Hack the body
How to properly fight aging in order to live happily ever after
Evgeny Kuznetsov, Forbes, 23.10.201
The post of the founder of the "Island" Sergey Fage about how he is trying to improve his performance and longevity, including using methods with unconfirmed clinical effectiveness, caused a negative reaction from supporters of evidence-based medicine. But there is another side to this topic: how to take care of your health in order to live a long and active life
The fashionable word "HYIP" has negative connotations in the Russian language – "hype, hype". An unhealthy and noisy discussion in which the baby is splashed out with water at the very beginning. And then they rattle empty basins. The problem is that very, very important things often splash out with such water. For example – as in the discussion about "biohacking" – the question of the real recovery of the nation.
Vital statistics
First let's look at the facts. In Russia (which is on the 110th place in life expectancy according to WHO statistics, right after Bolivia and the DPRK), they live 13 years less than the top three (Japan, Switzerland and Germany), and Russian men, in addition, live almost 12 years less than women. The main success of the leaders is not only and not so much the volume of health care costs, but a high degree of personal responsibility of people for their health and the focus of state programs on prevention.
For example, the average Japanese visits a doctor 15 (!) times a year, and at the age of 40 passes a mandatory and free check-up on all the main functions of the body and analysis of the prerequisites for cancer and other diseases of aging. In Germany, almost annual examinations are recommended (paid for by insurance), for example, women are taught to monitor the risks of breast cancer from the age of 30. Switzerland has the highest voluntary health insurance coverage in the world (99.5%), while the share of private money in total healthcare costs there is more than 30%. The Swiss are leaders in terms of personal responsibility for their health according to numerous surveys, and they follow the prescriptions of doctors and the discipline of medical recommendations better than others.
I became interested in this topic because the longest-lived man in my family, my father, died at the age of 54, when I was 17. Therefore, in the 90s I fully understood what responsibility for the family is, and good health is one of the conditions for it. Unfortunately for me, mass and accessible information on the real development of health has appeared relatively recently. But as soon as it appeared, I started using it.
Visible health problems
First, a little theory. Most of the skeptics who attacked Sergey Fage, who published an article about "biohacking", like to argue their position by saying that "they are 50, and the doctor is remembered only by injuries." This is a well–known position, but I note that the average age of cancer diagnosis in Russia in women is 64 years (cervical cancer is 52), the average age of detection of type II diabetes is 51 years (and more recently it was 54 years). At the same time, 9.6% of Russians suffer from diabetes in Russia. And the cumulative risk (the percentage of newborns who will die or get cancer before the age of 75) in Russia is 13.69% (2012, according to GLOBOCAN 2012, IARC – International Agency for Cancer Research). This is the highest (!) figure in the world. To put it simply: we can assume that mortality from cancer, diabetes and cardiovascular diseases increases by about 10 times for every decade after the age of 30. This means that all those who happily discuss the absence of the need to go to the doctor, most likely already have a tendency to develop the disease, but do nothing to detect it.
Both cancer and diabetes (as well as neurodegenerative diseases, Alzheimer's and Parkinson's diseases) are now called "diseases of aging". Many researchers consider aging itself to be a disease and at the same time daily identify many factors that either accompany or cause it. Numerous data show that cancer is preceded by long–term latent inflammation (which is easily detected by tests that almost no one does), and diabetes is insulin resistance (manifested in a mass of mild symptoms, such as changes in cheerfulness after meals, etc.). But early signals of the body in Russia are usually ignored, washed down with vodka.
The fashionable argument of opponents of "eating pills by the handful" is that "their heredity" is as strong as a rock. Yes, their moms, dads, grandparents lived a long and glorious century. But here, too, it is worth making a lyrical digression.
Until the middle of the XX century, the main mission of ensuring maximum human life expectancy (MPJ) was assumed by evolution, killing weak organisms in infancy and childhood with mass epidemics and diseases. The strongest survived. From this, the average life expectancy fell sharply (CPJ, which was about 35 years before the beginning of the XIX century), but the MPJ has not grown so much since that time (by 10-20 years). In other words, viruses and bacteria "knocked out" weak organisms from the population, which, however, were thereby deprived of the chance to become great scientists, musicians, and just good people.
The great achievements of medicine of the last century have removed this mechanism, infant and child death have fallen by orders of magnitude, but this has led to the fact that the genetics of modern man, that is, the ability of the body to cope with stress and aging in the population on its own (this is important!) is getting worse. In other words, humanity has begun to evolve socially rather than biologically, and the deterioration of the gene pool is counteracted by the improvement of medicine. Which, however, is true for those who use medicine.
Another important circumstance that should not give a reason to calm down is that a modern urban dweller (and we have an urbanized society), does not breathe the air of 50-70 years ago, walks 5-10 times less, and has an order of magnitude less routine daily physical activity. Therefore, all the numerous studies confirming the direct effect of regular (moderate) physical activity on longevity are simply a recognition of the fact that a person needs to get out of mass and harmful inactivity to the level of an average amount of physical effort for his type.
To sum up: even if you can boast of a good genome (for example, I can't), this does not mean that you will live at least as long as your ancestors without making special efforts. In a country where citizens believe that "the state is obliged to provide them with health" (by the way, it is written in the Constitution), this is sad news: the state does little for geroprotection and strengthening preventive medicine. So it's your own business, will you take the prevention of aging seriously, or will you have fun reporting on social networks how successfully you avoided the doctor.
Not a panacea, but a system
Now let's move from the big picture to a personal strategy. Many, as a rule, around the age of 50, abruptly begin to think about old age. And dream of a magic pill that will push it away. I think there is no such panacea and will never appear. The human body is too complicated, and there are too many systems and mechanisms in it that begin to age themselves, and the discord between them increases aging.
At the cellular level, aging of cells leads to a decrease in their sensitivity to basic molecules – for example, insulin. The removal of old cells from organs occurs more slowly over time, they accumulate, provoking latent inflammation of organs (and its consequence is often neoplasms). The fundamental systems of the body – endocrine and immune, change irreversibly with age, and all this is linked to changes in the psyche, behavior, cognitive functions. Even a super-effective medicine can fix one mechanism, but it will not keep the aging of the others. Aging is the most complex and diverse human disease, and it requires full respect for itself.
Recently, there have been many scientifically proven facts of increasing both the average and maximum life expectancy when using certain methods or drugs. The revolution in this area is happening before our eyes: literally every week there is a new study that brings new facts. The breakthrough is being made both through new methods (research on mice with a human genetic apparatus, that is, mice suffer from "human" versions of diseases and their metabolism is close to ours), and through the completion of long-term, and often decades-long population studies on tens and hundreds of thousands of people who started a long time ago.
All this leads to an explosive growth of information. More than 600,000 articles on medicine are published annually in the world (more than 10 million have been accumulated over 20 years). In each article – statistics, models, examples. Many articles contain revolutionary results. But physically, a modern doctor or researcher is not even able to view all the relevant articles, unless only the brightest ones are in the most authoritative publications or within a very narrow topic. And aging is a broad topic. A possible solution to the problem in the future will be artificial intelligence, which will be able to operate on all factors. For example, IBM Watson in some cases makes diagnoses better than doctors, but there is still work to be done on full-fledged artificial intelligence systems that will help in the fight against aging.
Today, when any doctor with any regalia undertakes to talk about aging, if he does not start with a disclaimer about the limitations of his understanding of the subject, then, unfortunately, he is deceiving you. It is physically impossible to keep all the variety of topics. Therefore, the modern struggle with old age is beginning to form completely different forms of organization of medicine (and patient strategies) than before.
Firstly, the fight against aging began to be taken seriously. 8 years ago, when I personally asked Silicon Valley investors how many Longevity projects they had, they answered – 0, the topic is too unproven. Now there are such projects in every (!) venture fund with a focus on Life Science, and even in Russian ones. A number of popularizers, such as Orbie di Gray, have managed to raise the broad interest of investors and sponsors in solving the problems of combating aging. In Russia, such an evangelist is Mikhail Batin, who actively promotes and develops the topic.
Secondly, the first data has been accumulated that confidently (scientifically provably) associate certain factors with aging. The greatest misconception of the century about "fatty food", which allegedly provokes the growth of cholesterol, has been defeated. The true "provocateur" of negative metabolic processes has been found and identified: these are sugar and other "fast" carbohydrates. Effective diets ("Mediterranean diet", "diet simulating starvation"), methods and the required intensity of sports (regular moderate exercise, and not extremely dangerous marathons at all), and so on and so forth have been identified.
Thirdly, research is beginning to bring concrete breakthroughs in relation to certain drugs, vitamins and minerals. For example, the drug metformin, which has been used for diabetics for half a century, has shown a lot of geroprotective properties, prevents cancer and other diseases. By the way, this was found out by looking at the average duration of diabetics treated with metformin – it turned out to be higher than that of the control group of "healthy". However, this does not mean that it is time to include it in everyone's daily diet – population studies on the scale of human life are still underway. But according to the indications, doctors prescribe it boldly enough.
Fourth, there are doctors who begin to carefully read all these materials and apply certain methods and approaches. From personal experience, I can say that the closest to understanding the scale of the problems are endocrinologists and immunologists, who are characterized by a systematic and broadest view of the human body. Alas, but more narrowly-sharpened specialists very often have a view "from their bell tower", although, of course, everything depends on how attentive the doctor is to the general flow of information.
Hackers vs Programmers
Then it's time to talk about the now fashionable "biohacking". Actually, initially this "movement" concerned very narrow applications for a sharp increase in individual human abilities – for example, the first story was about "night vision". However, now it is interpreted broadly – as a way to resist "biologically programmed" aging, and in general, the strengthening of cognitive and other functions at any age. The attitude to biohacking is different: from raptures to cheating, but it is necessary to treat it carefully.
Why did active measures to prevent aging and "diseases of old age" become called biohacking? The voices of those who consider aging itself to be a programmed process are becoming louder and louder. "Programmable wear", as in cars, to stimulate purchases. According to this version, the human body is "needed" only for reproductive functions, and therefore, having fulfilled them, it is destroyed, just as salmon dies after it has swept away caviar. But even those who believe that there is no "program", and aging is a natural process, agree that programs for self–maintenance of health and efficiency in the human body are active only in the reproductive phase, and after 30 begin to weaken. A healthy and productive person after an active reproductive phase is needed by society, not by nature, and therefore it is not his body that deals with health issues, but the person himself and medicine as a system – this is the "hacking" of the natural state of affairs, which does not suit us.
Biohackers in a trivial sense are all those who apply methods of maintaining a healthy lifestyle purposefully. And in this sense, the inclusion of new proven ways to support tone or health is simply a continuation of an already existing trend. On the other hand, people actually voluntarily become participants in a global experiment, having the prize of being the first to achieve the long-awaited result. This is called the now fashionable term civil science, but, undoubtedly, it should be carried out according to all the rules of science – that is, with the formulation of hypotheses, setting goals, coordinating methods and monitoring results. Therefore, a normal biohacker will not take a single step without advice from a doctor who will help him make a competent set of control metrics and will take into account the compatibility of techniques and drugs.
Tips for a long life
If we collect the most researched issues of life extension, then we can identify several topics. Please note that these are tips given from personal experience, perhaps you have personal characteristics, the actions of the medical plan must be coordinated with the doctor.
1. The fight against old age should begin ahead of time, optimally – at the age of 30, when the body systematically switches from growth to aging. At this moment, the first systemic shifts begin, which then, like an avalanche, gain their power by the age of 40-50-60. At a minimum, at this time it is necessary to learn how to regulate sleep and physical activity. You need to sleep at least 7-8 hours, exercise at least twice a week. Everything is simple.
At the same time (and preferably earlier), it is necessary to radically part with sugar and learn how to regulate carbohydrate intake (reduce their amount, especially the fastest, with a high glycemic index, such as French fries).
It is important at this time to make the first check–up on minerals and vitamins - their deficiency is not yet critical, but already leads to systemic shifts. At least in our latitudes, we systematically lack vitamin D and polyunsaturated fatty acids (omega 3, etc.). In men, zinc or magnesium deficiency accelerates the decline of testosterone. A systemic deficiency of B vitamins may begin to form. But in any case, all supplements should be coordinated with a doctor, because there is both individual sensitivity and individual intolerance.
At the same time, age-related gluten allergy begins to develop in the modern population. In Russia, they do not really know how to diagnose this problem, or rather, doctors do not think about this problem. And the consequences are often so diverse that it is impossible to say whether there is a simple symptom. However, since gluten-containing foods (all from wheat, for example) often have the highest glycemic index at the same time, it is useful for everyone to simply reduce the proportion of wheat in the diet. There is another reason: over the past 50 years, the amount of gluten in wheat has increased by an order of magnitude or more due to breeding (which was necessary for the ease of making a fluffy muffin). Therefore, in the traditional diet, the dose of this unsafe protein is exceeded enormously.
The hardest thing is to part with sugar. Therefore, if you refuse it, the body rebels, the person experiences almost withdrawal. But, according to the author's experience, not for long: it will be difficult for about a month, but the result, believe me, is worth it. A complete rejection of sugar leads to the most quickly tangible results in the form of an improvement in the condition, therefore I recommend it as the "first step" – if you could do it, you will do the rest, and the result is so clear that it is easier to do other steps.
2. The key indicator of incipient age-related problems is, oddly enough, mood and sleep. Anxiety, insomnia, lack of vigor in the morning, weakening concentration, fatigue, irritability and emotional instability are all signs of incipient system failures. And the Doctor forbid you to start compensating for these problems with psychostimulants or other drugs. And even more so (as is customary in Russia) – to fill problems with alcohol. The fact is that these trends, as a rule, are the consequences of the problems of fundamental systems – endocrine, immune, as well as the inability to systematically work out stress.
It is important to make a reservation here – stress harms the body. But a healthy body is able to react and overcome stress. And, therefore, the problem is either that the body begins to systematically surrender (pre-disease), and stresses begin to "break through the defense", or you have too much stress and you do not know how to block them and "hold the blow", and they begin to systematically undermine your body already.
This means that at 30 and after (and even better earlier) it's time for you to seriously start learning how to work with your psyche. Meditations, simple techniques for calming anxiety (for example, rational planning), courses and books on a good understanding of the world (which ones are to your taste or on the advice of a good psychotherapist or just a friend). In general, it's time to get used to the fact that everything in life is not at random, and your good mood and good communication with people is your responsibility for your health.
At this moment, if you enter into a tailspin (insomnia, severe anxiety, depression, aggression and systemic conflicts with neighbors) – do exactly two things. Make a complete checkup of the body (mainly for hormonal failures) and go to a psychotherapist. Learn to overcome such emotional storms once and for all (by finding the cause and effective treatment). This is the foundation of the skill of taking care of your own health.
3. With age, after 40, the direct consequences of early aging factors begin to form, for example, sleep worsens, hormonal background changes more strongly, insulin resistance occurs. It goes slower if you started at 30, but units start. So it's time to go through a full checkup and switch to controlled diets, basically their essence boils down to reducing the calorie content produced by reducing carbohydrate intake. Two important caveats. Firstly, "hard diets" (with severe hunger) are usually counterproductive. You need a moderate and controlled reduction in calorie intake. Secondly, the now fashionable ketogenic diet still has arguments both for and against, because, for example, I resorted to it only for a limited time (six months), under the supervision of a doctor, and having a specific medical task – to adjust the weight in a certain way (I have never had "overweight" problems, but the more however, this was the doctor's prescription).
The advantage of the "Mediterranean diet" is shown – less red meat, more fish and poultry, and necessarily a lot of vegetables and fiber. However, nightshade or something else may be harmful to you directly, so once again – consult your doctor. But the general approach to a reasonable strategy is moderation, do not rush to extremes. Veganism leads to a proven acute vitamin deficiency. Some of the useful proteins are not present in fish, but only in red meat. None of the "drastic" diets have proven longevity benefits. But a light (20-30%) calorie restriction and the body will accept it easily – and, it has been proven, will benefit.
In general, I highly recommend reading the book "The Intestines of a centenarian" by Alexey Moskalev, perhaps the best Russian gerontologist with an excellent talent for popularizing.
4. There are extremely promising results on geroprotective drugs, however, as I said earlier, in fact, you will become a participant in a large-scale study on their usefulness. Your risk, but I repeat, it is worth taking this path only under the supervision of a doctor. At a minimum, he will tell you when to stop, looking at certain parameters of the body.
Starting from the age of 40, regular annual prophylaxis and analyses of the main systemic markers should become mandatory. It is difficult to give an exact nomenclature, you can, for example, use the list of Mikhail Batin and his Open Longevity group, but at a minimum, you need to control thyroid hormones, blood sugar levels, testosterone/estrogen, C-reactive protein, cholesterol (high and low density) and triglycerides, glucose tolerance levels. Both a cardiologist and an endocrinologist will write you such a checkup in response to the most typical complaints of forty–year-olds - lethargy in the morning, lethargy after eating, lack of vigor and clarity of mind "like in 20" (yes, this is a symptom of problems, not the notorious "age"), weight gain and the like. If any indicator is out of the norm, then you can already discuss with your doctor what to do. In 90% of cases, proven vitamins and supplements will help for many years. Just make a reservation right away – not poly / multivitamin complexes from pharmacies on the advice of a pharmacist seller, but specific minerals / vitamins, the deficiency of which is established and diagnosed by tests.
Is it worth the notorious $200,000 that the founder of the "Island" Sergey Fage spent on biohacking? Of course not. But you will have to spend money. However, it's up to you to decide whether this is a good price for a healthy life.
And two important points in conclusion
The most unobvious thing in the "diets" of biohackers is psychostimulating substances. I'll tell you right away – the author has passed. A tangible and powerful surge of cheerfulness from the above described personally seems to me absolutely sufficient. The rest – if the doctor prescribes according to the indications.
And the second: the now fashionable sport of overcoming (triathlon, marathons) – this, alas, also refers more to the formation of dependence on a number of neurotransmitters (which are stimulated by such super-efforts) than to reasonable efforts to support life expectancy. Just think about why, in a well–known myth, a young professional warrior ran 42 km and died, but a modern clerk after three years of training did not. After a certain age (30-40), any stimulation of growth in the body (and increased tissue renewal after overloads leads to this) – enhances the processes that lead to the accumulation of errors in the body (for example, neoplasms). Current research shows that after 40, the insulin–like growth factor should be restrained, not boosted, so moderate workouts for pleasure are what you need, but a grueling run for the "endorphin arrival" is not.
And as it has become customary for us to say: you stay there, good health and good mood to you.
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