We humans have long dreamt of immortality. The ancient Greeks venerated the gods of Mount Olympus, who were said to sup on ambrosia to maintain eternal youth.
In Ireland, we told stories of Oisín venturing into Tír na nÓg. Right across the cultures of the world, there are tales of people seeking out the elixir of life.
The quest continues to this day. A Google search for longevity products turns up countless supplements promising everything from enhanced mitochondrial function and metabolic health to improved cognitive performance.
It finds treatments such as hyperbaric oxygen therapy and intravenous nicotinamide adenine dinucleotide therapy, which claim to slow the ageing process.
The super-rich are leading this effort to turn back time. Amazon’s Jeff Bezos, Google founders Larry Page and Sergey Brin, and ChatGPT pioneer Sam Altman have all invested in companies that aim to prolong human lifespan.
One of the most controversial names in the field of longevity is Bryan Johnson. He’s a 47-year-old American who sold his mobile payments app Venmo for $800m in 2013 and has since spent about $2m a year on a strict diet and exercise regimen, a cocktail of 100 or so daily supplements, therapies, and medical interventions to live for as long as possible.
Johnson and his team of doctors constantly monitor his health. They measure everything from his sleep quality and cardiovascular fitness to his muscle mass and function.
So far, the results place him in the top 1% of the 18-year-old population. Johnson shares details of how he has created his fountain of youth with millions of followers online, along with his brand of longevity products.
Nir Barzilai is a professor of medicine and genetics at the Albert Einstein College of Medicine in New York, the president of the Academy for Health and Lifespan Research, and the author of Age Later: Healthspan, Lifespan and the New Science of Longevity.
His views on pioneers like Johnson are mixed. “On one hand, Johnson brings attention to the field of longevity and the fact there are things we can all do to increase our health and life spans,” he says.
“But he’s putting science in jeopardy because all he’s essentially doing is studying himself. He’s putting himself in jeopardy because he takes so many supplements, some of which can be contradictory to one another. He’s also doing things like infusing himself with plasma from his 17-year-old son.
“My biggest fear is that he dies young because people will think that if he didn’t make it with all the money and effort he put into his longevity, then nobody is going to make it. They may as well not even try.”
This would be a big mistake as it’s long been proven that there’s a lot we can do to add healthy years to our lives.
Since 1998, when a Scandinavian twin study looked at 3,656 identical and 6,849 fraternal twin pairs, the scientific consensus has been that our genes only account for 20% to 30% of our longevity.
The remaining 70% allows us to take proactive steps to delay or even prevent the damage and decline we have come to associate with ageing.
Barzilai led a study called the Longevity Genes Project, which conducted genetic research on more than 700 healthy elderly people aged between 95 and 112 and their children.
It aimed to identify genes common to centenarians and to test which could be shown to slow ageing in cells.
Two drug therapies, a CETP inhibitor and an APOC3 inhibitor, have since been developed to attempt to mimic the effects of these genes and to enable people to live longer, healthier lives and avoid age-related diseases such as Alzheimer’s, type 2 diabetes and cardiovascular disease.
Barzilai is also looking at the further applications of long-established drugs like metformin.
“Metformin is derived from the French lilac plant and has been widely used for decades to regulate the symptoms of diabetes,” he says. “Over time, it became apparent that people taking metformin had a lower rate of cardiovascular disease, cancer, and Alzheimer’s disease than the general population. A recent study in the journal has shown that metformin changed the biology of ageing in monkeys to the equivalent of 15 years younger in humans.”
He is raising the funds for Tame, the Targeting Ageing with Metformin Trial in the US. Over six years, 14 leading research institutions will work with more than 3,000 individuals between the ages of 65 and 79 to seek to prove to the American Food and Drug Administration (FDA) that metformin delays the development or progression of age-related diseases.
“It’s a cheap drug that is already FDA-approved for other purposes,” says Barzilai. “Studies have already shown it can delay ageing in animals. We believe it may also influence the fundamental ageing factors underlying age-related conditions in humans.”
Johnson isn’t waiting for the results of Barzilai’s study. He and Jeff Bezos are just two of many people already taking metformin for its allegedly age-defying effects.
Texas-based longevity researcher Peter Attia is also interested in what we can learn from centenarians. In his book , he pays particular attention to a gene called FOXO3, which multiple studies have shown to be associated with ageing well.
He explains how FOXO3 regulates the activation of other genes involved in cellular repair. It’s key to maintaining health, and it’s been shown to activate more when we exercise. Attia uses this to argue in favour of regular exercise.
As proof, he cites a 2007 study carried out in the US and Canada that found participation in a six-month resistance exercise training programme reversed ageing symptoms in the skeletal muscle of older adults.
Apart from advocating for rapamycin, a naturally occurring substance that has been shown to extend lifespan in mice, which Attica takes and recommends to his patients, his advice is to focus on practical changes we can all make to improve our physical and mental function.
“We must be willing to change our habits when it comes to exercise, nutrition, sleep, and emotional health and then weave those habits into our daily lives,” he writes.
“Death will always be inevitable, but deterioration is less so. We can delay death and get the most out of our extra years.”
Cathal McCrory is a professor of life course development and ageing and the co-principal investigator of Tilda, the Irish longitudinal study on ageing.
He agrees that the time has come for us to reject the notion that ageing is a time of inevitable deterioration and to explore its health potential instead.
“Research shows ageing doesn’t necessarily equate to a decline in health, and environmental factors explain up to 70% of the differences in life expectancy,” he says.
“With proactive interventions, we can significantly influence the ageing process, potentially delaying or even preventing many aspects of decline. This offers the prospect of longer and healthier lives for older adults.”
He is as zealous as Attia in his belief in the power of exercise. “It’s one of the most vital components in maintaining physical health and cognitive function as we age,” he says.
“Regular physical activity has been shown to enhance mobility, improve mood, and reduce the risk of chronic diseases.”
There’s solid research to prove this, such as a 2022 study that analysed data from 116,221 American adults over 30 years and concluded that regular physical activity reduced the risk of all-cause mortality by up to 25%.
Other modifiable lifestyle factors include diet and nutrition, sleep, and emotional health. (See sidebar for more details.)
Barzilai thinks modern technology can help us to embed these habits in our lives. He points to his smartwatch and says “If I notice I haven’t hit my daily 10,000 steps, I make time for it in the evening. I use it to check my sleep quality. Wearing this allows me to optimise my habits for health.”
However, he cautions against taking a Bryan Johnson approach. “Access to knowledge is good, but he takes it to an obsessive compulsive level, monitoring himself constantly,” he says. “That doesn’t fit with the way most of us live.”
Attia writes in his book: “The most important ingredient in the whole longevity equation is the why. Why do we want to live longer? For what? For whom? Our life has to have clarity, purpose, and meaning.”
The approach compatible with living such a meaningful life involves making positive changes to how we exercise, eat, sleep, and support our emotional health.
“It’s never too late to start,” says McCrory. “Even into your 70s and beyond, initiating exercise, improving diet, prioritising sleep, and enhancing emotional health can all lead to significant improvements in health and quality of life.”
- Exercise has the greatest power to determine our health in old age. “That’s why we encourage individuals to find activities they enjoy, be it walking, swimming, dancing, gardening or hitting the gym,” says Prof Cathal McCrory. “Aiming for at least 150 minutes of moderate-intensity exercise each week broken into manageable sessions can lead to substantial benefit.”
- Focus on nutrition. TILDA nutritional epidemiologist Dr Deirdre O’Connor advises prioritising whole foods such as fruits, vegetables, wholegrains, lean proteins and healthy fats. “Additionally, wholegrain bread, fortified breakfast cereals, and yoghurts can play a critical role in older people’s diets by supporting immune function and overall health.”
- Check out the Mediterranean diet. It’s high in fruits, vegetables, legumes, beans, nuts, wholegrain cereals and unsaturated fats such as olive oil and low in meat and dairy. Several studies associate it with extended health and lifespan.
- Follow an anti- inflammatory diet. CORU registered dietitian Susan Byrne thinks such a diet may have merit. “Eating a wide variety of colourful fruit and vegetables increases our intake of anti- oxidants which could help reduce inflammation,” she says. “Other foods are also thought to dampen general inflammation. The Food Safety Authority of Ireland’s dietary guidelines for older adults suggest reducing the intake of saturated fats to less than 10% of energy intake to reduce the risk of developing chronic inflammatory conditions associated with ageing. They also recommend eating fish, including one portion of oily fish per week, to protect against these conditions.”
- Take vitamin D. “TILDA’s work shows that vitamin D is lacking in the older population, which has led to a national recommendation that those aged 65 and older should take a daily supplement of 15mgs to support their bone and muscle and immune health,” says O’Connor.
- Sleep well. “It’s vital for health and wellbeing at all ages, playing a crucial role in cognitive function, emotional health, physical recovery and even what we feel like eating,” says McCrory. “Poor sleep can exacerbate age-related health issues so establishing good sleep hygiene by maintaining a consistent sleep schedule and creating a restful environment is so important.”
- Look after emotional and mental health. “Managing stress, establishing and enhancing social connections and engaging in enjoyable activities can improve quality of life and ultimately enhance overall wellbeing,” says McCrory.
- Brush those teeth. Studies show that regular brushing and flossing is associated with increased longevity.
- Take up meditation. There’s research to prove that it can reduce the rate of cellular ageing.
- Laugh. It’s said to lower the risk of all-cause mortality.
