The 4 Angels of Death and How to Escape Them

Our Healthspan is limited by 4 Major Age-Related Diseases. In this article we learn what these 4 diseases are, and how we’re escaping from them.

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Medicine may seem complex (and it really is, when explored in detail), but this doesn’t mean we can’t get a plane view of what’s going on, and how to use this knowledge to our advantage. Indeed, the ICD (International Classification of Diseases), the world reference to date, created and published by the WHO (World Health Organisation), lists more that 55 000 diseases. However, make no mistake, this complexity is unnecessary to most of us, we need to focus on the fundamentals: if you want to optimise for healthspan (that is, the number of years you’ll live in good mental and physical health), and unless you have some specific/rare/particular condition, you need to pay attention to only 4 chronic diseases, which I have called “The 4 Angels of Death”.

Now, the fascinating part is that these 4 Angels of Death play a different game with each one of us. That is, they start in different positions, and come for us at different speeds. It’s like a huge life-long Pacman game. And if we’re good enough, just like in Pacman, we can escape from our ennemies, and get to the next level … So our job is first to study them in general, and then allocate our efforts and resources escape from them efficiently. Indeed, out of the 4 Angels of Death, our strategy is to always focus on and avoid the one who is closest to us, and moving the faster in our direction. There’s no point in spending too much energy on the ones who are far away, we need to fight the one who is actively threatening us the most.

So let’s start by listing our 4 ennemies. For each one of them, I’m giving some preventive measures which allow us to avoid these diseases. This is very complex, so I’m barely scratching the surface of this, and by the way I’m not a doctor, but the only reason I’m doing this is to send a message of self-responsibility and hope. We’re not powerless in the face of these diseases, we have tools to fight back and escape them.

Metabolic Disorder

In a nutshell, Metabolic Disorder is a cluster of diseases which have all in common the fact that your body can’t properly manage energy anymore. That means it can’t store it properly, can’t process it properly, or use it properly. Most of the time, it’s diabetes type 2 (your body can’t control the glucose levels in your blood), but also other conditions such as hyperinsulinemia (too much insulin in your blood), fatty liver disease, insulin resistance, etc.

I’m starting with this disease, because most of the time, people don’t die from it, but it is in some sort a very favourable “bedrock” for all the other chronic diseases. So avoiding it is a great strategic move.

Some examples of how to avoid this category of diseases:

– optimise your glucose levels

– optimise your BMI (Body Mass Index)

– physical activity (but not any activity, more in a future blog post)

Cardiovascular and Artherosclerotic Diseases

This is the number 1 cause of death. Everyone has had a friend, or a family member, who died of heart attack, or stroke. This is not coming from anywhere, each one of us may have a hereditary predisposition, but this is totally avoidable with the right preventive measures (more of it in a future blog post).

This category of diseases starts attacking our arteries decades before any symptom appear. Some examples on how to avoid cardiovascular diseases :

– sequencing our DNA to find out if we have a mutation which significantly increases our risks, called LP(a). If we have it, we have to aggressively reduce our LDL (Low Density Lipo-Protein, common called Bad Cholesterol).

-monitoring the general health of our arteries (for example using a Computer Coronary Tomography Angiography – CCTA).

– regular lab tests to monitor our LDL, HDL, ApoB, triglycerides (a bit technical, will come back in a future blog post). These results have to be be interpreted by a doctor, but you don’t have to wait to feel sick to do them.

– adapting one’s diet depending on the results of the 2 aspects aforementioned.

Cancer

If Cardiovascular Diseases is the number 1 cause, then Cancer is definitely number 2. Everyone knows what cancer is, no need to further explain it, however I think it’s important to mention some less-known facts about this disease:

– it’s not a disease, but a cluster of many diseases, each cancer is different, and this is also one of the reasons why it’s so difficult to treat it

– we all have cancers all the time, which is not a problem most of the time, it’s just that our immune system is so efficient at addressing cancer cells we are not even aware of them

– despite huge amounts of money and R&D effort poured into cancer, we still haven’t found strong treatments to fight it, especially when it is metastasized (which means that the cancer cells are not in one place anymore, but have moved basically everywhere else in your body).

There are some very interesting treatment for cancer (most of them still in clinical trials), most of them related to monoclonal antibodies and/or gene therapies, but for now, the best strategy we have at hand is to:

– keep our immune system as healthy as possible

– screen for cancer on a regular basis, through MRI and a new disruptive test called GRAIL, which detects more than 50 cancers from a simple blood sample

Neuro-degenerative diseases

This category of diseases encompasses Dementia and Alzheimer. It’s not the death of our bodies, but of our minds. There is a lot of mystery around this disease, and we don’t really understand it well. It seems to be caused (or at least associated with) high levels of 2 proteins in our brains, called “amyloid beta” and “tau”.

Different mechanisms are explored for neuro-degenerative diseases, but what is important to know for our purpose of maximising healthspan is that:

– there’s a mutation called APOE, which multiplies by around 10 the likelihood to suffer from neuro-degenerative diseases. A simple DNA sequencing test can identify that.

-possible routes towards neuro-degenerative diseases are: either through metabolic disorder (because your neurons don’t process glucose as they should), either arthero-sclerotic (because your neurons are not properly provided with the necessary nutriens, which cannot properly travel through your clogged arteries), either cognitive (in short, improper brain stimulation/no purposeful in life/insufficient social interaction).

What you can do to prevent neuro-degenerative diseases:

– fulfil your life with meaningful social interactions.

– stimulate your brain through intellectually challenging activites.

– optimise your physical health against artherosclerosis and metabolic disorder.

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This article may seem depressing, but on the one hand, understanding the rules of the game we’re playing will allow us to resist longer, and an amount of 20 or 30 additional years of healthy life is an absolute win in itself. On the other hand, by extending our healthspan, and staying alive as long as possible, we increase the probability of getting cured from these diseases thanks to new discoveries and breakthroughs coming in the next decades. We have a plan here!