As most of you know, I’m on a mission to help Humanity defeat aging by 2060. This is a bold, even unreasonable lifetime commitment. In order to maximise the odds of success, the very least is to find like minded people and execute seamlessly toward our common goal. Here I’m elaborating what has been achieved during the 1st Quarter of 2024, the failures and also what I’ve learned along the way.
The action plan
To summarize the overall structure, the plan is to build from the ground up a 3 layer ecosystem (from the top to the bottom):
– Layer 1: the “2060 Foundation”, whose purpose is to work on “longevity oriented” long term initiatives, such as fundamental R&D, federating the ecosystem, public and political advocacy.
– Layer 2: the “Longevity Startup Studio”, whose purpose is to generate profit through the creation of successful startups in the longevity space (both biotech and preventative health). The profit generated by the Startup Studio will fund the 2060 Foundation, because no matter how pure our intentions to help Humanity live longer and healthier are, nothing can be achieved without money.
– Layer 3: successful startups in the longevity space, created by the Longevity Startup Studio
The bad news is that this is a very complicated plan to put in place. The good news is that I’m not alone anymore, we’re already a small community of highly competent and motivated people who work together to make this happen.
– we’re roughly 100 members already, scientists, entrepreneurs, VCs, political activists, etc… all of them has specific skills, and is motivated by the same goal: defeat aging. This has been achieved with minimal to no communication or budget, which is very encouraging as to the potential of the mission to motivate a great number of people.
– we’ve created the Longevity Investment Club, federating startup founders and investors in the longevity space, and had our very first pitching session on the 5th of April, with 30 people signed up for this event.
– we’ve got serious discussions with one of the most renowed experts in longevity in the world (can’t disclose his name yet), to be part of the initiative and support our foundation. We’re working with him to build the foundation in the best possible way, with the right connections, the right advisory board, the right strategy, in order to avoid traps as much as possible.
The Longevity Startup Studio
The Longevity Startup Studio is the most complex project, but also the most promising, this is where profit will come from, this is what will create enough value for the Foundation to execute its mission:
– we’re 3 in the founding team, one of them a highly respected and successful biologist, medical doctor, and also entrepreneur in the medical field, and another one having worked with Elon Musk in one of his biotech initiatives, with a considerable expertise in venture capital.
– we have discussions for funding and partnership with the BPI France (the French Soverign Fund so to speak, responsible for funding innovation), and 2 biotech and health startup studios, who are interested by our expertise and our project.
Ikare.ai is supposed to be the very first startup created by the Startup Studio. It’s an online service for longevity consultations, where Medical Doctors and Health Coaches with deep expertise in Longevity help patients reach a Healthspan of 100+ years:
– we already have 15 patients being assisted by our doctors and coaches in their longevity journey. Interesting point, one of the patients is a principal scientist working for one of the best funded research facility in longevity in the Bay Area (for confidentiality reasons I can’t disclose names). But it’s funny that we’re so early on, but still taking care of the longevity of one of the best longevity experts in the world 🙂
– we’re a team of 4 cofounders, one of them being Dr Denys Coester, one of the best doctors in biohacking and longevity in France
The end game for Ikare.ai:
-1 longevity medical consultation / month for every human being aged 40+ (3 billion people worldwide as of today, but the demographic dynamic will bring more and more people in this category in the next years/decades).
-an AI longevity doctor, monitoring the overall health of billions of people, and issuing recommendations on what exams to take, at what frequency, recommending what preventative measures to take to preserve their long term health. Think of it as a huge AI-driven dashboard with green, orange and red lights for each patient, monitoring, and taking care of people’s health well before any disease or symptom appear.
Failures & Lessons Learned
When working on such a complex project, if we don’t have failures along the way, it means we’re not pushing hard enough. But rest assured, we’ve had some failures along the way also:
– we’ve lost a highly selective startup competition called Wilco, because we were not able to explain the vision and the product well enough in our slides (and also apparently because the slides looked unprofessional ?!? – that one hurt me a lot, I’ve put my heart in those slides 🙂 ). Next time I’ll “test” the pitch deck on more people, make it bulletproof, and take a professional designer to create world class visuals.
– one of the most professional and important potential investors in the Startup Studio told me that I was not qualified enough to be credible as the cofounder of such a structure. It seems they only consider serial-entrepreneurs in biotech. I’ll have to work more in order to explain why I’m the right person for this job.
Stay tuned, more is coming for the Second Quarter of 2024! Thanks for following the adventure, and for some of you, even getting involved in it!
I have recently created the “2060” Foundation with a small but visionary group of highly determined people: https://2060.life . Our purpose is to help Humanity defeat ageing by 2060. I describe in this article the rationale behind the creation of this Foundation, and also some details on the status and progress of the work being done by our team.
The World Today
The Modern Western Civilisation has been suffering from a chronic disease for the last 5 decades, and it’s only getting worse: it’s terrible and it’s called short-termism. It has become harder and harder to plan and execute any major long term project that spans on more than 5-10 years. We see it in Venture Capital: I’m over-simplifying, but no VC would invest in a startup having the potential to offer 1000X returns in 20 years. We see it in Politics: no politician will sponsor a project which will have results in 20 years from now, when his election term will be long gone. We see this short-termism everywhere.
There are some countries which are able to execute long term visions, and envision and plan for the future decades, such as Saudi Arabia, Arab United Emirates and China, to name a few. But winning the war against aging is one of Humanity’s biggest challenges, and need to be considered at the global scale.
The “2060” Foundation Vision
We have created 2060 to thwart short-termism: the Foundation will bear projects that promote longevity, and are not directly profitable or offer too long-term ROI horizons to make them fundable by public or private funding. We’re here to push and accelerate Humanity towards the tipping point beyond which the Longevity field will inevitably become mainstream.
We tend to overestimate what we can do in a year, and underestimate what we can do in a decade. Audacity, grit, determination and long-term resilience will pave the way towards major breakthroughs in the Longevity field. We will support all the initiatives and execute all the long-term projects that no one wants to focus on, but which are nevertheless of essence to move forward in Longevity.
“2060” is a Foundation and not a company because by definition a foundation doesn’t make profit (or the profit is reinvested by the Foundation back in Longevity projects). We want to be very explicit about the fact that our organisation is about adding years of healthy life to oneself, to the ones we love, and to Humanity as a whole, not for profit.
Thinking globally and long-term, acting locally and short-term
Having set the vision of the 2060 Foundation, we execute our plan with daily small and practical steps. No place for daydreaming! Here’s the projects we’ve started working on at the Foundation these days:
– legal paperwork for the “2060” Foundation. For now, in legal terms, “2060” is a “association loi 1901” incorporated in France, not yet a Foundation. This gives us a legal entity on the short term, until the more complex paperwork allows our Foundation to officially come into existence.
– a Longevity Investment Club. Finding Investors who understand and are interested in Longevity is still rare nowadays. Finding credible Startups and Entrepreneurs in the field is even harder. We’re gathering both groups of people around our Longevity Investment Club, to increase efficiency and transparency in the ecosystem. We want to see as many startups and investments as possible in Longevity. The Longevity Investment Club is up and running.
– a Longevity Community. We’re offering whoever wants to know more about longevity, a community of like-minded people (now Slack), with online and offline events about this fascinating topic.
– a Worldwide Longevity Network. Online presence is great, physical presence is even better. It’s not enough to meet online. The longevity community needs physical places to meet, hang out with like-minded people, do some blood tests, use some specific machines (like a DEXA scan for example, impossible to find in Marseille for example to my knowledge).
– as the team grows, and more and more people resonate with the Foundation goals, many other projects will be initiated by the Foundation during the weeks, months, years and decades to come. Stay tuned!
2060 and you
If our goal resonates with you, and you want to get involved in the Foundation, you can do a couple of things:
– sign up as an investor or entrepreneur in Longevity here, it’s free.
– sign up as a member in our foundation, and find out more about longevity and the fascinating people who push the field further every day, here
– last but not least, talk about 2060 and invite your friends to join for free
This article talks about one of the very first practical steps I’m taking in helping people reach a healthspan of 100 years or more: creating Dondy, the first online consultation platform, with a bunch of fellow entrepreneurs, exclusively dedicated to longevity and preventative health.
My own longevity journey
I’ve been followed for a while now by 2 medical doctors with expertise in preventative health and longevity, one in France, and one in the United States. I’ve learned a great deal about my body, my health, and my biggest risk factors when it comes to my genome. But having access to such experts at a reasonable price hasn’t been an easy feat:
-the standard primary care medical doctors, the ones you visit when you have a flu or a minor infection, were frustrated with me visiting them and having no specific problem (other than being healthy and aiming at staying like that as long as possible).
-there are luxury longevity clinics, such as Clinique La Prairie, mostly dedicated to celebrities such as Carla Bruni.
-there are private doctors such as Peter Attia, charging around $ 100 000 / year for his longevity expertise.
-there are more accessible longevity clinics, but only in the US, Israel, Dubai and other destinations, but none in France.
Long story short, none of them seemed to fit my need, which was to take care of my long term health through – 1. efficient, 2. informative and 3. self-empowering 4. no BS – longevity consultations at an affordable price. After searching a lot, I’ve found out the 2 doctors I’ve mentioned earlier, but what a challenge to get there! What a bumpy road! Only warriors and/or people with a lo(ooooooo)t of free time can get there!
Dondy: the idea and vision
Once upon a time, Bill Gates had a vision: “Early on, Paul Allen and I set the goal of a computer on every desk and in every home. It was a bold idea and a lot of people thought we were out of our minds to imagine it was possible”.
The audacity of Bill’s vision, but also the quality of the execution which came afterwards and turned his vision into reality inspired me. I said to myself: there are roughly 8 billion people on Earth, out of which 3 billion are older than 40 years old. Each one of these 3 billion people should have access to 1 longevity consultation per month. I would aim for the stars, but have my feet well on the ground on a daily basis to execute the plan.
I’ll be here to execute upon this vision on the long term, maybe 20 years, maybe more. I’m not here for short term profit or fame. I’m here to fix healthcare at global scale.
Practical aspects of Dondy
This is where the idea of creating a large global and affordable online longevity service came to my mind like a no-brainer: living the whole experience as an insider allowed me to imagine how this service should work:
-it would be a mix of medical expertise, life coaching and AI assistance. You see, optimizing your healthspan requires 5 levels of intervention: physical activity, food, sleep, mental health and supplements/drugs. It seems easy, but being specific about the details in each one of these aspects requires medical expertise, and differs greatly from person to person. Also, medical expertise is not enough, as lifestyle changes need self-discipline and dedication. Knowing what you have to do does not mean you’ll do it. This is where coaching and AI assistance comes into play: understand the kind of personality you have, and pushing for the right measures, at the right time, not too hard because you’ll quit, not too easy because it’s going to be insufficient. We’re dealing with medical expertise, but also with behavioural change. AI would “understand” patients and push only as much as needed.
-it would target from the start patients all across the world, no country boundaries, the world would be our playground from day 1.
-because of how sick care works nowadays, public welfare would not pay for these kind of preventative medical services, so first they would be targeting people who accept to pay for them from their pockets. Later on, we would convince health insurance systems to pay for it, and lower the price. We would be strong advocates of transitioning from sick care (go see the doctor when you’re sick and you have symptoms) to health care (avoid being sick in first place through pro active measures).
-we would measure biomarkers and progress, on a regular basis, and give people data on how they’re improving (or not), no BS, no stories, no make believe attitude. Just help people to the extent of how much they’re willing to put into living longer healthier. The most persistent and determined of us would have full programs, with physical activity, food restrictions, etc. However, the most comfortable would have light recommendations, just to make sure they stick to the program permanently. We would be accountable (and hold our patients accountable) for how much we improve their long term health.
-as medicine and science move forward at a breakneck pace, we would integrate new recommendations, new supplements/drugs, to always be at the edge of what is possible in longevity.
Business is business
No matter how well intentioned I am, on the one hand, CASH IS KING and on the other hand “Ideas are nothing, Execution is everything”. Profit makes the difference between a failure and a success, so the venture needed to be sustainable from the business point of view. This is where the uniqueness of France came in handy:
– France has a rich and untapped academic community, with excellent scientists, doctors and engineers. I would fully leverage this unique advantage.
– France has a very generous public funding system for innovation in AI and health, under the form of non-dilutive funding. I would fully leverage this advantage also.
For the first time in my life, creating a startup in France would not only not be a drawback, it would be a terrific advantage. However, instead of limiting myself to small niche local markets, as many startups do, I would target all the countries in the world, from day 1.
The service would use a freemium SaaS business model, because it is so strong, so resilient, and so scalable.
The dream team
This project is not an individual project, it needs an army of dedicated and mission-driven people. Along the way, I was lucky enough to meet the right people to start this venture:
–Guillaume Agis . Great technical skills, great experience as an entrepreneur. Swiss knife, doing everything quickly and well.
–Maxime Kamrani . Visionary AI engineer, with long term views on longevity. Great networker, knows everyone in Longevity worldwide. Attends all the events all the conferences in the field, everyone likes him.
–Denys Coester . One of the very first medical doctors and experts in Biohacking in France. Extensive and practical experience in behavioural change in patients. Medical doctor, but also coach and hypnotherapist.
In the very next weeks, we will focus on the following very practical goals: – incorporate the startup – create am MVP (Minimum Viable Product) – integrate into a startup incubator – get the first financing (from public non-dilutive subsidies) – onboard the very first few customers
By the way, if you’re interested in the initiative, please sign up to our waiting list, so that we’ll be able to let you know as soon as our service becomes available!
This article is a summary of what I’ve learned through the whole year 2023 about the longevity ecosystem, by talking to as many scientists, entrepreneurs, influencers, policy makers and investors I could. The longevity community is vibrant and dynamic, but very small and niche. Thanks to the tremendous scientific progress from the last 15 years, we are the first generation of humans for whom indefinite lifespan is an ambitious yet attainable goal. However, the future depends on us and we have to create it by ourselves.
The structure of the longevity ecosystem
The longevity ecosystem is split in 2 subgroups:
– the “healthspanners”. This group of people advocates for the more modest yet realistic approach of taking into consideration the state of knowledge on longevity as it is now, and applying it to the population. There is reasonable evidence that a mix of lifestyle choices (physical activity, food, sleep & mental health), and drugs/supplements, can extend an average human life in good health by 20 years or more. It requires self-discipline, a long term proactive mindset, but it is 100% realistic and within our reach as of today. With some tweaks, and some foreseeable medical breakthroughs yet to come in the next decades (but nothing crazy or science-fiction), the average human lifespan could be further extended even more. However, these basic methods will not allow humans to live beyond 120 years, which seems to be the ultimate hard limit for the human species as we know it.
– the “lifespanners”. This group of people aims for “radical life extension”. They don’t want to live only 10 or 20 years, but 100 years longer, or maybe even reach “indefinite lifespan”. However, in order to reach such a goal, and break the limit of the 120 years lifespan, humans have to re-engineer themselves at the cellular/genetic level. This is where fascinating research and development in longevity comes into play, with some top notch scientists working on crazy projects such as cryopreservation, organ 3D printing, gene therapies, stem cell treatments, cellular reprogramming, organ replacement and regenerative medicine. However, these projects are about fundamental R&D in biology, which is by definition a long term, uncertain – high risk high reward – initiative. Because of these features (long term + uncertainty), there is very little private money invested in it. At the same time, public funding, which should finance fundamental R&D, is inaccessible to longevity research because from the legal point of view, aging is not considered (yet) as a disease. Without private nor public money, the lifespanners’ field is dramatically underfunded, living at the expense of some rare billionaires who fund a couple of startups (ex. Altos Labs, Calico, Retro Biosciences, etc …) and in so doing they further push the field in the unfortunate position where the public opinion associates it with yet another spoiled rich people’s hobby.
Reaching indefinite lifespan
As Abraham Lincoln said, “The best way to predict the future is to create it”. But how do we create a world in which humans can live as long as they want?
Well, the best and most realistic mental model to reach this difficult but reachable goal involves audacity, a unique combination of short term and long term plans, as well as a notion called “longevity escape velocity”.
The action plan to reach indefinite lifespan requires decades to execute, and involves 3 components :
– the first component is an ecosystem of profit making longevity companies. The time is ripe for “healthspan” startups to be created and pave the way to the transition from the “sick care” – where people wait to be sick before they see a doctor, and when they do it’s often too late – to “health care” – where the approach is to monitor one’s health to prevent disease long before it actually occurs. This transition from “sick care” to “health care” is in itself ambitious and hard to succeed, because it requires dramatic changes in society, against very well organized and powerful groups of interest: the pharmaceutical industry, which needs to transition from selling expensive treatments to sick people, to selling preventative medical services to healthy people; the agrifood industry, which produces unhealthy but cheap and tasteful food; medical services and doctors, who in most countries are educated and live on treating sick people, and do not support preventative medicine; last but not least, politicians and Governments, who have to do more to promote healthy lifestyles. Despite the obstacles, this shift from sick care to health care is a short term realistic step towards living longer and healthier.
– the second component is an ecosystem of NGOs, think tanks and influencers, whose role is to bear the longevity projects which are not profitable (at least not directly and/or not in the short term). These projects can be financed by the aforementioned profitable “healthspan” companies, as part of the longer term strategy. Indeed, the transition from “sick care” to “health care” will allow people to live 20 years longer, but in order to go beyond, fundamental R&D needs to start right now, so that in a couple of decades, research projects starting now will hopefully yield positive results in 20 or 30 years. Thus, if the short term game is to create and fund as many profitable longevity “healthspan” companies, the long term game involves different projects, such as: a bottom up strategy, consisting in awakening the public opinion to the prospect of living longer healthier; a top down approach, consisting in reaching out to political decision makers, and advocating for larger public budgets for fundamental R&D in longevity; last but not least, funding and creating more “moonshot” longevity biotech startups.
– the third and last component of the overall strategy consists in applying the “longevity escape velocity” principle to our own lives, to benefit from the first 2 components – the short and long term action plans. Indeed, we can create and use the services of the “healthspan” companies to optimize our healthspan using common and accessible medical knowledge as of today. This will preserve us longer, and will increase the likelyhood of still being in good health in a couple of decades, when – if we execute well on the longer term plan – fundamental R&D will deliver new scientific breakthroughs. This will in turn allow us to benefit from those futuristic technologies, that will be available at that time, which may prolong our lifespan even more. This “longevity escape velocity” is a beautiful notion that dramatically increases our odds of success, because the probability that we would discover the cure against ageing in 40 years is lower than the probability of discovering a set of sequential less ambitious treatment (say every decade we discover something that allows us to live a decade more), which could ultimately lead to the final understanding of the aging process and how to stop or revert it.
Practical steps
The best solution I could come up with is to create a two-headed legal structure:
– a startup studio, that will incubate profit making longevity startups.
– a foundation, that will own a major portion of the shares (if not all) of the startup studio. This foundation will bear the unprofitable projects (nevertheless necessary for the end game), such as political advocacy, public opinion campaigns, as well as the fundamental R&D in the biology of aging.
Doing this requires a lifetime of dedication for an army of people, if you think it’s worth it, join me!
This article is the 2nd part of an article I’ve written a couple of months ago, where I have explained why I was sequencing my DNA, which you may read here. Since then, I got my results sent to me by Dante Labs, so the purpose of this 2nd article about the same topic is to explain what I’ve learned from it.
Practical aspects
In theory the process is very simple: you spit in a tube, send that tube by postmail to the DNA sequencing company, and then you get your results. However, in practice, things have been longer and more complicated than expected: although the sample has been sent in a timely manner, the DNA sequencing process took roughly 3 months, and needed some back and forth messaging between my assistant and Dante Labs. After months of waiting, their messages sounded pretty unconvincing and automatic, telling me that “my DNA is still being processed”.
Once I finally got the results, I got a 2nd surprise: they have indeed disclosed some results, but are asking me to pay another $199 to get the full package. I most likely will pay for these additional $199, because I’m so committed to exploring everything around longevity. If I find out meaningful things about me, interesting enough to share with you, I’ll probably post a 3rd part of this DNA sequencing series.
Overall, the customer experience has been somehow suboptimal. I’m so committed to making progress in my longevity journey, and finding as many things as possible about my body, that these minor hurdles did not stop me from doing it. However the “average” customer may be less positive, so there’s work to do in this area!
At the end of the day, knowing what is written in your genome is well worth some minor glitches!
Caveats, limitations and interpretation of the results
Before jumping into the specifics, I need to point out some facts about the results of DNA sequencing :
– your DNA is highly intricate, multifactorial and there’s much we haven’t discovered yet. Indeed there are 2 interesting notions: pleiotropy which means that a single gene codes for multiple phenotypes, and polygenic inheritance, which means that multiple genes code for the same phenotype. Well, there are plenty of those, which makes the DNA interpretation highly complex. Because of these limitations and intricacies, we just can’t be sure of what our genotype says about us.
– DNA decoding is not 100% reliable as of today. Your DNA code 3 billion base pairs long (like a very long word containing 3 billion letters among these – A, G, C, T). Because the DNA molecule is so tiny, and because of its length, there is a high likelihood of making mistakes in those 3 billion letters. Because of that, laboratories today scan it multiple times, just to make sure they haven’t made a mistake in reading some letters. My DNA has been read 30 times, but the gold standard is 100 times. Of course, the more passes you make, the more expensive it gets.
– most importantly, your DNA is NOT you. Because of the fascinating recent research in epigenetics in the last 15 years or so, we know today that whole portions of your DNA may be silenced by what is CH3 groups which stick to the portions of the DNA strand and prevent it from being expressed (so called DNA methylation). Well, depending on your environment and your lifestyle choices (the so called “exposome”), some genes will be over-expressed, and some other silenced, so having specific genes which increase the likelihood of some diseases does not mean they will necessarily be expressed.
Long story short, the results of DNA sequencing must be considered as a mere tool to add data points and fine tune your “risk profile” a little bit more, and hedge yourself against the most important risks, “just in case”. For example, having a gene that increases the risk of ASCVD (cardiovascular diseases) does not mean you’ll have it, but it may push you towards taking some more preventive measures against it, or maybe testing yourself more frequently against it, to detect it early and receive treatment against it as soon as necessary.
The results
Let me share the most salient results when it comes to my own DNA sequencing, and what actions I’m taking based on these new pieces of information.
I’ve found out a lot of good news, great genes (memory, speed of processing, etc…) but for the sake of keeping this article as short as possible, I won’t elaborate on them. Let’s just say that there are many aspects where I have very good genes (everyone has), and these areas won’t be factors of risk for me. The main focus needs to be on the higher risks, which we have to systematically mitigate :
– predisposition to weight gain (2 alleles of the FTO gene – TA and GG genotypes, both associated with weight gain and high BMI – body mass index + CT genotype of the CLOCK gene – associated with higher waist circumference). People who know me may consider this as laughable, because I’m slim, but my mom and my paternal grandmother are overweight. I mitigate this risk by practicing IR (intermittent fasing, eating 2 meals / day), roughly measuring my caloric intake (nothing extreme, but still keeping an eye on it), and regular physical activity (more or less 1h / weekday – excluded weekends when I spend time with family)
– obstructive sleep apnea (1 genotype GA of the TNF gene). Sleep apnea consists in short periods of time when you stop breathing during your sleep. This makes total sense since my father suffers from this conditions. This apparently benign condition can have serious and multiple long term effects: decrease the quality of your sleep, increase insulin resistance, and risks of cardiovascular diseases. The way I mitigate this risk is by monitoring it (my Oura ring and my Garmin watch monitor sleep apnea, but also oxygen blood saturation during sleep, which needs to be above 95% if no sleep apnea occurs). I have also learnt how to sleep in positions which do not obstruct my breathing.
– higher late onset Alzheimer’s disease (APOE genotype e3 & e4, e4 being the one which increases the risk by a factor 3 compared to the average population). Neuro-degenerative diseases are running in my family, my maternal grand-mother has dementia, so it makes totally sense that I’m exposed to it. Officially, Alzheimer’s disease has no cure as of today. However, the very last research is starting to show correlation between Alzheimer’s disease and metabolic syndrome (diabetes type 2) and arterosclerosis. Also, I’m confident that in the next 30-40 years, medicine will discover new treatments agains this disease, so I’m trying to keep myself informed about this topic.
– insulin resistance and metabolic syndrome (I have the CA genotype of the ENPP1 gene + AG genotype of the PNPLA3 gene associated with NAFLD – non alcoholic fatty liver disease). Discovering that I have this genotype was the final confirmation that I have to take aggressive preventive measures against this: wearing a CGM showed abnormal glucose levels (at the very limit between normal and abnormal values to be precise, I’ve written an article here about this), my blood tests showed the same congruent alerts (OGTT, HBA1C and fasting glucose levels). What I’m doing to mitigate this risk: I’ve stopped sugar altogether (except on trips and social events), I’ve significantly reduced my carbohydrates intake, taking measures to increase my muscle mass – because muscles absorb glucose. I’m also considering taking small quantities of metformin to further lower my glucose levels. I’ll soon write a new separate and dedicated article about this topic because it is such an important and common condition, which obviously concerns me, but may concern some of you also.
Conclusion
If you want to live more than 100 years in good health, DNA sequencing is a mandatory checkpoint. Knowing so much about yourself may seem daunting and stressful, you can choose to be ignorant, close your eyes and hope for the best. Or you can learn as much as possible about your risk factors, and aggressively hedge against these risks.
For the craziest of us, the way to mitigate those risks is not only by using DNA sequencing and all the other tools at our disposal already (as mere technology users), but also by pro-actively participating in financing and pushing anti-aging science forward (technology creators). Stay tuned, I’ll elaborate much more on this topic in the very next couple of months!
Rapamycin is an immunosupressant drug, mainly used today after organ transplants. However, recently, scientists have discovered that it may have “gero-protective” properties, arguably offering between 9% and 14% of additional lifespan in humans.
The story of Rapamycin
Rapamycin is a molecule produced by a bacteria called “Streptomyces hygroscopicus”, and was first discovered in 1964, by a Canadian scientist in the Easter Island (do the mysterious staring eyes statues ring a bell?). This molecule was firsthand intriguing by its unusually strong antifungal properties.
A couple of years later, the pharmaceutical company which was financing the research, called Ayerst, closed their canadian lab, and formally requested all rapamycin cultures and extracts to be destroyed. However, one of the researchers, called Suren Sehgal, did not obey orders, and hid the samples from Easter Island in his personal fridge.
A few years later, the Sehgal’s new management team agreed to resume the research on Rapamycin. It proved useful in healing all sorts of fungal conditions (athlete’s foot, body rash, etc.), but also in partially suppressing immune reactions to organ transplant rejection (mainly kidneys and liver), for which it has been approved by the FDA (Food and Drug Administration) in 1999.
However, this is where things get really interesting: back in 2006, Rapamycin has been shown to lengthen the lifespan of eukaryotic cells, that is, cells from multi-cellular organisms such as humans (experts out there please pardon me for the extreme approximation of this definition).
Why this time it may be different
Discovering the “youth pill” has been a human obsession since the most ancient times. It has inspired myths, writers, poets, explorers, and charlatans throughout the ages. It is said that selling so-called magical “eternal youth potions” has been the 2nd oldest profession on Earth 🙂 Juan Ponce de Leon (1474 – 1521), was such an utopian explorer, who is said to have devoted his life to searching the “fountain of youth“. Of course, none of them came anywhere close to it.
Well, today, scientists have valid reasons to consider that the time has finally come for such a groundbreaking discovery. Before explaining how this molecule works in complex multi-cellular organisms, let me tell you why this time it’s different:
– Rapamycin has been tested in various animal models (yeast, worms, flies, mice) and worked in all of them, which is extremely rare for any drug. Is now being tested on primates (a short-lived monkey called “marmoset“), dogs, and even elder humans with yet to be formally confirmed but promising and encouraging results so far.
– Rapamycin “makes sense” as a gero-protective molecule, by inhibiting a specific pathway in the eukaryotic cells. This cellular mechanism appeared so early in the evolution of life on Earth, that it is common to a big proportion of life forms as of today. More on the scientific explanation below in this article.
– This is by no way a scientific proof of anything , but many world renown scientists and doctors who study the aging processes take Rapamycin and publicly admit it, even disclosing how much and frequently they take it. They’ve made their choice, decided not to wait until FDA approves it, they have “skin in the game”, they eat their own dog food 🙂
How and why Rapamycin works
Mammals have a mechanism called mTor (mammalian target of rapamycin), which works like an “organism growth manager”: when nutrients are proficient, the mTor pathway is activated, and the organism goes into “growth mode”, cells divide, the cell metabolism increases. When nutrients are scarce, mTor is inhibited, and the organisms tends to go in “survival mode”, and each cell tends to “recycle” its waste, save energy, instead of spoiling resources.
Well, what Rapamycin does, and this is why it seems to work as an anti-aging drug, is that it inhibits mTor, forcing the organism and each and every cell within it, to go into “survival” mode: less nutrients waste, more recycling, less cell division, more cell repair.
Caveats
While there are very strong reasons to consider that Ramaycin may be the first gero-protector in the History of Mankind, we need to take into account that as of today, the scientific community has not finished the work on this very promising molecule:
– studies on humans are still incomplete
– optimal posology is still unclear (how much, how frequently should one take it?)
– the FDA has not yet approved this drug as an anti-aging treatment
– this drug has some minor side-effects (called mouth ulcers, which may be easily treated however and are insignificant given the advantages)
– even if unlikely, this drug may have yet unknown adverse effects
– you cannot buy this drug without prescription, and you won’t get a prescription as an anti-agind drug in many countries (France being one of them). It seems you can buy it in Spain without prescription, but I haven’t yet investigated enough to be sure of it.
– remember that the stakes here is “only” 9% – 14% of additional lifespan, which is at the same time a lot and very little. It doesn’t prevent us all from all the other longevity measures (healthy diet, physical activity, etc …). Also, it doesn’t prevent us from pressing the pedal to the metal and discover more efficient gero-protectors, pushing the human healthspan even further.
Me?
Some people asked me if I was taking Rapamycin. Given my promise of transparency, let me share my conclusions when it comes to this drug:
– I have personally talked to many scientists and doctors from the longevity ecosystem, many of them take Rapamycin. Some of them were very convincing in explaining why. They don’t want to wait 20 years for the FDA to approve this drug, they’ll be dead by then. Surprisingly, even the most cautious of them take it, under the assumption that even if it’s not useful, at least it’s not harmful.
– Almost all the credible trials related to Rapamycin, and scientific papers, show the same positive conclusion, being published on a regular basis. Sometime in the future, the FDA will approve the treatment when it will be 99.99% certain (not sure of the exact percentage, I just want you to get the idea). Well, as more and more papers and clinical trials results get published, the certainty will go from 90% to 95%, then 99%, and so on, the whole process taking decades. As I read those papers, it’s an ongoing process, where at every step, certainty goes up. At some point, I’d take now a drug that is 99% certain, rather than wait 15 years for it to be 99.99% certain. The numbers I’m using to explain my point are imprecise, but the rationale behind it isn’t. It all comes down to a risk management problem.
– I’m not taking this drug as of now, because I want to set up a biomarker “before – after” tracking protocol, I have too much of an engineer mindset to test stuff on myself just on “believing” it might work. Measuring is an absolute necessity for me. I want to identify the right biomarkers to measure before taking Rapamycin, decide how much I’ll take and how frequently, during how much time, and after that time span I’ll measure the same biomarkers again, to see the difference. Another reason why I’m not taking it yet is that I have to find the right way to buy it, no doctor will prescribe that in France 🙂
When I’ll move forward with this drug, I’ll let you know!
Your chronological age (current year – age of birth) says nothing about how young your cells are, and in what global shape your body is. You may very well be 70 years old (chronological age) with a body of a 50 years old (biological age), or the opposite. You want to remain biologically as young as possible as years pass by, but you can’t improve what you can’t measure. Only recently have we been able to measure the real biological age. I have done it for me, and so could you for a small amount of money.
Cell differentiation
We all start our journey in this world as an egg and a sperm, but as we grow, our cells start to differentiate and specialise. As a fun fact, there are around 200 cell types in the human body (more about it here). This is possible through complex but yet poorly understood processes called epigenetics, by which portions of the DNA in each cell are silenced, depending on its function in the body, and others, at the opposite, are expressed. It makes total sense if we think that the DNA information is the same in each and everyone of your 100 trillion cells, but each cell is different, it’s “running” a different “software program” subset of that global DNA information.
DNA methylation
Again, the mechanisms by which your DNA is partially expressed and partially silenced are poorly understood, but one of them is what we call the “DNA methylation”. DNA methylation consists in whole portions of your DNA being “blocked” by methyl groups (CH3) sticking to Cytosine bases. Thus, those portions of your DNA can’t be properly transcribed into RNA by the “RNA polymerase enzyme”, so they are silenced.
Relationship between DNA methylation and biological age
What is fascinating about DNA methylation is that this mechanism contributes to cell differentiation and thus to the existence of complex organisms such as us humans, to proper gene expression while we’re young and in good health. However, as we age, this DNA methylation becomes more and more chaotic, leading to different portions of DNA which were rightfully silenced, to start being expressed, and create havoc. Imagine portions of DNA related to your neurons being expressed in derm cells, it cannot but harm the overall order and functioning of your body. By the way, this epigenetic disorder has been officially recognised as one of the Hallmarks of Aging, as presented in one of my previous articles (read here).
Based on the hypothesis that DNA methylation disorder is associated with aging, back in 2011, a german scientist called Steve Horvath discovered specific methylation patterns in people’s DNA, allowing him to measure with precision the biological age of the human body. In other words, Steve turned a general observation into a statistically precise method to measure people’s biological age. He called that epigenetic clock.
Later on, multiple biomarkers and AI has been used to increase further the reliability of the epigenetic clock, and the price of these tests has diminished until they became accessible for virtually anyone, which further improved the reliability of the measurement, because the more data we have, the more reliable our statistical models.
So here we are today, with a cheap and precise system to measure how young and in good shape your body really is. Good news!
Why measure your biological age (and how to use it)
Now that we understand the theory, let me tell you that this epigenetic clock is still controversial, but absolutely paramount to the longevity field. As the saying goes, “you can’t improve what you can’t measure”. We want to stay young and in good shape as long as possible, and now “staying young” can be mathematically measured, so it can be improved, at the scientific level, but also at the individual level, for you and I.
If I’m talking to you about measuring your biological age, that is because there’s a strategy behind it. Especially if you’re at the beginning of your longevity journey, you may have some ideas of how to improve your overall health (quick wins are easy when you start: maybe improve your diet, maybe practicing more physical activity, sleeping better, taking some geroprotecting drugs, etc.). However, as this will require some effort on your side (and even some risk taking), you want to optimise that effort, and do more of the things that work, and less of the ones that don’t. Well, good news, your biological age is the Key Performance Indicator (KPI) you’re looking for.
The strategy happens in 3 distinct steps: 1. Do an initial test and find out your initial biological age, your “starting point” 2. Apply the measures you believe will be most impactful to improve your health and make you biologically younger 3. After a statistically significant period of time (to be defined depending on what exactly you’re trying, maybe 6 monts is a good order of magnitude), do a new test to find out how you biological age has evolved in between.
Practical aspects of biological age measurement
Now that you understand the theory as well as the rationale behind spending your time with DNA methylation, let me tell you my story with it. I’ve done my DNA methylation with a startup called Humanity, while I was in Montenegro, Zuzalu, back in May 2023. I don’t know if the Humanity app still offers this service but there are many options out there for you to use (if you want an advice, send me an email).
They’ve asked me to spit in a test tube and fill it above a certain line, and that was it! Other variants of the test require some drops of your blood, but whatever their process, it’s quick, easy and painless. It cost me between 200 and 400 dollars (I’m sorry, I don’t have the exact price, I’ve paid in Ethereum, and the pricing is not so relevant because of the volatility of the crypto).
The results took quite some time to come (this is why I’m writing this article only now), and I’m sharing them with you, please see below:
Now you know everything about me 🙂
More seriously, let’s analyse what this means: – when I took the test, my chronological age (current year – year of birth) was 41.8 years – however, my biological age (how young my cells are) was 42.7 years, which is older by 0.9 years than the average person
I must admit that I was a little bit surprised by the results, as I thought of myself of being in a very good physical and mental shape, and I was expecting a lower biological age, but what is most important for me, is that I now have a baseline to work on and compare against.
I’ve started whole lot of lifestyle changes (which I’ve shared with you in my previous articles – more to come!), and I’m curious how these will change (or not) my biological age, so in a couple of months, I’ll do the test again, and see how it evolved. When the time will come, I’ll openly share with you the results I got, and how successful (or not) the whole project was.
One of the powerful aspects (the most powerful?) of Medicine 3.0 is to use top notch technologies to provide us with valuable, easily accessible, cost efficient, and precise data about our health. Among the many tools allowing us to do that, DNA sequencing is of essence. This article analyses why and how to leverage DNA sequencing to maximise your healthspan.
The (his)story of human DNA sequencing
It’s always difficult to spot the exact chain of events that lead to a scientific breakthrough. The story arguably starts back in 1953, when Crick, Watson, Franklin and Wilkins discover the DNA helix (3 of them receive the Nobel price for this incredible discovery – Crick, Watson and Wilkins). It eventually culminated with the Human Genome Project which started in 1990, and took 13 years, until 2003, when the first Human Genome was sequenced, for a whooping budget of approximately $3 billion, under the leadership of a biotech entrepreneur called Craig Venter, and announced with a lot of media hype by the then President of the United States, Bill Clinton (ahead of time in 2000, 3 years before the final confirmation).
Since then, the process of human DNA sequencing has significantly increased in quality and reliability, and decreased in cost to a couple of hundreds of dollars (see below).
This evolution opened the door to a whole universe of possibilities when it comes to Medicine 3.0 healthcare.
Why I’m getting my DNA sequenced and why you should too
Sequencing your DNA is important because it gives you insights into specific risk factors (but also eventual strengths you may have) when it comes to your long term health. You can do many things to increase the likelyhood of you living 100 years or more in good health, but there’s so much on your plate that you won’t be able to do it all (and by the way, even if you could, it may turn your life into a nightmare), so you need to prioritize & optimize your efforts, to focus on the most important aspects. Remember my previous article, the strategy here is to find the weakest aspects of your health (the limiting factors), and to work harder on these (and eventually ignore the aspects where you have a strong family history and low risk).
Here’s a non-exhaustive list of DNA genes and alleles that you want to look at (there’s many more, as you can imagine, and new ones being discovered every year, but the purpose here is just to give you some examples):
– APOE is a gene responsible for creating lipo-proteins which transport fats in your body, and it’s strongly associated with neuro-degenerative diseases There’s 4 alleles in humans, e2, e3 and e4: e2 give you low neuro-degenerative risk, e3 is neutral, and e4 is associated with the highest risk. Since you have 2 versions of the same gene (one from your mother, one from you father), you want to know what are the 2 versions you have in your body, 2 x e2 being the best, 2 x e4 being the worst. Depending on how (un)lucky you are, there’s more or less aggressive preventive measures to reduce your risk profile. If you have 2 x e2, you’d probably do nothing. If you have 2 x e4, you’d probably aggressively optimize your lipid profile (make sure you keep your lipids (LDL) as low as possible in your body).
– LP(a) gene is associated with artherosclerosis. This gene controls the existence and concentration of a small “add-on” for your lipoproteins, which perturbates the body’s ability to handle blood clots and blood vessels repair and maintenance. The bigger the concentration of LP(a), the higher the risk of ASCVD (atherosclerotic cardiovascular disease).
– MTHFR is another gene associated with ASCVD. Depending on what alleles you have, you may be more or less exposed to this disease.
Again, there are many genes that tell you a great deal about your risk profile, and help you take informed decisions about what to focus on when it comes to healthspan optimisations. Some additional resources to read if you want to get into this rabbit hole here and here.
Practical aspects
Once you understand how important this self-discovery step is for your healthspan, you still need to get back with your feet on the ground, and find the right company to sequence your DNA, at the right price, with the right level of reliability. The latter is paramount, because your genome has around 3 billion nucleotide pairs, and a single error in decoding it may mean you taking the wrong measures to optimize your health. For this reason, DNA sequencing is being processed by reading your genome multiple times, and using advanced statistical models to make sure it provides the right data. When it comes to “DNA reads”, the golden standard as of 2023 is 100 times – this is what you would use if you have a suspicion of genetic disease. However, the “reasonable standard” as of 2023 is 30 “DNA reads”, which means that your DNA will be read 30 times to make sure it is reliable.
Following some recommendations, I wanted to try Nebula Genomics but as incredibly as it may sound, they don’t send their kits to France (but they do in virtually any other country).
I ended up working with Dante Labs. I do not have any conflict of interest regarding this company. As of now, I’m still waiting for my results to be analysed and sent back to me. I will keep you informed of the results, as soon as I receive them.
Limitations of DNA sequencing
This “breakneck paced” technological and economic evolution of the DNA sequencing has had surprising scientific consequences: initially, researchers thought that the human DNA was the ultimate book of human life, the “Holy Bible” holding all the secrets of human biology. This is what motivated the consortium of 6 countries (France, Germany, Japan, China, UK, USA) to fund the Human Genome Project, unlocking public money to fund the project.
A few years after the first human DNA was sequenced, the scientific community was to discover soon that this was only half of the story. Indeed, the genome is important – because it stores the information the ribosomes use to produce proteins in our cells) – but what is also just as important (if not even MORE IMPORTANT) is our epigenome: in order to work properly, specific and significant portions of the DNA of each cell are silenced, and do not express themselves. The epigenome describes how our genome is properly silenced, and how and what portions of our DNA is effectively expressed. Well, DNA sequencing tells us what our genome is, but it tells us NOTHING about our epigenome (but other technologies – such as methylation profiling- allow us to do this very cost-efficiently, more in a future blog post).
The takeaway
If sequencing your DNA is of essence, understanding that your life and your future is NOT your DNA is just as important! Your epigenome sits on top of your genome, and much of what is written in your genes – good or bad – can be overwritten by your epigenome, in ways that are still poorly understood today but which are determined by the 5 pillars of our playbook to live 100+ years or more in good health: nutrition, physical exercice, sleep, mental health, medication.
In fact, some studies suggest that your genome influences only 25% of how long you’re going to live, the rest of 75% being your epigenome (read more here).
Update 2023/11/02: for those who want to know more about what I discovered about myself from the results of this DNA sequencing, you can read part 2 here.
The evolution of Medicine can be thought of as having 3 major waves in the Human History, and we’re in the middle of a new paradigm shift, a major disruption. This article explains what these 3 major waves are, and how we are quickly shifting from Medicine 2.0 to Medicine 3.0.
When you visit a primary care physician, what is the question he/she’s asking you? I bet that question turns around something like this: “What is the problem / what symptoms do you have / what’s wrong / where does it hurt?”. I would also bet that you may be thinking that this is absolutely normal, and there’s no point in discussing about it, right? Well, not so fast, let’s travel together through the ages, and see how different sets of beliefs have given shape to different waves in Medicine (and what that means for our Healthspan). Peter Attia comes with a very interesting framework to explain all of it, which I would like to share with you in this article.
Medicine 1.0
For a very long time, Humanity lacked any scientific method to study any phenomenon. However, the urge of the Human Brain to find explanations for anything and everything led people to invent all sorts of superstitious or in any case scientifically unproven ways of dealing with the unknown. When it comes to human health, even when doctors tried to apply the scientific method, the complexity of the human body was just too high for them to uncover its mysteries, and they just lacked the technological tools to help them really understand what’s going on.
This is how all sorts of ominous “medical treatments” have appeared through History, and how they persisted through entire centuries or even millennia. Here are 2 of the most popular examples :
– trepanning. Trepanning consists in creating a hole in a patient’s skull. When people had various conditions, such as repetitive headaches, or mental disorders, trepanning was thought to allow evil to get out of someone’s head. No need to say that this was based on superstition and false science, but surprisingly, it worked in some situations, because it indeed decreases the pressure in the skull, which in some specific but rare cases can indeed yield some positive results.
-bloodletting. Bloodletting consists in letting a portion of a patient’s blood to spill out of the body. It was believed to heal many diseases. Similarly as with trepanning, this indeed may be appropriate in some very specific situations, but in the vast majority of cases, it was not only useless, but even very harmful to the patients, by weakening them in the very moment when they needed the most resources from their bodies.
Overall, Medicine 1.0 has been the norm until the 19th Century, and was characterized by chaotic cause to consequence associations, which led to catastrophic measures, often worsening the situation of the patients.
Medicine 2.0
It’s only in the late 19th Century, arguably with the work of Louis Pasteur, that Medicine shifted to a new paradigm. He discovered the Rabies vaccine in 1885, and Medicine changed profoundly after that, thanks to the discovery of vaccines of course, but also and most importantly thanks to the wide use of rigorous science and technological tools to study the human body and its diseases.
Medicine 2.0 tremendously improved public health, and let to incredible discoveries which led to a considerable increase in average lifespan :
– hygiene. Scientists discovered that very small life forms, such as bacteria and viruses, were responsible for a great number of diseases and infections, which could be avoided by simply washing one’s hands.
– vaccines. After the Ravies Vaccine, which turned Pasteur into an all-time international star, many other vaccines were discovered, driving to the almost-elimination of some very common diseases (smallpox, polio, etc …).
– antibiotics. Antibiotics were discovered in 1928 (penicillin), and this pave the way to many other categories of antibiotics being discovered since then. Today, there are more than 100 antibiotics.
Overall, in 2023, we still are in this Medicine 2.0 paradigm, which is characterized by :
-a scientific method which allows to assess, analyse, and treat different conditions. The most sophisticated and strong tool to do this is the “double blind clinical trial”, which proves the efficiency of a treatment beyond any reasonable possible doubt.
-an identified symptom/disease, that affects the patient, and can be easily diagnosed. This is very important, because Medicine 2.0 starts with a well identified problem, that threatens the health of a patient in such a way that it makes it easily identifiable, and places some level of urgency on the treatment to apply.
-a short-term cause-to-consequence relationship between the treatment and any possible positive results, which would put the patient into remission. The notion of “short-term cause-to-consequence relationship” is very important, because it emphasises the advantage but also the limitations of Medicine 2.0. It knows how to deal with relatively impactful diseases, when they can be healed by relatively impactful (and quick) treatments.
A great way to see Medicine 2.0 is to imagine a garage that will indeed repair your car, but with huge limitations as very few of the pieces of your car are replaceable, most of the other parts of your car are used beyond repair, and without doing any maintenance neither (only repair with limitations when something is broken). If you car is already old, the repair will tend to be pretty rudimentary, and will only give your vehicle a short additional lifespan before the next time it gets broken again.
Medicine 3.0
This is where things start to get interesting. Medicine 2.0 was a great way to introduce science into the field of human health. It helped us make a huge leap ahead, allowing us to do marvels when it comes to “quick death” (quick death is a shortcut for those situations where a sudden accident threatens the life of a healthy individual, such as for example a car accident, or an arm being cut and then being put back again by surgeons, or people being stabbed or shot, etc …). However, when it comes to “slow death”, that is chronic diseases (a.k.a. neuro-degenerative diseases, metabolic syndrome, cancer, cardio-vascular diseases), Medicine 2.0 is very limited. This happens because of the following reasons:
– chronic diseases start very early in life, and take decades before showing up. Medicine 2.0 does not know how to study such a long-term evolution.
-because of the differences between humans, and the complexity of the human body, very few treatments work for everyone. Most of the time, some treatment will work for a patient, and not for another one. Medicine 2.0 does not deal well with this personnalisation of the treatments, because the double blind medical trials, mandatory to bring a new drug on the market, are very difficult to apply (if not outward impossible) if we take into account that each patient is significantly different from another one.
Medicine 3.0 is the new wave which is coming as I write this article, to stack on top of Medicine 2.0, and bring a whole new standard of care to the whole world:
-the starting point for Medicine 3.0 is NOT a patient that is sick and needs to heal, but a patient that is in good health and wants to stay so for as long as possible. This is a profoundly different mindset for doctors to have!
-prediction and prevention. Medicine 3.0 understands that each individual’s DNA and lifestyle is a great starting point to predict and ultimately prevent some genetic and epigenetic risk factors. It therefore links causes to far-reaching consequences (for example, having a 2 x e4 alleles of the APOE gene, and not taking aggresive preventive measures to lower one’s lipid profile, increases tenfold the risk of suffering from neuro-degenerative diseases in 40 years from now).
-personnalization. Medicine 3.0 takes advantage of the last technological advances, and allows patients to gather huge amounts of data about their body, their biomarkers and their health in general, which was impossible before (for example, glucose used to be measured only during fasting, at a certain point in time. Only recently do we have CGMs to measure one’s glucose levels in real time). The treatments and preventive measures are also highly personnalised, starting from the premise that a trial and error process is possible before we find the best treatment for a patient. This data is then analized in the patient’s interest, allowing him and his doctors assess how efficient that treatment is. We’re relying less on population averages, and cohort analysis, and more on the specific use case of an identified patient.
Wrap up
Do you believe in this adage, that “a picture is worth 1000 words”? If you don’t, you will certainly change your mind when you’ll see the diagram I’ve designed for you to summarise the essence of Medicine 1.0 vs 2.0 vs 3.0.
Above, you have the average evolution of human health, as years pass by, moving us from birth to the inevitable decline and end of our lives. You can see that there’s a “quality of life threshold”, that is a level of overall health below which life is not worth living for (it may mean for example that you’re living but you’re paralysed, or you can’t take care of yourself, or you have Alzheimer’s and you can’t think straight anymore – overall, below the “quality of life threshold”, life is not worth living for anymore). You can easily see that as we age, our overall health decreases, and eventually reaches the “quality of life threshold”. Our purpose is to act in such a way, that our overall health stays above that “quality of life threshold” as long as possible (for HS100 members, that is at least 100 years old, if not more!).
Well, now that you understand the diagram, let’s study the different lines:
-the red line is the “Medicine 1.0” standard of care: basically people got sick, and when that happened, instead of having positive treatments that would improve their health, they would have trepanning and bloodletting, basically worsening their situations, and accelerating the decline of their health. Not cool.
-the black line is the “No Intervention” at all. That means that when people got sick, basically not doing anything, and letting the human body use its incredible resources to heal itself, was still better than “Medicine 1.0”.
-the blue line is “Medicine 2.0”. This is where we stand right now. Our life gets incrementally better than “no treatment at all”, because even though accidents are somewhat rare in our modern societies (gun wounds, car accidents, etc …), in the eventuality where you suffer such an unfortunate even, you’ll have HUGE chances of survival and remission, when compared to Medicine 1.0 or “no treatment”. However, Medicine 2.0 fails miserably to improve our Healthspan when it comes to chronic diseases. It just isn’t designed to fix these. So what is does instead, is to use infinite amounts of money to keep patients alive for a couple of additional years, but in a very poor general health condition, most often leaving them without any joy of living. This is why you see an inflection of the blue “Medicine 2.0” curve toward the extreme right of it, before intersecting 0, which is the end of life.
-finally, the best curve is obviously the green one, “Medicine 3.0”, where 3P measures (Preventive, Predictive and Personnalised) allow patients to take care of their long term health long before they feel any symptoms of any disease, carefully monitoring decades ahead how their biomarkers evolve over time. This data allows Medicine 3.0 to design efficient measures with long-term positive effects, helping patients stay healthy as long as possible. An interesting side-effect of this approach is that it allows to always focus on the “limiting factor”, ans as such, to increase healthspan, but also generate what is called “compressed morbidity”, which means that the amount of time where people are alive but impaired is much shorter than for the other alternatives.
So my dream is that soon enough, instead of “Medicine 2.0” doctors asking you “what problem do you have” when we start a medical consultation, the doctor will tell you “When I look at your biomarkers, I see you’re in good health, congratulations! Let’s work at keeping it that way for another 40 years!”.
Food is one of the 5 pillars of Longevity, and arguably the 2nd in terms of importance (right after physical activity). However, the Media is poisoning us with conflicting information about nutrition. All this massive data is either just noise or bad science, if not outward false information. You only need a couple of minutes to cut through all this BS and understand the fundamentals.
Since I can remember myself, every time when I’ve heard or read of nutrition, it was complex, weakly documented, and chaotic. And therefore lacking any interest. If you want to dive into this and study it for good, it’s indeed terribly complex, and honestly, my conclusion is that we know really little about it. But for most of us who don’t want to become professional nutritionists, things don’t have to be complicated. In fact, they’re dead simple. Read below!
The basics
Food is composed of Macro-nutrients and Micro-nutrients. The Micro-nutrients are nutrients that come in very small quantities, such as Vitamins and Minerals (<0.1% of food). The Macro-nutrients are the categories of nutrients that we find in food in bigger quantities (>0.1%).
The Micro-nutrients
What you need to know about micro-nutrients is :
-they come in many forms and shapes, and there’s no point in listing them all.
-you can find them mostly in vegetables and fruits. Depending on your specificity, you may need to take supplements to compensate for lack of different vitamins (for example B complex, or Mg, etc …).
The Macro-nutrients
There are 5 categories of Macro-nutrients:
-fats. Fats are very energy-dense. During intense or prolonged efforts, fats can break down and generate energy for the body. Fats are divided into 3 categories, saturated, mono-unsaturated and poly-unsaturated, but more about this in a future blog post, no need to over-complexify at this stage.
-carbohydrates. Sugar and starch are carbohydrates. Depending on how good your body is to process these, you may be better off avoiding carbohydrates as much as possible. Carbohydrates are quickly digested and released into your blood in the form of glucose. This mechanism, repeated over and over again during decades, may end up destroying your energy sensing mechanisms, and ultimately creating insulin resistance and type 2 diabetes. This is what we’re trying to avoid as much as possible with a CGM.
-proteins. Proteins are very important, because they’re the building blocks of your muscles (among others).
-fiber. Fiber is not a nutrient per se, because the body does not process it, but it’s very useful to the digestive system and is present in large quantities in the foods we eat.
-alcohol. It may come as surprising, but alcohol is a macro-nutrient. It is almost as energy-dense as the carbohydrates. It may be a social enhancer, but remember that while your body can cope with reasonable quantities of alcohol, unlike what you’ll see in articles here and there, it does NOT improve your health. So don’t believe what different lobbies tell you, don’t lie to yourself.
Your goal
So now that you know that food is Micro-nutrients (vitamins) and Macro-nutrients (fats, fiber, carbohydrates and protein), the next step is to understand what you’re aiming for when it comes to daily food intake:
– a daily overall energy intake of roughly 2000-2500 kcal (kilocalories) for men, and 1500-2000 kcal for women. Each macro-nutrient (except fiber) has a caloric value.
– a daily protein intake of 2g / kg (that means if you’re 70kg like me, you’d need 140g or protein / day). This is above the recommended “official” doses of 0.5 – 1g/kg, but recent studies show that this standard daily dose is absolutely insufficient.
– depending on how your body reacts to carbohydrates, you want to limit these, because as explained earlier they turn into glucose in your blood and you want your glucose levels to stay ideally at an average level below 100 ml/dl, with no spikes above 140 mg/dl and a GV (glucose variability) of less than 15%. You can measure this by wearing a CGM. There’s no general guideline as to how many carbohydrates to eat, you’ll just need to adjust it depending on your own body.
– very interestingly, most processed foods are unhealthy even when they contain the right macro-nutrients in the right proportion, so your aim is to eat as many unprocessed foods as possible. Eat vegetables you cook yourself, eat a fruit and not an fruit juice, etc. Not all the processed foods are bad (for example the Whey Protein), but most of the time, it’s easier to avoid them.
Putting this into practice
I’ve been putting all these guidelines in practice for the last couple of weeks, and I must admin it’s awkward and strenuous, but worth it to my eyes.
So it all starts with carefully reading the notice on every food package, where you’ll have the macro-nutrients quantities for each product, an example below :
The plan is to add all the macro-nutrients of the different foods you eat, do the math for a couple of days at least, and make sure that numbers add up to roughly the desired quantities (in terms of calories and protein intake, see above).
If you do this right, you end up with something similar to this:
In my situation, you can see that I’m roughly at 2000 kcal / day, which is ok, and around 120g of proteins / day, which is slightly sub-optimal (I should be at 140g). The quantity of carbohydrates is roughly between 50 and 100g / day, which is the maximum amount that my body can bear without releasing glucose in excess in my blood. Remember for you it may be more (lucky you!) or less.
On the longer term, once you get an intuition of what to eat and how much, you can discard this process of measuring everything, but first you need to get a sense of how this is working.
Indeed, later on, you’ll be able to monitor your food intake in a much more comfortable way, that is through measuring how much you weight on a monthly basis, and how much fat and lean mass you have with a DEXA scan every 3 months or more (but more on this in a future blog post).
A couple of practical observations
You’ll see that eating 2g of protein / kg / day is very hard (especially when you limit the overall energy). This is why I take some form of concentrated protein shake, called “whey isolate”.
I was also terribly surprised to notice that eating healthy in restaurants (even the more sophisticated French restaurants) is close to impossible. Indeed everything is filled with sugar and starch (sauces, soups, french fries, fruit juices, even gazpachos!). I’m not saying that it is absolutely impossible, and I’m sure in Paris for example, there may very well be some niche restaurants where you can eat a longevity-friendly meal, but it’s not mainstream, it’s not practical, it’s not the snack in the corner of your street, you need to be a connoisseur.
Another interesting observation is how marketing is distorting the message on healthy foods. In almost every restaurant you’ll have some “veggie” meal, and most diet-sensitive people will openly prefer that and think it’s healthy. It’s false, vegetarian food does not necessary mean healthy food (sugar and starch is vegetarian), and meat does not necessary mean unhealthy food (poultry and fish are great for health).
Wrap up
In a nutshell, here’s what you need to remember: – you need 2000-2500 kcal / day for men, and 1500-2000 kcal / day for women – you need roughly 150g of protein if you’re a man, 100g if you’re a woman – you need to keep carbohydrates and processed foods as low as possible – eating various vegetables and fruits will give you the necessary micro-nutrients
That’s all! Isn’t that easy?
PS1. Please note that my goal is to share with you what I discover, I’m not a doctor nor a nutritionist, and most likely, the article contains some approximations which would sound dissonant to an expert. However, I want to help as many people as possible understand the most fundamental mechanisms of nutrition, and provide them with insights that are easy to understand and apply today.
PS2. I hear some of you think outloud “Where’s the pleasure of eating delicious foods? French specialties? Exotic tastes?”. While I totally respect this point of view, the food industry has evolved in the last century to optimize for price, volume, regularity in production, and palatability, not long-term health. While a mix between both may be possible (healthy + tasteful), you really need to understand the rules of the game, and adjust accordingly.
