NOTE: This is a repost of an article I wrote for a newsletter column I am trying to get into the habit of writing.
I have tried to learn about longevity a couple of times only to be overwhelmed with technical arcana — this gene, that protein, this biomarker, that supplement, it’s all just too much. But when David Sinclair, the preeminent longevity researcher from Harvard Med School, starts talking about “the information theory” of aging, my ears perk up: “Finally, something I do understand!” The entire talk is off the record, but nearly everything has already appeared in his mega-successful book LifeSpan. In it, Sinclair writes upfront that he is not talking about immortality, just the kind of longevity where people in their eighties look like they are in their forties, where you suppress the infirmities typical of old-age so that when death finally comes, it will be quick and efficient. Sinclair’s overarching thesis is that aging is effectively a loss of information: there is information in the epigenetics of the cell, and aging is its gradual, natural degradation. He parallels this to Claude Shannon’s work on information transmission over noisy channels, and reaches conclusions on how to manage aging — either suppress the noise battering on epigenetics, or actively fix existing damages (in the style of error correction).
I have heard Sinclair describe aging as scratches in a CD, and that being serious about longevity is as simple and commonplace as being a bit more careful with your old CDs, or making backups of precious photographs. So, I wonder, why isn’t everyone doing it? Why are YOU, dear reader, not taking supplements and regularly measuring your biomarkers? Why, do you want to die younger than all your peers? Did you know over half of America is taking some kind of supplement? What kind of puritanical morality is stopping you? Importantly, why are you not making your family take supplements? Do you want to deprive your grandparents the ability to meet their great-grandchildren?
To illustrate just how simple this lifestyle choice is, in his book, Sinclair provides the regimen he in currently in (with appropriate disclaimers on how it might not work for everybody):
- I take 1 gram (1,000 mg) of NMN every morning, along with 1 gram of resveratrol (shaken into my homemade yogurt) and 1 gram of metformin.
- I take a daily dose of vitamin D, vitamin K2, and 83 mg of aspirin.
- I strive to keep my sugar, bread, and pasta intake as low as possible. I gave up desserts at age 40, though I do steal tastes.
- I try to skip one meal a day or at least make it really small. My busy schedule almost always means that I miss lunch most days of the week.
- Every few months, a phlebotomist comes to my home to draw my blood, which I have analyzed for dozens of biomarkers. When my levels of various markers are not optimal, I moderate them with food or exercise.
- I try to take a lot of steps each day and walk upstairs, and I go to the gym most weekends with my son, Ben; we lift weights, jog a bit, and hang out in the sauna before dunking in an ice-cold pool.
- I eat a lot of plants and try to avoid eating other mammals, even though they do taste good. If I work out, I will eat meat.
- I don’t smoke. I try to avoid microwaved plastic, excessive UV exposure, X-rays, and CT scans.
- I try to stay on the cool side during the day and when I sleep at night.
- I aim to keep my body weight or BMI in the optimal range for healthspan, which for me is 23 to 25.
He says he does it because: “I know exactly what is going to happen to me if I don’t do anything at all—and it’s not pretty. So what do I have to lose?” And clearly it seems to be working. At 50, he says, he feels like 30. Even his heart looks like a 30-year-old heart. He neither has gray hair nor is “super wrinkly.”
I look at Sinclair’s regimen above, and I tell myself: “Look, except for the supplements, I do most of it already.” Not to brag, but my BMI too is in the optimal range. I don’t drink soda, although I should probably eat less pastries and desserts. I am so lazy I almost never put together a breakfast; lunch is getting so expensive I am considering cutting it off entirely. I don’t smoke, I try to run for half an hour each day. Sun, I haven’t seen in weeks! In his book, Sinclair talks about eating a lot of stressed vegetables from plants grown in suboptimal conditions. Once again, I happen to be so lazy that by the time I go to a grocery store, all the good-looking vegetables are gone and I am left with the most stressed and the ugliest of them anyway.
Still, the question remains: why not take the supplements? Let’s break down the cost of Sinclair’s regimen. NMN + Resveratrol costs $49 for a 90-day supply. Vitamin D, Vitamin K2, and Aspirin cost $48 a year if purchased from Amazon, which also tells me Metformin requires a prescription and costs $4 with insurance ($105 without insurance) for a 90-day supply. This all adds up to, in the worst case, $1.85 a day. For comparison, New York City subway fare is three dollars a trip. Plus, if you cut down on lunches and desserts, you might even come out net positive financially. So, why aren’t you taking supplements? Do you not value your life enough to spend two dollars a day?
I have been telling myself I am uncertain how much supplements add relative to everything else, like eating healthy. Do supplements even add positively at all? Just the other day, I saw an article in JAMA that says multivitamin supplements actually increase mortality risk by four percent. Look, four percent is a large number, and I don’t have that kind of appetite for risk, to treat my body as some kind of petri dish. I don’t have the kind of money to replace my organs if one of them fails. I don’t have a teenage son to swap blood with.
The other issue is that there just is too much information out there. Sinclair’s regimen is only one recommendation out of many. Bryan Johnson famously takes 54 pills just for breakfast. Every geneticist has a different opinion on what works. Some swear by Ozempic, some by SGLT2 inhibitors (whatever that means), and some by Viagra (yes, I know what that means, winky face). Which do I take? Do I take all of them? Not to mention the thousand startups selling longevity therapies. The moment you, as a non-expert, enter this market, you become one of those “low-information suckers.” So I decide to just stay out of it, and to instead age and decay the way God originally intended.
Sadly, I am painfully aware that these are just excuses.
When I was in college, I used to work for the Bureau of Study Counsel, which occasionally did reports on how students studied and how they performed in classes. There was one result which has made a deep impression on me. The students who came from rather preppy backgrounds, those who grew up with tutors, were not shy of taking advantage of all the resources given to them: they shamelessly asked for extensions, showed up to professors’ doors even outside of office hours, hired external tutors, etc. On the other hand, the students who came from disadvantaged backgrounds would rather bang their heads on a wall until a solution to a math problem presented itself instead of seeking help: “It is not appropriate, it is not fair, it will make me look dumb, it might actually make me dumb.” They handicapped themselves with a misplaced sense of morality.
What does that mean for aging supplements? I fear that longevity might just become yet another flashpoint to the widening cham of inequality, one in which some advantaged communities enthusiastically pursue life extensions while others refuse to even consider life-altering therapies just because of some self-inflicted mental handicap, through religion or some notion of how one shouldn’t interfere with fate and/or natural aging. The natural process of death has always been though of as an indiscriminate leveler (“Pale death kicks with impartial foot at the hovels of the poor and the towers of kings”, “Death doesn’t discriminate between the sinners and the saints, It takes, and it takes, and it takes, blah blah blah). Perhaps no longer.
So, once again, why are you not taking supplements? Yes, the industry is full of opportunity and scammers who would sell you all sorts of personalized, AI-driven longevity therapies with a side of a shitcoin and an NFT. Yes, the research is opaque and the risks unclear. In spite of all that, it might still be worth it to ponder: what kind of risk tradeoffs am I willing to accept? Soon, as research matures, we are going to get the numbers: “At cost X today, you will increase your lifespan by Y +/- Z years.” How large or small do these numbers have to be for you to consider a serious treatment? Or are you simply waiting for everyone else to do it, and the cultural vibe to shift? This, literally being a matter of life and death, might be worth a few minutes of serious thought.