It is without a doubt that the last decade has seen a surge of interest in health, wellness, mindfulness, mental health, and longevity. I have to assume that with the mobile revolution and the ready availability of apps and wearables and other cool gadgets and tools, achieving those goals seems more accessible, hence the increased interest. Also, social media has been a catalyst for spreading (mis)information and a good bit of that seems to involve health and wellness. I certainly have noticed that many people with no medical background come up to me at events and educate me about how to eat, exercise, which supplements to take, the benefits of red wine for my heart, how to use AI to learn what to eat, etc. One big problem with all of this is that as a cardiologist I know much of that information to not be based on any science but good marketing. Of course, this is not an issue just with health and wellness. We see social media as a catalyst for misinformation on all kinds of areas, including geopolitics.
That brings us to longevity. Longevity, of course, would be connected to all of these themes. After-all, if you live healthier and eat better based on your genes and microbiome and engage in personalized fitness, the ultimate benefit will be a longer life. For the sake of this writing, I’m going to fold the concept of health span (living healthier, hopefully for longer!) into longevity, meaning that when I discuss longevity, I mean living longer but also healthier. For better or worse, longevity is the accepted term now and not everybody knows what health span means. It is astonishing how many articles, organizations, website, social media groups, and more are focused on this concept. There has been an explosion in the last 5 years and there are companies now that are selling longevity solutions. These include supplements, young blood infusion, cell therapy, hyperbaric chambers, red light therapy, and more. Back in September, I wrote an article for Fast Company, titled “The Business of Living Longer: Lessons for investors and entrepreneurs“. In that article, I discuss the longevity business, because that is what it has become: a business.
Many of the aforementioned therapies have zero evidence supporting their use for longevity but don’t mention that to the people who come up to me and educate me about the benefits of this stuff. They believe what they read in social media and company websites and are eager to defend it. I notice an emotional connection to whatever it is they’re trying at the moment and a tendency to dismiss the scientific method that has been the backbone of all of the progress we’ve made in the last 100 years. It seems that the requirements for evidence and the long and hard scientific work of creating that evidence is now inconvenient for most people. If people can feel good about themselves (since they’re doing something to help them live healthier and longer) by taking some supplements, then they want to believe!! The scientific community, who is busy doing the actual hard work of studying what can actually help us live healthier and longer, is not media savvy and is no match for people whose job it is to create the content that mesmerizes the masses. In this respect, I have to fault the scientific community. If they don’t realize that the world has changed and a big part of their job is to combat misinformation and clearly lay out what is fact vs. fiction when it comes to the health and medical topics, they will lose this battle to big business. And, they are losing at the moment, given what I see out there in terms of the amount of misinformation that companies are successfully spreading to secure a market for their products.
With all of that said, what is, then, the status of longevity research? Are there some real stuff being developed to help us live to 150? Well, let me start by saying that given that we’ve increased life expectancy from 35 to over 80 in the last 150 years, there’s much to celebrate already. To achieve the healthiest possible life and health span while all of this research is going on, avoid smoking, eat vegetables and fruits, exercise, minimize saturated fat, salt, and sugar as much as possible, wear your seatbelt, be social, and find a strong mission in life that keeps your motivated and inspired. The evidence on these interventions is a slam dunk. Promising areas of research include genomic instability, telomere attrition, epigenetic alteration, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem-cell exhaustion, and altered intercellular communication. These are research areas that can ultimately increase life span beyond what can be achieved with healthy living. You can say that these are the areas that can help you live beyond what your genes have in store for you if you lived your best life. Research shows that healthy living can ensure that you live past 60, 70, 80, and not die from an early heart attack or cancer (caused by smoking,) but to live into your hundreds, you need help from your genes. Well, these areas of research try to hack that process and help extend beyond what nature had in store for you when the blueprint of your life was created.
I will get into some of the details related to the mentioned areas in the next post but it’s important to note that there has not been a breakthrough yet in any of them (in spite of what you may read on a company website or on social media!) One key umbrella concept to know is that there is a growing school of thought in the medical community that explores keeping people healthy by arresting or slowing down the aging process. The underlying principle here is that most chronic diseases happen later in life and their incidence increases exponentially as we age. As you can see in the figure below, hypertension is rare under the age of 40, but the incidence and prevalence goes up dramatically after that. The same is true of hyperlipidemia, diabetes, heart disease, musculoskeletal issues and more. So, if you actually slow down the biological aging process inside the body, you can delay or prevent these chronic diseases. Since most of the disease burden on people and healthcare dollars are spent on managing chronic diseases, you can potentially improve quality of life for most people and save big bucks. In fact, you can help address the huge budgetary issues that most countries face today. Providing healthcare is often one of the largest line items in the budgets of advanced countries and a big driver of budget deficits.
Incidence and Prevalence of High Blood Pressure by Age
As you can see, longevity research may have implications for the entire economy and humanity. The dollars that healthcare is consuming is potentially crowding out investments in other productive parts of the economy such as education, research and development, and infrastructure. This will affect the rate of improvements in our standard of living. In the next post, we can delve into the promising areas and explore how close we might be to seeing some results from the ongoing research.
