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Anti-Aging: State of the Art (lesswrong.com)
122 points by jz_ on Jan 1, 2021 | hide | past | favorite | 47 comments



I find majority of anti-aging articles to be way too optimistic. Consider the following:

We still cannot treat many well understood diseases, including tuberous sclerosis, allergies, asthma, etc. We don't know the exact cause of multiple sclerosis, Parkinson's disease, type 2 diabetes, etc, despite studying those diseases for decades. We can't help you keep the color of your hair or regrow your missing teeth, despite tons of money dedicated to such therapies by the industry.

And articles like these talk about combating aging - a combination of development, damage, and likely an evolutionary mechanism, within 10-15 years. I cannot help but be skeptical.


Scepticism is healthy. That said, aging affects 100% of population and is lethal. The amount of funding & effort should be orders of magnitude larger than for any of diseases you mentioned.

I'm reading through Sinclair's book "Lifespan - Why We Age and Why We Don’t Have To" and I find it fascinating (especially the chapter on origins of life and proto-genes of aging). When Sinclair talks about time-scales, he makes comparison to cancer. During last 50 years medicine went from fighting symptoms to actually addressing source for some cancer types. The quote that stood out: "From looks of it aging is not going to be that hard to treat, far easier than curing cancer". Book's predictions may feel too optimistic to me, but I don't have any qualifications to make such claim against leading researcher in field.


Interesting! Is this book approachable by someone who knows nothing regarding biology/medicine/etc ? Thanks


Very much so. It's written for an interested and intelligent general audience.


The key is regrowing teeth and keeping hair colour..because that’s the crux of rejevenuation.

One of the crudest forms of medicine is dentistry. It’s a very brute force method of replacing lost parts. Teeth are the extension of our bodies and it’s connected to every aspect of life.

It’s similar to a living organ and is the sum total of our health. And what do we do with tooth loss? We replace it cosmetically and functionally.

We don’t see any other use for it. If we consider teeth regeneration like growing ourselves a kidney instead of a kidney transplant.(or heart), that would be the day anti ageing is in our sights.

But we have to first consider the problem and label it properly. It is known that plaque in teeth is indicative of heart plaque. Dental infections can get into the blood stream. Cavities point to other issues too. Dental health starts with gum health.

And yet..the remedy is not changing life style or eating habits or research into rejuvenation. But we knock them out and stick a ceramic one. Imagine if we stuck a silicone heart or a kidney like one would a breast implant. That’s the equivalent of fake teeth that is drilled and screwed to the jaw bone.

If we figure out how to regrow our teeth, half the battle is won.


> It is known that plaque in teeth is indicative of heart plaque.

Would you please link to some information about this?



I imagine dentures and hair dye killed most motivation to solve the two problems you listed. Everything else, I agree with.


I cured my asthma with Iodine and Magesium.

Iodine also seems to help type II according to some doctors.

Progress is slow, and I agree that most anti-aging results are over hyped.


Could you give more details, please?


We need automated and mainstream Vitamin and Mineral testing - without needing to go through the traditional healthcare system.


Theranos probably set that goal back a decade.


IMHO, that's because to answer these questions, we need to research fields that are labeled as pseudoscience for no good reason. For example, no serious scientist who cares about career and reputation can study things like "animal magnetism" - he would be labeled a lunatic and get ousted from the community (no more grants, no more employment in academia). Plus the state of things in academia doesn't encourage big bets.


As someone already totally on board with ending aging, I found this article not terribly helpful.

My main questions are "what should I be doing right now to stop my own body from aging?" and "when will more stuff be available for me to do that is not currently?"

The article didn't help much in this regard. As far as I can tell, there are a number of clinical trials I should watch to see if those drugs work in humans? But nothing actually confirmed yet? I sure hope they do pan out, but given how many treatments in general medical science cross the mice/primate-to-human barrier, I'm not feeling optimistic.

Note that in the article itself, the first comment and its replies get into this a bit, and the author does advise taking certain drugs right now. Maybe I'll try to convince my doctor to prescribe metformin...


Do you avoid sugar, fructose, calorie free sweeteners? Do you do strength training & cardio? Are you overweight? Is your waist to hip ratio ideal for your gender? Do you monitor your blood glucose? Get 8 hours of sleep consistently? Avoid stress? Do not live close to a highway / live in a place with high air quality? Get consistent screening for issues that your family has to catch them early? Get enough sunshine? Resolved depression or anxiety disorders? Have social connections you enjoy? Drink enough water? Do not smoke or drink alcohol? And sorry, the negatives of wine outweigh the benefits.

All of that is already hard to execute consistently in this society and is our most well known age reducing things we can do currently.

Edit: Some more: Do you fast semi regularly? Eat clean fish? Get outdoors in nature? Avoid allergens to stop triggering your immune system? Live in a dry and mold free house that still gets enough air circulation?


I do all that because I'm relatively wealthy and have plenty of time and freedom. And that does show. Aging still manifests as a slowly increasing suspectability to various damages like a minor allergy that puzzles doctors, minor hair loss, minor pain here and there, but this all adds up and wears the body out. The cause of aging must be a lot deeper than excessive consumption of sugar.


My point wasn't that I lack the knowledge of how to fight aging in these typical wealthy/time-rich-person ways. My point was that the article was not helpful in giving new information.


> calorie free sweeteners

Could you please provide some evidence for how these impact longevity? Especially those from natural sources, e.g. stevia and monk fruit. Not trying to be snarky, just genuinely curious!


Well for one, natural sweeteners interfere with the bodies insulin response. I.e. it will overproduce in anticipation, but then your blood sugar drops into oblivion, because well, you didn't actually eat sugar. Is this bad? Probably not if you don't overuse them.

Besides that? I can tell you my body is very sensitive and artificial sweeteners (I literally tried all different kinds) make hell break lose in it, much worse than sugar could ever be. So perhaps they aren't such a great replacement after all? This usually applies to everything humans try to lazily swap out in foods. Oh so I am vegan? Keep these meat replicas coming, only they are like 100 times worse for your health than the real thing...


Thanks for the information. After a bit of research I found this study from May 2020:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7257251/

> Artificial sweeteners are related to non-alcoholic fatty liver disease: Microbiota dysbiosis as a novel potential mechanism

> Non-alcoholic fatty liver disease (NAFLD) is a systemic and wide-spread disease characterized by accumulation of excess fat in the liver of people who drink little or no alcohol. Artificial sweeteners (ASs) or sugar substitutes are food additives that provide a sweet taste, and are also known as low-calorie or non-calorie sweeteners. Recently people consume increasingly more ASs to reduce their calorie intake. Gut microbiome is a complex ecosystem where 1014 microorganisms play several roles in host nutrition, bone mineralization, immune system regulation, xenobiotics metabolism, proliferation of intestinal cells, and protection against pathogens. A disruption in composition of the normal microbiota is known as ‘gut dysbiosis’ which may adversely affect body metabolism. It has recently been suggested that dysbiosis may contribute to the occurrence of NAFLD. The aim of the present study was to investigate the effects of ASs on the risk of NAFLD. The focus of this review is on microbiota changes and dysbiosis. Increasing evidence shows that ASs have a potential role in microbiota alteration and dysbiosis. We speculate that increased consumption of ASs can further raise the prevalence of NAFLD. However, further human studies are needed to determine this relationship definitively.


Well, am I the only one who can think of a better future where you can do/not do all those bad/good things and still live a long, healthy life?


Add one more from a previous thread on similar topics; regularly donate blood. Forcing your marrows to create new blood often seems to have a great effect on joint and heart problems.


This is a great list. What is the truth about wine?


Red wine contains resveratrol that have anti-aging effect on mice. To get effective dose of resveratrol, you would have to drink unhealthy amount of wine, which beats the purpose. You may google David Sinclair talks, he talks about resveratrol, NMN and metformin.



> when will more stuff be available for me to do that is not currently?

I like this list of drugs that are on the horizon: https://www.lifespan.io/road-maps/the-rejuvenation-roadmap/

(Phase 1-3 means it is being tested in humans.)


In my opinion the field of anti-aging is currently under-appreciated by a factor much greater than that of just about any other area, and this article is a great introduction to help garner interest in the field.

A minor improvement in slowing aging would save more years of life than curing cancer, and it's unfortunate that a lot of the most exciting discoveries and research are under-reported on (meanwhile, some of the least-exciting or relevant findings get significant hype by media outlets on occasion, die to seemingly random clickbait-ification algorithms).


Further, most serious diseases like cancer and heart disease that are major issues in developed nations are highly age related. Progress on one front will likely lead to improvements on others.


Let's also not forget some preventative measures. E.g.:

WHO estimates that around 7 million people die every year from exposure to polluted air.

https://www.who.int/news-room/air-pollution


Definitely, I don't want to understate how important things like that are; but I feel like the average person is already aware of the need to dedicate significant resources to improve air quality, and would even be happy if their tax money went to this cause. But yet I cannot say the same about anti-aging, and I think very few people are even aware that it is a real field with extreme potential to begin with.


Peter Attia's podcast (https://peterattiamd.com/podcast/) is focused on longevity and he has some great topics & speakers.


Like many virtuous science applications, curing disease, fighting child abuse, feeding the hungry, unless we start seeing either profitable business models around it or charitably funded research organizations that actually pay competitive salaries to attract and retain talent, this is all just aggrandizing. It’s usually pet projects of certain gurus or career researchers with extreme personalities and penchant for drumming up funding hype.

When the science is real and we’re talking about professional, legitimate deployment of a medically revolutionary technology, it won’t show up as fractious riff-raff biotech startups built on the back of post-docs and super cheap labor hoodwinked by idealism. Rather it will be companies or non-profits that actually pay high compensation to get results.


It's a common pattern that people start donating to illness research as soon as they have enough money.

While there are taxes implications, once more immediate needs are met, saving yourself from death in the future becomes something worth investing into.

Not everyone is that selfish or conscious about their selfishness, but I would expect this to manifest as a trend - which seems to match reality


Ok. I read the whole thing. As someone who participated in the proto-less-wrong type forums on anti ageing/longevity/being immortal almost close to two decades ago, I just want to add that even back in 2002, cryonics was ALWAYS plan B to many of us who spent our evenings chatting about how to live forever.

There is too much to say..but short version: Cryonics was not just bad science. It was considered by many of us then as bad science fiction...at its best. At its worst, no more useful than the Egyptian mummification attempts to become immortal. In the end, the Egyptian mummies ended to as fertilizer anyways.

Alcor that went by Life Extension then got into a right royal soup later when Ted Williams frozen body was separated from his head that went missing and was kicked around by a rogue employee. Several of his DNA samples went missing.

It was GNARLY. I slowly became disenchanted but I have to admit that reading this now, great strides have certainly been made..not so much as getting closer to anti-ageing, but more in terms of clarity of purpose.

On a slightly related(nostalgic) note: ‘neural link’ was always the reachable and desirable goal. And I think that’s where we will end up eventually. Neural links and clones/bionic/prosthetic aided clones.

Re: Ted Williams and Alcor .. https://connectingdirectors.com/53931-ted-williams

[..]But the worst was yet to come. Fast forward seven years to 2009, when a book by a former employee of Alcor hit the shelves containing explosive allegations of Alcor’s abusive treatment of Williams’ frozen head. Author Larry Johnson wrote that an empty tuna can was used as a pedestal to support the slugger’s head while experiments (which subsequently cracked his frozen brain) were conducted. When the tuna can became stuck to the head, an Alcor employee allegedly tried to dislodge it by swinging at it with a monkey wrench, in the process missing the can and connecting with Williams’ head instead. Johnson wrote that the impact sprayed “bits of frozen head” around the room.[..]


My estimated lifespan is probably close to 90 years, but very likely the last 15 to 20 will be marked by health issues of increasing difficulty. If the various modalities of life extension leave the shape of the healthy/sick profile but simply stretch it out another 30 years, I'm not sure I'd be happy about that. If it could simply remove sickness and I died healthy at 90, say of a massive stroke, that would be a great improvement over my current expected trajectory.

That leads to this thought: if anti-aging can't simply remove sickness but just stretches out the existing healthy/sick profile to say 120 years, one way to achieve what I want would be to accept the anti-aging drugs and enjoy good health, then kill myself at 90.

Lots of people will be horrified by the thought, but it is still an absolutely better outcome than not taking drugs and following the usual course of events. Also, my approach circumvents many (but not all) of the negative consequences that would occur if the anti-aging technology works and everyone uses it.


Do you think voluntary euthanasia should be open to older people? And what’s the floor on that age? 75? 100?

I have always wondered why we stop people from quitting life. Free will and all that. It seems to be the most basic of all freedoms.


Ditto. I'll kill myself when I'm done with life, if I ever will get to that stage, no matter the age. If I can prolong a healthy life, I'll do that.

I've seen too many old relatives tired of living or living in pain.

I don't see the point of making a big deal out of it, thinking that human life has some intrinsic value is like thinking the universe revolves around earth or that we're the chosen ones instead of some very advanced monkeys.


This reminds me of "Why I Hope To Die At 75", https://www.theatlantic.com/magazine/archive/2014/10/why-i-h... - do you agree with the reasons there?


Sustained-release melatonin before bed (minimum dose to maintain youthful serum; eg, REMfresh). Balance with vitamin D3 (+ K2) in the morning. Meet all RDAs with just a variety of whole quality foods. Last meal 3-4 hours before bed or earlier to not ruin hGH/IGF-1 release during first few hours of sleep. 2:2:1-2 calcium:phosphorus:magnesium ratio.


How about protein before bed if you’re getting a lot of exercise and looking for muscle gains? Or still bad?


I don't believe gains are that fragile. IGF-1 has a longer half-life.

More important is overall surplus (hard gainers need more), nutrition, regular gym time, and low stress/catabolism. Normalize cortisol, insulin, and thyroid/HPTA/metabolism.


Parabiosis (blood exchange), if it works, would seem to have a lot of societal implications around the question of where the good blood comes from.

The most obvious implementation would be for old, rich people to pay for the blood of young poor people. That could conceivably work, but it's also more than a little dystopian.

Some follow-up questions if this actually works are: how much blood are we talking about here? and is there a way to grow/manufacture blood in a lab, perhaps by growing human bone marrow outside the body?


The other question is whether a young person loses any lifespan, by forcing their body to generate additional blood at a younger age, by being a blood donor. I suppose this could be tested experimentally by performing frequent phlebotomies on a mice and observing if it affects life span.


In fact this has recently been studied.

>https://sciencenordic.com/body-death-denmark/frequent-blood-...

> A new study concludes that regular blood donors are not at a greater risk of a premature death than those who rarely donate blood.


The lowest hanging fruit today is just avoiding harmful things.


Kaya kalpa therapies are traditional for anti ageing and rejuvenation in Ayurveda. Of course, such packages are provided in spas these days. Obviously not practiced as in the texts.

Having said that, I have translated tamil and Sanskrit texts. I distinctly remember a verse that describes a preparation made with heavy metals ..I believe there was arsenic. And my fav ingredient there was Mercury. That would fix ani-ageing.

I always keep an open mind. One never knows. If only we knew what the ‘Soma’ creeper is and where it can be found..

Random google search result:

http://ayurveda-sedona.com/knowledge-center/anti-aging-rejuv...

[..] First of all, one is sequestered for about 90 days. The patient is to remain in a “Kuti” a specially built closed cottage or hut, where light does not enter. During those three months, they remain in the darkness, shielded from sunlight and outside visitors. There, they begin complete purification of the body through Pancha Karma detoxification techniques. Certain herbal pastes are rubbed onto the body to exfoliate, and than allowed to dry, drawing out toxins. Medicinal plants, leeches, sweating and vomiting therapies are used for further detoxification of every organ system. During this time, diet is very minimal, perhaps eating only once a day, or even fasting on liquids. Some yogis drank only warm cow’s milk, considered sacred by Hindu’s, during the whole process. Specialized salts were ingested to preserve the body.

After weeks of cleaning the body of all built up impurities, it is time to re-nourish tissues at the deepest levels. Abhyangha massages, mineral baths, shiro dhara, sacred essential oils and precious gems were used to anoint the body. At this time, the immune boosting rasayana herbs and fresh juices were administered. These tonics are full of antioxidants, fighting free radical damage. There are legends of rare, specialized rasyanas, such as the elusive “Soma” plant, found in the mountains of India. It is not quite clear where this creeper was exactly located, but apparently it was the secret ingredient necessary in the magical elixir of youth.

After their morning spa therapies, patients spent the majority of their time performing tapas, meditating, reciting mantras, and practicing yogic breath. This time of hibernation not only cleansed their physical body but transformed their subtle and emotional bodies as well. They release all stuck emotions, anger and grief. They clear karmas of past lives through inward reflection. They often had visions of God, bestowing blessings upon them, and filling them with light. Universal knowledge is revealed to them from the cosmos. They cultivate inner peace.

After the “Kuti-pravesika” (living in the dark cottage, sequestered for 90 days) the person emerges completely transformed. The old grey hair falls out and is replaced by black hair. Old teeth fell out, replaced by new teeth. Complexion becomes fair, wrinkles smooth out and skin’s elasticity is restored. Eyesight and hearing drastically improve. Age related joint/body pain is gone. Memory and concentration is sharp, and there is spiritual clarity. The normal gross, dense vibrations of the physical body are sped up to a lighter, subtler frequency.[..]


Yeah. Give me more years to waste, please.




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