The field of longevity medicine is just beginning to get its footing in science. Like any nascent and exciting field, there will be people who go all-in on the hype cycle – but it is important to reflect on the fact that, at the present moment, we are at the peak of inflated expectations.
The promise of longevity science designing a tonic or elixir that reveals the fountain of youth has long been a goal for humans who desire to cheat death. We must balance safety and efficacy with any intervention – the current “silver bullet” pills, drips, and peptides being promoted exist within an influencer echo chamber, not the evidence-based arena in which we practice medicine.
But there are legitimate scientists and academic laboratories around the world working to understand how a single intervention affects one of the most complex systems in the known universe: the human body.
This week, Dr. Jordan Shlain, Dr. Natalie Walsh, Dr. Justin Lofti, and Dr. Nima Afshar are sifting through the clickbait headlines and fascinating cocktail conversations to parse out what is real, what is overblown, and some practical steps one can take now.
While the longevity field lurches forward, we need to ask hard questions about the ethics and the science that’s emerging.
Last month, our partners at Neo.Life attended the Aging Research and Drug Development annual conference in Copenhagen. This is one of the early and important conferences that brings together the starry-eyed, the dreamers, the tinkerers, and legitimate scientists. The takeaways from that meeting were: lots to be excited about, lots of hard work ahead, ethics need to be center stage, and diversity is key. These are the key lessons from the field that our innovation team keeps coming back to – and it’s no different this month.
Many people, both inside and outside the field of medicine, are eager to partake in treatments and interventions that have not yet been proven in clinical trials. But in doing so, it’s not enough to say, “I feel better,” or “I don’t feel any side effects.” Rather, the single most important question to answer is: Is this promoting longevity or is it shortening my life? If this question cannot be answered, we think that it’s best to wait for the science to catch up to our existential desire to defeat aging. We need data – and the data is coming; yet it will take patience and the fullness of time.
“I always tell patients that we’re interested in what’s next, but there isn’t great evidence [yet],” says Dr. Justin Lofti of the drugs and interventions emerging in the longevity field. There’s a “difference between finding something in a petri dish versus having clinical results.” This evidence is what our doctors always come back to.
In response to Dr. Lofti, Dr. Natalie Walsh notes that interventions that work in mice, flies, and nematodes “just doesn’t translate [to humans] yet.” One example our doctors come back to is dogs and chocolate: As much as we see dogs as our best friends, if we give them chocolate they can die (of course, it’s perfectly safe for humans to eat chocolate). This is just to point out that if a science experiment works in a worm, that is a long way from a dog.
But the evidence that we do have for how to live a longer, healthier life is strong. “Ninety-three percent of it is lifestyle,” says Dr. Nima Afshar. “Diet, exercise, sleep, how much alcohol are we supposed to drink? There is clear evidence about the proper amount for the longest lifespan.”
“…at what point do you have enough data and enough confidence that this treatment does no harm and does provide benefit?”
It’s easy to get lost in “longevity fever” – this focus on living to 150. “I call it silver-bullet syndrome,” says Dr. Jordan Shlain. People are in search of a magic pill that will make them live longer. But “what it all boils down to is: Is it better to do something or is better to do nothing?” All the emerging interventions still have unknowns (what are the side effects? What are the benefits?). “The question is, at what point do you have enough data and enough confidence that this treatment does no harm and does provide benefit?” says Dr. Shlain. “This idea that medicine has a component of magic to it” – that you can take a drug and if it doesn’t work, there’s another drug to fix it – is the root of the problem. Maybe “you just chipped away at something that you’re never going to get back. I think that’s the part that people miss.”
It’s difficult to avoid all the marketing noise behind new supplements and drugs for longevity. “A lot of people think the evidence isn’t going fast enough. They want to be ahead of the evidence,” says Dr. Shlain. “That’s just gambling – and I’m not willing to gamble with my body and my life. However, I am very interested in pursuing high-quality science that promises to uncover how our body ages.”
So what are the things that we can do that are longevity-promoting? It’s a familiar refrain: diet, exercise, sleep, low stress levels. But it’s not one-size-fits-all.
“Biology is holistic,” says Dr. Afshar. “How do you live your whole life?” All these lifestyle components must work together, including one often overlooked part of our health: social connections. “I’ve met with patients who, over the years, have really changed their lifestyles towards happiness, towards stress reduction,” says Dr. Walsh. “We know that they probably have better health outcomes for making those changes.”
“The evidence is going to change,” says Dr. Walsh. “We know that about every area of medicine.” Being laser-focused on the ever-changing science and new discoveries is what Private Medical doctors do. That leaves room for members to live the best lives they can by developing good habits.
Like all Private Medical clinicians, Dr. Afshar works with his patients, letting the evidence guide them – together: “[I tell my patients to] live a good life, develop good habits. Let me think about all the minutia so you don’t have to worry about it as much.”