Science-based Longevity Medicine

Much nonsense has been written in the guise of longevity medicine. In Fantastic Voyage, Ray Kurzweil explains why he takes 250 pills every day and spends one day a week at a clinic getting IV vitamins, chelation, and acupuncture. He is convinced this regimen will keep him alive long enough for science to figure out how to keep him alive forever. In Healthy Aging, Andrew Weil chips in with his own mixture of science and magic. I pointed out the flaws in their reasoning in a review for Skeptic magazine – available online. There are many other popular books that promise to tell you how to live longer. Most of them amount to little more than speculation based on extrapolations from animal studies, in vitro studies, and odd non-clinical facts.

There simply is no evidence that any intervention will extend the human life span. The most promising idea from animal studies, severe calorie restriction, is not practical or palatable and would make adequate nutrition difficult. We don’t know how to prolong human life to, say, 130 years; but we do know how to prevent a number of diseases from causing premature demise at 60 or 70. That’s what real “longevity medicine” means.

To counteract all the belief-based and speculation-based “longevity medicine,” we needed a science-based longevity book. And now we have it. Carl Bartecchi, MD and Robert W. Schrier, MD have written a book entitled Living Healthier and Longer – What Works, What Doesn’t. The price is right – it is available online for free download.

This book is based firmly on science. It covers major diseases, risk factors, and the interventions that have been tested and shown to improve outcome. It doesn’t promise survival beyond the expected life span, but it shows you how to minimize the risk of avoidable diseases and live as long as possible given the constraints of genetic inheritance and the accidents of chance.

For those who think modern medicine doesn’t focus on prevention, here’s a whole book of refutation. It stresses appropriate screening tests, immunizations, smoking cessation, weight control, healthy diet, exercise, and proven interventions like low-dose aspirin. It even includes guidelines for the responsibilities of doctors and the responsibilities of patients so they can work together optimally.

I have a few quibbles with details: they recommend breast self-exam, which has recently been shown not to improve survival from breast cancer, and they recommend limiting egg consumption because of the cholesterol in eggs, outdated advice that most science-based doctors would disagree with based on more recent evidence. But most of what they say is solid mainstream science backed up by good quality evidence.

They cover vitamins in detail. They discuss the failures of antioxidants in clinical studies and the recent changes in recommendations for vitamin D. They dispel many popular myths:

Studies do not show that a healthy person who takes extra nutrients has increased energy, reduced fatigue, or added disease protection. .

The title of one chapter is particularly refreshing:

“Alternative Medicine – Alternative to What????”

They quote R. Barker Bausell’s Snake Oil Science and Edzard Ernst’s review of the evidence for acupuncture. They cover many of the things we have covered on this blog, including the failure of the NCCAM, the problems with the DSHEA, the dangers of chelation, the “natural” fallacy, the vagueness of claims to “support immune function,” herbal side effects, and contaminated products. They call homeopathy the ultimate hoax. They discuss the reasons things may seem to work when they do not. They conclude:

In spite of the many promises, alternative medicine practices are not short-cuts to living longer and healthier lives. In fact, according to Professor Bausell, “There is no compelling, credible scientific evidence to suggest that any CAM therapy benefits any medical condition or reduces any medical symptom (pain or otherwise) better than a placebo.” Of course, should any of these CAM therapies be found to be effective, that therapy becomes part of conventional medicine.

The book was reviewed favorably in the New England Journal of Medicine I hope the word will spread and this excellent resource will become the go-to reference for accurate information about science-based preventive medicine and “what really works” to live a long and healthy life. And I hope its on-line format will include constant updates as new information becomes available.

Posted in: Book & movie reviews, Science and Medicine

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