I do a 210 day water fests every year. So that would be, you know, literally not eating for ten days.

I try to do time restricted eating, which means I only usually eat between one or two and three. Seven when I travel in in the plane. I take a molecular hydrogen.

Wow. You know, I'm not even sure what some of that means. But one thing I've learned on this season of the podcast is that people will go through extraordinary lengths with the hope, the simple hope of living longer. Yeah, it's a worthy goal - live a long, healthy life. But as you just heard, some people are going to put a lot more effort into this than most.

Some of the things that I do that are more like what you're probably imagining biohackers would be would be nutrient drip abs. I usually do one per week.

I sometimes feel like we're all a little crazy, all of us. Biohackers.

Welcome to the world of biohacking. This is an emerging field and I guess maybe best described as finding ways to enhance our natural biology. Kyle Armour started a whole Facebook group devoted to biohacking back in 2017.

Biohacking to me is it's it's hacking your biology, right to be more efficient, more productive, just create more efficiencies and to live a fuller life.

Melina Vicario, who is based in Argentina and is regarded as sort of the voice of the Spanish speaking biohacking community, defines it like this.

Biohacking, for me, is a tool that gives people freedom. A user manual for humans in these days.

As the chief medical correspondent at CNN, I hear a lot about so-called hacks or miracle treatments that promise to slow or even reverse aging. We are pitched ideas around this topic all the time. Cold plunges, supplements, drugs, particular ways of eating or moving. We've spoken about some of these this season, and while some of them have real science to back them up, others can be much more questionable.

Dubbed vampire, plasma companies were hawking the infusion treatments for thousands of dollars, claiming to treat a number of conditions.

Does human growth hormone have anti-aging powers or does it contribute to heightened cancer risk and earlier death?

As a doctor and a journalist, I approach treatments that promise these radical, miraculous results. What they pretty heavy dose of skepticism. Does any of this actually work? How do you measure success? And most importantly, might they do more harm than good? Look - for almost all of our existence. Humans have been looking for the so-called fountain of youth. And every step of the way we have needed to separate the real science from the junk science. There are different motivations for different people. And to be fair, some of these bio hacks, they do show tremendous promise. For example, the idea of taking diabetes drugs to target aging. Well, today I'm going to talk to a scientist about that. He has studied this particular topic for years and then decided to start doing this himself. He has really revamped his entire life based on what he learned in his lab. And some of what he told me made me want to start to evaluate certain things in my own life as well.

If we prevent aging, we prevent age related diseases. We want to target aging before it starts. And what we claim is that we have the tools already to do that. This is my mission. It's to cure aging.

I'm Dr. Sanjay Gupta, and this is Chasing Life.

You might remember that earlier this season I had this really wonderful discussion with my own parents about them getting older. I asked both of them how they feel physically at this point in their lives. My mom, who's now in her early eighties, she really kind of surprised me. She said that she doesn't have any aches or pains and that she gets 9 hours of sleep a night. Frankly, I was pretty jealous.

I just turned 81 and I feel great. I probably feel younger than my age because I'm pretty active. I go to bed early and I get up early and we walk. We do water aerobics. We go to the gym. You know, I enjoy I still enjoy cooking very much, having friends over. So life is good.

My next guest, well, he paid close attention to that interview and says that my mom is probably definitely doing something right.

Your mother is demonstrating a slowing of the aging process.

Really?

Okay. Because it is untypical for an 80 something year old woman to sleep 9 hours and not to have pain. Right. The gerotrician are saying to their patients, if you wake up in the morning and you have no pain, you're dead. Okay.

Is that is that right?

It's it's well, it's jokingly. But, you know, pain is really common in elderly and and your mother exhibits no pain, which means she doesn't have this breakdown in aging, which means that her aging is slow as compared to other. And that's the point that there is a biological age and a chronological age.

That's Dr. Nir Barzilai. He is the director of the Institute for Aging Research at the Albert Einstein College of Medicine in New York City. He's also the author of the book Age Later. He's really interested in increasing our lifespan, but not without also increasing our health span. That's to say, the time we enjoy good health. Dr. Barzilai and I have actually met before. It was back in the mid 2000s when I was covering a story about slowing down the aging process.

By the way, when we found our first longevity gene, you came to our lab.

Yeah, I remember.

And you didn't have that and you were very frustrated by the way, we have other longevity genes and actually ones that could fit you better.

I was pretty frustrated, honestly. I was hoping that I had some sort of shortcut to an increased healthspan. But I guess I'll keep my fingers crossed that I at least carry one of the new longevity genes that he's talking about. But again, to be clear, this isn't just about aging. For Dr. Barzilai, this is about age related diseases. I'm going to keep making that distinction. Slow down. Even stop aging. And those diseases may be tremendously reduced as well. People could live longer and healthier.

We have to talk about health span. We used to talk about longevity, but when we said longevity, a lot of people assumed, okay, they get sick and now they're sick for longer. Okay. Longevity didn't sound good. I think Healthspan is good and there's a side effect for Healthspan if and by the way, why Healthspan? Because if we can target the biology of aging and we know that there's a biology of aging because we know who's young and who's old. But if we can target that, then we stop. Not one disease and not two disease, but all those diseases of aging the cancer, the diabetes, the cardiovascular disease, the dementia. Okay. So we want to target it's a prevention. We want to target the biology of aging and prevent all of those diseases. And and by doing that, will established health mean for the individual. And the major side effect will be longevity.

Let me share some basic math here. Dr. Barzilai estimates that our maximum lifespan, statistically speaking, is around 115 years. But we are dying at an average age of between 75 and 80. So for him, that leaves a lot of room for improvement, about 35 years worth. And to realize that potential, we have to tackle what causes us biologically to age in the first place.

We discovered what we call hallmarks of aging. What is the hallmark of aging? A hallmark of aging is something that goes wrong in animals and people. But if you fix them, then health span and lifespan of your animals or humans will increase. That's how we define hallmarks.

Let me hit pause here for a second and just explain about these hallmarks without getting too technical. Think of them as processes at the level of our cells and our genes that malfunction as we age and which then affect the ability of our body to work the way it should and the way that they used to. In all bars lie lists eight kinds of malfunctions, things like our ability for cells to grow and divide properly, or a decline in our immunity.

What's important to know is you don't have to fix all the hallmarks at once to get the effect on healthspan. You can target one and affect all others. In fact, eight medications that have been effective in humans, for example, metformin or the class of drugs as it's called, CO2 inhibitors are are ones that are targeting all the hallmarks of aging. Now, you would say, no, that's imposed. How? What do you mean, target all the hallmarks of aging? Well, the thing is, they're doing something that takes an old cell or an old organ or an old body and make it younger. And by making it younger, you fix a lot of things. So it looks like you did a lot of things. But actually what you fix is a very basic mechanism of the biology of aging, and those are the promises that we already have in clinic to say we can actually target the biology of aging and prevents diseases like cardiovascular disease, cancer, cognitive decline and mortality.

I know this is going to sound like a simple question, but when you're just trying to define aging, then, given all you just said, if you define aging, are you thinking of it more as a wear and tear phenomenon that is reflective of how many years you've been alive? How do you define aging?

Well, if you want the simple answer, I'm always talking about this a couple that live in the Midwest and the wife turns to the husband and says, Honey, why don't we go upstairs and make love? And the husband said, Sweetie, I cannot do both. Okay. That's the functional definition of aging. I don't know if you are going to put it in your podcast.

I think we have to.

But to simply to simply say it - we are moving somewhere, you know, around the age of 50 from this notion that we are building up things to now or we have to switch the energy and all in order to to start to break down. And the way you ask the question is, is really that is really the answer. It's the breakdown. And the reason I'm saying that is because we showed recently taking a huge amount of data from the UK Biobank that growth hormones are really good for you and protecting you from almost every disease when you're young and when you're old. It's the opposite. If you have high levels of growth hormones after the age of 50, you're actually at risk for more diseases. Why? Because you actually need to shift the energy. It doesn't make sense to grow when you're actually starting to deal with breakdown. And this breakdown will significantly increase between age 65 and 75. And in this sense, when I'm going to measure the effect of any drug that targets aging, I'll be interested mainly to see if I'm stopping the breakdown.

So you're saying as you age, you're you're you have more of this breakdown that you're describing that's associated oftentimes with symptoms that people might have in terms of aches and pains, sleep, mood, things like that. And that's basically what is happening when we're aging. That's the biological mechanism. It sounds like a wear and tear mechanism. More breakdown of cells. Is it is it that cells are not replicating as efficiently as they used to? And there's more breakdown products from those cells? How do you look at it?

So, yeah, so break down products is something that I describe, but it's more complicated than that. But I'll give you an example of another hallmark. Another hallmark is called senescence and senescence. It was referred to as zombie cells. We have cells, you know, we have just a certain capacity to divide. Okay? We cannot divide ourselves for forever. And the last division, okay, means the cell now is not going to divide anymore. But what determines that is the length of our telomeres, Right? Those are the additions and the end of the chromosome. And whenever the cell divide, those telomeres are getting shorter. And if they're too short, they're it's a crisis. And the cell says, okay, let let's let's stop it now. But when they stop it, when they retire, they they become a little fat and they secrete lots of stuff into the environment. And when you accumulate all of those cells, they're actually harmful. So one of the things we are trying to do is to remove those senescent cells. We're using what we call senility in order to to remove them. And we know in animals that if we remove those senescent cells in aging models, they get much, much healthier. And each one of those hallmarks will be another story that I can tell you. So there's the breakdown. And then there's this senescent cell accumulation. There's an epigenetic you know, things are happening above our our DNA that tells tells it what to do. There's lots of those mechanism, but all of them have been shown to be targeted and change our physiology and the rate of aging significantly. If we prevent aging, we prevent age related diseases. We don't want to continue to be in a situation where you get the disease and we know what to do with it. We want to target aging before it starts. And what we claim is that we have the tools already to do that. This is my mission. It's to cure aging. But one of the problems I have is for the FDA. To think about aging as a target.

I know you say it's a thorny topic, but there are people who refer to aging as a disease. They say aging is the disease. Is it a disease?

So my answer to that is aging is the mother of all those diseases.

So how close really are researchers like Dr. Barzilai to identifying and testing drugs in humans that could potentially extend health span? Well, the answer to that might surprise you.

Metformin is one of those drugs that targets all the hallmarks of aging. And that's the drug that I chose to go to the FDA and say use it as a tool and say, we will prove to you basically that aging can be targeted.

We'll be right back.

Now back to Chasing Life. Right before the break, we heard from Dr. Barzilai about why he wants to target aging. The answer - to reduce age related diseases. Okay, got that. The next natural question then is how? Barzilai, who is 67, by the way, says researchers are using three approaches named after stories you're probably going to recognize.

One of them is I call the Dorian Gray. Right. Dorian Gray didn't get old when he looked at the mirror. He he saw is young age, by the way. I'm looking at myself now and and I know that I'm much younger, that I'm a Dorian Gray.

You look fantastic.

I'm much younger.

I totally agree.

For 100 years old. I guess so. A so those are the drugs that actually showed that we we prevent overall mortality over five years, right? I mean, we have drugs like that. The second kind of things we're we're doing I'm calling it the Fountain of Youth or the Wolverine. And the third scenario, I call it Peter Pan or Forever Young, where you take 20 year old and you do a treatment every few months or every year or every couple of year, and you basically erase some of the epigenetics of aging and you repeat it. And so people will just stay younger. And maybe by that they even cross this 115 years maximum lifespan, maybe right in, in each one of those, we're making progress.

Okay. I love this. You know what approach he's talking about is the Dorian Gray, where aging a slow down so disease is delayed. There's also the Wolverine where aging is reversed. And then there's the Peter Pan, where aging never even happens. Now, one of the things I find so fascinating about Dr. Barzilai is that his passion doesn't just stop at the lab door. He is putting himself into the mix. He is willing to try some of these things himself, like metformin.

Metformin, people know it because it's a diabetic drug, but it wasn't like that in the 1920s or fifties. It's an extract of the French lilac and it was used to treat arthritis, prevent flu, prevent malaria. You know, other things when people notice that it lowers glucose in diabetics. But metformin is one of those drugs that target all the hallmarks of aging.

He has said this a few times now. So I want to linger on what Dr. Barzilai is saying here for a second, because I think it's really important. Just to recap, Metformin is a diabetes drug. It's used to lower blood sugar in patients with diabetes by improving the way their bodies use insulin, and it's been incredibly effective in that regard. By the way, it's also super cheap. It can have some side effects and for some people those side effects may be prohibitive. They'll pay close attention here because what Dr. Barzilai is saying is that metformin can target certain disease processes by addressing these hallmarks of aging, such as reducing inflammation, improving immunity and producing other desirable effects all the way at the cellular level.

There are studies that showed that people of metformin don't get diabetes, that people on metformin don't get cardiovascular disease in clinical trials, get less cognitive impairment. So we have a lot of data on that and that's the drug that they chose to go to the FDA and say use it as a tool and say we will prove to you basically that aging can be targeted. They don't agree that it's aging that's targeted, but that doesn't matter. They agreed to what happens if we show them that many diseases are going to be delayed? They said, Oh, that'll be great. They can call it whatever they want and we'll call it aging. It's fine.

Can we say that at this point that if you take metformin that you will delay what are often referred to as age related diseases?

Yes. And you know, if you notice the news, there was really interesting news that proves the point, I think. Let's start with that, that there are studies around the world, nine studies around the world uncovered that people in metformin had less than half the mortality and hospitalization. Okay. Those are people with diabetes. But that led to a two study. One of them was published a couple of months ago in the New England Journal of Medicine, comparing three drugs and only metformin delivered within three days of COVID, prevented mortality and hospitalization by 50% in Lancet, Metformin in clinical study prevented long COVID. By 50%. And there's another study in there. It is scary recently. So what am I telling you? Metformin targets the hallmarks of aging. One of the hallmarks of aging is the immune decline. Okay. If you give them it for men, when you have COVID, you take care of the immune decline and the inflammation, and you actually do much, much better. So, yes, metformin is this pill that has a remarkable effect on the hallmarks of aging and protects us from age related diseases.

I know that sounds remarkable, but again, caution is king. As a doctor, there's a lot you have to consider before recommending a patient take a new drug for something other than its FDA approved use. Dr. Barzilai says he understands those concerns, too. But I got to tell you this, as I talk to him, I realized he is all in on this. He feels like this mission of extending the life span, the health span is too important to hold back on a medication that could possibly help in so many different ways.

Remembering first day of medical school. We learned do no harm, free movement or not. Sure. Right? First day of medical school which made us conservative, right? We basically we rather not treat anyone and not get into trouble. The second day we learned that there's no always or never in medicine. Okay? Which really means, you know, this drug will help people, but one will get into trouble or die. Right. But I think that we have to find a way to be less conservative and in particular in drugs, that their major side effects is longevity. Right. We are much, much slower than where we should already be based on the evidence that we can do something about aging. And and we know that. And we proved it again and again. And there human trials in others, and we should just start doing that.

It's a fascinating area of research, no doubt, and it is so relevant to so many of us. But to be clear, I also want to point out that biohacking is not all about drugs. It's about a lot of things, including being very deliberate about how, what and when you eat.

The model that everybody was obsessed with when I started was the caloric restriction model. What's the caloric restriction model? You take brothers and you give half of them to eat whatever they want and the other half gets 40% less. You know, it's 60% of what the others got. When you do that, those caloric restricted animals live 40% longer, but they live also much, much healthier. And people took it to say, you know, we should have less for breakfast, lunch and dinner, but that's not what we've done. What we've done is we would give them the food in the morning and they would be hungry, so they would eat all the food and then they would fast for 23 hours. If we actually give them the food throughout the day, they're leaner, but they don't live much longer. And that's where this new idea of fasting, intermittent fasting or, you know, there's lots of names to that came through because fasting has been one of the of the major environmental way to actually target aging. And so a lot of us I'm fasting for at least 16 hours every day. Some are fasting 24 hours twice a week, some are fasting five days, three times a year. You know, there's a variability.

You fast for some 16 hours. And it's interesting because you're saying it's not necessarily the calorie restriction as much as it is the actual not having calories for a certain amount of time. First of all, what do you get out of this? Like, so what's your expectation for putting yourself through this 6 hours of fasting a day? If you had to say, okay, now why are you doing that? How much longer are you expected to live? Because you fast. How would you answer that question?

Well, the interesting thing with with what we're doing is that right? If you take something, if you do this and and and you go on, who are you comparing it to? You're not comparing it to you getting older regularly. Right. That's appropriate. But a lot of our intervention actually, you can measure things. So for me, what happened with the intermittent fasting, first of all, I lost weight and then you noticed another thing which a lot of people reports my physical, my exercise capacity have improved by significantly. I didn't expect it. I actually thought maybe I lose lean body mass. I probably didn't lose a lot Lean body mass. I lost maybe fat mass because what this fasting allows you is to move into fat metabolism and to glucose metabolism so it utilizes fat without changing my mind, body mass and with increased energy capacity. And so I could feel the benefits.

Is there a way to quantify the impact of that? I realize that you can't compare yourself to the perfect control group because that's you. But in animals, you said animals, certain animals. Lived 40% longer. What do we know about fasting and and life or health span? How much of a difference does it really make?

So there are studies in humans. There are good studies in humans, but they are short term. So I'm saying it upfront because short terms mean we haven't connected the to disease. Right. Or longevity.

But isn't isn't that a little bit of a problem, though? Because I mean, I understand the hypothesis and it there's a lot of logic to what you're saying, but ultimately trying to to do significant things in one's life, not even for 16 hours a day, take a new drug, things like that, with no clear cut, sort of their their meaning. You're not sure that it's actually going to extend your life. How do you how do you make the case how do you make the case to your friends? How do you make the case to the FDA?

So so it's a really good question. And look. Intermittent fasting is not going to be an FDA does the drugs. So the way I can push that is a study that we started doing actually, we had to stop it during COVID, where we bring young, young and old people and we fast them actually for 24 hours. But what we do is we check their biology, their you know, we check basically all the hallmarks of aging. And we see the time course in which it happens. So, for example, the major thing that is connected to aging, we all agree, is autophagy. Autophagy is the green energy garbage disposal. Are cells accumulating garbage. That's, you know, it's as natural as we we accumulate garbage and there's the mechanism that takes this garbage recirculated and you can actually use the component again. And this is something that declines with aging. And if you fix it, that's why it's Hallmark. If you fix it, your animals live longer and much, much healthier. So basically what I'm saying is we're looking at the time course in humans to get an improvement in autophagy, to see when you switch from carbohydrate to fed metabolism, to connect all the dots that have led to what we've seen in animals. But to do a study with 3000 people where half of them are intermittent fasting or not, I don't think it's ever it's ever going to happen, just like we're not going to do exercise, study or sleep for mortality. Right. I think that's that's our problem.

Another problem is the why live healthy. Yeah, sure, I think anyone would get that. But what about the actual tangible benefits we get from living longer than nature seemingly wants us to?

What's the cost? Right. Can we afford. And here is the biggest surprise. If so, our centenarians, they are not only living longer, they're living healthier longer. They're living 30 years longer, healthier. Not only they're living longer and healthier, they have a contraction of morbidity. They're sick very little time at the end of their lives. 30% of our centenarians don't have a disease. So we started to talk about longevity, dividend. And the CDC since 1993 shows us that the medical costs, the last two years of life, the medical cost of somebody who dies over the age of 100 is a third of those who die when there are 70. So so actually, there are trillions of dollars of saving. If we could just live healthy and die. Okay, which is kind of my perspective of of the future. Now comes Andrew Scott, who's the professor of economy at London School of Economy, said, What are you talking about? You're totally missing the point. He said, okay, so this guy's not in the hospital. What is he doing? He's traveling. He's shopping. He's getting things for his grandkids. So I think we have to understand that with this society that's growing. The best thing we can do for the economy and for the individual is to keep them healthier for longer.

I think that's certainly a noble goal, although admittedly, I think it's unclear if those economic impacts would actually shake out the way, Dr. Barzilai says. Regardless, I think it's really important to think about aging through this lens. I hope he's starting to think of it this way. How will me getting older and living healthy longer really impact the people and the world around me? I know I've thought about this a lot, especially as my three teenage daughters continuously grow older. What can we all do to try and get a leg up? Remember our biohackers from earlier? I think it's really important to remember that some of what they are suggesting does not require fancy medications or blood treatments or extreme diets. For Kyle Armour, it starts in the bedroom.

So sleep has been something that I like biohacking, the craziness. Like you need to sleep in a completely blacked out room and keep your bedroom away from like, don't go in your bedroom ever, except just to sleep.

And Melina Vicario says some of the best biohacking you can do is actually inside your own head, just through positive thinking and mindset. In fact, she calls it mind technology.

One of the principles of mind technology is that if I change the way I think, it changes what I feel and it changes what I can do. You will not only be happier, you will be youthful, you are full of energy. Your skin is going to glow, your hair is going to be strong and your muscles will be stronger. And I think that this is one of the most important biohackers and it's free.

Other free biohacks she recommends. This is a good one. Letting sunlight into your eyes before the light of your smartphone. She says that can help regulate bodily functions. Also not using personal products like shampoos and makeup that have a lot of potentially toxic chemicals. And also, finally, don't be afraid to hug, hug your family, hug your friends.

People may create the thought that all this is for the millionaires and the for the very rich people. This is not for me. But I can say that the biohacking is for everyone.

Even Dr. Barzilai, who could be considered a biohacker himself. He agrees that the simple hacks, they're the ones that can have the greatest impact.

Exercise, diet, sleep and social connectivity are the things that each one of us can do. We don't need to wait for drugs for that. Right. Okay. And that will assure us that we statistically assure us that we'll get over the age of 80. That might not be enough for everyone. And there are other people who will need more help because as we saw with your parents, the rate of aging changes between people and changes with the environment. Look, poor people die 20 years sooner in almost every city in the world. Okay, so what do you do with poverty? How how do you get them to have the environment that will allow them to live as long as others? Those are those are the challenges. They need help more than anyone. By the way, cancer survivors, they are aging rapidly. Look, we just gave them chemotherapy and radiation. We age them. They need help. People with HIV are getting diseases ten years before their cohort. If we want to go somewhere in space, okay. If we're going to Mars, not just spinning 20 minutes, the atmosphere, then we need to solve aging will never get to Mars without disease and we'll never get back if we don't solve aging. So there's a need to solve aging for for everyone and to increase the healthspan. And so for me, it's not a science fiction. It's a total science now.

Dr. Barzilai has a really fascinating perspective on all this, and it's one I don't think many people often consider. You know, as I've been having these conversations with my own family on the podcast, I've come to really savor the aging process and find that there is so much richness and texture to life in our later years, especially if we can stay healthy enough to enjoy them. So why do so many people have this obsession with preserving their youth with living as long as possible? That's how these so-called biohackers are often portrayed, skirting along the edges of science and sometimes safety to outlive us all. Well, to be clear, there can be risks to some of these hacks. It's important that you follow safety guidance, even ask your doctor if a particular treatment is right for you. But for Leon Kurita, his reason for trying these hacks, his why, if you will, is something I think we can all relate to. Even if you're not ready to start biohacking yourself.

When I look at my two year old daughter every day and I think, man, she is awesome and I just want to be here as long as possible with her. Yeah, it's worth it.

Next week on Chasing Life, we're going to take a close look at another drug that could help ease the aging process for seniors. And I'll tell you ahead of time. It's probably not the kind of medication you're thinking of.

I never thought I would be taken through a dispensary.

Right,.

By a 94 year old.

Who else would take you?

The medical benefits of medical marijuana? That's next time. Thanks for listening.

Chasing Life is a production of CNN Audio. Our podcast is produced by David Rind. Xavier Lopez and Grace Walker. Our senior producer and showrunner is Felicia Patinkin. Andrea Kane is our medical writer and Tommy Bazarian is our engineer. Dan Dzula is our technical director and the executive producer of CNN Audio is Steve Lickteig. Also, a special thanks to Ben Tinker, Amanda Sealy and Nadia Kounang of CNN Health.