What a 93-Year-Old Rowing Champion Can Teach Us About Aging Well | 10 - Longevity this Week #1

Summary

This 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

00:00

🚣‍♂️ 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.

05:00

🔍 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.

10:01

📉 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.

15:02

🤔 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.

20:04

🌱 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.

25:05

📚 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.

Keywords

💡vieillissement sain

Le vieillissement sain fait référence à la capacité de maintenir une bonne santé physique et mentale à un âge avancé. Dans le script, Richard Morgan est présenté comme un exemple exceptionnel de vieillissement sain, ayant commencé l'aviron à 72 ans et devenu un champion du monde à 93 ans. Cela illustre que l'activité physique régulière et une alimentation équilibrée peuvent contribuer à un vieillissement sain, même si l'on commence tard.

💡espérance de vie

L'espérance de vie désigne la durée moyenne de vie d'une population. Dans le script, il est question de l'écart croissant entre l'espérance de vie et l'espérance de santé, soulignant que bien que les gens vivent plus longtemps, ils ne vivent pas nécessairement ces années supplémentaires en bonne santé.

💡espérance de santé

L'espérance de santé est une mesure de la période pendant laquelle les individus peuvent s'attendre à vivre sans maladies graves ou incapacités. Le script mentionne une étude du Wall Street Journal sur la divergence croissante entre l'espérance de vie et l'espérance de santé, indiquant que les gens passent plus d'années de leur vie en mauvaise santé.

💡exercice physique

L'exercice physique est souligné dans le script comme un élément clé pour un vieillissement sain. Richard Morgan, par son dévouement à l'aviron et à l'entraînement en résistance, démontre comment l'exercice peut améliorer significativement la santé et la condition physique, même à un âge avancé.

💡composition corporelle

La composition corporelle, qui fait référence à la proportion de graisse et de muscle dans le corps, est un indicateur important de la santé. Richard Morgan, avec un pourcentage de graisse corporelle de 15%, illustre comment un mode de vie actif peut maintenir une composition corporelle saine chez les personnes âgées.

💡entraînement en résistance

L'entraînement en résistance est souligné comme une composante importante de l'exercice pour le vieillissement sain, contribuant à la force musculaire et à la densité osseuse. Dans le script, l'entraînement régulier de Morgan avec des exercices de résistance est un facteur clé de son excellente condition physique.

💡alimentation équilibrée

Une alimentation équilibrée, riche en protéines et faible en aliments hautement transformés, est présentée comme un autre pilier du vieillissement sain. Richard Morgan consomme une alimentation principalement composée d'aliments entiers et riches en protéines, ce qui contribue à sa santé exceptionnelle.

💡suppléments

Le script aborde la question des suppléments, notant que Morgan n'utilise pas de suppléments à l'exception des shakes protéinés. Cela suggère que les suppléments ne sont pas essentiels pour maintenir une bonne santé et une condition physique, tant que l'on suit une alimentation équilibrée et un programme d'exercice régulier.

💡résistance au vieillissement

La résistance au vieillissement fait référence à la capacité de maintenir une fonction physiologique optimale et de réduire le déclin lié à l'âge. Le script utilise l'exemple de Morgan pour illustrer comment l'exercice et une bonne nutrition peuvent contribuer à cette résistance, même chez les personnes très âgées.

💡obésité

L'obésité est discutée comme un facteur majeur affectant négativement la santé et réduisant l'espérance de santé. Le script mentionne les progrès dans le traitement de l'obésité, tels que les nouveaux médicaments, comme une raison d'optimisme pour l'amélioration de la santé publique et la réduction de la maladie chronique.

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

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