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Geroscience and the answers to ageing


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By Hazel Fulton on 30th January 2023

Scientists are pursuing the secrets to anti-aging with more determination – and more investment – than ever before. So how far away from longevity medicine are we?

When it comes to staying alive, humankind has made impressive progress since the turn of the last century. We are undoubtedly living longer – on average twice as long, in fact – and many scientists now believe our natural lifespan could be 125 years or more. But along with an increase in life expectancy we’ve experienced an equally sharp rise in disease, and the focus now is on healthy longevity: healthspan as well as lifespan.

To this end, the world’s richest are pumping billions into ‘geroscience’; a relatively new scientific field of research that looks at the hallmarks of biological aging and the connections between getting older and succumbing to disease. In just a couple of decades there have been some tantalising breakthroughs, and scientists have already succeeded in extending the lives of mice. As interest grows and the best scientific minds are lured away from academia and into tech-billionaire funded start-ups, translating that success across to humans seems not just possible, but likely.

Senolytic drugs are one such breakthrough – a discovery with the potential to be as game-changing as antibiotics. The theory behind them is simple: they target and remove old cells which have stopped dividing but haven’t died. Such cells build up in our bodies as we age, causing chronic inflammation and an ongoing immune response that can damage surrounding tissues. By eliminating them, senolytic drugs could prevent age-related problems like cancer and dementia before they occur, making medicine more proactive and less like a game of whack-a-mole. 

Another promising avenue of enquiry is the reprogramming of cells – a process already used to create stem cells out of adult tissue. By turning old cells young again,  scientists hope to fend off the problems associated with old age. Again, research on mice has shown that the science is there: experiments in rejuvenating liver tissue and reversing eyesight loss have been successful. Human trials are still to come, but it’s not a completely ridiculous notion that the world’s first 150-year-old human has already been born.

In the meantime, the world’s richest are throwing everything at the problem of aging in the hope that some of the methods might stick. The proven (if slightly boring) approaches are a given: eat well, take regular exercise, maintain a healthy weight, don’t smoke and don’t drink too much. But what else could you be doing while we wait for the scientists to produce a pill?

High-intensity exercise

As hunter-gatherers, our bodies were designed to be active into old age. Many of the chronic diseases we now face can be blamed on our increasingly sedentary lifestyles. So it follows that high intensity exercise might be the type of ‘good stress’ that slows – and even possibly reverses – age-related changes at a cellular level. Certainly, there’s evidence that it enhances insulin sensitivity more than continuous endurance training does, and it’s also been shown to delay the onset of neurodegenerative diseases like Parkinson’s and Alzheimer’s. 

Cold water submersion

Just as ice packs can reduce local inflammation and pain from an injury, it is thought that cold water therapy might reduce whole-body inflammation, boost the immune system and increase the body’s tolerance to stress and disease. Experiments have shown that fruit flies exposed to mild cold stress live longer. However, the operative word here is ‘mild’, because of course rapid or extreme cold exposure can kill. Studies in mice have shown both benefits and impediments to lifespan – clearly striking a balance is key. 

Reduced oxygen intake

Interest in oxygen restriction was piqued when a study by two Chinese researchers showed that Tibetans living at altitude – and therefore in a permanent state of hypoxia – tend to live longer than their low altitude counterparts. Indeed, cells do show a protective reaction to a drop in oxygen, and a reduced amount of the sorts of toxic proteins that build up over time and can be seen in the brain cells of people with conditions like Alzheimer’s. Could oxygen become the next dietary restriction?

Super supplementation

Among a host of (largely untested) supplements that claim to add years to your life, three stand out as warranting further study. The first is NMN, which slows the deterioration of cells by boosting levels of molecules called NAD+ that provide cells with energy. The second is Metformin, an established drug for diabetes which reduces glucose levels in the blood. Trials are currently looking at its potential as a longevity drug (and the herbal compound Berberine, which might work in the same way but with fewer side-effects). Lastly reservatrol – the chemical found in berries and red wine – is purported to prevent damage to cells caused by free-radicals, lower cholesterol and reduce inflammation. It works even better when there’s plenty of NAD+ available, so it’s often taken in conjunction with NMN.

Calorie restriction

Intentional fasting has become one of the most popular health trends in recent years and it’s not hard to see why: the benefits include better heart health, reduced inflammation, faster cell repair, improved blood sugar control and lower incidences of cancer. Put simply, fasting stops cells from growing and diving and puts them into survival mode, diverting energy to damage repair. Studies suggest that a strict low-calorie diet may slow ageing in primates. The question is, is it worth it?

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