The last post featured a video from Dr Nil Barzilai who is one of the leading academic physicians promoting the idea that chronic diseases and the rate aging are related and that when we treat one we always benefit the other. Here is the best news possible! We already have decades of experience with the drugs he points to as having the most benefit. I have quoted his list from the Business Insider.
“Metformin: one of the most widely prescribed and cheapest diabetes drugs on the market, it also has an impact on several key hallmarks of aging. It mimics some of the benefits of fasting and exercise, reducing inflammation and cancer risk. Barzilai says a large-scale, placebo-controlled trial of the drug for healthy aging will be getting underway this year in the US.
Rapamycin: originally harvested from a remote clump of dirt in the South Pacific, rapamycin is an anti-fungal compound that helps govern a key protein in our body. It tamps down cellular growth, having a beneficial effect on lots of processes tied to aging, including reducing inflammation and improving immune function. Many biohackers have already started taking small, self-prescribed doses of it, hoping to improve their own longevity.
ACE inhibitors: Angiotensin-converting enzyme (ACE) inhibitors are designed to lower a person's blood pressure. They keep blood flowing and can reduce stress on the heart. But studies in mice and rats suggest they can also extend the lives of animals with normal blood pressure.
SGLT2 inhibitors: Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a new-ish class of diabetes drugs that help lower a person's blood sugar by pushing more glucose out of their body in urine — and they're the most expensive drugs on this list. In some of the most rigorous anti-aging research to date (again, in mice) SGLT2s have been shown to extend lifespan. Researchers suspect that the same blood sugar-regulating benefits of these drugs can also help stave off many age-related diseases.”
Metformin and ACE inhibitors are drugs that have been in wide spread use for cardiovascular and related diseases for decades. There is a common denominator with these medications . Metformin directly inhibits the master genetic switch mTOR and directly activates the master genetic survival switch AMPK. Ace inhibitors do the same thing indirectly. Those are the key epigenetic switches involved in aging and the development of cardiovascular diseases and cancer. The SGLT2 inhibitors like Jardiance are newer and much more expensive but they work in diabetics and nondiabetics alike because they activate AMPK.
Here is another directly quote from the story about Dr. Barzilai:
“Problem is, it's hard to get independent investors, or even big pharmaceutical companies, excited about dirt-cheap drugs that are already available as generics or as relatively low-cost, extended-release tablets.
Researching potential anti-aging drugs that are already approved to treat other conditions has some clear benefits over other interventions. Unlike supplements, which are not approved by the US Food and Drug Administration, "the safety has been tested" on these drugs, and "the efficacy has been established" that they actually work to treat certain issues, Barzilai said.”
There it is! The answers exist now, but there is very little money to be made by promoting them. There is even more power in the link between chronic diseases and aging. “ These approaches seek to delay the onset and progression of multiple chronic conditions by targeting fundamental biological pathways of aging. This approach is more likely to improve overall health and function in old age than treating individual diseases, by addressing aging the largest and mostly ignored risk factor for the leading causes of morbidity in older adults.”
The diagram at the very beginning shows you how this all ties together. Look in the upper left corner at losartan. The ACE inhibitor lisinopril inhibits that same metabolism. You can also see on the diagram where Jardiance and metformin work. Even better, you can also see that statins and drugs like eplerenone also slow aging and delay chronic disease. Best of all, when you combine these inexpensive medications with diet and exercise we already have proof in humans of massive improvements in chronic disease treatement. We can already delay diabetic complications by eight years. We can prolong life in patients with diabetes by 8 years by applying the principles Dr. Barzilai advocates in the real world.
The Washington Post ran an article yesterday about a paper that disputes the heart benefits of intermittent fasting: https://www.washingtonpost.com/wellness/2024/03/18/intermittent-fasting-time-restricted-eating/
I trust your work in this area and hope a future article will address the article’s findings. Thanks for all you’re doing to inform us about the science in clear and understanding prose.
Drugs aren’t needed if people care for themselves in the right ways. We should be promoting
that if we want a healthier society!