Who is we? Of mice and men in longevity science | Book Reviews
LONG READ
Jason Fletcher
December 22nd, 2024
LSE
The re-election of Donald Trump to the US presidency this year has brought focus on pseudoscience in healthcare and the search for ‘silver bullets’ in health and longevity research. Jason Fletcher reviews three books which purport to have insights into how to live longer: Outlive: The Science and Art of Longevity by Peter Attia, Lifespan: Why we age—And why we don’t have to by David Sinclair, and How We Age: The Science of Longevity by Coleen Murphy. He writes that these books’ focus on ‘silver bullet’ solutions to aging takes focus away from slow diseases which are leading us to have shorter and less healthy lives.
Murphy, Coleen, How We Age: The Science of Longevity, Princeton University Press, 2023
On November 15th, the president-elect, Donald Trump announced that Robert F. Kennedy Jr. would be his nominee for Secretary of Health and Human Services. If RFK Jr. is confirmed by the US Senate and becomes health secretary, it will be an unfortunate watershed moment for the mainstreaming of pseudoscience in America. The grand irony of this is not lost on public health researchers: we’ll be appointing the country’s preeminent vaccine opponent to lead the Department of Health and Human Services only a few years after the world witnessed the unprecedented effectiveness and speed of discovery of COVID-19 vaccines. According to the National Institutes of Health, this modern marvel of science may have prevented more than 14 million deaths across the world in its first year alone. This was made possible thanks to randomized controlled trials (RCTs), which provide gold-standard evidence of a cause-and-effect relationship between an intervention (such as a drug) and a pre-specified outcome of interest.
Thanks to the COVID-19 vaccine, RCTs seemingly reclaimed their place on the pedestal of public consciousness, and many in public health hoped that the vaccine’s success foreshadowed a reversal in the popularization of pseudoscience and its more subtle cousin, the bait-and-switch, where instead of evidence and intervention strategies, we have “concepts of a plan”.
Searching for more public health ‘silver bullets’
Unfortunately, this hasn’t been the case. Americans continue to search for silver bullets for all manner of health issues, while the closest thing to a public health silver bullet in decades continues to be attacked by communities on the cusp of taking control of the American government. Part of the problem is that most of our remaining health questions are much more resistant to silver bullet answers than COVID-19 was. It is tougher to crowd out strategies with no evidence base, like injecting disinfectant to cure COVID-19, without gold-standard evidence to take their place (and even then…). We want to believe that a similar level of success is right around the corner for other causes of death and ailments, yet we have been fighting a seemingly intractable war on cancer for over fifty years. We have obesity, diabetes and opioid epidemics. Heart disease continues to kill millions. Central to these failures may be their slow accumulating effects. It turns out fast deaths, including many infectious diseases, have advantages; their speed allows us to know quickly and clearly when something works or does not. This is the perfect situation to leverage an RCT. We do not have to wait 20, 50, or 70 years to see if it works. But our remaining enemies work slowly to wear down our systems, to use our slow body processes of cell division and growth against us.
A lack of progress, zero RCTs showing human longevity gains, and the innate desire by humans to prolong life make for excellent pseudoscience and bait-and-switch markets, including a thriving literary genre. Most are pure snake oil salespersons not constrained by scientific evidence or standards. These “wellness experts” flourish in breathlessly touting the newest miracle diet or the newest exercise regimen. However, some authors in the longevity science genre take different tacks, and the successful authors who groan at the snake oil while making their own cases by employing a bait-and-switch, rather than straight pseudoscience are particularly revealing. These authors have 200-400 pages to fill and, in the end, zero silver bullets to show, so what do they do?
Robert F. Kennedy, Jr. speaking with supporters at a campaign rally at the Fox Tucson Theatre in Tucson, Arizona, February 2024.
“Robert F. Kennedy, Jr.” (CC BY-SA 2.0) by Gage Skidmore
Before loading their own counterfeit silver bullets, many authors trudge through a dense and anecdote-filled wasteland. They often write at length about individual centenarians—Betty smoked every day for 86 years, while Herb has eaten only bacon every morning since World War II and has eight percent body fat. Or they describe so-called ‘blue zones’ that mysteriously overproduce centenarians and provide surface-level observations about how one place is known for its beach and laid-back lifestyle while another one serves a lot of fish. After some wishy-washy “wouldn’t it be great if the beach was a silver bullet” discussion, we typically then move on to the even more treacherous wasteland of epidemiological studies, a posterchild of the warning, “correlation does not imply causation”. The treachery here comes in the form of the many promised oases dressed up as RCTs, often after the author has highlighted several mirages from other sources that we are too smart to have fallen for. Indeed, often we stay at a last oasis for the remainder of the book.
Attia makes an interesting claim that the key solution to the slow wear and tear on our bodies is to intensely focus on fortifying your body against the inevitable. There is a very similar idea in Alzheimer’s Disease of cognitive reserve. Faced with no effective treatments for dementia and an overwhelming lack of understanding, a remaining idea is to start our inevitable cognitive decline from a higher hill. The current hope is that educational attainment and stimulating work environments might all add to the height of our hill that we then slowly roll down later in life until we meet dementia criteria. Attia promotes a similar, but much more interventionalist, idea to invest in our own physical functioning reserves so that we start at a higher level when the declines start and thus might roll into death with high levels of physical functioning (that is, having a high ‘health span’). It’s an interesting idea, but we have no evidence that it works. Perhaps just as likely is that these maximalist interventions—always having a 30lb rucksack strapped to our backs—could cause injuries and make us not enjoy our life during our prime, which appear nowhere in Attia’s calculus. And again, it appears that his evidence is subject to a vote rather than our typical criteria: “While we can’t establish causality here, the strength and reproducibility of findings suggest this is more than just a correlation. Muscle helps us survive old age.”
The reader should be left with a great deal of uncertainty—we were promised the science of longevity, and we got it; it’s just incremental, inspirational, and aspirational. It’s not quite wiping down our grocery bags during COVID-19, but these are bullets painted silver.
Sinclair, David A., and Matthew D. LaPlante. Lifespan: Why we age—And why we don’t have to. Atria books, 2019.
In his 2019 book, Why We Age—And Why We Don’t Have To, David Sinclair approaches the subject differently than Attia. Sinclair is a scientist/researcher/professor at Harvard. He produces, rather than merely summarizes and amplifies, research. The reader still gets a walk through the wasteland with stops at various oases. But Sinclair also has a different focus, which is to move the goalpost. We learn a lot about lifespan and treatment successes… for worms and mice. It turns out that the US government (under NIH) and many venture capitalists have made major investments over several decades that have served to increase survival of yeast and worms. And using the tried-and-true method of bait and switch, readers are encouraged to dream about how these advances for worms will transform human longevity through understanding and tinkering with our biology.
Some choice passages include: “[DNA] can also tell you what food to eat, what microbiomes to cultivate in your gut and on your skin, and what therapies will work best to ensure that you reach your maximum potential lifespan”, “It won’t be long before prescribing a drug without first knowing a patient’s genome will seem medieval”, and “In the near future, proactive personal DNA scanning is going to be as routine as brushing our teeth.” This is certainly what 23andme was hoping for in their recent shift to subscription services en route to a complete collapse and probable removal from the Nasdaq. We never arrive at RCTs that show that what we’ve done to worms ports over to humans. The closest we get is an “ongoing” RCT for Metformin on longevity, which as far as I can tell has still not started, five years past the book’s claims. It’s an interesting form of snake oil – it’s not lying (exactly) when you encourage people to hope that we are like worms.
No silver bullets in longevity science
We might ask ourselves if we are repeating history. It’s not exactly as if our pursuit of longer lives or even immortality are new concepts. Selling the possibility certainly isn’t. But with so few actual silver bullets, most disease categories – as well as the longevity-focused investigators filling our bookstores and social media feeds – must toggle between incremental progress and hocking hope. Bruno Latour, the famed French intellectual, described the pre-Pasteur hygienists of mid-19th century France as having “…an accumulation of advice, precautions, recipes, opinions, remedies, regulations, anecdotes, case studies” because illness, “…can be caused by almost anything. Typhus may be due to contagion, but it may also be due to the soil, the air, and/or overcrowding. Nothing must be ignored, nothing dismissed.” Swap in aging for illness here and you have an apt description of what longevity science boils down to in 2024. Like our “wellness experts,” the 19th century hygienists similarly wandered adrift in a wasteland where “none of the evidence certain and none can be abandoned.” Latour labels this circumstance “all-round combat” because “…if anything can cause illness, nothing can be ignored.” Mix in enormous uncertainty and our current methods of surveillance, and we quickly arrive at Latour’s conclusion that, “to act everywhere is to act nowhere…like an army trying to defend a long frontier by spreading its forces thin.”
Further dividing our own forces to also defend against findings from animal models in addition to accumulated folk tales leaves us continuing to hope for a miracle while slouching toward shorter and less healthy lives. As we saw during the COVID-19 pandemic, we know how to go about getting an answer to these questions by deploying sufficient resources to attain gold standard evidence in humans. We also learned a great deal about the importance of combatting the snake oil salespeople and the loudest storytellers, and the Herculean effort required to do so in an information environment awash with counterfeit silver bullets and their enthusiastic purveyors. A big part of that is figuring out our scientific pronouns—whether “we” is we or them or everything. This in itself is a new battlefront in “all-round combat” yet unresolved.
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About the author
Jason Fletcher is a Vilas Distinguished Achievement Professor of Public Affairs with appointments in Applied Economics and Population Health Sciences at the La Follette School of Public Affairs at the University of Wisconsin–Madison. A specialist in health economics, economics of education, social genomics, and child and adolescent health policy, Professor Fletcher focuses his research on examining social network effects on adolescent education and health outcomes, combining genetics and social science research, estimating long-term consequences of childhood mental illness, and examining how in utero and early life conditions affect later life health, cognition, and mortality.
Posted In: Book Reviews | Healthcare and public services
The re-election of Donald Trump to the US presidency this year has brought focus on pseudoscience in healthcare and the search for ‘silver bullets’ in health and longevity research. Jason Fletcher reviews three books which purport to have insights into how to live longer: Outlive: The Science and Art of Longevity by Peter Attia, Lifespan: Why we age—And why we don’t have to by David Sinclair, and How We Age: The Science of Longevity by Coleen Murphy. He writes that these books’ focus on ‘silver bullet’ solutions to aging takes focus away from slow diseases which are leading us to have shorter and less healthy lives.
Murphy, Coleen, How We Age: The Science of Longevity, Princeton University Press, 2023
On November 15th, the president-elect, Donald Trump announced that Robert F. Kennedy Jr. would be his nominee for Secretary of Health and Human Services. If RFK Jr. is confirmed by the US Senate and becomes health secretary, it will be an unfortunate watershed moment for the mainstreaming of pseudoscience in America. The grand irony of this is not lost on public health researchers: we’ll be appointing the country’s preeminent vaccine opponent to lead the Department of Health and Human Services only a few years after the world witnessed the unprecedented effectiveness and speed of discovery of COVID-19 vaccines. According to the National Institutes of Health, this modern marvel of science may have prevented more than 14 million deaths across the world in its first year alone. This was made possible thanks to randomized controlled trials (RCTs), which provide gold-standard evidence of a cause-and-effect relationship between an intervention (such as a drug) and a pre-specified outcome of interest.
Thanks to the COVID-19 vaccine, RCTs seemingly reclaimed their place on the pedestal of public consciousness, and many in public health hoped that the vaccine’s success foreshadowed a reversal in the popularization of pseudoscience and its more subtle cousin, the bait-and-switch, where instead of evidence and intervention strategies, we have “concepts of a plan”.
Searching for more public health ‘silver bullets’
Unfortunately, this hasn’t been the case. Americans continue to search for silver bullets for all manner of health issues, while the closest thing to a public health silver bullet in decades continues to be attacked by communities on the cusp of taking control of the American government. Part of the problem is that most of our remaining health questions are much more resistant to silver bullet answers than COVID-19 was. It is tougher to crowd out strategies with no evidence base, like injecting disinfectant to cure COVID-19, without gold-standard evidence to take their place (and even then…). We want to believe that a similar level of success is right around the corner for other causes of death and ailments, yet we have been fighting a seemingly intractable war on cancer for over fifty years. We have obesity, diabetes and opioid epidemics. Heart disease continues to kill millions. Central to these failures may be their slow accumulating effects. It turns out fast deaths, including many infectious diseases, have advantages; their speed allows us to know quickly and clearly when something works or does not. This is the perfect situation to leverage an RCT. We do not have to wait 20, 50, or 70 years to see if it works. But our remaining enemies work slowly to wear down our systems, to use our slow body processes of cell division and growth against us.
A lack of progress, zero RCTs showing human longevity gains, and the innate desire by humans to prolong life make for excellent pseudoscience and bait-and-switch markets, including a thriving literary genre. Most are pure snake oil salespersons not constrained by scientific evidence or standards. These “wellness experts” flourish in breathlessly touting the newest miracle diet or the newest exercise regimen. However, some authors in the longevity science genre take different tacks, and the successful authors who groan at the snake oil while making their own cases by employing a bait-and-switch, rather than straight pseudoscience are particularly revealing. These authors have 200-400 pages to fill and, in the end, zero silver bullets to show, so what do they do?
Robert F. Kennedy, Jr. speaking with supporters at a campaign rally at the Fox Tucson Theatre in Tucson, Arizona, February 2024.
“Robert F. Kennedy, Jr.” (CC BY-SA 2.0) by Gage Skidmore
Before loading their own counterfeit silver bullets, many authors trudge through a dense and anecdote-filled wasteland. They often write at length about individual centenarians—Betty smoked every day for 86 years, while Herb has eaten only bacon every morning since World War II and has eight percent body fat. Or they describe so-called ‘blue zones’ that mysteriously overproduce centenarians and provide surface-level observations about how one place is known for its beach and laid-back lifestyle while another one serves a lot of fish. After some wishy-washy “wouldn’t it be great if the beach was a silver bullet” discussion, we typically then move on to the even more treacherous wasteland of epidemiological studies, a posterchild of the warning, “correlation does not imply causation”. The treachery here comes in the form of the many promised oases dressed up as RCTs, often after the author has highlighted several mirages from other sources that we are too smart to have fallen for. Indeed, often we stay at a last oasis for the remainder of the book.
Attia, Peter, and Bill Gifford. Outlive: The Science and Art of Longevity. Random House, 2023.
Peter Attia is one of the country’s most popular “wellness experts” who runs in similar circles to RFK Jr. (they have both appeared on the popular podcast, the Joe Rogan Experience), yet his work maintains a patina of scientific rigor. His 2023 book, Outlive: The Science and Art of Longevity is an apt example of this genre. Burnishing his “bro science” bona fides, he begins by highlighting extreme exercise and related performance (a favorite metric is VO2 max)—“exercise is by far the most potent longevity ‘drug’”. The quality of evidence for this is comparable to headline-grabbing studies associating red wine with early mortality or, conversely, extended life. Dr. Attia then moves through diet, sleep, emotional health and drugs, essentially with the same quality of evidence, which largely consists of centenarian anecdotes, research that ‘works’ in animal tests, and the epidemiological studies wasteland. It follows the tried-and-true template of focusing on the sheer number of existing studies and a heavy dose of anecdotes. Put another way, it’s the shock-and-awe approach that comes with rattling off specious study after specious study while sprinkling in compelling human-interest stories.
We are also meant to be dazzled by the level of surveillance we could engage in if so desired – diet is now “nutritional biochemistry” and we can personalize our eating patterns with our genetics and individuality. Likewise, the variety of sleep monitoring devices is massive, but the evidence that directly links specific sleep-related intervention targets with longevity is missing. And I don’t even know where to begin with the claims about exercise. One such claim that quantity beats quality of evidence notes, “…the epidemiology linking strength and cardiorespiratory fitness to lower risk for neurodegeneration is so uniform in its direction and magnitude that my own skepticism of the power of exercise has melted away.” Many dream of an exchange rate where enough bad studies eventually convert into one good one.
Peter Attia is one of the country’s most popular “wellness experts” who runs in similar circles to RFK Jr. (they have both appeared on the popular podcast, the Joe Rogan Experience), yet his work maintains a patina of scientific rigor. His 2023 book, Outlive: The Science and Art of Longevity is an apt example of this genre. Burnishing his “bro science” bona fides, he begins by highlighting extreme exercise and related performance (a favorite metric is VO2 max)—“exercise is by far the most potent longevity ‘drug’”. The quality of evidence for this is comparable to headline-grabbing studies associating red wine with early mortality or, conversely, extended life. Dr. Attia then moves through diet, sleep, emotional health and drugs, essentially with the same quality of evidence, which largely consists of centenarian anecdotes, research that ‘works’ in animal tests, and the epidemiological studies wasteland. It follows the tried-and-true template of focusing on the sheer number of existing studies and a heavy dose of anecdotes. Put another way, it’s the shock-and-awe approach that comes with rattling off specious study after specious study while sprinkling in compelling human-interest stories.
We are also meant to be dazzled by the level of surveillance we could engage in if so desired – diet is now “nutritional biochemistry” and we can personalize our eating patterns with our genetics and individuality. Likewise, the variety of sleep monitoring devices is massive, but the evidence that directly links specific sleep-related intervention targets with longevity is missing. And I don’t even know where to begin with the claims about exercise. One such claim that quantity beats quality of evidence notes, “…the epidemiology linking strength and cardiorespiratory fitness to lower risk for neurodegeneration is so uniform in its direction and magnitude that my own skepticism of the power of exercise has melted away.” Many dream of an exchange rate where enough bad studies eventually convert into one good one.
Attia makes an interesting claim that the key solution to the slow wear and tear on our bodies is to intensely focus on fortifying your body against the inevitable. There is a very similar idea in Alzheimer’s Disease of cognitive reserve. Faced with no effective treatments for dementia and an overwhelming lack of understanding, a remaining idea is to start our inevitable cognitive decline from a higher hill. The current hope is that educational attainment and stimulating work environments might all add to the height of our hill that we then slowly roll down later in life until we meet dementia criteria. Attia promotes a similar, but much more interventionalist, idea to invest in our own physical functioning reserves so that we start at a higher level when the declines start and thus might roll into death with high levels of physical functioning (that is, having a high ‘health span’). It’s an interesting idea, but we have no evidence that it works. Perhaps just as likely is that these maximalist interventions—always having a 30lb rucksack strapped to our backs—could cause injuries and make us not enjoy our life during our prime, which appear nowhere in Attia’s calculus. And again, it appears that his evidence is subject to a vote rather than our typical criteria: “While we can’t establish causality here, the strength and reproducibility of findings suggest this is more than just a correlation. Muscle helps us survive old age.”
The reader should be left with a great deal of uncertainty—we were promised the science of longevity, and we got it; it’s just incremental, inspirational, and aspirational. It’s not quite wiping down our grocery bags during COVID-19, but these are bullets painted silver.
Sinclair, David A., and Matthew D. LaPlante. Lifespan: Why we age—And why we don’t have to. Atria books, 2019.In his 2019 book, Why We Age—And Why We Don’t Have To, David Sinclair approaches the subject differently than Attia. Sinclair is a scientist/researcher/professor at Harvard. He produces, rather than merely summarizes and amplifies, research. The reader still gets a walk through the wasteland with stops at various oases. But Sinclair also has a different focus, which is to move the goalpost. We learn a lot about lifespan and treatment successes… for worms and mice. It turns out that the US government (under NIH) and many venture capitalists have made major investments over several decades that have served to increase survival of yeast and worms. And using the tried-and-true method of bait and switch, readers are encouraged to dream about how these advances for worms will transform human longevity through understanding and tinkering with our biology.
Some choice passages include: “[DNA] can also tell you what food to eat, what microbiomes to cultivate in your gut and on your skin, and what therapies will work best to ensure that you reach your maximum potential lifespan”, “It won’t be long before prescribing a drug without first knowing a patient’s genome will seem medieval”, and “In the near future, proactive personal DNA scanning is going to be as routine as brushing our teeth.” This is certainly what 23andme was hoping for in their recent shift to subscription services en route to a complete collapse and probable removal from the Nasdaq. We never arrive at RCTs that show that what we’ve done to worms ports over to humans. The closest we get is an “ongoing” RCT for Metformin on longevity, which as far as I can tell has still not started, five years past the book’s claims. It’s an interesting form of snake oil – it’s not lying (exactly) when you encourage people to hope that we are like worms.
Murphy, Coleen, How We Age: The Science of Longevity, Princeton University Press, 2023
Coleen Murphy’s 2023 book splits the difference a bit but leans more toward Sinclair with much more restraint. The book’s title, How We Age: The Science of Longevity, might be the most fraught for a purportedly serious and scientific book – who would have guessed that in an age of so much disagreement over proper pronoun use, “we” could get in the crosshairs? In this case, the main issue is that her human audience might expect that “we” equals “humans.” Only after slogging through 350 pages of experiments on flies, worms, and mice do we (the readers) realize the “we” to be a bait-and-switch. Sometimes, we do get some “we” advice for “we, the reader’s species”, but here Murphy includes flourishes reminiscent of Attia: “…but one of the easiest ways to extend our lifespan…is to exercise more” with no accompanying gold standard evidence in humans. While she focuses on worms, she mercifully does not traverse the wasteland that Attia and Sinclair trudge through.
Starting out, Murphy soothes that she won’t tell us what she eats or weighs or how she exercises because this is “just bad science.” But then she guards her flank (and the pronoun in her title) by telling us in advance that she will not be “using the popular phrase, ‘…at least in worms and flies.’” Of course, the phrase is popular because we (humans) really do want to know whether extending a worm’s life by 50 percent (aka, a couple weeks) has any meaning for us (humans); but Murphy is not going to play this diminutive game of qualifying the insights of her book. This is because “almost all we know” about longevity was first understood in model systems (e.g. worms) and then “tested later in higher organisms (mammals like mice)…”. She claims that we are “right in the middle” of understanding aging but that we don’t yet know “all of the answers”. Seems fine so far. Maybe this will be a purely descriptive book about worms and mice, just to satisfy our interest in these animals, right? Maybe the “we” is indeed supposed to be read as worms. Yet, she can’t resist ending her introduction by saying, “With this information at our disposal, we should be able to make wise decisions about how to manage our own longevity.” Here the “we” is not actually the worms but the readers. And now we are back to hopes and dreams.
While the Murphy book is a scientifically driven analysis (so many worms!), the author succumbs to the temptation to stretch a bit; to try to get back to the subject of her title: We. Many findings on mice or worms have “promise” as a “possible clinical therapeutic” or “may represent a new class of longevity treatments to be explored” with no accompanying evidence. The reader also gets a short excursion into findings on human athletes’ declining performance with age: “While anaerobic (sprinting) events generally show greater changes with age—just like a worm’s decline in maximum velocity…aerobic performance also declines, but at a later stage.” (italics added). It is in this way that the author, and this wing of the longevity-industrial complex, entices readers’ yearnings for good news. This aligns it with other full-on proclamations from Sinclair and Attia. The reader should wonder if the book should have been titled, How (Some) Creatures Age. But would humans buy this book?
Coleen Murphy’s 2023 book splits the difference a bit but leans more toward Sinclair with much more restraint. The book’s title, How We Age: The Science of Longevity, might be the most fraught for a purportedly serious and scientific book – who would have guessed that in an age of so much disagreement over proper pronoun use, “we” could get in the crosshairs? In this case, the main issue is that her human audience might expect that “we” equals “humans.” Only after slogging through 350 pages of experiments on flies, worms, and mice do we (the readers) realize the “we” to be a bait-and-switch. Sometimes, we do get some “we” advice for “we, the reader’s species”, but here Murphy includes flourishes reminiscent of Attia: “…but one of the easiest ways to extend our lifespan…is to exercise more” with no accompanying gold standard evidence in humans. While she focuses on worms, she mercifully does not traverse the wasteland that Attia and Sinclair trudge through.
Starting out, Murphy soothes that she won’t tell us what she eats or weighs or how she exercises because this is “just bad science.” But then she guards her flank (and the pronoun in her title) by telling us in advance that she will not be “using the popular phrase, ‘…at least in worms and flies.’” Of course, the phrase is popular because we (humans) really do want to know whether extending a worm’s life by 50 percent (aka, a couple weeks) has any meaning for us (humans); but Murphy is not going to play this diminutive game of qualifying the insights of her book. This is because “almost all we know” about longevity was first understood in model systems (e.g. worms) and then “tested later in higher organisms (mammals like mice)…”. She claims that we are “right in the middle” of understanding aging but that we don’t yet know “all of the answers”. Seems fine so far. Maybe this will be a purely descriptive book about worms and mice, just to satisfy our interest in these animals, right? Maybe the “we” is indeed supposed to be read as worms. Yet, she can’t resist ending her introduction by saying, “With this information at our disposal, we should be able to make wise decisions about how to manage our own longevity.” Here the “we” is not actually the worms but the readers. And now we are back to hopes and dreams.
While the Murphy book is a scientifically driven analysis (so many worms!), the author succumbs to the temptation to stretch a bit; to try to get back to the subject of her title: We. Many findings on mice or worms have “promise” as a “possible clinical therapeutic” or “may represent a new class of longevity treatments to be explored” with no accompanying evidence. The reader also gets a short excursion into findings on human athletes’ declining performance with age: “While anaerobic (sprinting) events generally show greater changes with age—just like a worm’s decline in maximum velocity…aerobic performance also declines, but at a later stage.” (italics added). It is in this way that the author, and this wing of the longevity-industrial complex, entices readers’ yearnings for good news. This aligns it with other full-on proclamations from Sinclair and Attia. The reader should wonder if the book should have been titled, How (Some) Creatures Age. But would humans buy this book?
No silver bullets in longevity science
We might ask ourselves if we are repeating history. It’s not exactly as if our pursuit of longer lives or even immortality are new concepts. Selling the possibility certainly isn’t. But with so few actual silver bullets, most disease categories – as well as the longevity-focused investigators filling our bookstores and social media feeds – must toggle between incremental progress and hocking hope. Bruno Latour, the famed French intellectual, described the pre-Pasteur hygienists of mid-19th century France as having “…an accumulation of advice, precautions, recipes, opinions, remedies, regulations, anecdotes, case studies” because illness, “…can be caused by almost anything. Typhus may be due to contagion, but it may also be due to the soil, the air, and/or overcrowding. Nothing must be ignored, nothing dismissed.” Swap in aging for illness here and you have an apt description of what longevity science boils down to in 2024. Like our “wellness experts,” the 19th century hygienists similarly wandered adrift in a wasteland where “none of the evidence certain and none can be abandoned.” Latour labels this circumstance “all-round combat” because “…if anything can cause illness, nothing can be ignored.” Mix in enormous uncertainty and our current methods of surveillance, and we quickly arrive at Latour’s conclusion that, “to act everywhere is to act nowhere…like an army trying to defend a long frontier by spreading its forces thin.”
Further dividing our own forces to also defend against findings from animal models in addition to accumulated folk tales leaves us continuing to hope for a miracle while slouching toward shorter and less healthy lives. As we saw during the COVID-19 pandemic, we know how to go about getting an answer to these questions by deploying sufficient resources to attain gold standard evidence in humans. We also learned a great deal about the importance of combatting the snake oil salespeople and the loudest storytellers, and the Herculean effort required to do so in an information environment awash with counterfeit silver bullets and their enthusiastic purveyors. A big part of that is figuring out our scientific pronouns—whether “we” is we or them or everything. This in itself is a new battlefront in “all-round combat” yet unresolved.
Note: This review gives the views of the reviewer, and not the position of USAPP – American Politics and Policy, nor the London School of Economics.
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About the author
Posted In: Book Reviews | Healthcare and public services
