Longevity Lab: Can You Live to 100? | Global Conference 2024
Milken Institute2024-06-16
Milken#Institute#Diamandis#buettner
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💫 Short Summary
Experts discuss advancements in longevity, focusing on interventions to slow aging, longevity drugs, healthy living, and environmental factors. Efforts include clinical trials, community initiatives, and policy changes for healthier lifestyles. The importance of nutrition, exercise, and optimism in promoting longevity is emphasized. Research into celytic drugs, senescent cells, and AI in drug discovery is highlighted. The goal is to extend lifespan, reverse functional decline, and improve overall well-being through holistic approaches. The potential for gene therapy, anti-aging drugs, and personalized medicine offers hope for a healthier and longer future.
✨ Highlights
📊 Transcript
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Panel discussion on longevity and living to 100 years old.
01:46Dr. Lloyd Miner emphasizes health and contribution to others in decision to live to 100.
Kristen Fortney discusses the need for new medicines and living healthier, not just longer.
Dr. Peter Diamandis suggests aiming for 120 years as a more realistic goal.
Dan highlights increase in life expectancy with advancements in genetics and healthcare.
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Potential for longevity drugs to increase lifespan and protect against cardiovascular disease.
05:51Advances in AI, quantum technology, diagnostics, and therapeutics are converging to address aging.
Goal of achieving 'longevity escape velocity' where science adds more than a decade to life per decade lived.
Behavioral changes and cutting-edge biotech are key factors in pursuing longevity.
Partnership between companies for clinical trials combining compounds for potential longevity benefits.
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Research on medicines for preventing diseases like Parkinson's, diabetes, and cardiovascular disease.
09:26Development of medications to promote healthy aging and weight loss.
Clinical trials testing the efficacy of drugs in slowing down aging processes.
Communities in blue zones where people live longer due to simple lifestyles and diets.
Efforts to replicate blue zone characteristics in American cities to improve health outcomes and reduce healthcare costs.
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Changing the environment to encourage healthier choices has shown positive results in reducing BMI, healthcare costs, and increasing life expectancy.
11:40Focus should be on changing surroundings rather than individual behavior or mindset.
Historical data from the 1980s shows that less time spent in cars, fewer fast-food restaurants, and more social interactions led to lower rates of obesity and chronic diseases.
Hope for a major breakthrough in the future, but attention to populations achieving desired outcomes can lead to significant improvements in life expectancy and healthcare costs.
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Public health interventions include taxing sugar, smoke-free laws, and gambling profit taxes.
16:48Strong political support is essential for implementing these changes, as demonstrated in the UK.
Transitioning from a sick care system to a true health care system necessitates changes in healthcare delivery and research methods.
Academic centers are crucial in training future healthcare leaders and advancing biomedical research, especially in areas like cancer treatment with immunotherapy.
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Social, behavioral, and environmental determinants of health are key predictors of life expectancy, with zip code more important than genetic code.
18:59Factors such as access to food supply, physical safety, and community engagement play a crucial role in determining health outcomes.
Blue zones provide valuable principles for improving health outcomes in different communities.
Educating physicians on these determinants is essential for creating effective interventions and promoting community well-being.
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Addressing sarcopenia is crucial for preventing loss of independence and negative health cycles.
21:55Azel prag, a compound, may mimic exercise effects, promoting better body composition and muscle health.
Apelin signaling, activated during exercise, holds promise in improving metabolism and muscle function.
Investing in human data sets aids in identifying potential drug candidates with translational success from lab to clinic.
Developing effective treatments for aging populations is essential.
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Importance of studying pathways to promote healthier and longer lives.
24:32Utilization of human data from biobanks like UK Biobank and Decode to study individuals who have lived longer due to genetics, diet, or exercise.
Collaboration with US, Norway, and Estonia biobanks to analyze frozen blood samples from 50 years ago for protein and metabolite measurements.
Introduction to X Prize health span competition incentivizing breakthrough ideas in longevity research and age reversal targets.
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Importance of reversing functional loss for longevity.
28:44A competition announced to reverse function loss by at least 10 years with significant capital and prize money.
Optimism emphasized as a key factor in longevity, with optimists living 15% longer than pessimists.
Optimism can be practiced and improved through personal self-study exercises.
Enhancing longevity and overall well-being through optimism and functional reversal.
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Importance of Gardening in Promoting Health and Longevity.
32:24Gardening in areas with land distribution history leads to increased life expectancy due to low-intensity physical activity and access to fresh produce.
Optimism and belief in a better future play a crucial role in longevity and fertility.
Policy makers should support communities and families by promoting gardens alongside healthcare systems.
Future healthcare approaches may include prescribing healthy foods and holistic health practices, such as 'food is medicine' programs.
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Importance of Nutrition in Healthcare Systems.
35:14Individuals play a crucial role in maintaining their health through proper diet and exercise.
Discrepancy between knowledge of healthy choices and actual implementation is highlighted.
Unhealthy societal norms impact medical advancements, emphasizing the need to address underlying societal issues.
Insights from personal longevity research missions and collaborations with experts are shared.
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Importance of digitization for functional medicine analysis.
39:23Emphasizes yearly full uploads and quarterly blood testing for health insights.
Sugar labeled as a poison, with recommendations for optimal sleep, exercise, optimism, and proactive disease detection.
Introduction to rapamycin as a potential longevity drug, ongoing research, and clinical trials.
Personal experiences and expert opinions on rapamycin's benefits and safety shared.
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Importance of Supplements and Diet in Longevity and Health.
43:21Eating beans, walnuts, and olive oil can have significant benefits for overall health.
Senescent cells are discussed as a potential cause of cancer and inflammation.
Celytic drugs show promise in targeting senescent cells for improved lifespan and healthspan.
Research efforts into celytic drugs face challenges and failures in the biotech industry.
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Challenges in developing cancer drugs involve targeting bad cells while sparing good ones, with recent clinical failures showcasing complexity.
48:16Advancements in biotech drug discovery are centered on identifying the appropriate patient population and indication.
Aging science has progressed, with multiple clinical trials examining mechanisms that affect aging.
New tools, biomarkers, and AI are facilitating more precise clinical testing, aiding in selecting suitable patients for trials.
The industry is evolving with improved predictive methods for human response to treatments, enabling multiple hypotheses to be tested simultaneously and advancing precision medicine.
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Potential of AI in revolutionizing processes in fundamental biology, drug discovery, and clinical trials.
49:20Generative AI could lead to more efficient and cost-effective workflows in these areas, benefiting patient populations.
Emphasis on ethical deployment of AI, highlighting privacy protection and responsible use to avoid biases.
Development of small molecule oral medicines as a more tolerable and cost-effective alternative for weight loss therapies.
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Shift towards chronic treatments in medicine for healthy weight loss.
53:25Companies are developing medicines for extended use with focus on tolerability.
Need to prioritize healthy habits and address societal norms for effectiveness.
Longevity drugs should address entire body system to prevent larger healthcare issues.
Blue zones emphasize factors like nature, family, purpose, and spirituality for a fulfilling life.
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Advancements in Epigenome Resetting and Anti-Aging Drugs
56:50Research is aimed at resetting the epigenome to a younger age through gene therapy or drugs, potentially increasing lifespan.
Anti-aging drugs are expected to become more prevalent in the next 20 years, with a focus on longevity and the integration of AI.
Medical progress in refined stem cell therapies offers hope for diseases such as cancer, with positive results observed in patients post-transplant.
Future developments in healthcare hold promise for disease prevention and prediction, leading to an optimistic outlook on healthcare advancements.
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Importance of expressing gratitude in daily interactions.
59:14A simple "thank you very much" can go a long way in showing appreciation.
Gratitude can strengthen relationships and improve overall well-being.
Small gestures of thanks can make a big impact on others.
Taking the time to express gratitude can create a more positive and supportive environment.
00:01good morning everybody it's so wonderful
00:03to be here I have been a health
00:05journalist for 25 years and in that time
00:09most of what I've done is tell other
00:12people's stories that changed pretty
00:14dramatically last November when I got a
00:17call from Northwestern University I was
00:19told they had a new longevity study that
00:21was getting underway and a new longevity
00:24lab did I want to cover the initiative
00:26and better yet did I want to sign up to
00:29participate in it
00:30I thought about it for a while and about
00:33a month later on a very snowy day just
00:36before Thanksgiving I found myself on
00:38the elevator of the Northwestern
00:40Memorial Hospital I took it to the 21st
00:43floor got out it felt much more like a
00:46spa than a hospital I was looking out to
00:50the shores of Lake Michigan and for the
00:52next 12 hours I was poked and I was
00:55proded and I literally rolled up my
00:58sleeve for science had my blood drawn
01:01and they did dozens and dozens of tests
01:04for the purpose of trying to understand
01:06what was the difference between my
01:08chronological age which is the date on
01:11my birth certificate and my biological
01:14age which is my rate of Aging compared
01:17to my peers what I found out was
01:20fascinating and what the goal of the
01:22study is is to figure out what
01:24interventions can be made to slow down
01:28the rate of Aging which which is exactly
01:30the work of everyone on the panel here
01:33so to get this started I'm going to do a
01:35quick lightning round I'm going to do
01:37some quick
01:39introductions and I want everyone to ask
01:41the same question of themselves you guys
01:43all showed up here because the name of
01:46this panel is can I live to a 100 so I
01:49want each of you to think about that in
01:51your own minds and a quick lightning
01:54round up here to each of you do you can
01:57you live to be 100 and do you want to
02:01and we'll start down there with you Dr
02:03Lloyd Miner he's dean of the Stanford
02:05Medical School and a personalized
02:07medicine
02:08expert uh yes I think uh increasingly we
02:12can live to be 100 would we would I want
02:15to depends on whether or not I could be
02:17healthy and if I can cont continue to
02:19contribute to others got it Kristen
02:21Fortney she's co-founder and CEO of
02:24bioage uh which is a clinical stage
02:26biotech company basically developing
02:29drugs to extend
02:32lifespan um yeah just to add to that I
02:34think we can even move the average
02:36lifespan to 100 I think it will require
02:39scientific innovation new medicines and
02:41again we want to make sure that we're
02:43living healthier not just longer Dr
02:46Peter diamandis founder of the xprize
02:48and the new health span competition you
02:51are an author and a longevity expert do
02:55you want to live to be 100 I I think 100
02:58is a lowball
03:01offer very good
03:04120 uh
03:06let uh let's save that for the
03:08conversation later let's add a few
03:10orders not orders of magnitude but a few
03:12a few multipliers on that a few
03:14multipliers all right Dan I like that
03:16attitude yeah so so the average maximum
03:20life expectancy of the human species
03:22right now in other words if you have an
03:25average set of genes and you live in the
03:26developed world you can expect 94 years
03:29reaching 100 right now you have to have
03:31won the genetic Lottery but that said
03:34since 1840 life expectancy of humans has
03:37gone up about two years per decade so
03:39I'm 63 right now and I expect uh so if I
03:43expect the 94 I got coming to me but an
03:46extra two years per decade so I should
03:47be able to hit 100 right on the nose and
03:49I'd be very happy with that right on the
03:51nose I love that all right so Lord James
03:55bethl you are now in the House of Lords
03:57you were minister of health during the
03:59pandem mic um you're very interested in
04:01how to incentivize Healthy Lifestyles in
04:03the UK do can you live to 100 and do you
04:07want to yeah no it's my full intention
04:09I'm I am working on it the amazing thing
04:11about the House of Lords is it's a job
04:13for life you you have it till you die I
04:15can't tell you how good peers look the
04:18members of the House of Lords are so
04:21motivated and have such a strong sense
04:23of mission about their roles that they
04:25really live forever it seems my my
04:28office mate is 94 years old and he's
04:30still going strong and that's that's
04:31definitely my full intention it shows
04:34the sense of mission is so important to
04:36getting people to live up for a long
04:38time uh Peter Health span longevity is a
04:42mega topic right now something everyone
04:45is talking about uh if we could think to
04:48living to 120 when can we start to see
04:51this is the science of aging and
04:54Longevity is it going to propel us
04:57forward in this decade so let me let me
05:00interpret that in a different way and
05:02say why
05:03now um so two reference points I agree
05:07with everything Dan said uh you know
05:11you've got a few species on this planet
05:13like the boohead whale that can live to
05:15200 years and the Greenland shark that
05:17can live to 500 years have babies at 200
05:19years when I was in medical school I
05:21asked the question why can they live
05:23that long and why can't we and I said
05:25it's either a hardware problem or a
05:27software problem and it's this decade
05:30that we're getting the tools to
05:32understand how to address the software
05:36and the hardware problem and so the why
05:38now comes down to three or four reasons
05:41one there's more Capital going in year
05:43on year on year people have finally
05:45realize they can't take it with them
05:48that's a a big win the second is the
05:51whole AI Revolution uh Ai and Longevity
05:54as we were discussing are converging
05:56Quantum technology quantum chemistry
05:58that's coming the second half of this
05:59decade
06:00uh Advanced Diagnostics to catch disease
06:03at stage zero and then a whole onslaught
06:06of Therapeutics and so those things all
06:09coming together hopefully will get us to
06:12what's called Longevity escape velocity
06:15which is today we're at you know two or
06:17three years per decade there'll be a
06:19point that for every decade you're alive
06:21science is adding more than a decade to
06:23your life so when people say what's your
06:26what's your longevity goal you know I
06:27used to say 700 years I now say to get
06:30to longevity escape velocity got it
06:32there's sort of two sides to this coin
06:35there's the behavioral side what can we
06:37do right now to be healthier through our
06:39daily habits um then there's also the
06:41Cutting Edge technology biotech Kristen
06:44I'm going to come to you next your
06:46company is now partnered with Eli Lily
06:49to run a stage two a phase two clinical
06:51trial looking at combining a compound
06:55that you have identified in your company
06:57and combining it with one of the gp1
07:00Agonist drugs which are the Blockbuster
07:03weight loss drugs do you now see this
07:06class of medications these these weight
07:08loss drugs as potential longevity drugs
07:12yeah that's a great question and
07:14certainly if you think about what
07:15longevity drugs are on the market today
07:17um they're they're arguably the best
07:19ones we have in the sense that they have
07:20the chance to move the average lifespan
07:22of the entire population right they
07:25probably can't do much for you if you're
07:26already in great shape but but half of
07:28America isn't and these drugs as you
07:30know are not only you know causing
07:33weight loss but they're also protecting
07:34you from cardiovascular disease
07:36protecting you from from Parkinson's
07:37even that was the most recent finding
07:39which I think was a surprise a
07:40surprising finding even for the
07:42scientists in the area and and what I
07:44love about that uh as a scientist
07:46working in the Aging area is that those
07:48of us trying to build companies in this
07:49space are really inspired by the idea of
07:52building medicines that don't just treat
07:54disease once you're already very sick
07:56but that have the potential to prevent
07:57or delay disease and you know until a
08:00couple years ago the best example I had
08:03of a therapeutic that was actually like
08:05that was a Statin um statins were first
08:07approved for a rare orphan disease it
08:10took 20 years for them to be used in the
08:12way they are today where they're
08:13actually used by most older people to
08:15delay disease um but now there's the
08:18incret tense these glp1 drugs Manjaro
08:20and Wavey um that are making an impact
08:23really quickly and I think are
08:24increasing the appreciation of of the
08:27power of medicines that can really delay
08:29disease and this is the area that we
08:30work into at bioage and you're going to
08:32be able to get an answer to your
08:34question pretty quickly of a clinical
08:35trial starting and within a year you're
08:37going to know something is it right
08:38that's right so so again those of us
08:40working on Aging medicines too you know
08:42if you have a drug you think it has the
08:43potential to slow aging what do you
08:45actually do in a clinical trial you
08:47can't actually see if your drug makes
08:48people live longer you don't want to run
08:49a clinical trial for for 10 years that's
08:51not practical but you want to go to a
08:53particular disease first and we really
08:55like obesity because it is a condition
08:58that does accelerate many facets of
09:00Aging especially in older people where
09:02you have increased risk of
09:03cardiovascular disease increased risk of
09:05diabetes and where yes you can prove
09:07efficacy really quickly um so our lead
09:09program has the potential to increase
09:12weight loss in an oral form and also
09:14promote healthy weight loss and and
09:16these trials take about a year and a
09:17half yeah great Dan I want to move over
09:19to you let's talk a little bit about the
09:21communities and how Community shapes
09:23help you have identified places where
09:26people are more likely to live to 100
09:28okanawa aara the NOA peninsula in Costa
09:32Rica um these are places that are
09:35usually sort of rugged far off the pace
09:38of life is very simple the way people
09:40eat is very simple it's night and day
09:42from the 247 lifestyle that many of us
09:46have here do you think it is possible to
09:48export what you have seen in these blue
09:51zones as you've called them and bring it
09:53here to this modern culture that we're
09:56living in I I know it is and and the
09:59value proposition these blue zones at
10:01middle-aged people are living in extra
10:0310 years so this isn't a theoretical or
10:06algorithmic hope it is real human beings
10:09with an average set of uh genes who are
10:12suffering one5 rate of cardiovascular
10:14disease in some cases one six the rate
10:16of type two diabetes and by the way it's
10:18those diseases that are driving about
10:2080% of our $4.4 trillion annual health
10:24care cost um so what what I've tried to
10:27do is find out exactly the the
10:30constellation of policy and nudges and
10:34uh uh lifestyle characteristics and uh
10:37bring them to American cities I've
10:39worked now in 20 American cities with
10:41these uh uh publicly supported privately
10:44funded blue zones projects where we
10:47don't try to go into a city of a million
10:49people like we did with Fort Worth Texas
10:51and convince them to eat peasant food or
10:54to uh walk or or to uh to um um you know
10:59get on a certain set of supplements or
11:01drugs we simply change their environment
11:05so to engineer their unconscious choices
11:08so they're silently nudged into moving
11:10more eating better socializing more and
11:13living their purpose and when you look
11:15at the policy environment restaurants
11:17grocery stores workplaces schools and
11:20then individuals home and you hire a
11:22group of people who focus on that for
11:24five years in every case as measured by
11:26galp we've seen the BMI go down
11:29healthcare costs go down and life
11:31expectancy go up real people not only
11:33rich people who can afford heroic
11:35interventions but poor people where I
11:38think the great the greater opportunity
11:40lies but there's an uphill battle here
11:42right I mean right now in the United
11:44States 100 million Americans have
11:46pre-diabetes by age 50 half have these
11:49lifestyle related chronic diseases do
11:52you think it's possible at this point to
11:56take people who are inured in this
11:58environment and help them make these
12:00personal Lifestyle
12:02Changes yeah I you cannot rely on
12:05individuals you know we we we spend $150
12:10billion dollar on diets and if you look
12:12at the very best diets uh they start out
12:14with a lot of steam but uh you lose
12:16about 90% of them in seven months and
12:19you lose 90% of them in two years so
12:20diets AR aren't working exercise
12:22programs you pe start in January you
12:24lose about 80% by the end of the year
12:27even if we'd come back from the Blue
12:28Zone with a pill or a supplement
12:30guaranteed to reverse aging if you look
12:33at the recidivism curve of
12:34pharmaceuticals you would lose almost
12:36all of them within about four years of
12:38people starting to take drugs so the
12:41answer really is not trying to convince
12:42people to change their mind or change
12:44their behavior it's changing their
12:47surroundings and the reason I know that
12:48would work uh in the 1980s many of us
12:52were alive then uh we had about uh
12:55onethird the rate of obesity one6 the
12:57rate of type 2 diabetes that isn't
13:00because they had better longevity
13:01programs or they had better supplements
13:03or because they they they had you know
13:06they were more disciplined better people
13:08uh the the environment then was we spent
13:12about a half the amount of time we spent
13:14in our cars today there were about 12th
13:16as many fast food restaurants and we
13:19didn't have groceries showing up at our
13:21front door uh we had to actually go out
13:23and shop and interact with our neighbors
13:25and carry our groceries out uh that you
13:27know I I believe in what Peter
13:29and my other panelists believe in I
13:31think there there is a going to be a
13:33time when we're going to have a major
13:34breakthrough um we can't see it yet uh
13:37the pace of Discovery is such that
13:39they're probably right but until then uh
13:42Americans could all get about 10 extra
13:44years of life expectancy and slash our
13:47annual health care cost I think by
13:49paying close attention to these
13:51populations that actually achieve the
13:53outcomes we want James I have heard you
13:56call the National Health Service in the
13:59UK the national sick service yes uh here
14:03you will often hear people say that the
14:05US healthare system is not health care
14:07it's disease care talk a little bit
14:10about what you mean by what you see in
14:13the National Health Service and what the
14:14problem is as you see it so we have many
14:16of the same problems in the UK as the US
14:19uh particularly around things like
14:20obesity cardiovascular respiratory
14:23diseases and that the underlying drivers
14:25of that are often overweight Hy
14:28potential
14:29um lack of activity it's the environment
14:32that people live in that is really uh
14:34affecting their long-term um uh
14:37longevity and if we're going to give
14:38team longevity the best chance of escape
14:42velocity we need to put pretty um uh
14:45healthy people into the hopper in the
14:47first place and that's not going to
14:49happen if they're in a um sick
14:51environment so we're actually going
14:53quite a lot further I do agree with Dan
14:54about the importance of of um uh the
14:57built environment but we are doing taxes
15:00on sugar we're bringing in a smoke-free
15:02uh Generation Um law that prevents
15:05younger people from Ever picking up
15:07smoking we're bringing in gambling
15:09profits taxes uh we're doing a whole
15:11bunch of quite big interventions to try
15:14to improve the environment and the
15:15interesting thing about it is that they
15:17have very strong political support from
15:21families from voters from taxpayers the
15:23penny has dropped amongst the the
15:25British voter that we can't live in this
15:28environment that making everyone sick
15:30and creating a huge Dropout from the
15:32workforce that's hitting our envir our
15:34economy really hard so ultimately I'd
15:36like to see some hospitals close and I'd
15:39like to see some taxes bent on the kind
15:41of prevention me measures that we were
15:42talking about earlier you would like to
15:43see hospitals closed oh for sure people
15:45don't like hospitals you know I I was in
15:47an election in the UK in 2019 when Boris
15:50uh won the election and our big
15:53commitment was we were going to build 40
15:54new hospitals and and we thought that
15:56that was a piece of sort of electoral
15:58genius and and did work NHS um worked
16:01very well for the conservative party
16:03when the pandemic came no one wanted to
16:05go to the hospitals and since then
16:07attendance at hospitals has dropped off
16:09a cliff people want to be healthy they
16:11want to be treated in their communities
16:12they want to live in an environment
16:14where the healthy choice is the easiest
16:15choice and so yes I would definitely
16:17like to see some hospitals close Lloyd I
16:19want to move down to you you are dean of
16:21the Stanford medical school and training
16:22a new generation of doctors when you
16:25think about this how is the curriculum
16:28changing or the thought process changing
16:30to try to train doctors in preventive
16:33care and do you think within your
16:35lifetime doctors will be prescribing
16:38longevity regiments or anti-aging drugs
16:42sure well to pick up on some of the
16:44points that U the other panelists have
16:46made I think you know in the United
16:48States we really have a sick care system
16:50not a Health Care System just as James
16:52was describing in the UK and um you know
16:57that making that transition is both a
16:59transition and how we deliver healthc
17:00care it's also a transition and how we
17:03think about doing and applying the
17:05science uh related to biomedicine in a
17:08more predictive and preventive way and
17:11that really begins with the research we
17:13do at academic centers and companies and
17:15other places and also the way in which
17:18we train the next generation of leaders
17:20both leaders in terms of the delivery of
17:22Health Care and also leaders in terms of
17:24driving biomedical research you know a
17:27lot of the the fundamental science and
17:30the early translational science that
17:32we've used to develop so many new
17:34Therapeutics and and it's it's important
17:36not to take for granted that um the
17:38advances we've seen over the past 10 12
17:41years in cancer for example with
17:43immunotherapy you know eclipse what we'd
17:45seen in the previous 30 years and we're
17:47only at the very beginning so we
17:50shouldn't turn our back on improvements
17:52in sick care but those same advances and
17:55those same approaches can be applied to
17:59developing better predictive measures
18:01developing better early interventions or
18:04even uh preventing disease entirely
18:06through understanding the mechanisms
18:08that ultimately lead to the development
18:09of disease and then finally back to the
18:12medical education front you know we we
18:15have to also look rigorously at the
18:18social behavioral and environmental
18:20determinants of Health uh a lot of the
18:23comments made already on the panel today
18:26uh have underscored what an important
18:28role those determinants play maybe 60
18:3070% of our determinants of Health come
18:33from social behavioral environmental
18:35determinants the rest from the medical
18:37care we receive and our genetics but we
18:40need to devote the same degree of
18:41scientific RI rigor and educational
18:43rigor to understanding those
18:45determinants and developing more
18:47affirmative
18:49interventions um in addition to talking
18:51about them and studying them uh and
18:54making the statement about their
18:55importance it's still a sad fact in the
18:57United States that
18:59the zip code in which a person lives is
19:02a better predictor of their life
19:04expectancy than their genetic code um we
19:07know some of the reasons for that but
19:09we're not we haven't devoted nearly
19:11enough attention to the science behind
19:14the interventions that can be effective
19:16at addressing those reasons say more
19:18about the the ZIP code I I came across
19:20this in some reporting I've done
19:22recently I was looking at the average
19:23life expectancy in uh Princeton New
19:25Jersey 92 years old you could put a
19:29ladder up in princet New Jersey and look
19:30down to a much poorer part of the state
19:32and see a zip to a zip code where people
19:35are likely to live 20 years to 70 or so
19:39so 22e difference in life Stan in zip
19:41code say a little bit more about how
19:44these social determinance of Health play
19:46such a big
19:47role sure well there are a variety of
19:50social determinants but uh the access to
19:52food supply the the access to physical
19:54safety in uh environments U that have
19:57high crime rat are associated of course
20:00with uh higher rates of gun violence are
20:02associated with lower life
20:04expectancy uh but you know back to what
20:08Dan was saying and it's it something
20:10that I think is really impressive about
20:12the work that Dan many things uh but
20:15impressive about the work that Dan and
20:16colleagues are doing how do we look at
20:18how do we learn from Blue zones uh we
20:21might call them indigenous blue zones
20:23and how do we take the principles and
20:24apply those in areas where maybe we'
20:27never thought they be applicable but I
20:29think as Dan and colleagues have shown
20:32um there are many principles that can be
20:34implemented uh in cities uh in
20:37communities that that haven't had the
20:39same access uh to resources that other
20:42communities have had uh and can be
20:44effective it takes Community engagement
20:47and I think back to your point on
20:48medical education you know how do we
20:51educate a generation of Physicians that
20:53yes uh understand the science and have
20:56every bit the scientific rigor that
20:58underpins the practice of medicine day
21:01but also see the way in which that
21:02science and that healthc care is
21:04deployed in
21:06communities Kristen I want to move on to
21:08you one of the surprises that I got uh
21:11at Northwestern University when I did
21:13the battery of tests as part of the
21:14longevity study is that I it turned out
21:17that I am very uh under muscled so my
21:21BMI is fine but when I went into a b pod
21:24and had my body composition analyzed I
21:27don't have enough muscle um and it turns
21:30out most many many women in my age don't
21:33sarcopenia is a growing problem in the
21:35United States you don't hear much about
21:37it but it's simply age related muscle
21:39loss so I've been lifting weights and
21:42and doing a bunch of resistance training
21:44to try to try to tackle that but Kristen
21:47you got my attention up last night when
21:49you were telling me that the compound
21:52you've identified you call it Azel prog
21:54is that right AEL prag AEL prag okay it
21:57is that you'll be testing with the gp1
21:59drug that it seems to mimic some of the
22:03effects of exercise in the body and may
22:05help promote better body composition is
22:08that right um yeah so a zeela prag is
22:11our lead compound and it's focused
22:13around a a molecular pathway called
22:15apelin signaling and apelin it's one of
22:17these molecules that your body makes
22:19when you're exercising and it's been
22:21shown um by some other scientists that
22:23if you add apelin to to an animal it can
22:26help recapitulate some of the benefits
22:27of exercise improved metabolism better
22:30mitochondrial biogenesis in your muscle
22:32and this is a pathway that in the human
22:34data sets we analyzed we saw a link to
22:36longevity but also better physical
22:38function as you age so we were initially
22:40really excited about this molecule for
22:42its potential in aging broadly and in
22:45sarcopenia um because as you mentioned
22:47this is really uh underappreciated
22:49everybody loses muscle mass as they age
22:52and this is really the key driver of
22:54loss of independence of ultimately being
22:56committed to a nursing home and
22:58importantly too it can be part of really
22:59a negative feedback cycle right like if
23:02you lose more muscle you're not going to
23:04exercise as much you're not going to
23:05walk as much you're going to lose even
23:06more muscle and this can have really
23:08dramatic consequences and just to give
23:10you an example um older people who
23:13suffer from a hip fracture um that
23:15dramatically increases your risk of
23:17dying in the next year and it's not
23:19because of your bone in every case the
23:21the bone usually is fully healed but
23:23it's because you're a mobile uh for so
23:25long at a stage of your life when
23:27atrophies really very much accelerated
23:30so this is an area that I think has been
23:32really understudied uh that has a lot of
23:34potential to improve the health of Aging
23:36populations and talk a little bit about
23:38your Discovery platform how is it that
23:40you were able to identify this compound
23:43and see its
23:44potential yeah so we invested a lot in
23:48creating large human data sets that are
23:50relevant to aging biology and the reason
23:53being is that we think this gives us
23:54more confidence in the translational
23:56potential of a mechanism and what I mean
23:58by that is that you might have a drug
24:00that works really great in the lab it
24:02maybe doubles the lifespan of your worm
24:04or maybe even your mouse but is it going
24:06to work in a human who knows like we're
24:07so very different and in lots of areas
24:10of biology um human data sets have
24:13helped with translation to the clinic
24:14with clinical success this is why you've
24:16seen Amgen by like decco genetics or why
24:19the UK bio bank is such a wonderful
24:21resource so we've invested in creating
24:23data sets that have um that long
24:26longitudinal followup like really you
24:28want to have samples and health records
24:30spanning several decades of people's
24:32lives um to help us get excited about
24:34certain mechanisms and part of the
24:36rationale too I think is that we want to
24:39try to copy things that already work
24:40right I'm more excited about about
24:42Pathways that mimic the effects of
24:43exercise because Exercise Works right it
24:45it helps us live healthier longer I'm
24:47more excited about Pathways that are
24:50differently expressed and people who are
24:52living a lot longer already um either
24:54because they have the right genes or the
24:56right diet or the right exercise regimes
24:58um so we use human data to help us get
25:01um excited about the translational
25:02potential of medicines like Aela and is
25:05there a US biobank similar to the UK
25:07biobank or where are you getting your
25:09your blood samples and all this data
25:11yeah we work with a few biobanks like we
25:13have we're looking for biobanks
25:15basically that are like UK biobank or
25:17decode but with one really important
25:19difference they have to have started
25:20collecting sample when people were
25:22middleaged and healthy and they have to
25:23track them for their entire rest of
25:25their lives this is actually really hard
25:27because everybody knows biobank is a
25:28great idea today 50 years ago not so
25:31much um but there's a few you know
25:33really forward-looking biobanks we have
25:35some collaborations with ones in the US
25:37uh in in Norway and Estonia uh and we
25:40look at those together and you literally
25:41have Frozen blood samples from 50 years
25:43ago yes these biobanks have um Frozen
25:46blood samples that are 50 years old
25:47which is amazing right because 50 years
25:49ago you couldn't do very much in those
25:51and today you have Technologies where
25:53you can go and look at like 11,000
25:55different proteins and measure those in
25:56those samples or thousands of metabol
25:58you can make a big list of all the
26:00molecules in the blood and these are
26:01technologies that didn't exist 10 20
26:03years ago yeah so Peter you founded the
26:07X prize the latest iteration of this is
26:10a health span competition talk about
26:12what the goal of the health span
26:14competition is uh who's enrolled and
26:17what the ultimate uh how you'll
26:19determine a winner sure so uh those of
26:23you who don't know the X prize this year
26:25is 30 years old we've launched 30 prizes
26:28uh about almost $600 million in
26:30incentive competitions that have driven
26:32tens of billions of dollars in
26:35R&D um about six years ago we started
26:38the conversation we're always looking
26:40for what's an area that isn't moving
26:42fast enough or where we could
26:44incentivize people that take bigger
26:46risks to drive a breakthrough right
26:49large organizations large corporations
26:52governments don't like trying crazy
26:55ideas because they have a high failure
26:57rate and if you have a high failure rate
27:00then you've got people criticizing you
27:03but the day before something is really a
27:05breakthrough it's a crazy idea so if
27:08you're not trying crazy ideas where do
27:10you try and get some significant
27:13breakthroughs so incentive competitions
27:15are a mechanism to drive that and we
27:18turned our eyes towards uh the field of
27:21longevity and realizing we can't run a
27:23competition for 30 years we said okay
27:26let's instead look at age reversal as a
27:29Target and then looking one step further
27:32it was can we look at in fact as you age
27:35you lose function you should know this
27:38your body was never designed to live
27:39past age 30 if you're over 30 you're on
27:41a very slow decline that's just you know
27:44thank Evolution for that uh but your
27:47immune system degrades your cognitive
27:49function degrades you have sarcopenia
27:51muscular degradation your homone segr
27:53all these things are just going downhill
27:55and it's pretty predictable so the
27:57question was could we ask teams to
28:02actually reverse functional loss because
28:05we can measure function easy and we
28:07decided to focus on three areas uh
28:10muscle um sarcopenia muscle is like the
28:13most important thing if you're over 60
28:15working out and maintaining muscle is
28:18the number one thing you can do in your
28:19life over everything else so please go
28:21to the gym tomorrow
28:23morning um the second thing besides
28:25muscle is uh immune function can we
28:29increase your immune function back to an
28:31earlier state which is really fighting
28:34cancer and fighting infectious disease
28:36and the third was cognitive because no
28:38one wants to be you know 150 drooling in
28:40a wheelchair and so we announced this
28:43competition the goal is you have to
28:44reverse function loss by at least 10
28:47years and with a goal of 20 years um I
28:50raised 141 million in capital for this
28:54there's 111 million in prize money uh
28:57one gentleman uh uh uh the founder of
29:01Lululemon um chip Olson put up the first
29:05uh third of that money because he's got
29:06a sar he's got a a muscular distrophy
29:09that he's looking to solve and then huci
29:12put up another third of this and we have
29:15about 300 teams entered I hope to get
29:17that to a thousand teams Kristen you are
29:19registering soon yes definitely okay
29:22good uh and uh the competition will go
29:25through 2030 uh we hope we'll have
29:28solution there so again this is all
29:30about you know reaching longevity Escape
29:32veloc if I can give you your cognitive
29:35muscular and immune function that you
29:38had 20 years earlier that's going to
29:40give you the ability to continue to
29:42function life to intercept the next set
29:45of breakthroughs we're a very important
29:47part of this longevity curve so uh
29:50that's what we're doing with the uh the
29:51ex prise right now so as we are waiting
29:54for breakthroughs I'm interested in what
29:57you will think about the longevity packs
30:01that are kind of hidden in plain sight I
30:03know for me personally as I've read a
30:05lot of literature and and interviewed
30:07many many experts as part of my
30:09longevity series at NPR one of the
30:11things I was struck by is there's some
30:13pretty convincing data on the power of
30:18optimism right yeah like isn't that
30:20hidden in plain sight isn't that
30:22something that what yeah pardon me power
30:24of what the power of
30:26optimism yeah right so people who have a
30:29set point of optimism live about 15%
30:32longer can I give you the numbers yes it
30:34was a study published in the National
30:36Academy of Sciences 69,000 women 1500
30:40guys uh and uh it was shown that
30:43optimists live on average 15% longer
30:45than pessimist so it's a double benefit
30:47right it's like really great to be an
30:49optimist and you live longer I mean
30:52what's to lose I mean there's toxic
30:53optimism right like if you're just
30:55completely not seeing reality but the
30:58the thing that really struck me about
30:59the optimism is along with that there
31:01have been a series of studies published
31:03that um are called best personal self-
31:06study so people think oh you know you're
31:08either an eore or your happy and Rosy
31:11personality that it's a set point that
31:12you can't change turns out you can
31:14there's actually three or four studies
31:16to show that you can move the needle on
31:17optimism by practicing these exercises
31:20of best personal self so again you know
31:23these are are things that are hidden in
31:26plain sight they're things that we can
31:27do do every day when you think about the
31:30loow hanging fruit of of longevity and
31:33habits that are linked to longevity what
31:36are your what are your best hacks so I I
31:39was just um in Italy I'm doing another
31:42project I found the area working with
31:44global burden of disease found the areas
31:46where people live the longest Health
31:47adjusted life expectancy so they're uh
31:51living about up to a dozen more years
31:53than Americans are without disability
31:55and without chronic disease and it's
31:57only this one region in Italy so I start
32:00looking around what are they doing as
32:01producing this and I had to go back in
32:04history and it went all the way back to
32:06Pope cisto I Pope cisto v um took over
32:12this particular area and he didn't want
32:15any big land owner to upur him power so
32:18he gave all the peasants a little piece
32:20of land and to this day when you drive
32:22through this area it looks like a green
32:24patch
32:25word like a huge green quilt
32:28so you start asking around what people
32:31do with their lives and it turns out 93%
32:35of people have their own
32:37garden so what does a garden mean Garden
32:40means that every day you're out watering
32:43you're out uh and by the way none of
32:45them go to the gym there's no gyms in
32:46this that I know of uh there's no
32:49Pilates studios there's no yoga studios
32:52uh but everybody has a garden so every
32:54day they're out watering or weeding low
32:58intensity physic digging harvesting and
33:00they emerge from this activity with what
33:03stronger legs stronger legs fresh
33:06vegetables strawberries and so it's this
33:10Plain Sight accessible to almost every
33:12American either in your backyard or in a
33:14public garden and We Know It lowers
33:16cortisol kind of closely associated with
33:18the feeling we get from optimism regular
33:21low intensity physical activity we all
33:23know we should be eating more fruits and
33:25vegetables why isn't there a garden
33:27intervention at the at the national
33:29level same is true in the NOA Peninsula
33:32right lot a long history of small
33:34shareholder F that's right middle yes
33:36yeah what do you think what is a
33:38longevity hack the sort of hidden in
33:40plain sight well I I think that optimism
33:43point is is key and it's a really big
33:45problem for policy makers for
33:47governments so a conference like this
33:49where we're we're talking about health
33:51care you know we should really be
33:52talking about uh the communities and the
33:55families that that we're trying to Cate
33:58and create an environment for and
33:59there's a link here with fertility as
34:01well longevity and fertility are a lot
34:03about a belief that your world is going
34:05to get better and that your children
34:06will have a better life than you will
34:09yourself at the moment uh governments
34:11are thinking more about building
34:13hospitals and trying to acquire more
34:16drugs and nurses I think the challenge
34:18for us is to try to match uh policies
34:23that support families communities
34:27Gardens as well as Health Care Systems
34:30that treat the sick so rebalancing the
34:32NHS budget well it's all tied together
34:35and and the doctors of tomorrow not only
34:38will they be prescribing they'll be
34:39handing out bags of carrots in order to
34:42try to encourage people to eat more
34:43healthily and to rebalance their uh
34:46their diet that may sound far-fetched
34:48but having a more holistic approach to
34:50health encouraging the gym encouraging
34:53healthy eating encouraging um uh uh
34:56confident families that's where a lot of
34:58the strength we're going to get from not
35:00just from the uh longevity drugs and the
35:03um very excellent xprize type hacks that
35:06we're going to see in the future right
35:07and Lloyd there's lots of initiatives
35:09Now new data on food is medicine
35:11programs incorporating food and and
35:14nutrition into the delivery of Health
35:17Care Systems where do you see this going
35:20well I think it it's got uh huge
35:23potential and and huge necessity um you
35:26know we are what we eat uh I think we've
35:29not only in medicine but just in society
35:32r large and and part of this
35:35transformation you know we need to be
35:37leading in terms of the health care we
35:39deliver but also importantly we have to
35:41change societal attitudes about health
35:45and and responsibility because yeah I
35:47think in in our country and United
35:49States in particular we've had a very
35:51passive approach in general I mean uh
35:54people understandably want to know that
35:57if they're sick they go to a healthc
35:59care provider and that healthc care
36:01provider is going to work with them and
36:03do everything they can to cure their
36:05illness or or to Forstall its
36:08development and to restore them to
36:10health um we've had far less emphasis on
36:13well what can each of us do as a
36:16healthcare consumer to maintain our
36:18health and the first step is in what we
36:22eat and monitoring what we eat and
36:25eating healthily and then as Peter was
36:27saying exercising in any number of
36:30different ways uh but the steps are
36:33seemingly straightforward but it
36:35involves a big cultural and attitudinal
36:37shift I think in terms of the way we as
36:41individuals in our society interpret
36:44health and responsibility for
36:45maintaining Health right there's a big
36:47gap between the knowing and the doing we
36:50know that we're supposed to sleep get a
36:52lot of rest eat well exercise but
36:55Society seems to push us in the other
36:58direction do you I think that's right I
37:01mean I said it before but the healthy
37:03choice is very often the most difficult
37:05Choice it's easier to order a Domino's
37:07delivery uh than it is to cook a meal
37:09and I think uh the medicines that we're
37:12creating and the therapies for extending
37:14life they're going to be fantastic but
37:16they won't work if they're building on a
37:18fundamentally unhealthy depressed
37:20population so in order to help the
37:23longevity people we need to fix these
37:25societal issues and to step in into the
37:27vested interests that are uh creating so
37:30many problems for for the health of our
37:32country Peter I want to ask you I've
37:34read your longevity book you are very
37:37open about all of the things that you
37:39you are experimenting with or trying in
37:40your own body uh you've told me that you
37:42take rap ayin um you list some
37:46supplements that you used one is called
37:48kettin or kettin um as I read it I was
37:52sort of wondering like how does he know
37:54because he's layered so many things
37:56together that you're trying simultaneous
37:57L how do you know which ones are are
38:00working or helping and and which ones
38:02aren't that's a great question my mom
38:04asked me the same
38:05question are you sure you she do great
38:09um a few things uh number one I'm on a
38:14constant Discovery Mission like like Dan
38:18like everybody here so every year for
38:20example I do um I go one year to the
38:23east coast one year to the West Coast
38:25and I go and I meet with the top 40 50
38:29scientists uh entrepreneurs in the
38:32longevity space I bring a number of
38:34family offices with me who are investing
38:36in those companies and it's a it's a
38:38great discovery of like year on year
38:40leveling up what are the latest
38:42breakthroughs where are things going um
38:45and so from these longevity Platinum
38:47trips I'm constantly
38:49learning the second thing is uh Tony
38:52Robbins and I and Bill cap built a
38:55company called Fountain life um
38:59uh that is sort of the most advanced
39:02Diagnostics and Therapeutics so what we
39:04do there is we digitize people we upload
39:08them it's 150 gigabytes of data it's
39:11everything knowable about you all
39:12Imaging all omix everything and all of
39:17that gets fed in on a functional
39:19medicine base to the Physicians and I do
39:23that full upload once a year and every
39:25quarter this is for me tomorrow morning
39:27uh a series of blood testing and I'm
39:30constantly measuring and and and moving
39:35the what's going on and so that gives me
39:38Insight okay right um there's a photo
39:42they're going to put up so I wrote a
39:43book with Tony Robbins which was 700
39:45Pages called uh life force which no one
39:48reads 700 Pages it's a great book it was
39:50New York Times bestseller for two months
39:52I put 120 page summary version of that
39:57um and this is in the form of diet sleep
40:01exercise mindset Med supplements and not
40:04dying from something stupid so I give
40:06out digital copies of this I mean the
40:08summary is sugar is a
40:10poison period end of statement your body
40:14was never intended to consume that much
40:16sugar it's a it's a neuroinflammatory
40:18cardiac inflammatory it's just not good
40:21you need eight hours of sleep you need
40:23exercise be optimistic the final thing
40:27is is and this is probably the most
40:29important your body is really great at
40:31hiding disease it's really great at
40:34hiding disease you don't know until you
40:36look 70% of all heart attacks have no
40:39precedent you don't feel a a cancer or
40:43IM active cancer till stage three or
40:44stage four right how many of you know
40:47someone who went to the doctor and said
40:48I'm sorry to tell you this but it didn't
40:50happen that morning right we don't test
40:52for most of the cancers that end up
40:53killing you gleo blastoma or or uh
40:57pancreatic cancer right so how do you
40:59know you've got to look right and people
41:03say I don't want to know you
41:05want to know you're going to find out
41:07eventually you want to know now or when
41:09it's too late so I urge you through
41:11whatever mechanisms if you're here in
41:13the
41:14room you can afford to be looking there
41:17are lots of different places you can go
41:18Fountain life is just one of them please
41:21look I I'll leave it at that I want to
41:24ask specifically about rap aasin because
41:26I think there's a lot of intrigue and
41:28mystery around it um and there's lists
41:32constantly being published of Silicon
41:33Valley Valley billionaires taking rap
41:35ayin and and and sort of looking at this
41:39from the outside wondering why are why
41:41are people taking rap Amin what's the
41:43evidence for it and will there ever be a
41:45clinical trial to determine if it is a
41:48longevity drug so I I'll add a little
41:51bit and I welcome my my panels here so I
41:54take uh six milligrams once a week right
41:58this is not an immunosuppressant level
42:01and the work that's done if you look I
42:03mean across scientists it is probably
42:05rated the number one most likely to be
42:09pro- longevity the the studies have not
42:11been completed yet but it it began as a
42:14drug to for transplant patients and it
42:17it would suppress immunity but you're
42:19saying that the dose you're taking it it
42:20does not anybody want to add to
42:24this anybody else taking a wrap my on on
42:27the table here no no okay so um uh the
42:32studies are hopefully being kicked off
42:34this year I know the buck is looking to
42:35get that study funded um and right now
42:39again in animal studies in large animal
42:41studies rapas in is a prolongevity um I
42:45used to be on Metformin I stopped taking
42:47metformin I switched over to berberine
42:49because my mission last year was to add
42:5110 pounds of muscle which was not easy
42:54but I did but I did it and it's I raised
42:57my protein intake 150 grams one gram per
42:59pound I work out 5 days a week I added
43:02you know other essential amino acids and
43:04other elements but it was a mission that
43:07it was like my number one objective to
43:09do that that and eight hours of sleep
43:12Dan I I have two revolutionary
43:15supplements to tell you all
43:18about if you look at the world's longest
43:21live people if you want to know what a
43:23centinary uh ate to live to be 100 you
43:25have to know what he or she were eating
43:27whole life with little kid middle AG
43:29lately and so we did a metaanalysis 155
43:33dietary studies done over the last 100
43:36years and we found that people who are
43:39actually making 200 eat a cup of beans a
43:42day it's associated with about four
43:45extra years of life expectancy so if you
43:47want to take a supplement take about 80
43:50black beans a day and if you don't like
43:52beans we also found that people who eat
43:55between 15 and 30 walnuts a day are
43:58living about three years longer than
44:00people who don't eat Walnuts and you
44:02don't even need a
44:03prescription all right how about olive
44:05oil olive oil I'm all for olive oil yes
44:08olive oil shots yeah yeah tell me about
44:11kettin kettin I mean there's kettin in
44:14in apples and in fruits why do you take
44:17it as a supplement I'm sorry for K
44:19kettin yeah so listen one of the things
44:21that's going on in the body right now is
44:24your your cells divide um about 50 times
44:28it's called the hayflick limit and at
44:30the end of that division uh it should
44:32have the decency to die sometimes it
44:35does not and it becomes a cancer cell
44:37where it's Immortal and continues
44:38growing other times it will become a
44:40scile cell and these scile cells are
44:43sitting around and generating
44:45inflammatory factors right in your skin
44:47in your liver and all of the organs of
44:48your body and keratin is one of in
44:52combination with other meds as well a
44:54syntic so the idea of can and their lots
44:57of different there's NK cell approaches
44:59there a lot of work being done right now
45:00in this can we give you a therapeutic
45:03that will go and kill these scile cells
45:05that are generating these inflammatory
45:07factors and and make the room for them
45:10to be replaced with younger more vibrant
45:11cells okay so sasin cells are cells that
45:14have stopped doing the work they're
45:15supposed to do but they're not dying off
45:17so they're flaking off little men cells
45:20is another name for them got it so
45:22there's a whole lot of research Kristen
45:24into drugs that could be cellytic drugs
45:27I was reading about a trial that turned
45:29out to kind of be a failure of a of an
45:32early candidate talk a little bit about
45:34sort of the the graveyard in in in in
45:38biotech like how many things are
45:40explored and don't kind of pan out is do
45:44we know everything we need to know about
45:45analytics or was just this particular
45:47compound not effective sure I mean I
45:49think cesson cells as a concept is are
45:52really well validated I think they've
45:53been described most vividly as as zombie
45:55cells right there's these cells that
45:57they're not doing anything useful and if
45:59anything they have toxic impacts on
46:00their neighbors and it's been shown by a
46:02lot of different groups that if you can
46:03take a middle-aged animal you can delete
46:06them somehow then that's actually hugely
46:08beneficial for function for lifespan for
46:10healthspan but the question is how do
46:13you delete those cells while sparing
46:14your Healthy ones and this is a tricky
46:16problem to solve it's the same reason
46:17why like my cancer drugs are tricky
46:19right you have to kill the bad cells
46:20while sparing the good cells and so most
46:23companies are still in the very early
46:25stages of figuring out out how to you
46:28know develop very specific medicines
46:29that can go in into an already old
46:32person with established U you know these
46:34cells throughout their body and
46:35specifically delete them um so there was
46:38uh yes one one high-profile clinical
46:40failure recently with the first such
46:42Target but keep in mind that you know
46:45these are these are early days right
46:46like
46:47biotech drug Discovery is hard you know
46:50it's a matter of finding out which
46:52Target to go after and you know
46:53selecting the right patient population
46:55and the right indication and and I think
46:57um Peter mentioned you said the right
46:59patient population is really important
47:01right because they might have been a
47:03success with a different population of
47:05patients that's right yeah and just to
47:06give you one example because this first
47:08drug that you know that had challenges
47:10in the clinic was really related to like
47:12was a cancer drug where there were some
47:13toxicity issues too potentially one of
47:15the really cool early science approaches
47:18is that your body when you're younger
47:19can clear this these cells on its own
47:21right so can we learn how that process
47:22already Works can we leverage that so I
47:24think we're going to see a lot more
47:25hypotheses tested rigorously in the
47:28clinic but but yeah just to emphasize
47:30right it's not only a matter of figuring
47:31out the right Target and the right
47:32medicine it's also the right patient
47:35population to sort of even see your
47:36effect right so these are all hard steps
47:38and this is really a very nent industry
47:41you know there's a ask researcher is
47:43this decade different than the last
47:45decade in terms of the tools you have to
47:48do much more per dollar per person yeah
47:51definitely in the clinic right so this
47:52is a area of science i' I've grown up in
47:55you know for my PhD Myst talk and then
47:57at the company and there's a few
47:59different things that are coming
48:00together at once once I think you know
48:02so so even separately from the
48:04technology angle aging science is mature
48:06now in a way it isn't before so there's
48:08like a dozen plus programs in serious
48:10well-powered clinical trials that are
48:12really testing you know mechanisms that
48:14have the potential to impact aging which
48:16is so exciting um but to your point
48:18Peter I think that the new tools are so
48:21enabling right because usually when you
48:24want to test a particular hypothesis
48:25especially if it's aging you know you
48:27have to go into a very large trial um
48:29and look for you know a small effect
48:31that might unfold over years uh and I
48:34think that with by by be able to select
48:36the right patients where they can have a
48:38large effect um biomarkers data sets AI
48:42are really helping us with early
48:44clinical drisking so it's all about you
48:46know doing your first trial to see that
48:48first hint of effect in a human because
48:50that's still like the challenge in
48:52biotech in general we're so terrible at
48:53predicting what happens in a human even
48:55if what works awesome and animal uh so I
48:58think that the new data sets the new
49:00methods the new human data in particular
49:02are helping us be very specific in the
49:04clinic which will let us test more
49:06hypotheses in parallel and Advance more
49:07medicines Lloyd you've written a lot
49:09about Precision medicine so as you
49:11listen to this is it possible that a
49:13cellytic drug that works in one person
49:15doesn't in another well you know just
49:19follow up on something that Kristen said
49:20we're we're 50 minutes into the
49:22discussion and Kristen just mentioned AI
49:25uh so I I do think that that we're at
49:28the cusp of a revolution all the way
49:30from fundamental biology being able to
49:33focus hypotheses even determine
49:35hypotheses or hone hypothesis from
49:37generative AI to accelerating processes
49:41of drug Discovery make making the
49:43processes that Kristen and colleagues
49:45work on every day more efficient more
49:48effective uh from both a time and a cost
49:51point of view and radically transforming
49:53the way we do clinical trials so that we
49:55can really glean an understanding of
49:58which population of patients would
50:00benefit from an intervention in ways
50:02that have been very laborious and and
50:05expensive and often ineffective in the
50:07past so I think the you know we're just
50:10now coming and I wouldn't say that we've
50:12come to grips with with how generative
50:15AI is going to change uh processes all
50:18the way from fundamental biological
50:20Discovery up through the design and
50:22conduct of clinical trials uh including
50:26by the way how we educate Physicians
50:28continuing to move away from a
50:30memorization B based curriculum and more
50:32problem solving and learning how to use
50:35the tools that are now at our fingertips
50:37but this is going to be a really
50:39exciting decade uh that I think is going
50:41to be transformed by by AI if we deploy
50:45it the way we should and that is
50:47ethically with a clear knowledge of what
50:50we need to protect at the top of the
50:52list is the Privacy the Primacy of
50:55privacy as well as the the responsible
50:57use of AI so that it doesn't perseverate
51:00and exacerbate the biases that already
51:02exist within the system mhm Kristen I
51:05want to go back to you and I think
51:06because there's such Intrigue about The
51:08glp gp1 Agonist drugs the woves of the
51:11world because they are Blockbuster class
51:14of drugs um I want to come back to you
51:17the compound that you're working on is a
51:19small molecule P compound you'll be
51:21testing it can be delivered in a pill um
51:25it also as you mentioned my mimic some
51:27of the the effects of exercise might
51:29help promote better body composition at
51:32a time when there's such discussion
51:34about these glp1 drugs from a cost point
51:37of view they're about
51:38$1,400 a month uh you hear a lot of
51:41stories of people who benefit greatly
51:44but also have gi distress or sort of
51:46lose their appetite um I'm wondering if
51:49you were thinking about your molecule as
51:52a potential kind of Maintenance molecule
51:55is this something that people could do
51:57after they lose weight um or is this
52:00something that will only work in
52:01combination for sure so we're still very
52:04much in the early days of of weight loss
52:06therapies right there are medicines now
52:07that are tremendously effective but
52:09they're they're imperfect in many ways
52:11um in terms of their their tolerability
52:13a lot of people have experienced side
52:15effects in terms of the price points as
52:17well right um so just to give you a few
52:20examples right like the the injectables
52:22right now mararo zap bound Etc they're
52:24super efficacious you can lose up to a
52:26quarter of your weight in a year um but
52:28they have these side effects right and
52:31what a lot of companies are trying to
52:32build now are like ideally small
52:34molecules where over time the cost of
52:36goods will be substantially lower right
52:39which can help with reimbursement with
52:40which can help with broader deployment
52:42and production um so small molecule oral
52:45medicine um better tolerated uh and also
52:48helping promote healthy weight loss so
52:50this is really where the the field is
52:52moving I think in the future and
52:53everyone is looking for mechanisms that
52:55like to your point right you could en
52:57Envision a future I mean I think what
52:59everyone is coming to grips with is the
53:00fact that these are not one andone
53:01therapies um because of course you can
53:03go on one of these medicines you can
53:04lose really a transformative amount of
53:06of weight if you're overweight but then
53:08once you get off um you generally regain
53:10that pretty quickly you sort of go back
53:11to normal so these are going to be
53:13chronic medicines and especially if we
53:15think of these as going on for several
53:17years not just one year then you have to
53:19worry a lot about tolerability right
53:21like people are willing to put up with
53:23that for a short amount of time but not
53:25not forever um and so we really think
53:28that the field and I think there's a
53:30number of companies working in this
53:31space trying to come up with with
53:33medicines um like ours that have that
53:35potential to be well tolerated to be
53:37used more more chronically uh and help
53:39you know maintain healthy body
53:41composition over a longer period of time
53:43got it we have just about five minutes
53:45left I'm going to take one question from
53:46the audience and ask it to each of you
53:49will we all be taking rapamycin or some
53:53other life extending drug 20 years from
53:56now now James oh for sure I mean the
53:59exciting progress we're making in the
54:02Therapeutics um uh is surely going to
54:05transform uh opportunities for people to
54:07live longer but that isn't the only
54:09thing that's going to happen uh we're
54:10also going to have to as described
54:12earlier sort out our own personal habits
54:15and those healthy habits are absolutely
54:17fundamental to having a healthy platform
54:19sort of the foundation that's the
54:20foundation and we do have to address the
54:23environment that we live in uh and the
54:25societal norms around Health we just
54:27don't prioritize it enough we've given
54:29too much space to people who frankly are
54:31making money out of our poor health uh
54:34and there there needs to be a
54:35transformation in the way in which we
54:37live in order to give those those drugs
54:39and therapies a chance Dan uh rap aasin
54:42are you sticking with
54:45beans yeah like you couldn't have
54:48predicted when Alexander Fleming was
54:49gonna accidentally drop orange mold on a
54:52petri dish and develop penicillin which
54:54was the biggest um in ation and raising
54:57life expectancy we've seen in the last
54:59century we're not there yet with any
55:01with any drugs I think you have to be
55:03careful about what you wish for with
55:05these longevity drugs because in many
55:06cases you look at Italy for example
55:09where life expectancy is going up but
55:10they're just um the a sicker population
55:13that's living longer and there's so many
55:15different systems that work in our
55:16bodies there's our knees our brains our
55:18eyes so if these longevity drugs don't
55:21address the entire system we might just
55:23be creating a bigger Health Care problem
55:25the other thing is in many cases they
55:27just elongate a crappy life and I just
55:30for a pitch to these blue zones areas
55:33these are places where they're not only
55:34living longer they're among the 10% of
55:36the happiest places we talked about
55:38optimism before and they get their
55:41longevity by being close to Nature
55:43growing their own food having dinner
55:45with their family having a sense of
55:46purpose having a rich spiritual life
55:48walking outside and bumping into their
55:50friends so for right now I still argue
55:53that there are better answers out there
55:54among the populations that are achieving
55:56it um but I I applaud my fellow
55:58panelists because I I do believe
56:00eventually there's going to be a major
56:02breakthrough that makes the human
56:03species better yeah Peter lifespan
56:06increased by about 60% between 1900 and
56:09and the year 2000 uh due to antibiotics
56:13uh clean water uhac to get the next the
56:16to get that next jump will everybody be
56:19taking rap ayin or some other I'm
56:21definitely going to go find some black
56:22beans and walnuts
56:24forun um so here's a question for you
56:26guys you've got the same 3.2 billion
56:29genes from your mom and your dad when
56:30you're born when you're 20 when you're
56:3250 when you're 100 why do you look
56:35different right why don't you have a
56:37six-pack when you're 90 years old and
56:40it's not your software you're running
56:42it's what genes are on and what genes
56:44are off right that's called your epig
56:47genome and today the hottest area of
56:50research is can we reset your epigenome
56:54to your younger age and in a lot of
56:56animal models and even into primates the
56:58belief is yes so will we be taking an
57:02epigenetic
57:03reprogramming gene therapy or drugs in
57:0620 years I think 100% here's the
57:09question do you want to live to
57:12120 not in a wheelchair drooling but
57:15what if you have the Aesthetics the
57:16cognition the mobility at that you had
57:19at 50 right you know I think it's the
57:22largest business opportunity on the
57:24planet Ai and longev there's nothing
57:26bigger than those so yeah Kristen 20
57:30years from now we're all taking some
57:31kind of anti-aging drug I mean
57:33definitely right like in a sense that's
57:35already true today most older people are
57:36on a Statin and at for men something to
57:38delay or prevent disease um and I think
57:41that there's a lot more coming down the
57:42pipeline as we touched on earlier we in
57:44very much the early days of the field
57:46and we know from all our work in animal
57:48models there's a lot of very potent
57:49levers on biology I mean as Peter
57:51mentioned there are a lot of examples in
57:53nature of animals that can live healthy
57:55and well in until they're several
57:56hundred years old which is amazing um so
57:59I think we're going to see a lot more
58:00exciting medical developments all right
58:02Lloyd you have the last word with less
58:03than a minute yes I think we'll be
58:05taking anti-aging drugs and I would just
58:07close with um a point of optimism you
58:10know every summer um we have a reunion
58:12of patients who've undergone bone marrow
58:15transplantation stem cell
58:16transplantation at Stanford 25 years ago
58:20bone transplantation was often times not
58:23successful it it was a difficult therapy
58:26to develop it's now a refined form of
58:29therapy for people who have cancer that
58:32recurs and fails other treatments and
58:34it's so inspiring to see hundreds of
58:36people and their families their children
58:38their
58:39grandchildren most of these patients now
58:43free of disease wouldn't be on this
58:45planet today if it hadn't been for the
58:49work that so many did to perfect stem
58:51cell bone
58:53transplantation um we're going to see
58:54that story repeated time and time again
58:57and in a way that doesn't just come at
58:59the very end stage of a disease that
59:02predicts or prevents the disease or
59:04forestalls its development Alto together
59:06and that's what makes me so optimistic
59:08about the future thank you very much to
59:10a wonderful panel and a great audience
59:12thanks for being
59:14here thank you very much
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