The anti-ageing industry as we are beginning to know it was still science fiction in 2007, but things are changing fast, thanks to an ageing population, scientific breakthroughs in biology and a paradigm shift in medical thinking. We are now looking at ageing as a disease which can be treated or even cured. Biogerontology (or the study of ageing in living creatures) has burst into the public consciousness.
As with any new industry, the excitement can sometimes lead medical practitioners (or new breeds of health-related voices like podcasters and health influencers) to promise the world with products/diets/regimes before the proof of their benefit has arrived.
With their length and long focus, books are the best resource to get reliable, detailed information about what is out there and whether there are lessons that are applicable to your own life.
1. Lifespan: Prof David Sinclair (4 stars)
The first book I read in this list and the one that excited me most at the time. Sydney boy Dr. Sinclair has since made the rounds on various podcasts and become a ‘longevity celebrity’.
Prof Sinclair’s background is as a scientist working on animal models rather than humans, which takes his insights a couple of steps away from practical human use. For example, much of his work has been related to experiments on a specific form of yeast. You can imagine that there are a few differences between a human organism and a microscopic cell of yeast. Nonetheless some of the breakthroughs on the horizon and the contagious enthusiasm and excitement in the text bring you along for the ride.
This book gets pretty deep on some of the cellular biology, but these sections are clearly marked and easy to skip if that isn’t your thing (it is mine). The metaphor of DNA as the information coded on our CD of life and epigenetic changes as scratches on that CD is intuitive and exciting, if we can find a way to buff those scratches out.
After dutiful explanation throughout about the nature of science and how we have to prove ‘X’ is safe and effective in humans with trials before knowing for sure whether we should take it, he takes an about face and gives a shopping list of pharmaceuticals and supplements which make up his ‘stack’, along with an anecdote about how his father is ‘winding back the clock’.
This famed scientist taking a turn away from his science with this speculative ‘stack’ sours the end to this book for me, though despite my inner critic the regime on his list is tempting. The promise of reversing the clock is tantalising.
2. Ageless: Andrew Steele (5 stars)
The best book on this list for me.
Dr. Steele takes a step by step look through some of the possible breakthroughs on the horizon, with considered and measured analysis of timelines, possible limitations and caveats of each. The translations from cutting edge scientific paper to layman’s concepts is the best of all of these volumes as well.
Despite being less excitable and more measured about the new treatments in the pipeline, there are nonetheless a multitude of breakthroughs which are either close to our grasp or in that frustrating funnel between small scale scientific proof and stage IV clinical trials in humans (a funnel which can sometimes take multiple decades).
From changes to autophagy (which appears to be close to implementation via a number of medications and supplements) through to further off, more sophisticated techniques like gene editing and stem cell therapy.
It’s a useful summary on simple things you can do today to ‘live long enough to live even longer’ i.e. if you can hang around another 20-30 years, the technology available at THAT time may be enough to not only stop the clock but start turning it back. Fingers and toes crossed.
3. The Telomere Effect: Elissa Epel and Elizabeth Blackburn (4 stars)
This book came as a surprise to me. Based on the other pop-science books on this list, I expected another book focussed on what is happening within cells and how we can change it. However, written by a biologist and a psychologist, this book spends much of its time focussing on stress.
The most notable study is one which compares the telomeres of mothers. One group of mothers are mothers of children with chronic diseases, adding a caregiving role to their parenting role and increasing their levels of stress compared to mothers of healthy children. They found significant shortening of telomeres in the group caring for unwell children, which is linked to shorter lifespans in these mothers.
Dr. Epel, the psychologist, then runs through a number of lifestyle factors that can increase stress and practical ways to manage them. This book took a close look at interventions for managing stress like good sleep, meditation and mindfulness practices on people’s wellbeing. It then tied these interventions for managing mental health back to the cell and the telomeres. If you are looking for ways to improve your mental health with one eye on living a longer and healthier life, this book is the one for you.
4. Age Later: Nir Barzilai (4.5 stars)
After a meandering and self-congratulatory opening few chapters, this opened up into my second favourite book on this list. Dr. Barzilai is personally an expert in a near-impossible number of fields and certainly has the credibility to be writing about the current state of play in anti-ageing medicine.
The book becomes more and more practical as it goes on, starting with some basics on how scientific trials are run and some of the criticisms that can be aimed against them, covering areas which we know aren’t particularly promising (such as Human Growth Hormone) and then areas where we still don’t know the best path forward (such as the ideal diet at different ages).
The story that stuck with me most from this book was that of humanin, a micropeptide which shows immense promise for treating conditions like Alzheimers and diabetes as well as the more speculative hope for whole cell regeneration. The tragedy of this molecule is that a US court ruled it cannot be patented, so no pharmaceutical company will undertake the trials to assess safety, efficacy and dose in humans or produce it on a large scale , as they won’t be able to make a profit.
The section on the TAME trial, bringing an already well-known and provably safe medication (metformin) to treat ageing is the most realistic and exciting trial I have seen in the space. The results of this trial are tantalisingly close, with some arms closing December 2022.
5. The Transhumanist Wager: Zoltan Istvan (zero stars)
I hated this book.
Somewhere between poorly written Ayn Randian philosophy and a disgruntled teenage boy’s fantasies, this book is nonetheless a cult classic in some circles as the guiding light of ‘transhumanism’.
Transhumanism is a philosophy aiming to enhance the human experience by increasing longevity as well as improving the human body in other ways (cyborg legs to run fast, anyone?).
The main character Jethro Knights (loosely based on the author) is on a quest to live forever at any cost, having to do battle with impossibly evil Christian fundamentalists who want to put a stop to his research. He builds a floating country on the ocean to escape them all and attracts all the best scientists in the world, before heroically fighting a war against every other country in the world and winning!
This delusional, tech-will-rule-the-world attitude has apparently gone over well in Silicon Valley, adding to my concerns that this class of super rich tech bros holds an outsized level of influence over the world at present.
Final note:
If you are interested in exploring longevity, some of the above books are a great place to start. If you’re interested in discussing specific treatments, come on in and visit me at Green Square Health.
I should note that as an Australian GP, I am bound by the current Australian prescribing guidelines and don’t prescribe medicines without rigorous safety data available. One of our mottos in medicine is ‘first do no harm’ and at Green Square Health we only endorse or prescribe treatments that are evidence based and safe. We do not encourage purchasing or consumption of untested substances, or substances acquired without quality assurance regarding purity and dose.
Dr. Phil Orme
Green Square Health