Practical – HS100.co

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!

Mapping the longevity ecosystem

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!

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!

I got my biological age measured

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.

Why I’m getting my DNA sequenced (part 1)

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).

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.

How to think about food intake

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.

Time is Money

Longevity and Money Management are 2 sides of the same coin. Once you understand that, you can easily apply all the lessons you’ve learned so hard during your life about finance and business in your Longevity Journey.

The Law of Compound Interest

Einstein has famously stated that “the people who understand compound interest will earn it, and those who don’t will pay it”. The general idea is that a small amount of money invested today, which generates a small interest every year that passes by, will eventually grow very big with small effort, if we keep the money invested long enough.

Well, when it comes to Longevity, it’s the same: the earlier you start, the greater the benefit, and the small effort you put today will eventually compound itself over the years and reward you with huge returns. Recent studies tend to prove for example that plaque in your arteries starts to accumulate as soon as in your teenage years, and this process continues under the radar for decades, until you get older and your arteries eventually get clogged. Preventing this from happening when you’re young takes a small amount of effort, but pays big decades after you’ve made this investment in your health.

There’s no “one size fits all” solution, no magic bullet

If I’d ask you how to get rich, and ask you to guarantee the success of that method you’ll come up with, you’d find this ridiculous, you’d probably laugh, and you’d certainly be right to do so! Succeeding in investment or business depends on your psychological profile, your education, your knowledge, how early you start, your risk aversion, your patience, and the other so many parameters that make you YOU. The world we live in is complex, and at least partially unpredictable. You have to make your bets, take risks, and find the right balance between persistence and flexibility.

Well, it’s the same for your Longevity Journey. The human body is just as complex as our economy, partially chaotic, and impossible to predict. In addition, it’s different for each one of us. So far, science has uncovered only a small fraction of how our biology works. So the solution in such a situation is to deal with uncertainty, follow a process of trial and error, until we get things right, accumulate knowledge about ourselves, and complete it with new discovers as they come along. Just as in business, there’s no easy way towards success, it’s going to take time, failures, there’s no magic recipe. But just as in business, work and consistency will eventually usually pay off.

Advice is cheap

I may sound controversial, but do you leave your wealth, you hard earned money, in the hands of so called “experts”, blindly trusting them to act “in your interest”? I’m not saying that you don’t have to listen to other’s opinions, be stubborn and take decisions in a vacuum. I’m saying that the healthy attitude when it comes to your money, is to listen carefully to everything everyone has to say, do your best to understand their point of view, and then do your homework by analysing everything, and then taking what seems to be the best decision for you. Financial advisors may have or have not conflicts of interest, but even if they don’t, they’ll never be as concerned as you by your own success.

Well, investigating and trying to understand as much as possible when it comes to your Longevity Journey is the right attitude to have also. Doctors have most of the time pure intentions, but :
– many times, they’re don’t agree with each other, which means that there’s no absolute truth, so that’s fine for anyone to have opinions, but you’re the one to make the final call
– they may have conflicts of interest, with Big Pharma educating them to prescribe certains treatments
– they don’t know you well as you know yourself
– they won’t be the ones suffering the consequences of the decisions they take for you

I don’t want to criticize doctors, I think they do the best they can given the complexity of their mission and the resources (time, money, knowledge) they have to do their job. However, just as you’re ultimately in charge of controlling your Money, you’re also ultimately in charge of controlling your Health. And there’s no one better suited than yourself to take the hard decisions for yourself.

Save for retirement

Most of us have a long-term financial plan. If we’re employees, our “Friend the State” may take care of this, through mandatory pension contributions on our wage. If we’re business owners, most of us have some sort of saving / investing plan for the long term (for example in the form of real estate, a low ROI / low risk investment). I can hardly imagine any responsible serious adult not thinking about their financial wellbeing in the very long term in one way or another.

Well, if you manage your financial capital for retirement, there’s no point in not managing your health capital for that time of your life also. The situation you want to find yourself in at that stage in your life is to be financially wealthy and at the same time physically and mentally healthy. And who knows, with a little bit of luck, you’ll have an interesting job and maybe you won’t have to retire anyway!

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.

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.

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!

What’s a CGM and why you need it

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.

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?