April 23, 2025
The Empire Club of Canada Presents
Investing in Life: The Science of Longevity and Planning Your Financial Future
Chairperson: Saurabh Popat, 3rd Vice Chair, Board of Directors, Empire Club of Canada
Moderator
Karli Farrow, President & CEO, Trillium Health Partners
Panellists
Dr. Kashif Irshad, Medical Director & Co-Founder, Lifespire
Dr. Samir Sinha, Geriatrician & Clinician Scientist, Sinai Health, the University Health Network; Director of Health Policy Research, the National Institute of Ageing
Alex Besharat, Executive Vice President, Canadian Wealth Management, Scotia Wealth Management
Head Table Guests
Carrie Bois, Treasurer, Empire Club of Canada; CEO, CNB Consulting
Welcome Address by Saurabh Popat, 3rd Vice Chair, Board of Directors, Empire Club of Canada
Good afternoon, everyone. I’m Saurabh Popat, the third Vice Chair of the Board at the Empire Club of Canada, and your host for today’s event.
To formally begin, I want to acknowledge that we are gathered on the Traditional and Treaty lands of the Mississaugas of the Credit, and the homelands of the Anishinaabe, Haudenosaunee, and the Wendat Peoples. I encourage you all to learn more about the Traditional Territory on which you work and live.
Now, today’s event would not be possible without the generous support of our sponsors. The Empire Club of Canada is a non-profit organization, and our sponsors generously support the club, and make these events possible, and complimentary, for our online viewers to attend. So, please join me, in thanking our Supporting Sponsors for today, CG Capital Markets, Manulife, and the Canadian Medical Association. We’re also deeply appreciative of our ongoing support of our Lead Season Sponsors, Bruce Power, and Hydro One, and our VIP Reception Season Sponsors, Ellis Don, and Waste Connections of Canada. Finally, thank you, to our Media Partner, the Toronto Star, and our AV Partner, Bespoke Audio Visual.
Now, if you have any questions for our speakers, please scan the QR code found on your program, or through the Q&A function, if you’re online. For those of you online, if you require technical assistance, use the chat feature.
Now, it’s my pleasure to welcome you, whether you’re joining us here in person, or tuning in online, to today’s timely and thought-provoking conversation, “Investing in Life: The Science of Longevity, and Planning Your Financial Future.”
Now, let’s start with a simple but powerful fact: the average Canadian today lives more than twice as long as they would have lived, just two centuries ago. In 1800, the average life expectancy in Canada was under 40 years; today, it’s over 82. And that kind of change reshapes everything: how we live, how we work, and how we age, and how we plan for the future. Because living longer works best when we’re also living well. And that’s the real challenge and opportunity, and the reason why we’re here today, to continue to explore.
Now, today’s events build on an important set of conversations we’ve been having here at the Empire Club of Canada for several years, from Dr. Samir Sinha’s call to action on the urgent need to support aging at home, to the Governor of the Bank of Canada, Tiff Macklem’s reminder that financial stability is what helps Canadians plan for the future. These conversations all point to the same reality: that Canadians are living longer, that longevity brings both incredible opportunity, and complex challenges.
Today, we take that conversation one step further. From emerging and innovative treatments and technologies that promise to delay the aging process, to new financial strategies developed to support a longer and more sustainable retirement, the science and the business of longevity is booming. Some of these developments, like personalized medicine, are backed by evidence, and transforming clinical practice. Others, like biohacking trends, or cold plunges, are dominating headlines, but raise more questions than answers. What does the science say? What does our financial planning need to account for? And how can we make longevity livable, and sustainable? Today’s event brings together, and brings back, four unique and respected leadership voices, to explore these questions. We’ll hear from leaders in medical innovation, health policy, and wealth management, and we’ll hear how the pursuit of longer life is reshaping our personal choices, and our shared future.
And now, to start us off, it’s my pleasure to introduce our first keynote speaker. Dr. Kashif Irshad is the Medical Director and Co-Founder of Lifespire, and the Chief of Thoracic Surgery at William Osler Health System. He is a leader in cancer surgery innovation, a specialist in bariatric care, and a diplomat of the American Board of Obesity Medicine. Now, what sets Dr. Irshad apart is his belief that longevity isn’t just about adding years to life; it’s about adding life to those years. His work at Lifespire focuses on prevention, early intervention, and continuous health optimization, using advanced diagnostics, biomarker testing, and personalized care plans, to help people control, or take control, of their health journey. Please join me, in welcoming Dr. Kashif Irshad.
Dr. Kashif Irshad, Medical Director & Co-Founder, Lifespire
Okay. Well, thank you so much, for the opportunity to speak today. And I hope these next 10 minutes will add 10 more healthy years to everyone’s life. So, as a cancer surgeon, with over 25 years of experience, I’ve had the privilege of witnessing some remarkable advancements in medicine. We’ve seen groundbreaking progress in areas like medical imaging, like robotics, immunotherapies, and more recently, the integration of AI. Acute care has evolved in ways that were unimaginable just a few decades ago. Yet despite these incredible innovations, I find myself grappling with an unsettling question: why are we, as a population, becoming sicker and sicker? Despite all these advancements, why has life expectancy not risen in parallel? Instead, many of us experience our last decade of life filled with disability, frequent visits to the hospital, and transitions into nursing homes. Our goal should be to lengthen life, but more importantly, to compress the time living in a state of disability, as much as we possibly can. Now, while progress in acute care medicine has saved countless lives, we’ve missed a critical point. We haven’t adequately empowered our patients to take charge of their own health, before the onset of disability. We focused the use of our technology on curing illness, actually, rather than preventing illness.
Now, in 2014, the New England Journal of Medicine published a study comparing low-dose CT scans to chest x-rays, for screening patients, high-risk patients, for lung cancer. What it did is it demonstrated a 20% relative risk reduction in overall mortality, for those screened with CT scan. This evidence was so compelling that it spurred a change in how we approach lung cancer screening. In 2015, I had the privilege of founding the first, and now the largest, lung cancer screening program in Canada, at William Osler Health System.
Now, as a lung cancer surgeon, I’ve had the opportunity to see firsthand how screening has saved lives. I can share two important observations, based on my experience. First, about 4% of patients that we screened were diagnosed with lung cancer. And for most of them, surgery performed at Osler was curative. The second, and perhaps the more profound observation, is what happens when we show patients the results of their scans—specifically, the images of their lungs, highlighting the damage caused by smoking. We show them their emphysema, the scarring, the calcium deposits in their coronary arteries, the damage already done by their smoking habit. When patients see these images, they realize that without changes, such as smoking cessation, their disease will only progress, leading to profound disability, and an early death.
Now, by providing patients with this visual biomarker, a tangible, undeniable representation of their own health, we can motivate them to take action. In fact, many patients who saw these images made the decision to quit smoking, and become more active, motivated not just by the prospect of avoiding lung cancer, but by the possibility of preventing other conditions, and ultimately, avoiding a prolonged period of disability and hospitalizations.
Now, this experience illustrates a crucial point. Biomarkers, whether visual, blood-based, genetic, or functional, can be powerful tools for sparking meaningful lifestyle changes. It’s not just about identifying diseases after they’ve developed; it’s about using the technology that we already have, to screen for early signs of unhealthy aging. We need to shift our focus towards empowering patients to change the trajectory of their life, of their health, before the onset of chronic disease.
Think of it this way: most of us in this room have already started planning for retirement. We’ve been taught to invest as early as possible, to maximize our RRSPs, and to meet with financial advisors regularly, to make tactical shifts in our investments. We often log into our banking apps, to track how our investments are doing, ensuring that we’re on track to live and retire comfortably. Now, imagine if we applied the same level of attention and touchpoints to our most prized asset: our health. How many of us truly know where our health stands? How many of us know whether our cardiovascular fitness has worsened over the past year? Are we maintaining our muscle strength? Are we becoming more insulin-resistant? Have we developed an unhealthy body fat percentage? Do we have adequate diversity in our gut microbiome? Just as we know our financial balance, we should have a clear, and real-time understanding of our health balance.
Now, this idea of proactive health management is what inspired me to co-found Lifespire, a clinic dedicated to helping individuals invest in their health, and extend both their lifespan and healthspan, which is the time spent living with minimal to no disability. Now, using technology to screen for markers of poor aging, we can motivate patients to make informed decisions about their health. The goal is to identify, and act on the numbers, before disability sets in. For example, cardiovascular disease begins in adolescence. By mitigating risk factors early, through things like exercise, diet, and aggressive lipid management, we can drastically reduce the burden of cardiovascular disease later in life.
Now, unfortunately, the field of longevity medicine has been hijacked by influencers, who promote unproven, costly interventions—everything from expensive and unregulated supplements, to questionable tactics like plasma transfusions, placenta capsules, coffee enemas. While some of these trends may have anecdotal or observational support, nothing has a greater impact on longevity than optimizing the four pillars of health: exercise, nutrition, sleep, and stress. Now, these pillars may sound simple and boring, but optimizing them without quantitative guidance is unlikely to result in habit change. Having your family doctor lecture you about these pillars is grossly inadequate. A 2019 Meta-analysis assessed the impact of annual health checks on risk factors. It demonstrated that annual health checks did not reduce mortality or improve lifestyle. They had no impact on smoking, no impact on alcohol use, exercise habits, or nutrition, in the long term. That’s where science-backed biomarker surveillance comes in.
Now, at our clinic, we track about 150 biomarkers, including exercise tests, bloodwork, DNA analysis, body composition, and even gut microbiome sequencing. But biomarkers alone are not enough. We need to provide them with real tactics, to optimize these biomarkers. We need to change, and retest, and reinforce these changes that they’ve made. This will only lead to long-lasting change.
Now, for example, we measure VO2 max annually. Now, VO2 max is the maximum amount of oxygen your body can use, based on the fitness of your health and lungs; it’s a powerful predictor of life expectancy. Now, increasing VO2 max by just one unit can reduce the risk of death by 20%, over 5 years. A poor VO2 max is equivalent to being a smoker, having hypertension, and diabetes combined. Now, left unchecked, VO2 max can naturally decline by as much as 15% per decade, which can really severely impact a person’s ability to live independently later in life. So, if you are 45 years old now, and have a VO2 max of 30, you may not notice disability now, as you may be leading a sedentary life. However, at age 65, it’s unlikely you’d be able to climb up a flight of stairs, without being severely short of breath. Now, by tracking VO2 max, we can help patients build a reserve of physical capacity, that will help them live independently, as they age. We use targeted interventions, that can improve VO2 max by as much as 30% within months.
Now, another example is grip strength. A simple test; it’s a strong predictor of longevity. Individuals with a higher grip strength are less likely to develop chronic disease, and experience cognitive decline. If we detect a decline in grip strength, we can intervene early, to prevent continued muscle loss, frailty, and a loss of independence.
Another actionable biomarker is the HOMO-IR, a simple blood test, that helps predict the risk of developing diabetes. High values indicate insulin resistance, a prequel to diabetes. Patients in the highest quartile have a 5x greater risk of developing diabetes over a 10-year period. By identifying this early, we can help patients make changes that will prevent the onset of diabetes, and its associated, often devastating, complications.
But the key to success isn’t just having access to the data; it’s about digitizing the data, and putting it in the hands, through an intuitive app experience, that makes critical health insights incredibly accessible and actionable. Now, with personalized biomarker data, progress tracking, and expert guidance at their fingertips, the app becomes a daily driver of behavioural change.
So, let me leave you with this: the heart attack at age 50 began as a teenager, Alzheimer’s at 70 actually started at age 40, the loss of independence at 80, well, that began at age 30. Longevity isn’t a concept you think about later; it’s a strategy you should commit to now. So, just last week, we built a customized one-year health optimization strategy for a 45-year-old gentleman, who joined Lifespire, with the goal to add 10 more years of vibrant, healthy life—not just to live longer, but to live better, to live well. Our strategy includes: improving his VO2 max by 30%, enhancing his cardiovascular capacity and resilience, aggressively reducing his apolipoprotein B to below 0.7, slashing his cardiovascular risk, reducing body fat from 29% to 19%, reclaiming his metabolic health, increasing grip strength by 25%, boosting strength and function, increasing gut microbiome diversity by 30%, laying the foundation for immune, mental, and metabolic resilience. And this is just in year one. So, I encourage everyone in this room to take control of their health, one data point, one habit, and one year at a time. Thank you.
Saurabh Popat
Thank you so much, Dr. Irshad, for that fascinating look at the science of longevity, and what it means for all of us, as we think about living longer and more fully—and hopefully, having a portfolio value that was shown up there, as well. It’s now my pleasure to introduce our next keynote speaker, Dr. Samir Sinha. Dr. Sinha is a leading geriatrician, clinical scientist, and Director of Health Policy Research at the National Institute on Aging. Dr. Sinha is one of Canada’s most respected voices on healthy aging, and a powerful advocate for policies that support people as they age with dignity and purpose. He’s a Rhodes Scholar, and a Professor in Medicine at the University of Toronto, and has helped shape national strategies on dementia and long-term care, advised governments across Canada, and brought global attention to the importance of compassionate, evidence-based care, for older adults. Please join me, in welcoming Dr. Samir Sinha.
Dr. Samir Sinha, Geriatrician & Clinician Scientist, Sinai Health, the University Health Network; Director of Health Policy Research, the National Institute of Ageing
Thank you very much, Saurabh, for that very kind introduction. And like Dr. Irshad, I, too, like to drink my coffee through my mouth. So, you know. But that’s just, you know, the key thing for today is: how do we really support longevity, and how do we look at this in the best possible way? When we consider, you know, what the greatest accomplishment of the 20th century was, some say it was putting a person on the moon. But I like to think it was that fact that we almost doubled our life expectancy, during the last century. You heard that around 1800, life expectancy was around 40 years of age. Well, by 1900, in Canada, it was 51 years of age. And by the time we created Medicare, back in 1965, we were now in our upper 60’s. Today, it’s about 82. And so, when you think about the fact that today, the chance of someone living to 100 is much higher than ever before—and indeed, centenarians are now considered one of the fastest growing segments of our society—I think we need to really take pride in the fact that we’ve really accomplished a lot as a society, overall.
The longest recorded life expectancies right now show us that, if all these stars align, you know, we could live up to, into our 120’s. And there’s a lot of science related to longevity medicine is suggesting that this is a reasonable target to aim towards, as well. But the key is trying to limit, and trying to avoid, the complications that can come with aging. Because to age well as possible, we need to actually make sure that we think about a number of the different factors that could affect us. And now, when we think about what actually supports us to live well, and live long, it’s not necessarily about being able to run a marathon at the age of 100; it’s about being cognitively, physically, and mentally well, enough so we can live as independently as possible. Certainly, whenever I talk to any of my patients, and ask them what they value most, it is their independence, and it’s that ability to stay healthy and engaged for as long as possible, with those around them.
But the reality is, is that for many of those who make it to 100, in our society, they’re going to be doing it requiring a lot of hands-on care, and they may be living with dementia, as well. And this is why it’s not just about living long, but it’s about living well, and trying to achieve the greatest compression of morbidity that is possible. Meaning, as Dr. Irshad said, it’s about maximizing the quality of life, within a person’s lifespan—now, sometimes even referred to as really expanding a person’s healthspan, as well.
Now, we’ve been forever intrigued with the notion of achieving immortality, and finding the fountain of youth, but all we’ve really found so far is the fountain of age. But along the way, we’ve learned a huge amount about what can allow us to age well, or achieve greater levels of healthy aging. And while some would like a quick fix, like a pill, or an app, or a gimmick, the reality is that all, you know, what we generally know, to promote healthy aging, is stuff that we, generally, have heard from our mom over time. And maybe it’s because what our mom’s been telling us since we were young seems to be obvious, or sometimes inconvenient, that we choose to look to more exciting and intriguing solutions. But I want to just share just a few of them with you, that really reminds us that these are the things that we know truly can impact healthy aging.
As Dr. Irshad said, it starts, really, from a young age. And so, we know that even just the act of trying to encourage people to complete high school, the more education you get, the more that you stimulate your brain, and the more that you actually rewire it, and wire it as such, to protect you from developing things like dementia. We know staying socially connected throughout your lifespan is really important, because loneliness and social isolation have been seen as the equivalent of smoking up to 15 cigarettes a day. It’s always important, no matter how old you are, to have a sense of purpose. Right now, for many people, it might be making the most of their careers. For some of my older patients, it’s being the best grandparent they can, and really helping the next generation meet their full potential. But whatever it is, it’s important that one has a sense of purpose, and that we encourage people to find that, and support that, as well. It’s also important to eat in moderation. And that means, you know, prioritizing plants over meats, and drinking in moderation. Smoking, don’t ever do it—or if you’ve ever done it, don’t do it anymore—get a reasonable amount of sleep, and exercise at least 150 minutes a week. Now, when people say, “What is the best type of exercise that I should pursue?” I remind people that a combination of cardio and resistance exercises is a good combination to do. But honestly, when I ask anybody, and they say, “What should I do?” I’m like, “What is the exercise you’re most likely going to do?” Because really, it’s about getting 150 minutes of moderate exercise a week. Whatever it is, it’s going to actually help reduce your risk of all-cause mortality by 31%.
And finally, prevent the preventable, right? Did you know that there are actually 14 modifiable risk factors that, if you address them, could reduce your future risk of developing a diagnosis of dementia by 50%? So, there are things that we can do, that don’t really require a lot of things, other than things that we know that we should be doing. And so, when we think about all these things together, I think my brother was pretty good in summing it up, when I was younger, by reminding me that my body is a temple, not a funhouse, and so, that one should respect it.
So, finally, we need to appreciate that our current retirement income system in Canada was developed when our average life expectancy was in our 60’s. We were never expected to live as long as we are now, as Canadians. And this is why governments are trying to renegotiate our social contracts, related to old age security, which is now the number one line item in Canada’s budget. But while Canada Pension Plan, or CPP, Old Age Security, or OAS, and the GIS, our Guaranteed Income Supplement, in one way or another, will actually help us exist, as we continue to age, in order to actually enjoy our Golden Years, our retirement income systems expect us to all have a well-stocked workplace pension plans, RRSPs, and TFSA—and if you saw that budget balance from Scotiabank, well, you truly are richer than you think.
But the key is, right now, the sad reality is that the average Canadian currently retiring without access to a workplace pension plan is retiring with approximately $3,000 in savings. Let that sink in. And so, the fact is that, while we should all be doing our part, for many people, it’s hard to do that part. And that means that they may be looking to at least 20 years ahead of themselves existing, rather than living. So, the bottom line is that longevity medicine really needs to be about ensuring that all Canadians know the basics of what it takes to promote our health, our social well-being, and our financial security as we age. And this is the heart of what we focus on and do, in and out, and every day, at the National Institute on Aging. We need to ensure that people know what they can do to promote healthy aging, and help them steer clear of distractions and snake oil.
And speaking of snake oil, here’s a fun fact: I actually, I have a degree in medical history, and I actually like to collect old medical cure bottles. And this is actually the very first bottle that I collected. It’s actually from 1900, when our average life expectancy was 51 years of age. It’s Congrese Balsamic Elixir—basically, it was balsamic vinegar—but it basically says that it will cure coughs, asthma, bronchitis, whooping cough, and consumption, now known as TB. Well, it was great on salad, but it didn’t really do all those things. So, even if someone in a white coat is trying to sell you it, just beware. And remember to stick, again, to what your mom largely taught you, and put your money into supporting a more secure retirement for you to enjoy, and also, kind of really following the good evidence out there. And these really are my secrets to truly aging well. Thank you.
Saurabh Popat
Thanks so much, Dr. Sinha. We’re now going to expand the conversation, and explore how longevity touches so many different parts of our lives, from our healthcare system, to our financial planning, to the very shape of our families and communities. Leading today’s discussion is Karli Farrow, President and CEO of Trillium Health Partners. Karli brings deep expertise in healthcare leadership and innovation, and a career-long commitment to building a more connected, and sustainable system of care. Joining Karli is Alex Besharat, Executive Vice-President of Canadian Wealth Management at Scotiabank. Alex has spent more than three decades helping Canadians navigate their financial futures, work that takes on new complexity, and new importance, as we plan for longer lives. And of course, we’re pleased to welcome back Dr. Kashif Irshad and Dr. Samir Sinha, to join this conversation, as well. Please join me, in welcoming our panel.
Karli Farrow, President & CEO, Trillium Health Partners
Hello, everybody. Can you hear me? So, my name’s Karli Farrow, as Saurabh just said. And it’s a real honour to be up here with some esteemed colleagues, and with Alex. I want to start by saying, for those of you who bought a ticket, and thought you might come in and find the Fountain of Youth, that is not the event today—though, if we have enough time, maybe we can ask our clinician colleagues if they can do personal health assessments at the end. Because I am sure there’s a good percentage of people in the audience that were taking some notes, to understand how we are going to achieve that extra 10 years of life.
I’m really, really excited to be a part of this dialogue, as the Empire Club is introducing us into topics of the intersection for Canadians of healthcare and prosperity. And I think longevity is something that is top-of-mind for all of us, as we think about the future of our country, and then zeroing down to that kind of healthspan, as you said, for us individually. I run a hospital where we experience almost 70% of our hospital beds on any given day are occupied by people who are over 65, and typically, have more than three chronic diseases that they are living with. So, this is a real, this is a real and present reality. And we know that, as we go forward in our generation, that aging population will increase.
So, with that, let’s get into the discussion. I’m going to start with you, Alex, because I think we’ve heard, now, about what is happening with our population, the reality that we all know and feel. But as you enter into this conversation, talk to us a little bit about what this means, when we think about healthspan, when we think about that extended life. Just to put the numbers into context for everyone, again—and these are a bit different than maybe what Dr. Sinha described—but in Ontario alone, in 2020, we were about 2.6 million people over the age of 65; by 2040, that number will be up to about 4.2 million. When we think about those over 85, from 300,000 to over 750,000. So, as we think about healthspan, quality of life, and link it to financial security, what does all of this extended longevity mean for us, Alex?
Alex Besharat, Executive Vice President, Canadian Wealth Management, Scotia Wealth Management
Let me just build on what was said already: one of our economists wrote a great paper about this. And one of the things that caught me, just really hit me, was that 90% of people expect to age at home. Now, that’s—I’m sure, if I asked for a show of hands, that would be the case here. Who doesn’t want that? Now, the truth is, to plan for that is a very complicated and mathematical problem. Look at all the difficulty that we’re struggling with now, and you know, in the world, the turmoil, and so on—just for the next three years. And it’s sat at the table, “What are you guys doing? What do we do, for the next year, two years, or three years?” Well, for people sitting at that table right there, the last five years of their lives is going to be the year 2095. Okay? 2095. They’re going to see the year 2100. Now, think about the uncertainty of planning for that today. Okay?
Now, I think the trick is, in many ways, not that different to what you mentioned, which is, you have to start early. And earlier, if you start—I need to start listening to some of your advice; I retire next year, so I have the time finally, at least that’s my excuse. But if you really think about that, it’s like going to a builder and say, “Look, I want to build a building. And can you build me a foundation?” And well, the first thing the engineer would say is, “How tall do you want to build this building?” And then, you’re going to say, “Well, I don’t really know. Might be 50, might be 70, might be 100.” Well, you have to—that engineer will say, “Okay. Well, I’ll build the foundation for 100.” Because it’s no point building a foundation for 50. Because once you get to 51, you’re wobbling, and at 70, it’s going to crumble. That’s just the way it is.
So, I think this, the idea that—what you said is a fact, now. What you do with it, from a financial perspective, is what are you going to do about that? And the over-building, and the earlier you start, are really the only things that you can do anything about. Because the level of uncertainty, we don’t know what’s going to happen in the next two years, with what’s going on, let alone the year 2070, 2075, 2080, 2085. I mean, those are relevant years, to the folks in this room—it’s an unusually young crowd; I like that. So, that’s, those are the things that is very much engaging of our mind.
Karli Farrow
Okay. I think there’s a general principle, which is: start early, thinking about longevity. And I think some of those statistics that you described, and what we think about, in terms of how do we actually pay for longer lives, is crucially important, and into the intersection of how we need to think about this, as communities and leaders. Okay, I’m going to go to our physician colleagues, here. Dr. Irshad, I’m going to go to you first. We do have some questions coming in. And so, let me combine this kind of—you touched on, how do we discern fact from fiction, when it comes to what we focus on. There’s a second question, that I’ll read again, but—just because I don’t want to give you two questions at once—but I’ll give you a little warning: the question that came from the audience was related to cardiovascular disease and diabetes being multifactorial. So, can biomarkers between them be studied, and would it help? So, park that chronic disease. But how do we know fact from fiction, in this world of so much marketing…
Dr. Kashif Irshad
Right.
Karli Farrow
…in the world of longevity?
Dr. Kashif Irshad
Yeah. I mean, there’s no question that we are inundated with a profound amount of information, and discerning fact from fiction can be quite challenging. I think there was a systematic review that I looked at, where they evaluated some of the facts that are being broadcast on all these social media platforms, and they found that 60% of the things being said were inaccurate, or false. And more surprising, that 15% of these falsehoods came from other physicians. So, that, that is a major concern. So, we really can’t depend on Zuckerberg or Musk, to be able to ensure that what we’re reading is accurate. So, when I see a patient who comes to me, and is asking me about a specific supplement, or a tactic, you know, I put them through a kind of four, four-step process. The first thing I do is ask them, “Why are you taking it?” And you’d be surprised, the majority of people who, you know, you plop a stack of 100 supplements, the majority of them don’t have any idea why they’re taking any of these supplements. And that’s concerning. So, the first question is, “Why are you taking this supplement? And what do you hope to achieve by taking this supplement?”
The second step I take, when I’m assessing these tactics is, what does the data show? And there’s huge, there’s a hierarchy of data. And I think the onus is on the clinician, but to teach the patient how to kind of weed through all the data. Now, at the bottom of the hierarchy is that, you know, that social media influencer, who’s telling you to do this. And they do it with such passion and excitement that you just get wrapped into it, and you start taking that suggestion, or that supplement that they’re trying to promote. So, that’s really at the bottom of the totem pole.
Then you have, surprisingly, physician medical advice; that’s just advice, and you have to dig deeper. So, right in the middle is observational studies, where they look at a correlation between one tactic and outcome—and unfortunately, these studies are filled with biases, and confounding factors. So, really, the ultimate study that you want to look at is a randomized control trial, looking at an intervention, and two control groups, and seeing what the differences are. And really, at the top of that, is a meta-analysis of a randomized control trial. So, if you have a tactic that has a meta-analysis of a randomized control trial showing benefit, that’s real data. And then, you have to really pay attention to this. So, that’s the data.
The third part is, how do you track it? Like, what—is there a biomarker that you have, to track results? Because if I tell you, you know, “Take a vitamin D supplement,” well, how do I know it’s working? There’s a biomarker for that; we can measure the results, we can measure your serum levels of vitamin D. And so, every single tactic should have a biomarker, for us to be able to assess success, and benefits from it.
And the last thing is, whether it’s safe, and whether it’s sourced correctly. And there’s—you have to make sure that, especially in the world of supplements, these are unregulated pills that you’re taking. They’re not Health Canada approved. You’ve got to be careful where you get them from. Like, Omega-3 fatty acids, for some reason, is a supplement that everyone takes. But there’s risk with taking fish oil—you know, if it’s oxidized, it can actually be harmful; if it’s not sourced correctly, it could have mercury contamination. So, you have to be able to ensure that they’re safe, and they’re sourced correctly. For Omega-3, there’s a website you can go to, which is third-party testing; you’ll be able to assess whether they’re safe, and good quality. So, you know, I go through this process with every single supplement for all our patients, to ensure that they’re investing in the right thing. Because these are expensive tactics. You want to make sure that they’re going to be helpful.
Karli Farrow
Okay, thank you. There’s a lot there. So, it’s no wonder people feel overwhelmed by this, right? So, maybe, Dr. Sinha, I will go to you next, to just try to pierce through on—we just have a quick audio fix, here—just to pierce through this complexity. And as we think about everything Dr. Irshad just talked about, we think about the reality of complex chronic diseases, is there a chance that this trend to longevity is actually making us all less well?
Dr. Samir Sinha
That’s a great question, Karli. You know, I think, when—I think, again, you know, nobody wants to die, and people want to live long, and people want to stay in their own homes for as long as possible. We have these hopes, and we have these desires. And I think as we age, and things start to ache, and we start realizing that we’re not as nimble as we used to be, I think people get very concerned—you know, obviously so. We want to live as long as possible, and as humans, we’re conditioned to want to do so. But you know, just as I was saying, there’s so much out there that plays on our fears, just as Dr. Irshad was saying. What will you see on social media, what you’re seeing there—and again, when you’re so overwhelmed, when you’re busy raising a family, working, doing all these other things, that’s why I think some people are then being influenced by, “Here’s a quick fix: just do this, or take that, and it’s going to solve your problems.” But often, you know, one of the other things that I would add to Dr. Irshad’s great list of—and it’s exactly what I do with my patients, as well—it’s like, who’s also giving that message, right? Because what’s in it for them? They’re making a lot of money selling this, or selling that, and is it proven? Is it helpful, right? And it seems exciting, it seems interesting, but what does the science say, and who’s going to benefit from this? Because I don’t think, in this case, it’s going to be you; I think it’s going to be their pocketbook, and so on.
And so, I think, yeah, it can be incredibly overwhelming, you know, as we look at this. And this is why, you know, as part of my remarks, I want to just really focus, again, on just some of the basics. Because, you know, recognizing that I have a number of patients, in my practice, who can’t afford any supplements; I have some patients who can’t afford the parking at our hospitals—you know about this, right? It’s like, how do you make sure that people have access? And also reminding people that, you know, even if you can’t, you know, look at biomarkers—and so many people in Canada don’t even have access to health care right now, with a primary care provider—how do we make sure that we can at least get some of the clear messages out?
So, that’s why, earlier this year, in the CMAJ, our Canadian Medical Association Journal, my colleague, Dr. Jane Thornton, who’s an Olympian, we published a big review, looking at the benefits of exercise. And the bottom line was:150 minutes a week, you know, is really all that you need—it’s not a huge amount, when you think about it. And the other key takeaway was: it will reduce your risk, you know, the early risk of death by 30%, right? And if I can just get that simple message out there—I don’t have a YouTube channel, I don’t have TikTok, I probably don’t have good rhythm, you know, to do all that good, you know, and a great voice, in that way—but that’s why I want to make sure that those key messages are out there.
And I think we need to do more as a society, especially our governments, our public health groups, our whole health care system. Because I know that, you know, as a CEO of one of our largest hospitals, and busiest hospitals in Canada, you don’t take pride in the fact that your emergency room is filled with people who didn’t have those opportunities to stay healthy and well. And so, I think that’s why I’m really proud to be here with Dr. Irshad, and others, saying, like, how can we make sure we get some of this core information out there, so that people aren’t so overwhelmed, and know that there are things they can do. And to the other points here, starting as early as possible, and just trying to get the basics right, is going to make a huge difference, overall.
QUESTION & ANSWER
Karli Farrow
And can, potentially, impact the most people. Really, really important point. I’m going to take the bridge that you opened up around government, because we have some questions coming in. And obviously, we are doing this panel during the midst of a federal election. So, Alex, I’m going to ask you the question from the audience, which is: as you think about looking at this from a perspective of the economy, and down to individual wealth, do you think that healthy aging and caring for seniors has been adequately addressed in this election campaign? And I’ll just put that out to the whole panel: are we talking about this enough, in the right way?
Alex Besharat
Look, I think, as a general statement, I think this subject still needs to have more of a front page, needs to be on the front pages. The challenge with it is, it’s not that dramatic, really. A lot of what we’ve talked about here is not dramatic. And in many ways, it’s not a political, particularly a political issue. My, my hope is—and I think that there’s an inevitability about this, but the earlier, again, like all those things, the earlier the better—is that we need to recognize that, unless this matching of longevity and financial health of citizens, unless this becomes more of a central theme on the years to come, then what you’re going to have is elder poverty. It just isn’t, it’s not a political statement, it’s nothing other than just simple math. That if you, when you retire, if you plan to retire at 60, 65, 70, but you have another 30 years that those savings have to last you, at any level—this isn’t a rich person, or poor person, or moderate person; it’s about the fact that, unless you are serious about accumulating, and saving, and planning your life around the extreme likelihood of longevity now, I think you, you are, you’re going to run into trouble. In a way, I think it should not be part of a political dialogue. It’s not a political issue. It is a societal reality, and societal issue. And so, that’s what I hope we get to. But we’re not there yet.
Karli Farrow
Do you think we’re talking enough about pension stability, in this country?
Alex Besharat
Well, look. I think one of the great, you know, a defined benefit pension plan is just a very good saving mechanism, and—as are RRSPs, TFSAs, they all have benefits, pros and cons. I certainly think that, if you were to evaluate your life, as you grow into the ’30s, ’40s, ’50s, if you don’t have certainty of income, that used to come with a defined benefit pension plan, okay, you don’t have it. That’s just reality. But then, there’s other things you can do. You could be better planned—you have to make up for it. So, I don’t think there’s only a way. No two people are the same—people have big families, small families, inheritance, no inheritance, you know, family health issues, none, have to take care. So, no two people are the same. So, I think that it’s difficult to just throw a blanket over, and say everybody should do this, or everybody should do that. It isn’t that. I think that, by planning properly, you actually get down to the core of who you are, and what are your needs. I bet you, if we, the three of us sat for an hour, and told each other everything, and put it on a table, we would have very, very, very different plans. Because that’s just the reality of the individual, and the circumstances of our lives, our families, our needs, and so on.
Karli Farrow
Okay. Thank you. I will say, from a hospital perspective, we do see a growing number of admissions. And some of the research that’s done with Dr. Sinha, and his colleagues, can start to bear this out. More long stay admissions happen when people are socially isolated, or in lower income brackets. So, it is something that we correlate, in the hospital, is the linkage between economic security and aging health.
Okay, I got to get back to our doctors, because people have a lot of questions. Again, as I said, we’re not doing personal consults, but there is a great question that I’ll pose, which is: as we think about longevity, how much is genetics just playing a role in this, and how much are these interventions that we’re talking about? Dr. Irshad, I’ll go to you.
Dr. Kashif Irshad
Yeah. And I do believe that we have a genetic ceiling. But there’s this new field of epigenetics, that’s quite exciting—how our behaviour and our environment actually impacts the expression of certain genes. I mean, again, it comes back to what Dr. Sinha has said, you know, the pillars of health: sleep, exercise, nutrition, stress management. All these things actually impact how your genes are expressed. But there’s no question that doing some genetic testing can tell us what we’re predisposed to getting. So, we do cancer screening, cancer genetic testing on all our patients, to identify what types of cancers patients are more susceptible to getting. And then we can customize their screening programs, based on their genotype. There are certain genes in Alzheimer’s, like the ApoE gene, where if you have ApoE4, if you have one from your mother and one from your father, and your genotype is E44, you are at significantly higher risk for developing Alzheimer’s disease. And then, you should know about this as early as you possibly can, so you can make those lifestyle decisions, to mitigate risk as much as possible. So, genes play a role, but they’re not your destiny. You can influence the expression of your genes, just by living a very, you know, wholesome life—again, paying attention to those four pillars that we’ve discussed.
Karli Farrow
Excellent. I’m going to go to you next, Dr. Sinha. So, how do you position longevity medicine and associated costs in a publicly-funded health care system that’s underfunded? And if only for private pay, what does future health equity really look like?
Dr. Samir Sinha
Yeah, no, it’s a great question. I want to back into that with, by answering your previous question about, we are in the middle of an election right now. And as you were just saying, there’s so much uncertainty in the world that I think is driving how we’re thinking about the issues, that the issues have been very focused on a few things: about our security as a country, our identity as a nation. But the one thing that we are certain about is that, within the next year or two, Canada will become officially a super-aged nation, when one-in-five citizens is 65 and older—and within less than a decade, one-in-four Canadians will be 65 and older. And that’s what the, that’s what it’ll look like, between 2030 and 2050, as our Baby Boomers start turning 85. So, if there is something that we can be certain around, it is that we are going to be a much older population, where there’s a lot of chronic illness, and poverty constraints choices—all of these sorts of things mean.
So, it’s great that we had a new cabinet announced, but I was upset to see that we actually lost our minister for seniors, right? Because when you think about the fastest-growing demographic in our society, the fact that we do not have a National Senior Strategy—and this is one of the biggest issues, as is climate change, facing our nation. We need to reinstate that role, we need to have a National Senior Strategy, because we have to look at this together. Because this will affect the prosperity of our nation, it’ll affect our ability to support caregivers—over 8 million Canadians are caregivers, balancing paid work, and unpaid caregiving duties—we have a huge burden of healthcare, that we will not be able to meet.
And so, when we start thinking to your, this question about, how do we actually start thinking about our publicly-funded health system, which is under threat, just in terms of just how can we sustain, with costs keep going up? The problem is that we’re just reacting to the problems that we see as a society, when we haven’t been as proactive as we can. We spend so little of our healthcare budget, you know, in prevention and wellness. And you know this—I mean, yes, you run a health system, but you run a health system, not a hospital, right? And I know you’re not owning the podium here, but I’m going to give you credit here. Because with what you’re doing, for example, you know, it’s also thinking about, how do we promote healthy eating, you know, from a young age? How do we support more physical activity? How do we support, you know, people completing high school—that protects us from developing dementia. Those sorts of things that we do. But I think this is where we need to think about wellness and prevention.
Because when we think about publicly-accessible vaccines, for example, things like the influenza vaccine, the pneumococcal vaccine, these are all freely available to older Canadians. The Public Health Agency of Canada set a target of 80% of people getting vaccinated. 99% of older Canadians got vaccinated against COVID, but we can’t even get our act together, to protect people against something that fills our hospitals every fall, with people who did not get a very preventative, you know, piece of healthcare. So, if we are talking, and if we want a sustainable healthcare system, if we want to sustain our economic prosperity as a nation, countries that are getting it right, and are doing it well, are really emphasizing on wellness and prevention. And that’s something that everyone can access, so that it doesn’t need to be just in the hands of a few privileged people. We really can take this information, this evidence, and make it much more widespread, and much more mainstream.
Karli Farrow
Such, such important points. And we have more questions than we can ever get to today, which we knew would be the case. I want to say that, wrapping it up around a call to action on wellness and prevention, I think, is what all of the panellists can agree to. And starting early, and often, with that, our health, and our financial security. And this being an important moment for the prosperity of our country, not only to think about some of the issues—I love that, Dr. Sinha—there are a lot of uncertain issues in the election we are in the midst of right now. And thank you to the Empire Club, for putting a certain issue onto the agenda, one that we know from the financial services sector, to the healthcare system, to our clinicians working at the point of care, and in research and innovation, we must stay focused on, because, as a super-aging nation—is that the term?
Dr. Samir Sinha
Super-aging.
Karli Farrow
Super-aging nation. We’re a super-aging nation, everyone in this room. So, let’s define our future prosperity around what it means to be a very healthy and wise super-aging nation. And thanks to the Empire Club, for having us. I’ll now turn it back to our moderator, Saurabh Popat. Thank you.
Saurabh Popat
Well, thank you, to our excellent panellists here today, for such an insightful and wide-ranging conversation. You’ve truly helped us see longevity from every angle, from scientific breakthroughs, to financial challenges, and how it touches our common humanity. It’s the bottom line of every part of how we live, and plan, and care for one another. Now, before we close, I’d like to invite my board colleague, Carrie Bois, Treasurer at the Empire Club of Canada, and CEO of CNB Consulting, to say a few words. Carrie?
Note of Appreciation by Carrie Bois, Treasurer, Empire Club of Canada; CEO, CNB Consulting
Well, wow. Can we have another round of applause, please, for the panellists, and great conversation? I didn’t expect to be so inspired today, by a topic that we certainly hear a lot about, but don’t really know where to start, and how to start tackling the many complicated issues that come with it. I think I was most impressed with the insights and expertise, and specifically, the passion, in advancing the conversation around longevity. And I think that everybody’s perspective have deeply enriched this conversation.
And I think it’s a unique perspective to longevity, that struck me today. Understanding that I think we have, certainly a strong desire, as part of Canadians in our population, to start addressing this issue, but don’t know where to start. Certainly, having the bookends of understanding from a more of a geriatric and aging perspective, and knowing what that looks like as a future state, and understanding, as well, from a prevention perspective, that we also have entrepreneurship alive and well in Canada, that are trying to now tackle this in a very profound way, and providing guidance to Canadians on how we start to navigate this. And now, all pulling it together, to make sure that the whole ecosystem around aging and longevity is being addressed. And we look at it from just, not just a health perspective; what does that mean from a financial perspective, from a political perspective and policy, and all the critical elements that come with that.
So, I hope all of you leave today with a deeper appreciation, thanks to our guests. And I want to thank you very much, for spending the time, and sharing your knowledge with us today. Thank you.
Concluding Remarks by Saurabh Popat
Thanks so much, Carrie. Thank you again to our panellists, sponsors, and of course, to all of you, for joining us here today, and online. I’d also like to recognize the students, and young leaders in the room today, from the University of Toronto, Queen’s University, and Humber Polytechnique. Thank you for joining us.
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I also hope that you’ll join us for our next set of Empire Club events. On May 6th, we’ll tackle a global issue with local impact, the rising cost of corruption, what it means for Canadian businesses, and how the private sector can protect itself, in an increasingly complex world. And stay in town for our Empire Nights evening, featuring a panel of leading pollsters, as they delve into the true drivers behind the election results, and explore what they mean for the future of our political landscape, and perhaps, for our super-aging society, as well. Tickets for both events are on sale now.
And as always, as a club of record, all Empire Club of Canada events are available to watch and listen to on our website. The recording of today’s event will be available shortly. Thank you all, for being a part of this important conversation. Enjoy the networking reception, and we look forward to seeing all of you at future events. This meeting is now adjourned. Thank you.
