Three years ago, Lifespan opened my eyes to the world of ageing research and the associated ethical and societal implications of longer, healthier lives.
For this detailed review of Lifespan, I revisited it, reading each chapter slowly and deliberately.
What I’d forgotten from my first reading was the emotional depth.
Lifespan is an optimistic book. It also includes real anger (at the way we currently die), frustration and disappointment (that ageing is not considered a disease), plus gentle, clever humour. I need to compliment the writing skills of Matthew D. LaPlante, who co-wrote Lifespan. If there were an award for brilliant sub-headers in popular science books, I’d nominate ‘Yeast of Eden’ right now.
It is written in three parts.
- Biology: Genes, the epigenome, and the information theory of ageing.
- Medicine / Future: Reprogramming, personalised medicine, and lines of research.
- Ethics and Society: Climate change and overpopulation.
Livespan Review: A Portal into the Rabbit Hole of Longevity Science
For all its flaws, without Lifespan I would never have gone down the rabbit hole of longevity science.
I would never have realised just how difficult the question of ‘I’m in, what do I do next?’ was to answer back in 2019.
That path ultimately led me to give up my old job and focus on my longevity habits framework here at the Age Well Times.
Below are five take-aways from David Sinclair’s Lifespan: Why We Age and Why We Don’t Have to.
Dr Sinclair appears on podcasts regularly. He has a new book underway. I’ll certainly be first in the pre-order queue. You’ll find Lifespan at Amazon – I’ll decline adding a commercial link here as I feel it could compromise the integrity of my review. It is super-easy to find via search.
Five Take Aways from my Review: Lifespan by Dr David Sinclair and Matthew D. LaPlante
#1 – The Epigenome and the Information Theory or Ageing
Sinclair defines ageing as the accumulation of cells which have lost their identity.
Each cell has identical DNA. The molecules which control which genes are expressed by which cell type is called the epigenome. To be a successful liver cell, neurone, skin cell and so on, the right genes must be expressed at the right times.
Cellular damage, and our natural ability to repair this damage, declines as we age. Dr Sinclair uses the analogy of a DVD accumulating scratches. At first, the digital song can be heard, despite the analogue damage to the disc. Slowly, the analogue (epigenetic) damage becomes too great. Cells lose their identity – becoming ‘exdifferentiated’.
The result is frailty, chronic conditions and, ultimately, death.
If there is a single ‘core’ of Lifespan, it is that ageing and the loss of cell identity are one and the same.
By slowing or reversing the loss of cellular identity, ageing (and those pesky chronic diseases) can be controlled.
#2 – David Sinclair’s Lifespan Review: The Cruel Way We Die (and our Long Decline)
Personal stories of the death David’s mother and grandmother were evocative, detailed, and poignant.
Death is hard enough to contemplate. Add the long, frail decline that today’s ‘Whack-a-Mole’ (or ‘Whack-a-Symptom’) approach to medicine will deliver, it is no wonder that death is rarely discussed.
Staying alive for longer in a frail state, unable to enjoy life while battling chronic diseases, is a horrific thought. This misconception is enough to scare people away from longevity science.
It is up to all of us in the field to explain that a longer life can be paired with a shorter decline. Instead of suffering for a decade or more, this could be compressed into a few years – after 10 or 20 extra healthy, active years.
Clinical data in mice already backs this up.
This part of the book was a personal call-to-action. Frail, diseased old age is not inevitable. Action is needed right now to avoid it. Like everyone else, I’m hoping for clinical breakthroughs. The damage from inflammation, senescent cells and oxidation is not stopping while we wait for researchers – and the end of life that it leads to is horrible.
#3 – Lifespan Review: Ageing is a Disease
Dr David Sinclair campaigns tirelessly for ageing to be defined as a disease.
He makes a compelling case in Lifespan.
This is far from an academic nuance. Funding for drug research depends on the potential profits any discoveries could yield. If ageing were a disease, doctors could prescribe drugs to combat it – which would be paid for by insurance policies or government budgets.
The roadblock covered in Lifespan is that the medical definition of a disease precludes anything which affects more than half of the population.
Ageing affects everybody – and so can’t be ‘formally’ classified as a disease.
The passion that Dr Sinclair has for this cause is tenable. Moves since Lifespan was published in the right direction include the approval of the TAME study by the FDA, and (albeit watered-down) codes added to the WHO ICD-11 cause of death reference guide.
There are counter arguments to defining ageing as a disease. Primarily the stigmatization of the older population. Secondly, whether there are other routes to generate the funding for ageing research that would mean this definition is not needed? For example, via secondary effects of lower chronic disease incidence. I’d like to see these addressed in more detail in the follow-up book.
That said, it is hard to look beyond the boost to research grants that would be unlocked – and the good that would do for all of us over the longer term.
#4 – Lifespan Book Review, Take-Away 3: The Mind-Blowing Complexity of Cellular Life
75,000 separate molecules, moving at 400 miles per hour, signalling mechanisms, energy cycles, oxidation and repair, and programmed death – cells are mind-blowingly complex.
I’m sure researchers, medics and academics worldwide are ready with ‘but wait, there is more!’.
For me the Lifespan book was a reset from simple school-days diagrams of cells with a few mitochondria, an organelle or two and a blob for a nucleus.
The incredible complexity of life was almost a shock. As were the ways we damage those intricate processes via seemingly benign habits like enjoying a desert or drinking one too many glasses of wine.
I battled with whether to include this as a key take-away.
That complexity, exponentially multiplied by the interactions between cells and external factors is both frightening and beautiful.
In the end it made my list of Lifespan take-aways. This is because my new appreciation of cell biology was the seed that made me take responsibility for damaging behaviours.
If the damage from sugar, seed oils and toxins was better understood in the context of the mind-blowing complexity of life – I believe that we’d have a lot easier time convincing people to develop new habits.
#5 – Improved Health Span is Coming: Ready or Not
The final part of Lifespan covers the societal and ethical implications of extending healthy lifespans.
It is slower-reading and denser than the first two sections. That said, there are engaging stories and anecdotes that bring the stark ethical dilemmas to life.
Climate and environmental concerns are strong enough for millions of people to dismiss life extension as selfish or destructive.
I think they have a point.
When you extrapolate the consumption and environmental damage caused by the average person in their day-to-day life by 20 or 30 extra years – the implications are frightening.
Yet lifespan and health span extension are coming, whether society is ready or not.
The time for a ‘should we, or shouldn’t we?’ debate is long gone. It is, ‘how does society look when we are healthy and active to 100+?’.
Sinclair covers education, the concept of retirement, and a new approach to living sustainably. And goes on to discuss the dilemma of the rich living longer while the poor die young and frail.
This section of Lifespan does a brilliant job of raising important points which I feel are glossed over in the ageing field.
A big counter argument is that trillions of dollars would be saved on healthcare for even small increases in average life expectancy. If that could be reinvested into green technology, improvements in agriculture and education, the net result would be positive for the environment.
It is a big assumption that politicians would behave so responsibly with the money. Let’s save that thorny debate for another day.
Wrapping Up: My Detailed Review of David Sinclair and Matthew D LePlante’s Lifespan: Why We Age and Why We Don’t Have To
Lifespan is a wonderful introduction to longevity science. It covers complex topics accessibly, with humour, emotion and the right balance between hard science and human stories.
Sinclair himself works tirelessly within the scientific community, and in the media as an advocate of longevity research.
While Lifespan will give you a broad overview, it does not contain specific actionable steps. This had me heading to Google a few years ago. With the results of my research driving me away from the area for more than a year.
Since Lifespan was published, research has blossomed. That makes me excited for the next book – you’ll find a detailed review here just as soon as I have read it.
If there is one big take away from Lifespan, it is that the field of longevity research is moving fast. Only a fool would damage their body beyond repair when their chances of a long, active, and healthy life are so close.
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