What a 93-Year-Old Rowing Champion Can Teach Us About Aging Well | 10 - Longevity this Week #1
Summary
TLDRThis podcast episode discusses healthy aging, using a 93-year-old champion rower as a case study. It analyzes his fitness routine and diet as possible contributors to his vitality at an advanced age. The hosts then examine research on worsening health spans despite rising life expectancies, discussing flaws in common health span metrics and offering perspectives on potential future trends.
Takeaways
- 🚣 Richard Morgan, à 93 ans, montre une santé et une forme physique comparables à celles d'une personne de 40 ans, remettant en question les idées reçues sur le vieillissement.
- 🏋️♂️ Débuter le sport et une alimentation équilibrée à un âge avancé, comme l'a fait Richard qui a commencé l'aviron à 72 ans, peut significativement améliorer la santé et la longévité.
- 📉 Une étude souligne un écart croissant entre l'espérance de vie en bonne santé et l'espérance de vie totale, indiquant que les Américains vivent plus longtemps mais avec plus de maladies.
- 🔬 Les recherches sur Richard Morgan, basées sur des données physiologiques, suggèrent que l'exercice et une alimentation adéquate peuvent inverser certains aspects du vieillissement.
- 💡 L'importance de l'entraînement en résistance et de l'exercice cardiovasculaire est soulignée pour maintenir la masse musculaire et la fonction cardiovasculaire avec l'âge.
- 🥗 Une alimentation riche en protéines et faible en aliments transformés contribue à la santé et à la longévité, sans nécessité de recourir à de nombreux suppléments.
- 🔎 Les études en laboratoire sur les animaux montrent des améliorations dans certains aspects de la santé grâce à l'exercice, mais n'indiquent pas nécessairement une augmentation de l'espérance de vie maximale.
- 🧮 La mesure de l'espérance de vie ajustée en fonction de la santé (HALE) et les débats sur sa précision montrent les difficultés à quantifier le 'bien-être' à travers le temps.
- 📚 La discussion met en lumière la nécessité de repenser les approches traditionnelles de la santé et de considérer la prévention et le traitement des causes sous-jacentes du vieillissement.
- 🔄 La possibilité de 'renverser' l'âge à travers des interventions ciblées sur le mode de vie et peut-être dans le futur, sur la biologie du vieillissement, offre une perspective optimiste pour améliorer la qualité de vie avec l'âge.
Q & A
Quelle est l'histoire de Richard Morgan, le champion d'aviron de 93 ans ?
-Richard Morgan est un champion d'aviron de 93 ans, connu pour sa condition physique exceptionnelle, comparable à celle d'une personne de 40 ans. Il a commencé l'aviron à 72 ans et a maintenu une routine d'entraînement rigoureuse, comprenant de l'exercice cardiovasculaire et de la musculation.
Quelles sont les caractéristiques physiologiques de Richard Morgan mentionnées dans l'article du Washington Post ?
-L'article mentionne que Richard Morgan possède une composition corporelle impressionnante, avec un pourcentage de graisse corporelle d'environ 15%. Il pèse 131 lbs (environ 59 kg) et mesure 5 pieds 3 pouces (environ 160 cm), ce qui lui donne un IMC dans la plage normale.
Comment la routine d'entraînement de Richard Morgan est-elle décrite dans la discussion ?
-Sa routine d'entraînement comprend environ 20 miles (environ 32 km) d'aviron par semaine, avec une répartition de 70% d'intensité faible, 20% d'intensité modérée et 10% d'intensité élevée. Il pratique également la musculation deux à trois fois par semaine.
Quel est l'impact de l'exercice sur le vieillissement selon les études de laboratoire mentionnées ?
-Les études sur les rongeurs suggèrent que l'exercice peut améliorer certains indicateurs de la santé sans nécessairement prolonger la durée de vie. Cependant, l'impact de l'exercice sur la santé humaine est considéré comme très bénéfique, surtout en termes de fonction musculaire, densité osseuse et fonction cardiovasculaire.
Quels sont les aspects du régime alimentaire de Richard Morgan qui contribuent à sa santé exceptionnelle ?
-Richard Morgan suit un régime riche en protéines, consommant environ 110 grammes de protéines par jour, et privilégie les aliments complets avec peu d'aliments hautement transformés. Il complète également son alimentation avec des shakes de protéines après ses entraînements.
Quelle est la différence entre l'espérance de vie en bonne santé (HLE) et l'espérance de vie, et comment cela a-t-il évolué ?
-L'espérance de vie en bonne santé (HLE) est une mesure qui tente de quantifier le nombre d'années qu'une personne peut s'attendre à vivre en bonne santé, tandis que l'espérance de vie est simplement la durée de vie moyenne. L'écart entre ces deux mesures s'est creusé au fil du temps, passant de 10,8 ans en 1990 à 12,7 ans récemment, indiquant une augmentation de la période de vie avec des maladies chroniques.
Quelles sont les limites de l'utilisation de l'espérance de vie ajustée en fonction de la santé (HALE) pour mesurer la santé globale ?
-L'utilisation de l'HALE est limitée car elle repose sur des estimations de sévérité des maladies et des handicaps qui peuvent être subjectives. De plus, cette mesure peut ne pas capturer avec précision ce que l'on considère comme une bonne santé, car elle peut ajuster les attentes de santé en fonction de l'âge et ne distingue pas clairement entre différentes qualités de santé.
Quelles sont les principales raisons d'optimisme concernant l'amélioration de la santé et de l'espérance de vie mentionnées ?
-Les raisons d'optimisme incluent les avancées dans le traitement du cancer, le développement de nouveaux médicaments contre l'obésité, une meilleure compréhension de la biologie du vieillissement et un changement vers une approche plus préventive de la santé, qui pourraient tous contribuer à améliorer la santé globale et potentiellement l'espérance de vie.
Comment la définition de la santé et du 'six span' pourrait-elle être améliorée pour mieux refléter l'état de santé des populations ?
-Une approche suggérée consiste à mesurer la santé de manière qualitative tout au long de la vie et à considérer le 'six span' comme la période passée avec au moins une maladie chronique significative. Cette méthode offre une mesure plus claire et plus directe de l'état de santé des individus et pourrait aider à mieux comprendre et à aborder les défis de la santé publique.
Quel est le potentiel d'impact des découvertes dans la science du vieillissement sur la santé et l'espérance de vie ?
-Les découvertes dans la science du vieillissement, en ciblant la biologie du vieillissement elle-même, ont le potentiel d'avoir un impact significatif sur la santé globale en abordant simultanément les déclins fonctionnels et les maladies liées à l'âge. Cela représente une approche fondamentalement nouvelle qui pourrait améliorer la santé et potentiellement augmenter l'espérance de vie.
Outlines
🚣♂️ Introduction à Richard Morgan et au concept de Longévité
Ce paragraphe présente Richard Morgan, un champion d'aviron de 93 ans, comme un exemple de vieillissement extrêmement sain, défiant les attentes traditionnelles de la santé et de la fitness à son âge. Matt Cabine et Nick Arapis discutent de la santé exceptionnelle de Richard et de son impact sur les concepts de durée de vie et d'espérance de santé. Ils explorent la routine d'entraînement et le régime alimentaire de Richard, suggérant que sa discipline pourrait offrir des leçons importantes sur le vieillissement et la santé. La conversation met en lumière l'importance de l'exercice et de la nutrition adéquate, remettant en question la nécessité de compléments alimentaires pour maintenir une bonne santé en vieillissant.
🔍 Analyse de la condition physique et de l'âge biologique
Dans ce segment, l'analyse se concentre sur les mesures physiologiques de Richard Morgan, en comparant sa condition physique à celle d'un individu dans la quarantaine ou la cinquantaine. Malgré les questions sur la précision de ces comparaisons, il est admis que Richard détient des attributs de jeunesse surprenants pour son âge, grâce à son régime d'entraînement et à son alimentation. Les auteurs discutent des limites et des implications des mesures utilisées, telles que la fréquence cardiaque maximale et la composition corporelle, soulignant la différence entre inverser certains traits de vieillissement et inverser le vieillissement lui-même.
📉 Discussion sur la santé, la longévité et les tendances de l'espérance de vie
Ce paragraphe explore la distinction entre l'espérance de vie et l'espérance de santé (Health span), soulignant un écart croissant entre les deux, exacerbé par des problèmes de terminologie et de mesure. Matt et Nick évaluent les implications de cette disparité à travers l'analyse de données et de tendances, questionnant les approches traditionnelles de la santé et la longévité. Ils critiquent les méthodes de calcul actuelles et proposent de nouvelles approches pour une meilleure compréhension et évaluation de la santé globale.
🤔 Critiques et solutions pour une meilleure mesure de la santé
Ici, la conversation se tourne vers les défis inhérents à la mesure de l'espérance de santé et propose des alternatives pour mieux évaluer et comprendre la santé au fil du temps. Les intervenants critiquent les méthodes existantes, comme le HALE (health-adjusted life expectancy), pour leur manque de précision et proposent des concepts tels que 'Sick Span' pour offrir une perspective plus nuancée et applicable de la santé à travers les âges.
🌱 Optimisme et stratégies pour l'avenir de la santé
Ce paragraphe conclut sur une note optimiste, évoquant les progrès réalisés dans le domaine de la médecine, en particulier dans le traitement du cancer et de l'obésité. Les auteurs discutent de l'impact potentiel de la science gérologique et des changements d'attitude envers la santé préventive. Ils soulignent l'importance de l'adoption d'approches proactives pour améliorer la longévité et la qualité de vie, en soulignant le rôle crucial de l'empowerment individuel dans la gestion de la santé.
📚 Synthèse et perspectives sur la longévité et la santé
Dans ce dernier paragraphe, la discussion résume les principaux points abordés dans l'épisode, en mettant l'accent sur l'importance de l'initiative personnelle dans l'amélioration de la santé et de la longévité. Matt et Nick encouragent les auditeurs à rester informés et engagés dans leur propre parcours de santé, et invitent les commentaires et suggestions pour de futurs épisodes, renforçant l'objectif de sensibilisation et d'éducation autour des enjeux de santé.
Mindmap
Keywords
💡vieillissement sain
💡espérance de vie
💡espérance de santé
💡exercice physique
💡composition corporelle
💡entraînement en résistance
💡alimentation équilibrée
💡suppléments
💡résistance au vieillissement
💡obésité
Highlights
93-year-old Richard Morgan has exceptional fitness for his age, including 15% body fat and high VO2 max.
Morgan began rowing at age 72 and trained consistently for 20+ years, including cardio, resistance training, and a whole foods diet.
Morgan's case shows it's never too late to start exercise and good lifestyle habits to significantly improve health.
While Morgan reversed some traits of aging, he did not fully reverse the aging process to become physiologically 40 years old.
Rodent studies show exercise improves healthspan metrics more reliably than lifespan, but have limitations in modeling human scenarios.
In people, exercise likely has significant anti-aging effects on physiology and function, especially resistance training.
There is a large and growing gap between life expectancy and health-adjusted life expectancy in the US.
The health-adjusted life expectancy metric likely underestimates declines in true healthspan.
An alternative metric is "sickspan", defined as the period of life spent with a chronic disease or disability.
By this measure, sickspan starts before age 40 for the average American, suggesting a gap of 40+ years from life expectancy.
The future trajectory of this gap depends on changes in both life expectancy and healthspan.
There are reasons for optimism about future healthspan, including cancer advances, anti-obesity drugs, geroscience discoveries and a shift toward preventative healthcare.
Empowering individuals to take control of their health is crucial to narrowing the healthspan/lifespan gap.
Please subscribe and provide suggestions for future podcast episodes.
Email [email protected] with questions or feedback.
Transcripts
the story of 93-year-old rowing Champion
Richard Morgan at 93 he's as fit as a
40-year-old this is a case example that
you don't have to take a bunch of
supplements or necessarily even any
could this be an example of someone
who's reversed their age it's probably
never too late to start everybody has an
opportunity to improve their health and
that that we know some of the ways that
people can accomplish that Americans are
sick for more of their lives the problem
being this growing gap between Health
expectancy and and life
expectancy my name is Matt cabine and
welcome to the optisan YouTube
channel hey everyone welcome to the
optisan podcast we are going to try
something new today uh so this is
something we call Longevity this week
and the idea here is that periodically
we'll pick you know somewhere between
two to four current stories in the field
and do a little bit of a deeper dive on
them and and try to distill out you know
some of the key insights or at least
give our our thoughts uh takeaways on
the stories so uh so today uh we picked
two recent stories one is about a
93-year-old world champion rower so an
example of what I would call extremely
healthy aging and what are some of the
lessons we might be able to learn from
that and the second is a article in the
Wall Street Journal recently that was
looking at the growing discrepancy
between Health expectancy and life
expectancy and so I'm joined again today
by Nick arapis and Nick and I are going
to talk through both of these articles
so hopefully you like this format and if
you do I'd encourage you to or even if
you don't I'd encourage you to leave
some comments below so we can try to uh
tweak it to uh to make it as useful as
possible so um okay so today we're going
to start with the story of 93-year-old
rowing Champion Richard Morgan um this
story actually first came across my
radar from an article in the Washington
Post the title of that article was at 93
he's as fit as a 40-year-old his body
offers lessons on aging and of course
you know given my sort naturally
skeptical mind the first thing I thought
was come on is he really as fit as a
40-year-old so did a little bit of
deeper digging and learned that the
Washington Post article was actually
based on a journal paper that was
published previously in the Journal of
Applied physiology and the title of that
paper uh is physiological
characteristics of a 92-year-old
four-time world champion Ro
and one thing that I thought was
interesting is the lead author on that
article was actually Richard's grandson
which is kind of cool um and for anybody
who's wondering the reason why it was 92
years old in the scientific publication
and 93 years old in the Washington Post
was because he actually had his 93rd
birthday in the intervening time between
those those two things so um anyways
Nick I know you had a chance to take a
look at both articles and I'm interested
to kind of get your takeaways yeah well
I'm impressed with his consistency to
his workout routine his his discipline
with his diet as well it also I to me
may show that it's never too late to
start an exercise and diet protocol
routine just so just some background for
the audience is like you said he's 92
years old at the time of the study he
began rowing as 72 years old and he was
pretty sedentary up until then right he
wasn't a lifelong athlete uh but worth
noting 20 years is still a pretty long
time right so he's had a a significant
training period to sort of get to the
point that he's at now yeah you could
say his training age 20 years right yeah
uh so he's won multiple group age
related world records for rowing uh and
his body composition is striking for
someone his age including his uh body
fat which I believe was 15 around there
15% right right yeah so if I remember
correctly he was about 131 lbs and um
5et 3 in tall so that gives him a BMI
you know right Square in the middle of
the normal range about 22.6 and yeah
body fat uh
15.4% probably just worth noting uh the
body fat assessment was not done by dexa
which is the gold standard um it was
done by electrical impedance which you
know could be off plus or minus 10% um
usually plus 10% so you know but even if
it was 16 and a half 177% body fat still
really impressive for even for somebody
in their 50s but for somebody his age
very impressive yeah well like you
mentioned the article said that he has a
fitness of a 40-year-old so is that true
yeah I mean again I think that's a
that's a hard thing to answer precisely
right uh um again we talked about body
composition from that perspective yeah I
think you would say he's got a body
composition that that would be
considered pretty good for somebody in
their 40s or 50s and if you take a
little bit closer look at some of his
physiological measurements so maximum
heart rate vital capacity things like
that um again all kind of in the range
that we would consider uh good for
somebody in their 40s or 50s I think he
uh one of the Articles or an interview
uh afterwards mentioned he had the
highest heart maximum heart rate that
had ever been recorded for somebody in
his a of his age so again I sure I think
it's I think it's fair to say that based
on those kinds of measurements he's got
a fitness level that we would consider
pretty good for somebody in their 40s or
50s I think you know it's it was kind of
unfortunate that they did not um do a
dexa scan I would have been interested
to know like what does his bone density
look like what did the positional muscle
mass look like um that could maybe a
little bit more information but but yeah
I mean I think it's you know reasonable
to say he's got pretty good Fitness
better than a lot of 40 and 50 year olds
yeah so uh what was his training routine
like yeah again I think you mentioned
consistency I think that uh plays an
important role here so it sounded like
um he uh didn't vary his routine very
much but he was very consistent so he
rode about 20 miles a week a nice
distribution of low intensity I think
about 70% low 20% moderate 10% High um
uh exercise for 40 minutes a day I think
one of the things that I took away and
thought was probably an important
component to his success was that in
addition to the rowing and the cardio
types of exercise he was very consistent
at doing resistance training two to
three times a week uh three sets of
lunges curls and rows to failure um and
so I think that combination you know as
we've talked about before of uh
cardiovascular training and weight
training plays a really important role
especially as people are getting older
in terms of maintaining muscle function
bone density things like that and what
aspects of his diet adop to you yeah
again I mean you know uh I think he had
a diet that most people would consider
pretty high quality so his grandson uh
mentioned that he primarily eats Whole
Foods so again you know very low and
highly processed foods um protein I
thought was interesting so he ate a diet
that was relatively high in protein so
again at a body weight of 130 pounds if
you just look at the RDA recommended
daily allowance for protein that would
be about 60 grams of protein a day um he
ate about 110 grams of protein a day I
think his grandson said that he had a
protein shake after um after his
workouts so again pretty consistent with
the idea that that a relatively high
protein diet in combination with regular
exercise including regular resistance
training is a path to success for many
people and and can play an important
role in maintaining muscle mass and
maintaining function as you get older
the other thing I thought was
interesting you know especially given my
um you know somewhat skeptical stance on
supplements was uh his grandson said
that he really doesn't take any
supplements other than the protein shake
and so again regardless of where you
kind of stand on supplements um I think
this is a case example example that you
don't have to take a bunch of
supplements or necessarily even any to
achieve what we would consider a pretty
successful Health span trajectory okay
yeah so we hear a lot of people talk
about how they can reverse age you know
reversing aging and so if he was in his
70s when he started now he's in his 90s
and the article says he has the fitness
of a 40-year-old could this be an
example of someone who's reversed their
age yeah again I think we have to be
really careful with the definitions that
we use and the Precision that we use in
our language I would say
um we know of many examples where you
can reverse certain traits that go along
with aging or certain aspects of Aging
right and so it should come as no
surprise to people that if you take a
sedentary person and I'm not talking
about Richard's case necessarily but if
you take a s sedentary say 50-year-old
person who's been eating a poor diet
very overweight you get them to start
eating a healthy diet exercising
regularly doing resistance training that
you can improve things like muscle mass
and V2 Max and and fitness measurements
um so we've known that for a long time I
would say that's not reversing Aging in
the sense that you are not
reversing biological aging as a whole
and I think in Richard's case I mean all
you have to do is look at some of the
pictures that were in both articles of
Richard he doesn't look like a
40-year-old right and so clearly while
he has improved physiological function
in certain organs and tissues maybe
reversed some aspects of Aging he has
not reversed Aging in the sense that he
went
from looking like acting like being a
90-year-old in every way to being a
40-year old in every way um and so I
would say no he has not reversed aging
uh as a whole okay what do we know about
exercise as an anti-aging strategy from
laboratory studies yeah so I think the
laboratory studies here are are somewhat
complicated to interpret this is mostly
going to come from work in rodents so
mice rats there are studies that have
looked at uh the effects of exercise on
health span metrics and lifespan in in
rodents um and in general the consensus
takeaway from those studies is that
exercise can improve some health span
metrics doesn't really seem to
significantly improve medium or maximum
lifespan now there are a couple of
outlier studies where they reported an
extension of lifespan those generally
are cases where the controls were
shorter lived than you would anticipate
so that's kind of hard to interpret but
again I think the consensus would be
that exercise in rodents can improve
some aspects of healthspan really
doesn't seem to significantly increase
lifespan but again I think it's really
important to appreciate that those are
hard studies to do because really the
only way that you can you know
effectively do lifelong exercise studies
in rodents is to put a running wheel in
the cage right so the comparison really
is is mice that don't have a running
wheel versus mice that do have a running
wheel um you're not controlling how much
they exercise it's all obviously
voluntary exercise um you can't really
model resistance training well in
laboratory animals there are people
who've done some of this that's really
hard to do over a lifespan study so I
would say we don't really have a good
comparison to what we might expect
exercise impact to be on longevity in
people the other thing that's probably
worth mentioning is um you know the
biggest things that exercise impacts in
people I believe in terms of health span
are going to be you know muscle function
muscle mass bone density um
cardiovascular function um those are not
things that really limit lifespan in
mice in general so mice typically don't
show a lot of sarcopenia they certainly
don't don't die from Falls and fractures
and things like that um and
cardiovascular disease is isn't really a
longevity limiting factor in mice most
mice in the laboratory are going to die
from cancer probably and so it may also
be a case where just the the the the
aging process and the the things that
exercise is is most potent and impacting
in people are just different in
laboratory animals so having said all of
that this is that's all my way of saying
I think we have to be careful not to
extrapolate Too Much from the laboratory
studies um and I think if you look at
the data in people you can make an
argument that EX exercise is probably
the most
effective longevity and health span
promoting intervention in people or
certainly right up there with healthy
diet I mean I think you could have a
debate about you know which could have
the bigger impact that's going to be
dependent on the person almost certainly
but it's it I don't think there's any
question that exercise positively
impacts the biological aging process in
people I think the question is more
around you know which types of exercise
are going to be most effective in
different people or at different life
stages things like that yeah that makes
sense so um so my last question is
what's sort of your big takeaway from
this
article yeah I mean I think you you sort
of alluded to to one of these things
earlier which is that it's probably
never too late to start right so I think
Richard's example you know certainly is
is probably an outlier and maybe he you
know is genetically predisposed to
responding exceptionally well to
exercise um but I think uh this is a
nice example of somebody who really
started taking control of his health in
a meaningful way you know in his early
70s it sounds like and has had pretty
remarkable results and I think that's
probably true for most people um and and
the the um studies that have been done
on lifestyle interventions or long
proong longevity interventions like rap
ay in laboratory animals I would say
tend to back this up where unless the
pathology of an age related disease has
gotten to the point where um modifying
the biology of aging isn't going to
modify that disease so for example if
you have metastatic cancer impacting the
aging process might not have any impact
on your disease progression unless a
disease pathology has gotten to that
point it doesn't really seem like
there's there's a a a time where it's
too late to have a positive impact
that's true in mice with Rapa M you can
start very very late in life and still
get many of the benefits and I think
it's um there's plenty of evidence in
people that that's true as well uh I'm
not I'm not suggesting that everybody go
out and start rowing 20 mil a week but I
think it's encouraging that that you
know everybody has an opportunity to
improve their health and that that we
know some of the ways that people can
accomplish that yeah good advice I think
that was a great discussion for our
first topic and leading into our next
one so it's from The Wall Street Journal
titled Americans are sick for more of
their lives by Alex Jan so Matt I know
this is something you've mentioned
before uh so I'm interested to hear what
you thought of the article yeah so I
think for the for the most part the
article got things right that really
talks about the growing discrep y
between Health span and lifespan um uh
it's an important topic um I would say
you know my one gut reaction when I
first read the article was that if
anything it's pretty dramatically
underestimating the scope of the problem
the problem being this growing gap
between Health expectancy and and life
expectancy um and I would say part of
the reason why the article again in my
opinion underestimated the problem has
to do with sloppy terminology around
Health span and what people mean when
they use that word or how we go about
measuring it and so you know I've talked
about this before um for people who want
a little bit more Nuance on that topic
I'd refer viewers to our episode on
defining Health span and its role in In
Living longer okay so this image on
screen right now was in the article and
could you help explain to me and the
audience what ihme was trying to explain
in this graph yeah so I mean what this
graphic is really showing is the gap
between what they refer to as health
adjusted life expectancy or hail um and
life expectancy so life expectancy is
pretty obvious that's just the the
length of life that the average person
is expected to live um hail is this
little bit more complicated in fact a
lot more complicated metric that is
supposed to be a quantitative measure of
healthspan and what the graphic shows is
that uh the gap between those two
numbers so how long we expect people to
live and how long we expect people to
live in a healthy state has gone from
about 10.8 years in 1990 to 12.7 years
today and again as I mentioned I think
that's an underestimate but I think it
reflects the fact that there is this
growing gap between Health expectancy
and life expectancy so you think the
graph is underestimating the true scale
of the pro problem so what would you say
to that yeah again I think um a little
bit has to do with the use of this
health adjusted life expectancy
interchangeably with health span and I
think that's a mistake um and and as
I've said before I would argue that
Health span really is a qualitative term
and what I mean by that is we don't have
a consensus way to actually measure
Health span um and I think part of that
is because health is not binary it
doesn't go from you know full health one
day to no Health the next day if at
least for most people it's really a
continuous variable that changes over
the life course it can even go up and
down as people go through different
experiences so hail is really an effort
to overcome this by creating a a
quantitative measure of health and U the
way they do this is really complicated I
actually wasn't able to find a single
formula that that um that gave the exact
calculation for Hail but basically it's
a uh combination of waiting different
diseases and disabilities that different
people may have based on you know
somewhat ambiguous severity estimation
to get a single number of Health um and
so one of the problems is that again I
don't really think that this hail metric
matches any reasonable or commonly
accepted definition of Health span or
really health or what we would consider
good health so why would they use
something like hail then yeah I mean I
think the obvious reason is they wanted
to have something they could measure and
I agree with that that's important I
think there are a couple of other
factors here that that may have um
complicated the way that that hail was
developed um one could be that there is
this expectation that older people are
supposed to be in poor health compared
to young people um and so this is sort
of adjusted for instead of considering
Health on an absolute scale in other
words you know what we would call poor
health in a 30-year-old might be
considered good health in a 60-year old
um and I I actually think that's a
mistake if you're trying to come up with
a calculation that's supposed to reflect
some quantitative metric of help and I
don't the other the other thing that I
think about I don't know for sure if
this is true but I do wonder if hail you
know um is in some ways an effort to be
a little bit politically correct and
what I mean by that is not Define anyone
who has a disability or a disease as
having less than good health and again I
get the rationale for that um but I I
don't know that that's helpful if we
really want to accurately measure Health
Trends yeah so it sounds like to me that
we don't have a great way of quantifying
Health span so do you have a suggestion
what we could do yeah I mean I think
there's a couple of approaches here that
I've thought about um one I talked about
in an article I published a few years
ago and the title of that article was
how healthy is the health span concept
and in that case I proposed that we
develop a quantitative metric of Health
which is kind of what hail is again I
don't I don't agree with the way hail
calculates Health but you could you
could come up with something but then
track that quantitative metric over the
life course right so what you really get
if you plotted that out would be a curve
where we've got this health metric on
the y- axis and chronological age on the
x-axis and then you could look at
something like the area under that curve
as a single metric proxy for Hells span
right so that's one approach another
approach would be just to kind of
reframe the discussion away from
healthspan again the problem with
talking about healthspan is Health
doesn't go from one to zero right
there's there's it's it's continuous uh
and we could talk about something like
six span which would which would then
Define six span as the period of Life
spent with at least one chronic disease
or disability and maybe we would say
significant chronic disease or
disability so there's still a little bit
of ambiguity there because we'd have to
Define what we mean by significant but
I'm confident that that that there that
we could reach consensus in the field
about you know what would fall into
significant disease or disability and
then six span becomes very easy to
calculate it's just the period of Life
spent with one or more of these chronic
diseases or disability um the nice thing
about this definition is it is binary so
it's pretty easy to calculate and
there's there's not a lot of ambiguity
about what we mean so if we use that
definition of six ban what does this Gap
look like yeah right so this is where I
think it gets interesting and this is
why I I uh suggest that that that the 12
years in the Wall Street Journal article
is a pretty massive underrepresent
presentation so you know if we just look
at a couple of Statistics right um one
from the CDC uh and this is a direct
quote from their website 60% of
Americans live with at least one chronic
disease like heart disease and stroke
cancer or diabetes okay so by my
definition of six span right this would
suggest that at least 60% of Americans
are in that period of life where six
span has started okay the other
statistic here that's relevant is just
the median age of the population in the
United States so according to the Census
Bureau the median age is 38.1 years so
that means 50% of Americans are under
38.1 years old 50% of Americans are
older than 38.1 years old so if we just
look at those two statistics 60% have a
chronic disease or
disability 50% are over 38.1
years it's pretty clear that six span on
average
starts at less than 38.1 years so even
if we use 38.1 years as the point at
which for the average American six span
begins that tells us that the difference
between 38.1 and average life expectancy
is a lot more than 12 years yeah and
that kind of makes sense when you
consider what up 40% of Americans are
obese yeah I mean I think that
statistics true so that would suggest
that the Gap is probably closer to 40
years than the 12.7 that they
recommended yeah exactly so so I think
that's exactly right um and again you
know we could have a discussion about is
that a good definition of how we would
Define somebody as not being in good
health I think
absolutely nobody could argue with the
statement that having a chronic disease
or disability is less than Optimal
Health and I would argue that it's
probably not what we would consider good
health so if we go with that definition
then yeah it looks like the gap right
now is around four decades okay so given
the current trends where do you see this
going in the future right so that's
that's the big question and and I think
it's um it's hard to know so I would
suggest that you know where this Gap
goes in the future really depends on two
things uh at at the most basic sense
what happens to life expectancy and what
happens to six span um so if we look at
life expectancy um I think it's kind of
unclear uh over the last three or four
decades there's been a pretty dramatic
increase in life expectancy in the
United States and other developed
countries around the world um that kind
of stopped about five or six years ago
and started to plateau and then with
covid-19 there's actually a drop in life
expectancy in the United States um and I
think we don't know where it's going to
go from here you know some people
predict that life expectancy is going to
start going up again some people predict
it's going to kind of plateau other
people predict it's going to go down I
really don't have a good guess as to
what's going to happen um and I think
this may be a case where you know the
United States may go on a different
trajectory than a lot of the rest of the
developed worlds you know we have some
systemic problems in our society around
drug use and uh inequities in healthare
that could impact life expectancy going
forward so I think we'll just have to
see um so the other piece here though is
what's going to happen to six span or
health span depending on how you want to
think about it and again I don't know I
mean I think there's there's positive
and negative pressures here on uh
population level Trends in health um I
do think there are some reasons to be
optimistic and so you know I'd point to
advances in cancer in particular so both
at the level of new screening methods
Imaging liquid biopsies combined with uh
immunotherapy for cancer I think there's
real reason for optimism that uh chronic
sickness and mortality due to cancer is
going to decrease in the coming years um
obesity you mentioned I think that's
another place where there's some reason
for optimism you know after Decades of
seeing you know very little hope when
you look at the Obesity Trends we now
have these drugs the gp1 agonists that
are pretty effective at helping people
lose weight and I think we're seeing new
generations of anti-obesity drugs in the
pipeline so um we don't know yet what
the long-term efficacy or or potential
downsides to those drugs are but right
now it looks pretty promising
um and so that could have a a and a
positive effect on not just obesity but
all of the other diseases of Aging that
go along with obesity um and then I
think uh another reason why I'm somewhat
optimistic is the science of Aging right
the discoveries that are coming out of
the field of geroscience um that that we
are now understanding the biology of
Aging in a much more sophisticated way
starting to develop therapies that can
actually Target that biology um and can
potentially have an outsized impact on
health span and potentially life
expectancy but Health Span in particular
and I would say this is a fundamentally
different approach than what has been
done before where typically biomedical
research uh pharmaceutical Discovery has
been focused on trying to treat
individual diseases in isolation if we
can Target the biology of Aging we can
have an impact on all of the functional
declines and diseases of Aging
simultaneously and I talked more about
this in the episode on um understanding
aging and disease and then the fourth
reason for optimism I would suggest is
that I think we are finally starting to
see a shift in mindset away from
traditional reactive disease care
towards more proactive preventative
health care I'm not naive enough to
think that you know that's happening
quickly or that it's going to be easy
but we're seeing more people talk about
it and I think that's to start and
clearly that's our mission at optisan is
to hasten that transition as much as we
can by enabling as many people as
possible to become empowered to take
control of their own health and so in my
view that's really the most impactful
way right now for us to start narrowing
this Gap and really start to push that
Health span curve out as far as possible
all right well thanks Matt I think
that's a good note to end on for our
first episode of longevity this week
yeah thanks Nick uh I enjoyed it hope
everyone else did too all right thanks
everyone for joining us for this first
edition of longevity this week I hope
you found it helpful and interesting uh
if you're enjoying this podcast series
please subscribe to our YouTube channel
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and feedback is in the YouTube comment
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directly by emailing us at optisan
podcast
gmail.com uh we of course always welcome
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guests you would like to see interviewed
or any questions you
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