I don’t normally consider myself a film critic but when Netflix recently added the new feature-length documentary on longevity entrepreneur Bryan Johnson, Don’t Die: The Man Who Wants to Live Forever, I figured this was as good a time as any to weigh in on the Johnson phenomenon.
Johnson, a former tech entrepreneur, has, in the space of a few years, turned himself into what his medical advisor, Oliver Zolman, describes as “the best guinea pig anyone could ask for.” Don’t Die takes us through Johnson’s daily routine: up at 4:30 a.m., then treatments like red light therapy and vagal nerve stimulation, then a multitude of supplements and drugs that will total about a hundred pills by day’s end, then a nutrient-dense vegan meal, then a hard-core work-out, then taking care of his online longevity products business, then a final vegan meal before 11 a.m., then in bed at 8:30 p.m., to be restored by 8 ½ hours of sleep.
And then there are the adjunctive therapies that have garnered almost as much attention as his regimented routine, like the blood plasma transfusions he’s received from his teenage son, and later provided for his father, a man in his 70s. The online showcase of this extreme longevity quest has proven irresistible to a legion of newly minted young fans, stirring up a legion of haters in the process.
So, by now, you may be wondering, am I a Bryan enthusiast or naysayer?
My take is somewhere in between. I endorse the basic message Johnson drives home in the film -- with some significant lifestyle changes, especially with regard to exercise and diet, you may fundamentally alter your trajectory of aging, slow it down, if you will. Exhibit A is, of course, Johnson who, by his own admission, was a physical and mental wreck before he embraced longevity as a kind of religion. (If young people are turned on by his message, so much the better; the changes they make, earlier in life, will have the biggest impact.) There are also many things to like about his specific protocols, including the longevity mix – a cocktail of geroprotectors, many of which I’ve covered in previous blog posts.
What you might not get from some of his more glib critics is that Johnson is not just swallowing a huge number of pills every day. The supplements, and a handful of off-label prescription drugs, are in the service of a “biomarkers of aging” approach to longevity that was, and still is, the basis for my Raffaele Medical practice. The premise is that by regularly, precisely measuring the function of each of our different organ systems, we can A) identify problem areas, where the body is, in a sense aging faster than we’d like and B) measure changes in function in response to any lifestyle or supplement/drug intervention, and then adjust the protocol according to the results. True to form, Johnson may have taken this to an extreme, but there’s nothing scattershot or random about it. His biomarkers are excellent.
The drawback is, they may only apply to him. (Consumers of Johnson’s Blueprint supplement packages will have to get their own testing done if they really want to know how and where the supplements are helping them.) Whereas in my practice, we can get a sense of the impact of what we do at a group level, i.e., my pool of patients, and contribute data to the research literature, enhancing the field’s understanding of, for instance, the supplement TA-65 and the SapereX diagnostic test for cellular senescence and autophagy.
I should also add that Johnson’s pronouncement that he’s “reversed” his aging by 5.1 years "could use a little more context than the film provides. The number is derived from a single, albeit well validated, epigenetic test, which by itself can’t give you the whole story or describe how each of his organ systems is aging. And this one biomarker of aging is unlikely to closely agree with the growing number of other biological clocks, which he would do well to measure if he isn't already. I’ve covered some of these clocks in a previous blog post.
All that said, Johnson’s “n of 1” approach is admirable, even if not sustainable for the average, or even above average, longevity seeker. In fact, my practice is composed entirely of patients following this personalized longevity medicine model. In my next blog post, I’ll lay out the testing stack used at Raffaele Medical and how I leverage PhysioAge practice analytics to gain deeper insights into the effects of various treatments on my patients as a whole.
Don’t Die: The Man Who Wants to Live Forever
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