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Are the Longevity Benefits of Acarbose Rooted in Its Role on the Gut Microbiota? (gethealthspan.com)
74 points by rpkoven 8 months ago | hide | past | favorite | 24 comments



For anyone even remotely interested in learning how research happens and how research should happen if it happens well, you should listen to the Peter Attia podcast with Richard Miller who runs the ITP program mentioned here. It’s definitely the most thoughtful research program that I can think of that’s currently running. https://peterattiamd.com/richardmiller/

Having said that Acarbose was still only shown to extend life in mice. The moment something is about gut microbiome I start losing confidence in the ability of mouse models in predicting human behavior.

When I originally heard about Acarbose in this episode I looked up Reddit as I usually do and the scant mentions all recalled smelly flatulence as a gross side effect. Take that for what you want! Not to mention it worked only in male mice and we have no idea how! This is not confidence inducing especially if you’re committing to becoming horrendously smelly!


> it worked only in male mice

There are multiple studies. The larger ones seem to find it working in female mice, too [1].

[1] https://pubmed.ncbi.nlm.nih.gov/30688027/


Sure but the discrepancy is too Much, suggesting a hormonal component. Which is all the more confusing since this blog post (leaving aside its preachiness) was about gut microbiome based efficacy. Thus the efficacy of this drug is validated in mice while its mechanisms is incontrovertibly spread along two dimensions I wouldn’t even individually trust to translate well from mice to humans, leave alone synergistically.


> acarbose was one of five molecules shown to increase lifespan

Rapacmycin, acarbose, glycine, canagliflozin and 17-a-estradiol [1]. Acarbose’s side effects include “flatulence (78% of patients) and diarrhea (14% of patients)” [2]. (It also appears to be hard on the liver.)

[1] https://www.nia.nih.gov/research/dab/interventions-testing-p...

[2] https://en.wikipedia.org/wiki/Acarbose


Most well-documented pharmacological intervention to increase lifespan in aspirin. The most well-documented non-pharmacological is caloric restriction (with some evidence showing protein restriction).


Why are diabetes drugs so often radically powerful for general health?

i.e. semaglutide for weight loss, canagliflozin for longevity, etc.


When insulin stops doing what it's supposed to (= diabetes) then a lot of bad stuff happens. Improving insulin function (insulin sensitivity) is the main principle behind many current diet-based health interventions such as intermediate fasting, keto dieting, apple cider vinegar, and so on.

Diabetes drugs improve or replace the role of insulin, through differing mechanisms, so it makes sense that they would have some of the same benefits.


Because we eat ourselves to death.


It would be interesting to see acarbose's lifespan effects compared to inulin in mice. Inulin has similar side effects in some people, hence why sunchokes/Jerusalem artichokes are also called "fartichokes".


> glycine

It’s fairly safe to discount any study that indicates significant health effects from a nonessential amino acid, especially in animal models.


> safe to discount any study that indicates significant health effects from a nonessential amino acid

One, that’s too much confidence for a topic we do not understand well. Two, the study found—with startlingly high confidence and a meaningful, if small, effect size—glycine “can mitigate methionine toxicity,” the latter being an essential amino acid [1].

[1] https://pubmed.ncbi.nlm.nih.gov/30916479/


Well the research is on rats. not to mention that the glycine specific one is funded by a glycine selling company. But despite all that, glycine has strong research backing it especially for reducing inflammation and allergies.


You know SALT is considered bad for you at high doses right?


I'd be interested to see if acarbose extends the life of obligate carnivores.

As far as I know the mice get a high sugar/starch diet, but afaik nobody ever stopped to see if they live longer on a high fat/high protein diet or not. not sure about this though.


At the center of all of this is short chain fatty acids. Higher levels of SCFAs are already known to be good for your health. With a healthy diet they can be driven up, too.


isn't it due to lowering blood sugar spikes? If so, I noticed that my blood sugar does not spike after a meal if I just walk casually on a treadmill for maybe 15 minutes after eating.


Always be wary of headlines structured like this:

“Are the Longevity Benefits of Acarbose Rooted in Its Effect on the Gut Microbiota?”

It presents something as fact (Acarbose has longevity benefits) in the form of a question. This sort of structure implies that it’s already been widely accepted as fact that this is true without overtly saying it and it’s commonly used in marketing to slip things by the brain’s natural BS filter. You can also commonly see this in agenda-driven media headlines.

The truth is that Acarbose hasn’t been shown to have longevity benefits in anything but mice, and even that research is questionable at best.

If you need further proof that this is marketing, notice the “products” button on the upper right, where the website that published this article happens to sell…you guessed it…Acarbose. The guy who wrote the article, Daniel Tawfik, is the founder of Zenpatient, the online pharmacy used to sell this and other medications.

We’re being marketed to. I’m flagging this post. It’s spam.


I think it is. I'm lactose intolerant, and somebody posted in one of the LI forums this morning asking about acarbose. I had never heard of it until today, and now it has also appeared on HN.


[flagged]


The relatively short US life expectancy at birth is mostly due to drug related and violent early deaths. Those middle aged US-Americans that are browsing the web for longevity drugs can expect to live as long as similar demographics in Europe and elsewhere, even without the drugs.


I’m sure diet also plays a role. I want a tool where I can ask “if an American man is not obese, doesn’t smoke/do drugs/drink alcohol, and is not predisposed to violent early death, what is the average lifespan for people with his characteristics?”


Would this be any different than “if a British man is not obese…” or “if a German man is not obese…”

I don’t think the interest in living longer is unique to Americans or something.


Totally agreed, “American” is interchangeable here


These aren’t exclusive searches.

Magical chemicals are used in addition to diet and exercise (the most well-known life extension intervention).

I don’t think anyone is “obsessed with miracle drugs” so much as they are just interested in useful info to live longer.


It's the same thing you see in the nootropics community- the more sick you are and the more you struggle to do anything about it, the more you want easy solutions that usually aren't there




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