for the quality of people’s lives.

It goes even more profoundly than antibiotics and how we’re born. The choices that we are presented as infants and as children and as young adults in terms of food is an area that I’m spending a lot of time focusing on because it turns out that we not just eat to nourish ourselves, but we can each simulate prompt and support and even boost our body’s defense systems. Some of the most amazing thing that I’ve been able to do is to take the twenty some years that I’ve had working with biotechnology and take the same industrial tools or research and crank the turret away from drugs and start to take a look at foods. If you use modern biotechnology thinking and rotate it towards the vegetable garden or the spice cabinet or the seafood section of the market and start asking, “What do the foods that we eat do to ourselves and our organs? How do they influence our defense systems, like immunity and circulation?”

TIP 049 | Angiogenesis

Angiogenesis: The number one rule is don’t wait to get a disease. Don’t assume that your health is a default state.

The microbiome, what we’ve discovered is amazing. For example, men are at risk for prostate cancer and it’s a disease that’s unpredictable in terms of how aggressive it could be, but research that we’ve been doing, and others, have shown that tomatoes contain natural chemicals that help them give them their color and flavor that can not only cut off the blood supply of prostate cancers, but can kill prostate cancer cells directly. The public health studies that have been published are equally remarkable. The studies of about 70,000 people have shown that those who ate about half a cup of cooked tomato sauce two to three times a week reduce their risk of prostate cancer by about 40%. Those that wind up developing prostate cancer despite that, the more tomato sauce they ate, the less aggressive the cancer was. That’s one example of this new undiscovered country of how foods interact with ourselves, healthy and sick.

With everything that you’ve been coming across, what is it that we can recommend to the audience to do to take action that will improve the quality of their life? Clearly eating tomatoes has a very strong benefit. What else?

Let’s start with the biggest picture. The number one rule is don’t wait to get a disease. Don’t assume that your health is a default state. Recognize that your body is firing on all cylinders, trying to stay healthy all the time. That means staying active, getting enough sleep, and choosing the right foods. There are other obvious things that would be important, like not smoking, but let’s talk about the foods. There’s a well-established mindset that we should be eating fresh foods as often as possible. One of the things we’re migrating away from are the industrialized, highly processed or ultra-processed foods that they call them. Whenever we can eat a little bit more similarly to how our grandparents and great grandparents ate, that’s probably a good habit to get started with as early as possible.

A lot of people that are your audience are like me and you, busy people that are running around doing their day-to-day tasks and trying to accomplish things that they feel that are important, and along the way, what we’ve been subjected to is the choice of convenient and inexpensive and close at hand. That’s usually the highly processed foods. From a message to the audience, a great dividend to be reaped by thinking about food as a joy of life, eating fresh food, looking at cultural traditions, Mediterranean diet, which is now well established to be healthy that includes tomatoes and olive oil and garlic. Those healthy ingredients and lots of vegetables and fish. Asian diets are also culturally synchronous to what we know at the scientific level about health.

The other thing that is important to think about is not to eat too much. A tip that I try to give my patients is whatever you might think you want to get at the buffet line with your eyes and your hands as you scoop it up, take only a third of that and leave the rest behind and don’t go back for seconds.

There was a study done on eating habits and just taking a smaller plate will lead you to eat less. One of the simple hacks is if you’re at a buffet, rather than taking a dinner plate, take a dessert plate and fill that up, then sit for a bit. Once you’re done and if you’re still hungry, you can go back for a bit, but it’s significantly smaller and requires more effort for refills, so you get to hack your own eating habits.

That is a great hack. Another one is while you’re eating, eat with people, so that you can have conversation. This is something that is so much tied to everything that you’re doing, which is hanging around with people that you like and that you find interests you and engage what you’re doing as you’re talking and eating. You’re eating the more slowly, which allows your brain to catch up with your stomach and tell you, “We probably had about enough right now. Let’s go out and do something else that’s fun and meaningful.”

One of the hacks that I love around this, too, is there was a study by Nicholas Christakis and James Fowler that looked at the obesity epidemic. What they found is that if you have a friend who’s obese, your chances of obesity increased by 45%, your friends who don’t know them by 25%, their friends by 10%, and their friends by 5%.One of the reasons that they believed that this was happening is that when you eat with people who have unhealthy habits, you give yourself permission to absorb those habits. They eat a bit more and they go for another round at the buffet, it’s now acceptable for you to do the same. If you’re going to sit down at meals and talk to people and you want to have healthy habits, find those people who have healthy habits and eat with them. They’ll probably take you to a healthier restaurant and it’ll hit a critical point in your dietary process.

If you want to look for some of the healthiest foods that science has come up with, we’ve put together a website called www.EatstoPeat.org. You’ll be able to get a whole list of healthy foods that you and your friends can go out to enjoy. It’s all put out by a nonprofit organization that is citing the actual literature, so if you don’t believe what is on the web, you can look up the actual research paper and see for yourself. What I love about this idea of hacking into health is that we no longer have to wait for the doctor or the hospital to serve it up to us. We can take steps ourselves with our family and friends and use those resources to educate ourselves and become empowered to be healthier people all the time.

TIP 049 | Angiogenesis

Angiogenesis: We can take steps ourselves with our family and friends and use those resources to educate ourselves and become empowered to be healthier people all the time.

This is a perfect transition. If people want to find out more about your work, where can they look you up? Where can they connect with you? Where can they find out more? You mentioned EatstoPeat.org.

For food, the best place to go is to www.EatstoPeat.org. About my overarching work, which is on treatments as well as prevention, please visit The Angiogenesis Foundation’s nonprofit website, which is www.Angio.org and you’ll read all about what we’re doing.

Are you active on Twitter or Instagram or any social media?

I am @DrWilliamLi. That’s the best way to find me.

This has been an absolute pleasure and really eye opening, especially your work on the bacteria that can increase sexual appetite and increase oxytocin. I hope to have more of that bacteria one day. Until next time.

For the audience, you have the anonymous interview coming up, so good luck and pay close attention. Thank you.

 

About Dr. Will Li

TIP 049 | AngiogenesisDr. William Li is a renowned doctor, scientist, and angiogenesis expert. His groundbreaking work impacts 70 diseases, including cancer, diabetes, blindness, heart disease, and obesity. Dr. Li’s popular TED Talk has garnered more than 11 million views. A guest expert on Dr. Oz, CNN, and MSNBC, Dr. Li has also been featured in USA Today, TIME, The Wall Street Journal, The Atlantic, and O Magazine. After graduating from Harvard, Dr. Li completed his medical internship and residency at Massachusetts General Hospital. Dr. Li has held faculty appointments at Harvard and Tufts University.

 Anonymous Guest Interview

As you know, I love this part of every episode. It’s the anonymous interview because I love playing games. We have the incredible Helen with us. Helen, thanks so much for joining us.

Thank you, Jon, for having me. This is exciting.

I’m a pretty fit guy, but there’s literally no chance that I have ever trained as hard as you do. I asked, “What did you do this past summer?” You said, “I went on all these trips and I got Rhabdo.” Can you tell me what Rhabdois?

I don’t know the exact scientific explanation of it, but what was explained to me when I was in the hospital was that you work out so hard that your muscles break down past the point of repair. They seep out blood and it get stuck in your kidney and it could be deadly. I flew to Colorado and we had a “mental toughness workout,” so I think that means I passed.

You’re completely insane. Is this common for people in your industry?

I know a couple of athletes got it. It was a variety of factors, flying to altitude and some other things, but I know a couple of athletes that have got it.

How tall are you?

5’3”.

I have literally no doubt that if we got into a fight, I’m a gonner. I don’t have a chance. It’s very humbling, I have to say.

I don’t think you would think that if you didn’t know what I did though.

TIP 049 | Angiogenesis

You work out so hard that your muscles break down past the point of repair.

Because you’re not like a massive human being or anything, but it’s absolutely amazing. What led you to go into sports? Was there a certain teacher that inspired you?

I began in this sport because I was terrible at every other sport that I did. I can name off those ones, which was gymnastics, diving, ballet. Everything that I entered, the instructor would ask my mom to not ever bring me back because I would shut down and cry. I was really shy and I didn’t like being watched. With diving, I was afraid of heights. Gymnastics, I was so afraid to do a backflip. By the time I joined this sport that I did, it was because my brother had joined and there weren’t enough kids. My mom didn’t want to make him have to quit, so she told me to just jump in there and be his dummy. After two weeks, I told my parents I can do everything my brother’s doing. They get to compete, and I don’t, so my dad made a bet with me that I could wrestle one match. If I won that, I could continue wrestling. That was the only match I won the entire year. I call it faith.

I was going to ask if you’ve ever lost a match to since because you have a pretty stellar record from what I understand.

In the past couple of years, yes.

Who’s now better at the sport? You or your brother?

I stuck with it longer. My brother would still say him. We’ll just leave it at that.

You’ve got the gold to prove it.

That’s my trump card for him.

Could you take him down?

No, he’s like way bigger than me. Maybe there are a couple of things that I could strategize, I think so.

For the audience to get a sense of what you look like, who would play you in a movie? You don’t get to pull like Will Smith.

In my mind, I envisioned like a Jennifer Lawrence’s Katniss, but that’s my imagination. I’m not that tall.

She’s not just totally hot, but a powerhouse. Whoever it is would have to have that eye of the tiger.

Her Katniss character was amazing. That’s just me fan-girling.

Was there a certain moment that you felt like you had arrived to some degree? Besides standing on the Olympic podium?

I believe I’ve had God-given talent my whole life and I’ve always had a desire to want to reach the highest level in my sport, but I struggled with confidence my entire life. I lost my confidence even after the Olympics, so there wasn’t ever this point of arrival. There are points of pause where you reflect on what counts and what you get out of the sport. When I stop and do that, then I’m like, “I’ve gotten a lot out of this and I can use this in life. I’m very grateful,” but there’s not a point where I’m like, “I did everything I wanted to.”

TIP 049 | Angiogenesis

There are points of pause where you reflect on what counts and what you get out of the sport.

Is there a hint or riddle you’d give people to figure out who you are? We know that you competed in the Olympics. We know how tall you are. We know several sports you don’t do.

I would tell them, “If they can score this correctly, they’ll get two points.” That’s about as vague, and hopefully a hint, as I can give.

I would’ve never gotten that. Your winters are pretty free, but every so often, you’re busy during the summer. This is a sport that’s traditionally male dominated as opposed to all the others.

It really narrows it down if I say it’s a combat sport.

People are like, “Combat sport? Is it the Biathlon where people are shooting?” They’ve got plenty to go on. For our audience, if you can figure out who Helen is, you could win an invitation to the Salon by Influencers and hang out with incredible heroes like Helen. Good luck.