My first step in helping people live 100 years

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.

me 🙂

What’s next?

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!

I’m getting my DNA sequenced (part 2)

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 may be the first “youth pill” in the History of Medecine

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!