Longevity Quotes

Whatever your body weight status, knowing your risk of diabetes can help promote its prevention. Many thin people of Asian ancestry are prone due to their genetic markup. Getting your polygenic risk score shouldn't be expensive or difficult. The data can be derived from a gene chip (array) used by companies like 23andMe or AncestryDNA or low-pass genome sequencing. Either method detects the several hundred letter variants among the 3 billion letters of the human genome, and a formula is used to calculate the score, with weighting of specific variants by their importance, and critical attention to the person's ancestry. [2025] - Eric Topol

A polygenic risk score can be inexpensively obtained from a gene chip (array) that assesses over a million common genomic variants that have been quantitatively validated to be associated with risk of a particular cancer, in terms of a score. While these were initially based on European ancestry cohorts, their accuracy and clinical utility have been markedly improved with diverse ancestry and large population data. The principal goal of a polygenic risk score is to identify high-risk individuals so that they can be followed closely. Polygenic risk scores can miss high-risk cases, which is why it's so important to have multiple layers of orthogonal (complementary, additive) data. [2025] - Eric Topol

Whole genome sequencing of our 3 billion letters can now be done for about $200. Some biomarkers can be used that are associated with a higher risk of specific cancers, such as proteins for risk of pancreatic cancer or a circulating microbiome DNA for lung cancer. Clonal hematopoiesis of indeterminate potential, clones of blood stem cells with driver gene mutation frequency ≥ 2%, is one such example, and it can be derived through genome sequencing. Its presence, which is increasingly common with aging, carries an elevenfold risk for blood cancer and increased risk of lung cancer and nonmelanoma skin cancer. [2025] - Eric Topol

Multicancer Early Detection (MCED) assays are constantly getting refined. There are also assays that detect certain proteins or metabolic markers, such as glycosaminoglycans, that indicate a higher likelihood that cancer may be present, as well as blood tests that combine cell-free tumor DNA and proteins in a panel. The test with the most extensive clinical experience to date is known as the GRAIL Galleri. It uses AI to determine whether there is a "cancer signal" and, if present, to help localize its likely organ source. The problem with this test that is marketed for $949 for people aged 50 and older is that the yield is remarkably low. Only 5 per 1,000 people test positive, and, of these, just 2 per 1,000 were actually diagnosed early, in stage 1 or 2, before the cancer spread. The proportion of false negatives among every 1,000 people tested is unknowable. [2025] - Eric Topol

Instead of theoretically spotting cancer at its earliest microscopic stage, MRI can only detect cancer once it exceeds a certain mass size; it's macroscopic and even less likely to find a tumor early than the micro testing. The chance that an abnormal MRI could promote "incidentalomas," benign findings such as nonmalignant nodule or cyst, is high: a meta-analysis of all the studies indicates that it occurs in at least 19% of people. That, along with the lack of sufficient evidence, is why the American College of Radiology recommends against total body-screening MRIs. [2025] - Eric Topol

Multiple studies in midlife and older adults indicate that sleep disturbance is the risk for late-onset dementia. Note the 7-hour cutoff for association with the lowest hazard ratio. After 7 hours, more sleep is associated with more risk. Other cardiovascular factors are tied to risk of Alzheimer's and all-cause dementia, including a very high HDL, high LDL, and elevation of systolic blood pressure. A retina image is independently helpful for prediction of high risk. Speech, analyzed with AI methods, can predict Alzheimer's disease within 6 years. People deemed at high risk must undergo further assessment and close surveillance. This includes a conventional brain MRI, or a resting-state functional MRI that can further differentiate risk and predict the disease up to 9 years in advance. [2025] - Eric Topol

As we await vaccines directed against Alzheimer's disease, more evidence of an association of the recombinant shingles vaccine (Shingrix) with reduction of dementia, including Alzheimer's, has emerged, which also raises the potential role of herpes zoster virus. Generally recommended for all people aged 50 years and older, this would be another specific consideration for high-risk individuals. [2025] - Eric Topol

From 137 studies in approximately 13,000 individuals, skin-to-skin touch significantly improved sleep, blood pressure, and mobility, while reducing fatigue, anxiety, pain, and depression. Whether it's a one-off brief hug or handshake or a 60-minute massage session, human touch appears to be consistently therapeutic, perhaps to an even greater extent among women. [2025] - Eric Topol

TruDiagnostic provides the DunedinPACE result and metrics for immune cell function, "fitness," telomere length, and other reports; GlycanAge ($348 for one test, $599 for two); Generation Lab (4 biological age tests for $149 per month and a VIP program for $3,499 per year). Companies including Tally Health, Elysium Health, and Novos Labs offer aging clocks and supplements to pair with them. I don't recommend any of these tests (or supplements), including telomere length and epigenetic clocks. There are useful in research studies, but there is lack of clinical validation from rigorous randomized trails that having some body clock information leads to improvement in metrics or health outcomes. [2025] - Eric Topol

Only about 15-30% or less of our lifespan appears determined by our genes, which means how we live our lives may determine the bulk of our destiny. [2023] - Michael Greger

Though it can increase the average lifespan of certain mice by 5%, at a higher dose, metformin actually shortens lifespan. Further reservations about its panacean prospects arise from the landmark Diabetes Prevention Program study in which the drug only appeared to benefit those at highest risk. One small study even found that despite metformin alleviating the insulin resistance of diabetics, the drug actually made things worse for nondiabetic obese individuals without the family history of diabetes. So, healthier individuals may not reap the benefits of metformin that we try to extrapolate from longevity studies on diabetics. [2023] - Michael Greger

As you age, your risk of developing and dying from cancer grows every year——until you hit 85 or 90. Interestingly, that's when your cancer risk begins to drop. At age 65, we're 100 times more likely to have a tumor than we're at age 35, but if you don't get a cancer diagnosis by a certain age, you may never get one. [2023] - Michael Greger

The ideal body mass index (BMI) for the longest life appears to be 20 to 22 (kg/m2). [2023] - Michael Greger

For adults 65 and older, the National Sleep Foundation recommends 7-8 hours of sleep a night, which correlates with about the sleep duration associated with the lowest risk of frailty and age-related muscle loss. [2023] - Michael Greger

Assuming that you're not someone who engages in ultrarisky behaviors like BASE jumping, motorcycle racing, or texting and driving, the odds are overwhelming that you'll die as a result of one of the chronic diseases of aging that I call the Four Horsemen: heart disease, cancer, neurodegenerative disease, or type 2 diabetes and related metabolic dysfunction. To achieve longevity-to live longer and liver better for longer-we must understand and confront these causes of slow death. [2023] - Peter Attia

Rapamycin has been demonstrated to do something that no other drug has ever done before: extend maximum lifespan in a mammal. Even though rapamycin is already approved for use in humans for multiple indications, there are formidable obstacles to launching a clinical trail to look at its possible impact on human aging-mainly, its potential side effects in healthy people, most notably the risk of immunosuppression. [2023] - Peter Attia

With a few exceptions, such as glioblastoma or other aggressive brain tumors, as well as certain lung and liver cancers, solid organ tumors typically kill you only when they spread to other organs. Breast cancer kills only when it becomes metastatic. Prostate cancer kills only when it becomes metastatic. You could live without either of those organs. So when you hear the sad story of someone dying from breast or prostate cancer, or even pancreatic or colon cancer, they died because the cancer spread to other, more critical organs such as the brain, the lungs, the liver, and bones. When cancer reaches those places, survival rates drop precipitously. [2023] - Peter Attia

I'm cautiously optimistic about the emergence of so-called "liquid biopsies" that seek to detect the presence of cancers via a blood test. These are used in two settings: to detect recurrences of cancer in patients following treatment and to screen for cancers in otherwise healthy patients, a fast-moving and exciting field called multicancer early detection. [2023] - Peter Attia

The Galleri test looks at methylation patterns of the cell-free DNA, which are basically chemical changes to the DNA molecules that suggest the presence of cancer. In a study, the Galleri test proved to have a very high specificity, about 99.5%, meaning only 0.5% of tests yielded a false positive. If the test says you have cancer, somewhere in your body, then it's likely that you do. The trade-off is that the resulting sensitivity can be low, depending on the stage. (That is, even if the test says you don't have cancer, you're not necessarily in the clear.) Keep in mind this test still has much higher resolution than radiographic tests such as MRI or mammogram. Those imaging-based tests require "seeing" the tumor, which can happen only when the tumor reaches a certain size. With Galleri, the test is looking at cell-free DNA, which can come from any size tumor-even ones that remain invisible to imaging tests. [2023] - Peter Attia

In Medicine 3.0, we have 5 tactical domains that we can address in order to alter someone's health. The first is exercise. I break it down into its components of aerobic efficiency, maximum aerobic output (VO₂ max), strength, and stability. Next is diet or nutrition-or as I prefer to call it, nutritional biochemistry. The third domain is sleep, which has gone underappreciated by Medicine 3.0 until relatively recently. The fourth domain encompasses a set of tools and techniques to manage and improve emotional health. Our fifth and final domain consists of the various drugs, supplements, and hormones that doctors lean about in medical school and beyond. [2023] - Peter Attia