Author: gabriel.cian

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.

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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.

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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).

Source here: https://www.genome.gov/about-genomics/fact-sheets/DNA-Sequencing-Costs-Data

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).

– KLOTHO is a gene whose KL-VS variant enhances human cognition. If you have it, lucky you, you may focus on other aspect of your healthspan!

– 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.

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.

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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.

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!

If you want to reach a Healthspan of 100+ years, you definitely need to play with a Continuous Glucose Monitor (CGM) at least a couple of times in your life. Read below to understand what it is and why it is so important. I’m not a doctor (and I assume you’re not either), so I’m over-simplifying the complexity of the human body to explain everything.

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The CGM

A CGM looks like a small white coin (see below on my arm).

The one I’ve chosen is called Frestyle Libre 3 from Abott Technologies (I have absolutely no stake, no hidden interest whatsoever in this company), it costs roughly $75. It lasts exactly 14 days from the moment you install it on your arm until it expires and you have to take it out and throw it. Its job is to measure the concentration of glucose in your blood every minute.

The role of Glucose in your Body

In a nutshell, Glucose is the fuel of your cells. When you eat, your digestive system breaks down food into different components, and glucose is sent into your bloodstream. If there’s too little of it, your cells don’t have enough energy. When there’s too much of it, serious and dramatic consequences may occur (such as loss of vision, kidney damage, etc …). So your body has an efficient lever to maintain your glucose level under control, a hormone produced by your pancreas, called insulin. Insulin may be considered as “the hormone of abundance”, because when you’re eating more than your body needs (abundance), the production of insulin will tell your body to store that additional glucose in your cells (mostly fat cells, liver and muscle cells).

So what?

You eat sugar, it flows into your bloodstream, then insulin tells your cells to absorb it, end of the story, so far so good right? Well, not quite, and this is where things get tricky and interesting!

During your first decades of life, this glucose / insulin system works perfectly, fine-tuning your glucose levels 24/24 and 7/7 to keep you healthy. However, as you grow older, your cells may become resistant to insulin, so that your pancreas needs to produce more and more insulin to keep your glucose levels within the desired limits, which is called “insulin resistance”. Most of the time, this happens because of decades of excessive quantities of sugar you ingest, associated with glucose spikes in your blood, which generates insulin spikes to compensate. Eventually, this vicious circle of your pancreas producing more and more insulin, and your cells becoming more and more resistant to insulin, ends up into diabetes (or more generally metabolic disorder), which means your body just can’t control glucose in your blood anymore.

If you want to live long and healthy, you want to avoid this at all costs. Metabolic disorder is the “foundation” of all the chronic diseases, which means that people suffering from this will have a skyrocketing probability of suffering from every other age-related major chronic disease (neuro-degenerative, cancer & cardio-vascular).

From Theory to Practice: Flatten the curve!

Now that you know how important it is to keep your glucose levels within a normal range, let’s get from theory to practice! So ideally, you want a fasting glucose level between 60 and 99 mg/dl (in the morning when you wake up, before having breakfast), and during the day, a glucose level as flat as possible. When you eat, depending on your diet, the glucose level will rise, then insulin will bring it back down, but you want small rather than ample variation around the mean.

Each individual will react differently to different foods, so this is why a CGM is essential, you can’t rely on how an average person reacts to a specific food. You need your own user’s manual!

So you have 14 days with a CGM on the back of your arm, this is the one time in your life you can eat the most delicious but unreasonably unhealthy food, just to see how your glucose levels spike (or not). Try everything, junk food, sugar, cake, soda, you name it. Let’s roll baby!

My personal use case

I’ve been wearing my firs CGM for 4 days now, and I’ve tried around 30 different foods, and here’s some examples of what I’ve learned about myself:

– fast-food skyrockets my glucose levels, I mean really crazy, above 230 mg/dl (which is huge), I’ve tested a Quick Giant + a big Coca-Cola + nuggets + lots of ketchup and mayonnaise. Yummy, so delicious, what a pitty!

– those delicious Liegeois with whipped cram send my glucose level to the sky also

– curiously, Taboulet Oriental (Tabbouleh) and Corn also triggered a spike, even more so than a that delicous but super-sugary chocolate “Toblerone”

– orange jus, fruits, potatoes, and pasta seem to be well tolerated, generating no spike of glucose

– 1h of moderate effort like jogging does not seem to influence my glucose

I’ll still test: different types of alcohol, and also sleep deprivation to see how it affects my body’s ability to control blood glucose. It seems from some studies that on average, sleep deprivation reduces your body’s ability to control glucose by as much as 40%. I can’t wait to test this!

Watch out for prediabetes

In addition to helping you understand what food to avoid, a CGM may also teach you something even more important, which is what your diabetes profile is. Oh boy could you have a big surprise (read below)! Diabetes is when your body can’t deal with glucose, because the insulin is either not produced in enough quantity, either because your cells don’t respond to it anymore :

– a glucose level of <100 mg/dl is OK

– a glucose level of 100 – 125 mg/dl means you may be prediabetic.

– a glucose level >125 mg/dl means you have diabetes

Knowing a couple of things related to prediabetes are of essence for your healthspan:

– prediabetes is most of the time asymptomatic, you don’t know it, you don’t feel it – until it is too late!

– prediabetics have an order of magnitude of 5 years of delay between their prediabetic condition and “type 2” diabetes. This is 5 years they won’t event be aware of, because as explained below, this is asymptomatic.

– this condition is extremely common, 80 million americans have it (out of 330 million roughly), which is almost 25%!

Prediabetes: if I may have it, you may have it!

Now, I’ve kept the most interesting part for the end of this article: during my first 4 days of CGM usage, my device has consistently measured a glucose level above 100 mg/dl, with variations between 100 and 200 mg/dl, and most of the values being around 110 mg/dl. If you’re carefully read what I’ve written above, you should understand that this means that I may be prediabetic.

I thought of myself as being almost perfectly healthy, and I invest a great deal of time and effort into staying into shape: I don’t drink, don’t smoke, I’m not overweight, I eat healthy (or so I think), I sleep well, I’m not stressed, I practice sports 5 times / week, etc …

It’s true that I have one diabetes “type 2” case in my family, but I thought it was because of a lack of care.

I have to do additional exams, before I consider this as a certainty, but my takeaway here for you is double:

1. if I have prediabetes, you may have it, don’t sleep on it before it is too late. Remember that 1 in 4 people have it.

2. detected and acted upon early, prediabetes is reversible. Don’t waste your time, don’t act like like an ostrich hiding its head in the sand, and hoping for the best.

Because I do care so much about your short and long term health, I want to ask 2 questions: Are you going to look elsewhere and hope for the best when it comes to your diabetes profile? Or are you going to start finding out as much as possible about your body by ordering a CGM today?

Some readers (thanks Gene!) told me the recent discoveries in medecine were fascinating, but most of all, they were interested in having actionable insights into what they could do TODAY to improve their Healthspan. I’m giving a couple of prioritized measures to take. Let’s dive into it!

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The Youth Pill

I will maybe dissapoint you, but just as there is no silver bullet to get rich, there is no magic pill to keep you young and healthy today (by the way, I’ll write a dedicated post about how similar longevity and money management are, stay tuned!). What we do have, however, is the ability to explore one’s health and body, and come up with a personalised, risk adjusted, long term plan to follow in order to reach 100+ healthy years. Depending on how quickly science moves forward, new breakthroughs are expected to help us improve even more our strategy and tactics, and eventually increase our odds to leave even longer and healthier lives (there’s a very interesting concept related to this, called Longevity Escape Velocity, which I’ll explain in the very following weeks).

First step: find a Medical Doctor specialized in Longevity Medecine

Every time when I think of Longevity, I first think of Money Management and try to evaluate how I would react in a similar situation. How to start in Longevity? Well, how did I start Investing in first place? A year and a half ago, I was a total ignorant in Money Management. One of the very first things I’ve done, was to get some professional help (from Finance Advisors and Investment Banks). I have considered none of what these Experts say as “Guaranteed 100% Verified Knowledge”, but I have questioned each one of their assumptions, statements and theories, and built mine on top (and most times against) those constructs. What resulted from this exploration process was a personal set of principles, convictions and an encompassing strategy which consistently guides my steps when it comes to Investing, that are sometimes similar but sometimes opposite to the so called “expert advice”.

Similarly, when it comes to Longevity, if there was only one thing you had to do to start your Longevity Journey, that one single step is, without any doubt, to find a Longevity Expert to assist you! The Human Body is a marvel of complexity, and what you’ll want to avoid at all costs is to hurt yourself by taking decisions based on an over-simplified version of what’s happening with you and how your body works. A Medical Doctor will assist you, help you take informed decisions.

Just so that you understand what to expect from such an Expert, this is how he will be able to help you:

– help you list the lab exams (blood, urine, etc.) you need to do, the ideal frequency for you, and interpret them. For example, if you have a cancer family history, you’ll want to do some detection tests more frequently. Same for Calcium Plaque for Artherosclerosis. This is highly technical, and unless you’re a health professional yourself, you’ll need guidance on it.

– help you find a Long term Longevity Strategy for you to execute. This amounts to finding the weak points in your health (current or to come), and build long term strategies to downplay them. For example, if you have a certain predisposition for Diabetes called LP(a), you’ll probably want to keep your LDL as low as possible (way below the commonly admitted threshold agreed upon in “standard medecine”).

– help you with tactics to improve (or maintain) your health, which means practical stuff to apply today. This may consist in a plethora of measures, just to give you a couple of examples: specific diet changes, physical activity, drugs, etc … This is where it gets tricky, because you’ll probably have the option to take some drugs that are commonly used for specific conditions, so they’ll improve some aspects of your health, while deteriorating some others, which may still be a good deal for you. The deeper you’ll go into it, the more this will be subject to a trial and error process, and risk adjustment.

– help you in real time with the dynamics of the whole process, how to adjust your strategy to the new scientific breakthroughs, the new problems that may arise in your health, what additional tests to do (or what to stop doing), etc. You are a living human being, you evolve, just as does the scientific knowledge associated with your body. Setting it up once and for all is great, but it’s not enough, you need to keep yourself updated!

As you see, the key word for the Assistance you’ll get from a Longevity Doctor is “help”, he will assist you, guide your journey, but you’ll have to make the final choices for yourself. You’re the CEO of your own health, nobody decides for you when it comes for such important decisions.

Important caveats here:

– just as there’s no absolute investment strategy, as each one of us evaluates and reacts to risk in different ways, there is no absolute Longevity action plan for you to execute blindly. No doctor will ever give you that (in fact anyone can tell you what to do, but that will be most likely sub-optimal). You have to find your own balance between short terms vs long terms risk, efforts and rewards. Just like in Investment, there are some no-brainers to apply with maximum confidence, but once you’ve executed that, you’ll never be able to sleep on your 2 years, you’ll never be 100% sure that you’ve taken the absolute right decisions. But you’ll improve systematically towards that goal!

– as of 2023, you’ll have a hard time finding Medical Doctors who understand what Longevity is and how to help you with it. This field is brand new, reaching some basic level of awareness in some countries and less in others. Things aren’t easy. When you’ll find such a Doctor, they may be overly expensive (I mean $30k / week), or pain incompetent. This is definitely harder that just visiting a doctor for a sore throat consultation. I’m taking about this in one of my previous posts. It’s going to be tough, but it’s definitely worth it! I’m openly sharing who’s my doctor and others I was able to find, with whoever wants to know more. Just write me and I’ll help you with that.

Next steps: some examples

I’d say that being assisted by a Longevity Medical Doctor is more or less the only aspect that should be common to everyone, and you should do prior to any concrete initiative to Improve your Long Term Healthspan. Once you have that in place, congratulations, you may be interested in taking other more tactical measures according to your preferences, lifestyle, and goals, such as:

– use some wearables. For example, I use an Oura Ring, which tracks a bunch of biomarkers, such as HRV (Heart Rate Variability), temperature, sleep quantity and quality, general physical shape, etc…

For me, the Oura Ring was a game changer, because before wearing it, I was overtraining and putting more pressure on myself that I was able to bear. This resulted in poor physical performance, a weakened immune system, chronic stress. All of these were blind spots before I was able to understand them thanks to my Oura Ring. The balance between effort and relaxation is a very important factor when it come to long term health.

– read as much as possible on longevity and functional medecine. Just as you sometimes have difficult Investment Decisions to take, and no one is more suitable than yourself to take them for you, there will be similarly difficult Health Decisions you’ll need to take. In order to be best prepared for such situations to come, you’ll have to read as much documentation as possible, on how the body works, and focus on your specific weaknesses. There are books, films, clinical studies, experts, new technologies coming down the road, in those fields. Find out as much as possible about them. Depending on how serious some condition is in your case, you may be tempted to test more or less experimental treatments (depending on the laws in your country of course).

– other tactics include CGM (Continuous Glucose Monitors), Epigenetic Clocks, Glycan Age Clocks, various invasive and non invasive tests, HBOT, Red Light Therapies, etc … but I’ll elaborate on those in detail in my next blog posts.

Overall, at first sight, it may seem a bit conceptual, daunting and blurry, but again, just as with Investing, after some time and effort to understand how it works, you’ll end up creating your own style, strategy and tactics with your own appropriate amount of regular adjustments and allocated time to it. It will most likely come down to specific measures to take in terms of food intake, physical activity, sleep/rest, lifestyle, and maybe (this is the trickiest) preventive supplements or drugs you’ll maybe take.