How long do you hope to live?
What do you imagine your life will be like at 60, at 80, at 100?
While the long-term trends in longevity have been great (up from about 47 in 1900 to the upper 70’s in 2000, in the United States ), there also seems to be a widespread perception that we’ve hit a plateau – that there are certain characteristics of age-related decline and death that can’t be avoided once we’re into our 80’s and 90’s. The major factors that increased longevity in the 20th century, such as improvements in infant mortality and vaccinations against disease, don’t help with the more intractable diseases of aging that we face today, such as cancer, heart disease, or Alzheimer’s. There seems to be a sense in the general population that 100 years would be as much as we could hope for.
But what if we can hope for more? What if we could be active and healthy well into our second century? Or even our third?
Aubrey de Grey talks about anti-aging medicine as a search for “engineered negligible senescence”. That is, we find some way to intervene (medical engineering) in the aging process (senescence) so that from year to year, the amount of aging that occurs is negligible. The ultimate goal here is that your odds of making it from one birthday to the next would be the same at 80 as they would be at 40 – and the same at 100, or 120… or 500. He and other anti-aging researchers acknowledge that this is a moving target; in the same way that we’re seeing far more Alzheimer’s and cancer patients now that people don’t die so easily of smallpox, there will be other issues in our biological systems that will be tough to tackle when we start living well past 100. But each problem that arises can be addressed in turn.
And there is hope that our current problems can be addressed. Two medical approaches in particular have come to the fore in the last decade that offer huge opportunities for healthy, robust life extension: Stem Cell therapies, and the Ketogenic Diet (and similar approaches to eating).
The first wave of stem cell therapies were focused on replacing damaged cells and tissues; the idea being if you could put some stem cells near damaged nerves and ligaments, they’d get the signals from the body to start replacing the missing nerve or ligament cells. (Same for muscles, liver, bone marrow, what have you.) But there’s a second wave of benefits that are being seen and used based purely on the products of the stem cells themselves. Stem cells produce particles called “exosomes”, which are full of signals and growth factors that can regenerate the existing tissue even without the need to grow new cells from the stem cell line. In the words of Neurosurgeon Marcella Madera, “the simplest explanation is that they are little nanoparticles full of awesome, regenerative juice.” 
The great thing about exosomes is that they’re not cells, and carry no genetic material – they can be extracted from stem cells and applied to different people without risk of rejection. They can also be produced much more cheaply than stem cells themselves.
It’s currently possible (but currently very expensive) to get stem cell therapies for your joints, your skin, even your brain. While this is out of reach of most of us for the time being, it’s an existing technology that will be much cheaper in 10 years. The impact on longevity will certainly be significant – stem cells and exosomes are already known to be helpful with neurodegenerative diseases, and the application to joints can keep us all moving well into later years, which is key for both health and life quality. Much more to come.
The Ketogenic Diet
American dietary practices and recommendations have been a real mixed bag over the last 70 years. We know that greasy fast food isn’t good for us, but it continues to be advertised continually, and formulated specifically to be addictive. But even when we look to the proper dietary recommendations from the medical and nutritional communities, there’s been a lot of bad data out there. The USDA recommendations that started coming out in the 1950s were heavily influenced by the existing food industries of the time, particularly the cereal industries.
So most of us grew up with dietary recommendations such as:
(1) Minimize fat
(2) Especially avoid saturated fat
(3) Avoid dietary cholesterol, such as from eggs
(4) Get most of your calories from complex carbohydrates
Not only have these been shown to be poor recommendations, they were never originally supported by the evidence.
The “Ketogenic” diet is so named because it triggers some level of ketosis in the body. Ketosis is an alternative approach to metabolizing food into energy; instead of turning carbs into sugar, ketosis is a process of turning fatty acids into ketone bodies, which can be directly used for energy. Some forms of the diet are especially extreme, where people try to go without more than 25g of carbs per day for months at a time; that can lead to some poor outcomes. But in contrast, the standard American diet has abundant carbohydrates at every meal, with the resultant blood sugar spikes and insulin responses; this is the entire basis of insulin resistance and type 2 diabetes. The trick is to use both metabolic pathways, but emphasize ketosis.
So this is generally a good approach – why do I place it with such high priority in an article on longevity? Because we’ve made our continuing advances into living longer, healthier lives even as this terrible conventional wisdom regarding what we eat (and our even worse habits of eating fast food and heavily processed food) have built an obesity epidemic over time. What would happen if we could turn this around? What sort of advances would we see, not just in the obvious diet-related diseases (diabetes, heart disease), but if we could also defend ourselves better against cancer and neurodegenerative diseases because of the quality of our nutrition?
This is a shift that can have a huge impact on our longevity, and every one of us can start in on it today. Do learn more about the ketogenic diet – while fat is wonderful nutrition, not all fats are equal, and some of them can be systemically damaging. (Old fryer vat oil is one of the worst; coconut, avocado, and olive oil are some of the best.) But it’s a very satisfying way to eat that could add years to your life.
My longevity goals are simple – I want to live forever or die trying. But I picked 120 as a particular milestone – currently, this is the maximum human age, only a handful of people have lived to their 120th birthday. And yet, if we can make a few changes in the coming decades which can reasonably be expected to extend lifespan (such as the keto diet) or which can actually rejuvenate our bodies (like stem cells), 120 might be in reach for many people who are otherwise only looking toward their 80’s or 90’s.
And beyond that, who knows? I’m approaching 50 now; my 120th birthday will be in 2090. What else will be possible by then? Can I extend by another 20 years? Can I be rejuvenated to the point where I feel like I’m 60 at 150? Maybe I can make it to the point of “engineered negligible senescence”. And at that point, the sky’s the limit. (Literally – the sun will explode someday, so we’d better figure out how to go somewhere if we want to live past that.)
I firmly believe the first people that will live past 200 are alive today. Are you among them? What actions can you take today, to help your odds?
Bulletproof – in addition to providing some of the highest-quality supplements around, Dave Asprey of Bulletproof, Inc hosts a regular podcast in which he interviews some of the greatest minds around on subjects of longevity and peak performance. This is my top source of new health information, because of the sheer variety of novel and useful approaches to living introduced. He has a book out, “The Bulletproof Diet”, which presents the best form of Keto I know.
Academic paper on Exosomes, and the many applications thereof: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684885/
Wikipedia summary of current stem cell therapies: