by Patrick Cox
February 4, 2017
Nassim Nicholas Taleb’s 2006 book, The Black Swan: The Impact of the Highly Improbable, popularized the view that societies have trouble dealing with big changes. Most people tend to think that things will go on pretty much as they have been… until they don’t.
This isn’t a new concept. Nor is the solution… “expect the unexpected.” That adage was attributed to Heraclitus of Ephesus, who lived in the 5th century BC.
Heraclitus held that the central truth of life is change. Most people don’t understand that truth, he said, so societies struggle to adapt to new things.
That brings us to today. A lot of people seem to be having a hard time adapting to the Trump presidency. His election was clearly not expected by most public intellectuals. So it might be viewed as a black swan.
There are, in fact, even bigger changes afoot. And the elites are doing no better at seeing those either.
Two black swans
I want to focus on two of these big changes. One is the demographic transition caused by increased life spans and sub-replacement birth rates. Some call this the flipping of the demographic pyramid.
The failure to recognize this change has already had serious societal problems. It has put Social Security, Medicare, pension plans, and many government budgets on the track to ruin.
We could have planned for this explosion in the number of older people and the reduction in the work force that pays their bills. But we didn’t, and the consequences will be brutal.
(Heraclitus, by the way, was known as the “weeping” philosopher.)
The second big change is the accelerating progress in anti-aging biotechnologies. There are compounds in labs right now that could dramatically improve and extend human health by a decade or more.
Even more startling are the recent announcements by two respected scientific organizations, including the Salk Institute, that aging can be reversed. Though the Salk Institute scientists are talking about “reversing the signs of aging,” they’re really working on making people biologically younger.
If you have trouble dealing with that kind of change, you’re not alone. So let’s talk about a slightly less disruptive black swan: geroprotectors.
Health spans and rapamycin
The most studied geroprotector is rapamycin. It clearly extends health spans in various animals by about 15%. In humans, that would translate to one more decade of health.
Though rapamycin produces side effects in humans that resemble type-2 diabetes, some scientists are using it anyway. There’s evidence from doctors who use rapamycin to treat Lupus that the side effects can be minimized by cycling doses in humans.
For this reason, I’m hearing that some scientists have been using the drug. One scientist who admits it is Dr. Mikhail Blagosklonny. When asked about the risks, he says the risks of taking rapamycin are less than those associated with not taking it.
I’ve also heard (but can’t confirm) that some scientists are taking rapamycin in conjunction with the second most studied anti-aging candidate, metformin. It’s fascinating that metformin is the standard treatment for type-2 diabetes.
The FDA has given the go-ahead for human trials of metformin as an anti-aging compound. It’s highly unlikely though that the FDA would approve trials of rapamycin as an anti-aging drug due to its side effects.
The anti-aging benefits of rapalogs
I talked recently to Richard Marshak, the CEO of Mount Tam Biotechnologies. Mount Tam is developing, a slightly altered version of the rapamycin molecule (in collaboration with the prestigious Buck Institute for Research on Aging). Called a rapalog, it is being developed to treat a specific form of Lupus.
Mount Tam’s molecule was altered to reduce side effects while preserving the benefits. The patent application for 37R-hydroxynorbornylrapamycin (HNR) or Tam-01 clearly states that the drug candidate does what it was designed to do.
When I first met Marshak, he played down the possibility that Tam-01 might be developed as a geroprotector. This is a sound business strategy. Talk of anti-aging geroprotectors tends to scare off investors who want a clear path to drug approval for a known disease.
While that hasn’t changed, Marshak admits that he is surprised that President Trump may appoint a proponent of anti-aging biotechnologies to lead the FDA. Trump’s candidates all know that biogerontologists want rapalogs approved for anti-aging purposes. So if one of them takes over the FDA, we might see a moonshot program to quickly validate a safe rapalog for anti-aging purposes. Then, Mount Tam could offer its rapalog as a geroprotector without panicking investors.
I’m cautiously optimistic. I’m also happy about Trump’s pick for head of the OMB, Rep. Mick Mulvaney. Mulvaney is brutally honest about the impending failure of the transfer programs for the aged. As biogeronotologists and demographers have been pointing out for years, those failures could be prevented if we can provide American workers more years of health.
Still, it’s going to take several years even under the best of conditions before a rapalog comes to market. There are other remarkable geroprotectors in labs now, but I don’t know what their timetables are.
One reason for delay may stem from the fact that many effective anti-aging drugs also treat various age-related diseases. That means these compounds may generate greater profits in the short run by addressing diseases rather than aging. FDA action, though, could reduce the cost of regulatory approval for geroprotectors. This would make them more attractive to investors.
So what do we do until a truly effective geroprotector is available?
Keep calm and lift weights
For the past few months, I’ve meant to tell you about an important study in the Journal of the American Geriatrics Society. The title is “Mediation of Cognitive Function Improvements by Strength Gains After Resistance Training in Older Adults with Mild Cognitive Impairment: Outcomes of the Study of Mental and Resistance Training.”
The study states that the early memory and cognitive problems associated with age can be reversed by lifting progressively heavier things. So this brings me back to Nassim Nicholas Taleb and his Black Swan metaphor.
Taleb recently coined a term “Intellectual Yet Idiot.” It’s often shortened to the acronym IYI. In the essay linked here, Taleb notes:
What we have been seeing worldwide, from India to the UK to the US, is the rebellion against the inner circle of no-skin-in-the-game policymaking “clerks” and journalists-insiders, that class of paternalistic semi-intellectual experts with some Ivy League, Oxford-Cambridge, or similar label-driven education who are telling the rest of us 1) what to do, 2) what to eat, 3) how to speak, 4) how to think… and 5) who to vote for.
Taleb goes on to describe the traits of the “academico-bureaucrats who feel entitled to run our lives.” I recommend the whole article but wanted to call special attention to the final sign of the IYI. Taleb writes, “He doesn’t even deadlift.”
I find this quite funny but also profoundly useful advice. Strength training is one of the most effective of the anti-aging therapies that the FDA lets us use. If you don’t deadlift, you should probably look into it. And you should also understand that most doctors know very little about strength training or its benefits. (Keep in mind, there are risks in prescribing any activity that could entail injury.)
Having suffered a nearly lethal car accident in my youth, I had back problems for decades. During that time, I was told not to deadlift or squat by several doctors. Then I did my own research, and things changed. After learning how to deadlift and squat correctly, my back problems went away entirely within a few years. If you’re not familiar with the deadlift, here’s a short video featuring legendary coach Marc Rippetoe.
Fortunately, there’s a fantastic and recently published book on the subject that makes research on progressive strength training simple. It’s The Barbell Prescription: Strength Training for Life After 40.
The lead author is Dr. Jonathon M. Sullivan, an associate professor of emergency medicine at Wayne State University. An ex-Marine, Sullivan is a trauma physician at Detroit Receiving Hospital and the owner of a gym (where he coaches weightlifting).
Though the book is aimed at older lifters, I think it’s the best book written on strength training. While Sullivan discusses cellular biology and gene switches, he also gives practical advice about weightlifting. In fact, my teenage daughter is reading it and quoting lines to me.
My one complaint about the book is its physical size. I’m guessing that it’s oversized because older lifters’ eyes are (in theory) less than perfect. Nevertheless, the huge paperback edition is unwieldy. Others have told me the same thing, so you might want to wait for the Kindle version.
Regardless, Nassim Taleb wrote the introduction to the book. In it, he explains why his research into financial risk is germane to his decision to lift weights. My thinking on this is basically the same as his.