The Secrets of Aging Well and Living Better
Chapter 1
Foreword
While I was writing this book, I turned 50, so the topic of aging is obvious—unlike in my last nutrition book, How not to Diet. That one was about losing weight. However, there is a clear parallel between the topics: both are influenced by unscrupulous commercial interests. Both the food industry and the anti-aging industry are multibillion-dollar giants. With that much money, the temptation apparently becomes irresistible to tout one’s products with all kinds of outlandish claims.
Even an educated layperson seeking basic, practical advice in one of these areas—living leaner or living longer—faces an impenetrable thicket of pills and potions. Even for me, as a physician who has the luxury of being neck-deep in peer-reviewed medical literature, it was a challenge to peel the naked truth out of the emperor’s new clothes. But that is precisely why this undertaking is so important. If it already took me three years to scour all the science for data on aging, then I fear the casual observer will hardly be able to tell facts from farce. A former president of The Gerontological Society of America wrote that “few subjects … are as misleading to the uncritical and as profitable to the unscrupulous.”
The field of anti-aging is “fertile ground for fraud, swindles, and the promise of quick riches,” and the popular literature on the topic contains “a great deal of misinformation.” Marketing often targets older people with its miracle cures. Undaunted, it peddles its wares both on the Internet and in brick-and-mortar “anti-aging clinics.” There have already been numerous Senate and Congressional hearings on the subject with titles such as “Swindlers, Hucksters and Quacks” or “Quackery—a 10-Billion-Dollar Scandal.” Today, the anti-aging industry in America is estimated to be worth 88 billion dollars, and globally it is 292 billion. It runs the gamut from wrinkle creams to the television preacher Pat Robertson, who offers “Pat’s Anti-Aging Protein Pancakes.” As an editorial in a business magazine put it, growing old may not be good for your health, “but it’s definitely good for business.”
Dazzled by science
According to an industry group, 60 percent of Americans over 65 use anti-aging products, but according to the director of the Institute for Biomedical Research on Aging, their effectiveness is largely not scientifically proven. Yet it is presented as if it were. For a long time, the tabloid press has been exploiting scientific breakthroughs, which profit hunters then pick up and opportunistically repackage.
In the 19th century, advances in the study of magnetism led to ads like this: “In America no one would need to be ill … if our magnetism-preserving underwear became part of the wardrobe of every lady and gentleman as well as of infants and children.” Less funny but more tragic is that public interest in Marie Curie’s work led to a range of radioactive products that supposedly “revitalized” and “gave energy.” The Wall Street Journal once ran the headline: “The Radium Water Worked Fine Until His Jaw Came Off.”
Today this so-called scienceploitation (“exploitation of science”) shows up in hundreds of shady “stem cell” clinics, especially in California and Florida, that use the language of science to lend their dubious therapies an air of legitimacy. In an article in Scientific American titled “No Fountain of Youth,” three renowned aging researchers concluded that “the public is being bombarded with noise and lies.”
One of those researchers was sued for over 200 million dollars by the co-founders of the American Academy of Anti-Aging Medicine because he had awarded the organization a Silver Fleece Award, a negative prize that calls out “the most ridiculous, outrageous, scientifically untenable, or exaggerated claims about interventions against aging or age-related diseases.” The Academy responded that it neither promotes nor supports any particular treatment, nor does it sell or support any commercial product. But a look at its website shows that in its directory—“Find Anti-Aging Products or Services”—it actively offers and displays an entire catalog of advertisements; the development of the products and services, the justification goes, was prompted by “numerous inquiries we receive daily.”
The “gerontological establishment” has been accused of deliberately sabotaging new enterprises like the American Academy of Anti-Aging Medicine, whose co-founder claims to be fighting the “outdated philosophy” that aging is inevitable, that nothing can be done about it, and that one must accept becoming old and dying. I can appreciate both sides of this conflict of interest: the research field of gerontology (the study of aging) struggles to preserve hard-won public grant money for basic research, while the more ambitious anti-aging crusaders challenge existing assumptions more fundamentally. “Simply stated,” the official response of the Academy of Anti-Aging Medicine to the criticism says, “the death cult of gerontology is desperately trying to uphold the obscure, antiquated attitude that aging is natural and inevitable.”
The anti-aging medicine movement would be more credible if its founders came out of research and were not “business-savvy entrepreneurs responding to market opportunities,” but the backlash against this new wave of anti-aging firms may have swung the pendulum too far in the other direction. It is true that, as the founder and editor-in-chief of Biogerontology noted, the history of anti-aging research is “rife with fraud, pseudoscience, quackery, and charlatanism,” but the (admirable!) fight against any whiff of impropriety seems to have led to a knee-jerk reaction that even runs counter to genuine scientific progress, so that even feasible interventions in the aging process are dismissed as “hot air.”
I know that in some circles today “science” is a dirty word. After years of Covid madness, colleagues whose intellect I used to respect seem to have abandoned their critical thinking. If you also believe in kabbalistic conspiracies, this is not the right book for you. It is true that the pandemic exposed glaring institutional weaknesses that made their way even into the scientific literature. Two of the most prestigious medical journals were forced to retract articles because of unverifiable data. Nevertheless, scientific journals remain the gold standard for the best possible approximation of the truth about our reality. To paraphrase Winston Churchill’s quote about democracy as a form of government, the peer-reviewed medical literature is the worst way of substantiating facts about health—except for all the others.
How I work
The editor-in-chief of a leading gerontology journal claims that most anti-aging scientists “known to a broad public unscrupulously dispense useless patent medicines.” It’s easy to get swept up by charismatic gurus, but when it comes to something as important and consequential as the health and well-being of our families, we should rely not on anecdotes but on evidence. That’s why I document every detail. How Not to Die had about 2000 footnotes; How Not to Diet 5000. This book ultimately had more than 13,000, which turned out to be a problem.
I had promised the publisher a book no longer than 600 pages, but when the manuscript was finished, it was more like 2150 pages. Oh dear! I didn’t want to sacrifice any content, so my first attempt at cutting it down was to put the 995 pages of sources online. In the back of the book there is a QR code and a web address (see.nf/citations) that lead to the complete list of all citations in this book.
Over the last three years, my team and I have read more than 20,000 articles on aging so you don’t have to—but you’re welcome to, of course! The advantage of putting the citations online is that it allows me to link every single one, so it takes you directly to the source. That way, you can download the PDFs and access the original research yourself.