Secrets of the Well-derly: ‘Super Agers’ book review
For a long and healthy life, diet and regular exercise are a better bet than trendy supplements and expensive longevity clinics.
More than half of American adults suffer from at least one chronic illness — most commonly diabetes, heart disease, cancer or neurodegeneration. By age 65, 80 per cent are afflicted with two or more conditions. Among those fortunate enough to reach 80, it’s rare to find anyone who has arrived unscathed. In 2008 a group of scientists at the Scripps Research Institute in San Diego set out to recruit 1,400 of these healthy souls — known as the Wellderly — to figure out how they managed it.
Led by the cardiologist Eric Topol, the researchers hoped to identify the genetic factors associated with healthy ageing. To their surprise, they found little in the DNA that stood out. They did, however, notice several striking traits. Compared with their peers, the disease-free subjects were generally thinner, exercised more frequently and seemed “remarkably upbeat,” often with rich social lives. These observations encouraged the research team to think about longevity (years of life) and healthspan (years of health) more broadly. In “Super Agers” Dr Topol shares the results of this intellectual exploration.
Over the past several years, Dr Topol has carved out a niche for himself as a curator of science news, scrutinising emerging research publications and sharing the highlights on his “Ground Truths” blog and podcast. He now turns his critical attention to the science of ageing.
“Nothing surpasses regular exercise for promotion of healthy ageing,” Dr Topol writes, calling it “the single most effective medical intervention that we know.” If you came up with a drug that delivered all the health benefits of exercise, he says, “it would be considered a miracle breakthrough.”
Happily, it’s never too late to start. Consider Richard Morgan, an Irishman in his 90s, who took up regular exercise for the first time in his 70s when he started using a rowing machine in his backyard shed. Mr Morgan has since won four world championships for indoor rowing.
Healthy eating and a good night’s sleep are also crucial. While the “evidence remains thin for what constitutes the best healthy diet,” Dr Topol writes, we have a better sense of what it doesn’t contain: ultra-processed foods (like hot dogs and snack cakes) that induce systemic inflammation and increase your risks for developing all the major age-related diseases.
One expert has called the sleep-loss epidemic “the greatest public health challenge we face in the twenty-first century.” Seven hours a night seems to be the elusive ideal, but the data supporting popular fixes such as melatonin or magnesium, or beds that modulate temperature, is underwhelming. Other hazards to beware include environmental contaminants such as air pollution and microplastics, as well as the harms associated with loneliness and social isolation. Dr Topol writes that spending time in nature can bring “diverse health benefits” and that music, optimism, hobbies and human touch all promote healthy ageing.
Expensive new weight-loss drugs like Ozempic and Zepbound, Dr Topol writes, have “extraordinary potential to promote health span.” In addition to stanching appetite, these drugs also seem to rapidly reduce harmful inflammation — an effect that “precedes and is independent of weight loss.” In the future, the author believes it’s “conceivable that most people will be taking” such medications, though he worries about the lifetime commitment they require, as well as the social inequities the pricey products are likely to exacerbate.
While he celebrates the progress researchers have made in understanding the biology of healthy ageing, Dr Topol decries the “longevity lifespan circus,” incredulously describing “fitness centres with intravenous anti-ageing drips.” Some clinics, he notes, charge up to $50,000 a week. He is particularly scornful of “carnival barker scientists,” spreading their false claims, hawking their supplements and contributing to “irrational exuberance in many dimensions.”
Dr Topol contends that there’s “little or no hard evidence for the benefit of taking any vitamins or supplements, especially in those who are following a healthy diet.” This includes nootropic supplements purported to improve learning and memory. “None of these have any meaningful clinical trial data to support their use,” he says. While acknowledging the promise of medicines like rapamycin and metformin, which may affect cellular processes linked to ageing, he sees “no justification” for their use as yet — a cautious perspective sure to be viewed as prudent by some and fusty by others.
Dr Topol is critical of the indiscriminate use of whole-body MRI scans and other comprehensive diagnostic tests marketed to the “curious affluent.” Instead, he favours a more selective approach to screening that focuses on high-risk individuals, ideally guided by genetic data and enhanced by artificial intelligence.
He’s not enthusiastic about companies that market tests of “biological age,” a composite estimate of bodily ageing (based on molecular markers) that he believes offers little actionable insight for patients. He’s more hopeful about the promise of organ-specific measures of ageing, since these indicators, if validated, could offer directional guidance and represent a step toward “preventive individualised medicine.”
As Dr Topol alerts readers upfront, his writing can be heavy on the technical details — necessary, he insists, due to the gravity of his topic. At times, the book reads like a dense academic review, in marked contrast to Dr Peter Attia and Bill Gifford’s popular “Outlive” (2023), which explores similar territory and breezily engages readers. Even so, in a discipline as dynamic as the science of ageing — with our longevity on the line, billions of dollars at stake and extraordinary claims flying around — it’s essential to establish ground truths of the sort that Dr Topol sturdily delivers.
Dr Shaywitz, a physician-scientist, is the founder of Astounding HealthTech, a lecturer at Harvard Medical School and an adjunct fellow at the American Enterprise Institute.
Wall Street Journal
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