Transcription
In the early 20th century, the average human lived just 32 years. Since then, life expectancy has more than doubled. It's been a remarkable achievement, even just in the last 150 years, which doubled our life expectancy. In 1850, it was 38. Today in the US, at 76. And there's no reason to think that that march is going to stop in wealthy countries. More and more people are living into their mid-eighties or even longer. It really reflects the point that it's all an interaction between the environment and genes. We could probably get to an average age of 90.
For thousands of years, humans have dreamed of extending life. The quest to slow and even reverse aging has become a scientific mission, one that's given birth to an industry, research and medicine that's advanced tremendously. And it starts with saying science builds the foundation and then applying it to people, improves their health and won Jeopardy!
But living longer doesn't come without consequences. Staying alive doesn't guarantee staying healthy. So while we're living longer lives, while we're living till 78, our health span is about ten years less globally. And in the US, we have the biggest divide between health spend and life span of 12.4 years. That divide is a problem for individuals, societies and economies. Scientific advancement may have found ways to extend life. But do the benefits outweigh the costs? As we have more older people going forward? Do we have systems in place for long-term care? Every country in the world is impacted by it.
I'm David Rubenstein. For nearly a decade, I've interviewed some of the most interesting and powerful people in the world. Presidents. Athletes. CEOs, entrepreneurs. I talk to them about their careers and their lives. Inevitably, we almost always end up talking about how they're living and how much they think about trying to live better. Rau trying to make sense of the mountain of new information available and the ambitious efforts underway to tackle the biggest health obstacles, or longevity. Come with me as I talk with the leading experts in science and medicine and ask them the questions we all have: how to be healthier and ultimately how to live longer.
In a lab at MIT in the 1990s, one scientist started asking himself the question, "What is the aging process? Was something we could understand and perhaps even slow down?" I knew that yeast very well, so we decided to study aging in yeast and had an entry point, had a goal which was to look for mutants that lived longer than they should and identify genes that conferred that ability to those mutant yeast cells. So in yeast, you found that some genes live longer than might otherwise be expected, and therefore there must be something to why they live longer. Yes. And your mission over the years has been to figure out if in humans there's another gene that could make humans live longer than would otherwise be expected. Yeah. So in yeast we identified what the gene was. So it boiled down to one gene. That single gene was called CO2. It led to the discovery of a whole family of genes, the sirtuins. Sirtuins repair DNA. They regulate metabolism. They keep cells stable and control stress responses. Has the scientific community accepted the idea that this is something that will induce longevity in humans? And the important thing is the cofactor they need, which is called NDI, and it has multiple roles in cells. One is to activate these sirtuins that are proteins that can keep you young. And what that does is what the search killings do is they're good for mitochondria. First of all, mitochondria are the powerhouse that makes energy for the cell cells. And the energy is like a lot of things need energy to work, they function. So that's one thing. The other thing they do is they help DNA repair in the nucleus of the cell. So the DNA gets damaged over time, needs to be fixed. And the sirtuins aid in that process and it aids in that process. At some point, somebody will win a Nobel Prize for this. If somebody can prove that one gene actually does cause people to live longer. I don't think about that. I really don't. And what I'm thinking about is, you know, does this have relevance to humans? And in particular, as far as humans? You know, we studied yeast and then these ones and then for ten years we studied mice, which is a mammal. And so we were really getting closer to humans in terms of the biology. So we believe we've set the table now to study humans eventually. Professor Guarantee. Turn this into a business. He developed a product designed to raise NAD levels in humans. I was really interested based on our studies on NAD and sirtuins, to see if we could deliver health benefits to humans in a shorter timeframe rather than a longer one. Everybody has a rate of aging and as you get older, that rate of aging starts to increase. And we think that raising any D levels is critical material that falls as you get older. So that's the problem. And 80 levels fall and you can boost it back up. You can reset the neck. And we think that resets the rate of aging to a slower rate. The effectiveness of NAD+ boosting supplements in humans is still unproven. Most human studies so far have been small. Many experts say the science behind so-called anti-aging supplements is still limited. So if there's an evolution as occurring, it must be that you know somebody's nature. Mother Nature aside, it's a good idea at some point for people not to live forever or organism not to live forever. So if you're trying to interfere with Mother Nature, is that a good thing? My personal belief is that it doesn't work that way, that the way it works is that evolution wants the species to survive. I think that there are benefits to having people live longer if they stay healthier. That's the key point. Longevity without health is, if not valuable. But if you can maintain healthy people productive when they're older, they no more.
While the science of aging excites many in the longevity field, Dr. Verdin recognizes that living longer isn't everything. Living long is one goal, but not at all costs. And actually, for a lot of people right now, living old means many years of disability, suffering Alzheimer's and all of this. So not really living your best life. So a major goal at this point is to increase your health, spend a healthy years of life to try to make your health spend and your lifespan coincide. If you were to follow, most of our recommendation of what we know is healthy for you, most people could expect to live to 95 in good health today. This is not with any drugs or any supplements. Based on their lifestyle interventions. So as the expert on aging, what do you do to prevent aging or to age at a slower pace than you might otherwise? What is your personal regimen for that? I try to have a healthy diet. I try to maintain my body weight. Fasting is excellent for you, and I think the easiest way to incorporate fasting in your routine is to to restrict the amount of hours that you're eating in any given day. So I try to eat over a period of 8 hours, which would be from noon to 8 p.m.. And in between this, I don't have any calories. Why is that so? Because, again, we talked about the sleep and the repair. So fasting is the sleeping of your metabolism. So essentially puts your body at rest and you allow allowed to repair. That's really the whole idea of fasting. There's actually a green energy mechanism that's called autophagy, where you take those misfolded proteins and you take them to their component and you can use them for energy again. So one of the things that fasting allows is for autophagy to get rid of this junk. Does dieting really ever work in the sense that the people stick with diets for more than a couple of months? I would say the closest to a healthy diet would be what we call the Mediterranean diet: fresh fruits, lean meat, not eating too much, mitigating all the fast sugar that's pretty. Sugar is the enemy. And our universe in the universe of longevity, we know that everything related to sugar metabolism is really all the pathways that drive aging. So avoid fruit juice, avoid cereals, avoid tropical fruits. Should I eat red meat? Is that good for me or not? I enjoy a hamburger, but I don't eat it every day. And if I eat it, I eat it from organic meat. The epidemiology is clear. You know, there's a direct link between the amount of red meat you eat, a whole series of cancer, heart disease and so on. So there's no problem with eating red meat. But if you eat it, eat it in moderation, and don't eat it too often. It was thought for a while that drinking two glasses of red wine every day would help your heart. Is there any evidence of that? We're a little bit in the situation with alcohol right now as we were with tobacco in the fifties, where we have a product which we know intrinsically is not healthy, but there are other added benefits drinking alcohol, which is the social aspect. And so I tell people, make the balance, you know, don't drink every day. When you drink, drink something of the best quality and and enjoy it with friends. Let's talk about exercise. Everybody says that exercise is good. You can live longer. Is there any medical evidence that exercising every day or every other day is really good for you? This is the strongest evidence that we have and I've argued that we don't have we will not have a better anti-aging medicine than exercise for the next 10 to 15 years. So it is extremely powerful. There's clear evidence that as we age, we lose muscle mass. And so lifting weights heavyweights is really a powerful way because your muscles is your are your most important metabolic organs. So if you want to be healthy, you need to have good muscle mass balance that becomes critical as you age because a lot of people will meet their end by falling, breaking their hips. Now, some people say you can take an anti-aging pill. Yes. And that this will enable you to live longer. What do you think about that? I'm highly skeptical. And the reason is is but not completely. So. There is a lot of evidence in animal models right now that we have supplements, interventions that increase lifespan and health span in these animal models. The commercial world has jumped on this and say, well, if it works in mice, it's going to work in humans. Many of these supplements that do work extremely well in animal models, we don't have any evidence or proof that they actually do work in humans. And, you know, the the key is always that you're going to do harm. Are you going to be helping? So my advice to people is that there are today a few supplements that I think many people should consider: Vitamin D after you've measured your level, because many of us are deficient; Vitamin B12. Same thing can be measured. Many of us are deficient; omega fatty acids, which is these protective fatty acids. Many of us don't eat enough fish or the type of oil that we need. And another one is creatine, which is a supplement that helps your muscle function and your brain function. So all of those, in my opinion, should be part of everybody's regiment.
I think it's an opportunity, the longevity economy. We need to start thinking differently about the way we have created our systems, like our pension systems, our social security systems, even the way we work. A study published last year looked at the lifestyles of more than 276,000 U.S. veterans. It found that adopting just eight healthy habits could add up to 24 years to a person's life. While genes do play a role, especially as we get older. Experts say longevity still comes down mostly to environment and lifestyle. If you have a first-degree relative, a parent or brother who has lived above 100, the likelihood that you're going to live above 90 is more than 90%. And that really speaks to in those families. There are genes that protect. But for you and I, most people, it is really all about lifestyle. As a matter of fact, 93% lifestyle, 7% genetics.
As more people live longer, that demographic shift starts to have economic impact. And that can put stress on systems designed with very different assumptions. That suppose somebody retires at 75 years old and they're just sitting in retirement homes and they're not really working. How does that add to the GDP? Or you're saying people work longer? First of all, those people have 40% of their economy basically in their value. I talked about health and what they do. What they do is something that needs adjustment, right? The social, the the age of retirement, it's adjustment. The Social Security needs adjustment. There has to be plan of how to use those people in a way that they like and these help for your Social Security card important as a bank. Social Security in the US was created 100 years ago. We haven't really changed it or updated it since then. It is going to become insolvent. There are the ones that nobody wants to talk about, some of the difficult ones, which is raising the retirement age. And I know it's a hot button issue, but other countries have done it successfully. For example, Denmark, I believe, is going to raise the retirement age to 70 by 2040. The World Economic Forum says Social Security reform should be a key priority for governments. It's released a report what it calls "Future Proofing the Longevity Economy," proposing scalable innovations that could be adopted across countries and industries. I think it's an opportunity, the longevity economy. And I think the way we should think about this is we're thinking about a 21st-century issue with 20th-century solutions. We need to start thinking differently about the way we have created our systems, like our pension systems, our social security systems, even the way we work.
These longevity reforms begin in the workplace. As people live longer and birthrates fall, companies face a new challenge: creating inclusive environments where multiple generations can thrive together. One of the most interesting things that's going to be happening in the workplace is this five-generation workforce that's working together side by side. However, are workplaces ready for that? Not necessarily. I think we need to really create more age-inclusive strategies for the workforce so that skilling and upskilling happens for all employees, not just employees that first come in are younger employees. Lifelong learning, skill building is something that should happen throughout life, and I think that's something people need to consider. And as people stay in the workplace longer, society will need to rethink what it means to live and work to 100. The society is not yet set up for people to live to be 100. If everybody's living to 100 because they're taking these drugs or other drugs that might come out, how is that going to change society? If you go from 82 to 100? But look again to my study, if we were interested in if our centenarians, did they get sick? When everybody gets sick when they're 60 and now they live sick for 40 years, or is their health spending lifespan goes together? And the answer is that it does. They they are healthy, 30 years longer. So they are healthy and they are living longer. But that's not really the major point. The major point is that they have contraction of morbidity. They're sick very little time at the end of their lives. We're sick five, eight years at the end of their lives. They're sick, weak. 30% of them don't wake up in the morning. And we started talking about this concept of longevity dividend. We went to the CDC. The CDC has looked at the medical expense in the last two years of life of somebody who died at age 100. It was third then. Those who died in their seventies, they have an economical value that when you calculate the economical value, this is it's by the way, it's $36 trillion a year. It's something we cannot afford not to do for extending health spend by two years. What I think is important is closing the gap between lifespan and health span, because while our life span is still 78 in the US, our health span really is only till about 66. So finding innovative ways, addressing them through public-private collaboration of how to reduce that 12-year gap between lifespan and health span and in turn that will help people be excited about living longer lives, replace them with the private sector. To think about an age-inclusive workforce, I want them to think about what it means to have older people stay at work longer if they want to, have to have caregivers come back to work if they want to, and how to ease that process. I want governments to talk about this issue. I feel like we're not talking about it enough. Aging is in your hand for most people, the way you, the decisions you make today and throughout your life, and again, it's never too late, is going to determine the outcome of how you live your last 20 or 30 years of life.
One of the longest-running studies on human life and happiness began in 1938. The Harvard Study of Adult Development has followed more than 700 people for nearly nine decades. It's now in its 87th year and still going strong. The big takeaway? Close relationships, not money or fame, are what keep people happiest and healthiest over time. Strong social ties protect us from stress. They slow down mental and physical decline. They predict long, happy lives, better than class IQ or even genes. Some people also say, I've read that if you want to live a long life, in addition, the factors we've already talked about have a relationship with somebody or some other group of people or relationships important. They're the number one predicting predictive factor in terms of your longevity. Remarkable, because it turns out the largest number of deep, loving relationship you have with your spouse, with your children, with friends. It doesn't matter who it is. But these have to be deep, deeply connecting, loving relationship. Your longer, your lifespan.
So as you wrap up being surgeon general for the second time, what would you like to tell Americans about what they should do with their health? One of the things that worries me is this deep sense of pain and unhappiness that I have sensed in so many people across our country, even when our economic needs are met, educational needs. I find that so many people are still experiencing that sense of despair. And I've found that what we really need in our lives is to build community, is to re-establish a group of people in our life where we can have relationships with them, where we can be of service and help one another, and where we can find our purpose in the people we love and in the people we serve. Those three elements of relationships, of purpose and and service, that is the try to fulfillment. Those are the core pillars of community is what I would want everyone to invest in, in their life. And it doesn't have to be difficult. We can start with just spending 15 minutes a day reaching out to someone we care about and checking in on them. That's how we build relationships. We can ask, Can I do one thing each day to help someone? That's how we engage in service. And we can start having honest, real conversations with our friends and with our children about how to find purpose in our life that's rooted in contributing to the lives of others. If we do this, these small steps can actually engineer a miracle in our lives. So my hope for individuals and for the country is to build community. This is what we need for our health and well-being, for our individuals. And that's what we need for the health of the nation.
Will there be other breakthroughs that you think will occur in the next five, ten or 15 years that people are working on now that could make things even better? I think it's likely, although I couldn't predict when and I couldn't predict what, because by definition, you don't know what a breakthrough is until it's happened. Let's look on what has been produced over recent ten years, 20 years, and say there's finally for the first time ever, something out there that you can do to intervene in this process. So for somebody who's watching this, to summarize everything we've said, if you could encapsulate in one paragraph what you have learned about aging and what you want people to know about aging, what would you say? I would say that aging is in your hand. For most people, the way you, the decisions you make today and throughout your life, and again, it's never too late, is going to determine the outcome of how you live your last 20 or 30 years of life. When you're healthy, even at age 107, life is very different than that. And really, I think that's the major thing. It's really about living healthier. The living longer is a side effect. In most religions, there's a concept of heaven. If you believe in that. Why are people so worried about dying? Because if you're going to go to heaven, you've lived a great life. Why are so many people so worried about living longer? That's a very philosophical question. And I think the the whole idea is that the whole concept of faith, I think people, you know, have faith. They live in confidence. Many people are more skeptical and they're wondering first that there's still a very significant degree of uncertainty. Is this true? Is it not true? And I've argued that you might have heard of Pascal's bet. I'm going to live the best life I can know because in case there is paradise, I want to go there. And so the whole field of longevity in some way, you know, when I started working on this, I started really applying more sort of rigorously all of what we've learned with the hope of living longer. What I've discovered during this process is when you optimize your lifestyle, the quality of your life changes in a dramatic manner. And in some way. For me, this has become almost like a Buddhist version of this, is that longevity is allowing me by optimizing my health to actually live and to be the best person I can be.
I'm David Rubenstein. This is Bloomberg.