
How Aging Research Is Changing Our Lives - dnetesn
http://aging.nautil.us/feature/226/how-aging-research-is-changing-our-lives
======
dahart
Great article, this is the first one on aging I've read in a while that has
it's head on straight and isn't trying to make weasel arguments that suggest
aging cures are just around the corner. Happy to see a clear distinction
between lifespan and longevity, so many people like to leverage confusion
between those concepts to argue that medical advancements have improved
longevity, like Ray Kurzweil does.

> People talk about healthcare, but in essence what we have right now is not
> healthcare. It’s sick care. Some people see their physician when they’re
> well, but most people don’t because there’s not much advice that they can
> give you other than not to smoke and to exercise and all that.

I feel like I identify with this; I want to have conversations with my doctor
all the time about routine advice seeking kind of stuff, but I don't because
there's nothing wrong, plus it costs a lot. I would love to have a health care
plan where conversations during and about being well were expected and
included, but I don't see it coming any time soon.

~~~
carbocation
There is just not much information about healthy living (though there is
plenty of noise).

Observational data suggests that eating a diverse diet (but not too much food
that you become overweight), being moderately active, limiting alcohol intake,
and avoiding smoking is healthy. Observational data can be confounded, but
it's not like we have (or are likely to have) randomized controlled trials of
different approaches to healthy living. (How long should the trial run before
you decide that the null hypothesis is true?)

So, most doctors aren't going to have much to say about what healthy living
truly is.

~~~
olewhalehunter
There is a ton of information of healthy living, the basic level of health you
mentioned, emphasizing fitness and lifestyle choices, is taught in most
physical education classes through primary education to high school, but phys
ed has been gutted since the 1960s, kids are staying inside more, and now even
schools sell sugar drinks and high sugar meals. The role of the homemaker is
now a cultural taboo, resulting in less home cooked meals and more fast food,
so the standards for what constitutes edible food is shit, and for similar
cultural reasons people are delaying childbirth beyond the window of fertility
which results in poorer genetic and physiological outcomes for their children.

The combined total of the entertainment industry (keeping you on the couch for
money) and the healthcare industry (money made from complications of staying
on the couch), is something like a whopping 1/4th of US GDP.

~~~
carbocation
> There is a ton of information of healthy living

Where is this "ton of information on healthy living" and what level of
evidence do you have for it?

I don't doubt that there is a set of things that people can do to be healthy.
I do not think that there is much _information_ about what those steps are.
Again, there is plenty of writing on the topic, but little information.

~~~
sn9
I suppose this is pretty subjective and depends on your level of knowledge on
the issues, but I feel that healthy living is more or less a solved problem
from a "what to do" standpoint. The main problem is breaking people of
unhealthy lifestyle habits while educating them on healthier habits (see books
like _Power of Habit_ for habit formation and modification).

I don't have links handy (edit: apparently I have a few) but just from reading
over the years, it seems that the highest impact things you can do (that you
have direct control over) to avoid the diseases of aging (both physical and
mental degeneration, as well as the usual lifestyle diseases like diabetes and
heart disease) while increasing or at least maintaining one's quality of life
include (1) regular strength training, (2) endurance training, (3) avoiding
processed foods and eating significantly more vegetables, (4) minimizing
visceral body fat levels, and (5) always be learning something new
(particularly relevant for lowering risks for cognitive degeneration).

For more specific and actionable advice:

1) Every able-bodied adult should invest anywhere from 6 months to 2 years of
dedicated strength training to build muscle mass and strength. The benefits
are numerous and well-documented (e.g.,
[https://en.wikipedia.org/wiki/Strength_training](https://en.wikipedia.org/wiki/Strength_training),
[http://startingstrength.com/article/science-
medicine/barbell...](http://startingstrength.com/article/science-
medicine/barbell_training_is_big_medicine)). A somewhat arbitrary floor
recommendation would be to maintain a level of strength that allows you to
deadlift twice your bodyweight and accomplish 20 pull ups in a row. This is a
non-trivial level of strength that requires training, but is achievable for
most people with intelligent (but not necessarily complicated) training. Any
competent strength coach can take you there. Reading the book _Starting
Strength_ by Rippetoe would be my recommendation of where to start.

2) The benefits of endurance training are similarly well-documented (e.g.,
[https://fivethirtyeight.com/features/the-5k-not-the-
marathon...](https://fivethirtyeight.com/features/the-5k-not-the-marathon-is-
the-ideal-race/)). The actual modality doesn't matter, but the only thing I
know anything about is running so I'll stick with that. Rowing or swimming or
hiking would also be great. A non-trivial goal to try and hit would be a level
of fitness that allows you to run a 5k in ~20 minutes or less. If you search
r/running, you'll see that this is surprisingly achievable as well. You simply
have to work your way up to anywhere from 30-50 miles per week of running at a
conversational pace. A good place to start would be Couch to 5K followed by
Bridge to 10K. Then follow the 10% rule for weekly increases in mileage. The
Running Order of Operations linked in the r/running sidebar has great
recommendations. (Other tips would be to make sure you're running slow enough;
the conversational pace tip is one metric, but another is to make sure your
heart beat stays below 180-[your_age]. Running the first few months with a
metronome app going in the background at 180 bpm and trying to sync your steps
to it and trying to minimize how loudly your steps are will also minimize the
impact forces and help you run more efficiently.)

3) Nutrition is filled with a bunch of contradictory advice, but there are
some pieces of advice I like that seem unlikely to change in the future. In
terms of what to eat, Michael Pollan's "Eat food, not too much, mostly
plants", is a great place to start. Another person I encourage people to look
up is Rhonda Patrick. She's a researcher who summarizes a lot of research
about nutrition and its interaction with physiology and genetics. If you
follow Pollan's advice of avoiding processed foods and eating more plants,
you'll be much better off. But if you know the current state of your nutrition
(e.g., based on what you're eating, how your weight is changing from week to
week, blood panels to check for nutritional deficiencies, etc.), then
Patrick's advice to get _at least_ 100% of your RDA of various micronutrients
will serve as a great framework for how to modify your diet further. Sites
like Cronometer.com or NutritionData can compare your current diet and show
you the likely distribution of your nutrient intake based on your diet and
allow you to model what the addition or subtraction of various foods would do
to that distribution. For example, you might find that you're regularly
deficient in choline, and mucking around on Cronometer might show you that the
addition of 2-4 eggs to your daily diet would resolve that.(Other really
useful resources include Wikipedia and examine.com)

4) The strength and endurance recommendations above are made much simpler if
you aren't overweight. But instead of chasing abs (not that there's anything
wrong with that), I'd recommend trying to get leaner until you've minimized
the amount of visceral body fat you have. Visceral body fat is something that
has a lot of evidence suggesting it's connected to several disease states
([http://www.health.harvard.edu/staying-healthy/abdominal-
fat-...](http://www.health.harvard.edu/staying-healthy/abdominal-fat-and-what-
to-do-about-it)), so minimizing it gives you a non-vain metric and motivation
for getting leaner that should increase your health along a variety of
objective metrics. Now you can't spot reduce fat, so the only way to reduce
visceral body fat is to lose body fat in general (genetics determines at what
point in your fat loss journey your body decides to dip into your visceral
body fat stores for energy). The sidebar in r/fitness and r/loseit have more
information on this improving body composition, but the main points are to
maintain a caloric deficit ([https://examine.com/nutrition/what-should-i-eat-
for-weight-l...](https://examine.com/nutrition/what-should-i-eat-for-weight-
loss/)) and eat enough protein (aim for 1 gram of protein per pound lean body
weight; [https://examine.com/nutrition/how-much-protein-do-i-need-
eve...](https://examine.com/nutrition/how-much-protein-do-i-need-every-day/)).

5) Anyone who's done any time dipping into the research on the diseases of
cognitive decline (e.g., Alzheimer's) will know that, in addition to diet and
exercise, one of the most important things you can do to lower one's risk is
to maintain a life-long habit of learning new things. By that I don't mean
trivia or a Wikipedia page per day (though there's nothing wrong with that),
but the learning of things that require you to really work for improvements.
I'm talking about stuff like music and playing instruments, foreign languages,
pure mathematics, chess, go, art, dance, etc. You have a lifetime so you don't
have to choose just one, just make sure it requires you to put in the work and
struggle a bit for improvement. Coursera's _Learning How to Learn_ course
would be an excellent place to start for the "how" of this, and your own
interests will probably lead you to the "what". (For languages, I'd recommend
the book _Fluent Forever_.)

The only other major factor that seems to really contribute to long-term
health is something that isn't entirely within your control, but you should
still put a lot of effort into it: regular interactions with people you love
like family and friends. If you don't have those, try and go out of your way
to expose yourself to more people so that you can find your people.

Other things in research that have been getting more attention include things
like meditation and practicing gratitude, but their benefits aren't as
objectively measurable as the above, though they're probably well worth
investigating and putting time in to.

Oh, and make sure you prioritize getting sufficient amounts of high quality
sleep. HN has had conversations in the past about this.

In general, "use it or lose it" seems to be a universal law when it comes to
one's mind and body.

~~~
chvid
What you are describing is a level of fitness that maybe 1% of the male
population have at a young age. It is not realistic to keep that level
throughout a full life. And it is probably unconstructive to try.

~~~
sn9
Most people don't know how and never try, which is why it's so rare.

At least as far as the strength goes, maintenance only requires 2 workouts per
week of perhaps an hour apiece.

The body was meant to be used. And people assume it's less capable than it is,
even in old age, but there are people who only started training late in life
that have exceeded my strength recommendations.

------
GCA10
Time to own up to the elephant in the room. Medicine so far has done a really
good job of prolonging people's seventies and eighties. All the symptoms of
advanced aging that used to be compressed into ages 70-82 or so, ending in
death, now can be stretched out from ages 70 to 98.

Will this initiative double the amount of time that we've got the full
capacity of our 20s and 30s? Or will it just allow people a prolonged, half-
century tour of the twilight years, from 70 to 120?

~~~
comboy
You can have pretty much the same mental condition when you are 70-80 years
old as when you are 20-30. But to have that you need to keep using your brain
and challenging it. Old people usually have much less opportunity to stay
mentally active. And less motivation.

Statements above are based mostly on The Brain That Changes Itself by Norman
Doidge[1] which I highly reccomend. Plus just listen to some old folks that
you can tell are still quick - Warren Buffet 86, Chomsky 88, James Harris
Simons 79 and so on.

1\. [https://www.amazon.com/Brain-That-Changes-Itself-
Frontiers/d...](https://www.amazon.com/Brain-That-Changes-Itself-
Frontiers/dp/0143113100)

~~~
tdist
Listing old, famous intellectual people that have retained their wits is poor
a excuse for evidence, since we don't know the ratio between old and famous
intellectuals that have lost their wits vs that have retained them.

~~~
comboy
We also don't know the ratio of those who could retain it if they would keep
thinking hard every day. It's really a lifestyle choice. You can still be
wise, but when you have a lot of money you can just relax and enjoy the nature
without wondering how it works. Some people just love thinking and studies
suggest that it keeps them good at it (refs in that book).

I didn't mean to show by these examples that this is the default, or even that
it's common. I don't think it is. But I hope it's getting better, mostly
thanks to the technological progress which can be stimulating for those who
choose to make use of it.

------
snvzz
There's the sens foundation, working on a "repair the damage we understand as
aging" approach.

[http://www.sens.org/](http://www.sens.org/)

~~~
agumonkey
De Grey is still actively seeking funding btw. (Since we're on YC land..)

------
dpatrick86
Great interview. I thought his comments about the upper limits of human
lifespan were especially interesting:

> There currently is an upper limit, and the upper limit is probably around
> 115, 120. You have a very large number—100 billion people to choose the
> number of people that have ever lived—and you have only one who has made it
> through to 122, Jeanne Calment. The second oldest was 119. It does seem
> there is an upper limit. Some people have shown that in the last hundred
> years, even though we have progressively increased the average lifespan, the
> number of people who live above 115 has not increased.

I also couldn't help but think that his remarks about immortality being the
naughty "I-word" is a roundabout way of addressing some of the excitement
stirred by a certain slightly sensationalistic wizardly chap in the aging
field.

~~~
neom
While immorality might be a stretch, CRISPR is certainly going to change how
we think about longevity in a sensationally magical way.

~~~
RivieraKid
How? CRISPR is overhyped. We don't even understand aging sufficiently enough.

~~~
kobeya
We don't currently is not he same as we won't ever.

------
Techowl
The Buck Institute [0], featured in this article, is a pretty outstanding
organization -- they're unique in being a sizable research center devoted to
researching aging. I'm excited to see their idea of age-related diseases as
biological maintenance problems gaining some traction.

I'm not entirely sure where the interviewer was going with this statement,
though.

> There’s a lot of Silicon-Valley buzz about longevity and many startups
> working to develop immortality pills.

I've yet to hear of a startup working on an "immortality pill."

[0] - [https://www.buckinstitute.org/](https://www.buckinstitute.org/)

~~~
reasonattlm
There are certainly startups / small companies working on rejuvenation
therapies, however, ways to repair the forms of damage that cause aging rather
than merely slowing down that damage a little as is the case for calorie
restriction mimetic drug development.

See for example these entities working on means to selectively remove
senescent cells, with Unity Biotechnolgy being the one connected to Buck
Institute researchers:

[https://oisinbio.com/](https://oisinbio.com/)

[http://unitybiotechnology.com/](http://unitybiotechnology.com/)

[http://www.siwatherapeutics.com/](http://www.siwatherapeutics.com/)

The presence of senescent cells have been shown to directly cause failure of
regeneration, fibrosis, fibrotic lung diseases, loss of tissue elasticity,
blood vessel calcification, faster progression of atherosclerosic lesions,
arthritis, chronic inflammation, immune system dysfunction, and retinal
degeneration, just to name a few items from papers published in the past two
years. More links are being established in research papers with each passing
year. The removal of these cells has been shown in mouse studies to quickly
reverse the age-related progression of many of these items.

~~~
msie
Any human trials yet?

~~~
reasonattlm
Unity will be starting human trials this year, so far as we know.

Oisin will follow later this year or in 2018, if they keep to the standard way
in which things work in biotech companies following an A round.

I have no idea what SIWA will be doing; they have been around on life support
for a while, and now resurrected by the newfound money coming into the field.
I'd imagine that their next step would be some form of trial, though it is
unclear as to where exactly they are in their animal study schedule.

There are people self-experimenting with senolytic drug candidates now, though
not in any way that will provide useful data. If you draw the line at
candidates for which there is in vivo evidence in mammals, you're left with
just the chemotherapeutics and foxo4-dri. (A pity that fisetin has no in vivo
evidence yet...). The chemotherapeutics are worth skipping over, since they
are ugly chemicals and really only a starting point for the development of
analogs without the horrible side-effects, and foxo4-dri hasn't been tested in
any formal way in humans yet.

At the pace at which new drug candidates are emerging and being tested, a
couple of years from now would be a good time to be self-experimenting.

------
agumonkey
I've seen some people in this field, I don't know how mature is their research
but they're not joking. Funny that they still encounter resistance based on
superficial argument and lack of renown.

------
rubber_duck
Hmm he says "Exercise is an incredible anti-aging medicine." but doesn't go
specific. Does this mean cardio workout or strength training ? I do very
little cardio but I do strength training >5h week - I wonder how those two
stack up in terms of long term health.

I remember reading that if you got enough ST you essentially get the same
cardiovascular benefits of cardio but I can't find the source.

------
paulcole
If they live long enough, some people may actually get paid by Nautilus.

------
Razengan
So we have the following use cases for immortality:

• "Selfish" vanity, fear, etc. including accumulation of wealth, power, etc.

• A desire to remain with loved ones, including pets, and to keep loved ones
around, including celebrities.

• A safeguard against unexpected "unfair" death, e.g. getting murdered,
assassinated or dying in a freak accident, or terrorist attack etc.

• Carrying out long-term plans that take longer than human lifespans.

• Participating in projects that take longer than human lifespans and may not
be easily restocked with new humans: e.g. traveling interstellar distances in
confined spaceships.

\- The aforementioned "plans" and "projects" may simply mean the preservation
and protection of certain things, ideas, cultures, rituals and records that
cannot be automated or archived.

• A desire to explore more of the universe than can be done in a mortal
lifespan.

\----

And the following possible ways where one or more of the above goals may be
achieved:

• Cloning. You basically get a new person that may or may not be "as good" as
the loved person/pet/celebrity you wanted to preserve.

• Mind/Memory archival/copying.

• Repairing/Rejuvenating one body for as long as you can.

• Separating the brain from the body and having it remotely control multiple
"backup" bodies.

• Reincarnation. This of course assumes a "higher" plane of existence where
our "true selves" actually live; e.g. this reality being a VR MMO that you can
only play for as long as you paid for.

~~~
melling
Did you read the article?

"First, if you hear the word immortality, just run"

No one is talking about immortality here.

~~~
Razengan
I'm making the cases for it!

After all, it's the culmination of all medical research, whether intended or
not. What happens when science "solves" aging and disease? What will we call
the state where people just don't die unless killed?

~~~
miloshadzic
Hell

~~~
Razengan
It would actually be closer to the idea of a heaven in some cultures.

