Fight Aging!

Robert A. Freitas Jr delivered this thought-provoking lecture at the Fifth Alcor Conference. He examines the high cost of death and plausible advances in anti-aging biotechnology and nanomedicine.

Link: http://www.rfreitas.com/Nano/DeathIsAnOutrage.htm

The Toronto Transhumanist Association have issued this press release. It points out the views and positions of Leon Kass, the chairman of the US President's Council on Bioethics. Essentially, Leon Kass wants you to die.

Link: http://www.longevitymeme.org/reprints/tta_pr_11_27_2002.cfm

CNN has a nice, clear article on recent research into life extension through caloric restriction. It's very good to see sensible, balanced articles like this making it into the mainstream press more often.

Link: http://www.cnn.com/2002/HEALTH/diet.fitness/11/28/eating.longevity.reut/index.html

BBC News is carrying an article on some interesting recent research. It suggests that only a small number of genes change with age. This hopefully means that genetic anti-aging therapies will be more easily developed, but it's early days yet.

Link: http://news.bbc.co.uk/1/hi/sci/tech/2521243.stm

ScienceDaily is reporting on progess in generating synthetic blood vessels. Small steps like this -- with the potential to help millions of people over future decades -- are very important. Overcoming fundamental limitations in healing and medicine will enable us to remain healthy and active for longer.

Link: http://www.sciencedaily.com/releases/2002/11/021126210341.htm

InfoAging is carrying this short, informative article on biogerontology: the study of the biology of aging. I'm very late in running this as news, but I first noticed it today.

Link: http://www.infoaging.org/feat20.html

As you may have already noticed, we have a slightly new look. The pages have expanded, and we've shifted things around. More will be coming later. Let us know what you think!

Link: http://www.longevitymeme.org

Yahoo News is carrying a piece on the barriers facing stem cell research. Hostile legislation is slowing research and making it harder for researchers to achieve results. Needless to say, this directly impacts your future health; we should all be writing to our representatives and expressing our indignation.

Link: http://story.news.yahoo.com/news?tmpl=story&u=/ap/20021119/ap_wo_en_po/fea_us_struggling_stem_cells_1

Wired has a pair of articles on the Alcor conference. The first is linked above, and here is the second. It isn't exactly stellar coverage -- both articles open up with the assertion of life extensionists as basically crazy -- which is disappointing coming from Wired.

Link: http://www.wired.com/news/medtech/0,1286,56476,00.html

A very interesting article from Eurekalert on current research that has succeeded in lengthening telomeres in human cells. As we all know, telomeres seem to play an important role in cellular -- and quite possibly human -- aging.

Link: http://www.eurekalert.org/pub_releases/2002-11/su-rcd111902.php

More and more researchers now agree that radical human life extension is only a matter of time. Aging is a biochemical process and humans will learn how to intervene in it and slow it down. Abolishing aging is theoretically possible. It is a goal that is not quite within reach yet, but it will be one day.

Copyright © Nick Bostrom

More and more researchers now agree that radical human life extension is only a matter of time. Aging is a biochemical process and humans will learn how to intervene in it and slow it down. Abolishing aging is theoretically possible. It is a goal that is not quite within reach yet, but it will be one day.

The question is, will it arrive in time? Or will you perish on the threshold of the era of much longer and healthier human life?

Human life expectancy is much longer today than it was in the past. A thousand years ago it was 25 years. Now it is over 75 years in Britain. This progress has been due mainly to a reduction in premature deaths, such as by infectious diseases, rather than to any slowing down of the aging process itself. Being able to cure specific diseases is wonderful, but it doesn’t get to the root of the problem. Aging breaks down your health and vitality, and eventually you get so weak that no amount of health care and medicine can prop you up. If it’s not stroke today, then it’s cancer tomorrow.

Just as you have begun to acquire a modicum of wisdom and experience, old age sets in to sap your energy and degrade your intellect. And then death swoops in to deliver the final insult. Now, there is real hope of ending this; that the last chapter of every human story need not play out this way.

In the last few years scientists have begun to catch glimpses of the biochemical processes underlying aging. Researchers are currently developing tools that will give us unprecedented control over basic biological processes on the cellular and genetic levels. These tools point to the realistic hope of greatly extended and much healthier human life spans.

Scientists have already extended life span in other species: in mice by over 30%. By changing just two genes, scientists have enabled nematode worms to live up to six times their normal life span.

Preventing aging in humans is complicated. Human ingenuity will have to solve some hard puzzles. Yet several promising research avenues are currently being pursued.

• Stem cells. Human stem cells - cells which can be made to grow into any other type of cell – can now be cultivated. Even in adults there are some cells that can be made to grow into almost any kind of cell. This opens enormous possibilities for regenerative medicine. New nerve cells can be grown and used to treat Parkinson’s and Alzheimer’s, or aging related dementia. Failing organs such as hearts and kidneys may be replaced by organs grown outside the body from the patient’s own stem cells.
• Telomerase. Individual cells can be "immortalized" by replenishing their telomeres (small DNA caps that sit at the end of the chromosomes). This removes the limit to how many times a cell can be made to divide, and therefore, how long it will live.
• Gene therapy. Somatic gene therapy will insert beneficial genes in the cells of adults, not only curing many hereditary diseases but also potentially offsetting the changes that occur with aging.
• Nanomedicine. When mature molecular nanotechnology is developed, maybe 20 years from now, it will be possible to manufacture and program small molecular machines that can enter individual cells and repair damage to DNA and other structures. Nanomedicine will eventually give us much greater control over the biochemical processes in our bodies.
• Many people, including especially the group of futurists and technologists known as "transhumanists", are now asking how extended life spans will affect society. For the individual, the traditional "linear life" paradigm, in which people migrate through education, then work, then leisure/retirement, may be replaced by a "cyclic life" paradigm, in which education, work and leisure are interspersed repeatedly through the life span. It will be normal for 50-year olds to go back to school and for 70-year-olds to start new careers. Consider the positive effects on society of a host of people with the wisdom of 150 years of life, and the vitality to bring that wisdom into action.

Having lots of 150-year olds around will no doubt change society quite a lot. But consider that even if we could stop aging today, it would still take seventy years before there were a considerable number of 150-year olds. In seventy years many other things will have changed. The whole technology basis will be totally different and unimaginably more advanced than today. One can’t look at life-extension in isolation from these other developments that will take place.

It is true that overpopulation must be avoided. However, in technologically advanced societies, couples tend to have fewer children - below the replacement rate. By spreading the benefits of technology, education, and women’s rights to countries that are currently poor, fertility rates will decline there too. It seems clear already that prosperous and well-educated people choose to have smaller families and to have children later in life.

If it really became necessary to control population growth, it is more feasible and ethical to do this by limiting the rate of new births than by forcing people who are already alive to die. It would not be selfish of us to hang on to life and reduce the number of new births. No one accuses a couple of being immoral if they decide to only have one child.

Finally - and perhaps before too long - our successors will learn to use the infinite resources in the universe outside our planet. In the meantime, a whole host of new technologies are already providing means to let us "walk more lightly upon the earth": More efficient and less ecologically damaging manufacturing, energy and transportation technologies make it possible for humanity to live in greater harmony with nature.

Life-extension will not place a burden on health care, because it will increase people’s health span, not just add some extra years in a care home in a state of dementia. When 80-year olds have the same physique and mental agility as people in their forties, they will be among the most economically productive members of society.

With a longer life expectancy, people will also have a personal stake in the future. This will lead to more responsible and sustainable policies.

I sometimes hear people say, "Wouldn’t it be boring to live forever?" But would it be more exciting to be dead? Indefinite life spans - just like the lives we have now - will be as boring or as exciting as we make them.

Transhumanists hold that at least some key parts of human nature are mutable. Much of what we now accept as inescapable is not an eternally given. On an evolutionary time scale, we haven’t been around for that long. Over the next few decades, we will develop technological tools that will enable those who so wish to change at least some of the fundamental attributes of their human nature. We transhumanists want to live longer and healthier lives and increase our intellectual, emotional and physical capacities. Humanity looks to me like a magnificent beginning but not the final word.

It’s irrelevant whether you’re an optimist or a pessimist. The only way to find what the world will be like fifty years hence is to be there and see for oneself. If we manage to avoid wiping ourselves out through accident or abuse of some military technology, then people may look back at the present and pity us for being so limited and subjected to so much suffering and ill health.

To stay alive is a basic human drive. It is a precondition for all other activities. Life-extension is the natural progression of medicine from curing diseases and the effects of aging to preventing them altogether. It follows the dictum laid down by many religions: that human life is sacred and should be cherished and preserved.

Let’s not be in the last generation to die of old age! We can improve our odds by demanding adequate funding for anti-aging research (which is currently pitifully underfunded). On an individual level, we may adopt a healthier life style and keep our fingers crossed. Some foresightful persons may consider a cryonics contract as a last resort. The concept of cryonics is optimistic, but it is not irrational. If your body is frozen in liquid nitrogen after you are declared legally dead, it can be preserved indefinitely without further tissue degradation. At some point in the future, medical science may progress to the point where it becomes possible to reverse the freezing damage and the original cause of death. Too many times in the past have people declared something technologically absolutely impossible - only to see it done a few years later. Indeed, many leading experts on nanotechnology anticipate that it will make it possible reanimate cryonics patients. Of course there is no guarantee. But being cryogenically suspended is the second worst thing that can happen to you!

Russell Blackford is an Australian writer. This article is based, in part, on his "Life Extension and its Enemies", Quadrant magazine, December 1999.

Copyright © Russell Blackford

I.

If some H.G. Wellsian counterpart to me had been alive a century ago, and speculating about the future development of science and technology, how would his contemporaries have reacted if he'd managed to make a series of broadly accurate prophecies about the 20th century?

He might have predicted how communications in the developed world would be revolutionized by the spread of telephones, radio broadcasts, television and the Internet. He might have described the emergence of sophisticated motor cars, aviation, space vehicles and probes, impressive ocean vessels, large-scale engineering techniques, freely available electricity, awesome weapons of mass destruction, extraordinarily precise scientific instruments, and biomedical advances in fields such as antibiotics, organ transplants, contraception and genomics. By the turn of the millennium, so he might have prophesied, all fields of human enterprise and activity would be altered strangely, dramatically and deeply by science and technology.

At the beginning of the 20th century, anyone seriously putting forward such a vision would have risked being called a crackpot, a fraud, or extravagant opportunist-at best, some kind of utopian dreamer. Yet exactly these innovations and more have come to be. While it is difficult to predict just what technological and social changes will take place during this new century and millennium, recent experience suggests they will be enormous. The development of technology will further shape how we live, how we see ourselves, perhaps our very nature.

Barring a successful program by governments to suppress technological change, we will increasingly transcend our biological limitations. In particular, it is possible that current research on the causes of human aging will lead to genuine breakthroughs in maximum life expectancy, not merely average life spans, opening up dramatic changes in social organization and mores.

II.

Those who oppose the development of futuristic technologies often express skepticism as to whether they are possible. There are, indeed, scientific and philosophical arguments as to why some technologies may not be feasible, at least as they are currently imagined by speculative thinkers. Despite the swiftness and power of our aircraft, we have never equaled the freedom and beauty of the birds.

However, as more technologies move from the realm of pure speculation to that of in-principle achievability, skepticism will increasingly be superseded by frightened resistance from neo-Luddites, with expressions of repugnance when new technologies appear "unnatural" and appeals for relinquishment when they appear too powerful. Radical technologies to extend human life are already encountering opposition, even though it is too early to state authoritatively that our maximum life expectancy, as opposed to the average life span, can be increased.

My fear is that we are more likely to turn out to be the last generation of mortals than the first generation of immortals. Yet, some scientists well qualified in the relevant fields speak openly of the possibility that aging can be defeated. There is at least a hope that we can live far longer, healthier and more active lives than ever before. This realization has caused a backlash, and it is surprisingly difficult to find support for such an attractive prospect from the cultural elites. On the contrary, writers, intellectuals and journalists display a negativity towards radical life extension that often shades into horror or disgust.

Worse, there is every sign that this backlash could grow into a widespread political struggle to ban life-extending technology and research. The current reaction to genetic technologies provides a precedent for this. The political forces that would be ranged against any effective life extension technology could easily win out-at least for a time. We have already seen such bizarre statements as Margaret Wertheim's wish to have the "choice" of a society in which she is not only free to decline the use of radical life extension technology, but in which everyone else is prevented from doing so, even if they want to. She actually argues for this in the name of freedom!

Supporters for legislative prohibitions will be found on both the Right and Left of the traditional political spectrum. The religious Right advocates the coercive use of state power to control private behavior inconsistent with its moral and metaphysical views. The Left has largely renounced its support for individual liberty. Many left-wing intellectuals and political agents see the political arena as one where power is to be seized and used to impose their own visions of the good. They have abandoned the classical liberal ideal of a society in which people are free to pursue their own values and life plans with as little restriction as possible. In those circumstances, Wertheim will not be alone in wishing to invoke the state's guns and police to suppress any radical life extension technology that begins to look feasible.

III.

Why all this resistance to something that seems good-the prospect of living much longer, of living healthily and actively deep into what we now think of as old age... and beyond? Why the urge to suppress our freedom in this area? Often, the opposition seems to be on metaphysical grounds, or it flows from a rationalization of death's inevitability as somehow desirable.

Wertheim is opposed to life extension fundamentally because she sees it as "selfish", but that alone is not usually a reason for conduct to attract legal prohibition. We are normally free to pursue self-regarding interests as long as we don't interfere violently or unreasonably with the bodies or property of our fellows. To be fair, she develops an argument that is not obviously ridiculous. She posits the following dilemma. If the technology is developed, it will either be restricted to a wealthy elite or become widely available. If it is closely confined to the wealthy, this will increase the gap between rich and poor. If it is spread widely, particularly if this applies globally, the outcome will be environmentally disastrous.

Well, we do not normally suppress goods and services because they may be disproportionally available to the rich. The whole point of legitimately acquiring wealth is that it becomes possible to buy things that are unavailable without it. However, it could be argued that the possibility of a radically extended life would be so important that it should become accessible to everyone. It is one thing (so the argument might go) to live in a society where some people possess many times the material wealth of others. The problems are an order of magnitude greater in a society where the rich have transcended their biology, leaving others behind and creating a formerly unimaginable gap between their interests and those of everyone else.

There is some force in this. It is certainly arguable that every attempt should be made to offer the choice of powerful new technologies, such as radical life extension, as widely as possible, as quickly as possible. But this confronts us with the other horn of Wertheim's dilemma. She relies on the undoubted fact that the Earth has a limited carrying capacity for human beings, which would be tested all the more severely if life expectancy increased.

At the same time, improvements in biomedical technology do not happen in a vacuum. For example, widely effective use of nanotechnology for biomedical purposes would exist only in a world that had developed nanotechnological manipulation for other purposes, such as new kinds of manufacturing. Powerful technologies for augmenting the human life span by attacking the genetic bases of aging would exist only in a world with high levels of genetic expertise for other uses, such as improved nutrition. No effective technology for radical life extension will be developed while work in other technological fields stays still. A world in which radical life extension is available will be one with vastly greater resources than ours.

Furthermore, there is a tendency for populations in developed countries actually to shrink unless growth is encouraged by the state through migration programs and other means. Affluent and educated people turn away from having large numbers of children in order to concentrate on other domains of their lives. If high levels of technology including, but not limited to, radical life extension became available globally, it should not be assumed that long-living human beings would breed at the rates that have predominated in past centuries under quite different social and economic arrangements.

A society of the very long-lived people might appear strange to us and do many things differently, but it need not have a devastating effect on global resources. In any event, no one has ever suggested that such considerations provide a legitimate argument against sanitation, immunization, safe roads and other measures for public health and safety, though average life spans would be reduced drastically if these were abandoned. Any interference by the state with people's control of their own bodies is surely a last-ditch resort for dealing with population problems.

Fortunately, the opponents of life extension will not have things all their own way. It is one thing to ban a technology such as reproductive cloning, which is likely to have attractions for relatively few people. It is quite another to deny us technologies that open up the possibility of dramatically enhanced lives for everyone. For myself, I see the argument as one between people who are committed to advancing the power of medical science to give us more life, and those who prefer to deny our freedom and impose their personal moral views. The position of the latter group is neither intellectually persuasive nor an acceptable basis for public policy in a liberal society. As the debate begins over radical life extension, I have no doubt which side I am on.

We're all genetically programmed to die, but advances in nanomedicine are expected to allow for "radical life extension" by 2050. Meanwhile, there's cryostasis - freezing the body immediately after death with a view toward resuscitation in the future.

Copyright © Terry Grossman M.D.

We're all genetically programmed to die, but advances in nanomedicine are expected to allow for "radical life extension" by 2050. Meanwhile, there's cryostasis--freezing the body immediately after death with a view toward resuscitation in the future.

What About Us?

Now that the oldest of my own generation, the "baby" boomers, are on the verge of becoming "geezer" boomers, many of us are finding it ever harder to deny the disquieting intimations of our own mortality. We have been forced to admit that, so far at least, nobody has ever managed to get out of life alive. We have started to look over our shoulders, perhaps a little anxiously, to see if anything can be done. Certainly there must be some answer, some rescue, some scientific miracle that can save us from the inevitable trip down Shady Lane.

This is despite the fact that all history, literature and religion, as well as all of our personal experience, tells us that there is no way out. Death seems certain. Even by following the healthiest of diets, a lifelong commitment to exercise, the most powerful nutrients money can buy and the best positive attitude imaginable, the sad truth seems to be that eventually every last one of us will grow old and die.

Even as advances in anti-aging medicine begin to forestall the ultimate ends of our lives, the next few decades will be particularly critical. Even with the acceleration in progress, many of us will still lose out to passing illness. Until dramatic technological advances are available, the twin dangers of fatal illness and accidental death will continue to dog our heels. For the near future at least, the specter of premature death will still loom to confound and confront us.

Research into anti-aging medicine will bring about dramatic breakthroughs in the years ahead, yet the aging process will probably not yield to any single magic treatment or remedy. Several decades may pass before the combined advances in genomics and proteomics, availability of prosthetic and biological replacement organs, breakthroughs in molecular nanotechnology, and perfection of the digital-cerebral interface bring about the effective end of Death-As-We-Know-It.

A few decades from now, many of us could find ourselves hanging on for dear life in a very weakened and debilitated state. With all of the sentimentality of a bulldozer for the forest it is about to destroy, the aging process will continue to decimate and erode each of us. In the end, no matter what we do, many of us will still succumb.

Therefore, for the near-term at least, we remain condemned to follow the script of our ancestors. We will continue to deteriorate over time. Our bodies are, in fact, programmed to dry up and wear down. From the moment of our conception, a timer begins hammering out the iambic cadence of our predestined mortality. Every cell of our bodies contains genetic instructions causing normal function to deteriorate at some preordained time. Each of our cells is eventually scheduled to begin an elegantly orchestrated process of self-destruction.

Evolution has been designed for survival of the species and gives not a fiddler's damn about any individual. The bottom line is that as far as the species is concerned, each and every one of us humans is pretty much outdated and unnecessary by the time we're out of our twenties. That same cocky attitude I know I held a mere two decades ago or so ("Never trust anyone over 30") has come back to haunt me now. What goes around has come around. Mother Nature is a cruel taskmistress, and Father Time isn't much better, to tell the truth.

Be fruitful and multiply, we are told, then get lost. That's why our own bodies begin to deteriorate just as soon as we've mixed our DNA with another of our genus.[1] Once we've sown our seeds and propagated, we rapidly become obsolete in terms of the survival of our species. We are given a bit more time to help rear our young--at least to the point that they can survive without us. Yet, it doesn't seem fair.

"What about us?" we cry.

"Who cares?" booms the Immutable Reply.

Unlike all other species, we possess powers of reflection and contemplation, which ultimately lead to existential fears. We seek a way out, some manner to defeat death, to avoid oblivion. Self preservation is arguably the most fundamental drive of all living creatures, and it is especially poignant, of course, to us humans, burdened as we are with the realization that, indeed, we are destined to die. Eternal life is our "impossible dream."

The practice of medicine arose to cure illness, to repair injury, to ease suffering. But despite the nobility of the endeavor, medicine has ultimately failed in every case, and death has always won. Since the beginning of recorded history, humans have turned to the only weapon they had with which they felt able to defeat death--they looked upwards, to the heavens above. By incorporating a belief system into human consciousness that included a promise of eternal life, some of the death's sting was neutralized. Each religion has come up with a different notion of how this might happen: heaven itself for some, nirvana for others; Valhalla, the Elysian Fields, The Happy Hunting Grounds ... and countless individual variations of those themes.[2]

Never Give Up

Over the course of the past few decades, however, scientists have begun to theorize that the human life span may not be as immutably fixed at six score as once thought. There is now talk that the lives of individuals now alive may possibly be extended for hundreds or even thousands of years.

While the term "immortality" may sound far-fetched, from a practical standpoint, I see no reason why humans shouldn't be able to live indefinitely. Just a few decades from now, we may see the length of human existence wind upward through more and more interesting times until death simply fades into the distant future.

We have grown accustomed to the idea that medical discoveries will be able to cure all disease. It is just a matter of time. We are no longer astounded by the idea of artificial joints and limbs, or organ transplants. News of medical "miracles" that can not only keep us alive, but keep us active and in good health far longer than previously believed, is daily newspaper fare.

We've come to expect that eventually medical science will solve almost all of our health problems. There even seems to be some growing public impatience these days that modern medicine has not yet been able to find a cure for AIDS, many forms of cancer, heart disease, etc. This has become especially poignant to those of us who can no longer consider ourselves young. For as we get closer each day to what appears to be the top of the mountain, the lightning strikes seem to be occurring closer together and with greater fury--and they have even begun to hit some of us! Funding cures for these illnesses has become critical for our own continued existence and well-being.

It is becoming a widespread belief that with our exponentially increasing knowledge of the human body, the determination and dedication of our health care professionals and our vast material resources that we should be able to accomplish this task. Our own desperate need to have it be so will somehow create the ways and means to enable us to live longer, healthier lives and ultimately, not have to die.

In fact, a growing number of scientists believe that this possibility is within our grasp. Many biologists, engineers and doctors have stated that advances in molecular nanotechnology (MNT) could provide exactly the tools we will need to repair, rejuvenate and preserve our own bodies so that they might last a very long time.[3]

Nanotechnology is defined simply as engineering at the molecular or even atomic level. The idea is to create machines that can manipulate atoms one at a time, so that we can place them in the right position to create any molecule that we wish.

As Ralph C. Merkle, Ph.D., a pioneering thinker in the field, puts it, "We are nearing an era when we will be able to build virtually any structure that is specified in atomic detail and which is consistent with the laws of chemistry and physics." That means that we'll be able to create anything from a steak to a grape, a diamond to a donut, a new pair of shoes to a new pair of lungs--anything. Almost for nothing to boot!

There are a few minimal applications of MNT available today. Even so, the most optimistic believers predict the major medical applications of MNT, won't be here for at least 25 years--and possibly not for 50 years or even more.

By far the most hopeful, authoritative prediction we've been able to find comes from Dr. Richard Smalley, the 1996 Nobel Prize winner in chemistry, who has predicted that engineers will be manufacturing "cellular devices" by 2010. But, it will take at least a couple of decades after that, scientists say, before we will be capable of manufacturing nanomachines capable of performing life-giving procedures.

In Nanomedicine, the first of a three volume series on the medical applications of nanotechnology by Dr. Robert Freitas, numerous medical applications of MNT are suggested. As just one example, consider the prospects for the "respirocyte." These nanotech spheres would float alongside of red blood cells in the blood stream. Under normal circumstances, these respirocytes would store oxygen at a very high concentration. This oxygen would be available to the body under emergency circumstances.

Let's say a patient were to suffer a massive heart attack or any other potentially fatal event. As soon as the individual's cardiac arrest monitor came on (built into our wristwatch, of course), the respirocytes would immediately begin to release their stored oxygen and simultaneously begin to remove carbon dioxide from the body. Early designs indicate that these very simple circulating devices could keep an individual alive for several hours, until definite medical care could be administered. (In the case of an otherwise fatal heart attack, this might involve prosthetic heart replacement.) This example is only the barest glimmer of what nanomedicne has to offer!

All of this is astounding, to say the least, and, clearly will transform Life-As-We-Know-It. Many of the details, repercussions, proposed methodologies and so on will be discussed in the following chapter, but those of us older than 40 years of age have a more pressing concern. How can we live long enough to take advantage of these upcoming miracles?

The requisite technology needed for "radical life extension" should be available sometime between 2025 and 2050--if all goes according to plan. But for those of us born in the mid-1950's or earlier, that's cutting the edge of oblivion a little bit too close to the bone. Many of us are going to find ourselves right on the cusp. The main focus of this book has been, in fact, teaching us what we can do to help buy a few more of these potentially critical years.

How existentially frustrating and galling to die just a few years before science comes up with the technology to keep everyone else going forever--so close and yet so far.

We have mentioned leapfrogging--the notion that if one can live to 80, one might reap the benefits that will extend life to 90; from 90, we might live to 110, from 110 to 150, and then who knows. The bottom line is this: Sometime during the 21st century the day should come at last, arguably the most wondrous day since creation, when Death gets a taste of its own medicine. But until this day of near infinite joy, The Grim Reaper will still come for us, tap us on the shoulder and take us away. What then?

All is still not lost. Not by a long shot! We can be like the frog in the cartoon and "Never give up." There is one last chance at continued survival even for people who have "died." I have mentioned that the line separating life and death has begun to fade, and that, in many cases, death comes simply because it seems inevitable and that there seems to be little merit in continuing the resuscitation efforts.

In addition, we recall an adage from the Emergency Room: "There is no such thing as a patient being cold and dead." By ensuring that a patient is cold right when they die, by definition, they are not really dead. This is the essence of "human cryostasis" (also historically termed "cryonics"), and, as defined by the Alcor Life Extension Foundation, is "the practice of maintaining patients currently classed as legally 'dead' at extremely low temperatures for treatment by future medicine."[4]

Under usual circumstances, our current definition of death simply means that the parties concerned with the patient's welfare (family, physicians, clergy, patient) have agreed that resuscitation efforts are no longer likely to be successful. Therefore, these measures are terminated and the patient is allowed to die.

In the event of cyostasis, the thinking is that the resuscitation efforts are simply not likely to be successful with present day technologies. Therefore, resuscitation with a view toward full restoration of normal function is just interrupted temporarily. The focus of the resuscitation effort is directed instead toward stabilizing the patient so that the present disease process is not allowed to cause any further damage. It is planned that full resuscitation with a view toward definitive cure will be resumed at some future time. This will be at a future date when medical science has advanced to the point of being able to cure the presently fatal disease process, as well as to reverse the added damage from the stabilization procedure itself. Patients in cryostasis are "legally dead," however, from a fundamental scientific standpoint they remain "potentially alive."

The Fundamental Theorem of Immortality Medicine

Ralph Merkle, PhD, a nanotechnology and cryostasis pioneer as well as a Director of the Alcor Life Extension Foundation, looks at it this way: "Cryonic suspension is a method of stabilizing the condition of someone who is terminally ill, so that they can be transported to the medical care facilities that will be available in the late 21st or 22nd century."

Notice that Dr. Merkle regards persons declared legally dead today to be merely "terminally ill" in the larger scheme of things. What we regard as "dead" today will merely be "seriously ill" tomorrow. In the words of Jerry Lemler, M.D., medical director of Alcor, "Death should not be equated with a lack of heartbeat or absence of breathing, even though, unfortunately, the term is still used in this archaic fashion. 'Death' is a state that should be reserved to apply to those individuals whose biological functions cannot ever be reversed to restore life. Period!" Consider what I have named The Fundamental Theorem of Immortality Medicine (FTIM): what we now call "death" is (or will soon turn out to be) just another disease.--in many cases, anyway.

History is filled with numerous, encouraging examples of how other diseases had once been uniformly fatal to earlier generations, but turned out to be completely curable later on. Tens of thousands of plague victims in the Middle Ages would have easily survived with antibiotics that are readily available today. Patients declared "dead" as recently as a few decades ago could have been "brought back" today with the equipment and knowledge readily available in almost every emergency room in the modern world. Currently, people are saved every day even without equipment of any kind whatsoever, simply through proper application of CPR (cardiopulmonary resuscitation). A few years ago these people would have died, because no one knew what to do. The same thing will happen again in the future.

The First Corollary to the Fundamental Theorem of Immortality Medicine states that the disease we now call death will soon be amenable to "treatment" in many cases by soon-to-be available therapies. Thanks to the Human Genome Project, genetic engineering, therapeutic cloning and other advances, many scientists predict the eradication of cancer and many other currently incurable diseases within the next 20 years or so. This is our hope for the medicine of the future. One of tools we may need to employ to enable us to take advantage of these future developments is cryopreservation.

Cryopreservation - Is - Cool

This is also the view of Robert C.W. Ettinger, the man regarded as the founder of the early cryonics movement. From this starting point, our current, more sophisticated methods of cryopreservation (or biostasis as it is called) have developed. The early cryonics movement began in 1962 with the private publication of the first version of Ettinger's book, The Prospect of Immortality.[5] "In all probability, you'd close your eyes, sick and old, in a present-day hospital bed, and you'll wake up, young and healthy, to a new and very long life in an amazing near-future world."

That was Ettinger's initial ideal, but there were a few rather substantial technical glitches that needed to be overcome. The most pressing problems involved the freezing process itself, which typically causes major and, often, irreparable damage to human tissue at the temperatures used for cryopreservation. Frozen tissues have a tendency to form cracks and split. The use of "cryoprotectants" to prevent major fissures of this sort became a major pursuit.

An even more difficult problem to solve was that of freezing damage to the individual cells. When the body undergoes the freezing process, water is drawn from each cell. This causes the cell to shrink, and unfrozen particles surrounding the cell can puncture the membrane of the cell wall.

These harmful effects are diminished by the process of replacing blood with cryoprotectant fluids, which inhibit or reduce the formation of the harmful ice crystals. The cryoprotectant used most successfully to date has been glycerol, a colorless, syrupy liquid made from fats and oils. It has numerous industrial applications, including everything from skin lotions to explosives.

Research involving the search for better cryoprotectants is ongoing at the present time. In fact, the largest human cryostasis organization in the world, Alcor, suspended their first patient by a newer process called "vitrification" rather than freezing just a few months ago. Vitrification is a process similar to freezing, but it involves cooling living tissue in such a way that it enters a glass-like rather than ice-like state. By doing so, almost all of the freezing damage described above is avoided. It is the feeling of most experts in the field that the long-term damage resulting from vitrification will be dramatically less than that from freezing.

Some recent experiments have shown that organs from small mammals have shown some preservation of function after cryovitrification and subsequent thawing. Cryovitrification of human organs and other medical applications is on the horizon.

Even so, there are many who still feel that because harmful effects from the freezing or even vitrification processes are unavoidable with current technology that human cryostasis is a waste of time and money at the present time. Such thinking causes the baby to be thrown out with the bath water. These critics are losing site of the fact that the entire foundation of human cryostasis depends upon future medical technologies. We don't need to repair the damage inherent in the freezing process today. Our present responsibility is simply to place the patient into cryostasis with as little damage as possible. The medical technologies of the future will be likely to have cures for the fatal diseases of today, as well as effective repair processes for the damage done by the freezing or cryovitrification process.[6]

Whether present methods of human cryostasis will ultimately be successful or not has to do with probabilities and statistics. Some experts predict that patients in cryostasis awaiting the repair and resuscitation technologies of future medical science have only a 1 in 1000 chance. I don't look at it this way. It's either 100% or zero. Another way to look at it is as follows: if you don't undergo cryostasis, you will most assuredly never become repairable at a later time, since further decay and deterioration have taken place. On the other hand, if you try it and it works, you will have the chance to be returned to a functioning condition. What have you got to lose? By funding one's cryostasis with life insurance, I figure, depending on your age, about $10-75 a month.

The Human Cryostasis Entry Procedure

Right now there are really only two organizations that have the personnel, technology and facilities to initiate and maintain human cryostasis: Alcor Life Extension Institute (Alcor) and The Cryonics Institute (CI). There are major differences between these two organizations in the way that patients are readied for entry into cryostasis. Alcor utilizes licensed health professionals to take charge of the patient every step of the way from clinical death to suspension, while CI outsources this work to funeral parlor operators. As a result, prices differ from $28,000 at CI to $50,000-150,00 at Alcor.

In addition, one needs to bear in mind that to effectively place a patient into cryostasis requires sophisticated procedures, pharmaceuticals, and equipment. This is not something that can be easily arranged at the last minute. Before any organization will consider allowing an individual admission to their facilities, prior arrangements are required. Consent forms need to be signed and financial arrangements made. This is why, at least at the present time, nothing can be done in cases where people die suddenly or unexpectedly without having made prior arrangements.

But, let's assume for now that a patient has made the appropriate arrangements and is prepared to enter cryostasis. To obtain the best results from the rescue and eventual cryopreservation operations, it is desirable to have a few days' notice of the patient's impending demise. This enables technicians to be on "stand by" at the bedside and ready to start the cooling procedure at a moment's notice.

Damage to the body after legal death occurs quickly under normal above-freezing conditions. The time before irreparable harm occurs is measured in hours, however, not minutes. Then again, we don't have days either. This means that if someone dies in the wilderness, or anywhere that would prevent technicians from getting to them within a half-day or so, the options for cryostasis are drastically reduced. Accidental deaths, such as those associated with fires or explosions, where the body or the brain, in particular, is irretrievably damaged or destroyed, are relative contraindications to suspension.

As the popularity of human cryostasis increases, which should occur as more people become aware of this possibility and the technology improves, options for cryostasis will no doubt extend to more remote areas. For now, however, the urban hospital or hospice is the optimum location for access to cryosuspension technology.

The first criteria that must be met before the cryotransport team can go to work is that the patient must be pronounced legally dead. According to the book published by the Alcor Foundation, Cryonics--Reaching for Tomorrow: "In actual medical practice, legal death seldom means that the final basis of life has yet been lost, only that a qualified authority sees no value in continuing to support life with present technology."

In most jurisdictions, the difference between clinical death and legal death isn't much. In the first case, absence of respiration and heartbeat, in the other, a piece of paper signed by a physician or mortician. That's it. Once the patient is declared legally dead, then the cryotransport team can get to work.

At the time of death, the patient should have something on their person, such as a medical-alert style bracelet on the wrist, which identifies them as a member of such-and-such cryostasis organization and which also advises health care personnel as to how the organization can be reached. In the case of the Alcor Life Extension Foundation, the ID bracelet also provides advice about beginning the initial suspension protocol, and gives phone numbers to alert Alcor's central laboratories. These numbers are manned 24 hours per day with personnel who can initiate rescue communications including physicians to advise the hospital personnel on initial protocols and procedures. In the case of CI, instructions are to make contact with a local mortician to begin the cooling procedure.

As soon as the heart stops beating, blood stops flowing and ischemic damage, which is tissue injury caused by lack of oxygen, begins to set in. This is why cryonicists would like to be able to begin the suspension just before a patient is declared legally dead. That way the last few beats of the patient's heart could be used to circulate anticoagulants and other important medications. Current laws do not permit that such measures be taken prior to death, however. Performing any interventions vis-à-vis freezing on even a "barely-living" person is still regarded as murder.

Therefore, as soon as possible after legal death has been declared, the cryotransport team begins the suspension protocol. At Alcor, the following procedures are implemented as soon as possible:

1) Anticoagulants are injected into the blood stream to minimize clotting. Other protective pharmaceuticals are utilized to combat cell membrane breakdown, stabilize blood pH, prevent the formation of bacterial colonies, minimize capillary leakage, block calcium and other unwanted ions from entering the cells, halt shivering reflexes which can speed up metabolism, prevent free radical damage, and in other ways prevent much of the catastrophic damage to tissues which will otherwise take place.

2) CPR (cardiopulmonary resuscitation) is instituted as a mechanism of circulating the medications administered. If the time since cardiac arrest is short, respiratory support with pure oxygen is utilized as well. Ideally, a bi-directional, hi-impulse "Thumper" is used to closely approach the circulatory efficiency of the human heart.

3) Initial cooling of the patient is begun, with the application of cold packs, ice water or a cooling blanket. Partial immersion of the patient in a mixture of crushed ice and water is best, particularly where the ice water is recirculated and either sprayed or otherwise delivered to surface areas of the body, so that the core temperature of the patient drops rapidly. Every 10 degree C drop of temperature reduces metabolism by 50% (75% in the brain), dramatically increasing the time before the damage caused by oxygen lack causes irreversible biological death.

Throughout this process, which takes anywhere from eight to twelve hours, technicians monitor body temperature, the rate of assimilation of the cryoprotective solution and other dynamics.

When these are complete, the technicians move the patient to a facility where further stabilization can be carried out. By means of extracorporeal circulation, blood is replaced by an "organ preservation solution," essentially identical to that used by organ transplant teams. This stabilizes the integrity of the patient's circulatory system. By now the temperature of the patient has been reduced to about 10 degrees C.

Following this initial stabilization, the patient is air-shipped to a central station. There, the final stages of preparation for cryogenic temperatures are completed. Additional cryoprotective agents are gradually added to the organ preservation fluids over a period of several hours, while technicians monitor body temperature, the rate of assimilation of the cryoprotective solution and other dynamics.

In cases where vitrification is to be carried out, specific proprietary, licensed compounds are used, including synthetic protein "freeze blockers" which inhibit crystal formation between --50 to --100 degrees C, the range where much of the freeze damage typically occurs. The difference between the best conventional cryoprotectants and the new compounds is dramatic. In one demonstration, conducted by the cryobiologists who developed these new compounds, two flasks, one with and one without these new "freeze blockers" were cooled through the zone of danger. Without the freeze blockers, the formerly clear fluid turned to a milky solid, indicating countless trillions of ice crystals. With the freeze blockers, it was like looking into a transparent solid of glass.

At the end of this second stage of cryoprotection, again describing the new procedure of vitrification, the patient will be at about --10 degrees C. Circulation through the vascular system at this temperature will still continue, but very slowly. As the ideal, target concentrations of the protective compounds are achieved, it is necessary that further "cooldown" with subsequent vitrification be brought about very rapidly.

Beginning at a temperature of about --10 degrees C, the temperature of the gas surrounding the patient (almost pure nitrogen) is dropped suddenly to -130 degrees C. The gas is circulated rapidly, as if the patient were in a strong wind. The core temperature of the patient's body drops at the rate of nearly one degree per minute, and is much, much faster at the surface. This is one of the keys to succesful vitrification--very rapid cooling. If the procedure is done properly, no ice crystals will form. It will take only a few hours for the procedure to be essentially complete, and the patient will then gradually settle to a temperature at which there are no more changes of a biochemical kind, even over very long periods time. Protection is complete.

In the final stage of cooling, the patient is transferred into other containers and placed in contact with liquid nitrogen vapors for the "final descent" to -196 degrees Centigrade. This takes an additional five to seven days. One technical problem that remains is that on the way to these colder temperatures, thermal stress cracks can form. This occurs whether vitrification is used or not. Hopefully, future technologies will soon make it possible to maintain patients at higher, safer temperatures or a mechanism developed to avoid these thermal fissures. Much remains to be done before even the best procedures of today are declared to be the early headwaters of true suspended animation, but rapid progress is being made.

At this point the patient, wrapped in super-strong shrink wrap, is immersed in liquid nitrogen--sometimes in the company of as many as three other colleagues--inside a tank that resembles a very large thermos bottle, with two layers and a vacuum in between.

And there the patients remain--suspended in liquid nitrogen, kept as intact as possible until such time as medical science has some certainty that they can be repaired and revived.

But Can It Work?

The bottom line, of course, boils down to one very basic question: Can it really work? Can once-viable living tissue be frozen solid or vitrified into a glass-like state, hard as a rock, and then be defrosted and revived?

Nobody knows for sure. Currently, it can not. If nanotechnology lives up to its promise--and to date there is nothing in science that precludes it--then any cell and any tissue should be able to be repaired.

Even putting nanotechnology aside for the moment, there have been many cases where living organs or even whole organisms have been frozen and after being thawed out exhibited normal functions in important respects. Experiments have included insects, some eels, human brain tissue, some small mammalian organs, even human sperm cells. In addition, there are many documented cases of human embryos that were suspended in liquid nitrogen--for anywhere from two months to seven years--and then reintroduced into the womb, carried to term and who are alive today.

Living in Glass Houses - Vitrification

The techniques for protecting cells and tissue from thermal injury (frostbite) are improving every day. The most recent technique involves "vitrification," where as mentioned above, tissues are transformed into glasslike solids as the temperature falls. This tends to stop the formation of ice crystals, which are what penetrate and destroy human cells during freezing. Alcor performed the first human vitrification of one of its members in the fall of 2000. Thanks to recent technological advances, vitrification is now being offered as an option to all "neurosuspension"[7] patients at Alcor.

Worked on indefatigably by Dr. Greg Fahy for the past twenty years, the fruits of his labors regarding improved cryonics techniques and vitrification are now finding clinical application.[8]

It is anticipated that even more dramatic advances in vitrification will be available in the next few years. Once again, I would like to reiterate the central theme of this book. By remaining alive and as healthy as possible for at long as possible, we increase our chances of being able to take advantage of these technological advances. Therefore, even if we aren't able to survive until the coming Singularity during our current life cycle, by following The Ten Pillars of Health, we hope at least to improve our chances of living long enough to take advantage of improved cryostasis preservation technologies such as vitrification.

Therefore, following the principles embodied in The Ten Pillars of Health makes an enormous amount of sense even if an individual is quite elderly right now. If we increase our chances of remaining alive for even a few extra months or years, we can dramatically improve our prospects for achieving extreme longevity by availing ourselves of the advances in vitrification right around the corner. Immortality is available to everyone, not only the young, the healthy and the lucky. For the very old, the unhealthy and the unlucky, there is the cryostasis option. With vitrification now commercially available, one's prospects for successful resuscitation and return to vibrant health at a future time have never been better. In this way, virtual immortality or at least the opportunity for extreme longevity is available to almost everyone.

The Soul--A Fly in the Soup?

Still, some other questions remain. For instance, upon your return, who will you be, really? And who will you have been during those decades that you were in cryostasis, in a state in which there was no biological activity whatsoever--presumably no thoughts, no feelings, no dreams, no consciousness, not anything?

You're certainly not alive, but are you ... dead?

The inevitable question arises as to the soul. What happens to that non-physical essence of each of that many believe is the core of our being? Each of us has our own answer to this question, and this answer may, in fact, determine whether or not we would even consider cryostasis as an option. This is not a question that science can answer, but is rather a matter of personal belief.

Yet there's no reason, as far as I can see, to dismiss cryostasis as evil or bad in a religious sense. After all, these incredible brains we have came from G-d, and must be part of the divine plan. And aren't we obligated, therefore, to be the best we can be and to use these brains to the best of our ability? The Bible tells us that Methuselah lived almost one thousand years, (969 to be exact), so why can't we?

Still, it's one thing to want to live forever, but it could be considered quite a preposterous vanity actually to take steps to do so. One is reminded of the tragic outcomes of Dr. Frankenstein, Dr. Faustus and other mortals who presumed to defy death. Their attempts at immortality did not end well for them.

On the other hand, as we have said before, humans are born tinkerers, constantly working at improving our lot in life. Upon initial discussion, many of our most profound technological advances have been ridiculed by the general populace, condemned as blasphemous by the pious and largely dismissed by experts in the field--until the experiments are uniformly successful and the advances are in place. Then all the nay-sayers find ways to make the proper adjustments, and gird their loins to oppose the next imaginative idea.

Of course, as the ads for investment opportunities are forced to remind us, past performance is no indication of future success. The fact that some ideas once regarded as foolish have turned out to be sound doesn't necessarily mean that human cryostasis will someday receive widespread acceptance. But in the present case, more and more reputable scientists are opening their minds to the possibilities that it just might work.

Is This Really What We Want?

For my own part, I believe that all the glitches are going to get worked out with respect to human cryostasis and molecular nanotechnology (MNT). Even so, I am not all that certain that I would much enjoy life in the world of the future after a lapse of several decades spent in a vat of liquid nitrogen. The world may turn into a place to which I might never grow accustomed.[9] Things may become a little too weird. Nevertheless, there's no way any of us will ever get to know if we'll be able to cross that bridge unless we come to that bridge.

Without cryonics and MNT, for some of us there will be little chance that we will even get close to that shore, let alone needing to wonder about crossing any bridges. If things work out such that we actually do make it over to the "other side," however, but find that we can't relate at all, I guess we'll just hang out with all the other "old-timers" like ourselves who can't relate either.

"He's just an old hippie who don't know what to do,
Whether to hang on to the old ways, or grab on to the new..."

Almost everyone I talk to about this agree about one thing. They, too, would love to see what's going to happen next. Everyone wants to know if the world will be a place TDF (to die for) or not. For my own part, I don't know the answer to this better than anyone else, but I am willing to die trying.

Why Isn't the Idea of Cryostasis More Popular?

As I proceeded with my research into the subject of cryostasis, I had occasion to consider this option from both a theoretical and a personal point of view. Much to my surprise, I discovered that the number of people who have chosen this alternative and are currently in suspension is only a few hundred worldwide, despite the fact that it has been available for over three decades. These few hundred souls represent "a spit in the ocean" of death in which we swim. I found it interesting that it took several years for me to "think about it" before actually arranging for my own suspension.

How can this be possible, given the fact that I am actually one of the few people I know who really believes that cryostasis has a reasonable chance of working? What is the thinking process that leads one to open wide the door to immortal life, then simply stand there gawking, yet not walk on through?

I have given considerable thought as to reasons behind my own procrastination. I think a short discussion of this topic may be of value, as I believe it may help others with their decision making. But, don't get me wrong. I don't think this is a decision to be taken lightly, and I have come up with several reasons why many people might be reluctant to make such a move.

First of all, making preparations for one's cryopreservation forces us to confront our own mortality in a very real, almost a palpable, way. This is discomforting on even the best of days.

Secondly, freezing one's body with a view toward perpetual life, at least at the current time, appears a solipsistic, even a narcissistic, act.

Thirdly, almost no one, including most reputable scientists working in the field, believes that it has any chance of working.

Finally, it is hard to give up completely and utterly on the status quo. Death, being one of Life's "bookends" is a fundamental part of the status quo. But just as Life-As-We-Know-It is just about over, so, too, is Death-As-We-Know-It.

The Comfort of Death

All of us have been raised with the "knowledge" that in time we will grow old, our bodies will deteriorate and we have a good chance of finishing our days in the agony of some terrible illness so bad that death may come as a relief. Dismal as these prospects may be, they provide us with boundaries, and the human mind loves closure.

Nevertheless, these are dreary prospects. To help us deal a little better with their finality, as well as to provide a balm for our utter helplessness and hopelessness, religion is available to give us peace. The blanket of peace that deep religious faith can provide is a wonder to behold and a blessing to possess. For better or worse, and I suspect with a considerable measure of each, it is also no longer an option for many. The problem is that we must somehow be able to suspend rational thought and accept "on faith" the presuppositions required as part of the "belief system" for most religions.

Religious faith is pretty much "right brain" activity. It isn't logical; in fact, most of the time, it defies logic. It supplies answers where science seems to find only more questions. Yet, most people have the faith that, somehow or another, thanks to their religion, they are going to live forever. Living "forever" here on Earth, the goal of cryonicists, isn't really necessary.

But, in some sense, "belief" in cryosuspension is a type of religion in its own right. Like most religions, it requires that certain things be taken "on faith," and it promises a payoff of eternal life to its followers. You have to pay to belong, and it is even mistrusted, if not actually persecuted, by non-believers. There are a number of similarities to the early days of a new religion.

If Gold Should Rust ...

I subscribe to an Internet newsgroup devoted to this topic of cryostasis.[10] Many of the philosophers, scientists and other interested parties who participate in these discussions have devoted considerable energy to performing research in this field, trying to increase the chances that cryostasis will work. Quite a few of them, however, have not yet taken steps to insure their own cryopreservation. As it is said, "If gold should rust, what is iron to do?" If the people at the very top of the heap don't even seem to believe in what they are doing, why should any of the rest of us? I think it simply boils down to human nature.

I don't think these people lack faith in cryostasis, rather I think it's similar to people's reaction to thoughts of life insurance. It's something we don't want to think about unless we are prodded into doing so. It relates to the first problem mentioned above. Since no one knows for certain whether or not cryostasis will work, it forces us to think about our own mortality.

To continue the life insurance analogy, when we are young and healthy (and life insurance is cheap), no one really thinks much about either life insurance (which is really death insurance) or cryostasis (which really is life insurance). That's why life insurance salespeople stay in business--we need them to prod us into thinking about such things. There isn't anyone around to prod us into doing something about having ourselves cryonically suspended. The reason for this is the lack of profit motive.

The price charged for cryosuspension essentially covers only the cost of the procedure. There is no built-in profit, which might be available as a commission to the people who would sell it. The more people there are who elect to have themselves suspended, however, the more this issue will be in the public eye. This publicity will help to prod some people to proceed with making plans for their own suspensions. When a critical mass is reached, it will begin to feed on itself and start to grow.

The second problem relates to the inherent selfishness of the act. How can you go about making arrangements for your own cryopreservation without doing the same for everyone else in your family?

Cryonics for Your Family Too

When you start to look into it, you find several options available with prices varying widely from $28,000 to $150,000. By choosing the least expensive option, one can afford to pay for the suspension of five people for the same price that one would have to pay just for oneself through the most expensive plan. Many people don't believe they can afford the more expensive option if they had to pay for it for everyone in their family. Yet, price is regarded as a measure of quality, and if something costs five times as much as something else, the implication is that it must be quite a bit better.

To complicate matters further, Alcor offers the "neurosuspension" option for $50,000 or so. In this scenario, only the brain is preserved, and the rest of the body is disposed of in one of the more conventional ways. Even though these are formidable amounts of money for many people, when these amounts are funded with life insurance policies, the monthly payments become quite affordable, even for spartan budgets.

One option is to purchase a term life insurance policy of the appropriate amount for each family member for whom we are personally responsible. We can then elect to pay the premium on these policies until such time as these family members are old enough and fiscally responsible for themselves. In most cases, this amounts to less than $20 a month each. Then, should they wish to join us and undergo suspension sometime in the future after (or even before) we're gone, they, too, will have that option. It's their choice.

There is no need to purchase these policies all at once, and, one benefit is that it will certainly made gift shopping for birthdays and holidays a lot easier. (Gee, Dad, thanks, it's just what I always wanted, a life insurance policy that will pay for me to get frozen after I die. Wow! What a guy!) All right, so they don't make good presents.

In addition, the recipients of these policies can name whomever they like as beneficiary of their life insurance policies. Obviously, the idea is that they name the cryonics organization who will suspend them upon their death; but, if they prefer, they can simply cash the policy out or use the proceeds in a more traditional fashion (such as paying for a funeral perhaps). We do not seek to force anyone else to go the route we have chosen. We all have different drummers. We merely wish to facilitate this option for them, to make it available if they so choose.

Financing cryotransport in this way makes it feasible for most folks. Unfortunately, people living on very limited means, from paycheck to paycheck, will still not be able to afford this. We do not live in a perfect world. I would like to see suspension become available for everyone. The more people who choose this option, the less expensive it will become. Cryosuspension will become socially acceptable. It will become what the Extropions[11] call a meme, a thought that has reached the critical mass necessary to become part of our collective consciousness.

Another important reason why it is beneficial for more people to "sign up" is because the cash infusion into the cryonics coffers that would result will lead to more research. Investment capital is urgently needed in the field of cryosuspension. As I said before, I believe there is a small, but distinct possibility, that individuals entering biostasis at the present time will someday be successfully reanimated. I feel that people, who will be suspended 10 or 20 years from now, however, will have a much better chance, perhaps approaching 100%--simply because the freezing process will be so much improved. The degree of injury suffered by human tissues will be dramatically reduced. Therefore, even if by following a healthy lifestyle, we die before extreme life extension becomes commonplace, we can still significantly increase our chances just by surviving a few more years. By avoiding the need for biostasis for several years, we will increase our chances of reanimation significantly, since the freezing process is likely to improve continuously with each passing year.

The Bottom Line

The bottom line is that many of us will need to look at the cryostasis option if we wish a taste of immortality pie. Certainly, joining a cryosuspension organization for anyone who is neither old or ill might statistically seem a bad investment. The incidence of fatal disease really begins to be significant only after 60 or 65 years of age. Still, the rather abrupt onset of terminal illness, or even sudden death, such as from a massive heart attack, does occur to individuals in their 40s and 50s, and sometimes even younger.

Paying the initiation fees and monthly dues to be an active member of a cryosuspension organization, as well as the cost of an insurance policy to fund the suspension itself, may seem an unnecessary extravagance to many people. Car payments and home mortgages, children's college expenses and caring for aging parents, or simply getting by on a fixed income during our retirement strains the budgets of many of us. Yet, for those with the financial where-with-all, buying a cryosuspension insurance policy might be a reasonable option at any age.

In addition to providing true "life" insurance, membership in a cryostasis organization provides needed capital to improve procedures and facilities for the time when we actually might need them. Another option is to "join" a cryosuspension organization as a "subscriber" rather than a member. This option avails one of regular publications and information about biostasis for a very nominal cost.12

Cell Storage Technologies: Youth Preservation

Cryostasis, the cryopreservation of one's mortal remains after death (or at the completion of one's "first life cycle" in cryonics parlance), with a view toward resuscitation in the future is clearly not everyone's cup of tea. There are countless reasons why people seem to prefer the comfort of the grave or the cleansing flames of the pyre to the excruciatingly cold waters of the liquid nitrogen dewar.

There is a lower rung on the cryostasis ladder, however, which requires much less of a step from the terra firma of quotidian reality. This intermediate step involves just a touch of cryostasis, and it does it in so much of a gentler, friendlier way as to make cryostasis much more acceptable to the average person. The reason being that it makes a lot of sense. This baby step allows one to dip a toe into the clear cryo waters without necessitating or even suggesting that you ever have to take the full plunge. Rather than freezing one's entire body, these "cell storage technologies" enable individuals to collect small samples of themselves and freeze them for their personal use sometime in the future.

The Ultimate Face Lift

Scientists today have the ability to take a tiny piece of your skin, and grow from it sheets and sheets of new skin. You say you like your skin just the way it is now and don't feel any need for new skin? Fine. What do think the chances are that you'll feel the same way in 30 or 40 years? But what if you had taken (and frozen) a sample way back at the turn of the century, say in 2002 or 2003, when you (and your skin) were decades younger? Now all your doctor has to do is thaw out that little piece of skin that you had saved way back when your skin was young and beautiful. Using cloning technologies that are already available, new, young skin could simply be grown for you. You will be able to have the same youthful skin you had 30 or 40 years before. Talk about turning back the clock. (Makes you wish you had taken that sample back when you were a teenager, doesn't it?)

Cell storage technology isn't restricted simply to recreating new skin. Every cell in your body contains within it the complete blueprint for creating every single cell in your entire body. A skin cell is a skin cell, yet within the nucleus of each skin cell are contained the genetic instructions for how to grow every other organ and tissue type in the body as well.

A skin cell isn't a skin cell because it has to. No one held a shotgun to its head and told it that it had to be a skin cell. It is this type of cell simply because certain "signaling molecules" told its nucleus what parts of its DNA to express.

Each cell in the body has a complete copy of the blueprint for the entire body. Our DNA has The Bill of Rights built right into it, which states that all genes are created equal and all cells have the right to grow up to be whatever they want. Thanks to the Human Genome Project, we now have a complete copy of this blueprint--all 30,000 genes and several billion "base pairs"[13]

By preserving a small sample of ourselves today, we effectively "freeze ourselves in time". These cell storage technologies are a brand new growth industry, which offers people of today a chance to save their youthful present day DNA and transport it into the future. Just as we discussed human cryostasis as a bridge by which people who die can transport themselves into the future so that they can avail themselves of the medical technologies of tomorrow, cryonic cell storage serves as a bridge for people today to transport their present youthfulness into the future.

Scientists are currently on the steep upward slope of the learning curve of these rejuvenating technologies. Today, they still don't have the ability to create new hearts or lungs or kidneys from the DNA instructions contained in skin cells. But this technology is being worked on today and only a few years away. Utilizing stem cell research and cloning technologies, scientists are very close to being able to do this very thing--to take one type of cell and instruct it how to become another type of cell or even a completely different organ. The timetable for the completion of this type of work suggests this technology should be perfected within the next one or two decades.

As part of the longevity evaluations performed in my anti-aging medical practice, we offer patients the opportunity to have a tiny skin sample taken from the back of the arm or leg and sent to the lab for cryopreservation. (For more information, see http://www.cells4life.org) Then, when the time comes some years down the line that it's time for a new heart or lungs or a pancreas or they just need some youthful skin to freshen up the appearance of their face, we expect that it will be a simple matter for the doctors of 2015 or 2025 simply to create the new organs or tissue from the youthful cells preserved today. For a relatively small amount of money, I feel this is the best "youth insurance policy" anyone can buy.

I think that cryostasis technology will soon be perfected to the point that human tissue, whether a tiny pinch of skin, a single organ or an entire body, will be able to be preserved at low temperature for prolonged periods without irreparable damage. The cell storage and cryopreservation-through-vitrification technologies discussed above should make this possible within the next few years. Some aspect of the cryosuspension technologies may play an important role in anyone's longevity program.

References

[1] For further information on why death and sex ("the little death" in French) go hand in hand, see Sex and The Origins of Death by William R. Clark, New York: Oxford Press, 1996.

[2] This covers heaven, but how about "the other place"? Largely to encourage the masses of people into providing adequate financial support for the infrastructure of most religions, in my opinion, the concept of hell was widely and extensively disseminated.

[3] Drexler, K. Eric. Engines of Creation. New York: Doubleday, 1986.

[4] Alcor Life Extension Foundation. Cryonics: Reaching for Tomorrow. Scottsdale AZ: Alcor Foundation, 1993.

[5] This book is available in its entirety online at extropy.org.

[6] A plausible explanation as to how this might be possible is presented by Drexler in Engines of Creation, pp. 136-138.

[7] "Neurosuspension" refers to freezing the head of the body only.

[8] Chamberlain, Fred. "Vitrification arrives: new technology preserves patients without ice damage." Cryonics, 4th qtr, 2000, 21: 4, pp. 4-9.

[9] Then again, it might be truly wonderful. For a thought-provoking, highly optimistic and thoroughly entertaining vision of how cryonic suspension might work, as well as what the world of the future might be like, read the novel The First Immortal by J.L. Halperin, New York: Ballantine Books, 1998.

[10] To subscribe to The Cryonics Mailing List (CryoNet) - send email to cryonet-request@cryonet.org with the subject line "subscribe."

[11] The Extropians are an interesting lot. As they define it, extropy is "a metaphor referring to attitudes and values shared by those who want to overcome human limits through technology." Just as transsexuals are people trapped in the bodies of individuals of the opposite gender, extropians are prototypical transhumans of the future trapped in the bodies of present day humans. For more information about their liberating philosophy of life and the world, check out their website.

[12] The websites for the two main cryosuspension organizations are: Alcor and Cryonics Institute.

[13] The exact structure of human DNA has now been mapped as a series of billions of letters, each representing one of the four nitrogenous bases, adenine, cytosine, guanine and thymidine. Human DNA defined by hundreds of thousands of pages even more unintelligible than Finnegan's Wake. Page after page, chapter after chapter, volume after volume of prose even harder to pronounce than street signs in Wales: CCGGATTATCG CGCACCGGATTATCG CGCACCGGATTATC, etc.

Can caloric restriction extend human lifespan?

Copyright © Ian Williams Goddard

Only one intervention has been proven to extend both the average and maximum lifespan of all animal species tested: reducing the consumption of dietary calories, or caloric restriction (CR). [1-2] While widely recommended, exercise and nutritional supplementation have not been shown to extend maximum lifespan. [3-5] Because CR extends maximum lifespan, scientists believe it actually slows the process of aging. CR is therefore used as a means to study the process of aging. [6,7]

The graph to the left shows the lifespans of four groups of mice, illustrating the dramatic life extension induced by life-long CR. [8] The first group (green) were controls who ate freely without restriction and define normal lifespan. The other three groups were subjected to different degrees of CR initiated at one month of age, which is equivalent to a 2 year old child. Such early onset CR results in stunted growth and is therefore not acceptable for humans. The results found that more CR resulted in more life extension -- a pattern that holds until CR becomes actual starvation, whereupon it shortens lifespan. [9] The graph is a two-frame animation. The second frame shows equivalent human lifespan.

Adult-onset CR: Only adult-onset-CR data are relevant for human consideration, and life extension is less when CR is initiated in midlife, approaching nil when initiated in late life. [10] The next graphs show the lifespans of two long-lived mouse types gradually subjected to 44% (B10) and 27% (B6) CR starting at 12.5 months of age versus controls. B10 mice started CR at a human-age equivalence of 30, while B6 mice started CR at a human-age equivalence of 40. [11] Note: Adult-onset CR extends animal life only when phased in gradually (over a period equivalent to 2.5 years in humans) and when augmented with a nutrient-enriched diet.

Caloric Restriction initiated in adult mice vs controls, and human lifespan equivalence.
Adult-onset CR extends life only when phased in gradually including a nutrient-enriched diet.

CR not only extends the lifespan of laboratory animals but also reduces the incidence of virtually all diseases of aging such as cancer, [12-15] heart disease, [16,17] diabetes, [18-20] osteoporosis, [21,22] auto-immune disorders, [23-25] neurological decline [26-30] and diseases such as Alzheimer's [31] and Parkinson's. [32-34] Those references are linked to abstracts at the National Library of Medicine, please follow them for further details. While CR has failed to extend some cognitive functions in the Fisher-344 rat, [35,36] overall, CR has been shown to dramatically extend both the life and health of all animal species tested to date.

From Mice to Men?

The question that matters is: Will CR do for humans in real life what it does for animals in the lab? Because we humans live so long, no CR lifespan experiments have been conducted on humans. However, if CR can extend human lifespan one would expect to find a correlation between low body weight and longevity, since eating less is associated with lower weight. The fact that such a correlation does exist tends to support the hypothesis that CR will do for humans what it does for other mammals.

While early studies suggested that lower body weight was associated with increased mortality, once researchers accounted for factors such as smoking and illness-induced weight loss, the data showed a correlation between lower weights and increased longevity. [37] Several examples:

* In 1985, the National Institute of Health, Centers for Disease Control, and the Department of Health and Human Services published a "special report" stating: "[S]tudies based on life insurance data, the American Cancer Society Study and other long-term studies, such as the Framingham Heart Study and the Manitoba Study, indicate that the weights associated with the greatest longevity tend to be below the average weights of the population as long as such weights are not associated with concurrent illness or a history of medical impairment." [38]

* In 1993, the Journal of the American Medical Association published a study that concluded: "In these prospective data, body weight and mortality were directly related. After accounting for confounding by cigarette smoking and bias resulting from illness-related weight loss or inappropriate control for the biologic effects of obesity, we found no evidence of excess mortality among lean men. Indeed, lowest mortality was observed among men weighing, on average, 20% below the US average for men of comparable age and height." [39]

* In 1995, a study published in New England Journal of Medicine concluded: "Among women who never smoked, the leanest women ... had the lowest mortality, and even women with average weights had higher mortality. Mortality was lowest among women whose weights were below the range of recommended weights in the current U.S. guidelines. Moreover, a weight gain of 10 kg of more since the age of 18 was associated with increased mortality in middle adulthood. These data indicate that the lowest mortality rate for U.S. middle- aged women is found at body weights at least 15 percent below the U.S. average for women of similar age." [40]

* In 1997, the American Journal of Clinical Nutrition published a study on body weight and mortality stating: "We conclude that when appropriate adjustments are made for effects of smoking and underlying disease, optimal weights [for longevity] are below average in both men and women; this appears to be true throughout the adult life span." [41]

While such studies based on epidemiological data establish correlation, not causation, the weight of these findings among human populations in addition to laboratory proof that CR extends the lifespan of other mammals tends to favor the hypothesis that CR will also extend human lifespan.

Okinawa: Less Calories More Life

The Japanese district of Okinawa has the longest average lifespan in the world [42] and the highest percentage of centenarians -- people living to a 100 or more -- ever documented from reliable records. [43] Consistent with CR-induced life extension, Okinawans also eat up to 40 percent fewer calories than Americans [44] and 17 percent fewer calories than the Japanese average. [45] The caloric intake of Okinawan children is 36 percent below the Japanese recommended intake. [45] And yet, satisfying a necessary ingredient for CR-induced life extension, Okinawans have adequate nutrition. [45]

Not only do Okinawans have reduced mortality, but also consistent with animal CR research, they enjoy reduced morbidity from a range of causes. For example, these findings were presented at the annual meeting of the American Geriatrics Society (2001) [44]:

Compared to Americans, Okinawan elders

are 75% more likely to retain cognitive ability
get 80% fewer breast and prostate cancers
get 50% fewer ovarian and colon cancers
have 50% fewer hip fractures
have 80% fewer heart attacks

While many factors may contribute to Okinawan lifespan, researchers tend to favor the CR theory as the best explanation. [44] Even without explicit human CR research, available data tends to favor the hypothesis that CR-induced life extension may be a universal effect that applies to all species including humans. Perhaps the next best thing to human research is CR research on primates, which is currently underway.

Primate CR Research

Since 1987, the National Institute on Aging has been conducting a long-term study of CR on rhesus monkeys. In 1999, the NIA researchers stated: "[E]merging data from studies of CR in rhesus monkeys show promise that the model is working in a manner similar to that seen in rodents thereby strengthening the possibility that the well known effects of CR on lifespan, disease, and aging processes may be generalizable to all species." [46]

More recently, I contacted NIA researcher George Roth, who told me: "Morbidity and mortality appear to be lower in CR monkeys." He stated further that this difference from controls is approaching statistical significance. [47] About the NIA study, Modern Maturity states: "The incidence of diabetes ... is greatly reduced in monkeys on a restricted diet. The monkeys also show fewer signs of spinal arthritis, a common condition they share with humans." [48] These monkeys show other signs of reduced aging, such as a prevention of age-associated decline in melatonin levels. [49]

This table shows other bio-markers in the CR monkeys and comparison to findings in CR rodents. [46]

Findings in NIA Primate CR Study	Matches Rodent Data
(-) Body weight	yes
(-) Fat and lean mass	yes
(-) Time to sexual maturation	yes
(-) Time to skeletal maturation	yes
(-) Fasting glucose/insulin	yes
(-) Metabolic rate (short-term)	yes
(*) Metabolic rate (long-term)	yes
(-) Body temperature	yes
(*) or (+) Locomotion	yes
(-) Triglycerides	yes
(+) IGF-1/growth hormone	yes
(-) Il-6	yes
(*) Wound closure rate	yes
(*) Clonal proliferation	yes/?
(*) B-gal senescent cells	?
(-) Lymphocyte number	yes
(*) Lymphocyte calcium response	no

(-) = decrease, (+) = increase, (*) = no change

While researchers at the Wisconsin Regional Primate Center found different gene-expression changes between CR primates and rodents, [50] the overall body of evidence cited above suggests that CR is doing for primates -- and thus may do for humans -- what it does for all other animal species tested. Considering the long duration of human lifespan, data derived from primate research in addition to human body-weight data and examples such as Okinawa may be as close as we will come to answering the question: Will CR do for humans what it does for all other animals tested?

Discussion

Having reviewed the available data, one might be inclined to consider embarking upon a CR regime. The correlation between below-average body weight and longevity is by itself sufficient to suggest the wisdom of such. But there are several things one must first consider. For example, any CR regime should (a) be implemented gradually over time, (b) include only highly nutritious foods and supplementation to avoid malnutrition, and (c) be supervised from the beginning by a knowledgeable physician.

An article recently published in Scientific American implies that only extreme near-starvation CR will result in appreciable health benefits. [1] However, the data indicate that deriving benefits from CR is a matter of degree, not all-or-nothing. In other words, some CR is likely to result in some health benefits, while progressively more may result in progressively more benefits that fall off only as CR becomes malnutrition, whereupon CR becomes harmful. Merely cutting out junk foods, virtually all of which are high-caloric, by itself could result in moderate CR.

Initiating CR in mice during adulthood extended average lifespan but failed to extend maximum lifespan until researchers implemented adult-onset CR gradually and provided a nutrient enriched diet for the rest of their lives. In the first study to shown that -- illustrated in the second graphs above -- CR was initiated at an incremental level for one month, followed thereafter by a higher level of CR. [11] That one month phase-in equals approximately 2.5 human years. In a more recent study, caloric intake in mice was reduced by 16% for two weeks, followed by 45% CR thereafter. [51] Those two weeks equal around 1.3 human years. A gradual phase-in also makes CR easier, allowing appetite to adjust. In my own experience, CR has increased my enjoyment of food.

Another other key to CR is optimal nutrition. Many third-world countries have lower caloric intake and yet do not live longer due in large to inadequate nutrition. Okinawa on the other hand is an example of low caloric intake with adequate nutrition, which researchers believe may be why Okinawans live so long. [44] However, while CR prolongs cognitive functions into old age in animals, researchers at the USDA found evidence of cognitive impairment during CR in obese women [52] probably associated with reduced levels of iron despite the fact that the women were still consuming twice the recommended daily allowance of iron. [53] The same research found significantly improved word recall. [52] But before taking iron supplements consider that excess iron may promote diseases such as cancer [54,55], Alzheimer's [56], and Parkinson's. [57]

The fact that the women doing CR had reduced iron levels despite consuming twice the recommended amount of iron highlights the wisdom of consulting a physician before embarking upon a long-term CR program in order to establish baseline blood measures of as wide a range of nutrients and other health bio-markers as possible. This way the effects of CR on your health can be monitored to detect and correct any deficiencies that might result. Despite the extensive medical literature on CR-induced life extension, some physicians may not be aware of it, especially of its exploratory application in humans. It might therefore be wise to seek out a physician knowledgeable in preventative and anti-aging medicine. [58] It would also be wise to consult resources on CR, such as the website of one of the leading CR experts, Dr Roy Walford. [59]

This is not the end of this report, just the beginning. The following references are not there to look impressive but to serve as an open door to a wide body of information on CR and all the details cited above. Enjoy...

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References

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[1] Taubes, G. (2000). The Famine of Youth. Scientific American, June.

[2] Study that discovered caloric restriction extends animal lifespan: McCay CM, et al. (1935). The effect of retarded growth upon the length of life span and upon the ultimate body size. Journal of Nutrition, 10(1), pages 63-79.

[3] Skalicky M, & Viidik A. (2000). The collagen biomarker of aging can be influenced by physical exercise also in senescent rats. Experimental Gerontology, August, 35(5), pages 595-603.

[4] Holloszy JO. (1993). Exercise increases average longevity of female rats despite increased food intake and no growth retardation. Journal of Gerontology, May, 48(3), pages B97-100.

[5] Meydani M, et al. (1998). The effect of long-term dietary supplementation with antioxidants. Annals of the New York Academy of Sciences, November, 20;854, pages 352-60.

[6] Merker K. (2001). Proteolysis, caloric restriction and aging. Mechanisms of Ageing and Development, May 31, 122(7), pages 595-615.

[7] Weindruch R. (2002). Gene expression profiling of aging using DNA microarrays. Mechanisms of Ageing and Development, January, 123(2-3), pages 177-93.

[8] Weindruch R, et al. (1986). The retardation of aging in mice by dietary restriction: longevity, cancer, immunity and lifetime energy intake. Journal of Nutrition, April, 116(4), pages 641-54.

[9] Weindruch R, & Sohal RS. (1997). Seminars in medicine of the Beth Israel Deaconess Medical Center. Caloric intake and aging. The New England Journal of Medicine, October 2, pages 986-94.

[10] Lipman RD, et al. (1998). Effects of caloric restriction or augmentation in adult rats: longevity and lesion biomarkers of aging. Aging (Milano). December, 10(6), pages 463-70.

[11] Weindruch R, & Walford RL. (1982). Dietary restriction in mice beginning at 1 year of age: effect on life-span and spontaneous cancer incidence. Science, March 12, 215(4538), pages 1415-8.

Cancer

[12] Kritchevsky D, & Klurfeld DM. (1986). Influence of caloric intake on experimental carcinogenesis: a review. Advances in Experimental Medicine & Biology, 206, pages 55-68.

[13] Albanes D. (1987) Caloric intake, body weight, and cancer: a review. Nutrition & Cancer, 9(4), pages 199-217.

[14] Kritchevsky D. (1997). Caloric restriction and experimental mammary carcinogenesis. Breast Cancer Research & Treatment, Nov-Dec, 46(2-3), pages 161-7.

[15] Kritchevsky D. (2001). Caloric restriction and cancer. Journal of Nutritional Science and Vitaminology (Tokyo). February, 47(1), page 13-9.

Heart Disease

[16] Swoap SJ. (2001). Altered leptin signaling is sufficient, but not required, for hypotension associated with caloric restriction. American Journal of Physiology, Heart & Circulatory Physiology, December, 281(6):H2473-9.

[17] Keenan KP, et al (1994). The effects of overfeeding and dietary restriction on Sprague-Dawley rat survival and early pathology biomarkers of aging. Toxicologic Pathology, May-June, 22(3), pages 300-15.

Diabetes

[18] Stern JS, et at. (2001). Calorie restriction in obesity: prevention of kidney disease in rodents. Journal of Nutrition, March, 131(3), pages 913S-917S.

[19] Fujioka K, et al (2000). Weight loss with sibutramine improves glycaemic control and other metabolic parameters in obese patients with type 2 diabetes mellitus. Diabetes, Obesity & Metabolism, June, 2(3), pages 175-87.

[20] Okauchi N, et al. (1995). Is caloric restriction effective in preventing diabetes mellitus in the Otsuka Long Evans Tokushima fatty rat, a model of spontaneous non-insulin-dependent diabetes mellitus? Diabetes Research and Clinical Practice, February, 27(2), pages 97-106.

Osteoporosis

[21] Kalu DN. (1984). Aging and dietary modulation of rat skeleton and parathyroid hormone. Endocrinology, October, 115(4), pages 1239-47.

[22] Kalu DN. (1984). Lifelong food restriction prevents senile osteopenia and hyperparathyroidism in F344 rats. Mechanisms of Ageing and Development, July, 26(1), pages 103-12.

Auto-immune disorders

[23] Fernandes G. (1983). Influence of diet on vascular lesions in autoimmune-prone B/W mice. Proceedings of the National Academy of Sciences, February, 80(3), pages 874-7.

[24] Nandy K. (1982). Effects of controlled dietary restriction on brain-reactive antibodies in sera of aging mice. Mechanisms of Ageing & Development, February, 18(2), pages 97-102.

[25] Fernandes G, et al. (1976). Influence of diet on survival of mice. Proceedings of the National Academy of Sciences, April, 73(4), pages 1279-83.

Neurological decline

[26] Means LW, et al.(1993). Mid-life onset of dietary restriction extends life and prolongs cognitive functioning. Physiology & Behavior, September, 54(3), pages 503-8.

[27] Pitsikas N, & Algeri S. (1992). Deterioration of spatial and nonspatial reference and working memory in aged rats: protective effect of life-long calorie restriction. Neurobiology of Aging, May-Jun, 13(3), pages 369-73.

[28] Pitsikas N, et al. (1990). Effect of life-long hypocaloric diet on age-related changes in motor and cognitive behavior in a rat population. Neurobiology of Aging, July-August, 11(4), pages 417-23.

[29] Eckles-Smith K, et al. (2000). Caloric restriction prevents age-related deficits in LTP and in NMDA receptor expression. Brain Research, Molecular Brain Research, May 31, 78(1-2), pages 154-62.

[30] Lee CK, et al. (2000). Gene-expression profile of the ageing brain in mice. Nature Genetics, July, 25(3), pages 294-7.

Alzheimer's

[31] Mattson MP. (2000). Existing data suggest that Alzheimer's disease is preventable. Annals of the New York Academy of Sciences, 924, pages 153-9.

Parkinson's

[32] Roth GS, et al. (1984). Delayed loss of striatal dopamine receptors during aging of dietarily restricted rats. Brain Research, May 21, 300(1), pages 27-32.

[33] Levin P, et al. (1981). Dietary restriction retards the age-associated loss of rat striatal dopaminergic receptors. Science, October 30, 214(4520), pages 561-2.

[34] Ingram DK, et al. (1987). Dietary restriction benefits learning and motor performance of aged mice. Journal of Gerontology, January, 42(1), pages 78-81.

Other topics

[35] Markowska AL. (1999). Life-long diet restriction failed to retard cognitive aging in Fischer-344 rats. Neurobiology of Aging, March-April, 20(2), pages 177-89.

[36] Campbell BA, & Gaddy JR. (1987). Rate of aging and dietary restriction: sensory and motor function in the Fischer 344 rat. Journal of Gerontology, March, 42(2), pages 154-9.

[37] Manson JE. (1987). Body weight and longevity. A reassessment. Journal of the American Medical Association, January 16, 257(3), pages 353-8.

[38] NIHNC, CDC, & DHHS. (1985). Body weight, health and longevity: conclusions and recommendations of the workshop. Nutrition Reviews, February, 43(2), pages 61-3.

[39] Lee IM. et al. (1993). Body weight and mortality. A 27-year follow-up of middle-aged men. Journal of the American Medical Association, December 15, 270(23), pages 2823-8.

[40] Manson E. et al. (1995). Body wight and mortality among women. New England Journal of Medicine, September 14, 333(11), pages 677-85.

[41] Solomon CG. (1997). Obesity and mortality: a review of the epidemiologic data. American Journal of Clinical Nutrition, October, 66(4 Suppl), pages 1044S-1050S.

[42] Investigating the world's longest-live people. Okinawa Centenarian Study.

[43] Willcox BJ, et al. (2001). Evidence-based Extreme Longevity: The Case of Okinawa, Japan. Presidential Poster Session of the American Geriatrics Society Annual Meeting.

[44] Okinawa Centenarian Study data presented at the American Geriatrics Society annual meeting, 2001; cited by McCord H, & McVeigh G, (2002). NutritionNews: "Magic" Appetite Shutoff from the Orient. Prevention, January, pages 52-3.

[45] Kagawa Y. (1978). Impact of Westernization on the nutrition of Japanese: changes in physique, cancer, longevity and centenarians. Preventive Medicine, June, 7(2), pages 205-17.

[46] Lane MA. (1999). Nutritional modulation of aging in nonhuman primates. Journal of Nutrition, Health & Aging, 3(2), pages 69-76.

[47] Email response from NIA researcher George Roth (geor@vax.grc.nia.nih.gov), January 1, 2002.

[48] Warshofsky F. (1999). The Methuselah Factor. Modern Maturity, November-December.

[49] Roth GS. (2001). Dietary caloric restriction prevents the age-related decline in plasma melatonin levels of rhesus monkeys. Journal of Clinical Endocrinology & Metabolism, July, 86(7), pages 3292-5.

[50] Kayo T, el al. (2001). Influences of aging and caloric restriction on the transcriptional profile of skeletal muscle from rhesus monkeys. Proceedings of the National Academy of Sciences, April 24, 98(9), pages 5093-8.

[51] Shelley X, et a1. (2001). Genomic profiling of short- and long-term caloric restriction effects in the liver of aging mice. Proceedings of the National Academy of Sciences, September, 98(19), pages 10630-35.

[52] Kretsch, MJ, et al. (1997). Cognitive effects of a long-term weight reducing diet. International Journal of Obesity and Related Metabolic Disorders, January, 21(1), pages 14-21.

[53] Kretsch MJ, et al. (1998). Cognitive function, iron status, and hemoglobin concentration in obese dieting women. European Journal of Clinical Nutrition, July, 52(7), pages 512-8.

[54] Blanc JF, et al. (2000). Iron overlaod and cancer. Bulletin de l'Academie Nationale de Medecine, 184(2), pages 355-63.

[55] Nunez MT , et al. (2001). Iron-induced oxidative damage in colon carcinoma (Caco-2) cells. Free Radical Research, Jan;34(1), pages 57-68.

[56] Jeanie D. (2000). High Iron Levels Identified in Brains of Alzheimer's Patients. WebMD Medical News, February, 28.

[57] Levites Y. (2002). Attenuation of 6-hydroxydopamine (6-OHDA)-induced nuclear factor-kappaB (NF-kappaB) activation and cell death by tea extracts in neuronal cultures(1). Biochemical Pharmacology, January, 63(1), pages 21-29.

[58] Search for a Physician or Practitioner, American Academy of Anti-Aging Medicine.

[59] http://www.walford.com/

InfoAging is carrying another piece warning about side effects of human growth hormones. Supplements are not the path to a longer life guys. It's just fine-tuning the machine, and probably just as beneficial in moderation.

Link: http://www.infoaging.org/news_article.html?SMContentIndex=2&SMContentSet=0

My attention was directed to another wonderful article by Ronald Bailey at Reason Magazine. Have a look, and by all means search out his other articles on life extension and biotechnology. Great reads.

Link: http://www.reason.com/0208/fe.rb.forever.shtml

The Longevity Meme has moved providers again. My apologies for recent inactivity -- things should be back up and running within the next few days. I will begin a facelift and tidying up of the Longevity Meme in due course. With the experience I've gained in the last year of running the site, I should do a far better job in the year to come.

Link: http://www.longevitymeme.org

Anti-ageing technology may present us with the awful scenario of extended lifespan but limited improvement in quality of life. Living forever -- or at least for long periods of time -- with dementia is known as "The Tithonus Option." This paper argues that the Tithonus Option is unlikely to eventuate. Copyright © Chris Lawson

[0] Introduction

Summary

Anti-ageing technology may present us with the awful scenario of extended lifespan but limited improvement in quality of life. Living forever -- or at least for long periods of time -- with dementia is known as "The Tithonus Option."

This paper argues that the Tithonus Option is unlikely to eventuate. [This paper was presented at the Worldcon SF Convention, Melbourne Australia on 6 September 1999. Many thanks to Damien Broderick, who started my brain working on the subject, to Russell and Jenny Blackford, who were instrumental in developing the academic track at the Worldcon, and most of all to the audience whose questions and comments helped clarify and extend the presentation you see here.]

The Future of Ageing

Future technology offers us visions of power that rival the dreams of myth and legend. As Clarke's Law puts it: "any sufficiently advanced technology is indistinguishable from magic." One of those magic dreams is of immortality. However, as in the legends, immortality comes at a price.

In this paper I have not addressed population control or equitable distribution of anti-ageing technology, although I do not mean to dismiss their importance. This paper addresses another possibility altogether: the fear that we will live longer, but in bad health and decrepitude.

This is the "Tithonus Option" -- immortal life with eternal dementia. I will be arguing that the Tithonus Option is not a strong possibility even in the advent of advanced anti-ageing technology.

[This article germinated when Damien Broderick asked me to look over some chapters of his book on immortality, The Last Mortal Generation. The "Tithonus Option" piqued my interest and I replied to Damien with a short version of the argument on these pages. You can find that summary in Damien's book.]

Tithonus and Eos

In Greek mythology, Tithonus was a handsome mortal who fell in love with Eos, the goddess of the dawn. Eos realised that her beloved Tithonus was destined to age and die. She begged Zeus to grant her lover immortal life.

Zeus was a jealous god, prone to acts of deception in order to seduce beautiful gods and mortals, and he was not pleased with Eos's infatuation with a rival. In a classic Devil's Bargain, he granted Eos's wish -- literally. He made Tithonus immortal, but did not grant him eternal youth.

As Tithonus aged, he became increasingly debilitated and demented, eventually driving Eos to distraction with his constant babbling.

In despair, she turned Tithonus into a grasshopper. In Greek mythology, the grasshopper is immortal. (In a close cultural parallel, the Chinese believed that locusts live forever.) This myth also explains why grasshoppers chirrup ceaselessly, like demented old men.

[1] Modern Tithonus Myths

Summary

There are several foreseeable outcomes for anti-ageing technology. Various scenarios arise in science fiction stories such as R.G. Riel's "A Short Prayer" and Ian McDonald's "The Days of Solomon Gursky."

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We live in a special period of history. For the first time, the majority of people living in the First World can expect to live well into their seventies. Even so, our final years are usually marked by impaired health and often senile dementia. However, new technologies have the potential to extend our lifespan, perhaps indefinitely. I am talking here of advances in genetic engineering and the blue-sky future of nanotechnology.

There are three foreseeable futures. The first is that we will live and die much as we do today. It is almost inevitable that genetics will provide new ways of extending our lives, but there is no guarantee that these life extensions will add more than a few years or significantly reduce the prevalence of dementia and debility. The second possibility is that technology will grant large extensions in lifespan, but will not be able to stave off dementia. This is the Tithonus Option. The third possibility is that technology will be able to repair the damage done to our cancer cells and arteries and neurons, thus giving us effective immortality.

A Modern Tithonus Myth

In R.G. Riel's "A Short Prayer" (Eidolon #22/23), a priest is kept alive for centuries on life support. As his body decays, ever more invasive procedures are performed to save him, and more and more of his vital bodily functions are taken over by machines. Eventually all that is left of the original priest is a small part of his brain which recites catechisms over and over.

This is the nightmare of the Tithonus Option: Eternal life, or at least centuries-long life, with zero quality of life.

Superficially, this seems a reasonable possibility. While genetic engineering and nanotechnology may help extend our lives for centuries, it does not follow that future technology will be able to repair all wear-and-tear on the brain and heart. Unless future technology can repair all microscopic injuries, then the Tithonus Option ought to be a possibility.

I will be arguing, however, that the Tithonus Option is not a likely outcome -- but for other reasons.

A Modern Immortality Myth

Ian McDonald's novella "The Days of Solomon Gursky" (Asimov's SF, June 1998) follows the life of a nanotech designer whose inventions allow humans to stave off disease and improve their bodies. They are effectively immortal barring extreme accidents such as nuclear explosions.

Solomon Gursky manages to travel the limits of the cosmos and eventually outlives the Universe itself.

This is immortality, or the Gursky Option. Gurskys can live forever, and in excellent health.Only accidents, murders, and suicides can kill Gurskys since virtually all human disease is curable.As we shall see, Gurskys' lifespans are measured not by life expectancy but by half-life.

[2] Exponential and Gurskian Death Rates

Summary

Currently, death rates increase exponentially with age (approximately). It is feared that anti-ageing technology will prolong life, but will not prevent dementia or other causes of increasing debility. Immortals such as Solomon Gursky have access to such powerful medical technology that they only die from accident, murder, or suicide. Gursky lifespans are best measured by half-lives.

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Australian data shows an approximately exponential increase in death rate by age. Although one would expect regional and sociocultural differences, the broad picture should apply equally well in any Western nation.

Death rates are expressed as deaths per 100,000 people per year.

The Tithonus Option is the Middle Path

Data collected by the Australian Bureau of Statistics (ABS) shows an exponential increase in deaths per year when separated into age groups.

[The ABS data is tabulated in an odd fashion. The age brackets are: less than 1 year, 1-14, 15-24, 25-44, 45-54, 55-64, 65-74, 75-84, and 85 and over.]

By comparison, Gurskys have a constant death rate per annum. They experience no increase in death rate with age.

The Tithonus Option lies in the area between these two curves. With the current pattern of death rate, most people will die within a few years of developing dementia or severely reduced mobility. Gurskys, with their access to highly advanced medical technology, would not expect their health to deteriorate over time.

Therefore longevity plus debility lies somewhere between the Gurskys and modern mortals.

Population Curves

A population curve is a graph of the number of surviving members of a cohort plotted against age. These curves are the same as the cumulative death rate subtracted from a set population. [These curves are approximately the same as the death rate curves above flipped on the y-axis.]

The graph above shows the exponential death rate increasing to form a population crash in the later decades. The Gursky population, with its non-exponential death rate, shows a steady population attrition but no population crash. Only a small fraction of the Gurskys have died by the time the entire cohort of today is gone.

Gurskys Have Half-Lives

The scale on the graph above hides some valuable information. When the x-axis is scaled up by a factor of ten (that is, each block on the x-axis represents 150 years instead of 15 years, see right), the population curve of Gurskys reveals a steady decay curve just like the decay of radioactive elements.

Just as for radioactive elements, Gursky populations are best measured by half-life rather than by life expectancy.

This has several important ramifications. There is no upper limit on the age of a Gursky.Based on modern calculations, a population that only dies in accidents will have a half-life of500 years. [This assumes that the rate of fatal accidents will remain constant despiteimproved medical technology and that there will be minimal psycho-social changes with the availability of virtual immortality. These assumptions are unlikely to hold true, but it is the best approximation we can make today.]

Note that a Gursky who has lived 500 years has a 50% chance of living another 500 years. And should a Gursky survive that to reach 1000 years of age, he still has a 50% chance of living another 500 years. This is always true: no matter what the age of a Gursky, he has a 50% chance of surviving another half-life.

As the curve makes clear, modern mortals are a mere blip in the lives of Gurskys.

[3] The Reason for Exponential Death Rates

Summary

Death rate increases exponentially because our bodies accumulate damage.Errors in our DNA lead to cancer. Plaques accumulate in our arteries and cause strokeand heart disease. Diseases of "accumulated damage" exhibit exponential growth curves.Some causes of death can only be modelled approximately by an exponential curve (accidents), others bear no relationship (murder and suicide).

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Accumulated Mutation Load is Exponential

The graph below plots the rate of death from colon cancer by age. It shows an exponential growth curve.

Cancer is not a simple disease. It results when a cell begins to reproduce uncontrollably.Since our cells contain several safety mechanisms, a cancer cell has to bypass many safety nets in order to survive. This means that each cell has to accumulate several mutations or it will not become a clinical cancer. In the case of colon cancer, six separate mutations are necessary to convert a normal colonic cell into a malignant tumour.

This explains why cancer deaths exhibit an exponential curve: it takes years of accumulated mutations for cells to begin turning malignant. Also, the rate of mutation itself also increases over time as our bodies accumulate a greater load of radiation and chemical mutagens. So it is no surprise that cancer increases exponentially with age.

Cancer

Cancer is caused by accumulated mutational load over time.Most primary cancers are not fatal in themselves unless they cause direct damage to vital body parts, such as a brain tumour compressing the contents of the skull.

Instead, most fatal cancers are the result of secondary tumours that have spread throughout the body via blood or lymphatics. The most common sites of secondary tumours are the lungs, liver, and brain.

Vascular Disease

While cancers are the result of accumulated errors in DNA, vascular disease is the result of accumulated errors in arteries called atheroma or plaque. Atheromas are flash points for clots, which can then break off and become lodged in a narrowing of an artery, blocking off the blood supply to the tissues supplied by that artery.

A massive heart attack can cut off the blood supply to the bottom of the heart. Having no blood supply, this part of the heart dies, with the result that the heart then fails to act as an efficient pump -- and then the rest of the body is in serious peril. Surrounding the heart is a blood clot that formed when blood leaked through the damaged heart wall to form a capsular clot around the heart.

Strokes most commonly arise from the same pathological mechanism as a heart attack. That is, a clot breaks off from an arterial plaque. The clot then lodges in one of the small arteries in the brain, cutting off the blood supply and killing brain tissue.

Consider instead a haemorrhagic stroke -- it is caused by an artery bursting in the brain and the blood pouring out under pressure. The resulting blood clot kills brain tissue by direct pressure effect. Although this is a different mechanism to the "occlusive" strokes mentioned above, it is caused by long-standing hypertension (high blood pressure) wearing down the elasticity of arterial walls. As such, it represents another example of accumulated errors, and therefore follows an exponential curve when plotted against age.

Accidents

Accidental deaths follow a complex curve. Young people are more likely to die of accidents thanthose in their forties. This is due to the high rate of risk-taking behaviours. Young peopleare more likely to drive faster or ski a dangerous slope, for instance. With increasing age comes increasing safety awareness. So the curve for accidental death shows a distinct "hill" with a peak in the late teens/early twenties.

However, after that blip due to risk-taking, accidents reassert an exponential curve. The elderly are far more likely to die as a result of accidents than even the highest risk-taking age group. We tend to neglect this problem because accidental deaths in the elderly are significantly fewer than deaths by vascular disease or cancer, whereas in young people accidents are the most common cause of all deaths.

Accidental deaths show an exponential curve because, in the elderly, they too are the result of accumulated damage. Reduced balance, co-ordination, and reflex response times put the elderly at greater risk of having an accident. Osteoporosis means that smaller forces can result in significant injuries. Diabetes and vascular disease mean that injuries take longer to heal, thus increasing the risk of immobility and infirmity. As a result, accidental deaths can be roughly modelled by an exponential curve.

Homicide and Suicide

Murder and suicide do not follow an exponential growth curve because they are not caused byaccumulated bodily errors. The causes of murder and suicide are extremely complex, and dependon social, cultural, and psychological factors, none of which are amenable to simple formulaicanalysis.

Since the death rate from murder and suicide in most societies is dwarfed by other causes, we shall ignore it for the purpose of this argument. However, it is worth noting that prolonged lifespans may result in increasing suicide rates and risk-taking if boredom sets in. It is very difficult to predict the death-rate profile of future societies.

Exponential Curves and the Western Way of Dying

In non-Western societies, especially those where life expectancy is still hovering around the mid-forties, cancer and vascular disease are relatively uncommon causes of death. Infection and malnutrition are still the primary causes of death in Third World countries.

This has interesting implications for Westerners. As our medical technology and public healthstrategies improve, we have eradicated infection and malnutrition as the major causes of death.(People still die of infections and nutritional deficiencies, but these are no longer in the same ballpark as cancer or heart disease.)

I would argue that diseases of accumulated damage, that is those that exhibit an exponentialgrowth curve, are destined to be the primary causes of death in wealthy countries. With wealth,nations can reduce the rate of infections, but even applied efforts to reduce heart disease orrisk of cancer are limited by the exponential nature of their progress. Even if we can reducethe incidence of heart attacks by, say, 50% at the age of 65, this will only prolong lifespan by a few years because the exponential curve will quickly catch up.

The only possible escape from these cumulative diseases is if we develop advanced medical technology capable of repairing our bodily errors. This is the Gursky Option.

[4] Excluding Causes of Death Does Not Dramatically Extend Lifespan

Summary

Excluding selected causes of death (such as cancer) makes very little difference to life expectancy in an exponential scenario. Even a ten-fold reduction in base death rate leads to less than a doubling of life expectancy. Exponential death rates necessarily put severe limits on the possibility of longevity beyond two centuries.

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Death Rates in Australia

The graph above shows the death rate in Australia plotted against age. As it shows, the curve is roughly exponential and males have a more dramatic increase than females.

Roughly speaking, the curve for males can be decribed as death rate = 1.118 ^age and for females as death rate = 1.111 ^age, where age is in years and death rate is in deaths per 100,000 people per year.

This is, I must point out, an approximation. The death curves do not follow perfect exponential functions. Death curves are best seen as a sum of many curves from specific causes of death, some with slightly different values of the constant (that is, the a in the function y = a ^x), and some which are not exponential at all.

Real and Idealised Death Rates

As the graph to the right shows, the real death curve as drawn from ABS data on death rates is a close match to an exponential curve. There are slight differences between the two curves, but clearly an exponential function is a reasonable approximation of real death rates.

When male and female deaths are combined, the function that best fits the curve is:death rate = 1.114 ^age, where age is in years and death rate is expressed asdeaths per 100,000 people per year.

When one draws the curve out past the limit of ABS statistics (see right), one sees the sharp upsweep of the death rate curve on the idealised exponential function. (The ABS data runs out at "greater than 85 years.") Note that these curves are exactly the same as in the graph above, only on a greater scale and with the idealised curve projected past the domain limit of the real curve.

While it is difficult to draw a life expectancy from these curves, one can derive a "life limit", that is, the greatest age one would expect a person to reach. This limit can be derived by extrapolating the exponential curve until the death rate per 100,000 people per year is greater than 100,000. Clearly, at this point one would expect all humans at the life limit to die within the year. [Note that this is a statistical point; there is no absolute requirement for every single person of that age to die in that year.]

By this exponential curve, the life limit for males is 103.2 years, and for females is 109.4 years. [deaths = 1.114 ^age and a life limit of 106.6 years.] This seems broadly in agreement with reality, where the oldest living persons are almost always women, and the upper limit is around 120 years.

The Surprising Stability of Life Limit

Originally I had planned to respond to Damien Broderick about the terrible possibility of the Tithonus Option. I took the original ABS data on death rates and excluded causes that I believed would be most likely to be cured by future genetic technology.I excluded: infection, cancer, congenital anomalies, pregnancy-related deaths, immune disease, haematological conditions, endocrine conditions, and dermatological conditions. Then I recalculated the exponential function to be y = 1.105 ^age, which yieldeda life limit of 115, a mere 9 years better than the current life limit!

The graph compares the current population curve with the population curve with the excluded diseases. As this makes clear, even excluding important disease groups such as cancer (which results in roughly 30% of all deaths) makes only minimal changes to the life limit.

This finding surprised me since I had expected a far greater extension in lifespan.To confirm my new suspicions, I postulated extremely effective medical technology and came up with the graph to the right. These curves were derived by taking the death rate of females aged 70, excluding the causes mentioned above, and dividing by two. This gave a "fantasy" function of deaths = 1.089 ^age. Remarkably, this function yielded a life limit of 135.0 years, a tiny increase given the halving of the death rate at age 70.

To push the concept even further, I postulated an "extreme fantasy" scenario in which the death rate of idealised women aged 70 was only a tenth its current value. [That is, only 80 deaths per 100,000 people per year compared to 798 as derived from the ABS statistics with the above conditions excluded.] This yielded the function deaths = 1.065 ^age, with a modest increase in life limit to 183.9 years. This means that reducing the current death rate by more than a factor of ten leads to less than a doubling of life limit.

Even more remarkable is the slope of the population curves. Clearly, even in the "extreme fantasy" (10x improvement) scenario, the population curve plunges dramatically. This means that there is little difference on the Tithonus region of the "extreme fantasy" curve compared to that of the current curve. In short, even dramatic improvements in medical technology will not result in the Tithonus Option.

[5] Conclusion

Summary

Exponential death rates and increasing debility go hand in hand. Solve one and the other must follow (Gurskian immortality). If debility persists, then so will exponential death (current pattern). Therefore the Tithonus Option is not a likely outcome of anti-ageing technology.

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This graph is repeated from the end of the last page because it shows the core of the argument. Even when death rates are slashed dramatically for the purpose of modelling advanced medical technology, the death rates increase exponentially, the population curve crashes, and there is still virtually no window for the Tithonus Option.

The Tithonus Option exists in a region that will never be dramatically enlarged by medical intervention. If future technology can repair the errors that accumulate in our bodies, then we will not become demented or debilitated and we will have become Gurskian immortals. If our future technology cannot repair our accumulated errors, then we must experience an exponential death rate with its inevitable population crash, and none of us will live long with debility.

Either we will live into old age in good health...

...or we will live and die as we do today.

Phil Graves outlines some of his thoughts on life extension through calorie restriction and other forms of diet.

Copyright © Phil Graves.

As a first principle, there is, or rather should be, no such thing as a "diet" in the sense of a temporary alteration in eating habits, in order to get back to some prior desirable weight or size. Any temporary eating change will lead only to temporary changes in weight. A diet in the best sense of that term is essentially a life-style choice to be followed indefinitely. This is not to say that one’s diet should not change or possess great variety or be delicious. Indeed, as scientific knowledge about the diet-health-longevity nexus advances, one would expect to alter one’s diet. Healthy diets would be generally expected to incorporate a wide variety of foods and they should be mostly great tasting.

A second principle is that there is certainly no single best diet for everyone. There is enormous genetic variation among human beings (e.g. height, bone density, skinfold thickness, body fat, fat-free mass, and body fat distribution have all been shown to have a genetic influence). That variation will likely reflect itself in widely varying micro- and macro-nutrient requirements and ideals. Many diseases are known to have at least some genetic causation (e.g. Type 1 diabetes which is more common among Caucasians than African-Americans or Native-Americans, familial hypercholesterolemia, hereditary hemochromatosis, among many others). While great progress has been made in specific cases, very little is generally known about the implications of the genetic diversity of human beings for optimal diets. Moreover, there is considerable variation in dietary needs at different exercise levels and at different stages of the life cycle. For example, a fit, trained athlete will require more calories, water, iron, and certain B vitamins. Nutritional requirements and ideals will vary during pregnancy, infancy, adolescence, and in old age. Hence, what follows is of necessity general (and written largely from the perspective of an active adult) - if in doubt, seek medical advice.

A third principle, underlying the present effort, is that the proper diet for a given individual should be based on the best information that science has to offer. Some people may, for personal religious or ethical reasons, not wish to include items in their diet that would otherwise be healthy for them. Others may avoid or embrace various dietary measures out of ignorance (see "Fads, Frauds, and Quackery," by S. Barrett and V. Herbert, Chapter 109 in Modern Nutrition in Health and Disease, 9th Edition, M. Shils, J. Olson, M. Shike, and A. Ross, eds. 1999). This is the "bible" of the traditional nutritional establishment, incidentally, and may be referred to sporadically. In general, I will minimize references and attempt to keep everything as simple and readable as possible. The goal, then, is to understand the science relating diet to health and longevity. If the science of a topic is "controversial," I’ll note that as I go, along with providing some sections of specific controversies at the end.

The Key Insight: Calorie Restriction Reduces Disease and Extends Life

In literally thousands of experiments, on a wide range of animals (almost certainly to include humans!), calorie restriction has greatly extended maximum and average lifespans and improved disease resistance, including resistance to many cancers. There is still uncertainty about why calorie restriction has these desired effects. Two important reasons proposed for the benefits of calorie restriction are: 1) fewer calories mean that there will be a reduction in the accumulation of oxidant and free-radical damage, and 2) fewer calories alter fat deposition, obesity, and hormones. The practical effect of this is improve the immune response of calorie-restricted (hereafter CR) animals. There are numerous reputable websites to learn more about the underlying animal studies (preliminary corroborative results are now coming out on the rhesus monkey experiments currently underway). Indeed, there are already convincing studies demonstrating the health benefits (and, no doubt, the longevity benefits…though not enough time has passed to observe these!) in humans. See the Sears and Walford references in the bibliography, and for a fascinating more general account of why we age check out Austad. For present purposes, that CR - with adequate or optimal nutrition (the first controversy) - is good for your prospects for a long, healthy life will be taken as a given. The science is unambiguous and the life extension benefits have been known (surprisingly) since 1935. The interesting questions revolve around related issues.

What is Calorie Restriction?

You might (in an ideal world) want to get an extensive blood test, so that you can verify for yourself the benefits of CR as they occur. Also, in an ideal world, you would want to calculate how many calories you are currently eating. This will add some useful precision, if others are to learn from your experience with CR - remember that you are a pioneer and that leaving a record is a good thing. But, unfortunately, I did not do the latter, so I have only a loose understanding of what percentage of CR I am engaged in at any particular time.

The range of recommended calorie restriction levels is from 10% to 25% from the unrestricted diet (Walford believes most people should start CR with 1,800 to 2,200 calories per day). But, you don’t want to lose too much weight and you don’t want to lose it too fast! A number of ways of thinking about CR have emerged. If you feel weak, lightheaded, or are overly tired and sleep a lot, you are either losing too fast or not getting enough nutrition with your reduced caloric intake - you should feel better, not worse, if things are going right.

To give a reference, it would be difficult for most people to lose more than a pound a week of true weight (ignoring water) in a healthy way. Since a pound loss (3500 calories, roughly) in a week breaks down to 500 calories per day, that is a quite substantial restriction (16.7% CR if one is initially at 3,000 calories a day, which is plenty of food). Note that the "Percent Daily Values" on all of the food packages these days refer to a 2,000-calorie diet, with gram numbers also being given for the 2,500 calorie diet. If you were eating at those levels before restriction, losing one pound a week would be 25% and 20% CR respectively. So, you are "safer" to take six weeks to lose 6 pounds, though this, too, is likely to vary with the individual. When I lost 12 pounds in that time (2 per week), I felt very bad, but Ray (another CR Society member) lost 15 pounds in 6 weeks and felt fine. The key is to be guided by how you feel - you are supposed to feel better, not worse. If you feel worse, lose more slowly. Remember that when you are losing fat you are also losing muscle along with that fat; you may also be releasing toxins stored in fat too rapidly.

Also, and especially if you are moderately to very active, you will find your fat percentage declining steadily as you lose weight. Walford believes that you should not let that fall below 6-10% for men and 10-15% for women. This is not terribly likely to happen for most people on CR - the 1990 mean values for males between 40 and 75 years old varied from 25.3 to 26.8% while the female means were 34.9 to 39.0% for those age groups! For men between 40 and 75, a 13 to16% body fat will put you in the lowest 5% of the nation, while for women, a 25 to 28% body fat will also make them leaner than 19 out of 20 people! And, we’ve gotten a bit fatter since 1990. So, it’s not too likely that you will acquire a dangerously low fat percentage. Despite Walford’s warning, having quite low body fat percentages may not be so terribly undesirable at least for particular individuals (Frank Shorter was estimated to be only 1-3% fat when he won the Olympic marathon in 1972!).

A rough measure of how fat people are is the Body Mass Index or BMI. This can be calculated by dividing your weight in kilograms (2.2 pounds to a kilogram) by the square of your height in meters (39.4 inches to a meter). Thus, if you weigh 150 lbs. (68.2kg) at a height of 5’9" (69" or 1.75m) tall and weigh 150 lbs., your BMI is 68.2kg/3.0625 = 22.3. Traditional nutrition/health sources say that the BMI for "normal" men and women should be in the range of 20-27, which roughly corresponded to the 10th and 75th percentile values in 1971-74. For a flavor of where you stand, from 1990 data (we’ve gotten fatter since then!), consider

BMI	Adult Men (%)	Adult Women (%)
21-24.9M	37	55
25-26.9	25	15
27-29.9	25	10
30	13	20

Hence, women generally have lower BMIs, except among the very obese, where there are more women than men. The reconciliation of these BMI data with the earlier data that indicated that women have higher fat percentages (true at every BMI) than men comes via the greater amount of lean body mass among men.

I would guess that the average BMI of the members of the CR Society (a newsgroup on the web) would be well under 21, with many as low as 17. A recent study has indicated that those with lower BMIs are much healthier and less prone to disease and premature death than those with high BMIs.

While perhaps a depressing revelation for many, it turns out that you do not get CR’s health benefits by losing weight via increased caloric expenditure. It is true that a typical person could lose 1 pound a week either by restricting calories an average of 500 per day or by running 5 miles every day (losing an average of 100 calories per mile more-or-less regardless of speed) and eating the original number of calories. The reason exercise does not give CR benefits even if it gave equivalent CR weight stems from how CR is hypothesized to work. Food is the source of 90% of the oxidants or free radicals in the body - reducing food reduces oxidative damage. Exercise, ironically, actually contributes to free radical formation by burning that food faster. These negative effects are for most people (the non-CRers) more than offset by the health benefits of exercise, so that average lifespan is certainly increased by exercise. [Probably the oxidative damage is more than offset by positive effects of improved fat deposition, reduced obesity, and improved hormone status.] But a number of rodent experiments indicate that exercise doesn’t add anything to the maximum lifespan and fairly little to the average lifespan when animals are already calorie restricted. It is the CR that gives the benefits - exercise to feel better and to maintain independence in old age, but don’t exercise as a substitute for calorie restriction. Note, too, that while CR won’t make you stronger, it will make you relatively stronger - you’ll be able to do more push-ups and chin-ups, for example, just because you have less weight to lift! These benefits will be manifest in everything you do as you move around in your lighter body throughout the day.

Will a Longer Calorie-Restricted Life Really be "Better?"

In some respects, only you can answer that question. In economic terms, the answer may depend on your "internal rate of time discount," or perhaps what psychologists might call a desire for "immediate gratification" versus "deferred gratification." That is, if you find yourself really wanting things right now, rather than later, any perceived suffering now is not likely to be compensated for by having more years (of said suffering) in the distant future. People who smoke must obviously greatly discount the future, for example. But, so do people who run up charge cards that eventually must be paid for, and so do those who fail to save for retirement, as other examples.

As someone posting a note on a web newsgroup put it, "To me the whole calorie restriction thing is like the idea that you shouldn't drive your car, because people sometimes have accidents and crash into each other. So you can make your car live longer by not driving it, but where's the fun in that?" But, as someone responded on that same newsgroup, "The fun is that someday - perhaps within 30-50 years - science will be able to "roll back the aging clock" and make us all young again. And keep us that way. So we try to make our cars last until that day comes. Because then we can drive them forever." Those people, I would argue, will never understand each other because they have different rates of time preference.

CR, for many people, has some serious downsides that you should be prepared for, in the event they occur. You may be colder in your everyday activities (CR lowers body temperature usually, another possible mechanism underlying its anti-aging benefits). You may need to dress warmer or raise the temperature of your home to feel equally comfortable. The reactions of people you meet (they might think you look like you have cancer or AIDS or have an eating disorder) can be a problem. This is mostly a problem while you are in the process of losing weight; when you stabilize for a while they are likely to notice it less and less. Also fairly common are irritability and loss of libido (some of that may be offset by ingestible substances, but whether those substances might offset some of the benefits of CR is unknown at this time). Also, a recent concern in the CR Society newsgroup is that those on substantial CR might have more rapid bone loss than those on mild CR and ad lib eaters. The preceding issues may have an important effect on the degree of CR you wish to practice.

But, there are different "spins" on this issue. CR doesn’t really result in much suffering, if it is done properly - or at least it doesn’t for many people, including me. In particular, one can substitute along taste/nutrition/calorie lines to arrive at a meal that is equally pleasurable and filling to eat, but that has fewer calories and actually more nutrition. Moreover, there are other pleasures that come with CR that tend to offset any remaining "suffering," namely losing weight, feeling better, and being more attractive to others (subject to the caveat above). Too, remember that there are degrees of CR, and 10%CR is much easier than 25%CR. In fact, some feel that those starting CR in midlife (say, 40-50 years old) should practice more mild CR than might be desirable on longevity grounds for those starting as young adults. One might also begin with lower levels of restriction, find that it is not so difficult, and later increase the amount CR, gradually increasing the health and longevity benefits. To understand that, we need to get into how to practice CR:

How Does One "Calorie Restrict?"

As to background facts, proteins and carbohydrates have four calories per gram, while fats have nine calories per gram. For perspective, 4 grams of pure sugar is about one teaspoon and has 16 calories. A typical sweetened soda may be thought of as swallowing 9 or 10 teaspoons full of sugar! Similarly, the commonly mentioned 3-ounce serving of meat (at 28.35 grams to an ounce, that is 85 grams of meat) is approximately the size of a deck of playing cards.

If one is going to calorie restrict, you must reduce the numbers of grams of something…and, unless you reduce everything in proportion, the ratios of protein, carbohydrates, and fats will change. The current American average intake is 35% fat (12% saturated, 3% transfats, 14% monounsaturated, and 6% polyunsaturated - more on these breakdowns later), 50% carbohydrate, and 15% protein. In fact, virtually every diet variant (discussed later under "controversies") recommends a change from the current American eating pattern! But, this is also where the many diet controversies start in earnest, when compared as a baseline reference to the American Heart Association recommendations. For example, a (declining) number of people believe in very high carbohydrate and very low-fat diets (notably, Ornish), while others believe in moderately high protein and very high fat and very low carbohydrates (Atkins). Higher protein, less saturated fat, but more polyunsaturated and monounsaturated fats in the same overall fat intake, with lower carbohydrates roughly characterizes Sears, while Reaven recommends more mono and poly fats, with reduced carbohydrates. These approaches are discussed more fully in the "controversies" section later - CRers generally believe that almost any diet that is effective in reducing calories substantially will extend life greatly (provided nutrition is adequate), though momentum is growing in Sears' direction. I will "cut to the chase" and make recommendations that will certainly not be accepted by all, but that will provide a basis for later discussion of the controversies. These recommendations have come largely come from web discussions among members of the CR Society, tempered (or perhaps tampered) by my own views here and there.

Begin with your current, unrestricted diet (the so-called "ad libitum" diet in the case of the rats - what they eat when rat chow is freely available). The basic idea is to substitute foods that have more nutrition per calorie for foods that have less nutrition per calorie, while gradually reducing the number of calories. The goal is to get equal or better nutrition from fewer calories. This is not hard…as a practical matter, one should attempt something like the following:

Curtail the "whites" (most bread, potatoes, pasta, and rice), since they don’t deliver very much nutrition per calorie, and they often have very high glycemic indexes - result in excessive insulin production, ultimately in insulin resistance and adult-onset diabetes. If you must eat grains, eat whole grains - for their better fiber, mineral, anti-oxidant, anti-cancer and cholesterol reduction benefits.

Curtail the desserts and the snacks (pies, cakes, candy, potato chips, pretzels, etc.) for they deliver almost no nutrition per calorie. Increase fruits (especially berries, like blueberries, blackberries, or strawberries) to fully or partly substitute for the desserts. Substitute tea (discourages stroke, heart attack, cancer, and neurological damage) for empty-calorie sodas.

Curtail saturated fats (reduce red meat portions, trim visible fat, substitute liquid oils, especially olive or canola, for butter and hard margarine, use skim instead of full fat milk, etc.) to improve heart/cancer health in addition to saving nine calories per gram.

Increase fish consumption, especially high omega-3 oil varieties (cold-water fish like tuna, salmon, etc. Note that there is some controversy on this, with some advocating greater flax or walnut oil rather than fish. Eat more tree nuts, especially walnuts and almonds to replace fatty meats)

Increase vegetables of almost any type, the more variety the better, by as much as you need to enable you to feel full at the end of a meal.

One of the members of the CR Society expressed a simple way to think about conducting CR that may be useful for some:

1) Be sure to eat twice as much food (by weight), as you ate on your pre-CR diet,

2) Make sure that the average calorie density of your new CR foods is 1/4 the calorie density of your pre-CR diet, and

3) Make sure that your new CR food has double the nutritional density of your pre-CR foods. This may require more knowledge of calorie density and nutritional density than most people have acquired, so there are a number of books with a wide range of recipes to give you a flavor of what this means (notably, the Walford and Sears references at the end).

Yet another way to think about diet under CR is to consider Paleolithic diets. The idea here is that mankind’s optimal diet (the one we have evolved to handle) does not include the "recent foods" that we only began consuming in large quantities in the last 5,000-10,000 years when agriculture began to replace the earlier hunter-gatherer system of food collection. In this view, the diet was mostly meat, non-starchy vegetables, and fruits - the meats eaten being mostly quite lean and everything eaten mostly raw. Stone Age people ate three times as much of a wide variety of vegetables and fruits as modern man. Vegetables and fruits (along with nuts, legumes, and honey) provided a rather astounding 65% of daily calories (with 100 grams of fiber). The remaining 35% of calories (2-3 times what is recommended in many diets today) was protein, largely from game animals, eggs, wild fowl, fish, and shellfish (along with the protein contained in the vegetables). Modern meat, especially red meat, has high levels of saturated fat - a more appropriate analogy to the type of meat eaten long ago would be skinless white meat poultry.

Contrast the modern American diet. It is argued that 55% of our modern diet is "new food" (cereal grains, milk, milk products, sugar, sweeteners, processed fats, and alcohol). Only 17% of calories currently come from fruits, vegetables, legumes, and nuts. And, 28% of calories come from fatty meats, domesticated poultry, fish, eggs, and shellfish.

Evidence indicates that the hunter-gatherers were healthier, with greater height (as suggested by the protein numbers above), better tooth retention, and longer life expectancy than was the case for the farmers, who arrived on the scene quite recently in evolutionary terms. Indeed, the life expectancy of paleo man was low compared to modern man only because of infections, injuries, and complications of childbirth…long-lived individuals without modern diseases of aging ("Syndrome X," coined by Reaven) would have existed in substantial numbers. There is debate about when farmers first domesticated animals and about when breads were made, and so on. But, on the whole, the story that we have evolved over the vast eons of time to eat mostly lean meat, vegetables, and fruits (with legumes and nuts) seems fairly compelling. The stomach/gut system in man would appear to be designed for omnivores, with the acids and enzymes to digest meat and fats along with considerable vegetable handling capacity. Under "controversies" some implications for vegetarianism are discussed.

Regardless of how one wishes to think of CR, however, success is fairly easily achieved by reducing mostly-empty calorie foods and especially increasing non-starchy vegetables and, to a lesser extent fruits (especially the berries). The plates you serve look more colorful and appetizing, too! The preceding is the "bare-bones" take on CR. You really should begin with a blood test and an examination of the calorie content of the foods you eat in a typical week. Just write down everything you eat on a pad of paper, and you can come back later to analyze how many calories it is. Otherwise, if you are like me, you will never be able to know what your CR is relative to your Ad Lib benchmark diet. You don’t have to do anything with that list for as long as you want - you may never care about all the "sciencey" issues. But, it’ll be there if you get more deeply into CR, as a great many people have.

The Diet "Controversies"

There are a number of controversies regarding CR, even among people who have been practicing it for many years. There are likely to be more such controversies, both that I am unaware of, and that will emerge as science progresses in the future. I will begin with the most controversial and important.

Macro-Nutrient Composition?

The table below compares the average American diet percentages with those recommended by conventional medicine (the AHA recommendations) and various diet experts:

Diet Approach	Protein	Saturated Fat	Mono-Poly Fat	Carbohydrates	Cholesterol
American, actual	15	15 (3 trans)	20 (14 & 6)	50	300-400mg
Am. Heart Assn.	15	5-10	20	55-60	< 300mg
Atkins	22*	25*	35*	18*	880*
Ornish	15-20	3	7	70-75	5mg
Reaven	15	5-10	30-35	45	< 300
Sears	30	6	24	40	210

* = calculated from Atkins recommended menus (no specific recommendations. Much of this information came from: Center for Science in the Public Interest, Volume 27 (no. 2), March 2000)

Interestingly, the actual American diet looks quite a bit like the AHA recommendations, with the exception of a bit more saturated fat and a bit less carbohydrates. Yet while Americans were moving closer to the AHA guidelines (more carbohydrates, less fat) between the late ‘70s and the early ‘90s, the obesity rate soared from 46% to 55%! So, while heart disease directly related to saturated fat’s role in clogging the arteries with LDL cholesterol has been declining, the extra weight (along with, more controversially, insulin and glucose swings) is likely to create a future epidemic of adult-onset (Type II) diabetes (with heart disease just occurring a bit later due to that!). Diagnosis: too much total food, as overall calories increased by some 200 per day over this period - cutting fat evidently caused total food intake to increase. Also, the carbohydrates consumed in the actual American diet are low-nutrient (potatoes in a myriad of forms, iceberg lettuce, bread, etc.), leading to major health problems due to their "crowding out" of vegetables and fruits that are vastly better for us. In addition, the carbohydrates consumed to excess are "high-glycemic" (tend to raise blood glucose more, and more rapidly, leading to undesirable insulin over-production - see Brand-Miller, Wolever, Colaguiri and Powell for more on the glycemic index). Note that high-glycemic carbohydrate diets are precisely how cattle are fattened in the feedlots of America (corn-fed)...reduced exercise and increased starchy carbohydrates are doing the same thing to Americans that we do to our cattle!

Atkins swings abruptly away from carbohydrates, but his diet is too overtly unhealthy due to the saturated fat (raising LDL cholesterol, hence increasing coronary artery diseases) and the failure to get enough phytonutrients from fruits and vegetables.

Ornish has a "total system" of weight loss, exercise, and meditation. It is a very demanding system that is difficult to follow, unless highly motivated (e.g. told that your arteries are about to close due to plaque formation, people might follow it!). It is probably a good plan for people with particular medical problems and has been shown to actually reverse plaque formation within arteries. If you can stay thin enough on this diet, it is probably fine for healthy people as well. You must, however, choose carbohydrates fairly carefully to maintain enough satiation to keep a stable weight and get the nutrients.

Reaven, however, believes that his plan would be better than Ornish’s because he claims that his diet would (under the same conditions of exercise and lost weight) be better yet because it would raise HDL levels and lower triglycerides, because of the increased emphasis on unsaturated oils. Reaven recognizes that there will be insufficient calcium in his diet and argues for a 500 mg supplement. In terms of medical professional qualifications, Reaven is vastly superior to the other competing diet authors, having authored over 500 scientific papers. But, his arguments appear most valid only for Ad Lib diets. Failing to consider what happens to nutrient intake when calories are restricted is, for me, the biggest problem with Reaven’s approach.

Any of the above approaches would likely be a substantial improvement over actual eating practices in much of the developed world. The difficulties come when one wishes to incorporate greatly reduced caloric intake into such diets. This is why Sears’ dietary approach has the greatest appeal among most CRers.

Sears program calls for increased protein, but with low saturated fat. Total fats come in at the AHA recommendation by increasing the mono- and polyunsaturated fat (see the Simopoulos and Robinson book for more on the important topic of fat). The big difference between the AHA recommendations and the Sears Zone is that carbohydrates are dropped to 40% from 55-60% to raise the protein percentage. Sears drops the carbohydrates by dropping the calorie dense but nutrient poor starches and sugars as described earlier.

Reemphasizing, probably all of the diets will work for many people, if they can lose weight on them and can enjoy them enough to maintain them as a life-style change, rather than as a temporary diet. Those who practice CR to improve and extend life, however, are attempting to go well beyond the goals of most dieters. CRers are attempting to eat 10-25% fewer calories than ad libitum feeding forever and will eventually get well below initial "setpoint" weight (the weight you tend to naturally be at, often what you weighed at around age 30). And, they want to do this without compromising their nutritional status.

A principal reason most CRers prefer the Sears approach is that when losing weight you lose more fat than muscle (particularly if moderately active). Hence you become a higher percentage muscle and a lower percentage fat (as Walford observed in the Biosphere II setting). Partly because of this, the consensus among CRers is that CR increases the need for protein, relative to non-CR diets. An ad libitum diet with 15% protein is probably fine for most people because the overall diets are excessive from a CR perspective (that is, 15% of 3000 calories is 450 calories and, at 4 calories per gram, is 112.5 grams of protein). With a 15% protein CR diet, too little protein is allowed in - the 15% becomes 15% of too small a number for the importance of protein to the human organism (15% of 1500 calories is 225 calories - only 56.25 grams of protein).

Expanding, without protein nothing moves in the human body. Protein is actually the second largest store of energy in the body, after fat; carbohydrates, despite their rapid availability, are depleted in a few hours of taxing activity. We certainly don’t want protein being used as a source of energy when there are important cellular processes to be done. The "official" recommended intake of "high-quality reference protein" (think of egg whites) is .8gm/kg/day. A 154 lb. man (70kg) should then be getting 56gm/day. That is not too terribly much - 2 ounces a day (2/3 of a deck of cards worth of protein, if that protein is "reference" protein). But the case is more complex: First, there are the digestibility issues - is the body going to take in the proteins we actually eat as well as the reference protein? Second, and more important for most people, is the fact that proteins are created from 20 amino acids, of which 8 are "essential" (you can’t make the protein in your body unless they are present from the diet). Virtually all vegetable sources of protein are either incomplete or have percentages of amino acids that are not ideal for making human protein (they are after all plants, and don’t move - this is also the reason they don’t have, generally, any fat). Foods have to be mixed very carefully (though this is certainly possible, at least with an ad lib diet, a subject we’ll return to below) to get sufficient protein from non-animal sources. Animals are very much "more like us" in terms of the amino acids their protein is made of, hence protein insufficiency is rare in the developed world among non-vegans. In the most recent discussion of optimal protein intake in the CR Society, the consensus was that double the "official" recommendations would be better, 1.6g/kg/day. This is because the lower calorie intake might end up causing some protein to be used for energy, because we are a higher percentage protein per kg of body weight, and possibly to minimize any stresses caused by CR.

Returning to the Sears diet approach, by dropping, or substantially curtailing, the starches and sugars, one can actually increase the weight of the nutritionally dense, but low-calorie vegetables and fruits. This allows an increase in the percentage of protein taken in, as is optimal. Hence, you can get better nutrition, stay feeling full longer (from the generally low glycemic index vegetables and fruits), and enjoy your meals more. As a consequence, CR with the Sears approach doesn’t seem to involve as much "suffering" for most members of the CR Society. Additionally, the Sears Zone is by far the diet most closely related to the Stone Age diet discussed earlier, which may imply some evolutionary superiority.

Vegetarianism?

It is certainly possible for an ad libitum eater to eat a healthy diet as a vegetarian…and they may even live longer than the typical ad lib eater of other diet types. But to a CR person who intends to live vastly longer than this, vegetarianism presents serious difficulties. Indeed, a few of our members were practicing vegetarians for many years, then converted to something closer to a Sears-type diet. As time went by as CR vegetarians, they began to get weaker and suffer an increased rate of disease. Interestingly, it may actually take quite a long time for this to happen. The reason is that the diet is only a one short-run source of protein…proteins of a wide variety are constantly breaking down in the body, providing raw input for the construction of new protein. In fact, only a little over a fourth of the daily use of protein in the "free amino acid pool" available for the formation of new protein comes from protein ingested that day (typically, only 90gm of a 340gm total). Since the 250gm of amino acids broken down from our innards must have just the amino acid balance we need, shortages in the diet may not manifest themselves for a long time. [Also, the vegetarian must be very concerned about Vitamin B12, which is very abundant in meats of various sorts, but quite difficult to obtain in sufficient quantities from a vegetarian diet. It would be wise to supplement at least this vitamin if you are contemplating a vegetarian diet.]

So here’s the bottom line: if we restrict calories and we’re vegetarians, there are not many opportunities to get enough of the right balance of amino acids, especially since CR people are likely to need more protein per kg of body weight. Japan currently has the longest average life spans in the world, but within Japan the Okinawan islanders who eat an abundance of animal seafood and many vegetables (and much less rice and other starchy foods) have the very longest average life expectancies. If on moral or other grounds you want to be a vegetarian, be very wary if attempting to gain the benefits of CR, too.

Role of Exercise?

As already mentioned, exercise has a certain dual nature. On the one hand, it increases the average life expectancy of those who exercise, among ad lib eaters. And, it is usually taken to be quality of life enhancing per se, to enjoy the functioning of a stronger body. But, it appears not to increase the maximum lifespan of CR rodents (the lifespans of the top 10%, say). The extra food eaten (and the exercise itself, as noted above) to maintain any given body weight will increase the formation of oxidants ("free radicals") that are partly blamed for the symptoms we observe as aging.

But, most of the people on CR do engage in at least moderate exercise. There are proven health benefits and quality-of-life concerns, that for most, offset what are minor CR negatives (the maximum lifespans of the exercised CR rats are nearly as long as the unexercised, and sometimes the average age at death is higher, despite not raising the maximal lifespan).

Raw vs. Cooked?

The raw versus cooked debate probably stems from a combination of two concerns. First, from the paleodiet versus "new foods" perspective, foods probably should not generally be cooked since the control of fire was a fairly recent invention (although that assertion is fairly controversial, too). Second, there is evidence of carcinogens being created in the cooking process.

On the other hand, there are some nutrients in certain vegetables that are better absorbed if cooked (carrots, spinach, etc.). And, there are heightened concerns with sanitation/pathogens for raw foods.

Overall, I would guess that most CRers eat a higher percentage of their food raw than does the general population, and the foods we do cook are usually cooked less long. Many CRers are quite fastidious (in terms of the contamination issue - see list discussions of grapefruit seed extract as a safe vegetable cleaner) and the knowledge that some foods are more nutritious cooked enables people to pick and choose what to cook. Ultimately, I think this is mostly an aesthetic issue - whatever tastes better at a particular time is likely to have a following. For example, sometimes I prefer bell peppers cooked, but at other times (and especially for the sweeter red ones) I eat them like an apple - quick, tasty and nutritious.

"Organic" vs. Traditional?

There has been considerable debate on this issue in the CR Society newsgroup. Some of the concerns are eco-system integrity, "dosage making the poison," natural versus synthetic pesticides and additives, and economic issues.

People are split on the issue of which would be better for the environment, organic or traditional (mono-culture, with artificial fertilizers and pesticides). One faction feels that the fertilizers are not sufficiently diverse and soils are being depleted (resulting in inferior nutrient content in traditional vegetables and fruits), while pesticides are believed to be likely to have dangerous, poorly understood eco-system effects that should be avoided (biomagnification, for example). The other side, believes that there is essentially no nutritional difference between the nutritional content of organic versus traditional foods (this is the position of The Berkeley Wellness letter, for example, and other "establishment" types). They also believe that broadly-applied organic methods would (because of lower yields, combined with the large number of animals needed to get the manure nutrients to put on the land) result in rapid habitat destruction, and indeed massive world human starvation if carried out on a large scale. There is an astonishing amount of fertilizer put on traditional crops, which would require extremely large amounts of any organic substitute…it must come from somewhere. Nobel laureate Norman Borlaug, who has arguably saved the lives of a billion people as a central figure in the green revolution, believes that converting to organic produce in a big way would be ecosystem destructive and would, moreover, likely kill hundreds of millions of people.

The "dose is the poison" and the natural versus man-made pesticides and additives issues revolve around how damaging low-dose pesticide residues are and whether the specific chemicals, some new to the human body, behave differently, from natural pesticides with which we co-evolved. Bruce Ames, well-known Berkeley expert, claims that we are exposed to 10,000 times as much natural pesticides as we are man-made pesticides, since plants contain many compounds designed to thwart the critters (usually small insects, parasites, and the like) that bedevil them. He argues that the chemical compounds are often quite similar in structure to artificial pesticides and that the liver evolved to handle a wide variety of new things. He notes that the few animal studies that examine cancer or mutagenic activity of commonly-consumed goods (e.g. coffee) have "flunk" rates about the same as the artificial pesticides in the same sorts of high-dose tests. Safrole, for example, is a powerful carcinogen and is abundantly present in ordinary black pepper. There are many such examples - the point is not to get you to stop using pepper! But, he argues (for both artificial and natural chemicals) that the liver has an amazing ability to detoxify the small amounts that we actually consume of most things. Others on the CR list are concerned about even small amounts of artificial additives, and prefer to eat organic foods. [On the other hand, I’d certainly rather be able to wash the pesticides off a vegetable than have a genetically modified vegetable that contained a pesticide that I would have to eat!]

The economic argument is related to the eco-system implications. If vegetables and fruits were to be grown organically, they are likely to be much more expensive (I think, as an economist, very much moreso than now, though there is disagreement about that on the list). If the price rises for things that are good for people, they will buy them in smaller quantities. And, it is those very vegetables and fruits that contain the phytochemicals that help us deal with carcinogenic compounds. We may become on net substantially less healthy (at considerable cost undertaken to make us more healthy, ironically), should organic foods displace traditional foods in a big way.

I’m frankly not sure what the "truth" is, though I personally almost always ignore the organic produce (mostly because it looks less fresh, like it isn’t selling as fast). Others on CR always try to buy organic when possible. I think much of it comes down to whether you like the taste of the organic better or don’t notice the difference and how much you are willing to pay for your food. It may not matter too much either way, since the CR immune system is better able to handle whatever goes into your body, in any event, relative to the ad lib eater.

Alcohol?

Some CRers drink and some don’t. I won’t be discussing heavy drinkers; that is clearly unhealthy. For the ad lib eater, moderate alcohol consumption is almost certainly healthy (particularly red wine). But, the principal reason for that health effect may be that alcohol offsets the undesirable blood chemistry generated by the typical American diet. So, from a CRer’s perspective, those 7 calories per gram (yep, it’s an unusual carbohydrate that has more calories per gram than others - but doesn’t appear to act that way in terms of weight gain, for some reason) are just empty calories. On the other hand, quercetin, resveratrol, and other ingredients in red wine and to a lesser extent in red grape juice, have been demonstrated to reduce cancer. The consensus of the CR Society would likely be that, on net, it’s not worth it…but perhaps it doesn’t matter too much. Some use grape juice, but then you’ve got the sugars…. Moderation is, of course, key.

Supplements and other "potions"?

Here we have a real split among the CR Society group! Some feel that the increased vegetables and fruits (with the quality meats and proper fat profiles) render vitamin supplementation unnecessary. One person recently noted that he is using fewer pills over time as he continues with CR. The high nutrient density of the CR diet, combined with the internal body changes (lower temperature, some hormonal changes, etc.) are argued to guarantee more than 100% of the RDAs (even the recently modified ones that recommend more of several things).

Others (I’m in this group…but could possibly be swayed) take megadoses of vitamins and minerals and other "potions." The extensive discussion on the CR Society list of the many things that people take to increase their probability of extending their healthy years is beyond the scope of this introduction. See, however, Packer and Colman for the latest on anti-oxidant networks. Suffice it to say that some of us spend many thousands of dollars a year on "neutraceuticals," while the more typical CRer probably takes a complete (100% RDA) vitamin pill and perhaps a little extra C and E, and maybe some fish oil (or, better, flax seed oil). An interesting and informative place to begin if you are interested in going beyond CR, is the Life Extension Foundation (www.lef.org).

What about "glycemic index"?

Humans have a great many "feedback" mechanisms to keep our bodies functioning normally (e.g. to maintain temperature). Among those systems is the glucose-insulin feedback loop. When you eat, your digestive system eventually puts increased glucose in the bloodstream. Glucose is the fuel that runs the body, much like gasoline in a car. But, like a car, the fuel doesn’t "automatically" go into the cylinders from the gas tank, rather a precise set of operations result in the fuel injector injecting the fuel just when you want it to. You can drive a car without knowing anything about how that system works, just like you can practice CR without knowing anything about how it works! This material is a bit complicated, but I'll make it as clear as possible.

Imagine the impact of a lifetime of rapid starts and stops on your car - you are putting more total gasoline into the car and you are damaging your car in the process...it's "lifespan" will be shorter. Similarly, putting high glycemic index carbohydrates into you puts more total glucose into your system over your lifetime. It turns out that some of that glucose forms "cross-links" with proteins (called "non-enzymatic glycosylation") and that those cross-links are a prime cause of everything we think of when we think of "old people" (wrinkles, "liver" spots, stiffness, progressive stiffening of the arteries, etc.). Hence, putting more glucose into your body, results in more rapid aging other things equal (some people have genetic advantages, of course). So, you want to eat mostly low glycemic index foods.

The following is somewhat controversial, and some on-going research may soon clarify some things. The second reason many prefer low-glycemic index foods, is the relationship between glucose and insulin. As with the car, glucose doesn’t "automatically" go into the cells that use it for fuel, but rather the cells must be "opened" to enable the glucose to enter. When the feedback mechanisms of the body sense that glucose is elevated after a meal, a series of hormonal commands have the practical effect of increasing insulin in the bloodstream. It is insulin that enables the glucose to go into the various cells (muscle, fat, etc.) in the body. Insulin is, then, absolutely critical to the functioning of the body. But, with aging (and with excessive glucose intake, as CRers believe), the body gets progressively more resistant to the insulin - to do its job more insulin must be pumped out. The role of excess insulin in "causing" Type II diabetes is controversial, but some believe that too much insulin over long periods is a really bad thing. Excess insulin (hyperinsulinemia) is argued to increase body fat, mess with the balance of other hormones causing blood pressure to rise, reduce HDL (the good cholesterol), increase total cholesterol, etc. Perhaps, one of the reasons why CR extends lifespan, then, is by reducing lifetime exposure to insulin. This is all background for the "glycemic index" of foods, to which we turn.

The glycemic index is a measure, where either white bread or pure glucose is used as a reference point, of how rapidly and how much particular foods raise glucose in the body after being eaten (technically, it's the integral under the glucose concentration curve). In the context of the previous discussion, the glucose spike of a high-glycemic food will in turn create an insulin spike during which extra-normal amounts of insulin are produced (though the relationship between glucose and insulin is poorly understood, hence this is somewhat speculative). This exacerbates the problems discussed in the preceding paragraph. You may or may not feel hungry again sooner, but that is a common folk belief (e.g. hungry two hours later after Chinese food, due to the rice, if true). The "whites" (eating plain potato, white bread, or "sticky" forms of rice is almost exactly like eating pure sugar from a glucose creation perspective) and sugars already discussed tend to have high glycemic indexes (as do carrots and corn, interestingly). The glycemic index of the average of the food in the stomach determines the overall glucose spike to expect (hence, carrots and corn can go into a healthy stir-fry with lots of other vegetables, since that ameliorates their individual effects).

Most CRers tend to reduce the amount of high-glycemic foods they eat. Those that are eaten are mixed with items having a lower glycemic index to help even out insulin production, reducing the overall amount created.

Fasting?

As would be implied by the preceding, getting the same number of calories by, say, alternating days with no food with days with lots of food, is likely to result in a greater total creation of insulin, than eating more evenly. It is probably the case that an essentially continuous nutrient flow is the best way to even blood glucose and minimize insulin output. On the other hand, it is also the case that many CRers find that they can’t really effectively practice CRer without something like fasting going on. Indeed, "break fast" (the origin of our breakfast) is not eaten by some CRers, because they find it makes them hungrier for lunch. The lesson, I believe, is that it is more important to practice CR effectively, with how one is able to succeed at it being secondary. We know that if less glucose-creating food goes in, less insulin gets created.

Epilog

As one of the CR Society members (Warren) put it so well: The successful voluntary practice of CR in humans is

1) the life-long focused commitment
2) to gain knowledge, self-control, and motivation
3) to reduce calories consumed,
4) while maintaining adequate nutrition,
5) under active monitoring of current state of health,
6) with the hope of living better,
7) and the hope of living longer.

That's really it in a nutshell.

Scientific learning is an on-going process, yet we have to make decisions today. The following captures what many of us are doing in practicing CR in a world where all the information we'd like to have is not currently available:

"Life is the art of drawing sufficient conclusions from insufficient premises." - Samuel Butler

References

Atkins, R.C. Dr. Atkins New Diet Revolution, M. Evans, January 1999.

Austad, S. Why We Age: What Science is Discovering about the Body's Journey through Life, Wiley: New York, 1997.

Brand-Miller, J, T.M.S. Wolever, S. Colagiuri, and K. Powell, The Glucose Revolution, Marlowe and Company: New York, 1999.

Center for Science in the Public Interest, Nutrition Action Health Letter, Vol 27, no. 2 (March 2000).

Packer, L. and C. Colman, The Antioxidant Miracle, Wiley: New York, 1999.

Reaven, G. Syndrome X: Overcoming the Silent Killer that Can Give You a Heart Attack, Simon & Schuster: New York, 2000.

Sears, B. The Anti-Aging Zone, Regan Books (imprint of HarperCollins Publishers): New York, 1999.

Shils, M.E., J.A. Olson, M. Shike, and A.C. Ross, (eds) Modern Nutrition in Health and Disease, 9th Ed. Williams and Wilkins: Baltimore, 1999.

Simopoulos, A.P. and J. Robinson, The Omega Diet, Harper Perennial: New York, 1999.

Walford, R.L. Beyond the 120 Year Diet: How to Double Your Vital Years, Four Walls Eight Windows, 2000.

Walford, R.L. and Walford, L. The Anti-Aging Plan, Four Walls Eight Windows: New York, 1994.

You may have noticed references to transhumanism and transhumanists in posts here at Fight Aging! What is transhumanism, and how is it relevant to longevity science and the work of extending the healthy human life span? Read on for a short overview: transhumanism in a nutshell.

Transhumanism is a cultural movement and philosophy of action that builds upon humanism, so we should look at humanism first of all. Humanism is an influential, time-honored philosophy that argues for rationality and certain fundamental human rights, freedoms, and responsibilities. Humanist thinkers have for centuries discussed and advocated the existence of humane societies, human cultures built on reason and free inquiry. In terms of addressing everyday life, humanist philosophy attempts to answer questions like "How should we behave toward one another?" or "What is the best way to live within the constraints imposed on us by the human condition?" In essence, humanist thinkers across the ages tell us this:

We're all in the same boat here: by all means work towards your dreams, but be nice to your neighbor and don't tread on anyone's toes.

Like humanism, transhumanism is a philosophy of life and human action: an evolving, much-debated collection of ideas about society, goals, and the best way to live. Transhumanism extends the foundation of humanism by embracing technological progress for the purpose of overcoming the limitations and suffering inherent in the present human condition. Transhumanism is, fundamentally, the idea that humanity can, and should, strive to overcome naturally existing limits in order to attain greater individual choice and capabilities - physically, mentally, and socially. Transhumanist thinkers tell us this:

Humanism is a good start. But while being nice and not treading on toes, the dreams we work towards can include a fleet of better boats for all of us.

As you might imagine, transhumanism as a cultural movement is closely tied to an enthusiasm for ethical, responsible, and rapid technological progress. Progress in science and technology brings greater choice to individuals and adds new options for improving the human condition. This is really nothing new: we humans have been pulling ourselves up by our bootstraps for millennia: fire, farming, steam, bicycles, antibiotics, vaccines, modern dentistry, cell phones, and so forth. Each new invention, and the science that enabled it, allows us to overcome a limitation or a cause of suffering. We can fly where we couldn't before, we can survive diseases that once killed or crippled us, and we can engage in ten thousand new types of entertaining or challenging activities that once upon a time didn't even exist.

Transhumanists take this common sense view of technological progress and look ahead to a future in which far greater and more beneficial advances are possible: modern science and technology can lead to radical improvements in the human condition, and so should be used to this end. If today we enjoy our newfound ability to communicate cheaply across vast distances, for example, then tomorrow we might enjoy the benefits of longevity science, organ regeneration, and aging reversal. These and many other transformative changes that might be produced by new biotechnologies are very plausible, foreseen by scientists around the world, and we should welcome their advent.

Given the emphasis that transhumanist thought places on progress and overcoming the limitations that make life difficult or cause suffering, it is only natural that transhumanists should support longevity science, rejuvenation medicine, and other forms of advanced biotechnology. Aging and age-related disease takes a terrible toll on us all, yet may plausibly be slowed or reversed in the decades ahead. Transhumanism and advocacy for longer, healthier lives have gone hand-in-hand for many writers since the 1980s - and even earlier, before transhumanism acquired its present name. At that time, few people took life extension research seriously and it was very much in the fringe, both in academia and the medical research community.

Most influential transhumanist thinkers have at one time or another written on the subject of extending life through biotechnology, and many have done so extensively. When you read about applied aging research, progress in understanding the genetics of human longevity, and progress towards medicine that can extend the healthy human life span, remember that transhumanists have been advocating greater awareness of - and funding for - this promising field of research for a good many years.

Last updated: August 20th 2013.

Cryonics is the only present option offering a chance at a much longer life in the future that is open to older and seriously ill people, the many individuals who do not have the time to wait for the arrival of rejuvenation therapies. Cryonics is a part of the broad field of low-temperature storage of biological materials, in this case the practice of placing humans and animals into that storage immediately following clinical death, thereby halting all biological processes and preserving tissues, especially the brain tissues that incorporate the fine structures presently thought to store the data of the mind. This is not mere freezing, which damages cells, but rather a process of vitrification that employs cryopreservant chemicals to prevent ice crystal formation and preserve the small-scale structure of tissues. This is known as cryosuspension within the industry.

Cryosuspension is undertaken with the expectation that advances in medical technology may eventually enable restoration of preserved individuals to life and health. For so long as the structure of tissue is preserved intact, it is possible that advanced technologies can one day work with it. Thus a small industry of cryonics providers offers cryosuspension services and a small number of patients take advantage of this in the hopes that future clinicians will have access to technologies for revival and repair, most likely based on applications of molecular nanotechnology.

Facing Up to an Unpleasant Reality

Death is not a topic that anyone likes to think about, and that is just as true of advocates for longevity science as anyone else. We have to recognize, however, that the future of greatly extended healthy lives, produced by technologies such as SENS therapies, regenerative medicine, and medical nanotechnology, will not arrive soon enough to benefit everyone. Many people are too old to wait for decades, or suffer from other conditions that will kill them before cures can be developed. This is an unpleasant reality and we must face up to it.

A billion people will die between now and the earliest possible plausible date for the first package of rough and ready but working rejuvenation therapies, at least twenty years in the future. That date will only be hit if fundraising and other matters proceed very well over the next few years. Another few decades will pass after that point in order for the technologies of rejuvenation to work their way out to global availability at low cost, and the toll of deaths caused by aging will continue in less fortunate regions while this happens. Do we just write these people off and forge ahead regardless? Of course not. Instead, we can turn to the science and business of cryonics: an industry presently small, but which in a better world would be large enough to help everyone.

The practice of cryonics is an ongoing medical experiment with an unknown chance of success, though the odds improve as progress continues towards reversible vitrification of organs, and evidence for maintenance of memory through vitrification and thawing is obtained from experiments in lower animals. Responsible cryonicists understand that cryonic suspension is an educated gamble. The chances are certainly better than zero, however, and as one wag noted, "the control group in this experiment isn't doing so well." By this, he was referring to the vast number of people who are cremated, buried, or otherwise interred. The chance of any plausible future science restoring them to life is zero.

Still the Only Viable Backup Plan

Front and center, the primary plan for longevity for people in middle age and younger today is to help push through enough of the right medical research focused on rejuvenation. Our bodies are aging, accumulating damage, but methods of repairing that damage are slowly edging their way towards clinical application. Once in the clinic they will slowly become better. At some point the improvement in repair methodologies will add healthy life expectancy for older people faster than a year with every passing chronological year. Everyone with access to the latest stable medical technology at that point will have beaten the curve: they will no longer suffer and die due to aging. The question for each of us is where that point occurs in the life span, or indeed whether it occurs at all - and that is where activism and funding comes in. We can't make ourselves younger (yet), but you can help to speed up the development process.

That is the primary plan, and for every primary plan there must be a backup plan. Never bet on just one horse. The backup plan for evading the end that comes with death by aging is cryonics: low-temperature preservation of the fine structure of the brain on clinical death. Cryonics organizations will maintain the data of your mind in its physical form for the decades it will take for restoration to active life to become a viable possibility. That will, at minimum, require near complete control over cellular biochemistry and regeneration, as well as a mature molecular nanotechnology industry capable of repairing broken cell structures, removing cryoprotectant from tissues, and similar tasks. None of these goals are impossible or unforeseen, it is just that the necessary technologies don't exist today. Preserved individuals have all the time in the world to wait, of course.

A backup plan is never as good as the primary plan. That is why it is the backup plan. In order to be cryopreserved you have to undergo a very unpleasant set of experiences; you have to age and you have to die, and do so naturally with little help, since our backwards legal systems don't allow for assisted euthanasia in a constructive way that can mesh with cryonics protocols and organizational procedures. Further, in comparison to remaining alive and healthy thanks to the development of working rejuvenation treatments, cryonics will for a long time to come be a leap into the dark with an unknown chance at ultimate success. It is still infinitely better than any of the other possible choices open to the billions who will die too soon to benefit from near future rejuvenation therapies.

Where to Learn More

The cryonics community is friendly and supportive and has been around for decades. The community and the industry it supports have been ever-so-slowly growing since the early 1970s. To find out more about cryonics and its history of development, you might want to peruse the following pages:

• Alcor explains cryonics.
• Common myths and misunderstandings about cryonics.
• Cryonics at Wikipedia.
• Cryonics as an extension of metabolic arrest medicine.
• The Cryonet community, archives and resources.

In addition, an excellent article on the philosophy and practice of cryonics can be found here at Fight Aging!:

• Why Cryosuspension Makes Sense

A Future that Includes Post-Mortem Critical Care

If you die tomorrow, then cryonics is the only chance you have at a longer life in the future. But there will always be a role for what we might term post-mortem critical care of the sort provided by the present cryonics industry. This is a shorthand for the collection of technologies and services assembled to preserve the fine structure of the brain (and thus the mind it contains) following death, and keep that tissue preserved until such time as the patient can be restored to life. At present cryonics is the only available post-mortem critical care option, and we have a fair few years to wait before medical technologies to advance to the point at which restoration is safe and feasible. Hence the chance of eventual restoration for any one preserved individual is unknown but greater than zero.

In a future in which the technology to restore a preserved person exists, cryonics and other preservation technologies such as plastination will occupy a more dynamic position in the medical toolkit, and patients might expect to wait in a preserved state only for transport to the nearest major population center. Even after aging and disease is completely conquered by means of advanced biotechnology, there will be an ongoing toll of death due to accidents. Death isn't going away completely, no matter how well we do in the field of medicine in the foreseeable future: medicine can't wave away falling rocks. But first things first. There is a way to go yet before that better world arrives.

How to Sign Up For Cryosuspension

You can sign up for cryosuspension fairly easily both inside and outside the US through one of the established cryonics providers or supporting organizations. You can learn more at the websites for the companies. Alcor is the largest of the providers, has the most comprehensive online information. If you have questions, just ask. Company staff will be happy to help.

• Alcor Life Extension Foundation
• Cryonics Institute

More recently other providers and initiatives to start new providers have started to emerge outside the US, the most advanced of which is KrioRus in Russia. Cryosuspension is expensive, on a par with major surgery, but can be paid for in a cost-effective manner through life insurance. You purchase a policy that pays out to the provider on your death and they take it from there: if you set this up well in advance, the monthly cost of a life insurance policy is low. This is far and away the most common payment method and the majority of people suspended or signed up are of modest means.

Last updated: September 18th 2016.

Calorie restriction or caloric restriction, usually abbreviated to CR, is a strategy proven to extend healthy, average, and maximum life span in many short lived species, including mice and rats, and at least healthy and average life span in primates. In research papers it is more usually called dietary restriction, abbreviated to DR, and rodent studies conducted over the past 20 years have reliably demonstrated up to a 40% increase in maximum life span through life-long DR.

These benefits to health and longevity have been shown in animal studies to roughly scale with the degree of calorie restriction imposed, but there is good reason to believe that any gain in primate (and especially human) life span through CR is much more modest than that observed in mice. The calorie restriction response exists in near all species tested to date, and probably evolved very early in the history of life on Earth as a way to increase the chances of surviving seasonal famines or other periodic shortages. Such shortages are the same length whether you are a mouse living a few years or a man living for decades, but for the mouse a season is a much greater fraction of a life span, and thus only the mouse evolved dramatic extension of life in response to famine.

While human calorie restriction doesn't have the same impact on life span, it does provide numerous benefits, such as a greatly lowered risk for most degenerative conditions of aging, and improved measures of health. In recent years, human studies of long-term and short-term calorie restriction have comprehensively demonstrated these benefits. Many researchers believe that the evidence to date shows the practice of CR will in fact extend the healthy human life span, but there simply isn't enough data yet to pin down the effects on life expectancy. It is plausible that they are at least as good as those resulting from exercise. If so, it could mean a difference of 5-10 years of life.

Calorie Restriction Research

The beneficial effects of CR in laboratory animals have been known for more than 80 years, but only in the past 15 years has an appreciable level of funding and attention been given to this field. Human studies such as CALERIE have been underway for years and many research groups are digging into the operating details of cells and metabolism to firstly explain how the CR response works to extend life, and secondly to try to produce treatments that can mimic this effect. So far a great deal has been learned, but little headway has been made towards calorie restriction mimetic therapies. The genes and processes that control metabolism are notoriously complex, and scientists do not yet have a complete understanding of even this one narrow slice of the bigger picture.

So what is known at present? Loss of visceral fat tissue should be mentioned in the context of CR, as we all know that if you eat fewer calories, you will tend to slim down. A mountain of research indicates that carrying excess body fat is harmful to your long term health in many different ways. Even modest levels of excess weight increases the risk of later suffering common age-related conditions such as diabetes, cancer, and Alzheimer's, with one of the contributing factors being the relationship between fat cells and chronic inflammation. It is no exaggeration to say that if you are overweight, you will have a shorter, less healthy life. This is repeated by the scientific community in study after study. Given all of this, it is plausible that some portion of the health benefits of CR stem from the accompanying loss of fat tissue, although biochemical research indicates that there is clearly more than just that going on under the hood. CR is also creating a variety of positive changes in the controlling mechanisms of metabolism.

For example, it appears that CR provides a boost to the processes of autophagy. Autophagy is the way in which cells remove damaged components in order to recycle the materials into new replacement parts. Several lines of research indicate specific types of damaged cellular components left to cause problems over time contribute to age-related decline and damage inflicted upon the rest of your body's machinery. A greater level of autophagy may help reduce this contribution to the aging process, and thereby extend life.

Practicing Calorie Restriction

How to get started on CR? Fortunately it isn't hard: a wealth of information and many, many starting points exist out there. A restricted diet of this sort aims to reduce the intake of calories to a level 20-40% lower than is typical, while still providing all the necessary nutrients and vitamins. With this in mind, CR is sometimes called "calorie restriction with optimal nutrition" or CRON, and its practitioners have accumulated many years of experience in how best to achieve this end. Good books and a supportive community exist to help newcomers adopt the best practices for CR in humans. Mild CR can be as easy as adopting a much healthier diet, taking a few supplements and not eating snacks. You might find the following path useful.

Obtain a Copy of "The Longevity Diet: Discover Calorie Restriction"

This book is a very good, easy introduction to the principles and simple ideas behind calorie restriction. Beyond that, it is a practical guide that will help you over a lot of the early pitfalls. It handily answers the "what exactly is it I eat?" question and offers some great tips for new practitioners.

• The Longevity Diet Website

Practice Eating a Better Diet First

While waiting for your book to arrive, you can start to shift your diet in preparation. Have a look at this resource for a class of diets known as "paleodiets":

• Investigating Paleodiets

The selling point of paleodiets is that they replicate the hunter/gatherer diet of our ancestors, and are therefore better for us. This is not an argument advocated here at all, but trying out a paleodiet is a great introduction to many of the strategies you'll adopt while on a calorie restriction diet. One thing that you will find out quite early on in your journey into calorie restriction is that you have to stop eating any significant amount of highly processed, rich, modern foods. These items are delicious, but heavy in calories and light in nutritional value.

In the US, you can walk into any corner store and eat 1500 Kcal of junk food (chips, chocolate, and so forth) at a cost of $10. You'll be hungry again a few hours later. That same $10 could feed you for two days if you buy vegetables, rice, and beans. You could eat 1500 Kcal each day and hardly be hungry at all. These two examples lie at the opposite ends of the spectrum, but most people eat many more "empty calories" (calories that do not provide vitamins and essential micronutrients) than they should. Adopting a paleodiet for a while is an easy way to start thinking seriously about what you eat, how you cook, and how you can better organize your eating habits. It's a smaller and more manageable step than leaping straight into calorie restriction.

If you were eating an unhealthy diet, you will probably notice the benefits of healthy eating within a few weeks. Your palate will become more sensitive to subtle tastes, you'll need less sleep, feel more alert, and mood swings will be diminished. Much of this stems from cutting the intake of processed sugars.

Pay Attention to Calories

Counting calories is a good thing, and something that you have to pay attention to. Your body will let you eat far more than is good for you, so your brain is going to have to take over managing the process. Almost everything you buy from the grocery or supermarket has the calorie content listed on the packet.

Note that most manufacturers list calorie content by portion, and that even a lowly bar of chocolate usually has two portions. Marketing departments don't like the number of calories to be too high, as people won't buy it ... so they'll just divide the product into more portions with a lower calorie count per portion. Sneaky! Most foods have more calories than you might think. You can recognize the new practitioners of calorie restriction at the supermarket: they'll be the ones looking at many different product packages and muttering "wow, I had no idea!"

For foods like apples, rice, loose vegetables, and so forth, you will need a book of calorie values. Recent editions tend to contain (fairly horrifying) values for fast foods as well as the more usual suspects. You might try the well regarded "Food Values of Portions Commonly Used":

• Food Values of Portions Commonly Used at Amazon.com

If you'd prefer an online reference, NutritionData provides a wealth of searchable information on various foods:

• NutritionData website

Remember the Supplements

You should always take a good multivitamin supplement when practicing calorie restriction. In theory it's perfectly possible to obtain all the vitamins and micronutrients you need from your food. In practice, for most people living busy, working lives, this just isn't going to happen. Remember to take your supplements.

The Water Trick

Many people find it easy to mistake low-level thirst for low-level hunger. A very helpful tactic for those practicing calorie restriction is to drink a glass of water when first feeling hungry. If you are still hungry twenty minutes later, then maybe it's time to think about eating. Half the time, you were just thirsty, however.

If You Have Questions, Ask!

There is a large and very helpful calorie restriction community out there. You might start to become involved by joining the CR Society mailing lists and feel free to speak out. These folks have plenty of advice and helpful hints for newcomers. Everyone was new to calorie restriction at some point in the past, and there are no stupid questions.

• Visit the CR Society website

It's Just a Diet, So Relax

Too many people approach diets in an all-or-nothing way. They slip up or eat poorly one day, become stressed, and abandon the diet entirely in frustration. The key to health through diet is a relaxed attitude. If you slip up, let it go. Keep at it, do better next time, and work on the average. Remember that a diet is simply a tool to make you healthier, and thus enable you to keep up with what you enjoy in life.

The Future of Your Longevity

If you've read this far, you are probably interested in living a longer, healthier life. Calorie restriction is still the only widely available tool in the longevity toolkit today, which, when you stop to think about it, is a rather sorry state of affairs. This will not always be the case, however, as medical science and biotechnology are advancing ever onward. It is worth remembering that as time progresses your remaining healthy life span is determined ever less by how well you maintain your health, and ever more by the rate of progress in regenerative medicine, work aimed at repairing the accumulated cellular damage that is the root cause of all age-related disease and infirmity.

You should look into calorie restriction today, but also consider the long-term view: supporting medical research into extending and restoring health is just as important, and it will become ever more important as time goes on that you made some effort to help the development of better longevity medicine.

Last updated: May 20th, 2014.

Anti-aging can be a difficult topic to address: a war is currently fought over the meaning of the term in research and medicine, and as a brand for products in an energetic and often fraudulent marketplace. Even mentioning anti-aging medicine is likely to prejudice many readers, but I will try to put this all into context.

Defining Anti-Aging

Anti-aging now has a number of quite different common meanings and connotations, each of which is championed by a particular group or loose coalition of interests. Advocates for these groups have a way of diving into the fray without defining their terms, and this tends to make reading about the surrounding debates somewhat confusing for a newcomer.

In the scientific community anti-aging research refers exclusively to slowing, preventing, or reversing the aging process. While the future is looking very promising, there is presently no proven and available medical technology that slows or reverses aging in humans. (Although the jury is still out on the practice of calorie restriction and regular exercise). Nor is there any currently available method short of waiting for people to die to accurately measure the effects of an alleged anti-aging therapy.

In the medical and reputable business community, anti-aging medicine means the early detection, prevention, and treatment of age-related diseases. This is quite different from tackling the aging process itself, and a wide array of strategies and therapies are currently available. Calorie restriction, for example, lowers the risk of suffering a wide range of age-related conditions.

In the wider business community - which includes a great many fraudulent or frivolous ventures - anti-aging is a valuable brand and a demonstrated way to increase sales. At the worse end of the scale, this leads to snake oil salesmen, "anti-aging" potions that may or may not make your skin look younger, and infomercials that tout the "anti-aging" benefits of various foods. Broadly, and very charitably, we can look at these varied definitions of anti-aging as meaning "to look and feel younger in some way." This has no bearing on how long you live or how healthy you actually are, and many of these products simple do not achieve the results claimed.

The confusion of greatest interest here is between the first two definitions above: treating the disease of aging versus treating aging itself. Many interventions can lengthen an individual's life span by preventing or curing specific age-related diseases that would otherwise prove fatal. For example, ask yourself whether a method of preventing heart disease or type 2 diabetes is anti-aging medicine. The therapy in question might have no effect on the underlying aging process, but it would nonetheless help many people to live comparatively longer, healthier lives. Is this anti-aging research? Scientists say no, some medical and business groups say yes.

Why Can't They All Just Get Along?

Scientists are appalled at what is going on in the anti-aging marketplace. The more reputable businesses in that marketplace are appalled by the hucksters and pervasive fraud. Anti-aging is a valuable brand in science and business, and all of these groups are attempting to control or profit from the brand: the war over the meaning of "anti-aging" is thus fought for money, but more importantly for the perception of legitimacy.

Perception of legitimacy goes a long way towards determining funding for scientific research and revenues for a business. Scientists feel, quite rightly, that the noise and nonsense coming from the anti-aging marketplace damages the prospects for serious anti-aging research. If the public believes that anti-aging means high-priced cosmetics marketed to the gullible, then no scientist is going to obtain funding for a serious proposal in longevity science that uses the word "anti-aging" no matter how accurate it might be. Worse than that, people start to assume that real efforts to reverse aging must be impossible - and science at the large scale requires public support and understanding to thrive.

Businesses in the "anti-aging" marketplace make money from the aura of legitimacy whether or not their products perform as advertised, and so a lot of effort is expended to create and maintain this perception. Businesspeople with working, accurately marketed products carry out their own fight against opportunists and frauds who damage the market and the brand.

A common objection to the way in which anti-aging businesses establish legitimacy is that they cherry-pick supportive studies in areas in which the facts are still unsure and scientists are still working towards a conclusion. A few positive studies are not enough to settle any question or recommend any course of action in the complex world of medicine. Many business don't even go that far, and settle for a cargo-cult patchwork assembly of disconnected research results, nonsense or irrelevant when taken together as a whole. Sadly this usually works to sell products, even as it promotes scientific illiteracy and misunderstanding.

The vast amount of money spent on products that claim to turn back the clock or at least hide the progression of aging demonstrates that people want real anti-aging medicines. The issue is that these real anti-aging therapies don't exist yet: an entire industry of business and manufacture has come into existence in advance of the products it should be selling, and somehow is still thriving.

We Are Not There Yet

The concept of optimizing natural longevity is useful when trying to draw a distinct line between what you can do now to lead a longer, healthier life, and what will be possible in the future. We can presume that there exists, for each person, some maximum life expectancy that can be reached using modern medicine and appropriate lifestyle and diet choices. You might adopt calorie restriction, exercise regularly, keep up a good relationship with a physician, and spend an appropriate amount on preventative healthcare. You will have access to modern clinics to treat age-related disease when it strikes. Each of these items will help raise the odds of living longer and in better health than you would otherwise have done. Does this make them anti-aging strategies, preventative medicine, or merely adequate maintenance for an aging body?

If we possessed medical technologies that could extend the healthy human life span to 150 years or more then it is a fair bet that no-one would be arguing about the semantics of anti-aging research and medicine. In large part, these battles over meaning and legitimacy stem from the present absence of anti-aging therapies capable of greatly extend healthy life span. A year here and a year there are better than nothing, but far more effective medical technologies are possible in the near future.

Thus a focus on medical research and funding is vital and central to any efforts made to live longer healthy lives. We are simply not there yet! People always want a silver bullet right now, and focus on tiny short term gains at the expense of long term development. If a tenth of the effort spent on redefining anti-aging, selling junk and lies, or trying to optimize natural longevity was spent on developing the medicine of the future - ways to actually reverse aging such as repair of mitochondria and restoration of aged stem cell populations - then we would be well underway towards that goal.

The modern medicine and lifestyle choices like calorie restriction that are all we have access to in the here and now are largely ineffective in the grand scheme of what is possible when it comes to human aging and longevity. They are poor first steps on a very long road. Medical science can do far, far better in the future, but getting there will require work, activism, and support for longevity research rather than the present grubbing around in the "anti-aging" marketplace.

Last updated: May 5th 2013.

Activism is very important. Persistent and vocal advocacy for a cause directly influences the amount of money flowing into that cause: think of the fight to cure AIDS, cancer research, Alzheimer's research and now healthy life extension. Productively framing, placing and keeping a problem front and center in the mainstream of our culture is hard work, but that education and persuasion unlocks purses far and wide. Government money is usually the least of these resources. Far more funding comes from venture, charitable and corporate concerns. Corporations and venture capitalists see mainstream culture explicitly in terms of needs and markets for future products. If a need is shouted loudly enough, money will be directed to answer that need. Charitable causes answer the same needs - and more certainly goes to those needs shouted loudly from the rooftops - but through voluntary donations and giving.

Why Is Publicity Important?

Research and research funding ebbs and flows on public awareness and public opinion. Government funding is usually a small amount of the whole if a field is popular or well known. If the market sees money to be made by selling people what they want to buy, then companies will bloom and research funds will pour forth.

The science of healthy life extension, aging and longevity research, is currently very underfunded in comparison to, say, cancer, heart disease or AIDS research. When you stop to think about it, this is a very strange state of affairs. After all, everyone ages. Almost everyone is prepared to pay money to slow or halt the progress of aging. Witness the success of vendors claiming to supply "anti-aging" products!

So why is aging and longevity science languishing in comparison to other fields? One answer is that the wider public really doesn't understand the near future potential of this research. The blame for this state of affairs may or may not be laid at the feet of the scientific community, but it isn't an insurmountable barrier. We can look at what happened in the 80s and 90s for AIDS research, for example. Activist groups were well aware of the possibilities that future research could bring. They worked long and hard, and raised a great noise to the heavens. Lo and behold, the flow of resources to AIDS research increased dramatically. Today, AIDS in Western countries is almost a manageable, chronic condition rather than a death sentence - and this happened in only 20 years. When political and economic barriers are overcome, AIDS patients elsewhere in the world will enjoy the same benefits.

Something like this could - and indeed should - happen for the degenerations of aging. We need to organize, speak up and make ourselves heard.

AIDS funding in the 80s and 90s is one crowning example of a victory for activism and advocacy. In a comparatively short few years, AIDS moved from obscure disease to the center of media attention. There was a close relationship between activists and researchers by that time. The floodgates of research funding opened and AIDS progressed from death sentence to manageable condition for those with access to treatment.

There is a point to this examination of past history: we should be trying to repeat the sucesses of the fight against AIDS for aging and longevity research. This branch of science is woefully underfunded and still largely funded by governments - a recipe for slow progress. Major corporate concerns and venture capitalists do not yet see a potential market worthy of investment. The same goes for major philanthropic organizations. Why is this? One reason is that we don't see the loud clamor and noise of people demanding a real cure for aging. There is no ACT UP (one of the loudest early AIDS activism groups) to cultivate, shape, channel and present the nascent demand for longevity research and medical technologies to repair and reverse the damage of aging.

Active advocacy groups are the point of the spear, and can only come into being with the support of a large community. Effective advocacy cannot exist in a vacuum. Fight Aging!, the SENS Foundation, the Methuselah Foundation, the Alliance for Aging Research, the American Aging Association, the Immortality Institute, the CR Society, and other diverse pro-life-extension organizations didn't spring into existence from nothing. They interact with and are encouraged and supported by many overlapping communities interested in healthy life extension.

There has been a real growth in size and sophistication of healthy life extension communities across the past decade, largely thanks to the power of the Internet and the actions of a core of motivated leaders. As a united group, they have come to the point of being able to say: "Real, meaningful healthy life extension is what we want. Let us make it happen!"

How Do We Make It Happen?

What can you do to help the development and awareness of future healthy life extension therapies? I suggest the following easy ways to get started and get involved:

• Subscribe to the Newsletter

  We'll keep you up to date on current events, news and healthy life extension activism projects. You decide when and where to join in when we do something new and interesting.

• Join the wider healthy life extension commmunity

  Join the community and get talking! Make a donation to the SENS Foundation to support their longevity research; subscribe to the CR Society mailing lists; join the Immortality Institute forums; keep up with the news posted here at Fight Aging!

• Tell your friends about Fight Aging!

  Fight Aging! is well worth sharing. The more people who know about healthy life extension and are willing to help out, the better off we all are. Bring all your friends along and swell the ranks of people interested in longer, healthier lives.

• Take action today!

  Visit the Take Action! section and see what's going on. Chances are, there's an activist project that you could quickly and easily help with. You'll be helping to ensue your future health and longevity; every little bit counts!

For a final thought, let's come back to growing the community. If you stop to think about it, every extra person contributing to the healthy life extension community directly increases all our chances of living a much longer, healthier life. Everyone can help, and it doesn't take much effort.

Every wall is built one brick at a time. Have you mentioned healthy life extension to your friends today? Show Fight Aging! to a neighbor. Introduce someone to the Immortality Institute or mention the Methuselah Foundation at the office. Post Fight Aging! articles or newsletters to bulletin boards or online groups you belong to. After all, this is no different from sharing the normal run-of-the-mill health advice. Go ahead! You'll be helping people.

In short, healthy life extension is not a niche community anymore, and hasn't been for a while. So let's stop behaving like one.

The Opposition

Scientific progress is a wonderful thing. Progress means that we live in houses rather than caves; that we live in comfort rather than hardship. We shouldn't forget that the vast majority of people slaved just to stay alive for a few short decades in past centuries, living in filth and disease.

Many people do forget. They discount and belittle the tremendous benefits that science has brought to humanity. They would shackle the engine of progress and halt the advance of science. They have their reasons; fear of change often heads the list. Luddites of one form or another have existed throughout history, but have always been defeated. A good thing too! But defeat simply seems to mean that the next generation will live better, longer lives while fighting hard to prevent their children from enjoying the same benefits.

Today, humanity stands on the brink of real, meaningful longevity medicine. Readily available therapies to repair and prevent the damage we suffer simply from living could be mere decades away. Yet, people in positions of influence or power (such as Leon Kass, former chair of the President's Council for Bioethics, and Francis Fukuyama, to name but a few) devote their time to blocking research and speaking out openly against extended health and life.

This isn't isolated, and this isn't just a matter of distaste for advances in medicine for healthy life extension. It's part of a bigger war against scientific progress in all forms. We see it in the globalization debate, in local, national and international politics, in arguments over genetically modified foods. Influential and well-funded factions want to stop or even turn back the clock of progress for everyone. While they can live as they like in their own lives, they have no right to force their views on the world. Alas, they continue to try.

Unfortunately, we cannot dismiss the efforts of people like Leon Kass. While he is helping (in his own backwards way) to raise awareness of the possibilities of healthy life extension, he and his bioethicist cronies have a real ability to damage and hold back medical research. Their voices are used to justify legislation to restrict, shut down or criminalize vast swathes of important, relevant medical research in the US. France and Germany have already done this: it's not as though we can pretend that it can't happen elsewhere.

We cannot afford to lose these battles! The longevity-enhancing, age-repairing medicine of the future is by no means a done deal. Human science is capable of achieving so much that has simply not been accomplished, or even attempted in the years to date. We could have had permanent bases on the Moon, irrigated the Sahara and catalogued all life on the deepest ocean floor over the last 50 years. We have not. Likewise, there is no guarantee that advances in medicine will bring radical life extension rapidly enough to help those of us reading this now.

We must stand up and support what we believe in: more medical research, freedom for researchers, better medicine and healthier, far longer lives!

Last updated: December 7th, 2010.