Begin Again with Davina McCall - Anti-Aging: Could This Be The Miracle Drug? The Secret To Living Longer. With Expert Andrew Steele

Episode Date: January 23, 2025

In this episode of Begin Again, Davina is joined by Andrew Steele, scientist, author, and advocate for unlocking the secrets of human longevity. Andrew delves into the fascinating science of ageing, challenging the notion that growing older as we know it is inevitable. Drawing on cutting-edge research and groundbreaking developments in anti-ageing science, he explores the transformative potential of extending not just lifespan but health-span. Through this eye-opening conversation, Andrew reveals how small changes today could lead to a future where we age better, and perhaps even slower, offering the knowledge and inspiration to rethink our approach to ageing and well-being. Follow me here: www.instagram.com/beginagain https://www.tiktok.com/@beginagainpod  (00:00) Intro (01:32) Andrew's Interest In Aging (05:14) What Is The End Goal? (07:06) Life Span vs. Health Span (10:16) Menopause And Aging In Women (21:06) The Anti-Aging Miracle Drug (25:05) How Close Are We To Having An Anti-Aging Drug? (25:46) What Other Anti-Aging Drugs Are Being Developed? (27:31) The Truth About Inflammation (32:13) Holistic Medicine (32:50) Funding Research (35:22) Andrew's Dream For Your Future (36:58) What Will Death Look Like With Anti-Aging Drugs? (38:42) Misconceptions About Aging (42:50) Zoe Ad (44:20) Longer Life Spans And Overpopulation (47:54) Spreading The Word (52:05) How Would We Take An Anti-Aging Drug? (54:48) Artificial Intelligence (AI) (57:16) The Hallmarks Of Aging (1:00:11) Societal Changes (1:02:11) The Best Advice For A Long And Healthy Life (1:14:50) Andrew's Book (1:19:15) Davina's Round-Up Sponsored by: ZOE - https://zoe.com and use code DAVINA10 Learn more about your ad choices. Visit megaphone.fm/adchoices

As a 56-year-old woman, I do believe that I'm way over halfway to the end of my life, and you can tell me if that all might change. Imagine we lived in a world where we didn't have aging. People were living much, much longer, much, much healthier lives. Are you talking about a world where people could live to 90 healthily? As you get older, your risk of cancer, your risk of heart disease, your risk of dementia, all of these diseases, the risk goes up exponentially, just like that risk of death. Aging is the thing that causes dementia. Aging also causes cancer. Aging also causes heart disease.

And so maybe we should be looking to solve this problem before it happens. What does this miracle cure look like? How are we going to do this? The first thing... What would be your dream? Ultimately, you know, I just want to help people avoid this suffering as best as possible. Andrew, how close are we, do you think? We could have an anti-aging drug in the next five or ten years. Shut up.

Yeah, it's incredible. Sorry, I keep telling you to shut up, but you're just blowing my mind. That's absolutely incredible. What are the major things that you would say to somebody, if you want to live, If you want to live the longest and healthiest life possible, okay, these are the things I would advise. So the first thing is... Welcome Andrew Steele, thanks so much.

And I am fascin noted by this topic because as a 56-year-old woman, I do believe that I'm way over halfway to the end of my life. And you can tell me if I am or not or what's going to happen in the future or whether I might, that all might change moving forwards. But first of all, what got you interested? in ageing? A lot of people ask me this and they sort of assume maybe I had some, you know, terrible experience with an ageing parent or something when I was younger or aging grandparent. It's actually a graph. So I started out as a physicist. And so as you can imagine, the way that

I see the world is a little bit statistical, a little bit mathematical. And this graph, it's a very simple graph, but it's just, it's really powerful. It really spoke to me when I saw it. And it's, it's a graph of your risk of death depending on how long ago you were born. So obviously, on the bottom, you've got how old you are and at the side you've got how likely you are to die. I think all of us know that as you get older, you are more likely to die, but just how much really shocked me. So let's try and put some numbers to it. If you're lucky enough to be born in the rich world, you've got a risk of death of about

half a percent that year, so you might be born with congenital abnormality or cancer or something like that. But if you're fortunate enough to make it through that first year, your risk of death goes down and down and down until the age of 10. And current 10-year-olds have an incredible title. They are the safest humans in the history of our species. They've got a less than one in 10,000 chance of not making their 11. birthday. But unfortunately, it's bad news from there on. Exactly. So our risk of death roughly doubles

every eight years. So by the time you're my age, I'm 39, my risk of death this year is about one in a thousand. Now, I quite like those odds. Yes, that sounds quite good. Because that means if that were to continue for the rest of my life, I'd live into my thousand and thirties on average. But of course, unfortunately, that isn't what happens. We carry on doubling and doubling and doubling something every eight years. By 65, it's about 1% per year. Still all right. You still live to 165 on average if that continue, but unfortunately 1% is now a big enough number that doubling it is really starting to matter. And if you and I are lucky enough to live into our 90s, but unlucky enough that none of the science we're going to talk about today has come to fruition, we'll have a chance of death of

about one in six. That's life and death at the roll of a dice every single year. And you know, you can look at that as a human and you can think, well, that's terrifying. We've got this exponential wall of mortality coming at me. Or you can look at it as someone just finishing a PhD in physics. and you can think, wow, there's something really fascinating going on here. It looks like there's this incredible synchronized increase in the risk of all different kinds of problems. You know, cancer, heart disease, dementia, frailty. Obviously, the wrinkles of the grey hair, we all know comes along with aging.

And perhaps if we could understand the processes that cause that huge increase and huge change in all of our bodies, then maybe we could slow those changes down and do something about it. So I decided to switch to biology and find out if that was even possible. Does your physicist brain massively help you come at this from sort of with a bit of lateral thinking? I think so. And I think you actually find a lot of people who work in longevity science have a physics or a maths or a computer science background. And I think it's because, you know, I found this myself. My wife's a doctor. When I first met her and started talking to her about the idea of medicines to slow down the aging process, she thought I was crazy.

And that's because I think if you're a medic, if you're a biologist, there's not a single lecturer. this in most medical or biology degrees. It's not a page in the textbook about aging, which is kind of wild when you think about it because it's one of the few like almost universal processes in biology. Yeah. And yet there's nothing taught about it in university. And what that means is I think, you know, medics, biologists, they're taught very rightly to be extremely skeptical. I'm not my doctor to be super skeptical, checking out all the evidence, making sure that the treatments they're giving me a safe, have got really good, you know, clinical trials behind them. But what that can mean is, you know, aging, anti-aging, particularly this phrase, it's got sort of

overtones of cosmetics, of snake oil, of quacks, of skin cream. So, you know, trying to sell that idea to people who haven't been taught that it exists is really, really difficult. But if you come at it, you know, perhaps almost naively, actually, as a mathematical, a physical scientist, you just look at this correlation. You say, what is going on here? And if we can understand it, can we do something about it? What would your end goal look like?

I mean, I want to talk to you about how we're going to get there, but sort of what do you want to happen? What I really want is just to decrease suffering. So it's, you know, when you start talking about this stuff, I get a lot of questions about immortality and can we live to 200. These are interesting philosophical things. Obviously, you can write sci-fi about them. What I really care about is the fact that as you get older, your risk of cancer, your risk of heart disease, your risk of dementia, all of these diseases, the risk goes up exponentially, just like that risk of death, you know, increasing massively when you get to the age of 60 or 70 or 80. And so if we can understand the processes that cause all of these diseases, we can push those further and further back into the

future and we can keep people healthier for longer. And it's not just the diseases, because I think that's another problem because our medical system views things through this very sort of disease centric lens. Maybe you're getting a bit frail, he's starting to lose a bit of muscle, but it's not getting to the point where you could get a medical diagnosis. If it gets really bad, we call it sarcopenia. But if you're just a bit weak and having trouble opening jars and can't get up the stairs anymore, then, you know, like if you a walking stick or give you some assistive stuff around the house. And that's great. You know, we need to do those things to help our older people. But wouldn't it be fantastic if we could come up with medicines that could stop people losing that muscle in the first

place? And that's just, that's my real end game here. I mean, what I love is you're 39 and I'm 56 and I'm in three years time, I will be 60 and you're talking about 60, 70, 80 and you know, I am that person and these are all concerns that I think about. I don't want it to rule my life. but I am making decisions in my day-to-day life to try and stave off as much as is humanly possible. These illnesses, are you talking about a world where people could live, we were talking about 90-year-olds earlier, to 90 healthily and then die in their sleep? Well, this is an interesting question. This is the sort of gets to the hub of a debate about lifespan versus health span. And what I want to do is expand that health span.

And what people are sometimes a bit more concerned about is this idea of extending lifespan. And I think the reason for that concern is that, you know, you imagine if you're going to live to, let's say, 100, you might spend the last 20 years in a nursing hand. We don't want to do that. We don't want to stretch out that period at the end of life at all. And also, let's face it, governments and wouldn't be able to afford it. Exactly. You know, we've already got an ageing population. If I're dragging out that period of frailty, people aren't contributing to the economy, they can't stay active, they can't stay working.

This could be a big problem. But the thing is, imagine I did stretch out, you know, our lives to 90 in good health. why would we die in our sleep? Because if you're healthy, what's going to kill you? You know, ultimately, there's this sort of myth, I think, that you can die of old age. It used to be acceptable to write it on a death certificate. And I think sometimes it is still used. I think the Queen's death certificate said old age,

because that's perhaps the most diplomatic thing to put on there rather than ascribe it to a particular cause. But actually, you know, most people die of a thing. And that thing, be it cancer, be it heart disease, often slowly, you know, saps your independence over years, sometimes decades. You know, when you have a heart attack, it's often not that you're absolutely fine the day before and suddenly snap, you know, you have a heart attack and you fall down dead. There are years during it your heart is getting less good at pumping, your blood vessels getting thinner and thinner.

You're getting slower. This has a huge impact on your day-to-day activities, you know, whether it's playing with your grandkids, whether it's traveling, whatever it is you want to do, it, it gets harder because of these changes. And so I think we've got to bust this idea that you can just die peacefully in your sleep. But some people are lucky enough to do that. And obviously, I hope that for everybody. but the real thing we need to concentrate on is trying to reduce the suffering from these diseases. Does that mean, I want to know all how we're going to do this in a minute, but do you think reducing how our frailty or improving our health as we get older, surely that would just mean extending our life as well? I think it would ultimately. You can sort of see this as a side effect.

But actually, you know, this is something we're already phenomenally good at. you know, if you think about let's time travel back to the 1830s, life expectancy in that time was 30 or 40 years old. Yeah, fascinating. And so we've essentially doubled what it means to be human in the last sort of two centuries. And, you know, obviously there have been big societal changes while that's happened, but the world has not ended, you know, we're still pressing on. And actually, you know, the goal of most modern medicine, if I was talking to you as a cancer

researcher, you wouldn't be asking me this question. You wouldn't be saying, oh, you know, these people are you curing of all that cancer, aren't they going to be bored with all those extra years of healthy life for giving them? But as soon as you start talking about ageing, and this is really common, people put it in a very separate ethical moral category. And the only real distinction for me between, you know, a cancer drug or an aging drug, is that the aging drug has the power to be much more effective because it wouldn't just hit the cancer.

It would also hit the heart disease. It would also hit the dementia. It would also hit the frailty. And most importantly, it would be a preventative medicine, so it would stop you getting ill in the first place. And so for all those reasons, I'm really excited about it. But I think for all those reasons as well, people do treat it somehow slightly differently to the rest of modern medicine.

You've just slightly blown my mind. Wonderful. Yeah, I love this. I really hope you're enjoying this episode. And if you can, give us a follow. I'm interested. You know, what you said, I suppose as a menopausal woman, I think this is fascinating because the argument for HRT for me has always been looked 200 years ago. You wouldn't live past 40. You'd never hit the menopause. So, you you wouldn't go through this thing where you stop being of childbearing age and then have to deal with the estrogen, why wouldn't you take something that would help you feel better? I mean, in a way, this is kind of in a very small way, a tiny way of making somebody feel

absolutely fantastic for 10, 20, 30 more years than they would have done normally. You know, I'm, my joints aren't aching. Estrogen is WD40 for the whole body for a woman. My blood vessels are softer. I'm thinking that there is new sites coming out in terms of Alzheimer's risk and estrogen. So, sorry, I mean, that's a very long answer. And I am going to ask you a question in a minute, but that's really blown my mind. I think, I guess the next question would be, what does this mirror?

cure look like, how are we going to do this? I'm actually going to rewind back a bit and just mention something that you said, which is that most women back in the day, and this, you know, men as well, wouldn't have made it past 40. This is a bit of a misconception about life expectancy. So there are two things that saying the life expectancy was 35 in the UK in 1800 gets slightly wrong. The first thing is that actually a huge amount of the death that happened in that time was in very, very either early childhood or the teenage years. So you had roughly a 50-50 chance of making it to the age of 20. And what that meant was that you're dragging life expectancy down an awful lot because life expectancy is just the average amount of time that somebody in that year lived.

And so the first thing that's saying life expectancy was 40 does is it masks this terrible toll of infant mortality. But the second weird thing about that, and this is actually a really fascinating thing about menopause, is that actually, you know, if you did make it to 20, you probably had 40, 50 years of life expectancy left, which means living in your 60s, your 70s maybe. You would have seen the odd 90-year-old in the 1800s. There wouldn't have been many of them, but they were about. And so this sort of headline life expectancy statistic masks that. And then that leads to this really fascinating question about menopause. Why do women die such a long time after their reproductive lifespan? This is almost unique in the animal kingdom.

So human females undergo menopause. We think that certain species of whale, or carers, killer whales, people might have heard of undergo menopause. I think giraffes. There's a couple of other species we have a little bit of evidence for, but mostly. animals experience a gradual decline in fertility throughout life. They don't experience this sudden sort of dropping off a cliff at a particular age.

And so there's this really fascinating, just evolutionary question. Why do human women? And it is just women. Why do we still exist after the most important thing? That wasn't quite how I put it. No, but it is interesting. I mean, I feel like we exist to care for the mothers and be a grandparent. Yes.

I actually think we have a very important role in doing that. Even if you thought back to cavemen and women, as an elder, an elder woman, you have the wiseness, the experience. I feel like that is Amara. Yeah, this is called the grandmother hypothesis. You might have heard of it. No. And so the idea is that maybe one of the reasons that older women stick around post-reproductively,

maybe one of the reasons this reproduction falls off a cliff is because of the wisdom they can give to the later generations. And actually, there are some really fascinating studies in killer whales where they've looked at these pods of whales, they're swimming around, they've often got this older matriarch. And because she's been around for decades and decades and decades, she knows where all the food is. And so if there's a bad season and food over here isn't able to be found, she'll know the other place in the ocean where you can get some new fish and some fresh fish. And what they've noticed is that there's actually a survival penalty that's paid.

If that matriarch dies, then those pods are less successful in the years that follow. And, you know, it's the same probably with human grandmas. They're able to care for the kids. they're able to, you know, help the mothers, help the fathers, help around, you know, the village or whatever it might have been. I think that from an evolutionary point of view, if you run through the maths, doesn't explain everything about, you know, why women go through menopause. But it's certainly a pretty compelling argument as to, you know, one reason.

And the other one is probably just your child, bearing a child is very, very hard work, as, you know, anyone who's been through it can attest. It's not just about whether your ovaries can produce eggs. It's also about the resilience of every other system in your body in order to, you know, carry that baby to term. And then obviously giving birth is, I gather, quite a lot of fun as well. I actually loved giving birth. Did you? Yeah. I mean, obviously it's intense. It's really intense, but I feel kind of sorry for men in a way because that experience of pushing out a being and then them crying and you looking at them. And the wonder and the magic of that is beyond like belief.

you, it's incredible. I can totally believe that. My wife's actually pregnant at the moment. Oh, and it's a, it's a strange, strange thing because she's got this, this human growing inside of her and I can see it moving and I can feel it moving. But at the same time, I am that much more distant from it. And, you know, at the moment, it's still not quite real to me in some ways because, you know, obviously I know it's coming. I understand the biology going on here. But, you know, it's not going to be very many months now before we have a little tiny human being to care for. And that's be absolutely transformative. So it really is an incredible experience. But at the same time, you know, I wouldn't want my wife going through this at 90. So maybe evolution's calculus.

I mean, would sort of staying on this theme a little bit, if we did elongate health and prevent aging, then would that mean that women evolutionarily would continue, kind of that they would continue childbearing until later? Would that happen? This is a question. It's a fascinating question. Actually, I think the best way to answer this to talk about one of the potential therapies, which is actually being tried in this exact context right now. Is it? Yes. Shut up. I think this is a really, and it's a really interesting case in point because one of the challenges with testing and anti-aging medicine is that imagine it slows down aging by, let's say 10% just pick a random number out of the air. And you're going to do this study. It's going to be

years before you can pick up that those people are living 10% longer, they're getting cancer 10% later, whatever it might be. So what we need to do is try and find, what I call indications in the medical jargon. So basically stuff that we can measure over a shorter time scale. And a really interesting example of this is the menopause because the female ovary, for whatever reason, ages much, much faster than any other organ system in your body. If you look at the liver or the lungs or the brain, they don't all change exactly the same time and it varies from person to person. But mostly, everything's basically fine until your 60, then starts sort of going downhill a little bit and increasing rapidly as time goes on. Whereas the

ovary, ages maybe two and a half times faster, depending on how you define it. And obviously, you know, a lot of women have stopped menstruating in their early 40s and perhaps into their mid-50s. So that is an incredible, you know, model system is how scientists would look at this. It's a fascinating example of saying that ages much more quickly. So maybe we can do the experiment much more quickly. And there's a trial called Vibrant at Columbia University where they're giving women a drug called rapamycin. We can talk a bit about that in a minute. And the idea is they're giving it to women who are perhaps going into slightly early, you know, their periods are getting a bit less regular, just to see if they can extend that window of fertility.

And this isn't, of course, just about fertility. Exactly as you said, you know, when you lose your hormones from your ovaries, you get the bone, you get less muscle mass. There are loads of changes that happen in your body that come alongside that. And so although, you know, whether or not you're having a period, whether or not you can get pregnant, is a really easy to sort of short-term endpoint. The hope is that by slowing down aging, maybe with a drug like opomysic, we can then, you know, keep women healthier for longer as well as giving them a longer window opportunity to reproduce.

And would giving women estrogen even though they can't, would it make sense that I'm not asking because I'm just interested out of HRT and I don't have a hidden agenda that women should take HRT, but does it make sense that replacing women's estrogen would help them live longer? It's an interesting question and there are, we haven't got the perfect study unfortunately as we often haven't in ageing, but we have got some suggestive evidence that it sort of points us in that direction. So for example, if you look back in medical records, we'll have a lot of women who've had, and I actually call it hormone therapy. I've got a scientist I love called Jennifer Garrison,

who's trying to get rid of this word replacement. Because she thinks it implies a sort of deficiency in women. And actually... Oh my God, I love that. Yeah, I was... What's her name? Jennifer Garrison. Big up Jennifer Garrison.

Yeah, she's great. She's absolutely fantastic. Really crusading on this, all this sort of women's health stuff. Yeah, hormone therapy. Yeah. And the other thing that she, you know, if we're going to talk in amankleture, she doesn't like calling the ovaries reproductive organs either

because they do so much more because they're in this constant conversation with, you know, all parts of the rest of your body, all these hormones. they're giving off. Exactly. For your body. This huge number of different functions. Women who have their menopause later tend to live longer. And it's not a huge effect.

The sort of spread of ages of menopause is 10, 15 years. And the extra life expectancy you get is maybe two or three years if you're at the very latest end of that. This isn't, you know, if any women are watching listening to this, who had early menopause, this doesn't mean you're going to die. It's a statistical thing. Yeah. But, you know, there is clearly some kind of effect going on there.

We also know, and there's this fascinating experiment published in 2020 in mice. and they sometimes do slightly strange things in mice, so forgive the weirdness of this experiment. But they took some ovaries from young mice and transplanted them into older mice, and they found that it made the mice live longer. So these older mice are somehow being given a new lease of life by the hormones that are being provided. And whatever other interactions those ovaries are doing inside the body. And the strangest thing, and we do not have an explanation for this, is that if they first removed the egg cells from those ovaries,

then transplanted the young ovaries without eggs into an older mouse, The mice lived even longer still, they lived 36% longer than mice that hadn't been given these transplanted. So it's not working ovaries, it's just ovaries producing estrogen. It depends what you mean by working. So the hypothesis, and again, this is completely speculative. We don't know if this is how it works yet. But the hypothesis is that maybe the cycling, when those eggs are present, where's the ovaries

out essentially? And so if they're still able to do all the cool non-reproductive stuff that they do, they can maintain mouse health and carry on, keep those mice healthier for longer and therefore living longer without necessarily needing to cycle and produce an egg once a month or whatever that might be. I don't understand. Like, when do you sleep? I mean, you've got so much information at your fingertips and so many realizations to

be had and to do. You were talking about the drug that was given to the women who were going to try and stay of baby making age or stay fertile for longer. Tell me about that drug. So this drug. I'm going to talk to you about it in a minute. It's called Rapamycin. Yeah.

It's a fascinating. story behind Rapamycin. It was discovered first in the soil of Easter Island, which is the island with the massive stoneheads. And in the Polynesian, that's called Rapanui. So that's where the drug gets its name. And it was first discovered during this Canadian expedition because the Chilean government were going to build an airport on the island. It's 2,000 miles into the Pacific Ocean. It's been this isolated human habitat for hundreds and hundreds of years. So this expedition went and took all these samples before the airport came and disturbed this pristine habitat. And in one of the soil samples, they found a particular kind of bacteria. And those bacteria, for some reason, fungi,

couldn't grow on the plate near the bacteria. So the scientists were scratching their heads, these bacteria must have some kind of antifungal agent. And they isolated this molecule. It's called rapamycin. And it turns out it has a lot more uses. So it doesn't just stop fungal cells from growing. It actually stops most kinds of complex cells from growing. So the obvious thing that you could do with this, and there's a guy called Surin Segal, who's the scientist who discovered this, he thought this could be a cancer therapy. Because obviously, can't is cells that grow out of control. So if you can stop the cells growing, potentially a way to treat cancer. But he spent about a decade trying to make this work and basically couldn't. His drug company

shuttered the whole program. He ended up taking the bacteria home, hiding them in a freezer, in an ice cream tub. He wrote, do not eat on this tub. And then when his lab moved from Canada to the US, he sell-take the freezer shot and smuggled this across the Canadian US border. And eventually, after another 10 years, managed to convince the drug company to restart the program. And this This drug has already saved millions of lives because it is indeed a cancer therapy for certain kinds of cancer. It also works as an immune suppressant because it stops the cells in the immune system dividing. If you have an organ transplant to stop your immune system attacking and rejecting that organ,

they use rapamycin for that. And it's also used as a coating for stents. So if you've got one of these little things that you put in your heart to expand the blood vessels, they coat it with rapamycin to keep that blood vessel nice and wide open after the stents been inserted. But then in 2009, this result came out showing that it actually extends the lifespan of mice. So it can extend the life's from the mice by about 25% if you give it in the right dose. 25%. Yes. And what's really cool about it is, again, we're not dragging out that sort of

ill period at the end of life. It seems to rejuvenate them in loads of different ways. It's probably the best studied anti-aging drug. We've tried it in loads of different mice, you know, so we tried it when they're actually tried it in middle age. So you're saying you're coming up to 60. These mice are actually about 60 in human years. They were 20 months old when they were first given this drug. And this was actually an experimental mistake, fascinatingly enough. They tried to give it to the mice when they were young, but they gave it to them in their food, and it wasn't making it into their blood. So they reformulated the drug, took them about two years to do it. And actually the scientists were like, well, there's no point doing the experiment now, because

if we slow down aging a bit, but we do it at the very end of life, we probably won't see an effect. But we've got the mice, you've got the drug, let's give it a go. And what they found was, even if you give it very, very late, it has this incredible effect. And we found that if you go it to young mice, if you give it to old mice, if you give it continuously, if you give it intermittently, it seems to have this incredible rejuvenative power on the mice, it makes them live longer, it makes them healthier. We've actually got some preliminary data now in marmosets, which are primates, they're like much more closely related to us that shows that rappamacin works in them as well. So we just need to find out if this stuff works in people.

So when would that happen? Well, she says. Yeah, exactly, taking notes. What we really need actually is just to fund a clinical trial. And this is the very frustrating thing because rapamycin was discovered way back in the 1970s, nobody has the patent for it anymore. And that means it's not in a drug company's interest to run that trial because no one's going to make any money. We find out reprimicin is this elixir of youth, then unfortunately nobody can make any money off the patent because it doesn't exist anymore.

So what we need to do is get together, you know, probably some public funded or some philanthropically funded scientists and just run this trial and see what happens. So I think the best advice I can give in terms of trying to find these anti-aging drugs isn't to run out and read all the literature. We haven't got an anti-aging drug that we've proved works in humans yet, but it's to kind of campaign for more funding for the trials, I think it's the most important thing.

Andrew, how close are we, do you think? I think where potentially we could have an anti-aging drug in the next five or ten years if we can just do the trials. Because we've got, you know, I've talked about ruffer mycin, but we've got dozens of ideas to slow down and reverse ageing in mice, in cells in a dish, in worms, in flies, and all these things that we do in the lab. And it would be mind-boggling to me if none of these translate into humans. Because, you know, obviously there are difficulties.

Mice aren't just tiny people. They've got loads of differences in their biology. drugs don't always translate, but it would be absolutely incredible if none of these, you know, so, so many different ideas that we've got in the lab could translate into human beings. And so we just need to try a few of these things, I think. What are the next steps then? Because you're talking about that drug, but you said that there are loads of others being developed.

What do you know of? So I think the best way to think about this in my book I break it down into 10 what are called hallmarks of the aging process. Different scientists have slightly different numbers. We fight about this at conferences. But we're all basically talking about the same thing. And these are the fundamental cellular and molecular processes that drive aging. And this is driving every aspect of aging, by the way.

So it's the wrinkles, the gray hair, the cancer, the dementia. We know that they're all caused by different sort of quantities of these hallmarks acting together. And so let's talk about what some of those things are to make it a bit less abstract. You can start at the very, very small level, things like damage and mutations to our DNA. It's the genetic code that's inside every one of our cells. And if there are mistakes in that genetic code, then the cells can start behaving in a way that they shouldn't behave. And the most famous example of that is cancer.

If you accumulate enough mutations in a particular cell, then that cell can lose the ability to detect when it should stop dividing, and it can just carry on growing and growing and growing and turn into a tumour. Then we could sort of zoom out a bit further and we could say stuff's happening inside the cells that's going wrong. You can get dysfunction in the cells. So you can get something called a senescent cell. And senesent is just the biological word for old.

So these are cells that have accumulated in your body as you get older. They've either divided too many times. Maybe they've got some damage to their DNA. Maybe they're just stressed because I'm not talking about stress in the sort of, you know, everyday sense, but chemically, biochemically stressed inside an older body. Then these cells build up as we get older. And we also have a problem that as we get older, our immune system gets less good at clearing them away because our immune system's aging at the same time.

And so that means that these build up and build up and build up. And we can see that they drive a whole range of age-related problems. And then if we zoom out further, actually I've already mentioned, one of the other hallmarks of aging is the aging of the immune system. Because we know as you get older, you get increased inflammation. This is kind of a low-level paranoia of our immune system. I mean, I've got to say inflammation is such a buzzword, isn't it? At the moment, everybody's paranoid about sugar spikes and, you know,

and I know it's a menopausal woman, inflammation, we don't process sugar as well. So inflammation is a dreaded thing. It's really tricky because you see, you know, inflammation has a very specific scientific meaning. It's a phrase that means acute inflammation is a good thing. So we mustn't think that all inflammation is bad. If you get a bacterial infection or a viral infection or you cut yourself, you need your immune system to rush to the site of the problem, sort it out. That is acute inflammation. And as long as it dies off again after the problem has been solved, that's great news. The problem is that as we get older, it starts to build up and build up and build up. And I think inflammation is one of those words that's been, you know, if you see it on social media, it can sometimes be a bit of a red flag. And it really frustrates me because another red flag is a word like holistic. So I am all about holistic medicine in the same. sense that. We know that these hallmarks of aging affect every system in your body. It's important to understand that the aging body isn't one thing going wrong. It's a collection of,

you know, processes all interacting with each other. We've already seen, you know, the immune system ages, which means it gets less good at clearing these senescent cells. So that's a connection there. There are loads of connections between the hallmarks of aging. So holistic is the way to think about this thing. But if you see someone talking about holistic medicine on social media, that immediately sets off alarm bells in my head, they're not, what their writing might not necessarily be true. It's often the sort of thing that either quack doctors say or influences who haven't got medical qualifications. And it's really frustrating because these are often like perfectly legitimate words. Like inflammation is a really important concept.

It might even be one of the most important aspects of aging. But if you see someone talking about, you know, some supplement that can reduce your inflammation, that's where we start straying into the slightly pseudosciencey. And, you know, do you want to reduce your inflammation? Because obviously you do in general. You want to reduce the sort of bad chronic stuff that increases as we age. But I want my immune system to be standing guard ready to do it. It's acute inflammation if we need to.

So we've got to be very careful. The immune system is a really complicated system. We want to try and make it optimal, perhaps, rather than just trying to tamp it down all the time. I think what's interesting with all the information that we get, and you're right from people that potentially aren't qualified or aren't experts, and they pick up on buzzwords and they use that for clicks. What happens is that we end up super paranoid about all the, the different things in our body that can go wrong and then that causes stress, which causes

inflammation. You know, and in fact we're doing ourselves a disservice. When you talk about a holistic medicine, is it like a thing that will stop all of the things or protect all the things? How does it work? So it might not be all the things, but it might be a significant sub-cell of them. I think actually the best example, I've mentioned these senescent cells. We have drugs that can remove these senescent cells, but leave the rest of the cells of the body intact.

And there was a trial that came out in 2018 and they gave mice this combination of drugs. It was a cocktail of desatinib, which is a chemotherapy drug, but it was given it much lower doses than you'd normally give it in chemo. And also one called chrysitin, which is a flavonol. It's found in fruit and veg, it's sometimes sold as a supplement. And they found actually just by dripping these things on cells in a dish, they were very effective at killing this in essence of cells, but leaving the rest of the cells, you know, alive, basically. And they gave this combination to mice, and it basically made the mice biologically younger.

So they waited until they were 24 months old, which is maybe 70 years old in human these are old mice. Yeah. And it made them live a bit longer. So they weren't just dragging out that period of frailty at the end of life. They were actually living healthier as well. They had less cancer. They had less heart problems.

They had fewer cataracts, the clouding of the lenses of their eyes. The mice had less frailty in the way they measured this, they basically send the mice to the gym. So they had tiny little mouse sized treadmills in these experiments. And the mice that had had the drugs could run further and faster on these little treadmills than the mice that hadn't. reverse some of their cognitive aging. So if you put a mouse in a maze, a young mouse is really keen to explore, always to find the cheese, whatever mice do in maze. I'm a, you know, I'm a physicist

and a computational biologist never worked for mice in the lab. But these mice zoom around trying to find the stuff, if you put an older mouse into a maze, they're often a bit more anxious, don't really want to explore. And they found that by removing these senescent cells, they actually reinvigorated some of that youthful curiosity. And honestly, these mice, they just look great. Like, you do not need to be... I've actually seen a picture on something on your page, I think, of the mouse that's kind of old and a bit like losing its fur or its fur's gone a bit kind of scruffy and then the other one's so spelt and bigger. Yeah.

Yeah, yeah. I definitely like recommend people go and find some images of these mice online that have had this analytic drugs. Sobering. It's surprising. What this really shows us, and this is, you know, to come back to your question about holistic medicine, these senescent cells, they don't just cause cancer. They don't just cause heart disease.

They don't just cause frailty. They don't just cause cognitive decline. They don't just cause the sort of cosmetic stuff, the wrinkles, the grey hair. They are at least a factor in maybe all of those things, maybe even the entire ageing process. So that is holistic. So that does seem like a holistic treatment. So if that research happened in 2018, and you know this to be true, this is fact, like is it really because of the patent thing and that pharma companies can't make that enormous amount of money out of the patent,

that it's not going further? surely as a matter for the world, governments, this should be something we should be looking at. You're really talking my language. This is exactly the sort of thing that I would say. I think governments need to step up here. To give an example, in the US, they have a National Institute for Aging, it's NIH. But there's this running joke in Ageing Biology. It actually stands for National Institute on Alzheimer's disease.

Because about two-thirds of the funding goes toward dementia. Now, dementia research is hugely important. Please do not get me wrong. But aging is the thing that causes that dementia. Aging also causes cancer. Aging also causes heart disease. And so maybe we should be looking sort of upstream and trying to solve this problem before it happens.

And the National Institute for Aging does have an aging biology division. That gets about $1.30 per American per year compared to almost $20,000 per American is spent on the healthcare system. So, you know, even if you're just looking at this from a purely economic point of view, a huge amount of that healthcare spend is going on treating the chronic slow diseases of aging as cancer treatments, it's dementia treatments and so on. It's caring for people who've got these diseases. There's obviously a wider economic impact as well because people have to give up work,

they have to care for their relatives. And also, outside the economic stuff, it's just rubbish. So I'd happily put more than a dollar of a person toward that. And actually, I think in a lot of countries like the UK, like the rest of Europe, those numbers are very hard to find because we don't have a National Institute for Aging in most of those countries. And they're probably even lower. I mean, it is a thing for the economy, surely, because like you said, the aging population, it's only getting bigger.

We were talking about we don't want to spend 20 years. We don't want to just get older and not get fitter. We don't want to spend 20 years in a home. There's so much at stake here. But it was interesting because, you know, when I first heard about you and, like, read your book, I was like, I don't, oh, I don't know if I want to live older. I don't know if I want to, even if I was healthy. Would I get bored? Do I want to work till I'm 80 or 90?

But listening to you talk, I suppose, meeting you in true life, as it were. It is food for thought, isn't it? Because not looking after aging parents, I think looking after aging parents when you hit midlife and you're hitting menopause and you're hitting your, it's so hard because you also are hitting a time when you could begin again, right? Like it's a time to be reborn. and yet you're struck with all these other issues. What would be your dream for your future?

I just want to be as healthy as possible for as long as possible. And I want my friends and family, and I mean, actually everyone around the world, ultimately, you know, I just want to help people avoid this suffering as best as possible. Because I think that health is just the most important thing. And I think that preserving that health is going to have this enormous, wide-ranging benefits. When you think about, you know, would I want to live longer because I'd be bored,

I think, you know, if my friends are alive, if they're happy and healthy, if I can still travel, I can still get out and see them, you know, we can still go down to the pub, whatever, you know, whatever it is you enjoy, why would I get bored? Like there are more films and, you know, books to read than I can possibly do in my lifetime and there are only more and more being produced. A slightly ridiculous example I sometimes like to give is there are 200 countries in the world, almost, depending on how you count them. And that means if I were to visit two countries a year, I probably couldn't manage all 200 of them.

And I bet there's more than one interesting thing per country. Yes. And I know that's a bit of a ridiculous thing to say, but it just sort of puts in context. There's so much stuff out there in the world to experience. And I think this partly comes from a place of privilege. I've got a fantastic job. I love learning. This is a great thing.

But I think as society, as we're getting richer, as people are being lifted out of poverty. And if we can keep people healthier for longer, that obviously feeds back in a positive way as well. my vision is just a world where people are healthier for as long as possible. I mean, I suppose at some point people have to die. What's death going to look like? What it will probably look like is the same way that death in young adults looks at the moment. So it's not as though 30-year-olds never get cancer. Obviously, it's thankfully much, much rarer, but it's not as though it never happens

because sometimes you'll get that combination of mutations, et cetera, et cetera. You know, we can still have infectious diseases, you can still get hit by a bus. There's nothing that all this ageing. stuff is going to do to help with that. So there will still be, you know, it's not as they're going to live forever. But it just means that hopefully fewer people will have to suffer this sort of 10, 20, 30 years of slow degeneration at the end of life. I think that's, you just said something that really hit hard about the people dying because I think that was one of the saddest things. My granny who brought me up, so she was like a mum to me really. She died at 98. But, you know, all of her

friends had gone and she was lonely and I did think that's so sad and in fact my my mum my stepmom but I call it my mum she's 75 and she's got that a little bit now that you know friends get in poor health and everything and I suppose it would be a gift to people to have a wider social circle quality of life we know that connection's so important I feel like um people people, like you said, you know, when you talk about aging, you're thinking about plastic surgery or Botox or fillers and everybody kind of slightly pooh-poo's that. And like, you know, it's not like, I haven't tried a bit of Botox here because I didn't want to frown anymore. And like, you know, I full, I full pray of that as well because we want to stay kind of, I try and stay

as healthy as I can for as long as I can, blah, blah, blah, blah, but I am getting older and I can feel it. But you're right that the word aging comes with a kind of, like you shouldn't try and sort of age longer, or stay alive longer or stay young for longer. There's something wrong with that. Aging is a natural process. What would you say to them? Yeah, and I think that one of the really common thoughts you get back

is isn't this just for vain billionaires? Yes. Who want to, you know, they've got all the money in the world. Yeah, I mean, that crossed my mind. And they need time to spend it. You know, they've got all the money, but they haven't got all the time. And I think, you know, my question in response to that would be,

what is vain about not wanting to get Alzheimer's disease? What is vain about not wanting to get cancer? I think none of us would wish it upon other people. None of us really want it for ourselves. I think that this word aging, it's actually a really problematic word. I think it is, from a scientific point of view, it is the shortest way to describe the process that I'm talking about

because the single biggest predictor of your risk of heart disease or your risk of heart attack is how old you are. So for example, if you have high blood pressure, it roughly doubles your risk of heart disease. If you're 80 rather than 40, it multiplies your risk by 10. Now, to call that aging, I think, is entirely accurate. But the problem is, you know, aging is, firstly, it's just the passage of time. So, you know, we can't stop aging in the sense that you're still going to have more candles on your birthday cake. Even if you live to 150, you're still aging in some sense.

Like, you know, calendar years are still passing. And we also have, you know, the accumulation of wisdom. The fact that you're watching, you know, your family grow up, you're watching your grandchildren, your great-grandchildren, whatever it might be. Great-great-grandchildren. You know, this is, social progress is happening. All kinds of things happen that are aging, that aren't bad. And we've somehow got to tease out those.

And you also, you know, you don't want to make this too depressing. Because actually, you know, the real flip side of our aging society narrative is that we are living longer, healthier lives than ever before. When I do talks on this, I love to do a quiz. I get everyone to stand up and I ask them to sit down when they think I've put the number for global life expectancy up on my slides. And I have not yet had an audience get this right. I've done this in with, you know, senior academics.

I've done it with all kinds of people. Everybody gets this wrong. So if you're, you know, listening or watching at home, just think now, what do you think global life expectancy is? I won't put you on the spot. This is, but this is the average, you know, life expectancy in every country around the world. And you pulled them all together. So you pull them all together, not just the rich countries, not just the poor countries,

all of them together. The answer is it 72. six years. Now, I think that surprises most people because when you're in school, you're taught that there's this really big, poor part of the world, the developing world, they haven't got access to healthcare, they're much less wealthy than us, they haven't got access to sanitation. But actually, we've done an incredible job over the last 50 years particularly of increasing the life expectancy in those countries. India went from my life expectancy. I think it was about 35, 36 years old in 1970, and it's almost 70 years old today. So it's this absolute

transformation. And what that means is that most people in most countries can now expect to grow old, which is an absolutely beautiful, remarkable thing. It's a wonderful thing about the time that we live in now. What that means is that we're now facing aging, not as a, you know, a wonderful thing to aspire to. I mean, it is that. I'd rather die of old age than get hit by a bus at 25. But it's also a medical problem. It's not, you know, necessarily a problem in other ways. But, you know, It's that medical aspect of it that I think we need to do something about. And I've been racking my brains for years to come up with a better word to describe what it is I want to create medical treatments for. I think ageing is the best word.

But it comes with all of this baggage. It does. It requires, you know, we've been sat here talking for how long now. And, you know, we're just scratching the surface of this subject. So, yeah, it's tough. So let's talk about Zoe, who sponsor this podcast. Okay, so you're in the supermarket. it. And everywhere you look, there's offers on crisps and biscuits and all the naughty, unhealthy foods.

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right now. We're running out of time and we still don't know the rules. Don't miss what the movie blog calls something you need to watch. Saving those children is how we all go home. From Binge All Episodes exclusively on Paramount Plus. I mean another thing I guess to look at is that the fact that we had a population boom in the 60s. I'm part of that.

I am part of a very big aging population in the UK with not enough young people to pay all of the pensions and care home bills in the future, possibly elongating life might help with that. Yeah, and I think keeping people healthier for longer is an overlooked policy in this regard. Most countries in the rich world now have a fertility rate, that's number of children per woman, of less than two. And that means apart from migration in some countries, their populations are actually in decline. Japan's population has been in decline for about the last decade, which is really incredible. Their economy is shrinking just because their population is going. down. So this is something that's happening now. In fact, serious demographers, places like

the UN, places like the Institute of the Health Metrics and Evaluation, these are big international bodies are predicting that maybe in the second half of this century, the human population on Earth is actually going to decrease. It's not definitely going to happen. We obviously don't know how many babies people are going to have in future, but there's definitely a direction of travel here where you might think, you know, as well as providing incentives to help women have more kids, you know, financial or whatever those incentives might be, maybe we could do something to increase their reproductive window like we were talking about earlier. A lot of women my age, they're making really tough decisions right now.

They're thinking, should I press on with my career and get that next promotion? Or should I, and unfortunately, since the burden of care does tend to still fall on women, should I take a little hit in my career and have the kids that I want to have? And a huge number of women don't have as many kids as they want to have. They might have zero when they wanted to have some. They might have one when they wanted to have two. So this is a really complex problem that isn't purely economic. It isn't purely to do with career.

It isn't purely to do with anything. So there are loads, you know, it's very multivariate, but extending that reproductive window, I actually think, you know, treatments for age in here are a feminist issue. And then at the other sort of later in life, if we can keep people healthier for longer, you know, the problem, there's this phrase the dependency ratio, which I don't really like, because again, it's a bit derogatory. But often the way that we draw the dependency ratio is to say anyone under the age of 18 and anyone over the age of 65, now that age 65, the first time that's a very time that

came up was when pensions were first introduced in the United Kingdom in 1923. Wow. Life expectancy then was about 65. So what that means is most people didn't make it that far. Yeah. And then, you know, the pension was basically an apology from the state saying, oh, you know, you're going to have a horrible next few years, there's some money to try and tide you over. Whereas we're now at a point where the pension age for men only actually increased in 2019 from 65, even though life expectancy has gone up by about 20 years in the century between those two things happening. And when we talk about the dependency ratio, we still talk about that age of 65, even though it's very, very out of date. My parents are still, thankfully, very healthy.

And a lot of people who, you know, in their late 60s, early 70s, maybe they could still be working. Sorry, Mom and Dad, I don't mean to say, you should get your nose back to the grindstone. But, you know, at least they're healthy and therefore not, you know, costing the healthcare system money. And so I think it's unfair to just draw this sort of, you know, hard line and say as soon as you hit 65, you go from a useful productive member of society to a dependent that's just a drain on the system. We've actually got to start thinking about this in, we've already got to change the way we think about it because people are living healthier longer than they have in the past. But if we could keep people healthier for longer with any kinds of medicine and with diet

and health advice and all the stuff we already know how to do, then that could dramatically reduce the fraction of life that we spend in ill health. And that's ultimately, if we can reduce that, that reduces the economic cost. I mean, we're talking so much about economy and ageing and aging populations and how with a possibly a dwindling population that possibly this could be an economical answer. Who's listening? Frustratingly few people. I think we need to get this idea out there. I'm often asked for health advice and I'm very happy to talk about diet and exercise and sleep and I think these things are all hugely, hugely important. I'm going to hit you up for that later. Of course. Yeah, I'm really, I'm really imprised. But I think the single most important piece of health

advice is to get out there and spread the word about aging biology. Because I think, you know, if we want politicians to listen, firstly, they have to even heard of it. And that's, you know, very basic level of understanding needs to be achieved. But also, you know, scientists, doctors, loads of other people need to be convinced of this. And if you want the politicians to listen, we need the voters to know about this stuff. We need people to be saying, look, if I'm going to vote for your party, I need you to be investing in aging science. And that's slightly strange. You know, when people vote, when people go to the ballot box, they're normally thinking about the economy or they're thinking about, you know, the health, the health,

service. These things are very integrated to ageing science, but not many people make the connection between the amount of funding going into a slightly nerdy, frankly, kind of scientific research, and then these big things that we normally vote on. So I think we've just got to understand that this is a thing, and that's the sort of first part of the challenge. So get out there and spread the word. Have you spoken, have you gone to speak to governments? I've tried. I actually talk to the Malaysian government back in June, and it's just very, very difficult because obviously there are loads and loads of challenges you've got a new government here in UK. Yeah, I mean, I guess every time there's a change in governments, you've got to start all over again.

Exactly. And this is like a much longer term problem than can be tackled in a single parliamentary term. Yes. I also think as a community, longevity science just hasn't been great at lobbying about this. Part of the problem is that we just haven't got, you know, we can talk in the abstract about the economic stuff. And I think it's, I think the answers are quite clear. But there have only been two major papers on the economics of longevity in the last 20 years. At least from a longevity science point of view. Obviously, there's a lot of demography and that kind of work. There was a paper that came out in 2021 by a professor here in London called Andrew Scott. And it estimated that if we could slow down the aging process to the tune of one year with some hypothetical drug,

that will be worth $38 trillion to the US economy. It's absolutely remarkable amount of money. But imagine I ran up to Keir Starmer and said, you know, look at this. This is for the US so we can scale the number down for the UK, et cetera, et cetera. I'd say, look at all these trillions of dollars that we could have. He would then say, okay. When are we going to get it? It's before the next election.

Is it going to be before the next election? What will it mean for the NHS? How much is it going to cost pension systems? Surely it would be great for the NHS. I think it would. I think it would. But again, looking at the NHS, it's fighting fires at the moment. They've got a huge, huge backlog.

So much pressure. So, you know, getting people to take their eyes off the here and now, you know, poor doctors and, you know, GPs, they're so overwhelmed with what they have to deal with day to day. I completely understand. They haven't got the headspace to deal with, you know, thinking about these lofty ideas of aging biology. But ultimately, I think healthcare systems around the world need this stuff to work. I think the problem is longevity, ageing biology would strike fear into lots of medic's heart. I don't know how your wife was when you said it at the beginning.

I don't want people to live longer. They won't be as well. It's complex. There's a lot going on. There's a lot to get at. You need time in front of people. People never have time. They can give you a 15-minute window.

Exactly. You've got kind of a quiet, an uphill struggle. I don't mean to kind of feel. No, no, I think you're right, because having been talking about this. I mean, that was a joke really, but I, but you have. No, it's serious. It's very serious. Like, we, we, I've been talking about this stuff for years. And I haven't yet found a way to really pithily explain everything we've just talked about.

How on earth could you condense? I think you've done it. That's very kind of you. But, you know, we're very lucky that podcasts exist. And people can sit down and, you know, stick something in their ears and sit down for a few hours with somebody. I think if I had five minutes, I could do it. my best, but it's very hard to bust all of these myths and explain all of these nuances and, you know, maybe someone's worried they're going to be unhealthy and we're going to stretch

out that unhealthy part at the end of life. Maybe they're worried about the overpopulation question. Maybe they're worried about, you know, won't this cause all kinds of other ethical problems. And I guess the other interesting thing is trying to get, trying to explain it to a government and then understanding that the government then has to explain it to a whole population, it will all be up in arms about it and going, longevity, it's just vanity and it'll only be for the the wealthy and it'll then be, but actually it could be something if you're saying that the patent doesn't exist, which means that the drugs would probably be cheaper. When the patent exists, drugs are enormously expensive, but when there is no patent,

drugs are usually cheaper to manufacture? Absolutely. So it would be readily available to everybody. It's not like it would only be for rich people, even if it wasn't provided on the NHS. Is it something when you've been looking at these different drugs and everything, is it something that if it did work in humans, you'd have to take daily, weekly, injections? I think we just don't know. And it depends a lot on the sort of mechanism of action. So something like rapamycin. And actually they've tried both in mice or they've given it just for a short

period. There was even a paper that came up very recently where they gave mice rapamycin sometime in sort of early middle age, maybe in sort of their 30s in mouse terms. And that effect persisted throughout their lives. So that might be a possibility. So what just one hit? Just one hit. essentially. Shut up. Yeah, it's incredible. Sorry, I keep telling you to shut up, but you'll just blow my mind. That's absolutely incredible. So one hit of something, a drug. And we need to understand more about the biology to work out when exactly is the best time to intervene in people. I think at first, the time we're going to do the trials is going to be in older people. But what we really want to do, and this is another huge, huge topic just to add another thing into the mix, if we did

one of these trials, there's a trial called the Tame trial that's been proposed for years and has never quite achieved its funding again because metformin, tame targeting aging with metformin. Metformin is a diabetes drug. Quite a lot of people watching or listening might be taking this drug for their diabetes. Right. And there's some evidence that it slows down the aging process as well. But the problem is we haven't got that perfect study because normally, obviously, it's a diabetes drug. You give it to people with diabetes. What we'd need to do to find out if it works as an aging drug is give it to people who don't necessarily have diabetes. Oh, I see if it works in the general population. So this is, you know, very fascinating with the early evidence. Yeah, you sign me up.

A Zempic. And this is another fascinating one. There was actually a study this week suggesting that maybe a Zempec is an anti-aging drug. Now we've got to be really careful teasing these things apart because we know that being overweight actually increases inflammation, to go back to that word, it essentially accelerates the aging process for a variety of reasons. So, you know, being a bit overweight is like aging a little bit faster, which is as though the body clock is just ticking a little bit more rapidly. And so maybe a Zenpick, because it's only been tried so far in overweight populations, because it's reducing their weight, maybe it's slowing down their aging by simply reducing how much they weigh. What we need to do, if we want to, you know, if we think

this actually does target aging? Firstly, we need to find out, does a Zempec hit any of those hallmarks of aging? I talked about earlier. That would be one way to show it. Or secondly, we could just try it out in a population who aren't overweight and see if it works. Can I go back to AI? Yes, yes, yes. We've got a totally side-tracked. Is it going to help us? So, yeah, and what frustrates me about all this stuff is that we are getting distracted

by trying to optimise all this health advice when really you just need to do what your mother told you and then look at the exciting stuff that's coming in the future. And AI is a really good example because I think that our understanding of aging, I said there are these 10 hallmarks and we should absolutely be trying to develop treatments for each of these 10 hallmarks. But the way I like to think about the hallmarks of aging, it's nice to think about them as a list, and that's a good sort of starting point for understanding aging biology. But actually, they're more like the key stations, perhaps on the London underground, and aging is then the tube map. And so what we want to do is understand that tube map. We want to understand

how all the hallmarks connect together. There are probably lots of other little stations, little hallmarks that we haven't discovered yet. Little processes happening inside our biology that all connect together in some way. And how on earth are we going to decode all of this stuff? where we're going to need probably to use artificial intelligence, because what AI is really good at is looking at these enormous biological data sets and delving in, finding the patterns, finding the connections. And so what I think we really need to do, firstly, I think we need to be a bit less excited about the chat GPs and these sort of language models.

We need to be more excited about the much nerdier artificial intelligence stuff. So there was something called AlphaFold that came out of DeepMind, which is a part of Google based here in London. And what this could do is it could predict actually from that amino acids, sequence of proteins. I said the proteins are made of these Lego building blocks. Although we know the building blocks of all the proteins, what's very hard to determine is sort of the instructions for the Lego, because although you put them all eye in a certain order, the protein then folds up into this incredibly intricate, complicated three-dimensional shape. And it's that that determines

how the protein works inside your body. And almost impossible for you guys to figure that out with it. It's been something where we've, you know, we've spent decades and decades. It's been called the protein folding problem. It was held up as one of these, like one of the hardest problems in biology. And we've been chipping away, getting 1% better this year, 1% better the next year. And then suddenly, artificial intelligence comes in and just blows the whole field apart. No one believed the results when they first came out because they were so good. And it's fixed it. It hasn't.

It hasn't quite solved it. Nearly there. My protein folding colleagues would be annoyed with me if I said it had solved it. But it's a huge, huge step forward. So AI, along with humans, will be speeding up and developing a lot more scientific discoveries. Yeah, yeah, definitely. Can you tell me about the 10 aging? I feel like picking up.

Get your book. Get your book. And tell me, do you like the markings in there. Yeah, I do. I can see this. This has clearly been red. Thank you. Yeah, no, this is one, it's like the seven deadly sins.

It's the one you forget that's going to kill me. Yeah. Well, I don't want to like, I mean, you did write it, so I forgive you, you know. So chapter four, why we age. Yeah. The first hallmark is DNA damaging mutations, which you already mentioned. Yeah. Which I call trouble in the double helix.

We've got crimmed telomeres. So a lot of people have heard of telomeres. They're these protective clips on the end of our DNA. And every time our cells divide, the protective caps get shorter and shorter. So you can imagine in your cells and your body, they're trying to divide all the time in order to replenish your skin or the lining of your intestines or something like that. So there are lots of places where this is happening. And as those telomeres get shorter, eventually they get critically short and the cell can't divide anymore.

And actually it becomes a senescent cell. So that you can see these things are really connected together. Is it difficult? knowing that this is happening in your body? I mean, yes, it is. What's kind of reassuring for me at the moment is that my risk of death per year is so, so low. It's all right for you.

Yeah, exactly. And it's also the case that, you know, most people are live today, and you're definitely, I would include in this, and most people listening, watching to this podcast, we've got decades ahead of us for this stuff to happen. Like if you're really critically ill now, unfortunately, you know, these things probably aren't going to come in time.

but if you've got, you know, the average person on planet Earth is in their 30s, their late 30s. And that means if they're going to live to an average life expectancy in the rich world, that's about 40 years ahead of them. There's a lot of science can happen in that 40 years. Yes. Now imagine then, you know, these developments with AI, we've got these developments understanding the aging hallmarks and so on. We've got our first anti-aging drugs could be with us in the next five or ten years with sufficient funding. Then if those drugs can increase your healthy lifespan a little bit, that means you might have another five or ten years. scientists to develop the next round of treatments and so on and so on. And that means it's very

hard to predict how long someone in middle age now might live. Because if you can maintain your health, if you can, you know, if you're obviously, if you're lucky, a big part of this is luck. But, and if we get lucky as a sort of scientific community, we can carry on developing drugs and pushing things further and further back into the future. So I'm, I'm really optimistic about, you know, obviously not just my life's one. This isn't a selfish pursuit, but like the lifespan of most people alive today, I think could be changed by these kinds of drugs. What's fascinating is that I've spent my whole life up until probably 20 years ago, just kind of knowing where it was going. I'm going to be like this.

This is going to happen at this age. This is going to happen at this age. And then I would say probably early 2000s, dawn of social media, everything sort of changed. We had the ability to kind of tap into Google, look up anything that we wanted to, and everything sort of changed. And then understanding that people are going to have six or seven different jobs in their lifetime rather than the job for life that we all kind of thought. we were going to get when I was a young girl. And it's just such an incredible time of not knowing what the future holds, which is so, it's, my children have grown up in an era where they're used to that. Like that, that is their life and they know that's what it's going to be like.

But for me, it's such a weird thing to get my head around. It is really strange. I think when we talk about this idea of, you know, like, what are we going to do when people live longer and, you know, wouldn't it be boring to have the same job for like 60 years? years if you start when you're 20 and work till you're 80. Of course it would. And the fact is that people are living that long in good health already. Not everybody. It's not universally distributed, but this is already an issue for people who are living today. And the fact is as well, the world of work is changing so fast. Yeah. Like if you started working in 1980, it's quite likely that the exact job you started doing doesn't exist today. And that's going to carry on getting faster and

faster and faster. And so we need to be thinking about things like, you know, retraining, maybe take a five-year sabbatical in the middle of your career and go back to university and learn a new set of skills. Yeah. What sort of skills that will be useful in the future? Exactly. Because the future is already looking different to how it was when you went to university 15, 20 years ago. Exactly. And I think that it's funny because, you know, when people ask me about these big ethical

questions that result from people living longer lives, my answer is often, actually we need to be doing this anyway. Yeah. Like even with people only living as long as they are now, you know, this is something we have to do right now. And if we then live an extra five, 10, 20 years because of these drugs, then, you know, we're just going to have to do it more. But it's not a fundamental, it's not a problem that it's fundamentally doesn't exist now

and will exist if we create treatments to keep people healthier. I'm not going to put you through the agony of having to read through your... Can I just... Three is problems with proteins. Can I just ask you one other thing? Andrew. So before we end, I want to end on a positive because I think people will be thinking, oh my God, he's telling me all these things that are like literally just out of reach for me.

What are the, I mean, I know you get asked this a lot, so I'm really sorry, but what are the major things that you would say to somebody, if you want to live the longest and healthiest life possible, okay, these are the things I would advise. So the first thing is quit smoking because smoking takes. And vaping? What's your take on that? I think vaping is almost certainly safer than smoking. You aren't literally inhaling, you know, burning stuff into your lungs. It probably isn't safer than not vaping. we haven't got, you know, the amazing five-decade-long data to tell us one way or the other.

But quit smoking. If it can help you quit smoking, it will definitely help. This is a really optimistic thing, actually, about all of these bits of health advice. It's never too late to start. Yes. So if you quit smoking when you're 30 or before you're 30, you basically get all of the years back. Like, it's not quite as good as had you never smoked, but it's more or less there. Even if you quit when you're in your 60s, you'll still probably get a couple of years back.

That level of inflammation that comes along with smoking cigarettes, after a few months starts to subside and you gradually revert back to the sort of biology of someone who's not smoked ever in their lives. So you really can, no matter how late you're thinking of quitting, it is never too late. And this is really true of all these things. Exercise is a really good example as well. We should all definitely be trying to get more cardio, you know, trying to do 15, 30 minutes of exercise a day. But we've seen that strength training is super important too. I think that's something that I've neglected historically. especially as you get older.

And again, it's never too late to start. I found a fascinating study where they got 90-somethings and gave them a strength training program. And over the course of a few weeks, they got stronger, they could walk further and faster. You know, it just really is never too late to start. And it's also no step is too small. Like if you're literally sedentary,

you never get up off the couch all day, you get the car to, you drive your car to work, sit at your desk all day, drive home, have a TV dinner. If you just walk for five minutes a day, you've already increased your health. And actually we find that the first part is the most beneficial. So you get diminishing returns.

As you start doing more and more exercise, when you get to sort of 25, 30 minutes a day on average of moderate to vigorous exercise, the benefits really start to flatten off. Now, if you love running for 60 minutes a day, I don't want to put you off, do it, knock yourself out. If you're someone who hasn't got either the drive or the privilege, frankly, to fit that much exercise into your routine, then even just getting.

a couple of minutes, start small, you know, just get yourself out of the house and start moving. And you'll find that those next steps are going to be easier and easier. It's really, really important. Being a bit more active. And I think actually, we've done ourselves a bit of a disservice as a sort of medical community calling it exercise. You sort of imagine you've got to get your lycra on and, you know, go down the gym. It's not like brisk walk like you're late to the tube.

Yeah. You know, you'll get off a tube stop early. Exactly. You've started. It doesn't necessarily mean it's going to solve all your health problems, but you can start to get to the point where, you know, you're able to maybe go for a short run. You do something like couch to 5K.

I'm doing that right now. Are you really? Yeah, I got lost all my gains over the summer. And I'm doing it right now. It's so easy done, isn't it? But I love it.

Yeah. Because the other thing is, I think it's important to remember no matter how fit you are, you do have to maintain it. And it's easy to lose, but it's also easy to get back. Absolutely.

You know, if you jump back on it. I had a really busy month traveling in June and I was watching my resting heart rate on my watch. And it just got worse and worse and worse. It's mad,

and it took me about another month or two to get it back down to where I like it to be. Really interesting. So it's interesting to track your, you know, progress on these wearables if you find that something that motivates you. But equally, I think some people do find it to be a demotivator. They find it stressful.

We're constantly having this little thing on their wrist haranguing them. And stress isn't good either. Exactly. So that's a really important thing. I think getting a good night's sleep. We've got pretty good evidence that can be good for your health, probably aiming for seven to eight hours. I think it's more than most people get.

I think what else have we got? There's also some less conventional stuff. So there's the stuff that I think, you know, so the first thing to say is about all that health advice, it can sound a bit boring because you've probably heard it before. However, the thing that really excited me about this health advice is two things. Firstly, it's that now we understand it literally slows down the aging process to do those things. Right. So people who exercise, people who don't smoke, they are aging more slowly than people who do. Who do.

Yeah, or don't. Yeah, yeah, yeah, yeah. I know what you mean. very non-concusing way. Yeah. So I think that just really drives me because I think, you know, you're not, exercise is a great example. When you're running or when you're cycling, you can feel your lungs. You can feel your heart pumping. It's clearly benefiting your cardiovascular system, you're a respiratory system. But we also know that people who exercise, they get less cancer, they get less dementia. So it's having this systemic effect on your body. It's not just affecting

the one organ system. It's not just affecting your muscles. You know, it's having this much, much broader effect. So that's a really exciting thing. And the second thing that really excites me about it is because these treatments for aging aren't necessarily decades away, then if you can live that little bit longer in good health. By doing those things. By doing those things, that might mean you're around in time for the treatments that can then make you live longer still. So I think that's just really exciting. You said there were some weirder things. Yes, exactly, some weird things. Yeah, let's give me those. Give me those. Give me those. I've got interested in that. These are the things where it's like understanding aging biology makes you realize it's something you hadn't appreciated.

Actually has an impact. And my favorite example, this is brushing your teeth. So, It's a good idea to brush one's teeth for a variety of reasons. You know, tooth pain is horrible, visits to the dentist can be expensive. How many times a day? Twice a day, I think is probably good. And flossing or cleaning between the teeth in any way that you fancy seems to be quite important as well. Water flossers can be quite a good way of doing this. Literally, I mean, I've had to use a sensitive teeth toothpaste because those water flosses...

They can be a bit cold. Sometimes in the winter. But I love brushing my teeth. I mean, I do brush my teeth three times a day, but I have to go sensitive because, you know, otherwise you end up sort of brushing everything away, but I love it. Yes. I think the thing that we've learned is that, so the first studies that came out are in the 90s and they showed that people who had better oral health, so cleaner teeth, less gum

disease, tended to get less heart disease. And the problem with these kinds of studies is because they're observational studies, you obviously can't randomize people to not brush their teeth and see if they have less health overall. You might think maybe the people who are really obsessive about brushing their teeth or really conscientious, they also have better other. health behaviours, they exercise more, they eat better. So maybe it's a correlation, but that isn't the way the causation is happening. That's not actually causing the other thing. What we

subsequently found is we've got increasing evidence that actually there is a causative role here. And again, actually, we're going to come back to that word inflammation. So we said chronic inflammation is where your immune system is constantly a little bit hyperactive. Now if you've got gum disease, we've got bacteria in your mouth that are causing tooth decay, then that is a fight that your immune system can never quite win. It's constantly this sort of fizzing and buzzing of inflammation happening in your mouth. And that we know can then have an impact throughout your body. It can increase the risk of heart attack, for example. And there's even some evidence that if you look in the brains of people who have dementia, you can see that you can find the bacteria that

cause gum disease. Now, we don't know that that is one is causing the other. It might be that those bacteria are taking advantage of the fact that the brain has dementia and using that as an excuse to sneak in. But that is enough evidence for me to be all over dental hygiene. I can see. people around the world reaching for the floss. So what are the other ones? I would say the other thing that's less conventional is don't bother with supplements. Because... Ooh, you're going to blow people's minds here.

I mean, I'm a bit of a believer. Oh, interesting. Of that myself. There are certain... I take a couple. My daughter's a dietician. There have been a couple that she's told me, vitamin D3, especially in the winter.

Yep. And magnesium glycinate. Yes, so I think vitamin D, I actually do take vitamin D. I don't think it will work, but I think it's so cheap and I think the risk is so low, it's worth a pop. So yeah, and not megadosing, I think is important. Not, don't mega-nose, exactly, yeah. So I think 500 international units, I think is 12.5 micograms a day. Yes.

Is the recommended daily allowance? Just take that, that's fine. Yes. But you don't need to be taking 50,000 minutes a day. I think they do use this in older people. So if you've got a vitamin D serious vitamin D deficiency and you're older. As you get older, you get more deficient in vitamin D. You don't know, and that's worth knowing.

If you go into hospital and you've got a really low level, they'll sometimes give you a megadose for a short period of time for a few weeks or months to, it's called a loading dose, and then they put you back on a normal dose afterwards. But as a sort of healthy person, you don't need to make a dose on vitamin D. The other important thing to say is, like, with supplements, if your doctor has recommended that you're deficient in something, then it's take it.

Yeah, take it. It's absolutely important. But a lot of vitamin supplements are based on an old hypothesis in aging science. So they're what are called antioxidant supplements. So these things like vitamin C. And the hypothesis was that when our bodies are burning food, the way that we make energy is we get food and we essentially burn it with the oxygen in the air.

So you eat your food and there's sugar in the food. The oxygen in the air then burns that sugar and that's how you produce your energy. That's happening inside your cells all the time. Now, because oxygen is a really reactive chemical, sometimes the mitochondria in your cells that are doing this reaction. mitochondria, the little power plants inside your cells.

So they're the things that are burning all of that food and turning it into energy. And sometimes they fumble the oxygen molecule effectively. And they create this kind of reactive, free radical it's called. And that can go around. I've heard about free radicals and they're bad. Well, this is the interesting thing. Oh. So we thought they were bad.

Oh. And this was for a long time a really leading theory of aging. That's what I've grown up believing. Because if you get a free radical, it can damage your DNA, you can damage the proteins inside your cells. So the theory was that maybe if you have a lot of these free radicals, it can increase the speed of this damage and that would increase the rate of which you aged. And this was a theory of aging for decades.

When did it change? Am I really behind the curve? No, not really behind the curve. It's definitely still out there on the internet. Yes, okay. The studies are only really done in the 2000s. Okay. So that's, you know, this is quite a recent change.

And what we found is actually, and this is sort of unsurprising, it's one of those things that's not surprising with hindsight. life has been breathing oxygen for about a billion years. Yes. And that means we have got mechanisms to deal with these free radicals. And actually, our body uses them for things. So the mitochondria, they are the power plants of the cell. But they also talk to the other parts of your cell.

And one of the ways they talk is using free radicals. One of my favorite uses of free radicals is that there are little immune cells called neutrophils. And if you have a bacterial infection, the neutrophils rush to the place of the bacteria are. And they basically spray these free radicals all over them and kill the bacteria. So they're using the fact that the free radicals are damaging, but to your advantage. So what's interesting is that I feel like in advertising, over the years, I have heard these words as buzzwords to make you buy something. You know, free radicals, bad, that's what I've always had in my mind. And neutrophils.

Nutrophils. I'm sure I've heard that word before in an advertising campaign for something. So in terms of supplements, our body actually knows what it's doing. We've got to just kind of trust that over years, billions of, well, like hundreds of thousands of years that humans have existed or life has existed, we've evolved to work. Yeah, exactly. And so if you take some vitamin C, for example, that's an antioxidant. It mops up some of these free radicals.

And it's quite likely that your body will just produce more free radicals to compensate for the fact because it still needs them. They're still important to its function. I don't think this theory has been completely discarded. Clearly, these molecules do still get damaged by free radicals in our bodies, but it's a bit more complicated. Yes. I mean, it's science.

I mean, I do think that, that we on social media, we're all guilty of sometimes really oversimplifying something that's way more complicated, way more nuanced. Somebody says take something, but then there's always a counter argument, or actually, do you know what you maybe should think twice, about that or you're not a scientist, don't talk about it. So there's a lot to get at.

I mean, I work alongside another company and they often say, look, these kind of shelf multi-vits in a gummy, you know, in sugar. And it's like it's just weighing it all up. It's very difficult. And I think, you know, this is to talk about the uphill struggle that you mentioned earlier. If you're trying to sell a product, it's much easier to say, you know, this is a bad and take this product and it makes the bad thing go away. And when my message really is we need to increase government funding for science research,

that's a much less simple, straightforward message. And it's also something it's much harder for people to go away and do, you know, I'd love people to write to their MPs to get out there and talk about this stuff. But it's harder than just buying a product and, you know, hoping it will make you healthier. So that's the real challenge we've all got. I mean, I think first off, Andrew, what we've got to do is say to people, if you are interested in this topic, get this book. Well, thank you.

Get this book, read up about it. The new science of getting older without getting old. What I did love, Andrew, is that actually, if you don't want to read this, if you're not brilliant at reading, you know, watch this over again. Really get your head into it. Really understand the topic. And if you are interested, what do they do? Do they write their MP and say, can we look into the science of ageing?

I think the best thing is just to spread the word. It really is to, like, show people that this isn't some crackpot science. have you been called a crap pot then? Not quite as far as crackpot. But I think there's a real history of this stuff. You know, we've had Chinese emperors who thought they were going to live forever by drinking potions made of mercury. Well, again, this is the vanity thing, isn't it?

There was a guy in the 1930s who thought that he could increase people's lifespan by sowing pieces of monkey testicle to them. And so we've had this incredible history of really ridiculous claims being made. made. And so people are naturally immunized against that stuff. And I think a lot of people think this is science fiction. And it just isn't. It's science. It's science. It really is. And we've got so many ways that, you know, you go through and as I was writing the book, I was just amazed by how many examples we have. We have animals that literally do not age. This isn't some hypothetical, you know, far future thing. We have animals that do not have an increasing risk of death

as they get older. So from a biological standpoint, they have cracked it. The question is is how can we bottle that and give it to human beings as well? Yeah, I mean, I know you're coming from a wonderful place of, but I guess if you're trying to talk to governments economically, it seems to make sense. Yes. For a government. Yeah, I absolutely agree. And I suppose they're always trying to think about that and you're thinking about humanity.

You know, there are so many, I have to say, it's been quite, quite interesting, you know, if you'd have told me before I'd have seen this book, before I'd have spoken to you, you'd of just mooted this idea of longevity in five minutes, like, you know, what you might get in front of a dignitary or a politician, that I've sort of done a 360, or no, not a 360, because that's a coming back to where I was, a 180, let's say. It's really open my eyes to looking at life and lifespan in a completely different way, so I really want to thank you for that. You're very welcome.

And I really want to thank you as well, because. I think that the conversation around female health as we get older is a really fascinating lens through which to look at this. Actually, I'm going to go back to something Jen Garrison said, this incredible scientist. She said that, you know, if we look at women who undergo problems with their ovaries in their 20s, then suddenly medical science comes in and tries to fix that problem. But if a woman starts losing the function of our ovaries in her 40s or her 50s, that's just a natural process.

Natural, yeah. And I think it's the same with ageing. If a young person gets cancer, you know, we throw everything in the kitchen sink at them to try and save them, which is absolutely right. But if someone in their 80s gets cancer, we do still treat them. But there's just a bit of a sense of, well, they've had a good innings. That's their life. And there's a sort of ageism there. And I think that by understanding that, I think the women's health prism is a really good way to look at it because it happens so much earlier in life.

And it's quite an interesting because only, Hormone therapy, I'm going to call it that from now. Only maybe 20, 25% of women that can take hormone therapy, take hormone therapy. And we're still sometimes vilified, really, by some people in the medical profession and the media for kind of over-medicalizing something because we want to feel okay still as we get older. I find that fascinating that people are so freaked out by it. So I'm sure, you know, you deal with a lot of different opinions in what you do. I think that's exactly one of the problems with ageing biology is that people say,

why are we medicalising a natural process of getting old? And the answer is, you know, biology has dealt us this hand that means in your fifth, sixth, seventh, eighth decade, you do start to degenerate and deteriorate. And I don't want that for anybody. And unfortunately, the only way to change this is medicine. You know, you can exercise, you can diet, you can not smoke, you can do all the right stuff. And at the end of the day, I cannot guarantee that you'll make it at 80 in good health. This isn't immortality.

This isn't living to 150. This isn't tech billionaires. This is, you know, being a granny and being healthy enough to enjoy your time with your grandchildren. And the fact that we can't guarantee that means I want medicines to help us get closer to being able to guarantee that. I mean, being somebody that's closer to 80 than you are a lot closer. That sounds very attractive to me, but I'm still not sure if I want to do. live to 110 or 2010. I'll ask you when you're 109. Deal. Thank you, Andrew. Thank you so much. Thank you for talking to me today. That's blown my mind. I'm not sure I've told any of my guests

so far to shut up twice during an interview. I think what's interesting about Andrew's science around longevity is that before I read his book and before I spoke to him, I was, I was, I was sort of a bit ante it. You know, why would we want to live longer? Surely that's kind of going against nature. But he argues it so brilliantly and gave such great examples of ways that it could and should work, that it's made me quite frustrated that he's struggling so much when we seem to be at the cusp of some amazing discoveries, but all it needs.

And it would be of such economic benefit. to so many different countries that more research isn't being done into it. But what an interesting guy. I hope you'd enjoyed it as much as I did.