Aging & Longevity Grand Challenge
As the inaugural challenge in its Grand Challenges in Health and
Medicine initiative, the National Academy of Medicine will seek to
transform the future of human aging and longevity by catalyzing
innovation and progress.
Human beings are living longer than ever before, thanks to dramatic
advances in medicine, public health, and economic and social progress. Exciting innovations in science and technology have potential to improve quality of life as we age — and even extend the lifespan. As the world’s aging population approaches a tipping point, accompanied by unsustainable health care costs and social burden, it has never been more urgent to support the next breakthroughs in healthy aging.
Is Heart Rate Variability the best biomarker of the time to track our longevity? In this episode, we look at why HRV may be the best way to track how well you are aging and the bets being placed on it in Silicon Valley to drive innovation in anti-aging and longevity research.
Previously we’ve looked at using HRV for training and recovery, stress management, and tracking hormesis. If you are new to biohacking, HRV is an easy economical way to start tracking. All one needs is a heart rate strap and phone app.
Do we have enough talent in healthcare? Learn how the 21st century is poised to become “The Healthcare Century,” and why Humans need apply.
About Joon Yun
Dr. Joon Yun is managing partner and president of Palo Alto Investors, LLC, an investment management firm founded in 1989 with $1 billion in assets invested in healthcare. Board certified in Radiology, Joon served on the clinical faculty at Stanford from 2000-2006. He received his B.A. from Harvard, M.D. from Duke Medical School, and clinical training at Stanford. Joon has served on several corporate and non-profit boards and has published dozens of patents, scientific articles, and business essays. He is a contributor to Forbes and is the health editor for Evolution magazine. Joon recently agreed to donate a $1million Palo Alto Prize to reverse the aging process.
A World Bank report estimated that the 2014 GDP toll, directly and indirectly, attributable to the recent Ebola outbreak in Africa will be between $2.2 billion and $7.4 billion. The viral outbreak has infected 14,000 people.
If so, what is the implied economic benefit—in terms of averted GDP loss—of health innovations that rid the world of the bubonic plague, which once killed an estimated one-third of the global population in 5 years, and smallpox, which killed an estimated 300 million people last century? What is the implied economic benefit of health innovations that now allow those infected with the human immunodeficiency virus (HIV)—which has killed 32 million people globally—to be able to live as long as uninfected individuals?
Earlier in 2014, a media furor arose over another virus, hepatitis C. As companies usher in the first curative drugs for this deadly viral pandemic that has already infected 130 million people globally, politicians are tripping over themselves in on drug pricing.
While a debate rages about the cost of these drugs, it is also important to contemplate and calculate the implied GDP benefit—the health dividend, if you will—accrued by economies made healthier by these innovations. The public is generally unaware that they are collecting this health dividend because the human mind tends to overlook averted losses despite its significant economic value.
The first Keynote: “Hiding in Plain Sight – Massive Trends Missed by the Masses”, was given by Dr. Joon Yun, a renowned investor and Managing Partner and President of Palo Alto Investors, LLC, a hedge fund founded in 1989 with over $1 billion in assets under management. The audience was captured by his talk on e.g. aging and the ability to remain stable or remaining the same. “When we are young for instance we can be rebound from a bad night’s sleep quickly, when we are old, it can take days to recover. When we are young, our eyes adjust to changing focal length, when we are old, the focus never quite rebalances“, said Yun. The original “health system” is our inborn, adaptive homeostatic capacity, endowed by nature and shaped by evolution. Once humans reach reproductive senescence by their mid-40s, however, a progressive erosion of innate homeostatic capacity begins, manifesting in the panoply of aging diseases. Our proposal for 21st-century healthcare is a paradigmatic revolution—restoring homeostatic capacity instead of restoring homeostasis—as a way to end aging. If we can put homeostatic capacity, and thus health, back in the body, healthcare costs could contract dramatically. The feed-forward relationship between health innovation and increasing future consumption—a vicious cycle that threatens aging economies everywhere including Europe and the United States—would finally be decoupled. Median lifespan could telescope to a number of years that might have once seemed unimaginable. Human capacity would finally be fully unleashed.
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Not long ago, consumers could access health information about as easily as they could access plutonium. This is changing rapidly in the information age. As a result, consumers—rather than doctors, government, insurers, hospitals, or healthcare companies—will own the Healthcare Century. Any healthcare institution that ignores this trend does so at its peril.
Before the information age, consumers were almost entirely beholden to their physicians for information about health and disease. Now, consumers increasingly educate themselves using the Internet to learn about their health, illnesses, and symptoms. Every day, the patient-doctor relationship becomes more of a partnership as patients come up the learning curve.
Human endeavor creates value. Healthier people endeavor more. Thus, health is a creator of value, of prosperity. The converse is also true. Wealthier societies demand more healthcare. When life is grand, people want to live longer and they want to maintain healthy bodies. Therefore, health and wealth form a virtuous, feed-forward cycle.
The immune system defends hosts against internal and external biologic threats. It also records an antigenic map of the environment such that it can appropriately respond to stimuli as benign or threatening.
A lesser-known function of the immune system may be to sample the microbiome for potentially beneficial traits it can add to the host inventory. Rather than executing wholesale destruction of pathogens, the host can benefit by domesticating invading organisms or parts thereof. The function can be summed in the word “xenovation”, innovation achieved through the selection and integration of foreign traits. Implications for biologic evolution, meme evolution, and computing evolution are discussed.
Components of pathogens can be processed and rendered benign or useful through various mechanisms. A historical example of this phenomenon is the domestication of one prokaryote (or at least its energetic machinery) by another to form a eukaryote. A current example is the processing of pathogen antigens for surface redisplay to other players in the immune system. The ability to protect against reinfection is a trait acquired via the pathogen. It is intuitively appealing to speculate that the immune system is in a perpetual state of exploration for innovative traits through domestication.
The exact mechanisms by which immune cells domesticate microbial traits remain to be elucidated. How sequences associated with those traits might end up in the germline also remains to be investigated.
Social mobility enabled by innovations in technology, communication, and transportation has dramatically increased the liquidity of our relationships. Some of the hard-wired social traits that we inherited from our tribally-minded ancestors may be maladaptive and not properly suited to handle modern relationship dynamics.
Our attraction to new social opportunities was shaped when such opportunities were far more limited than they are today. Not unlike our attraction to sweet, fat, and salty foods, little selection pressure existed in the old world for evolving upper limits on our attractions for new social opportunities. But does a tendency to be intrigued by new social opportunities make us happier people in a world where access to new opportunities is virtually limitless?
Evolutionary medicine (also referred to as Darwinian medicine) is the application of evolutionary theory to the understanding of human ailments.1 2 3 It explores evolutionary mechanisms of disease, offering a complementary framework to the proximate mechanistic explanations that prevail in medicine today. In this paper, we consider the application of evolutionary theory to the treatment of ailments.
A major contribution of evolutionary medicine is the framing of human diseases as maladaptations of our prehistoric factory settings. Our physiologic processes were shaped during prehistoric evolution to meet the needs of the era, but those same processes may behave maladaptively in the modern environment and produce disease. We take that notion one step further and propose an overarching therapeutic paradigm for human ailments based on evolutionary theory—the induction of adaptations in the body as a way to treat disease. It is the idea of creating somatic traits in the body that evolution might otherwise need to create over many generations through the sheer force of variation and natural selection. In the same way, that evolution has endowed us with traits that shield against biotic and abiotic stress to maintain homeostasis, we propose treating patients by endowing the body with buffers against ailments.