Last week, I was on a rather illustrious panel speaking on the topic of how to maximize one’s healthy lifespan — something we humans seem to have been interested in for millennia. Before one starts to think about what to do, one first must consider the timeline. Most medical research, with very few exceptions, is done on a 5- or maximum 7-year time horizon. But what happens if the timeline is 40 or 50 years? This is the discussion I had with a Stanford-trained physician next to me on that panel. Her personal horizon is 40 years, and it got me thinking.
If one has a slightly high LDL (bad) cholesterol level, and perhaps a small amount of calcium showing up in a CT scan of one’s heart, should one do anything? If one is looking at a 5-year horizon or even 10-year, there is one answer, but if we look many decades out, there is a very different outlook. This is fundamentally the difference between the disease model of medicine and the prevention model. For the disease model, there is not currently a problem and if the possibility of a problem in the next 5 or 10 years is small, then everything is fine. Do nothing. This is not how I, or the above mentioned doctor, look at things.
So far, the extraordinary Bryan Johnson from SuperAge podcast #131 excepted, there is an assumed decay arc that happens with age. That small but not insignificant amount of cholesterol in the blood may well be continuing to cause calcium to build up over the decades. After 40 years, those not-so-bad arteries could be a real problem. Note: The number one cause of death in America today is cardiovascular disease. My personal thoughts, and this is not a recommendation to anyone, is stop the issue before it becomes a disease needing treatment. My situation is informed by having spent a year in a hospital at age 49 which ended with having my spleen removed. Nothing focuses the mind like near death. I also have a bounty of top medical and science people I can call upon whenever I have a question. Often these questions are around how to be the best I can be; and if I do X, are there any downside risks or complications I need to be aware of. To all those who ask why I exercise as I do, focus on sleeping well, and make conscious choices about what I eat, this is why. This is just me being me and not a program for everyone but, being a slow achiever, I have a clear vision of how I want to be at 95. That’s my timeline. What is yours?
Onward and upward,
David
