Longevity Philosophy

5 Big Ideas That Will Deliver More Years NOW

The longevity space is filled with empty claims! For example:

-              This supplement will extend your life (C15, spermidine, D3, fish oil, etc.)

Truth:

No supplement has ever been shown to extend human life in all comers (outside of a nutrient deficiency). If your Longevity provider has you on a supplement subscription for life extension…..you are being played.

-              This drug, peptide, hormone will extend life

Truth:

No drug, peptide, or hormone has ever been shown to extend lifespan in all comers in a human clinical research trial (outside of a specific clinical indication. E.g. hypertension [referred to as a mortality benefit]). Some commonly used “longevity treatments” like growth hormone, may even shorten life.

-              AI will revolutionize longevity and we are close to longevity escape velocity.

Truth:

AI is revolutionizing data accumulation, handling, and analysis. However AI is yet to extend lifespan in humans at all. Until AI leads to any measurable life extension, this claim remains unproven. Until we can measurably slow aging (beyond proven lifestyle interventions), longevity escape velocity will remain in the realm of science fiction.

Now, I sincerely hope that in the near future we have medications and supplements that can extend life. I hope AI, and its ability to analyze huge datasets, will lead to proven life extending therapies.  I even believe that many of these things are coming (if we avoid a major societal setback – e.g. The Dark Ages, part 2).

But for now, they are not here. Might some drugs that extend human lifespan be hiding among us (rapamycin, SGLT2 inhibitors, GLP1 agonists, metformin)…..absolutely and hopefully. But none have been validated to do so clinically to date.

So is Longevity Medicine legit. YES. BIG TIME.

But lets focus on what works now, in the present moment. What philosophies will deliver LONGEVITY now?

5 BIG IDEAS

1.        What gets measured gets managed

-              We are all in denial about the stat of our health and avoid the things we need to do most

-              This is true for individuals as well as societally on a macro scale

-              The Cure (Individual Scale) measure your health and fitness with regular testing

-              (Macro Scale) Measure the effect of policies, city layouts, businesses, and public programs on society.

-              Without measuring something, it is nearly impossible to manage or improve it.

-              Prevention and prediction are ripe and ready to increase human longevity today. The signs of chronic disease can be picked up and measured years before formal diagnosis. Preventing disease will extend lifespan and healthspan. Prevention and prediction starts with measuring. Look and you will find. This is a place AI will help. AI is also deriving data from things like chest xrays and other diagnostics. Things that humans are unable to see (e.g. risk of afib and cardiac death from a chest xray alone)

-              If you never check your blood pressure, kidney function, cholesterol, or fitness level you may be ignoring a serious problem. Start measuring them, and you will not help but be able to do something about any concerning findings.

-              As a PCP, I frequently ask sedentary people how their fitness is in clinic or the hospital. They usually told me “good”. Then when I measured them on cardiopulmonary exercise test or a PT evaluation in the hospital, it opened their eyes. Not only does measuring diagnose their poor fitness, but most people even feel compelled to start improving it.

2.        We must engineer our environments to maximize longevity.

-              Behavior is out of our control

-              We cannot escape our environment, but we can engineer it

-              Again, This is true on a personal and macro level, societal level.

-              Cities with more walking paths, gyms, less air pollution, better water, more community engagement, and etc. will lead to improved human longevity.

-              People who engineer their environment for health live longer

-              Example: My patient goes home and drinks 5 ETOH drinks nightly. They kept saying, “Im just gonna stop”. It did not work. What did work: changing their environment. The patient was unable to move, the wife liked wine so getting ETOH out of the house, was not possible. What did help: Patient told his spouse to give him trouble when he had a drink; he started an early morning workout plan so you don’t have the energy to drink at night. Pretty soon he got so into working out, that drinking regularly just didn’t work for him anymore. His environment changed. His behaviors followed.

3.        Improving fitness is the best longevity intervention we have

-              Great fitness offers individuals a 400% reduction in all-cause mortality and decades to healthspan.

-              Improving fitness improves grit, the most desirable longevity trait. Its hard to have grit if you are out of shape, and wear out very easily..

-              When I take care of critically ill patients, their physiology looks the same as a person running a marathon. Fitness makes you more able to survive serious illness. To keep going when death comes knocking

-              When I take care of elderly folks in the hospital, the reason they need nursing homes is immobility and lack of strength. When elderly patients become unable to get out of bed, death often follows quickly.

-              A lot of longevity people have told me “Im tired of hearing about exercise”. Instead they want to talk about sexier longevity  topics (e.g. epigenetic programming) that are in no way available to humans at this time. As a clinician, I am obsessed with fitness. Fitness is fundamental to longevity and it’s the best tool we have. Its also what I see people loose later in life and lead to disease and death. Loosing fitness ruins peoples lives. Additionally, nothing is more sexy than being fit. Its basically being younger.

4.        Questions are much more important than answers

-              Answers are constantly changing, the right questions are timeless

-              This is why clinical research and medical practice must become one. I

-              Static papers are not enough. We need to be investigating constantly and plans must be updated constantly

-              1000 years ago the most common cause of death was probably death a at childbirth, accidents, infections, homicide, etc. Today it is heart disease. The answer changes, but the question remains critically important, “what is killing people”.

-              I was super bummed that my professional liability insurance was so much higher because I run my health screening program at Longetrics as a clinical trial. Constantly studying and analyzing results should be encouraged and even part of standard practice. Not something that is penalized or considered a risk.

5.        Hardcore longevity is boring all the time. Make sure to have some fun along the way.

-              Never forget to party, celebrate, adventure, and take risks. Life is short

-              Its always ok to take calculated risks – yes I will be drinking ETOH at your wedding, climbing mountains, flying plains, Thai Kickboxing, and eating ice cream by the pint occasionally, and etc.

-              In spite of Big Idea 2 (Environment) I am just not in favor of banning things like soda, cigarettes, donuts, human drivers, cannabis, ETOH, and many other things that are harmful but immediately pleasurable. I am certainly down to tax them a little more and give people better tools to avoid them. But, lets not get crazy. Life remains short and ice cream tastes incredible.

-              Moderation is key. But sometimes, Let's F***ing Party!

Allow me to introduce a new Longevity term:

LAMEGEVITY

Definition: Years of life lost going over the top trying to do unproven things or just ruining your life from a strict lifestyle adherence regimen (I go to bed every night at 8am without exception).

Don’t let Lamegevity get you. Live your life.

References

-              This is an opinion piece. I encourage you to fact check everything though. You will find that all of the claims are supported by data. Your supplement subscription is probably wack, at least if you are thinking it will help you live longer.