Ageless: The New Science of Getting Older Without Getting Old, by Andrew Steele

• Category: Non-fiction
• Rating: 3 out of 5
• Tags: Ageing, Human Longevity
• How I learned about it: Review in The Economist

My update on longevity research continues with Ageless, by Andrew Steele (See also The Price of Immortality, by Peter Ward).  Unlike Peter Ward’s book, which includes anecdotes about the weird side of the immortalist movement, Ageless is a serious and comprehensive look at the scientific research into the causes of ageing and its prevention.

Steele advocates for a new way of looking at ageing, moving from the treatment of individual age-related conditions like heart disease, cancer, arthritis, and dementia to treating ageing as a single condition.  He notes that currently, drugs are only approved if they treat a specific disease, and ageing isn’t on the list, so regulatory bodies like the US FDA wouldn’t approve a treatment for ageing if one was invented.  (This seems far-fetched to me, as a successful treatment for ageing would treat a wide range of specific diseases, and presumably the FDA would rush to approve such a beneficial treatment).

There are objections to a deliberate program to increase longevity, which could lead to overpopulation and environmental damage, or might benefit only the rich and powerful, and would allow tyrants to live longer, too.  Steele neatly overrides these objections with a conceptual reversal: if ageing didn’t already exist, you wouldn’t invent it as a solution to these problems, thus condemning billions to the suffering brought on by the conditions of old age.

There’s a familiar laundry-list of the categories into which the causes of age-related problems fall, including accumulated genetic and epigenetic damage, shortened telomeres, reduced autophagy and accumulation of senescent cells, malfunctioning mitochondria and chemical signaling, changes in the microbiome of the gut, and immune system decline.  Research shows there is potential for treating many of these conditions, using drugs, stem cell therapy, microbiome treatment, young blood to rejuvenate older bodies, or gene therapy.  Fasting shows promise, too – you might be able to “Live, Fast, Die Old.”  Yeast, worms, flies, spiders, fish, mice, rats, hamsters, dogs, and rhesus monkeys (although that’s ambiguous) live 50 to 85% longer with severe dietary restriction, although people who try it report irritability, that they feel the cold more, and have decreased libido.

For now, the best advice to improve your health and lifespan is pretty basic.  Don’t smoke, don’t’ get fat, and eat healthily – not too much, reduce meat, eat a variety of fruits and vegetables, reduce foods high in sugar and fat, don’t drink much alcohol.  Exercise, and get 7-8 hours sleep a night.  Get vaccinated, wash your hands, wear sunscreen, brush your teeth, and keep blood pressure low.  Be a woman.  Don’t take supplements (unless you have a specific vitamin deficiency) – that’s just a way to make expensive urine.  Unsurprisingly, Steele doesn’t suggest male castration as a way to extend lifespan – if done before puberty, it adds years to your life.

Trials are underway.  In the meantime, you can only eat right, keep fit, and wait.

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The Price of Immortality: The Race to Live Forever, by Peter Ward

• Category: Non-fiction
• Rating: 2 out of 5
• Tags: Ageing, Immortality, Human Longevity
• How I learned about it: Library catalogue and Economist Review

The last book I read about extending human longevity came out in 2010 (see Long for This World, by Jonathon Weiner), so I thought it was time for an update.  “The Price of Immortality” is described as being in the spirit of Jon Ronson, which intrigued me since I’ve enjoyed some of Ronson’s work like The Psychopath Test and The Men Who Stare at Goats.

“The Price of Immortality” contains an odd mix: there are serious summaries of the latest scientific longevity research, alongside descriptions of fringe-element “immortalists” who have a nearly religious faith that immortality is within reach, meeting in church to hear overly-optimistic “sermons” from longevity experts and promoters; taking supplements instead of sacrament.

Immortalists pin their hopes on technologies like cryonics, which has had a history of being underfunded and unscientific.  Some hope to upload their consciousness into some form of digital storage, or that nanotech will enable cellular-level repair.

Cryonics is the “freeze and wait” approach, in which your dead body is preserved by freezing in the hope that future technologies can repair the damage and bring you back to life.  Scientists wanted to work in the lab and on animals instead of jumping straight to people.  Impatient immortalists wanted to get going right away, and some tried to set up services to meet the demand.  Lack of planning led to some wacky events, like frozen bodies being stored in places like a garage and an industrial park, or hauled around in a truck packed with dry ice.  Mortuaries had no means to prepare bodies for cryopreservation, so they were prepared illegally at the cryonics services office.  When money ran out to keep bodies frozen, they were left in the open to decompose.  Running short on containers to store frozen bodies, one guy squeezed several bodies into a one-person capsule, partially thawing the bodies so they could be squeezed in.

There are some equally wacky treatments offered for longevity – one speaker at a longevity conference recommended “rectally administered ozone therapy”.  “So just to recap: [he] told…attendees…to take a toxic gas and literally blow it up their own asses.”  It’s almost as if the speaker was trying to see how absurd he could be before the audience caught on and chucked him out.  There are lots of diets, supplements and fake stem cell therapies that don’t work, but which people are happy to sell you.

On the more serious side, we meet Aubrey de Grey and learn the concept of “escape velocity,” the point at which new technologies keep you alive long enough for the next new treatment to keep you going, and so on indefinitely.  We learn the nine hallmarks of aging, including epigenetic alteration, cellular senescence, stem cell exhaustion, and telomere shortening, all areas of promising research, but none of which has yet produced a viable treatment for humans.  There’s a telling quote from Dr. Judith Campisi, who was able to extend the health span (but not the life span) of mice in her research on cellular senescence.  While she agrees that research can find ways to treat the symptoms of aging, she says, “I can guarantee one thing: you will die one day.”

There are those who think they can live longer and those who want to live forever.  Impatient immortalists, frustrated by regulatory barriers, indulge in self-experimentation to speed progress, or ask that terminally ill patients be allowed to try experimental anti-aging treatments to accelerate advancement.

Jon Ronson is great at presenting absurd material in a dryly humorous way, and I was hoping for more of the same from Peter Ward.  Unfortunately, I was disappointed – there is plenty of absurdity in “The Price of Immortality”, but somehow it fails to capitalize on the humour value.

 

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Younger Next Year: Live Strong, Fit, Sexy, and Smart – Until You’re 80 and Beyond, by Chris Crowley and Henry S. Lodge, MD

Category: Non-fiction; Rating: 3 out of 5; Ageing, Fitness, Health

The thinking about ageing has changed in the last couple of decades.  We used to be told that there wasn’t a lot we could do to change the trajectory of our declining years.  The biggest factor in determining lifespan, we were told, was genetic – if your parents lived a long time, then so might you.  Similarly, we were told to expect a constant, steady decline in our fitness and health as we aged, and there wasn’t much we could do about it.

Turns out that’s wrong.  Regular, vigorous exercise and a healthy diet can actually prevent around 70% of the decay associated with ageing.  The sore joints, obesity and apathy attributed to so-called “normal” ageing aren’t normal at all, and can be prevented.  It’s no big secret: the key is to exercise regularly and eat healthily.  Younger Next Year recommends vigorous exercise six times a week, including four sessions of aerobic exercise and two of resistance training (weights).

“Vigorous” means that you have to work pretty hard, going to failure with the weights, and including time at 70-75% of your maximum heart rate plus some all-out sprints during your aerobic workouts (but only after you’ve slowly worked up to it if you haven’t been exercising regularly already).

The advice about nutrition is straight-forward – stop eating crap.  Don’t diet, just eat sensibly, and not too much.

There’s one more requirement for a long and healthy life, and that’s to care.  Whether it’s a loved one, a community, a job or a cause, people with someone or something to care about do better than those who don’t.

There’s nothing here that we don’t already know, but there is something about the way this book is written that makes it an effective motivator.  It emphasizes the control we have over our health, the benefits of healthy behaviour, and the ailments we can prevent.

It’s not really an exercise book, as it doesn’t go into a lot of detail about what to do – there are no lists of weight-lifting exercises or recommended run-walk-sprint intervals.  It’s not a diet book, either, as it doesn’t have any meal plans or calorie counts.  What it really is, as a friend of mine commented, is a “crowbar” book – it pries you off the couch and gets you moving, and that’s a very good thing.

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The Longevity Paradox: How to Die Young at a Ripe Old Age, by Steven R. Gundry, MD

Category: Non-Fiction;  Rating: 2 out of 5;  Tags: Health, Diet, Ageing, Microbiome

I’m pretty sure that if I asked a bunch of general practitioners or nutritionists for their best advice for living a long and healthy life, they would say the usual:  exercise, eat lots of vegetables and some fresh fruit.  Eat fish, chicken, and a little red meat.  Avoid sugar, fast food, junk food, and fried food.  Maintain a healthy weight.  Don’t smoke.  Drink alcohol in moderation.

However, there are lots of books that question this advice.  They say that the established medical community is mistaken, and/or that the authorities have provided deliberately misleading advice.  Depending on who you believe, you should eat fat, not eat fat, or eat only certain kinds of fat.  You should avoid salt and sugar, or eat what your body craves.  You should fast, graze lightly all day, or skip dinner.  Avoid red meat, or all meat, or carbs.  Eat naturally fermented foods, or lots of supplements, or probiotics.

Gundry’s theory, based on his clinical experience, is that the secret to a long and healthy life is to eat in a way that keep your population of gut bacteria in a healthful balance and avoids “leaky gut” syndrome.  He claims that the benefits include better health in almost all ways, both physical and mental, supporting these claims with anecdotes about patients who have, for example, miraculously reversed the effects of severe arthritis.

Gundry might be right, but I’m not buying it.  He started to lose me when he began referring to the intestinal microbiome as my “gut buddies.”  I’m all for making complex scientific ideas understandable, but that’s dumbing things down a bit much for me.  Then he made vague claims about how bad the food supply is:  Glyphosphate, the active ingredient in the weed-killer Round-up, was found in 93 percent of urine samples tested.  But detectable does not mean harmful, and Gundry does not examine the evidence further.

Gundry claims that “all cognitive decline stems from the same root cause: neuroimflammation,” which “is now recognized as the true cause of serious degenerative diseases such as Parkinson’s, Alzheimer’s, and dementia”, and which starts in the gut.  That’s news to me, since I I thought that the causes of Alzheimer’s were still poorly understood.  And earlier in the book, Gundry says we should not eat animal protein, because it’s rich in iron, which increases the risk of Alzheimer’s disease.  The contradictory claims could be resolved if the problem with iron was that it caused inflammation, but it’s not; iron is instead supposed to cause problems with mitochondria.

Gundry has an interesting theory, and there is evidence showing that overall health is related to the gut bacteria, but I’m not ready to adopt the rather extreme diet he recommends: limited dairy, no grains, limited fruits, no sugar, no eggs, no vegetable oil (except olive oil), and limited animal protein.

Long for this World: The Strange Science of Immortality, by Jonathan Weiner

Wouldn’t it be great if we never aged?  If all the diseases of ageing could be prevented, treated, or cured, we’d be effectively immortal; our lives shortened only by accident or violence.  But would it really be great?  Apart from the problem of boredom, Weiner reminds us that it’s not just good people who’d be around for a long, long time; while we were trying to enjoy our lives, we might also have to endure the company of great tyrants and dictators.  So there are two questions explored in this book: can we significantly lengthen human lifespans, and if so, should we?

The argument that we can is supported by a colourful Cambridge University programmer and amateur theoretical biologist named Aubrey David Nicholas Jasper de Grey.  We all get the terminal disease of ageing, which has been described elsewhere as nothing less than a crime against humanity.  If it’s a medical problem, we can treat it, and if we can, de Grey believes we should.  He thinks there may be no limit to the human lifespan, that the gains over the last century or two, which added decades to our lives, can be made to seem trivial.  He talks of lifespans of one to two thousand years.  He thinks if we’re not pursuing longevity, we’re wasting time, letting people die while we fail to tackle the single greatest problem faced by humanity.  He breaks the problem down into a mere seven major sub-problems, and proposes a strategy for tackling each one.  It may sound easy (solve just seven problems, and we’re immortal!), but Weiner points out that de Grey’s list of problems bears a close resemblance to a list of the most difficult problems in medicine.  One, for example, is a cure for cancer.

Aubrey de Grey has his supporters, but other scientists studying ageing are much more cautious.  They talk about incremental gains in lifespan as small problems are solved.  This is more helpful than it may sound – life expectancy is still rising by about two years per decade, or about five hours per day.  So for every day we live, we get an extra five hours of life.  Aubrey de Grey extrapolates this to what he calls “escape velocity,” the point at which you live just long enough for a cure for your next disease to have been found before you get it.

The seven problems of ageing can be briefly summarized – there’s junk that builds up, both inside and outside cells.  There are mutations, both inside the nucleus and in mitochondrial DNA.  There are cells that form tumours, and cells that stop dividing and die.  And there are molecular crosslinks that gradually form and stiffen up all our tissues.  The details involve things like tau tangles and beta-amyloid protein (the junk between nerve cells), lipofuscin (the junk inside cells) and telomeres (the bit at the tip of a chromosome that shortens each time a cell divides, limiting the number of divisions).  The solutions involve genetic engineering, drugs to stimulate the immune system and cellular clean-up systems, and more drugs to fix the crosslinks.  The proposed cure for cancer is the most radical, requiring genetic engineering and rounds of chemo, followed by a lifetime requirement for top-ups of stem cells.  None of it’s easy, but we could do it!

In contrast to the techno-enthusiasm of immortalists like Aubrey de Grey, Weiner provides snippets from history and literature to illustrate changing attitudes toward ageing, longevity and immortality.  We are a long way from achieving escape velocity.  There’s still time to decide what to do when we get there.