Hi, this is Kopi Time podcast series on markets and economies from DBS Group Research. I'm Taiu Bei, chief economist, welcoming you to our 149th episode. Today we will discuss longevity with the foremost expert in the field. Brian Kennedy is distinguished professor of biochemistry and physiology at Yong Lu Lin School of Medicine at National University of Singapore. He's also the director of the Center
for Healthy Longevity National University Health System. Professor Brian Kennedy, welcome to Kobe time.
Thanks, pleasure to be here.
It's great to have you. This is a subject close to my heart. I was just telling you right before this recording that all the 40-somethings and 50-somethings I know they're, they're deep into this. So I will have a lot of eager friends listening into this podcast. Uh prof, let's begin by defining senescence.
Yeah, senescence is a, a term that gets used for multiple meanings, and I think that's one of the reasons that it's complicated for people to understand. So for instance, when a uh salmon comes back into the fresh water and dies, that's called senescence. Um, but I think most people In in today's discussion would refer to it as the uh cessation of division of cells in your body, uh, so, uh, cells can for a variety of different reasons, stop dividing
and enter into a senescent state. Uh, and in that senescent state, they're no longer able to support regeneration of tissues, but they still are live cells and they can secrete factors that are pro-inflammatory. No Go ahead, please. No,
go ahead, no, no, I'm, I'm listening. Yeah,
so 11 thing senescence is therefore is to keep cells from becoming cancer cells. So when something goes wrong in a cell and it may be on its way to being a tumor cell, the senescence pathway can be invoked and that stops the cell from being able to divide. So in a sense, it's anti-cancer.
On the other hand, these, these cells secrete pro-inflammatory factors that influence cells around them and maybe even throughout the body in some cases, if there's enough senescence and so that can actually stimulate aging and cancer, so it's kind of a trade-off.
Right, OK, so that's exactly where I was to jump into. So the question I guess is, you know, so what are the molecular hallmarks of aging? Is it, is it the what you just described that the cells stop dividing and then they may be secreting inflammatory material?
Yeah, I, I think we can list several different things that are driving the aging process. Cells in essence is certainly one of them. Um, the inability of your adult stem cells to replenish their tissues, levels of inflammation in the body, your telomeres, DNA damage, all of these things probably contribute to the aging process. Um, and, uh, it's still somewhat of a mystery to put them in order and talk about how they contribute,
what percentage each of, each of them contributes. So I think a better way of thinking about it is that You have a a network in your body that maintains health and it's kind of a homeostatic network, uh, and this network can respond to things that happen in your body. You, you know, you get out in the sun, you get skin damage, you start eating a lot of fast food, you know, your body adapts to that and it keeps
you healthy for the most part. But over time that network breaks down, and when it breaks down, These hallmarks of what you see, high levels of inflammation, your stem cells don't work as well, so all of a sudden the senescent burden goes way up. Um, and so they're, they're telling you that aging is happening, but I think preserving the network is really what we want to do to keep people young, not, you know, treat each hallmark separately. I think that that so far hasn't worked very well.
And when does it begin? My son is 11 years old. Clearly he is not going through the process of aging yet, but would he at the age of 18, at 25, is it hard to put a marker around that?
Well, I, I may even disagree with you. I think we we recently did a biomarker study using DNA methylation of 10,000 Singaporeans. And we happened to have a birth cohort in that study, so we were looking at newborn babies, and already we can detect that baby boys were older than baby girls. Uh, and so that suggests that maybe aging starts in the womb, you know, and that already there's something happening that's different between boys and girls.
Um, so, certainly during development, you don't see manifestations of aging, you know, kids are getting stronger, they're getting smarter, their, their brain is, is developing, um, and so, you know, you begin to see the decline in aging in adulthood, you know, maybe. You know, starting around 30 maybe, but And there may be parameters that are driving that aging process that are not detectable, but happening throughout life.
And is the manifestation of aging first in cognition or is it more physiological developments that you pick up as signs of aging?
Well, I, I think that a lot of people would say that the ovarian aging is the first thing you really see in women, so you, you know, you have a decline in fertility starting in your 30s and Uh, menopause somewhere in your 40s and 50s, um, that's indicating that ovaries are, are aging, I think. Uh, also, your thymus tends to undergo what's called involution, which leads
to a dramatic reduction in production of immune cells. So those are two things that happen relatively early during the aging process, um. Muscle loss, you know, starts usually around 40 and people say you, the average person loses about 1% muscle mass a year after that. Um, cognitive decline, and, and actually physical decline, it depends on how you measure it, you know, you don't see a whole lot of 40 year old athletes right at the top level.
Um, and already when you're measuring how fast like neurons fire and connect, you know, it's already slowing down at that point, but it's hard to measure because your body's, like I said, is good at compensating, you know, so it finds other ways to adapt to to to things that are going a little bit slower and you don't
really notice that in your daily life. So, if you really want to take really deep measures, you can already start to see things in 30s and 40s, but You know, in terms of actual functioning disease-free health, you know, that's usually not until 50s and 60s where you begin to see a significant decline.
I recall reading somewhere that in terms of physics and pure mathematics, the pathbreaking discoveries come from scientists who are in their late 20s, early 30s. They even the Nobel laureates don't necessarily go through pathbreaking discoveries in the late 30s and 40s. I've heard about musicians that the really brilliant musicians are much younger than the older ones.
Yeah, I think that that's certainly, it's certainly been well uh defined for math and physics. Um, you know, biology research is a little bit different because I have a whole team of people working with me and so it's not. You know, we may have a great discovery, I hope we do, but whether it comes from my brain or one of the young people's brains is debatable.
Um, Proff Kennedy, I have heard you talk, ah, in, in public forum in, in terms of the distinction between lifespan and health span, and really that I've also heard you talk about this phrase, uh, compressed morbidity. So could you help us sort of walk through these three things?
So, so healthspan is, it's a little bit hard to define, but I think you can understand that. It's the period of time that you're largely disease-free and that you're highly functional in life, um. And you typically that if the average lifespan in Singapore
is 85, the average health span would be around low 70s. Um, and so there's a period of time, maybe a decade on average, where people are alive, but they're not in good health, or they're not functioning well, uh, and that would be, that's where all the healthcare costs are and that's where quality of life diminishes dramatically.
So if you have an intervention that uh compresses morbidity, and we've published that with alphakitic glittering in mice, uh, what you see is that the health span goes up more than the lifespan. So it's, it causes a small increase in lifespan, but a big increase in health span. And so that period of time when you're sick and have multi morbidity gets diminished, and so that's what compressed morbidity is. And that's really what we would like to see, right? Are you, you.
You know, jokingly, you'd like to be totally healthy and then eventually get hit by a bus. I mean, there's, I mean, maybe not, but you get the idea.
Yeah, I think, uh, Atul Goanes being mortal in the very first chapter has something about like that his grandfather, who was a lawyer till his 90s, basically, you know, was healthy till the day he died because he got hit by something like that. Um, but, uh, I, you know, in WHO they have this, uh, life expectancy adjusted marker called HAL, HALE Health adjusted life expectancy. So is that the way to look at it then that instead of looking at
that's one parameter you can use to try to measure health span. I think there are different ways to look at it, but, um, and like I said, it's there I don't know if there's consensus on how to measure it, but um. That would be one parameter you could think of, yes.
I, I just like the fact that Singapore ranks number one in the health adjusted life expectancy metric.
Yeah, I mean, Singapore is doing quite well, and you know, what I hope is that they really make a commitment to healthy longevity because the the time is right to do that and this island could be the, the model case for really extending health span because uh there's a lot of things going in advantage for Singapore, uh, it's small, manageable, um, already have good healthcare system. Uh, and I think there's also a population that believes
in the government. So when the government takes the lead on something, people will follow, you know, you, you could say anything in the US you could say. You know, drink 3 cups of water a day or more and then half the population would disagree with you on my definitions
for sure, absolutely, uh, I want to talk in greater detail about Singapore uh later. I just want to cover a couple of things first with you. Uh, when I told my wife that, you know, I was gonna Discuss with you this this health span lifespan issue. She basically said, well, it's largely genetics. So is it largely genetics or and she's a polysci PhD, so let's not necessarily give her full credence. You, the expert, tell me whether the genetics versus environment, how much do these things matter?
How much trouble am I going to get if I disagree with her she has a very old you get. Um, there's certainly a genetic component, but most research suggests that it's relatively small, maybe 30% of the, of the equation, and the rest of it is sort of lifestyle environment, where you live, how you live. Um, and that it is very important. Now, there's an exception to that though. There are people that live to be centenarians. Um, they chose, they got there by choosing
the right parents. Uh, that's very genetic when, so people with exceptional longevity have the right genetics, but this is extremely rare. The, the vast majority of us, um, uh, environment and lifestyle are probably more important. But this,
this genetic lottery fascinates me. I'll give you my personal example. My mom, she's no longer with us. She had all sorts of morbidities, even at a fairly young age, diabetes related morbidity and so on in her 60s. My dad still around 90+. We had his 90th birthday last year. Fingers crossed, he lives longer, and he has never really stressed out about, you know, the right diet or the right pills, whereas my mom who did pass away, actually was far more worried about her
health. Yeah. Well, there's two things I would say to that. One is that, uh, centenarians don't typically live well, that they have the genetics, right? So they, if you look at them, they were more likely to be a little bit overweight. Now, they weren't like crazy obese, but they were more likely
to be a little bit overweight. Uh, and near Barzilai's study of Ashkenazi Jews, they're slightly more likely to be smoking than than the po you know, so they have the right genetics, they're resistant, um. I would also say that. I, I think it's great to be uh very alert to a healthy lifestyle and doing your best to live a healthy life, but I don't think worrying about it
constantly is a good thing. And so, you know, I, I think that sometimes people forget the, the, the level that stress plays in their aging, uh, and trying to manage your stress, um, is, is critical. It's hard for us to study that in animals, but I'm convinced it's a critical component of aging, the mindset, you know. And so you said father, not worrying, and he seems to like go through life and take things kind of as they come, maybe yeah, your father's worried that could have been a factor.
Right.
Um, OK, so let's talk about the things that we can control, um, you know, diet, this issue has been around for maybe half a century, and there is my mother, so exactly. So since we can't control our father and mother, uh, the things that we can, let's talk a little bit about diet and exercise, the two things that, you know, a lot of people talk about, where do we stand in terms of scientific zeitgeist in these two areas?
Let's start with exercise because I think it's a little bit of an easier discussion. Um, you do it. If some combination of resistance training and cardiovascular training is probably good for everybody. Um, it's important to try to do both, as as you get older, you wanna try to maintain that muscle mass. So one of the most important things you can do is keep your muscle mass. Um, but, you know, cardiovascular health is obviously good for your heart and your vascular system, and
And a range of other systems as well. So, uh, the, the key to me is sustainability, you know, and trying to find exercise programs that fit your needs. If you're doing something and you don't like it, you're, you're gonna stop doing it. I just be honest, you know. So, um, for me, you know, I enjoy running. I, I kind of get my mindfulness from running.
It's, it's meditative almost for me as well. Um, and so it's very good for me, and then I for I forced myself to go do weightlifting, and I've, I've learned to live with it. I don't love it, but I don't hate it either, and so, and I feel good after I, I complete it, so, uh, and I can see the benefit of doing it over the long term, so. You know, that that for me is what works, but if, if tennis works for you, that's great. The the key is find something that's sustainable.
The um one point that I wanted, sorry, I, did I lose you? you can hear me, right? Yeah, um, we're going to get your diet for a second. I just want to share with you my personal slightly off-track observation on this issue. I also like to run. I also like the fact that during running all sorts A serendipitous thing can happen. I was in Dubai yesterday. I went running and I saw two peacocks flexing their
plumes in just all glory. If I were driving or biking, I would not have seen that, and that that delight, I think will sustain my running habit for years to come. Yeah,
I run outside instead of treadmills almost I only run on a treadmill if there's no other choice because I think you're right, you experience the world being outside running and Although I did try to run in Dubai last summer and that was, that didn't go well.
December, January, February is what you want to do. Yeah, absolutely. Um, you had mentioned about the muscle loss aspect, about 1% muscle loss in your 40s onward, uh, so resistance training is something that you would want. People in their 40s onward to focus on as well,
yeah, for sure. And also it's good for your bones, you know, one of the things that maintains bone density is putting resistance on your bones, you know, putting load on your bones. And so, um, when you're doing uh resistance training, you're not only helping your muscle but your bones as well.
Shouldn't dairy also help with respect to bone? Got lots of calcium?
Uh, dairy is complicated. Um, you want to maintain the appropriate calcium levels for sure, uh, as you age. Um, a lot of studies suggest that very high dairy, accelerates aging. Um, there are a lot of, uh, observational studies in, in humans to suggest that. Uh, so I tend to, I keep to a very low dairy diet. I eat yogurt and I, I will
eat cheese sometimes, but I don't drink milk, uh, at all. So, but, you know, how your body reacts to that and what happens to your calcium levels is something you should be measuring, and this is, this is one point I would like to make is that people ask me about supplements and vitamins and all of all of these things. Well, you need to know where you are on this equation. You need to be able to, you need to know
your vitamin levels. You need to know your meta metabolic levels, and, you know, we, and now we have a clinical aging clock where we can measure your biologic age based on 50 clinical variables that everybody should be getting anyway. You know, it's uh it's LDL and inflammatory factors and so if you're, if you're one of these people that likes to do interventions, whether it's lifestyle or supplements or drugs, a lot of people are taking rapamycin.
You should be measuring outcomes as well and and trying to find the strategy that works best for you, uh, and I think a lot of people, uh, I think I always actually I think my my God, I don't know what your levels. These are.
Um, prof, we sort of lost you in the last 30 seconds. Just let's just uh go back to that point of the, uh, after you talked about dairy, but the 30, 40 things that you can do to test your vitamin levels, that part, let's repeat that part.
Yeah, so we recently generated a clinical chemistry clock that predicts your biologic age, and it does so from about 40 or 50 analytes that you commonly get when you get, uh, go to a doctor's office or hospital. And these are things you should be doing all the time, measuring these factors. These things like HbA1C, LDL, inflammatory factors. Um, and you should know what those are, and if you have them, we can also tell you your biologic age,
but you should also know your vitamin levels. Typically these things are not measured, um, and people ask me, should I take vitamin D or B complex, and I, I'm like, I don't know, what are your levels? And they don't know. So, uh, you should measure yourself and, and pay attention to how you're doing, uh, before you just start taking a bunch of different things.
All right, let's go to the broader issue of diet, which you already have sort of foreshadowed that it's a bit complex. um, what should one be eating and what should one be avoiding?
Yeah, I mean, this is still highly debated. You can find experts that will say just about anything. I think the two common diets that people talk about for aging are a vegetable rich diet, uh, that's low in, uh, red meat and dairy, uh, kind of a Mediterranean diet, um, and, uh, and that's the one I tend to believe in, uh, and then there is another group that are very keto-oriented, so they're like high protein, high fat, no carbs, um.
I think that that keto diet probably makes people lose weight, but it also unbalances your uh uh nutrition such that your body has to make relatively serious adaptation to what it needs, and I think over the long term, most of the evidence suggests that having high amino acid levels accelerates aspects of aging, uh, whereas if you look at the animal models where you keep Uh, calorie and take uh isochlorine, so you're, we're not
changing total calories, and then you change macronutrients, it's actually high carb, low protein that's associated with longer lifespan. But there are two caveats to that. One is that it's complex carbs, not simple sugars. I think those are, are not good for you. Um, the other is that for humans, if you say you're eating a diet rich in carbohydrates, you're probably getting way too many calories. Carbohydrates is the fastest way to over nutrition, and I think
that's why people perceive it as bad. But if you're eating complex carbs and you're not eating too many calories, it's probably not bad for you.
But when I think of diet in this part of the world, there's a lot of noodles or rice in people's diet. Those are pretty simple carbs, right? Yeah,
well, especially white rice. That's why there's been a lot of movement to have brown rice or other types of rice that are maintaining some of their nutrient richness.
And I'm I'm, I'm I'm smiling a little bit because as you said, that these days you can hear just about every Variety of arguments in this regard, so in uh social media right now, there's a whole anti-brown rice movement about how brown rice is bad and we should be eating white rice, not really sure how scientific those observations are, but to your point there.
I don't know the details of that argument, but like I said, I, I'm sure we could find somebody that advocates for the milkshake diet if we looked hard enough. This field is, is, um.
Well, it's not, we have a rough idea of what people should do for health, but you know, there's a lot of details that we don't have good research on and A lot of serious scientists try to understand what's good for you and what's bad for you, and then on top of that, there's a lot of people trying to make money that are advocating for things that may not have a lot of science behind them. So, I, I,
I get it. I understand when people are trying to do healthy longevity, it's not as easy as it sounds because depending on who you read and, and, and what nutrition religion you brought to you, you may be doing completely different things, so.
So let's talk about the science of slowing or even reversing aging. You run a lab. You have talked in public forum a lot about alpha keto glutarates and also, if I'm pronouncing it right, spermmis. Tell us a little bit about these two molecules.
Yeah, so, and, and I think that's just two of a bunch of different molecules. I'll start with AKG cause we've done a lot of research on it. Um, and, and actually we have a product on the market called Rejuin that has ato glutarate, it's time release version, plus some vitamins, uh, full disclosure, I'm involved with that company, um. But, uh, what, this is a central metabolite in the body. You may have heard of NAD, that's another central metabolite.
These things are important for hundreds of reactions in the cell. Basically, they're important for metabolism and Excuse me, the levels go down with aging? Uh, and if you bring the levels back up, uh, you can improve aspects of health span or life span. Uh, so, uh, I think that there's pretty good evidence for both of
those molecules. Uh, it's hard with NAD back up because you can't take pills with NAD, um, so that, so people do precursors, uh, with NM or you know things that are converted to NAD. But even NMR don't get good bioavailability, so you, you swallow a pill, very, not that much of it gets in the bloodstream. Um, there are ways around it. Now there's a company that I'm helping out called IX BioPharma that has a sublingual NAD, so this is directly NAD
and it goes directly into the bloodstream that way. Uh, so, uh, those two, those two, metabolites are probably very important for aging. Uh, spermidine is a natural product, uh, and it activates autophagy in itself. Uh, and so autophagy is kind of a, a,
a garbage collection service for your cells. It takes the damaged proteins and organelles and recycles the recycles them into, uh, primary ingredients that can make new proteins, uh, and it's important to clear out the damage in your cells and if you can enhance autophagy. It's typically good for aging as well, spermidine is one of the molecules that does that.
But there are a lot of other natural products that I think are impacting aging, and we tend to uh believe that a lot of people believe that supplements are kind of all snake oil and uh again, it's a, it's a very, it's a profit-driven market, so, you know, it's kind of the wild west, but I think there are a lot of good ingredients in there that help people.
The most important thing we need to do is figure out which people respond to which supplements or drugs or lifestyle changes, any of these things, and improve their aging, and right now we're still trying to figure that out. How do we personalize this? Um, you know, it's I, instead of telling everybody to take 10 different things or every everybody to take one thing, we, we really wanna know which person needs which intervention and, and that, I don't think we're there yet as a field.
And your scientific approach is to try these things on mice and then try it on humans, or is there something in between?
Well, we use a whole range of bottles, so we use uh uh yeast, worms, flies, killifish, which are these rapidly aging fish from Africa and, and mice. Uh, we don't use primates, uh, primates live a long time, so it, it kind of makes the studies hard and they also cost a fortune. Um, and so we, we don't do that. We do some stem cell models in the lab as well in in vitro organoid models, uh, but I think that My beliefs is that. There's gonna be a lot of conservation of, of aging
pathways between animals and humans and other animals. Uh, the reason I say that is that, you know, we found the sirtuin pathway affects aging by studying single-celled yeast, and it turns out to be relevant to human aging. We found the MTOR pathway that way. The insulin IGF pathway comes from worms and flies. It seems like for whatever reason, the pathways that govern
aging are highly conserved between species. And so I think if something is working in a mouse, there's a pretty high probability that it's gonna work in a human, and that's different from disease because the actual diseases humans get are different than the ones mice get. And so you can sort of engineer a human disease in a mouse, but that's not the same thing as having the disease developed naturally in a human.
And so I think the disease models in mice are not as good as the aging model will be.
OK, I'm absolutely fascinated by that point. I think David Sinclair in his book sort of talks about it that, you know, you don't have to wait for the final trial on humans. As long as you know these are not doing harm. If I show you some good results out of mice, you can probably go ahead and take it. I think that's David's argument to some extent.
Yeah, I, I, in principle, I agree with that. I mean, you never for sure know about safety, so, you know, the question is, you know, where do you want to be on the, the, the risk reward spectrum for healthy longevity? Uh, if you want to be an early adopter, you know, and you know the safety profile and and the and and the potential efficacy of something.
Uh, and you want to try it. I, I support that. I, I think one of the problems we have in medicine is that we don't have, we don't empower patients or clients, uh, and, um, they go in, they have 6 minutes with the doctor, the doctor looks at some charts and says you have to do this and you should do that and you should do that. And the patient's not invested in doing it. And so even when you give them statins, they tend not to take it, you know, so.
Uh, compliance is very low. Uh, I think that we need to work on empowering people to make their own decisions, and if they wanna be like me, I try a lot of different things. If they wanna be, you know, on the edge and try things, I think it's OK as long as they're educated.
OK to try metformin.
Um, metformin is not my favorite intervention, but I, you know, it's, it's a very safe one. So there, there are very rare side effects that can happen. Uh, and so that, that should be kept in mind. Uh, I, I would, my personal recommendation on that is if you have, um, you should take metformin or, or one of the newer drugs in the market, a GOPonister. Uh, SCLLT inhibitors, but, um, it's still unclear whether those drugs for somebody with normal weight and normal glucose, whether
those drugs are gonna enhance longevity. Uh, and there's evidence for the GLP agonist and also metformin that they take the wrong way, they can reduce muscle mass, which is not good. Now, my guess is that can be highly managed and anybody that is obese should be on one of these drugs cause the, the, the accelerated aging you get from obesity is extreme. Um, but I don't know what to recommend for people that are in relatively optimal, uh, weight at the moment. I think that's still an unknown. OK.
Um, I was listening to one of your conversations recently where you were alluding to the next brave frontier, gene therapy and stem cell therapy.
Yeah, I'm, I'm really excited about gene therapy because, you know, before we were identifying drugs that extend lifespan in different animals, we were doing a lot of genetic mutations. So, you know, we have hundreds of genes that affect aging in yeast and worms and maybe uh almost 100 in mice, I would guess. Uh, the what if you can effectively manipulate the genome, it gives you a much wider range of possibility.
Uh, for changing aging, I believe, and it looks like gene therapy is finally, uh, reaching the, the, the forefront, you know, it's being used to treat rare childhood diseases, um, and there are already clinics that you can get gene therapy done in humans. It may be possible to do it in, in ways that you don't actually integrate the gene into the genome, and so you don't, you take less risk of making mutations in your genome with gene therapy.
So I, I think it offers great promise. I'm not sure whether it's, it's, we're at the point where the, the, the rewards outweigh the risk for aging yet, but I think we'll get there and I think it'll open up a range of possibilities.
I recently read Walter Isaacson's biography of Jennifer Doudna, the Code Breaker book, and the work is absolutely fascinating and the acceleration and innovation in that area in the last 1520 years is pretty astounding.
Yeah, like CRISPR cusine is really a revolution, you know, and we, we could always make the genetic changes we wanted in yeast, and that's one of the reasons it was such a powerful organism, uh, but now you can effectively do that in cell culture and gene therapy is starting to be able to do it in people. Uh, it's, it's exciting for sure.
Uh, how computationally intensive is some of this research, and the reason I asked you is because, you know, artificial intelligence and all the rage and, you know, large language models and so on. Um, are any of those recent developments in computer science helpful for the kind of research that we're talking about here? Yeah,
it's dramatically changing the field. Half my labs doing AI and I never thought I would say that, um, and, um. You know, more and more people are coming to work every day on that topic, and it's, it's being used for a wide range of things. For one, we're using them to make biologic aging clocks to measure how you age, um, but we're also using it to select drugs that might be better at, uh, some disease or even extending longevity, um, we, we recently published a paper.
Um, with careful and, uh, looking at how to query large language models to get, uh, appropriate answers for longevity. So like an example would be like, should I take rapamycin and 52 and, you know, I have diabetes, uh, and, you know, the people are doing this now, a lot of doctors will say you shouldn't ask large language models those questions, but people are asking them every day, it's happening. And so we're trying to figure out how to improve the responses of the LLMs.
In a way that gives good medical advice to people. So I think that's just 3 examples. There's so many different ways that AI is being used now that it's, it, it's really quite amazing.
Um, a few years ago I had Professor Dean Ho on my podcast. I'm sure you know Dean, and he was talking about in the context of personalized recommendation that AI can take in all the data from a patient overnight and then give you very specific recommendations of the dosage for the following day. At that time, I had, you know, of course, you know, it was years before large language models entered my consciousness, but I suppose this is one way of thinking about it as well.
Yeah, it's getting there. I mean, you know, you can also. Take it down directions where you get the wrong answers, and so I think that the value of elements for medicine is, is, is gonna continue to, to grow, uh, and, uh, already I think you can get really meaningful information back, but with a note of caution perhaps.
Right, I mean, for my personal work in the world of finance and economics, times I find it most useful is when I control the information that is ingesting. So when I upload a document and ask it to do some analysis on that, that's where the real value added comes to me. I don't necessarily trust it to tap the entire internet and give me the right answers.
Yeah, yeah, but it's, it's changing so fast, you know, I'm starting to wonder when I'm gonna be obsolete.
Um, uh, let's talk about Singapore. Uh, I know you're deeply involved in the research scene here. Give me a sense of how is the state of affairs on longevity related research in Singapore beyond your lab.
Well, I, I think there's quite a, a field growing here. It's, it's, uh, not much was happening when it came 7.5 years ago. I mean, there was certainly, if you think of aging in a broader sense, there was good geriatric medicine here, there's geriatric research. You know, I jokingly say that geriatricians focus on aging. My job is to focus on non-aging. So, you know, we're typically looking at middle-aged people trying to prevent aging, uh, so it's a little bit of a different approach, but
geriatrics is essential. You need geriatricians nowhere in the world has enough of them, and, uh, there's some very good ones here. And also there are programs focused on social aging that are very successful on. Um, uh, and, and other aspects of aging, financial aspects, and, and, and some health aspects of aging. Uh, we kind of brought this sort of molecular biology approach and to slow the aging process, and I, I think we're over the time we've built an ecosystem now of people that are
thinking about this. I would also say that governments really, uh, even by the time we got here, they already knew how much of a problem they had with the aging population. I mean they have Um, major challenges because extremely low birth rate, people are living a long time, and immigration is a challenge on a small island like this. So, um, they'd already recognized
this as a challenge. I think they've been taking their time trying to figure out where to invest in mitigating the problem, but, uh, I'm, I'm excited to hear that there's a lot of interest in focusing on healthy longevity going forward and You know, I, I think that it's really changing the mindset to say that, you know, Putting up better signs to keep people with Alzheimer's from getting lost is fine, uh, but it's not solving the
economic challenge of aging. The way to solve that is to keep people healthy, keep them working, keep them raising their grandkids, keep them spending money in the economy and traveling and doing all the things that keep the economy moving, and the only way to get to there is by keeping them healthy, not waiting till they get sick and Throwing a lot of money and trying to treat them. So I think there's a recognition of that now and
a belief that that's possible. So I think it's it's even gonna go faster as we go forward.
And speaking of sort of the public sector of Singapore and its intervention in the day to day lives of Singaporeans, I mean, are you an advocate of, for example, subsidizing healthy diet or giving people exercise vouchers, or you think that there has to be a smarter ground up way of doing it as opposed to a top down manner from heaven from the government?
Yeah, I don't think any government's figured this out yet, and, uh, you know, so this comes into play in a whole range of ideas. You can, you can do carrots like that. You know, you can also have an approach where you have to pay a little bit of your healthcare costs, where the government takes care of most of it, but you're on the hook for a little bit of it to try to motivate you to stay healthy, um.
Different countries are trying different uh approaches right now, and in the first country that finds a strategy to really increase healthy lifestyle is gonna benefit tremendously. I guess the countries that are closest to that are probably Northern European countries, so. And Denmark, places like that, people are very active, they're less obese people and uh they're benefiting from a more healthy lifestyle. Uh, Singapore is not bad, but I think
people don't exercise enough here, and it's partly climate. Uh, also, the, the food is relatively healthy, certainly it's healthy relative to America, but, uh, at the same time, you know, you go to the store and You know, you buy these cold teas in the store and they're like full of sugar. There's still some simple things that could be done that could really help out. And uh if I'm doing a 20k run, one of the piece full of sugar is really nice, but uh
having it every day would be a disaster. I mean, we, we need to like Make simple changes, continue to make simple changes that promote the health of the population.
Well, one thing I saw in Singapore 15 years ago when I moved here was the absence of covered sidewalks, and today it's a sea change. There's so many sidewalks that are covered and it makes a huge difference in my ability to run through those areas.
Yeah, me too. Uh, I, I agree with that. Uh, little things like that help for sure, but they're not the solution, you know, the solution is also to just go after the molecular biology and slow aging. Um, I, I think we need to, those sort of environmental changes are good, but they don't, they stand alone. I don't think they're going to solve the problem.
Sure, I have saved the hardest question for you at the end, which is, is aging a disease and if it's a disease, should it be covered by health insurance, any aging related treatment?
I'll I'll turn the question around and say that it should be covered by health insurance, whether it's a disease or not. You know, we can get into semantic arguments about whether it's a disease, but if it's, if you don't wanna call it a disease, you have to at least acknowledge it's the biggest risk factor for every disease we're afraid of. Um, and when you think of the most successful drugs on the market, they're not treating overt diseases. They're treating high
blood pressure. Why do you treat high blood pressure? Cause you don't want a heart attack. You, you don't want cardiovascular disease in the future. They're treating high glucose, uh, they're treating high cholesterol. Um, these are the drugs that work. They're, and they're reimbursed. And so if we acknowledge these things are risk factors for disease and we should treat them, we should also acknowledge that aging is a 100 times bigger risk factor
than any of those. So we should reimburse treatment for that too. I, I honestly, I think I would call it a disease, but I, as long as I can treat it and it gets reimbursed, you can call it anything you want.
Uh, well, that's, that's a great note too, and uh Professor Brian Kennedy, thank you so much for your time and insights.
Anytime. Thanks
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