Three Perspectives on Longevity: Fantasy, Reality and Confusion

A book review of three books on longevity:

Fantastic Voyage: Live Long Enough to Live Forever by Ray Kurzweil and Terry Grossman, M.D. Rodale, 2004. 400 pp. $24.95 ISBN: 1579549543.

Anti-Aging Medicine: The Hype and the Reality, edited by S. Jay Olshansky, Leonard Hayflick, and Thomas T. Perls. The Gerontological Society of America, 2004. 195 pp. $20.00. ISSN: 1079-5006.

Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well-Being, by Andrew Weil, M.D. Knopf. 2005, 304 pp. $27.95. ISBN: 0375407553.

 

Fantastic Voyage

Ray Kurzweil is an inventor, thinker, and futurist who believes he can live forever, and that you can too if you read his book, Fantastic Voyage: Live Long Enough to Live Forever. Since Kurzweil is no crackpot, and he says he has extraordinary science to back up his extraordinary claim, this is fair game for skeptical analysis, starting with the dedication to two of the authors’ ancestors, one of whom lived to age 104 with no health advice at all (which is an argument against the book) and the other who died at age 58 but “could have been alive today” if he had read this book (a claim for which there is no evidence presented).

At the age of 35 Kurzweil developed diabetes, which jolted him into doing something about his health prospects. He convinced himself that future technology promises immortality, and that present knowledge will allow him to survive long enough to take advantage of it. Some day we will understand the genome, have specific preventions for all the processes of aging, and send tiny robots through our veins to fix whatever goes wrong. Eventually we can stop breathing, replace our blood cells with trillions of more efficient nanobots, and dispense with most of our organs. He describes some fascinating speculations derived from cutting edge research—they’re fun to think about, and some of them may even come true.

After extensive research, Kurzweil designed a personal program that he believes will slow his aging processes. He gets virtual colonoscopies, CAT scans, thallium stress tests, “extensive cancer screens” and PSA levels. Every few months he gets tested for dozens of nutrient levels (vitamins, minerals, fats, hormones, metabolic by-products). Based on test results, he fine tunes his supplement program. He takes just about every product in the diet supplement market in an effort to “reprogram his biochemistry,” downing as many as 250 pills of nutritionals a day. Yes, 250 pills a day! For example: acetyl-l-carnitine, vinpocetine, phosphatidylserine, ginkgo biloba, glycerlyphosphorylcholine, nextrutine and quercetin for brain health and lutein and bilberry extract for eye health. To boost antioxidant levels he takes vitamins, minerals, plus 16 different supplements. In addition to the 250 pills, he also ingests Chinese herbs prescribed by Dr. Glenn Rothfeld. Once a week, he spends the day at a complementary medicine health clinic getting half a dozen IV nutritionals, IV chelation, and acupuncture. He practices weight control, strict (organic) diet, exercise, massage, meditation, seeks balance in life, and keeps his brain active. He avoids toxins, drinks 10 glasses of alkalinized (pH 9.5) water a day, uses an ionic air filter, and has had his mercury amalgam fillings removed.

He lives in fear of cell phones, shower water, electric razors, plastic, the aluminum in deodorants, and the White Satan: sugar.

Kurzweil says he avoids “ideas that are unproven or appear to be risky,” but I cannot see that he ever met an idea he didn’t like. In the entire book, I could only find two things he rejected: kava, and IV human growth hormone (although he does recommend DHEA). He is a walking advertisement for the diet supplement industry.

Kurzweil’s co-author is Terry Grossman, an MD who runs a longevity clinic. Grossman became a convert to alternative medicine when pine bark capsules cured his knee pain. “Being a scientist,” he verified that the pain went away when he took the pills and returned when he stopped. Of course, he always knew when he was taking them, so we cannot discount placebo. Grossman “only” takes 64 supplement pills a day, plus 24 traditional Chinese medicine pillules prescribed by his wife.

Kurzweil and Grossman advocate genomic testing to see what diseases you are susceptible to and to guide your preventive program, but they don’t make a good case for it. Genomic testing is in its infancy, and many diseases are multifactorial. The factors are complex; they interact with each other and with the environment. The examples they give of personalized advice derived from an individual’s genome are not substantially different from general advice applicable to everyone.

Fantastic Voyage is more like “fantasy” voyage. Kurzweil and Grossman accept the myths that aspartame is harmful and that thorough chewing of food is vital to health, and they believe it is not feasible to get optimal levels of nutrients from food alone. They recommend eliminating wheat from the diet and taking high doses of beta-carotene, which The Medical Letter says no one should take. The alkaline water they recommend is called “snake oil on tap” by others, and even Andrew Weil’s website calls it bogus.

I guess if you try enough things, one of them just might work. On the other hand, there is also a very good chance that the combination of everything but the kitchen sink will do more harm than good. How much do 250 pills weigh? How might the supplements interact? What fillers and other ingredients are in the pills? To follow their advice might be like being a guinea pig in an uncontrolled experiment. They’re a lot braver than I am.

Kurzweil and Grossman are also convinced that heart disease and the majority of cancers can be prevented by environmental and lifestyle choices. Maybe; but that hasn’t been proven. The big mistake they make is to assume that animal and test tube experiments are relevant to humans, and that small preliminary studies can be used to direct therapeutic advice. There’s many a slip twixt test tube and clinical practice. Antioxidants have shown all kinds of benefits in the lab, but when you give them to large groups of real people as supplements, they always seem to do more harm than good.

And a supplement may change the level of something on a blood test but not have any practical influence on health. Kurzweil and Gross have not discovered the importance of POEMS—Patient Oriented Evidence That Matters. And they obviously haven’t read the Quackwatch website! Much of what they recommend has been evaluated and debunked there.

Kurzweil and Grossman also offer pseudoscientific statements with no critical comment: “Shiatsu and acupressure massage are…intended to correct imbalances according to principles of energy flow between different organ systems in the body.” “The elaborate structures formed by water molecules as a result of its electrical field create a form of memory that has been demonstrated by magnetic resonance imaging (MRI) machines.”

These guys are obsessed. The book represents the triumph of hope over evidence and common sense. Taking 250 pills a day and worrying about absorbing chlorine through the skin from your shower water are not likely to make you live any longer, although I can see how they might make it seem a lot longer.

Anti-Aging Medicine

NOW FOR A MORE SOBER VIEW OF rigorously scientific thinking about antiaging medicine: Jay Olshansky, Leonard Hayflick, and Thomas T. Perls say there’s no such thing. Their edited volume, Anti-Aging Medicine: The Hype and the Reality, is a compendium of papers by respected scientists who study the aging process and treat the elderly. They conclude:

There is no intervention known to slow, stop, or reverse the fundamental aging process in humans.

Anti-aging quackery is rampant in today’s marketplace, and the use of human growth hormone (HGH) to slow aging is actually illegal. There is concern about the safety of supplements and of medications like natural hormones. The use of micronutrient and antioxidant supplements is not supported by the literature. “Systems that suggest the ability of biomarkers of aging and agents to favorably affect them are not scientifically based.”

That pretty well shoots Fantastic Voyage all to hell!

The authors—all experts on the biology of aging—go on to discuss the complexities of the processes we lump together as “aging,” the philosophical and sociological consequences that would result from life extension, the status of current research, and other fascinating subjects, presenting debates with both pro and con arguments and rebuttals.

Healthy Aging

What does America’s leading integrative medicine guru Andrew Weil have to say on the subject of aging and longevity? In Healthy Aging he agrees that “There are no antiaging medicines. Scientific evidence is incomplete at best, and totally lacking at worst, for all of the products and services.” He gives an example of the kind of faulty thinking Kurzweil uses: resveratrol makes yeast cells live longer. It’s “possible” that it might do the same for people. “Without much more evidence to support their case, resveratrol enthusiasts have leapt to just this conclusion.” Weil does not mince words:

These are the hard facts: It is theoretically possible to extend the human life span, but no methods of doing so are currently available. We do not really even know if calorie restriction will do it for us. Furthermore, it is unlikely that any such methods will become available in time for anyone reading this book to make use of them.

…these theoretical breakthroughs serve only as serious distractions from what’s important, namely, learning to accept the universality and inevitability of aging, understanding both its challenges and promises, and knowing how to keep minds and bodies as healthy as possible as we move through life’s successive stages.

Weil teaches us how to age gracefully and maintain balance in our lives. He gives good advice about prevention: weight, smoking, immunizations, appropriate screening tests, the limitations of some screening tests like prostate-specific antigen (PSA) and computed tomography (CT) calcium screening for heart disease.

So far, so good. If he had had the sense to stop there, Healthy Aging would have been an excellent book.

Unfortunately, Weil goes on to mix sense with silliness, medicine with metaphysics, as he does indiscriminately in his previous books.

Weil thinks we should eat more plants, even “natural toxins” such as betel, qat, opium, coca, coffee, tea, chocolate, kava, and marijuana, because these may help bolster our defenses against oxidative stress.

Should we supplement with antioxidants? “Not only is there insufficient evidence that taking them will do you any good, some experts think they might be harmful.” But he throws reason to the winds and takes them anyway. Multivitamins, CoQ10, grape seed extract and pine bark extract, alpha-lipoic acid, ginger, turmeric, DHEA, a medley of immune-enhancing mushrooms (Weil has always had a fondness for mushrooms, psychedelic and otherwise), astragalus, milk thistle, ginseng, arctic root, and Cordyceps. He says all these definitely work and are safe. The scientific consensus begs to differ.

Weil says evidence based medicine “discounts the evidence of experience.” As he explains: “I maintain that it is possible to look at the world scientifically and also to be aware of nonmaterial reality.” He speaks of qi and prana unquestioningly, saying breath is the link to this basic life energy that circulates through us. He recommends specific breathing exercises, body work, massage and meditation. He trusts intuition; he believes in multiple realities.

Weil concludes: “I believe in magic and mystery. I am also committed to scientific method and knowledge based on evidence. How can this be? I have told you that I operate from a both-and mentality, not an either-or one.” He thinks consciousness is primary, more basic than matter or energy, and he thinks it directs the evolution of the material universe (huh?). He offers no evidence to support this claim.

Oh, by the way, he sells the supplements he recommends.

Conclusion: Three different approaches, but only one makes sense

Intellectually, we all know  that life ends in death; but there comes a time in every life when that knowledge hits home emotionally. How we react to that realization says a lot about our character. These three books represent three very different approaches.

Kurzweil is a denier who is running scared and wants to believe he can cheat death. He is brilliant in his own field, but is a poor judge of medical studies. He has fallen into the same trap Linus Pauling did when he aggressively promoted vitamin C and orthomolecular medicine on the basis of preliminary evidence that was later discredited. It is sad to see a good intellect fall prey to obsessions and delusions; it is sadder to see those delusions aided and abetted by a medical doctor in a folie a deux; it is sadder still when books are published encouraging others to share their delusions.

Weil is much more realistic, but he is incapable of sticking strictly to the evidence and insists on the validity of his intuitive insights. He goes beyond the facts and asks us to trust him because he thinks he is smarter than unaided science.

Anti-Aging Medicine is the only one that stays firmly grounded in the realm of science and critical thinking. The reality is that we don’t yet know how to prolong our lifespan. We can spend our allotted time popping pills and worrying about the aluminum in our deodorant, or we can relax, follow the most up-to-date solid science (in moderation), and try to get the most possible enjoyment out of the years we have left.

One of my college professors used to say that your age has very little to do with the number of years you have lived. My grandmother said when she realized she had a 65-year old son she knew she must be old, but she still didn’t feel old inside. Most of us would like to live as long as possible, but we can accept death as an integral part of life; knowing that we are going to die makes life just that much more precious. Personally, I plan to eat a variety of non-organic foods, drink unalkalinized tap water, stay active, indulge in a little White Satanic sugar, eschew diet supplements, and find something more interesting to do than taking 250 pills a day.

This article was originally published in Skeptic magazine.

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.