The new science of getting older...
...without getting old
I wanted to share an interview this week that I conducted with Andrew Steele, the author of “Aging, The New Science of Getting Older Without Getting Old.” His amazing book was the topic of my last newsletter, but I thought you might enjoy hearing directly from him. Steele is a computational biologist who has a PhD in physics from Oxford and worked at the Francis Crick Institute, using machine learning to decode our DNA. In short, he’s a brainiac, but one who can explain complex ideas in English, rather than science-ese. I hope you enjoy our conversation, which has been edited for length.
Me: You say aging is the disease and things like cancer can be thought of as a symptom. Explain that.
Steele: There is a bit of a debate about this in aging biology about whether aging can be called a disease. I like to sit on the fence on that. On the one hand, the FDA is more likely to approve drugs to cure a specific disease, but on the other hand maybe I don’t want to tell people who are 40, 50, 60 that they are diseased just because they were born a long time ago.
Aging predisposes us to heart disease, cancer, dementia. The average age of cancer diagnosis is 66 years. It’s easy to forget that. People who get a lot of publicity are 30-year-old women who get breast cancer. But the most dangerous decade for cancer is your eighties. Cancer is a disease of damaged DNA, changes and mutations to your genetic code and the longer you’ve been alive the more likely it is to happen. It’s a function of the aging process.
Me: How can cancer survivors promote their own longevity?
He: I’m not a medical doctor but what has surprised me is that lots of things that we consider very basic bits of health advice, things like don’t smoke, get enough exercise, eat a healthy diet, not too much meat, what these things do is slow down the aging process, which is incredible. Eating well doesn’t sound like a particularly exciting piece of advice but imagine it slowing down this aging process that is cumulative.
Exercise is a good example – when you go for a run, the cardiovascular benefits are obvious, but there is evidence, when it comes to certain types of cancer that exercise can reduce the rate of these cancers happening. It has a much broader effect. It’s not just working your heart; it’s also reducing inflammation and slowing down aging in your body. All these things make you healthier across the board.
Me: This idea that if you do simple things to stay healthy you can live longer so that by the time some of these anti-aging innovations are available, you’ll be around to use them. Tell us about that.
He: That’s one of the things that really excited me. Some of these treatments will be with us, I think, in the next 10 years. One of the treatments, this idea of killing senescent cells (cells that are aging and subject to damage and stress) we’ve already seen is an effective way to make mice biologically younger. They live longer, but they aren’t just staggering along. They have less heart disease, less cataracts, they are less frail, they are more curious. The first human trials (in senolytics) started in 2018. There are 20 or 30 companies trying to turn to these senolytic drugs that kill these aging cells into a human treatment. It won’t happen overnight, there will have to be drug trials, but it will be surprising if we don’t have senoltyic treatments in five or 10 years that slow down or reverse aging.
There are also ideas for repurposing existing drugs. A popular one, there is about to be a big trial in the U.S., called TAME for targeting aging with metformin, which is a diabetes drug widely prescribed and there is some evidence it slows aging. If that trial works, we could all start popping that pretty soon. And, that means, if you can live a bit longer by eating well and exercising, you’ll be alive in time for metformin and that will could allow you to be around for the next innovation.
Me: Could there be unintended consequences to some of these treatments?
Steele: When it comes to senolytics, there doesn’t seem to be any so far. But you do have to take these findings with a pinch of salt. We can’t assume these senescent cells are all bad. There might be some part of your biology where they are essential. Perhaps they are important to the brain. We don’t know. We don’t want to clear them entirely. It’s definitely worth doing these trials and seeing the side effects before we hand them out to everybody. We try it out on groups of patients that don’t have options. If it’s safe, you can roll it out to more people.
Me: When I was reading your book, I was imagining science fiction storylines with people living forever. How do these drugs become part of conventional medicine?
He: I think it will be so much more mundane than that. Although I talk about a cure for aging and you might imagine a single pill that allows everyone to live 1,000, that’s not going to happen. It’s more likely they will come drip by drip and slowly you’ll live longer and in good health. At no point will you think, I’m immortal now. You’ll just live longer and in good health. It’s going to be a revolution in slow motion.
Me: You understand the very latest in anti-aging treatments what do you do and how old are you?
He: I’m 35 and I follow all the basic stuff. I understand these things are slowing the aging process. The longer I live in good health the more likely I will be to take advantage of these treatments. These are real motivators for me. Because my wife is a doctor, I measure my blood pressure. It’s vital to keep an eye on your body and be aware of what’s changing. I don’t do much more than that.