Instant Genius - The anti-ageing wonder drugs of the near future

Episode Date: January 5, 2024

Could you ever take a pill that actually prevents ageing? If we’re lucky, absolutely. In fact, such a pill might be available within the next decade. That’s according to our guest today Andrew Steele, the author of Ageless: The New Science of Getting Older Without Getting Old. In this episode, the second and final of our anti-ageing specials, Andrew unpacks the most promising longevity drugs currently being trialled. If you haven’t done so already, check out part one of this series, where Andrew explains the simple lifestyle changes that can slow, stop and potentially reverse your biological age. Learn more about your ad choices. Visit podcastchoices.com/adchoices

You said this place was steps from the water. We just haven't found the steps yet. How much did we save? Enough. Enough to get lost! Or you could book a stay with Hilton. Welcome to your oceanfront room. Just steps from the water.

The Hilton sale is on now. Book on Hilton.com or the Hilton app and save up to 20% to get the stay you expected. When you want savings, not surprises. It matters where you stay. Hilton, for the stay. No one goes to Hank's for his spreadsheets. They go for a darn good pizza.

Lately, though, the shop's been quiet. So Hank decides to bring back the $1 slice. He asks Copilot in Microsoft Excel to look at his sales and costs. Help him see if he can afford it. Co-pilot shows Hank where the money's going and which little extras make the dollar slice work. Now, Hanks has a line out the door. Hank makes the pizza.

Co-Pilot handles the spreadsheets. Learn more at M365Copilot.com slash work. When you need to build up your team to handle the growing chaos at work, use Indeed sponsored jobs. It gives your job posts the boost it needs to be seen and helps reach people with the right skills, certifications, and more. Spend less time searching and more time actually interviewing candidates who check all your boxes. Listeners of this show will get a $75-sponsored job credit at Indeed.com slash podcast.

That's Indeed.com slash podcast. Terms and conditions apply. Need a hiring hero? This is a job for Indeed sponsored jobs. This podcast is sponsored by name, audio and focal. Streaming has made music more accessible than ever, but true listening is about more than ease. It's about quality.

British audio experts name audio, alongside French acoustic specialist focal, combine handcrafted tradition with cutting-edge innovation and high-end materials, delivering digital precision with analogue warmth, so you can experience exceptional sound at home. Music just as the artist intended. Visit name audio.com to learn more. Welcome to Instant Genius, bite-sized masterclass in podcast form.

I'm Thomas Ling, digital editor at BBC Science Focus magazine. Could there ever be a pill that actually prevents ageing? Very, very possibly yes, and if we're lucky, it might be available within the next decade. That's according to our guest today, Andrew Still, the author of Ageless The New Signs of Getting Older, getting old. In this episode, part two of our anti-aging special, Andrew impacts the most promising longevity drugs currently being trialed. If you haven't done so already, I highly recommend checking out part one where Andrew explains the simple lifestyle changes that can slow, stop and potentially reverse your biological age.

So we've impacted quite a lot about different behaviours, which people can do, which might help their biological age. Let's get into the drugs. now. So what are drugs are you particularly excited about? Hopefully that the drugs connected with, you know, slowing down your age. But tell me everything that you want. I actually often cast this as a piece of unconventional sounding health advice, right? So I think if you're already trying to tick all the boxes that you can, you know, being as healthy as you possibly can be, the single best thing that you can do for your life expectancy isn't to, you know, peruse the list of supplements and try and, you know, find the one or two special magic ones that might improve our lifespan today. It's to spread

the word about aging biology. And that might sound like quite a counterintuitive bit of health advice. So let me unpack that a bit. But ultimately, this is the reason that I decided to move, you know, from a career that was purely based in science to writing a book about this stuff. Because I think raising the profile of aging biology is probably the most important thing we can do. And the reason for that is that I'll talk a bit about some specific examples in a second. But these drugs are not decades away. We've got drugs that we already think can slow down, maybe even reverse the aging process. I've already mentioned rapamycin to make mice live 10% longer and actually lots of other organisms too. And we found that that effect is robust.

We've repeated it in loads and loads of different experiments. All we're missing is the human trial to tell us one way or the other, whether that is actually going to work. And what this means is that if you can live long and healthy enough to benefit from those first drugs, which could be available in the next five or ten years, then that might mean you live a little bit longer and healthier still. And then we can start talking about the more advanced stuff, the gene therapy, the stem cell therapy, things that can sound a bit sci-fi. But, you know, there are only 20 or 30 years into the future. We've already got some gene therapy and stem cell therapy. cell therapies that are being used in the clinic right now. They're just not sort of considered

safe enough to use in the general population as an anti-aging thing. They're being used for specific, you know, very dangerous diseases. As we learn more about those, those are going to come online as well. And that means that I think for most people alive today, these anti-aging drugs are going to come in time. The real challenge is getting the trials funded to demonstrate whether they work one way or the other. So it's all very well doing an experiment in mice. What we need is to increase the funding for the science to make sure that the research can be done, to make sure that we can be checking out loads of new avenues to develop the next generation of treatments and so on. And let me give you an example of one drug that I think is a potentially interesting anti-aging agent,

but we just don't know. And the frustration, again, is the sort of lack of money for the research. There's a drug called metformin, which actually quite a few people listening to this might be taking. It's one of the most widely prescribed drugs in the world. It's a diabetes drug traditionally. We've been prescribing it in the UK since the 1950s. We've obviously therefore got decades and decades of experience. We know it's a drug that doesn't have serious side effects. But there was a fascinating study that was done using medical records, I think, in Scotland. And what they found was, they were trying to do a head-to-head trial between metformin

and another class of diabetes drugs called sulfonylureas. And the ultimate aim of the study was to find out whether metformin or sulfanolureas were better. Just to be really, really comprehensive, they also included a control group of people who weren't taking either drug. And the reason those people weren't taking either drug is because they didn't have diabetes. So that's why they weren't taking a diabetes drug, right? So what they found was, firstly, metformin is better than sulfonylurea, so that was the sort of the main takeaway from the trial from a diabetology point of view. But they also found that the people who are taking metformin lived slightly longer than the control group.

Now that's really interesting because, as I said, the reason the control group were in the control group is because they didn't have diabetes. And we know that diabetes is associated with a whole load of other age-related health conditions. So, for example, people who have diabetes tend to be more overweight. they tend to get less exercise. And actually, we know that diabetes is at least to some extent reversible if you can reduce your body weight and get a bit more active. So there's clearly, you know, they tend to be an unhealthy population in that respect. We also know that diabetes can increase your risk of all kinds of age-related problems

and heart diseases or cardiovascular issues are one of the main ones. But there are all kinds of different things that can come along with diabetes. So you'd expect those people to die sooner. But it seemed as though the metformin was maybe having some kind of anti-aging effect and meaning they lived a little bit longer than, you know, quite and quite healthy people who weren't taking the drug. Now, there's a problem with this study, and that's that this study was done using medical records. So they were looking back at people, you know, throughout the course of their medical history, rather than looking forwards, you know, giving them a drug and intervening

and seeing what changed. And that means that just like with the sort of toothbrushing example I gave just now, there could be some third variable that means correlation isn't causation, and that's what explains the fact that metformin seems to prolong life. And to give an example for that, if you've got diabetes, you're probably going to visit your doctor fairly regularly and have your, you know, have your blood sugar measured and have various other things done while you're there. They might test your blood pressure. They might, you know, see if you're developing any new symptoms that you haven't reported yet. Whereas if you're someone in the general population who hasn't got diabetes, you might be a bit less willing to go and see a doctor. There's nothing really overtly wrong

with you. And something like blood pressure, it's a condition that doesn't have any symptoms if you have high blood pressure until, you know, you get a heart attack or until something really severe starts happening. And so that means that someone who's got diabetes might just be getting better general medical care, better preventative medicine, that means that could be the reason they live longer. So what we want to do is a trial called Tame, which stands for targeting, aging with metformin. And what that trial hopes to do is to give 3,000 older people, split them into two groups, and give half of them metformin, the actual drug, half of them of placebo, so an inactive tablet that otherwise looks the same, and then watch them for three or four or five years. And over that

period of time, these people, you know, some of them are going to come down with cancer, some of them are going to get heart disease and so on and so on. And they're going to count all of the age-related diseases in these two different groups. And they're obviously going to count if people die as well. And what they're hoping to find is whether or not metformin actually can slow down the aging process if you give it to a healthy population, a population who don't have diabetes at the start of the study. And because this is randomized, because it's random whether you get the metformin

or the placebo inactive pill, we then know that the only difference between these two groups is that whether they got the placebo or the active drug. And that means we can finally understand whether it does slow down in the aging process. And this trial, it's hoped to cost about $70 million, but frustratingly, they still are waiting for like a couple of tens of millions of dollars because it's really, really hard to get the funding for this trial. Drug companies aren't super interested because this is a drug that's been around for about a century now, so it's off patent, as we say, which means they aren't collecting huge amounts of revenue.

The tablets actually cost pennies per pill. So, you know, no one's going to make a huge amount of money if this succeeds. And, you know, public funders of research aren't necessarily that interested. because it's a bit speculative and 70 million. It's cheap in terms of the size of the problem of aging. And imagine the economic benefits, if we could slow down aging a little bit with this very, very cheap medicine.

But it's very big for public funding of science grant. Most scientific grants are tens or hundreds of thousands, not tens of millions. So it's very, very difficult and sort of falls between the cracks. And this is a classic story when it comes to aging biology research. If you look at the numbers, it's about a dollar per American is spent on basic aging biology research by the US government.

even though aging kills 85% of Americans. And so that's why I say that really sort of raising the profile of this research, allowing trials like tame and allowing sort of discovery of new drugs is really what's going to move the needle in terms of how long, not just how long you live. So although it's a piece of personal health advice, it's also how long your friends, your family, billions of people, you know, you've never met around the world.

I think the thing that's really going to make a big difference in terms of how long all of us live is that research into aging biology and finding drugs that really can slow down the aging process. So do you think it's a case of, of getting the word out and getting people to pressure governments or be donating personally. Like, have you, for instance, donated any money to this tame research? Well, I am a scientist-turned-author, and unfortunately neither of those actually careers. I often say if I was a billionaire, which unfortunately I'm not, I would give away like 995 million

of my dollars, euros, pounds, or I was sort of billionaire I am to aging research, because I think this is the single most important and most neglected challenge. Climate change is definitely up there in terms of importance, by the way, but I just think it's much less neglected than ageing research because there are already a lot of people, not enough, but still more than are working on ageing research, looking into that. So I think there's definitely some scope for personal donation. I think you can donate to afar, which is the American Federation of Aging Research, which are the people who are sort of orchestrating tame.

But I think why the really key things is just is spreading the word, because frankly, I think billionaires, so I often get asked when, you know, when doing interviews, why are all these billionaires so obsessed with living forever? Actually, they really aren't. there are like a handful of billionaires who are donating any substantial fraction of their net worth, or even investing a substantial fraction of their net worth into aging biology. You can count them on the fingers of two hands, even though there are, I think, two and a half thousand billionaires in the world or something like that. There's only a really small number who are actually doing something about this stuff.

And that's because billionaires are just essentially like you and me, apart from they happen to have a billion dollars, pounds or euros. And that means they're often not aware of this aging biology research. It's something that not a lot of members of the public know about, not a lot of politicians know about it. So it's definitely important to try and raise the profile with those people because they're funding the science. The other challenge is that even scientists and doctors don't know much about this stuff. And that's why I ended up, you know, moving from science into writing a book. Because I decided if I can inspire even two scientists to change career into aging biology, I've already doubled my impact, right?

And what I found while I was working as a scientist, I spent five years working as a computational biologist at the Francis Crick Institute in London. And I was working with some absolutely top biologists who'd been to, you know, they've got incredible degrees, incredible PhDs from great universities. I, by the way, stopped studying biology when I was 16. I did a GCSE in the UK. And I found that I was often the most knowledgeable person in the room about aging biology. That isn't because I'm some kind of genius. It's because I've read a few books. I'd read a few scientific papers about this topic. But if you're a biologist, you often don't get a single lecture on aging, which is crazy because it is perhaps one of the most universal processes in biology. Like apart from evolution,

aging is definitely up there as being one of the most important things that happens to almost all organisms, apart from those tortoises and a few other animals that I mentioned that don't age. And even they're interesting from an ageing point of view because they don't do it. So why is that not taught? It's incredible. I also, during this time I met my wife, my wife is a doctor. And when I first started talking to her about the idea of medicines that could treat aging, she thought I was crazy. And again, it's because there's not a page in any medical textbook about these anti-aging

medicines, which is mad because she was a student at the time. She in her career is going to be prescribing the sorts of medicines that I'm talking about, you know, whether it's metformin, whether it's the next generation, whether it's the gene therapies, the stem cell therapies that are going to be perhaps 20 or 30 years away, that is still well within her lifetime, well within her scientific career, well within the lifetimes and most people alive today. And yet doctors aren't given any information on this. And that means that their initial reaction is often confused or hostile, or they think it's some sort of crazy crank snake oil stuff. Because obviously, you know, the phrase anti-aging, if you think of anything about it, you know, you might think about skin cream.

You might think about the, you know, decades or centuries of snake oil salesmen who've been trying to like push different stuff on people. A fantastic example I often think of is in the 1920s. I was a guy who thought that sewing monkey testicles to people was a way to prolong their virility. And you're just like, you know, this is not a field that has a great historical reputation. And for the longest time, actually biologists thought that aging was just too complicated to study. They thought it was something where the whole sort of system of your body falls apart in a million different ways. How on earth could you possibly get a handle on that?

We now, thankfully, know that there are single genes. They're obviously single drugs I've talked about as well that might be able to slow down the aging process. Ambition comes in all shapes and sizes. At First Citizens Bank, we roll with your goals because we're built for what you're building. Fit for your ambition for Citizens Bank. It's peak pollination season, and my business is scaling fast. To keep the nectar flowing, I need a phone plan with top priority data speed.

That's why I chose GoogleFi Wireless. My connections stay strong even when the hive is buzzing. Plus, unlimited plans started $35 a month. Now that's a deal that doesn't stay. Explore GoogleFi Wireless plans today. Plus taxes and government fees. GoogleFi Wireless is not subject to data traffic deprioritization during times of high network usage. This podcast is sponsored by Name, Audio and Focal.

With over 100 years of combined expertise, Name and Focal have been bringing music to listeners just as the artist intended. Since day one, this mantra has shaped every innovation in high-fi design, technology and acoustic engineering, balancing craftsmanship and tradition with pioneering thinking. Name Audio pushes cutting-edge technology to ensure digital precision whilst sustaining Pratt, pace, rhythm and timing, the elusive quality that makes music feel alive and gives it emotional texture. Today, in partnership with French acoustic specialist focal, name audio creates systems that deliver exceptional sound, and unforgettable listening experiences at home.

Try it for yourself at a focal powered by name boutique. Visit focal powered by name.com for more information. What would you say to someone who listened to that and then thought if you increased everyone's age, isn't that just delaying a lot of problems? And then also, if everyone is able to age quite a bit further than what they normally used to, is that going to lead to overpopulation

and perhaps worse problems in areas like climate change? are great questions. And I think they're, you know, they're often the first questions that I get when I give a talk about this, which sometimes really surprises me because I'm like, don't you want to know how to live longer? No, everyone's very worried about climate change. And honestly, I'm very worried about climate change too. When I was at the end of that physics PhD, I very nearly took a different left turn and became a climate scientist, which would have been a bit more of an obvious use of my physics credentials, actually, and going into computational biology. The reason I didn't, as I said just now is that, although I think climate change is a huge, huge, important, I think, you know, an extra voice in climate science would have been important. I think we do need more people working on that. But I I can have a bigger impact in ageing. To answer your first question, I think it is important to try and extend people's healthy lives, even if we do still have that period of unhealthiness at the end, because if I can live a larger fraction of my life in good health, if I can live to the age of 120 in good health and then spend five years at the end essentially falling off a cliff and, you know, becoming very unwell for a short period of time, I think that is better than doing what we do

today, which has lived to the age of 65 or 70, then spend maybe 10, 20, 30 years in ill health. I think that bigger fraction is an important thing. And actually, you know, imagine I was a cancer researcher. This is not a question that you'd ask a cancer researcher, right? If someone came on and said, oh, we've got this incredible new cancer cure, it's going to sort out people with this particular kind of cancer, no one would say, oh, you know, isn't it a problem that we're going to extend their lives? And isn't that just pushing the problem further back into the future?

I mean, that's essentially what medicine is doing. And if we can carry on pushing that problem further and further back and live healthier for longer, I consider that a success, whether that being cancer research, or whether it being what I think will probably be more effective in the long term, understanding the aging process that causes that cancer and also causes the frailty, the heart disease, the dementia, pushing all of those things back together, I think can only be a good thing. Specifically in terms of the question of overpopulation, which is I think definitely the most common question that I get, it actually, even if we were to completely cure aging, so even if we were to go

full tortoise and have a risk of death that's flat with time, I think it would make a surprisingly small difference to the population. So I'm by no means an expert demographic modeler. What I decided to do was download a bunch of data from the United Nations, who are one of the sort of big bodies that do population projections looking at into the future. And we know the population of the Earth at the moment is about 8 billion people. We just crossed that threshold, I think, late last year. And we're going to sort of carry on increasing to some time in the middle of the century, or maybe a little bit later.

And if you look at the United Nations projections, they have something called the medium variant, which is sort of their best guess based on birth rates and life expectancy and all kinds of things. They think we're going to have about 9.8 billion people by 2050. Now, I thought what happens if I cure aging, so literally have a risk of death that's flat with time in somewhere in young adulthood, and I do that by 2025. Now, there are a number of reasons that this is completely ridiculous. Firstly, we've got to solve all the science in the next, I think we're running out of time. We've only got two years, a year since I did this calculation.

We've also got to roll out these drugs or treatments or whatever they might be universally to every country in the world, every single human being, you know, every tiny little Tibetan village has to have access to this medication in order for these calculations to make. sense. This is an absolutely absurd scenario. If you're an aging optimist like me, it's a best case scenario. If you're a population pessimist, it's the worst case scenario. But let's play it out and just see what that might mean. Well, if we were to cure aging in two years time, and what we'd find is that the number of people on earth, rather than being 9.8 billion in 2050, would actually be about 11.3 billion. Now, it's that a lot. On the one hand, it's like one and a half extra billion mouths to feed or whatever, you know, people using resources. And on the other hand, that's only a 16% increase.

And I would happily work harder, you know, 16% harder to cut back my carbon dioxide, to cut back the amount of plastic I use, to cut back my land use by eating less meat and, you know, doing various things to lighten my footprint on the earth, if it meant dramatically less cancer, dramatically less Alzheimer's, you know, dramatically less heart disease, people living with less frailty for longer. I think that's a trade-off I would happily, happily make. And actually, I think the key problem with this question about overpopulation is that it's not the people, it is the resources we use.

and there's already huge, huge inequality in resource use. The top 10% of people use about 50% of the carbon dioxide, or I should say emit about 50% of the carbon dioxide, whereas the bottom 50% of people emit about 10% of the carbon dioxide. So all that's to say, in terms of population, even if we were to literally kill the poorest 50% of people on Earth, by the way, I'm absolutely not advocating this as a policy, this is a thought experiment,

but we would only reduce global carbon emissions by about 10%. That is not enough to even begin to think about solving climate change. So clearly, if we want to get those bottom 50% of people in terms of wealth up to a quote-unquote Western standards of living, we're going to have to work out how to do that in a way that emits far less carbon dioxide per person. And that is a problem that we've got irrespective of what happens in terms of the aging biology. There's a lot of hype around senolitics in the moment. Can you explain what they are and how they work? Yeah, seniletics are definitely one of the things that I'm most excited about.

Because if you think about drugs like rapamycin or metformin, these might be able to be approved a bit quicker because these are drugs that we already use for other things. And so they've already got approval. But these other drugs that can target specific aspects of the aging process are what I'm really excited about in the future. And if you look at why we age, if you ask a biologist, why we age, we've done very well to get to this so late in the podcast, by the way. So we've got a list of, depends exactly who you ask.

In my book, I have 10 things, 10 hallmarks of the aging process. And we hypothesize that these are things that essentially cause us to get older. They cause the cancer, they cause the wrinkles, they cause all the different changes that happen as we age. These senilitic drugs are targeting what's number five on my list. This is the accumulation of what are called senescent cells. Now, senescent is a word we've already come across. It's the biological word for getting older.

And these are cells that accumulate in all of our bodies as we get older. So their cells, they might have divided too many times, and so they enter this sort of state of arrest where they no longer divide. They can have accumulated a lot of DNA damage. That's another reason the cell might put on the brakes because they've accumulated that DNA damage, those mutations. and so the body thinks, well, that looks a bit like it might turn into a cancer. I'm just going to stop it dividing now because if a cell can't divide, it can't become a cancer.

So anyway, there are a variety of different reasons that these cells increase in number as we get older. And what we found is they then secrete this toxic cocktail of molecules that essentially accelerates the whole of the aging process. And so scientists thought this is a thing that increases as you get older. It seems to drive a whole range of age-related diseases. What would happen if we got rid of them? And so they went on the search for drugs that could remove these senescent cells, but leave the rest of the cells of your body intact. And there was a paper published in 2018

where scientists tried out this combination. They waited until mice for about 24 months old. And that's quite old in mouse terms. Obviously, anyone who's ever kept a pet mouse or no, they live a lot less long than humans do. It's sort of 60 or 70 years old in human terms. And when they gave the mice these drugs, they cleared out the senescent cells.

They basically got biologically younger. So the first thing was, they lived a bit longer, which is a good start. But again, like with the calorie restriction experiments, they aren't dragging out that period of frailty at the end of life. They're staying healthier for longer too, so they get less cancer, they get less heart disease, they get fewer cataracts. They're less frail.

So in these experiments, they essentially send the mice to the gym in order to test their frailty. And so they can run further and faster on these tiny mouse-sized treadmills that they've got if they give them the senescent cell killing drugs than the controls who are the same age that haven't had the treatment. They're more curious. So it seems to rejuvenate some of their cognitive youthfulness. So if you put a young mouse in a maze, it'll often be very excited. is, you know, be in this new environment, can it find the cheese, whatever it might be.

Or as you put an older mouse in a maze, they're often a bit more anxious, maybe just a bit more sedentary, less willing to explore. But by giving them these senolytic drugs, again, they rejuvenated that youthful curiosity. It was as though they reduced their biological age in that sense. And frankly, these animals, they just look fantastic. I've mentioned a few times I was a computational biologist. So that means I was, you know, doing computer code analyzing DNA and medical record data and that sort of thing. I didn't set foot in the lab when I was working as a biologist. But you do not need to be an expert.

even to my wildly untrained eye, you can see the difference. The mouse that's had the drugs versus the mouse that hasn't had the drugs, the ones that have taken the seniletics, they have less gray fur, they have thicker fur, they have plumber skin, they gain less weight. They just look like younger animals, even though they're the same age. And I think this really shows us, the seniletics don't just extend lysman. They don't just reduce disease. They don't just reduce frailty.

They don't just reduce aesthetic aging. They do all of these things together. And that's the real dream of anti-aging medications. to identify one of these 10 hallmarks, or perhaps, you know, an 11th or a 12th one that we haven't discovered yet. It's to go in and reduce the way that hallmark changes with age, you know, kill these senescent cells, improve the functioning of the mitochondria, the power plants inside your cell, whatever it might be, to a more youthful state. And then hopefully impact not just on one disease of aging, not just in one part of aging, but on the whole of the process itself. And the most exciting thing about this is that these drugs are preventative medication.

We don't wait until people are ill to give them. we give them to people to stop them from getting it in the first place. Now, there are already human trials going on for these drugs. There are 20 or 30 companies that are trying to turn this from an idea that clearly works in mice to something that works in human beings. And if we get lucky, it might only be, you know, 10 years before we're giving these things out to slow down the aging process and make all of us live healthier for longer. Wow. I look forward to that.

I do have to ask you, and I'm sure a lot of people want to know, your thoughts on Brian Johnson. Of course, not the ACDC lead singer, but the ultra-rich US businessman who spends millions each year on anti-aging technology. So for those who don't know, he downs over 100 pills every day, collects his own stool samples, and reportedly sleeps with a tiny jetpack attached to his penis to monitor his nighttime erections. Do you think we should all be living like Brian Johnson? Well, I should declare before we start this answer, I've got a bit of a conflict of interest, because Brian actually blocked me on Twitter. And the reason that Brian blocked me on Twitter

is because I suggested he's reportedly worth about $400 million because of a sale of a company a few years ago. And that means that he's actually got enough money to fund that tame trial that I was talking about earlier, this trial into using metformin for aging. And metformin is one of the drugs that he currently takes. So I said, Brian, you know, you're doing this sort of, what we call in science an n-equals one experiment

because there's one participant. This isn't particularly scientifically useful. even if Brian Johnson lives to 120, maybe he just had the right genes and all this other stuff that he's doing is a fair for sideshow. So it's very hard to draw any strong conclusions. What you need to do is a proper randomised trial. And so I suggest this to him and he said, you know, you can't tell me how to spend my money and hit the block button, unfortunately. But I do think that what he's doing has a variety of sort of negative consequences for the field of aging biology. The first is, I actually think he might be shortening his own lifespan. And there are two ways in which I think he's doing that.

I think in terms of the exercise that he does, that's probably good. I think most of us could afford to do a bit more exercise. In terms of the diet that he eats, apart from the needlessly specific prescriptiveness of it and the fact that he eats exactly the same thing every day, it's plant-based. He's getting a lot of protein from things like nuts. Most of us could do with eating something that was a little bit more toward the Brian Johnson direction, even if we don't go full blueprint. But then these hundred supplements he's taking a day, we know that biology is phenomenally

complicated. We don't have evidence for all of those hundred supplements working. and we might have a mouse study, or we might have a study that's been done on some cells in a dish. But we do know that the human body is this incredibly complicated, very tightly controlled system, and all drugs have side effects, and also all drugs have interactions. So one of the things you do learn in medical school is that if you're trying to give an older person a drug, for example, they're often already taking three or four or five drugs for some other conditions that they've got. You want to be very careful if you add a sixth drug to make sure it's not going to interact in some bad way

with one of the drugs they're already taking. It seems almost certain that if you take 100 things, those interactions are going to be negative, just because biology is hard, you know, where a system that's been optimized over billions of years by evolution, by natural selection, the idea that you can just chuck 100 random things in there and improve matters, even if there were evidence that each of those things individually improved human lifespan, which there isn't, by the way, I think it's just incredibly low. So that's the first way in which I'm worried he's shortened his own lifespan. But the second way that really worries me is that if you look at the posts he makes on social media,

the videos, his interviews and the media, that sort of stuff, you see sort of two genres of comment below these things. One of them is they're a hardcore of biohackers who think Brian Johnson is amazing and what he's doing is hugely beneficial for science. I hope I've already explained because it's an equals one experiment. I don't think it is particularly beneficial for science. But then I think the majority of the comments are, oh my God, you know, even if I had $2 million a year, I wouldn't spend it doing this or, oh, you know, if this is what living longer looks like, I'd rather live a shorter time and actually have some fun. I don't want to get up at 5 a.m. every day and, you know, eat exactly the same food and do this incredibly rigorous exercise program and take 100 pills and

sleep alone because that improves my sleep quality. These are not compromises that most of us would be willing to make. So I think the second way in which he's reducing his life expectancy is that I've already said aging biology isn't something that has a huge, you know, popular understanding of it. People haven't heard of it. People think it's something to do with cranks or quacks or whatever it might be. And if their first exposure to it is Brian Johnson, they think, oh God, this is clearly something a plaything of billionaires, these incredible, ultra-wealthy people who want to stretch out their own time on earth for no particular reason, living this ridiculous lifestyle that I wouldn't even want. Whereas my vision for anti-aging medicine is something that's very simple that everybody can do,

that we can integrate into all of our lives. It's not some highfalutin, you know, two billion dollar a year set of tests and a set of supplements. It's something that's much, much more down to earth. It's something that costs pennies per pill, a drug like metformin or a drug like, you know, something else that we can manufacture incredibly cheaply. Because that, I think, is where the real benefit is going to be. So my concern is that that then puts people off aging biology. I think it's just something for billionaires. I think it's something that's incredibly inaccessible for reasons other than money

just because it's hugely undesirable. When actually, I don't think that's the case at all. And just to put myself in the position, imagine I were a billionaire. And I was, imagine I'm just a billionaire. Not only that I'm super selfish, all I want to do is live as long as possible, you know, the classic evil genius billionaire, right? Would you want to be in that context, the n-equals one, the first person to take a particular anti-aging drug, I think you really wouldn't. Because, you know,

we've seen with Jeff Bezos and Elon Musk, like how often their space rockets have exploded during the testing phase. Actually, drugs are even harder to design than rockets, right? There are so many drugs that work in mice or work in a phase one clinical trial, but then don't work when you spread them out into the wider population. I want to be the 100,000th person to take a drug, or the millionth person to take a drug after it's had incredibly extensive safety and efficacy testing to make sure that it really, really works. And if you're going to give that drug, drug to 100,000 or a million people to test it that it works, it can't be something that costs, you know, $10 million a year because it's not going to be possible to run the clinical trial.

It's going to be too expensive even for the richest billionaires. And so I think that what you really want, if you are even a completely selfish billionaire, I'm not necessarily saying they are, but, you know, even if you were that hypothetical evil genius, what you want is a thriving, a flourishing, anti-aging industry that then creates this whole sort of range of different ideas. We don't know what's going to work, so we're going to have to try a whole range of approaches. We need big clinical trials to check that those things that we think work actually do work in people. And that is how the billionaire is going to live longer.

But that means it's also going to trickle down to the rest of us. And so I think if I was Brian Johnson, I'd be using that incredible platform that he clearly has. He's really able to get his word out there into the media. I'd be using that to advocate for aging biology research, not to spend two million a year doing a bunch of, frankly, unnecessary medical tests and doing an experiment. I really don't think it's a very much benefit to science. Absolutely fascinating. Andrew, thank you so, so much for your time.

It's been an absolute pleasure speaking to you. Thank you very much. You're hiring me. It's been a lot of fun. That was Andrew Steele, author of Ageless, The New Science of Getting Old Without Getting Old. If you like to hear more from him, check out the last episode of Instant Genius, where he discusses the simple lifestyle changes you can make to slow, stop, and potentially reverse your biological age. Be also sure to check out Andrew's YouTube, Instagram and TikTok pages,

also his latest feature on anti-aging for BBC Science Focus magazine, available across our digital channels. As always, this episode of Instant Genius was brought to you by the team behind BBC Science Focus magazine, which you can find on sale now in supermarkets and newsagents as well as your preferred app store. You can, of course, also find us online at sciencefocus.com. This podcast is sponsored by name. audio and focal. The texture and emotional depth of music can be lost through digital sources or

poor signal. Name Audio believes you can have digital precision with analog warmth. Alongside French acoustic specialist focal, name creates high-end audio systems combining innovation with craftsmanship so you can listen to music, just as the artist intended. Discover more at nameadio.com. Enjoy more ways to save at Ralph's, like low prices in every aisle. And when you download the Ralph's app, you can clip and save more with digital coupons every week. Plus, you can earn fuel points to save up to $1 per gallon at the pump. At Ralph's, you can enjoy more ways to save and more rewards every time you shop. So it's always easy to save big every day with savings and rewards.

Ralph's SoCal for over 150 years, savings may vary by state. Fuel restrictions apply. See site for details. You can't reason with the sun. Trust us. We've tried. This summer, it's time to put that angry ball of fire on mute. Columbia's Omni-Shade technology is engineered to protect you from the sun's harsh rays

that can burn and damage your skin. The sun is relentless, but so is our gear. Level up your summer at Columbia.com to spend more time outside and less time slathering on alolotion. You're welcome. Columbia. engineered for whatever.