the future of medicine

The DO Book Club, Feb. 2020: Lifespan

Aging is a disease that can be cured, writes Harvard researcher David Sinclair, PhD, who shares his findings—and the anti-aging tactics he uses.

Welcome back to The DO Book Club! For February, I read Lifespan: Why We Age—and Why We Don’t Have To, by David A. Sinclair, PhD, and Matthew D. LaPlante. If you’ve read this one, please share your thoughts in the comments below. And if you’d like to write a book review for a future month, please email me at abrown@osteopathic.org.

Plot summary

Through most of the book, Dr. Sinclair dives deep into the research that led to his development of the Information Theory of Aging. The theory states that the standard scientifically proven hallmarks of aging (including telomere attrition, inflammation of healthy cells by senescent cells, and stem cell exhaustion) can actually all be boiled down to one root cause: cellular loss of epigenetic information.

He says that while cells repair themselves naturally, over a lifetime of handling damage, their digital DNA code (the genetic building blocks made up of A, T, C and G) remains remarkably intact, but their much more complex and delicate analog epigenetic code (which provides detailed instructions for gene expression), deteriorates.

This deterioration, he says, is the basis of all those typical hallmarks. He likens the loss of epigenetic information to scratches that accumulate on a CD or DVD over time, which eventually prevent it from performing its function.

That’s the farthest into the weeds I’ll go on the specifics of the theory, but the upshot of it is, by strengthening cells’ repair mechanisms, Dr. Sinclair believes aging can be significantly slowed down, and in some cases reversed. Aging is a disease that can be cured, he says.

Dr. Sinclair, who is 50, employs many measures in his daily life that he says have noticeably slowed his own rate of aging. He gives a detailed list of these on p. 304. Some are tried-and-true, like exercising, not smoking, maintaining a healthy weight, and limiting his intake of sugars, breads and desserts. But some of the more unique methods include:

  • Taking daily doses of nicotinamide mononucleotide (NMN), which his research found capable of improving the health and increasing the lifespan of mice, and reservatrol, a compound also found in red wine that can reduce the risk of heart disease or cancer.
  • Intermittently fasting in the middle of the day.
  • Analyzing his blood for dozens of biomarkers every few months, and moderating where necessary.
  • Keeping his indoor environment a bit cooler than room temperature when he can.

It should be noted that Dr. Sinclair has a financial stake in some of the items on this list. According to Kaiser Health News, he is listed as an inventor on a patent licensed to an anti-aging supplement company called Elysium Health, and an investor in InsideTracker, the company whose technology he uses to measure his biological age.

Interesting tidbits for DOs

Advances in health monitoring will play a large role in helping slow the rate of human aging, Dr. Sinclair says. Most people in the world will have access to DNA sequencing and wearable devices in the coming decades, he says. The power of artificial intelligence to track each individual’s health more precisely than ever before may help doctors make more consistently accurate diagnoses.

Dr. Sinclair acknowledges that biotracking on this scale comes with obvious concerns about privacy and the need to establish the public’s trust that their personal medical information is being kept securely. If handled ethically, however, it can pay big dividends, he says.

He shares an anecdote about a woman who was initially diagnosed with an aggressive form of lung cancer, but sought a second opinion using precision DNA sequencing. Sequencing of the biopsy of the tumor revealed a vastly different, more precise diagnosis: The cancer was still aggressive, but it was really a solid form of leukemia growing on her lung; this realization helped doctors tailor her treatment plan more effectively. If this technology becomes available in wearable devices, it will expedite this process and ensure that initial diagnoses are more accurate (p.178).

Notable quotes

Dr. Sinclair spends the last part of the book addressing concerns about the ramifications of a world where human lifespans are longer.

“What if giving billions of people longer and healthier lives enables our species to do greater harm to this planet and to one another? … I’m still optimistic about our shared future. I don’t agree with the naysayers. But that doesn’t mean I don’t listen to them.” (p. 219)

I personally didn’t find his counterarguments to these concerns all that compelling, but his outlook on pushing human lifespans toward 150 are rooted in improving quality of life with preventive care, which all physicians would likely be on board with. He says someday in the not too distant future, you will regularly see 100- or even 120-year-olds running marathons.

“As a species, we are living much longer than ever. But not much better. Not at all. Over the past century we have gained additional years, but not additional life—not life worth living anyway.” (p. 5)

Obviously that’s a pretty controversial take on life as we know it, but it’s consistent with his stated beliefs that aging can be made more gradual and less painful.

Takeaways

I have mixed feelings on this book. Dr. Sinclair’s research and his summary of prior research that led to his theory are really fascinating. His goals for the human race are lofty, but he firmly believes he’ll achieve them and help people around the world live much longer, healthier lives.

However, he lost me toward the end of the book when he started trying to address (valid) concerns about the global impacts of a population that ages slower, especially given the current population’s rate of consumption. He spent a lot of time discussing various issues, but not much time discussing possible solutions.

Also, while Dr. Sinclair has the support of Harvard Medical School, some of the anti-aging methods he has access to aren’t affordable for most people. He says he hopes to someday see a world where everyone can access the care they need to age slower, but for now some of it rings a bit idealistic.

Regardless, I recommend it if you want to learn more about his research and how it could impact health care in the future. As a precursor, I recommend Paul Henry de Kruif’s 1932 book on lifespan-extending medical advances, aptly named Men Against Death. It provides a great look at the state of medical research in the early 20th century.

March’s book

For March, The DO Book Club will be reading Brain on Fire: My Month of Madness, by Susannah Cahalan. We encourage all who are interested to read along!

As a reminder, if you read Lifespan or January’s Book Club pick, The Destiny of the Republic, and want your reflections to be shared in future posts, or want to write your own book review for a future month, please leave a comment below or email abrown@osteopathic.org.

Happy reading!

Related reading:

Life is short: Apparently only 115 years at the most

Intermittent fasting: Can we fast our way to better health?

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