The Longevity Imperative: Redefining the Way We Age
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To keeping people alive, you not keeping them healthy.

The view that medicine starts with disease is by the problem, because they should start with help.

One in five for one in six brits amounts to a hundred ago to the government. How do you finance that?

Is your four one case set free to live to a one hundred people?

S and you can be a hundred and fifty running hundred years. You can look on youtube.

And instead of this being a crisis that could be that great is accomplishment of events.

Let's start this episode with a thought experiment. What would you do if you knew you were going to die today? And what would you do if you were impossible to die today? I bet let's separate from the outcomes that those days would look pretty different because probabilities guide our decisions.

And that is the promise of today's conversation. We as humans have extended the asian curve, meaning we are probably tics living longer and a whole of longer. In one hundred and sixty five, the most common age of death was in the first year in the U.

K. Now that's flipped to eighty seven. And contrary to popular belief, we are still extending lifespan.

So what happens when the calculus is no longer avoiding dying Young, but perhaps striving to live extremely old? Plus, what does your life work? And how does this impact our society, not just in the health system, but the financial sector, career planning and even drug sign?

Joining us to discuss exactly this, a doctor, Andrew Scott, author of the longer the imperative, a book published earlier this year alongside found in general partner of a sixteen beyon health D. J. pont. Let's get to IT.

As a reminder, the content here is for informational purposes only, should not be taken as legal, business tax or experiment advice or be used to evaluate any investment or security, and is not directed at any investors or potential investors in any asic gene fund. Please note that asic sense year and syphilis az may also maintain investments in the companies discussed in this cast. For more details, including a link to orm investments, please see a six and city outcome slack disclosure.

You could have named the book many things. The longevity imperative is very specific and very telling. I think of what message you're trying to get across. Let's start there. Why use the term imperative?

I A that economists. And I think we got a sort of face the chAllenges we have in the world ahead of us. And this one just drops off the radar.

We talk about A A, I climate change. Now we have to adapt and adjust. But when IT comes to this topic, we tend about an aging society.

And we really get beyon talking about adult type and get ones. So I wanted to just sort of elevate this topic right out there. And the meaning of imperative is vital importance.

And actually, I think it's got a double play too, because it's not just vitally important for society because we will avoid a pensions crisis and health crisis. It's quite important for all of us because for the first time ever in human history, the Young can expect to become the very old. And so how we age is now an incredibly important thing.

Let's quickly double click on that because you actually compare the criticality of longevity, two things like, let's say, A I or climate change, other areas or sectors where people widely address as really critical and widely impact for why do you position at their relative to those other areas?

Because I think it's right up that just as important, we fear getting out. We fear out crying in our skills at. And so that's why there is that longevity imperative.

What are you going to do now to age well? But itching is notice sexy word. I know no one that says, yeah, great.

We got an aging society, which is sort of strangers, one of the greatest to cheapen of the century, to get global life expectancy above seventy phenomenon. Few are children to moon. You are parents natchally to away mid life.

More grandparents meet in their grandchildren. And we say that we've a magical society. I mean, it's just A A really weird while you're frame and the people switch off with aging, whether when he comes to A N climate change, it's like h this is really important.

If we don't do this, we're going to have a bad outcome. Can be crucial for humanity, crucial for my individual future. And all of those statements hold for how you deal with your long life.

So that's why it's up there. And it's not just, I think, me being obsessed with this topic. I can give you very, very hard data about the welfare games, but also the economic consequences. If we don't adapt the pensions crisis, the unsustainable health burden. M, the bridge is right out there.

I don't think anyone really is, other than people have. Look at the economics, understand the impact this is having on us, not just as individuals, but as a country, and the amount of debt, the amount of expense that comes long with our current health care system especially, which is exacerbated with age. It's a very hidden and civic problem. And so I think imperative is bought on.

absolutely. And i'd love to dip into how we do need to refashion our economic system, our tax system, the way that people think about their careers because you talk about all of that under. But before we get to that, let's maybe take stock of how lifespan and then also health span have changed and selves are not the same thing, ground us in how things have change maybe over the last hundred years or so. yeah.

So if you look at the of income countries that last one hundred years, life expectancies, reason at till three years every decade in lower income countries even faster. And so global life expectancy is now over seventy three. I think it's worth just pausing at that point.

Global life experienced over seventy three around the world. A child borne today cannot expect to live into an eighth decade. And actually that's based upon no further chain.

So it's probably a greater than that because life expected to see the increasing in many countries in high income countries like the U. K. The U.

K. Government says that fifty percent of children born today will live to be about nineteen. That's extraordinary. And I started my book with a somewhat dramatic statistic, which is not about average life expectancy, but what is the most common age of death.

When I was brighten the book, I wanted you to make a personal to illustrate these demographic trends with my own family. And I discovered my family was stunning, the average, they hit the every single demographic drain completely. But the most striking one was that when I was born, the most common agent death was child on the one in the U.

K. And I was a twin. And my twin died in the first few days of life. So I thought that was quite right.

But that was the most common age of death, and today, the most the common age of death. I think it's eighty seven, eighty eight, something like that 呀。 In my lifetime, the model age of death has shifted.

I mean, it's complicated. I did life, expect, see its average mean and media. But wow, sand back at the irish played, says, we give birth, describe the grave of the light flick as instant. And then IT goes out the lights for curing a lot along. Now that's what we got prepare for yeah I mean.

you share so many interesting statistics, i'll just share one more that surprised me. Based on twenty twenty data, you said that a newborn n girl in japan has a ninety nine point six percent chance of living to twenty and ninety nine percent chance of reaching forty and ninety six percent chance of making up to sixty. I mean, those are just astounding numbers, which to your point, we're not millennia away from those statistics like just the opposite of those a few decades ago, he said, in one thousand nine hundred and sixty five, we were looking at completely different numbers.

And what sort of happening is there is a concept of survival rate, the probable of a newborn reaching a certain age. And IT sort of rectangle zing. Is you just said the chances of a child, a female, in japan, reaching sixty? Is that right behind now? And now the chance getting seventy is getting higher and higher and higher.

So that's the real sort of shift we've load in from mortality dramatically. We made big steps and improve the middle mortality, although the U. S. To go some problems of late. And of course, now the games are coming up, old ages. And so life expenses now been driven by fools in mortality, old age, such that eighty percent of life expected gains in the richer countries is coming from what hotel rates coming down after seventy. So it's just getting further further along this rectangle ization.

absolutely. N. V, J. I love to bring you in here. As you look at both the bio and help side of things, what gives you confidence that this trend might continue?

Yeah, I think there's a lot of excitement about studying the biology of agent for various reasons. I in first off, it's actually kind of shocking how poorly IT has been studied and how little time has gone into IT. But another thing that maybe is at the heart of aging and disease is the fact that many diseases are exacerbated with age like cancer, alzheimer's, type two diabetes.

And so given that there may actually be some common precursors are interesting to go after, either from a therapeutic of view, but obviously also from a lifestyle point of view. Even simple things like we know, being overweight is a massive cultivation for any of those things. And so part the chance will be as the society, what we want to handle through the traditional healthcare are model, which is basically a secure model dealing with disease. Or what can we do more broadly to actually get to longevity, never sort of engaged with the medical model that way?

Yeah and of course, you said, IT, is that true your whole life? I think for me, that's why I stress a longeve vale's society, not an aging society. An agency says, what do you do with without people? Where's the real change? The Young expect to become old when you really got ten percent chance of making IT to ninety.

You really shouldn't say, thinking your four thirties and forties, what can I do now and make sure unhealthy in my nineties, but when there's a fifty percent chance of, I can't my goodness, ss, you've got to start doing that. And we have this diseased focus model, which just doesn't work as we get older. Because N, S V G, I says chronic diseases have this common source.

I think that's really interesting. What is the x that affects all these later diseases? And they could be aging, IT could be obesity, and G, L, P, one, IT could be through exercise.

And of course, that focuses on a really key issue, which is health IT. Just strikes me as dunning that we don't just say, how do we remaining health, we say how do we prevent disease. Just show you the orientation of the system.

And there's a quote by W I. Jordan, which are using the book, which is out of health, is the concept that the medicine knows nothing about him. I said these other days of cardiologists, he said, no health is just an incomplete diagnosis. Something happens. And then, I mean, but IT is quite striking.

Can we speak to that really quickly? Because something that you and many others have pointed out recently is this trend toward specialization in health care. And at face value, someone who is not involved in this world, actually that sounds pretty great, right? The fact that for anything that I run into, there's going to be some specialist to study this much longer than the average doctor who can solve my problem. And so just as we're kind of addressing the state of affairs, can you speak to that specific trend and specialization and how maybe it's not as compelling as you might think if we're trying to achieve this .

idea of lung levity, everything I speciation, I think women come to drug development, we can say that this chAllenges is there because we are a little drugs being developed for very serious specific conditions where you can charge a love, but you only affect a small number of people, brilliant that you affect those people.

But what about the cross cutting breakfast that we really need? But now I think it's a consequence of this kind of disease specialization in in particular as you start to have an older population. I think the rule of the specialization is you beat spending one morning with the cancer specialist, one morning with the cardigans co specialist, one with the diabetic clinic, so you're going to get massive polypharmacy.

So multiple description of drugs where you got no idea how they interact because we haven't got to nickles to try improve IT. And then I think the other chAllenge you got is that the trouble as you get older is you get all these aging related diseases, and fantastic if you can reduce the risk of cancer that's trying this. But you still go dimension out.

Used to go diabetes is in cardiological all, which will low the quality of your life. So he could do something early that affected multiple diseases. The whole is greater than the some of its parts, which specialization is not going to give you.

I think Andrew hitt, in that the view that medicine starts with disease is part the problem because we should start with health and to maintain health rather than to fix disease. Like we all don't want our houses to be on fire. So we have smoke alarms.

We wait into the houses on fire. That's both unfortunate. Also, there's only so much you can do in some ways we ask a lot from a cute care and they can do reckless things, this kind of amazing.

But IT would be a lot healthier, but also a lot cheaper to be able to address these issues early. But that has its own chAllenges. And part of is just not the way .

the system is built to work. I think that is the problem because what you got that is your keeping people alive, you know, keeping them healthy. And that's the real changing about my west spectacle is successful and keeping people alive.

But as we're going beyond seventy into eighties and nineties, we slow down the dying process but not the aging process. And that's not a problem because you're going to spend even more money on sensible things, but you're getting not Better health outcomes. IT is an economist.

There's a various tools where you can put dollar values on health gains and you can add those to GDP. S I look here at the welfare gains we've got and Sunny the last the cage, you're seen a really big slowdown in the rich countries in terms of the health benefits they are getting, but health expenditure is still rising. Yeah, the U. S. They have that being specifically bad compared to other countries.

This is a good point to a really double click on the fact that I think that a lot of people don't realize the societal impact of just that spend. There has been a lot of talk where in the election year about inequality between middle class and upper class that a lot of middle ass genes and wages have been zero in flat.

But actually, if health care could have been kept at the same costs that, say, thirty years ago, then the middle ass was seen huge gains. Basically, health care and his rising costs is eating up these games. And so it's not just about keeping us healthy, which would be great, is about the health of the nation and the health of economy. So that has really broad reaching impacts.

IT does. And there's also another link as well, which is some the amount on moment, which is making a broader case of prevention, which is that if you could stop people in their fifties having heart attacked, ed, they can Carry on working. And that then generates each benefits and GDP and taxes and benefits.

And this, that causes the key thing because you've got more and more old to if you want to make them work for longer, you've GTA keep them healthier and products for longer. You got got to say, hey, i've raise the social security age. Good luck.

So we think about these incentives and how these health care systems really need to think about where they allocate their resources. IT really is a very multivu equation. And I i'd love free to break down how these systems actually do decide where to invest, know there are different metrics, whether it's VS or quality, quality adJusting life year that different groups use.

But then in addition to that, I just wanted to call a one other metric from your book, which is about this idea of action versus prevention in twenty twenty total, U. S. Health care expenditures was four point one trillion dollars, which is around twelve point five thousand per person.

But of that, only around three hundred and sixty three dollars was spent on prevention. So I think that really highlights exactly what both of you just spoke to, which is the idea that we're not investing in prevention, at least compared to the action when something goes wrong. So could you speak how these health care systems choose to divy up the resources? So what's interesting globally.

we've got the same problem. We got a pensions problem and a health problem. And then, of course, if you look within the details, the pension and health is another countries wildly different that will going wrong in different ways.

But in a lot of them, basically, broadly speaking, the mystery of finance over check to the ministry of health, mister health got that stock of money, has decide how to allocated. And IT will look at some health measures, again, in varies in my country of the U. K.

One of the big targets is waiting this for Operations, which is just a crazy metric because I can't everything out that links in to health measures very well, but that's A A measure. But there's also this medical concept of equality, which is a quality adJusting life here. And so if you have a treatment that saves a child's life and they can live to eighty, you've saved eighty years.

But you quality are just the years for the sort of level of health that you get. And so broadly speaking, you can't get that. And then you set a Price for every quality in the U.

K. I like thirty thousand pounds. It's about forty thousand dollars. And say if this treatment comes in less than that Price, it's worthy. If it's not, then do that in the us.

The budget is much bigger and it's more of a commercial decision. I would say that happens. And of course, that question that how much you can pass on to the but there's all sort of value based pricing in that as well.

Most of the measures are all very internal to the health system. I think that's for me, a really big issue because with budgets under constraint, take the U K. Where the health system actually they spent a lot of money, but they are not getting Better outcomes.

We got more mode to people who need Operations, need the help replacement at center. You come inside them now, not gonna do IT. So you haven't got the money to finance prevention and you're just stuck forever doing hit replace in Operations.

So the case of prevention in the moment is sort of made, will IT save me within the health sister if I spend this now? Will IT reduce Operating costs now. And the problem with that is prevention tends to take a bit of time to come through.

The other problem you got in the U. S. Health system is that with multiple health providers, one person's expenditure could be someone else is benefit rather than them. In the UK is not easier because we have one health system. The ministerial finance pays for everything so they can see the savings.

But this is one very keen to sort of say i'll hold on a IT though there's another game to prevention, which is these Billy benefits in the U K. I'm sure at summer in the U S, if you're fifteen, you have a heart attack, your six times more likely to be the labor market. I want you late markets very hard to get back in again, so you can stop that person leaving. You ve got this knock on effect in terms of income, G, D, P and revenue. And that's not currently taking into account .

very little time is discussed on prevention nutrition. And also those fields are complex and highly debated. So there's the education part, which I think there's a huge room for improvement. But then at least n in the U S.

The big question is who's gna pay for IT? And with existing players, they unfortunately have to do with the reality where people may switch payers every two or three years. And prevention is a long term game.

There's A A big push for value base care, and I think there's new models for that and exciting things happening, especially in areas like medical advantage. But in the end, I think what we're gonna is high deductable plans and choices like iqua that will allow actually consumers to be the ultimate payer. And in the end, we kind of our deal ultimate payer and dollars, and we are obviously the ultimate payer and health care results.

And so we care about value. I care about my children's health and my wife's health and someone in a way that no insurance company, me wood. And I think that shift for who's gonna pay and me choosing how my dollars are spent could also facilitate more prevention.

Yeah, it's a really interesting point. Two, because, of course, once you move away from the disease model, the health is to know everything is the air that you breathe. It's the ridden state that you live in.

It's the food that you buy. And I think you're going to say IT go retAiling a very big way. Of course, not everyone is going to spend in a vest in health. But I do think as a logical consequence, prevention, if the health provide is one, provide IT sufficiently other people will, whether that be wearing able devices or whatever. So I think the health economy just starts to get even bigger.

And I think something that a lot of people don't realize is that if you look at the determinants of health, and especially mortality, genetics is a large part like thirty forty percent. All of medicine is basically ten percent. And then a large fraction, like forty percent of social determines.

So if you're spouse smokes, guess what? You'll either be smoking or you will have second and smoke where your IP code predicts your health. To large degree, those social determinants are a huge part. And addressing that should be part of health care. Right now, the health care really is that ten percent of providing disease focus care and you're missing that forty percent.

I complete agree. I mean, the social economy determines a huge behavior and environment, explained the majority. But one thing is an interesting is people kind of resistant, the idea that aging is myself. But you just look at inner quality and you say what we ve found a way to speed up ageing, see social action determined. So it's proof positive that we can really affect how we age and it's somehow just doesn't get into the consciousness.

Yeah and I think examples that you gave in the book are that on a very small scale, you are seeing some insurance companies incentivize people who exercise or have healthy habits or get discounts on healthy food. I'm surprised or not seeing that more candidly, but maybe this is a good transition for us to talk about social implications and the major parts of society that do need to be restructured, as some of this is somewhat inevitable, right is things like the health system, the financial sector, taxes and career planning, drug design.

that the very simply idea of the book, which is for the first time ever, you can expect to become old. So you're going to make sure that you're healthy and engage for longer. You've got to invest more in a human capital.

And of course, if you don't invest in your future, and actually your future is very good, you run out of money, you run out of skills, you're run out of purpose, you run out of health. But we had never set up our institutions to say head is under liver life to his ninety that remains healthy and engaged. So nothing is sort of untouched, including culture and psychology.

But where are the main things? I obvious ly, that the health system here mean a shift to a focus on delivering health rather than treating disease. Work clearly has to change.

And in an early about one hundred of life, I total talked about how we created a three stage life in the twenty century of education, work, retirement. If you just stretched that out to ninety, looks pretty unappealing, pretty miserable. And I think for me, the very simple of motion here is longest is about having more time.

So the question is, what you want to do with that time? And how do you in particularly distribute leasure across your life? And in the tourney century, we fixed retirement age that prolonged is to more, more leasure.

The end of life comments are around the world said, now that doesn't stuck up. You can have to work for longer. So I think we may take less leasure at the end of life, but we spread more leasure across life.

We might start work later. We might take the crew break. Your last job might be part time, or you might go part time sometime in the middle.

We are creates gonna, I think, a lot more transition, some chosen by you, some force upon you. And that, I think, has big implications for sorts of different people. So you are a manu worker, age fifty.

You can Carry on working in a physical job. How do you transition into something different if you are investment banker, working all those out? I am doing this beyond the age of forty five, fifty.

Do you take a break, retrain and do something? Or wrapped into this is education intention, so many things. But finance comes into IT as well, because the simple pension industry says a money when you're working, run IT down when you retire.

But if you got this sort of multistage life accumulation, accumulation becomes much more complicated. So I think finance has to probably do three things. One is do long run saving products that have a much more flexible pattern, totally tie financing into health.

And then the other big chAllenge is that a we met one thousand nine hundred and twenty and we developed a life insurance industry that paid out if you die Young. But sort of the risk now is not that you die at the average, but most will die above the average. And there's no small child are going above a hundred.

And one in five, one in six brits amounts live to one hundred to go to the government. How do you finance that so that living insurance, how do I provide you a study's stream of income in case you sort of little really long life is a huge financial one? Yeah, I think there are .

crisis also that I those who have anticipated seated, I don't think everyday people think about this way, which is the shift, at least the united states, from pensions, which have defined payout ts, to four in one case, which have defined contributions, that in the context of living to ninety, and maybe in time to one hundred is your four. One case set for you to live to one hundred is IT built.

And so does that mean for when you stop working? And can you have a health san long enough so you can build for one k so you can pay for your life span? All these things are things that are gonna be fundamental to us. And by the time we're there, it's too late to make changes.

And think you think how long work, how long I live for, how much money do I need my retire and most they return going to be. Those answers are going to diff wild of a different people. It's impossible to be precise about them.

So whatever plan you've got, you've got to have some flexibility in IT. And the key flexibility is investing in your human capital, investing in your health and your skills. If suddenly you find another glass money, you can Carry on working for longer. But if you haven't got the skills, having got the health, then you got a really big financial problems. I think that's the other thing that long gry the portfolio sudden becomes not just my four one, kay IT is my health and my school was an integrating those together is really important.

And I think something you're calling out is just how this dynamic has completely flipped on a tat right before I was, how do I void dying early, right? And now it's what do I do if I live too long? Like that is a really interesting phenomena.

But to your point, the statistics backed up in terms of your probability, and we do make decisions as humans based on probability, maybe on that and of the people who maybe might say, you know what like, I don't know if I want to live forever or living to one hundred IT doesn't actually sound so great. You mentioned pretty repetitive ly throughout your book this bias that people seem to have around aging and the aging population, both on a personal level, but then on the societal level of requiring the support of many others who have not sustained their health span. So can you just speak to this further and talk about how maybe we need to update our tires based on these shifts?

There are definitely some cultural differences here, and you can. U. S.

Is a one end of the spectrum. But in general, we underestimate the capacity of older people. That's ages.

M, and the trouble with that is that means we underestimate the capacity. And later life. And I enjoyed doing a story. I was teaching some chinese N B, A students this summer, and I was shining the chinese demographic data.

These students, late twenty, early thirties, and china's demographic changes is quickly striking, is going for one point four billion people to one billion, forty five percent, and even more than eight sixty five. I was sort of showing the data and showing how, in thirty five years time, that all these people aged over sixty five of night said to these chinese ambitions, how you feel about that. I said, it's a problem.

I, I support these old people. They are gonna get ill and need a pension. I said, what you are, these old people and I said, what you mean, the old people? I said, no, they are.

And he was remarkable how the penny drop, oh my good. When everyone hears ban aging the side with old people, it's not about me, understand ine, I be fit and healthy. And IT was quite remarkable how a negative old people. And we don't recognize that the big changes, the yg can I expect to become the old and IT is also some reasons for that about why we have that negativity bats of fundamental problem because you underestimate capacity and later years, you will under investing. And so you lead to the very sort of outcomes that you fear.

And then there's just all the sort of problems of ages, and that comes any form of visits, which is, if you assume the on the basis of a characteristic age, this is what you like, then you ve got a problem. Because actually, the real thing about aging is diversity, people really, really diversity. And you can be a hundred and battery running hundred meters, you can look at IT on youtube, or you can be fifty and in a wilcher.

And I think society has become very focused on chronic gc age. I think it's really interesting. In england, in sixteen, no one we introduced the Elizabeth and poles and IT was look after the poor and the old, but no one knew how people, whether were very difficult, wasn't much numeracy.

So until very recently, people didn't know when they were born or how old they were. The song happy birthday comes in the nineteen thirty, just kind of. So what the polo said was, okay, old is someone who who's lived a long time and can't the conform themselves.

So the whole test was about, could you be functional then? Bureaux acy comes longer as this nightmare, this test, let's just save everyone over sixty five years old. And that's what we do today.

We say everyone over sixty five years old. But of course, the problem that clonogenic ical measure that he just means how long you live. And for me, there's too much more important measures.

One is many more years you can expect to live. And fifty nine and fifteen nine, I have to pay differently from my father and my grandfather, fifteen nine, because I can expect more witness. And then, of course, the other thing is my biological age, sort of, how is my body aging and how my dealing with IT. And of course, if you have that approach, you start to think about actually being fifty and nine doesn't return we much about Andrew. It's not that an important piece of information, but we zoom in a chron logical like to, we seem everyone over sixty five years old, that is an enormous problem, pretty for firms, for instance, because when I rise out of, see a presentation of the ageing society store and a consultant comes on, I know immediate and say, hey, we should invest in khans and cruel ships because everyone over sixty five is going to want a cruise or go to and we'd lost the market completely if that's what you think.

Yeah, I was just right before this actually watching a video of Robert Marshall, the french hundred five year old cyclist he unfortunate passed away at one hundred nine, but at one hundred and five he was still cycling, still beating centenarian records. So to your point, age very much isn't metric, but there are many others to pay attention to.

And so I feel like a lot of listeners at this point are convinced that maybe longevity is more complex and important than I realized prior. And so on a personal level, they are probably asking, okay, so what should I do, right? Because I can impact this, maybe starting out there. How would you both think about the eighty, twenty.

the big promise, both when we talk about dian exercise, I think the first misconception is that there is a right diet for everybody and a right exercise plane. And this is so individualized that we've seen now lots of companies crop up to try to measure things that will help you to know what the right diet is for you. And so IT starts with die exercise, but I think that's a lot easier said than done.

It's really trying to figure out what is important for you. But from there, I think there are intriguing things on the horizon that are maybe a probably more a little bleeding edge. People take meet four and people take other supplements.

I put that in the twenty or the five percent. I wouldn't start with that at all. I think if you've optimize your diet and you've optimize your exercise and you realize still getting P S in your fifties of other weights or cardio, whatever, and you want to go that last bit, that's one thing. But I think there's a lot of long line fruit, especially for people who are fairly sedentary.

I'm not a medical doctors. I don't take anything as not so prescribe and proven simply because I can't want to my own health enough. It's working.

I only takes lots of supplements. They were shouts and said, will miss you, ander. I don't take any of that. And I agree this exciting stuff coming along, it's I was a disappointing thing because people always want the easy answer and there are also easy answer. It's exercise, diet, sleep, enjoyment.

The company at the moment, I would broadly say, although this sums latest evidence of that high intensity exercise and this way of sleeping at sector and fasting, broadly speaking, we know what works. What's changed is incentive to do IT. And I think that's the message you grow, not some secret technique going to change everything we have done brutally inventing and innovating and intervention techniques we nagged up with the same thing on the prevention and data is going to be really important.

And then I think we're start seeing some more personalized medicine coming along. Yeah, but none of that is gonna en quickly. So I left with the stuff that really does make a big difference. I mean, if you look at the evidence on tiki healthy life expectancy, you are talking about another year or two for each other things you do in terms of way exercise. Let's stacks up quite a lot.

Yeah i've seen myself and others like it's not overnight, but you can see games in the first year and then the compound and then it's about keeping a going. I think the maintaining is the harder part to avoid injury and to build that discipline. We could also talk a little bit about the sizes beyond the eighty twenty.

This is like the nine, nine point nine to point one, but like the size fight stuff is that they are just amazing new discoveries and biology of cells and even organisms, this called human architecture. And many people are searching for what really could be a fountain of youth that is like way often. I don't think you are to be taking a pill like that anytime soon.

But intermediate things, there's new pathway is that are course on to pathways are exercise and there's drugs in face two for that, even the G, L, P. Ones and there's posing cons of them may help you get started if your obese. It's about to come up with a plan where this is not going to be a fat diet. This is gonna the rest of your life.

The jeep ones are really interesting. And I think we still got some way to go to work out exactly what they're doing. But what is so interesting is festive that looks like IT gets people a sense of agency in control so they can do other thing so that, that has benefits.

Tal health, it's selecting multiple diseases is a bit like that when there is biomarkers and something affecting to happen outside of an effect on obesity, which courses exactly the sort of thing that we need to have because but is very complicated. Aging is not just one process. And so unlike to be just one pill we take, that is everything.

But I get the analogy with interest rates and the economy. The government changes the interest rates to try and control the economy. It's not perfect, but IT has a pretty big impact.

And so what's the equivalent? And I think that's a really interesting example, the G P. one.

And then you said, I think IT be lots of all the stuff i'm particular taken by stem cells, which you can then just regrow a liver. And that's pretty simple. Y, but that I think is sort of pretty feasible to happen.

Drugs at three of writers will not be wonderful. So I think that's the sort of beginnings of aging Better rather than his. Something is going to keep up to one hundred and fifty yeah.

if i'm taking anything away from both of you is just that maybe we are at this interesting juncture where IT really pays to think about this. And I know that sounds really simplistic, but if we take your example, Andrew, of your kind of family tree, that longer gev ity that happened to decade over a decade was a little bit passive. IT wasn't passive in terms of the millions of, not billions of people working toward those longevity gains.

But your father or your grandfather weren't necessarily thinking. Let me go test my view to max. Let me eat certain things.

But now we do have more information than ever, especially in as U. V J, that eighty percent right? We're not even talking about the sized stuff here. So there are very clear things that people have agency over.

Are there any other second, third order effects of this, quote, long geordy revolution that you don't think we've necessarily touched on yet that really people should be thinking about? For example, one that you mentioned your book, Andrew was maniac, is something that a lot of people don't think about. But the health impact to fifty percent of humans is pretty substantial.

Was very interesting because because as a huge impact on women's later life, when women tend to live for longer but getting to ill health before men. And so a successful animal is really important for later future health. And it's an accelerated form of ageing, and it's quite rare in the amount animals.

So humans are quite unusual and having a manuals, and of course, men's reproductive ability declines in a general form of age, but women doesn't. So I think it's a really interesting area. And you know, our role models about how we live and what is old, what is old, have been formed from centuries and millennia.

A, I radically need to change. And then the other thing I think it's important to stress is that we don't have been more of people. But in many countries, the U.

S. Is example. You should have a pyramid that was lots of people, the boss of not more like a straight toller, and say, you got a equality.

And because of that, intergenerational connectivity becomes incredibly important. And we design our institutions around the hierarchy, but we gotta get much Better than intergenerational mixing. How would you stop a hierarchy blocking progress for the Young? How do you generally learn from one another and exploit that? That's gonna incredibly important.

There's a virtuous cycle and a vicious cycle. The vicious cycle is what we've been talking about, where people are not paying test to their health. They can't work, but they live long enough that they're very expensive, contributing to GDP the virtual a cycle is where people can maintain health band.

They can continue to work, continue to contribute to the four one k and instead of this being a crisis, that could be a agreed accomplishment of humanity to allow people in their sixties and seventies and eighties to have master of contributions like we only expect from people were Younger. That was the amazing future. And theoretically, we have all the elements we just have to choose to do IT. And it's sort of mobilizing people to this problem. I think this is the imperative.

If you think about IT, the F, D, A was started before we even had access to panics lan, or modern day antibodies, would you think kind of just speaks to the idea that these institutions, while they do many good things, are really, at least to some extent, a relic of the past. But that's exciting because there are clear winds.

Yes, I often quite mouths because mouth is back. In seventeen ninety nine, however, comes up with this very miserable cases that says, populations grow exponentially. Our resources grow.

dinner. We got too many people and are always going to have problems of the honest disease, feminine sector. And that negativity is sort of shared with the aging society story.

The ageing society story doesn't think we got too many people, says, which is living too long. We're out letting our villages support this life, so gonna get ill and we're gonna a pensions crisis. So it's interesting.

Go back and math right on the world. Population was not even one billion. Now it's over eight. And what of has got wrong is you didn't see if innovation, invention, ingenuity and new institutions that will come with the industrial revolution and nate increased productivity. We d invest in health and education, which further increased the quality of life.

And I think that's a metaphor for this aging society story, where invention, where the uy, where the innovation, where's new institutions? Because we can make this long life healthier and more productive. We just goes .

on doing all right, that is all for today. If you did make IT as far, first of all, thank you. We put a lot of thought into each of these episodes, whether it's guess the calendar touches cycles with our amazing out of your Tommy until music is just right. So if you like what we put together, consider dropping as a line at rate. This pocket 点 com flash is extensive and let us know what your favor episodes I don't make my day and i'm sure Thomas to will catch you on the flip side。