It’s a classic example of the easy pitfalls that take place in this space. One lab using one type of largely irrelevant animal model found a positive result, but that result had no bearing on what would be seen in more models and certainly not what would be apparent in the species of interest, which is us, humans. The lesson is that we have to be much more skeptical of geroprotective agents, and we probably want to see “success” across multiple species that span a much greater segment of evolutionary time. Even then, there will never be a substitute for some sort of human study that demonstrates efficacy – if not in a hard outcome that relates to lifespan, at least in a soft outcome that relates to some measure of healthspan.
I still remain optimistic about the drug rapamycin. We are still very early in the understanding of what this drug might do for humans, though we are quite advanced in our understanding of what it does for animals. And generally without exception, the results are more significant for rapamycin in non-human models than any other drug or molecule that’s ever been tested. I think the next decade will tell us a lot about the potential benefit in humans.
If you had to recommend one thing for someone to do to improve their health or maximize healthspan, what would that be? OK, what’s the number two?
Unfortunately, these questions are categorically impossible to answer without knowing more about the “someone” in question. For example, if you were asking this in the context of a person who doesn’t exercise, then both my number one and number two recommendation would be to exercise. Because the benefits in terms of all-cause mortality when you go from zero exercise to just three hours a week of exercise is about a 50% improvement. Nothing else would match this, including the cessation of smoking.
Similarly, if I encountered a person who was sleeping only four hours per night, this would probably be the number one thing I would have to adjust before making any other recommendation because no other recommendation would even stick in the context of a person who is sleeping so poorly. So while it’s tempting to have lists of priorities, it really depends on the individual and where they’re starting.
How do you see social media impacting people’s health, and/or the information about health, positively or negatively? And what can be done to make people’s usual sources of information more relevant or valuable or accurate?
Social media is a tool, and like any tool, it has some positive effects, and it has some negative effects. I’m not an expert in this, so speaking only from my own personal experience and the bits that I have read on behalf of people who are far more knowledgeable on this topic, it would seem to me that social media is a net negative, but there are ways that one can use it to limit its negativity. One example is how little time you spend on it, how little time you spend, for example, reading comments.
For me personally, I have a phone that does not have any social media on it. It doesn’t have any apps that would allow me to look at social media. So I’ve made it very easy to go places and still access my phone and camera (which is probably my favorite feature on a phone), but I can’t look at Twitter, Instagram, or anything else. I have found that doing that makes me a lot happier than when I have access to those things, which is part of what tells me that those things are generally a net negative.
At the same time, I certainly use social media as a tool to spread information and as a way to gather some information, and in that context, I find it useful. Of course, not all information we find on social media is accurate, so it’s important to consider the source. I look for content from experts in medicine and scientific research – not popular press and trending hashtags – as the most reliable sources and opinions.
Can you say more about healthspan versus lifespan?
When people hear the word longevity, the knee-jerk reaction is to think only of lifespan. And many understandably have a negative reaction to the word longevity because they view it only as lifespan extension, which people correctly accept is not of particular value if quality of life is not matching it. Therefore, a more complete definition is necessary which includes healthspan, the quality of life.
It’s tragic to have a very short lifespan even with good health (such as someone dying young in an accident), and similarly, an extremely long lifespan without healthspan is also tragic because it is a life of misery. So our goal should be to optimize both of these – to live longer, but more importantly, to live well during as much of life as possible.
How do you recommend people modify their approach to healthspan if they are starting at age 20 versus 40 versus 60 versus 80 for example?
The fundamental difference between these ages is what’s achievable. The 20-year-old has the same advantage for health that a 20-year-old has with saving for retirement – they don’t really need to save that much of their paycheck every week, and they don’t need an exceptionally high rate of return on that investment to ensure that they have more than adequate resources at the latter part of their life. But they also have a disadvantage in that the motivation to save for the future might be lacking because the future is very abstract.
Conversely, the 80-year-old has no difficulty with motivation for saving if they find themselves with insufficient funds. However, they don’t have a very long runway in order to make up for the deficit. And of course the same is true with health. The 20-year-old doesn’t really need to do Herculean things or make living longer their full-time job to reap enormous benefits 60 or 70 years hence. The problem is that most people in their 20s are, at best, thinking about short-term performance or looks, etc, and at worst, not thinking about this at all. And at the other end of the spectrum, the 80-year-old is all too familiar with her mortality, but if she hasn’t done anything about it until she reaches that age, she will have far less ability to course-correct.
