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29 December 2020

The best book on the science of aging in the last ten years

Filed under: aging, books, rejuveneering, science, The Abolition of Aging — Tags: , — David Wood @ 10:44 am

Science points to many possibilities for aging to be reversed. Within a few decades, medical therapies based on these possibilities could become widespread and affordable, allowing all of us, if we wish, to remain in a youthful state for much longer than is currently the norm – perhaps even indefinitely. Instead of healthcare systems continuing to consume huge financial resources in order to treat people with the extended chronic diseases that become increasingly common as patients’ bodies age, much smaller expenditure would keep all of us much healthier for the vast majority of the time.

Nevertheless, far too many people fail to take these possibilities seriously. They believe that aging is basically inevitable, and that people who say otherwise are deluded and/or irresponsible.

Public opinion matters. Investments made by governments and by businesses alike are heavily influenced by perceived public reaction. Without active public support for smart investments in support of the science and medicine that could systematically reverse aging, that outcome will be pushed backwards in time – perhaps even indefinitely.

What can change this public opinion? An important part of the answer is to take the time to explain the science of aging in an accessible, engaging way – including the many recent experimental breakthroughs that, collectively, show such promise.

That’s exactly what Dr Andrew Steele accomplishes in his excellent book Ageless: The new science of getting older without getting old.

The audio version of this book became available on Christmas Eve, narrated by Andrew himself. It has been a delight to listen to it over the intervening days.

Over the last few years, I’ve learned a great deal from a number of books that address the science of aging, and I’ve been happy to recommend these books to wider audiences. These include:

But I hope that these esteemed authors won’t mind if I nominate Andrew Steele’s book as a better starting point into the whole subject. Here’s what’s special about it:

  • It provides a systematic treatment of the science, showing clear relationships between the many different angles to what is undeniably a complex subject
  • The way it explains the science seems just right for the general reader with a good basic education – neither over-simplified or over-dense
  • There’s good material all the way through the book, to keep readers turning the pages
  • The author is clearly passionate about his research, seeing it as important, but he avoids any in-your-face evangelism
  • The book avoids excessive claims or hyperbole: the claims it makes are, in my view, always well based
  • Where research results have been disappointing, there’s no attempt to hide these or gloss over them
  • The book includes many interesting anecdotes, but the point of these stories is always the science, rather than the personalities or psychologies of the researchers involved, or clashing business interests, or whatever
  • The information it contains is right up to date, as of late 2020.

Compared to other research, Ageless provides a slightly different decomposition of what is known as the hallmarks of aging, offering ten in total:

  1. DNA damage and mutations
  2. Trimmed telomeres
  3. Protein problems: autophagy, amyloids and adducts
  4. Epigenetic alterations
  5. Accumulation of senescent cells
  6. Malfunctioning mitochondria
  7. Signal failure
  8. Changes in the microbiome
  9. Cellular exhaustion
  10. Malfunction of the immune system

As the book points out, there are three criteria for something to be a useful “hallmark of aging”:

  1. It needs to increase with age
  2. Accelerating a hallmark’s progress should accelerate aging
  3. Reducing the hallmark should decrease aging

The core of the book is a fascinating survey of interventions that could reduce each of these hallmarks and thereby decrease aging – that is, decrease the probability of dying in the next year. These interventions are grouped into four categories:

  1. Remove
  2. Replace
  3. Repair
  4. Reprogram

Each category of intervention is in turn split into several subgroups. Yes, the treatment of aging is likely to be complicated. However, there are plenty of examples in which single interventions turned out to have multiple positive effects on different hallmarks of aging.

There are a couple of points where some readers might quibble with the content, for example regarding dietary supplements, or whether the concept of group selection can ever be useful within evolutionary theory.

However, my own presentations on the subject of the abolition of aging will almost certainly evolve in the light of the framework and examples in Ageless. I’m much the wiser from reading it.

Here’s my advice to anyone who, like me, believes the subject of reversing aging is important, and who wishes to accelerate progress in this field:

  • Read Ageless with some care, all the way through
  • Digest its contents and explore the implications, for example via discussion in online groups
  • Recommend others to read it too.

Ideally, a sizeable proportion of the book’s readers will alter their own research or other activity, in order to assist the projects covered in Ageless.

Finally, a brief comparison between Ageless and the remarkable grandfather book of this whole field: Ending Aging: The Rejuvenation Breakthroughs That Could Reverse Human Aging in Our Lifetime, authored by Aubrey de Grey and Michael Rae. Ending Aging was published in 2007 and remains highly relevant, even though numerous experimental findings and new ideas have emerged since its publication. There’s a deep overlap in the basic approach advocated in the two books. Both books are written by polymaths who are evidently very bright – people who, incidentally, did their first research in fields outside biology, and who brought valuable external perspectives to the field.

So I see Ageless as a worthy successor to Ending Aging. Indeed, it’s probably a better starting point for people less familiar with this field, in view of its coverage of important developments since 2007, and some readers may find Andrew’s writing style more accessible.

26 August 2012

Yoga, mindfulness, science, and human progress

Filed under: books, change, culture, Google, medicine, science, yoga — David Wood @ 12:07 am

Friday’s Financial Times carried a major article “The mind business“:

Yoga, meditation, ‘mindfulness’ – why some of the west’s biggest companies are embracing eastern spirituality

The article describes a seven-year long culture transformation initiative within business giant General Mills, as an example a growing wave of corporate interest in the disciplines of yoga, meditation, and ‘mindfulness’. It also mentions similar initiatives at Target, First Direct, Aetna, and Google, among others.

The article quotes Professor William George, the former CEO and Chairman of the Board of Medtronic, who is an intelligent fan of mindfulness. In a Harvard Business Review interview, Professor George makes the following points:

Mindfulness is a state of being fully present, aware of oneself and other people, and sensitive to one’s reactions to stressful situations. Leaders who are mindful tend to be more effective in understanding and relating to others, and motivating them toward shared goals. Hence, they become more effective in leadership roles…

Leaders with low emotional intelligence (EQ) often lack self-awareness and self-compassion, which can lead to a lack of self-regulation. This also makes it very difficult for them to feel compassion and empathy for others. Thus, they struggle to establish sustainable, authentic relationships.

Leaders who do not take time for introspection and reflection may be vulnerable to being seduced by external rewards, such as power, money, and recognition. Or they may feel a need to appear so perfect to others that they cannot admit vulnerabilities and acknowledge mistakes. Some of the recent difficulties of Hewlett-Packard, British Petroleum, CEOs of failed Wall Street firms, and dozens of leaders who failed in the post-Enron era are examples of this…

Public awareness of ‘mindfulness’ has recently received a significant boost from the publication of a book by one of Google’s earliest employees, Chade-Meng Tan. The book’s title is smart, playing on Google’s re-invention and dominance of the Search business: “Search inside yourself“. The sub-title of the book is both provocative and playful: The unexpected path to achieving success, happiness (and world peace).

The book’s website claims,

Meng has distilled emotional intelligence into a set of practical and proven tools and skills that anyone can learn and develop. Created in collaboration with a Zen master, a CEO, a Stanford University scientist, and Daniel Goleman (the guy who literally wrote the book on emotional intelligence), this program is grounded in science and expressed in a way that even a skeptical, compulsively pragmatic, engineering-oriented brain like Meng’s can process…

It’s playful, but it’s also serious. It’s a great idea to re-express the ideas of mindfulness in ways that software engineers find interesting and compelling. It uses the language of algorithms – familiar to all software engineers – to discuss techniques for improved mental performance.

(Aside: Meng has a remarkable gallery of photographs of himself alongside industry titans, leading politicians, media stars, famous book authors, and others. He’s impressively well connected.)

But does this stuff work?

Sure, these exercises can leave people feeling good, but do concrete long-term effects persist?

These are big questions, and for now, I’d like to zero in to a question that’s (marginally) smaller. I’ll leave further discussion about mindfulness and meditation for another occasion, and look now at the yoga side of this grand endeavour. Does yoga work?

My reason for focussing on the yoga aspect is that I can speak with more confidence about yoga than about mindfulness or meditation. That’s because I’ve been attending yoga classes, semi-regularly, for nearly 24 months. What I’ve experienced in these classes, and my discussions with fellow participants, has prompted me to read more, to try to make sense of what I’ve seen and heard.

I kept hearing about one particular book about yoga, “The Science of Yoga: The Risks and the Rewards“, written by Pulitzer prize-winning New York Times science journalist William J. Broad.

Broad is no newcomer to yoga – he has been practising the discipline since 1970. As he explains in the Acknowledgements section of the book, he initially thought it would take him nine months to write it, but it turned into a five-year project. The result shows – the book bristles with references to over a century’s worth of research, carried out all over the globe.

“The Science of Yoga” has received a great deal of criticism, especially from within the yoga community itself. Don’t let these criticisms put you off reading the book. It’s a mine of useful information.

The book has been criticised because of its less-than-reverential approach to many of the pioneers of yoga, as well as to some contemporary yoga leaders. The book also punctures several widespread myths about yoga – including claims made in many popular books. Some of these myths are enumerated in a handy review of Broad’s book by Liz Neporent, “What Yoga Can—and Can’t—Do: A look at the benefits and limitations of this popular, mind-body practice“:

  1. Yoga is a good cardiovascular workout
  2. Yoga boosts metabolism
  3. Yoga floods your body with oxygen
  4. Yoga doesn’t cause injuries
  5. Yoga is good for flexibility and balance
  6. Yoga improves mood
  7. Yoga is good for your brain
  8. Yoga improves your sex life

It turns out the four of these eight claims are strongly contradicted by growing scientific evidence. On the other hand, the other four are strongly supported. (I’ll leave you to do your own reading to find out which are which…)

The analysis Broad assembles doesn’t just point to correlations and statistics. It explains underlying mechanisms, so far as they are presently understood. In other words, it covers, not just the fact that yoga works, but why it works.

As well as summarising the scientific investigations that have been carried out regarding yoga, Broad provides lots of insight into the history of yoga – puncturing various more myths along the way. (For example, there’s no evidence that the popular “Sun salutation” exercises existed prior to the twentieth century. And advanced yogis aren’t actually able to stop their hearts.)

As you can see, there’s lots of good news here, for yoga enthusiasts, alongside some warnings about significant dangers.

Broad is convinced that yoga, carefully prescribed to the specific needs of individuals, can work wonders in curing various physical ailments. Broad’s discussions with Loren Fishman MD, in the chapter entitled “Healing”, form a great high point in the book. Fishman is an example of someone who immersed himself in the study of medicine after already learning about yoga. (Fishman learned yoga from none other than BKS Iyengar, who he travelled to Pune, India, to meet in 1973. Iyengar comes out well in Broad’s book, although Broad does find some aspects of Iyengar’s writing to be questionable. Full disclosure: the type of yoga I personally practice is Iyengar.)

For example, Fishman described yoga’s applicability to treat osteoporosis, the bone disease, which in turn “lies behind millions of fractures of the hip, spine, and wrist”:

Yoga stretching… works beautifully to stimulate the rebuilding of the bone. It happens at the molecular level. Stress on a bone prompts it to grow denser and stronger in the way that best counteracts the stress. Fishman said that for three years he had been conducting a study to find out which poses worked best to stimulate the rejuvenation.

“It’s a big thing”, he said of the disease. “Two hundred million women in the world have it and most can’t afford the drugs”, some of which produce serious side effects. By contrast, Fishman enthused, “Yoga is free”…

In addition to its beneficial effect on the body, yoga can have several key beneficial effects on the mind – helping in the treatment of depression, calming the spirit, and boosting creativity.

In the epilogue to the book, Broad envisions two possible futures for yoga. Here’s his description of the undesirable future:

In one scenario, the fog has thickened as competing groups and corporations view for market share among the bewildered. The chains offer their styles while spiritual groups offer theirs, with experts from different groups clashing over differing claims…

The disputes resemble the old disagreements of religion. Factionalism has soared… hundreds of brands, all claiming unique and often contradictory virtues.

Yet, for all the activity, yoga makes only a small contribution to global health care because most of the claims go unproven in the court of medical science. The general public sees yoga mainly as a cult that corporations try to exploit.

But a much more positive outcome is also possible:

In the other scenario, yoga has gone mainstream and plays an important role in society. A comprehensive program of scientific study… produced a strong consensus on where yoga fails and where it succeeds. Colleges of yoga science now abound. Yoga doctors are accepted members of the establishment, their natural therapies often considered gentler and more reliable than pills. Yoga classes are taught by certified instructors whose training is as rigorous as that of physical therapists. Yoga retreats foster art and innovation, conflict resolution, and serious negotiating…

Broad clearly recognises that his own book is far from the last word on many of the topics he covers. In many cases, more research is needed, to isolate likely chains between causes and effects. He frequently refers to research carried out within the 12-24 months prior to the book’s publication. We can expect ongoing research to bring additional clarity – for example, to shed more light on the fascinating area of the scientific underpinning of “kundalini awakening“. Broad comments,

The science of yoga has only just begun. In my judgement, the topic has such depth and resonance that the voyage of discovery will go on for centuries…

Studies… will spread to investigations ever more central to life and living, to questions of insight and ecstasy, to being and consciousness. Ultimately, the social understanding that follows in the wake of scientific discovery will address issues of human evolution and what we decide to become as a species.

I say “amen” to all this, but with two clarifications of my own:

  • Alongside a deeper understanding and wider application of yoga, improving human well-being, I expect leaps and bounds of improvement in “hard technology” fields such as genetic analysis, personalised medicines, stem cell therapy, nano-surgery, and artificial organs – which will work in concert with yoga and mindfulness to have an even more dramatic effect
  • Because I see the pace of scientific improvement as increasing, I think the most significant gains in knowledge are likely to happen in the next few decades, rather than stretching out over centuries.

Footnote: Earlier this week, William J Broad featured in a fifteen minute interview in a public radio broadcast. In this interview, Broad describes the adverse reaction of “the yoga industrial complex” to his book – “they hate this book, because it’s exploding myths… there’s an economic incentive for people to only focus on the good and deny the bad”.

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