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SHOW 108 TRANSCRIPT
Can You Really Extend Your Life?

HOW long will you live? Think you'll make it to ninety? A hundred? A hundred and twenty? With all the talk about increased longevity, it's time to learn the facts, fads, and fallacies that characterize the study of aging. There are lots of exciting developments and lots of phony promises. Long life is humanity's ancient and perennial goal. Prophets promised it; explorers searched for it. We all want ourselves and our loved ones to stay alive and well, vigorous and vibrant, as long as possible. We toast, "To Life". The real trick is to live younger and not just longer. Wouldn't you rather disembark at ninety, having lived most of your senior years as hale as a forty-year-old, than slog on to a hundred, wheezing, hobbling, and in a perpetual fog? Lotions, potions, diets, drugs--they are everywhere and offer a dizzying array of choices. How do you attain true longevity amid the clamor of conflicting claims? What exactly is the biology of aging--and the best, most sensible ways to slow its pace? Our five panelists, experts in gerontology and human fitness, give their prescriptions for a long life. 

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PARTICIPANTS 

Dr. W. French Anderson, director of USC's Gene Therapy Laboratories, is the current national champion in karate for his age group. French talks about his personal fitness agenda.

Dr. Arthur De Vany, a former professional athlete, is a professor of economics at the University of California at Irvine. Art, who is in great shape, is the originator of the radical Evolutionary Fitness plan. 

Dr. Sherwin (Shep) Nuland, a surgeon who teaches medical ethics at Yale, is the best-selling author of How We Die. Shep expresses his concerns about extending human life.

Dr. Gregory Stock, a biophysicist, is director of UCLA's Program on Medicine, Technology, and Society. Greg envisions a future in which we adjust our own biology to live well past our present maximum life span.

Dr. Roy Walford, a professor of pathology at UCLA and the physician on the Biosphere 2 team, is the author of The 120-Year Diet. Roy believes that the chief factor affecting longevity is diet, especially calorie restriction.

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ROBERT: Roy, you're one of the leading authorities on the biology of aging. Your most recent book is The Anti-Aging Plan. Give us an overview of the primary factors in aging and what we can do to retard the inevitable. What should I be doing to live as long as I can?

ROY: You should eat a diet low in calories but high in nutrients. There's evidence for the life-extending effectiveness of that [regimen]. Then you have to exercise and maybe take some supplements. These are the best measures we know of, at the moment. 

ROBERT: French, in addition to being the father of gene therapy, you're a national champion in various martial arts. Does exercise aid longevity?

FRENCH: We need to distinguish between two factors that determine the length of your life. First, you can die prematurely--from some disease such as cancer, heart disease, or pneumonia. Second, if you don't die from a disease, how long can you live and what will the quality of that life be? Exercise is a critical part both of extending life and improving its quality. And I'm a bit of a maverick, because I feel that diet has much less of a role than most people think--including, it seems, everyone else on this panel. More important, in my opinion, is being active, both mentally and physically.

ROBERT: Suppose somebody hits you with a karate chop?
FRENCH: Then it wouldn't make any difference whether I was in the habit of eating hamburgers and pizzas or salads.

ROBERT: Shep, as a surgeon and author of two best-selling books on the workings of the human body, do you see any danger in interrupting the natural order by our increasing obsession with life extension?

SHEP: This term "life extension" is a little ambiguous. We have to differentiate between "life expectancy," which is what each of us would like to increase personally, and "life span," which is the natural, species-specific number of years.

ROBERT: There is a theoretical maximum life span for each species.

SHEP: Yes, but what concerns me is DNA research on telomeres. 

ROBERT: What are telomeres?

FRENCH: Telomeres are little bunches of DNA at both ends of our chromosomes. The telomeres [in our somatic cells] decrease in size over time, as the cells keep dividing, [and thus play a key role in cellular aging]. There's an enzyme called telomerase that not only prevents this decrease but can also make the telomeres longer. Cells [in the laboratory], exposed to increased telomerase, will divide seventy-five times, instead of the usual fifty. And so people are starting to have these wonderful fantasies that we can use this procedure throughout the entire body, for all of our cells, and thereby increase our normal [maximum] life span--which, for our species, is about a hundred and twenty years. This prospect concerns me, too. 

ROBERT: Shep, why does it concern you?

SHEP: Think about our planet and the implications of extended life--ecological turbulence, social turbulence, economic turbulence.

ROBERT: I'll get dizzy.

SHEP: Well, get dizzy! I, too, like the fantasy of continued life, whether it's the maintenance of physical life or the religious idea of life after death, which has been with us since we were primitive. There are reasons that all animals and plants die at a given time. I can't imagine a greater form of tampering with biological laws than trying to increase life spans.

ROBERT: Art, you're a mathematical economist who takes longevity and fitness very seriously. Tell us about your theory of evolutionary fitness.

ART: I try to imagine the environment in which the human genome and human metabolism developed. I see an evolutionary environment of hunters and gatherers living with abundant, highly nutritious, low-caloric plant food, and low fats. I see our ancestors engaging in activities that promote those hormones that retard chronically elevated insulin levels; high insulin is facilitated by too little exercise and a diet that's too high in simple carbohydrates. I don't think there's a theoretical limit to life. I see aging more as a cascade--as a breakdown of coordination among all the billions of cooperative cells within the human body. The loss of the proper response to glucose, due to high insulin, is one of the primary leading indicators--as an economist would say--of the cascade that leads to aging and deterioration.

ROBERT: Greg, you're the author of a book called Metaman, which creatively merges humans and machines into what you call a global superorganism. How does life extension affect this superorganism?

GREG: The superorganism I speak of is really human endeavor--society as a whole, knitted together by technology. These linkages accelerate our ability to apply new technologies to transform ourselves, and an obvious target is aging: not just preventing people from dying prematurely--that is, extending life expectancy--but extending the maximum human life span. As we unravel our own biology to the point where we can begin to alter and adjust it, we will extend the human life span beyond a hundred and twenty years, which is the possible limit now. Our challenge is to last in a healthy state until this transformation becomes possible--I'd say in a generation or so. 

ROBERT: Roy, describe the biology of aging.

ROY: Let me start by talking about the survival curve. The entire population is at a hundred-percent survival rate at the time of birth, and the rate eventually dribbles off to zero out at about a hundred and ten years, minus an occasional outlier. This is the maximum life span; when everyone has died, the survival curve hits zero. The fifty-percent point on the curve is the average life expectancy. 

ROBERT: Average life expectancy differs from country to country, but there is a species-specific maximum for life span.

ROY: Both can be extended in animals by caloric restriction. You can extend the whole survival curve, including the animals' maximum life span. If this were applied to humans, it would extend the human life span curve out to a hundred and forty or a hundred and fifty years old. 

ROBERT: Let's get back to me. What do I have to eat to extend my survival probability curve?

ROY: A low calorie, high quality diet is what works with animals. You could call it starvation on a healthy diet. 

ROBERT: It doesn't sound like fun, but it may be worth it. Are there dangers in extrapolating from animals to humans?
ROY: At the moment, there are three monkey colonies in the United States living on calorie-restricted diets. Our close relatives are showing the same extensive health-enhancing physiological changes. One colony is showing a decreased incidence of diabetes, which is a good indication of retarded aging in a monkey population. And preliminary studies of humans show that a low-calorie diet induces the same sort of physiological changes as it does in rodents and monkeys.

ROBERT: Tell us about Biosphere 2.

ROY: Biosphere 2 was a big [3.15 acres] glass bubble in southern Arizona, in which eight people lived totally enclosed and sealed for two years, [beginning in September 1991]. I was the physician inside. By accident--since there was an El Niño occurrence and that limited the light coming through the glass, and since there were more insect pests in the agriculture section than we had anticipated--we couldn't produce enough food in terms of calories. But the quality of the food was very good. So I recognized this situation as a so-called experiment of nature, which we could take advantage of. I told all the inhabitants that we'd be hungry but we'd also be very healthy. And so we all elected not to import food, in order to preserve the integrity of the experiment. 

ROBERT: In addition to restricting calories, do you recommend making any changes in proportions of fats, carbohydrates, or proteins? For example, do you add supplements or any special types of foods?
ROY: You have to plan the low-calorie diet so that you're not deficient in any vitamins, minerals, or other essentials. If you just eat less of the normal bad American diet, you soon get into vitamin deficiencies that will certainly not extend your life span. So the low-calorie diet has to be nutrient-dense. There's pretty strong evidence now accumulated that this will work in humans.

GREG: It takes an enormous amount of self-control to essentially starve yourself in a controlled fashion. I can imagine the primates in those colonies wailing, "Oh, my God! I've been selected for the restriction diet, and to make things worse I'm going to live twenty-five-percent longer." I think the ideal--and there's a lot of research directed toward that--is to understand the biology of what's really causing the longer life span promoted by the caloric restriction, and to emulate that in some way pharmaceutically or genetically.

ROY: Calorie restriction is not something that everyone can do. But some can. There's an Internet calorie-restriction group of about three hundred people now in operation. It's possible.

FRENCH: "Restricted" means what? What's the recommended calorie intake per day?

ROY: It depends on the individual, but something like fifteen hundred to sixteen hundred calories.
ROBERT: For what body weight? 

ROY: You can't quite do it like that. You have to be ten to twenty percent below what's called your set point, which is defined as your normal weight if you were continuing to eat normally. You can also calibrate it by body temperature. People on a real calorie restriction diet have a body temperature lower by one and a half degrees. 

ROBERT: French, are you being converted? Might you give up some of your dinner?

FRENCH: No, although I absolutely agree with Roy [Walford]'s basic point. Also Art [De Vany]'s, that human beings are part of nature. And if one does what are really very logical things, in terms of not overeating and so on, better health will result.

ROBERT: But calorie restriction is different from not overeating. 

FRENCH: Exactly. At times, I do naturally what Roy is advocating, which is basically not eating for days.

ROBERT: Is that just because you're working too hard?

FRENCH: It's for a number of reasons, but I like to keep the system a little bit stressed; I think it's healthy. My concern is that there are so many nutritionists who claim so many things--eat less of this or more of that, take these or those supplements. I think all this nutritional advice is less important than simply leading a very active, physical existence. 

SHEP: If human beings are part of nature, as two of my colleagues here say, why do we want to increase our species' natural life span? Considering the delicate balance of the ecology of this planet, why do we want to take one species and increase the number of its elderly, with whom we are already having massive problems. It's not as if we were increasing the number of people thirty-five to fifty--the most productive members of our society. Or, as I like to think, sixty-five; the age of optimum productivity gets older every year. Why are we spending so much time, money, and societal and scientific resources attempting to destroy our ecology and our social system? What's the great benefit of living longer? 

ROBERT: This is the classic trade-off between individual interests and collective needs.

ROY: There are three illusions common to arguments against longevity. First, the problem of population explosion. The real population problem is an excess of births: if too many children are born, this leads to an exponential population increase, whereas if everybody just stopped dying, the increase would be linear. If, starting in prehistoric times, nobody ever died but each person had only one child, the linear increase would now have produced about half a billion people on earth. But because of over-birthing, we have the population escalating enormously. So I don't think that's enough of an argument against life extension. The second illusion is that humankind has always had to find a reason to make death acceptable, which has plagued gerontology since the beginning. Religion tells us that you don't really die, you go to some other place. There have been all sorts of such rationalization of death, and extended life being bad for the ecology is just the latest example. The third illusion is that if you extend the human life span, you're only extending old age. But we move the entire survival curve out, not just its right-hand edge--so that the centenarians of tomorrow are going to resemble the forty- or fifty-years-olds of today.

ROBERT: That's the hope. 

ROY: It's the reality. If you extend the human survival curve by fundamentally retarding the aging process, you extend all age groups.

GREG: I agree with Roy. If you really feel that we shouldn't extend the human life span, then the expenditures that should be stopped are those for the treatment of age-related diseases. Society spends enormous resources on cancer, heart disease, Alzheimer's--all of the maladies that come toward the end of life. If we can get at the fundamental biology of aging, then we would delay these diseases. People want to live longer; there's no question about that. What we really want is for people who can live longer to also live younger. Otherwise we should have a life expectancy of forty-five, as it was at the turn of the century. Is that what you think it should be?

SHEP: Well, another concern of mine is, What will happen to young people when older people remain productive into their seventies and beyond? Traditionally in our society, younger people have replaced older people who were dropping out of the job market. This limit on opportunities for young people is just one of the problems we face. Because the birthrate doesn't seem likely to change.

GREG: The birthrates have changed in the developed world.

SHEP: The developed world represents a relatively small part of the world's population. Isn't this another example of a kind of imperialism that works fine for the West but doesn't work elsewhere in the world?

GREG: We seem to apply advanced medicine to the developed world without a great deal of compunction.

SHEP: That doesn't mean it's good. 

ROBERT: There's a natural tension between what will be good for ourselves personally and what will be good for society communally. Humans have faced this tension from the moment when we started to think; it's not going to go away.

ROY: It depends on how you look at the current structure of society, which is stratified like this: When you're a child, you go through a learning period, then there's a period of work, then a period of leisure or retirement. With a longer-lived society, you alter this stratification; people learn throughout life, people work throughout life, and there's no particular retirement, since you have leisure throughout life. That's a different social structure. This is where we're headed, and it obviates the objection of not making room for the young. 

ROBERT: Shep, your book How We Die states that "death with dignity" is more wish than reality, and that death in fact is undignified and harsh. Do you think longevity research can ease the process of death, which we all face?

SHEP: I'd like to think that research on life expectancy will compress the curve of suffering before death. We're already beginning to see improvements in quality of life, such that instead of dying slowly of some degenerative disease over five or six years, people are going along quite well and then dropping off over a relatively short period of time. This is the kind of longevity research that, with finite resources, I'd like to encourage. 

ROBERT: Recall the words of that famous longevity philosopher, Norma Desmond, the aging movie star of Sunset Boulevard. She said there was nothing wrong with being fifty unless you were trying to act twenty. 

SHEP: What's interesting to me is that at the beginning of our discussion, Robert chose age ninety--he said something like "Gee, I'd rather die at ninety." But why not seventy, which is a much more realistic age for most of us to die?

ROBERT: Twenty years ago I would have said seventy, but I'm now fifty-five. Let's move on to some of the fads and fallacies that we see in aging research. There seems to be more strange stuff circulating about longevity than even about religion.

ROY: The main reason we see so many fads is that you can make a good argument for a number of things that ought to influence aging, like vitamin E. If you read the vitamin E literature, it looks as though vitamin E should have an effect on aging, but when you actually give it to animals and run a test, it doesn't. 

ROBERT: Do you take vitamins?

ROY: I take a general multivitamin, but it's not a big part of my program.

ART: I take antioxidants, such as E and C, which I do think are far more effective. And I take B-complex.

ROBERT: I take vitamins, not because I believe they're all that effective but because other people say they are. I'd feel bad psychologically if I didn't take vitamins, and this negative placebo effect might make me sick. 

GREG: The real reason there are so many fads is because human beings so deeply crave a longer, healthier life--and therefore there's money to be made in the field. This is why, when we unravel our biology sufficiently, we'll almost certainly intervene and retard aging, regardless of the larger social issues. Longevity is just too compelling a temptation. 

ART: Fads develop because people want quick, easy solutions to problems. In truth, longevity relates to how you live your life on a day-to-day basis. It has nothing to do with some magic pill. 

ROBERT: What about some of the new chemicals, such as DHEA, melatonin, and the like?

ROY: They haven't been shown, convincingly, to increase maximum life span in animal experiments, which is really the only indicator as to whether fundamental aging has been retarded. 

ROBERT: Many people are ingesting these chemicals. 

ROY: Some people argue that such-and-such ought to work, or might work, and this persuades other people to take it. But animal experiments should be conducted first, and generally they aren't. 

ROBERT: French, out on the medical frontier, do you see aging becoming a target for your gene therapy bullets?

FRENCH: Unfortunately, the answer is yes. There's a lot of money to be made if you can develop a gene technique that switches off aging--and in fact we've located genes that do relate to aging, in fruit flies and other organisms. I say "unfortunately" because we know so little about the human body--or about animal bodies, for that matter. New feedback mechanisms, new regulators, and other new factors are being found all the time. So we have no idea what would happen if we tried to put a gene into a cell to interfere with something as fundamental as the aging clock. After all, nature has set the survival time. In my opinion, anti-aging genetic engineering would be a tremendously dangerous thing, but do I think somebody will do it? Yes.

ROBERT: What are some of the specific benefits of exercise, particularly for retarding aging? 

SHEP: Exercise slows osteoporosis and can actually increase bone density. Here's how it works: the build-up of muscle increase stress on the bones, and the bones respond by building themselves up. That's very easily measured radiographically. Exercise also causes cholesterol to drop. Longevity seems to be increased. An interesting by-product is that anaerobic exercise--heavy weight lifting--burns about six to seven times as many calories as does aerobic exercise, the reason being that weight lifting breaks down muscle fibers and in the rebuilding of these fibers a lot of calories are expended. 

ROBERT: So the effect of that kind of exercise lasts long beyond the actual workout?

SHEP: Exactly. You're out of the gym for forty-eight hours and you're still burning up those calories. And if you got sore--got a charley horse--from working too hard in the gym, that's a good sign. The most important factor as far as aging is concerned is that if you keep exercising heavily until, let's say, you're forty-five or fifty and then stop, that's not nearly as beneficial as beginning to exercise when you're sixty and continuing it. So for all people of my age--sixty-five--get thee to a gym and start an exercise program, which is what I did. I just started last year. My cholesterol has dropped, and, to interest all of you, my testosterone has increased significantly. 

ROBERT: Let's talk about testosterone. What about patches worn by men in their sixties and seventies to increase testosterone? 

ROY: Again, there's no evidence that testosterone increases either maximum survival or retards basic aging. Whether an increase makes you feel better, I don't know. 

ROBERT: There could be health dangers hidden in superficial appearances. Bodybuilders take steroids, and although they look the picture of health, underneath they're deteriorating.

ROY: Absolutely. You have to distinguish between supplements, like vitamins E and C, which in normal amounts don't do harm, and synthetic hormonelike chemicals that can cause a great deal of harm. 

ROBERT: Are there dangers in taking multiple supplements whose interactions have not been studied? 

ROY: It depends on the supplements. You should be much more careful about taking, for example, growth hormone. It's quite different from, say, vitamin C, in terms of potential harm compared to potential benefit. 

ROBERT: What's interesting about the benefits of weight lifting for osteoporosis is that for a long time resistance training was almost ridiculed. It may make you look better, we were told, but it doesn't have any health benefits. And then, relatively recently, opinions changed. 

ART: I've known this for many years. If you look at our ancestral activity patterns, you can see that we had lots of languid periods of rest interspersed with a few short bursts of very-high-intensity efforts. When you engage in bodybuilding or high-threshold kinds of activities--sprinting up a hill as opposed to taking a walk, say--you release lactic acid, which in turn releases beneficial hormones. 

ROBERT: You advocate a great deal of variety in exercise, less aerobics, and many periods of rest. Is there danger of too much exercise?

ART: Absolutely. We mistakenly apply an industrial model to what's really a self-organized natural system. Variety is crucial. Repetitive stress breaks down all bodily tissues and is a fundamental cause of the premature aging of connective tissue. Heavy aerobicizers are producing excess levels of free radicals, which are aggressive groups of ionized atoms that damage cells. Boston Marathon participants have a high rate of brain cancer. Lots of joggers die of heart fibrillation. I had a colleague last year who died of it, in one of his ten-kilometer races; he had some scar tissue in his heart, which can break down the coordination waves. An aerobicizer or jogger restrains the chaos in the heartbeat, which is natural to an adaptive heart. 

ROBERT: The human body is a complex system in which simple solutions are usually wrong and occasionally dangerous. Aerobic exercise is good for the heart and the circulatory system, but it can have ill effects when it's overdone.

GREG: So what do you do? 

ART: I know what to do. I know what really works. I'm sixty-one and I have seven percent body fat.

ROBERT: You're just lucky because you picked good parents. 

ART: My dad died at seventy-one of congestive heart failure; all his arteries were clogged up. I believe in variety and intensity of exercise, along with a moderately low calorie diet of the kind that Roy emphasizes. Although with my basal metabolism and muscle mass, "low calorie" for me is something like thirty-five hundred calories a day. Americans in general overeat and underexert. And what they do eat is all-too-simple carbohydrates; the pasta that most people eat is a bowl of sugar briefly deferred, low in nutrition and high in calories. The body can't metabolize that kind of load. 

ROBERT: How many hours a week does everyone here exercise? I do about five to six.

ART: I do about an hour and a half. 

GREG: About two.

ROY: About four.

SHEP: About five. 

FRENCH: When I'm in training for national competition, which I'm now in, it's a lot of hours a week. But then I'll go for a week or two without doing anything. Actually, most of what I do is play. 

ROBERT: We're ready for a prediction. A hundred years from now, what is the average life expectancy in America? 

ROY: I'll still be here…. Many people alive today--at least, the children--will live through the next century and on into the following one. The average life expectancy will be a hundred and fifty years.

GREG: I recently convened a group of leading researchers in the biology of aging, and they were of the opinion that a hundred and fifty or more was a very realistic possibility. 

ART: That doesn't square with the rapid rise of adult-onset diabetes and the surge of multiple sclerosis and a variety of other diseases. I don't have a number. It's always a distribution, and statistical fallacies arise because you have a finite sample. Frankly, I'm not interested--I probably won't be here. But I'm going to be as healthy as I can for the rest of my life.

FRENCH: I'm not sure that I can separate what I think from what I hope, but my feeling is that there won't be a major increase in life span. Nature will continue to dictate how long our cells survive. My number for average life expectancy would be a hundred and twenty, but I suspect that Roy's survival curve will be such that human beings will be much healthier, much more active, much more productive for much longer--and then we'll suddenly crash. We'll go on for a hundred and twenty years, and then on the last day collapse.

SHEP: What we'll see is a compression of morbidity and suffering, with the recognition that even nerve cells can change if we work with them. Osteoporosis will decrease, if we exercise. We'll see vigorous people of a hundred and a hundred and ten, and they'll all be dead at a hundred and twenty, notwithstanding everything we've heard. 

ROBERT: CONCLUDING COMMENT

DESPITE differences of opinion, there seems to be a common-sense prescription for longevity and long life. Eat a healthy, balanced diet of whole grains, fresh fruits and vegetables, some nuts; limit calories and animal fats. If you take vitamins, stick to the basics, like E and C. Exercise regularly, including aerobic and weight lifting; sleep well; be serene. Avoid injury, tobacco, excess alcohol, and stress--and keep fire detectors in your home. You can keep an eye out for all those "magic pills," but don't obsess and don't experiment with the latest fad. Moderation, though not a very original prescription, is often the right course. What's your Report Card? Here's mine: good on the diet, excellent on the exercise, but lousy on the stress--there is just too much pressure doing these health shows. But suppose you do live to a hundred and twenty? How much more junk can you stuff into your closets? It's been said that millions seek immortality who don't know what to do on a rainy afternoon. But if rainy afternoons are not a problem for you, longevity is an attractive prospect. It takes common sense to bring us closer to truth.

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