You’ve almost got to feel sorry for the activity tracker on Dr. David Agus’s wrist—the thing must be exhausted. The USC professor of medicine and engineering regularly speaks at the World Economic Forum, is the resident health expert on CBS This Morning, and has written two best-selling books: The End of Illness and A Short Guide to a Long Life. In his recently released title, The Lucky Years: How to Thrive in the Brave New World of Health, the 51-year-old general practitioner (yes, he regularly sees patients, too, including Eli Broad and Sumner Redstone) again draws on big data and his own oncology research to point readers toward the latest medical findings on well-being and living a longer life. In addition to heading USC’s Norris Westside Cancer Center, Agus oversees a team of 50 researchers and students near downtown at the Keck Center for Applied Molecular Medicine. Several of his best-known recommendations—take a statin every day to stave off heart disease, ditch the vitamins—have met with pushback among his peers, but Agus says he prefers to see the world in black and white, right down to his wardrobe. On the advice of his former patient Steve Jobs, Agus wears a black sweater and white button-down shirt to work every day, one less decision to make in a life that’s full of them. Agus has two children with his wife, actress Amy Povich (which makes TV host Maury Povich his father-in-law). Energetic and fast-talking, Agus spoke to us in his Beverly Hills office (naturally, there was a treadmill desk in the corner).
How much of your success is tied to working in L.A.?
We have such an open attitude here about adopting lifestyle changes. I took my son to Amsterdam, and we went to Anne Frank’s house. You see that her room where she lived for two years had cutouts of Hollywood magazines on the walls. You start to see the power of what this city is. We trivialize it because we’re here, but you start to realize that the entire world lives through what is created here.
And that applies to health and fitness, too?
They look to us for new ideas, for innovation. I moved here in 2000, and all of a sudden Steven Spielberg started to donate money to our research—and, you know, I never asked him. My first ten years here he supported our research, and so did Sumner Redstone. Last year Brad Grey and Paramount Pictures hosted a big benefit for us, and it was awesome. They all just step up, and we’ve never asked.
So you’re a general practitioner and an oncologist. How does that work?
I’m a cancer doc, and I also take care of some of their general medical stuff. We’ve taken care of a lot of high-profile people over the years. Part of the reason I can stand up to them is because many times people at that level—people let them do whatever they want to do. I’m a university professor. They’re not paying me a concierge fee. I get paid whatever Medicare pays because they’re all on Medicare. Steve Jobs fired me a hundred times. It didn’t matter. He always came back later in the day.
Sounds like people in power like to be told what to do every now and then.
Exactly. There’s a great article that came out in a science magazine saying you can only make so many decisions in a day and then your brain shuts off. So many of these high-level people—at the end of the day, they’ve made enough.
You say we’re living in the lucky years in terms of medical research and our access to information. Aren’t there many competing moments in medical history that would make you say, “Oh, my God, without that we couldn’t have cured this.”
It’s a convergence of many things. All of a sudden the technology is here. It’s scalable, and it’s approachable. I do the CBS Morning Show once or twice a week. Three or four years ago there would be nothing for me to talk about. Literally. All of a sudden breakthroughs are happening at a staggering pace. [Intel cofounder] Andy Grove calls it the “strategic inflection point.” You can either adapt and succeed or not adapt and fail. In these lucky years the discoveries are happening literally as we speak. But ethics, legal—all these things haven’t caught up yet. That’s somewhat scary. We can now change one letter of your 3 billion-letter code with this enzyme called CRISPR, and it’s wild and it’s exciting because you can correct things. We can have a new era in medicine where I can take your immune cells and make them target something. It’s amazing. Scientists in China just changed the human embryo with it.
Doesn’t that frighten you?
It scares the hell out of me! But whose job is it to say “We don’t want to give up on science, but we have to do it right”?
Whose job do you think it should be?
Just like we had a czar for security, we need to put together some position whose job it is to oversee all the things that are happening and make sure they’re done right.
What does the surgeon general do?
Not much. They’re spokespeople. If I challenge you to say who the surgeon general is…
I couldn’t. For some reason I always remember the guy with the beard.
C. Everett Koop. Nobody knows who the surgeon general is. In order to get normative change, you need leadership, and we don’t have that.
At a moment when it seems as if we need it more than ever.
Drug pricing is another great example. It’s out of control, and it’s inappropriate. At the same time, without biotech and pharmaceutical companies, we have no hope. We need them, but they have to operate ethically and appropriately, and we need to price based on value, not just on what the market will bear.
A throughline in all of your books is empowering readers to collect and analyze their medical data themselves. For instance, you’re a big proponent of activity trackers.
Right now the doctor visit is, you go in, he or she draws your blood, checks your blood pressure, looks at all your vitals and weight, and you go home. A couple of days later they call you with the results. That makes no sense. Very soon everything will be drawn by you. You prick your finger, you check a month of blood pressures. You go in to your doctor with all these metrics, and you sit down with him or her and have a real discussion over the data. Tracking your own health puts you in the driver’s seat.
Without the proper context, can’t having access to all of this information just freak someone out?
Hippocrates, 2,400 years ago, used to write: “If I ate dinner and had sex within an hour of dinner, I didn’t perform well.”
Hippocrates wrote that?
Oh, he wrote things like “If I had too much milk product, I felt bloated.” He would say if it happened to him, one size fits all. He would make all these dictums based on it. And so would Maimonides 1,000 years later, and then we forgot to listen. Those were the two great leaders of medicine; anything before 100 years ago, those were the two. If you read their writings, it was all about listening to their own body. I know myself. If I have more than two glasses of wine, I fall asleep, and then I wake up three or four hours later. Alcohol is a depressant, but then you get a rebound surge of adrenaline. I try to stick to a glass and three quarters—not always, but most of the time. Do I need technology to do that? No. Do I need to sequence my genes to know if I’m at risk for breast cancer or heart disease? No, I can ask Aunt Marge. I can ask my mother or my father. As long as you’re not adopted, you can get a family history.
What are other things we could be doing to take control of our health?
There’s data that every year you delay retirement, you reduce Alzheimer’s by over 3 percent. If you don’t use it, you lose it. One way of preventing Alzheimer’s is keeping your brain active. I take my watch and put it from my left hand to my right hand; that stimulates crossover in my brain because I’m doing physical activity along with a sensation. Just rearranging the furniture in your bedroom stimulates your brain. Drive a different way to work every day. Little things can help.
I wear a Fitbit, but my husband won’t because he doesn’t like the notion of his health stats being so easily accessible.
People breaking into data is one thing. But at the same time, I ask my patients, “Do you want to be part of the problem or part of the cure?” Since I’ve been practicing, every patient to date has donated their information. You bank online, you put your card into a machine at the corner, and nobody thinks twice. But I talk about your health care data and “Oh, my gosh, don’t get near it.”
You’re emphatic about your beliefs, which is what I’m guessing led Dr. Oz to call you the “most controversial doctor in America.”
I’ve learned in doing these things with CBS News that if I say things in black and white, to an extreme, it creates debate. But if I say things in the middle, no one pays attention.
So that’s part of your strategy.
No question about it. It’s just to create discourse about this. And the beauty is, I can speak to a couple million people every morning. I get calls literally every time from a senate office or a couple of congresspeople because they listen and they want to know more about it. Then I get Charlie Rose calling afterward: “How does it affect me?” [Laughs.]
Let’s go back to the idea that small changes in your routine can stimulate your brain. What else?
The self-driving car is a thing of Silicon Valley that will be used by Silicon Valley only. Remember, evolution selects out for who can hunt and then find their way back to the village. It’s pattern recognition with physical activity. Driving is one of the few ways we achieve that. We don’t want cars to drive for us, or our brains are going to go numb. Yes, if you’ve had too much to drink, if you’re stuck on the 405, a self-driving car is awesome. But most of the time, driving is good for us.
Sleep seven to nine hours, find time to meditate, walk 10,000 steps, eat freshly made meals—all while raising a family, possibly commuting a long distance, maintaining a job. I wonder: How do we achieve it all in a day? How do you prioritize?
To me, it’s family time. I don’t go out at night. I don’t go out for dinners. I’m home almost every night. I want to be there with my kids at night and in the morning for breakfast. That’s the most important thing I can do. It’ll help center me, put everything in place. I get up very early, and the days I have to go to CBS, I do. The other days I get up early and write. Me and the dog sit there, and I have perfect quiet time and I write. And I do my exercise: I alternate yoga, Pilates, and tennis.
So you keep a pretty solid routine.
At 6 a.m. I have someone come to me, so I’m kind of forced to do it. And listen, I don’t like yoga, but it works.
You don’t like yoga? I love yoga.
I don’t, but I skip one week and I feel it. It doesn’t hurt you, and it doesn’t stretch one muscle more than another. That’s the biggest mistake people make. Their trainer says, “Let’s stretch this muscle and this muscle,” and they forget about a couple of others. This is tight, and that’s loose, and it causes all these problems. Yoga’s a holistic way of doing that, and it really works.
You work out in the morning, but you advocate movement throughout the day.
We need to build that in. If I’m going to build a school, I want to put one classroom as far away from another classroom as possible. I don’t have a printer in my office. I don’t want one because I want to get up and walk somewhere. It’s very hard when I tell people, “Listen, I want you to do this today because it’s going to help you in 20 years.” They roll their eyes at me. But if I give them a short-term metric, like percent of movement or whenever the Apple watch thumps you when you don’t move, that is different.
What about diet? It seems as though there’s always a new study that contradicts another about how we should eat.
What we know about diet is very simple. It’s not just what you eat, it’s when you eat. One of the biggest causes of stress is irregularity in schedule. People with the same weight who graze—versus people who eat meals at the same time every day—have a higher incidence of diabetes. Your insulin keeps going up because your body doesn’t know when it’s going to get food, and your body becomes resistant to that insulin. The Mediterranean diet trumps all: It doesn’t matter whether it’s fresh or frozen. A low-fat diet’s the worst you can do; a good-fat diet’s the best you can do. I alternate eggs and cheese and yogurt in the morning. At lunch, all of a sudden, we’re doing this UberEATS.
The rap on you is that you’re anti-vitamin supplements. Is that a fair characterization?
I’m not against vitamins; I’m just for the data. As soon as there’s a positive study, I will change my tune. But there have been thousands done, and none were ever positive.
What’s the harm, though?
Everyone is taking vitamin D every day or calcium or vitamin B without second thoughts. There are a lot more side effects to those and no benefit, so we have to change that psychology. First of all, it’s the same companies making both. Pfizer, Novartis—they make many of the vitamins.
There is this idea that the vitamin companies are not evil and the pharmaceutical companies are.
They’re the same. Almost every vitamin is made by the pharmaceutical companies. But yes, there’s a notion that there’s weakness in taking pills, strength in taking vitamins. It’s empowering. And so, again, we need leadership there.
You’ve encouraged readers to take a statin to reduce cholesterol as part of their daily health care regimen because it can help delay heart attacks and strokes, even in people with normal cholesterol. Other doctors disagree.
I take a statin every day. Am I happy about it? No. But I look at the data, and I want to play with my grandkids. I have heart disease in my family. I have cancer in my family. I had three uncles die of cancer in the last six months. It’s real, and I want to do everything I can to prevent it. I want to enjoy things. Any cancer patient or heart disease patient or Alzheimer’s patient will tell you, “I wish I did something more to prevent this, but it’s too late now.” How do you get someone to do something today that is going to help them 30 years from now? That’s the hard part.