In his masterful book “Lifespan: Why We Age- And Why We Don’t Have To” David Sinclair asks, “What if, in our 60’s, we weren’t fretting about leaving a legacy but beginning one? What if we didn’t have to worry that the clock was ticking? In fact, he makes the case that we are closer than you think to changing what “old age” looks like, feels like, performs like. David Sinclair is an optimist of course, but he’s also a Harvard professor and one of the most prolific researchers in the area of aging, or senescence. His lab has turned out paper after paper, building and transforming our understanding of the aging process. Some of the things he has uncovered have rapidly entered the mainstream, at least the mainstream consciousness of groups willing to act on early information, before it is proven and tested in prospective trials. We have learned that a little bit of stress is good for the body, for example, periods of cold, periods of fasting, eating less volumes of food (even 12% less) than most, exercising daily. He does not preach extremes- a brisk cold walk after dinner will do.
If we wait for mainstream science, we will be waiting a long time. Perhaps our great grandchildren will benefit from the discoveries being made at this moment. In public health and medicine as we know it, scientific truth is vetted one variable at a time, one study at a time. But aging is affected by so many variables- our microbiome (gut flora), our diet, our activity, our environment, and of course, last, but not least, our genetics. Studies would have to deal with almost an infinite number of variations, and integrate all possibilities. Medicine has not been good at this historically, which is why medical progress has tilted toward pharmaceutical intervention. The patient receives drug X vs. a placebo, and it is a simple trial to design and easy to analyze results.
In a “longevity” medical consultation, we want to know everything about our patient’s everyday life, but we also evaluate their genomic “script” so we can peer ahead. The process of culling through the variants (called SNPs) acts a little bit like a GPS system that warns of a traffic jam ahead, and most of the information is actionable. Small changes in the DNA code can predict lower or higher production of different proteins, or faster or slower pathways in the metabolism. Genomic analysis is not a diagnostic tool, it acts more like a decision support tool. For example, knowing someone is predicted to be slower at clearing amyloid, we can promote healthy behaviors (foods, supplements, herbals, exercise prescription) that specifically work on their particular challenge, neutralizing its impact. Analyzing hundreds of genes and their pathways, we can survey a lot of your future challenges and design a path forward. None of this was possible even 5 years ago, without the high throughput lower cost genomic work and the powerful computing systems that can analyze and quantitate DNA variations.