Fundamental Shift in the Science of Aging

Preface to Cracking the Aging Code
by Josh Mitteldorf and Dorion Sagan

Flatiron Press, June 2016

During the twentieth century, medical technology took enormous strides toward the conquest of infectious disease and recovery from trauma. With hygiene and sanitation, then antibiotics in the 1930s and an ever-expanding arsenal of vaccines, many plagues of the past have been banished; tuberculosis, polio, syphilis, whooping cough, diphtheria, and cholera were once feared as a death sentence, and now they are footnotes in the mortality statistics. The diseases that remain are all associated with aging; diabetes, arthritis, and osteoporosis are growing, and the Big Three killers are cardiovascular disease, cancer, and Alzheimer's. Tens of billions of dollars have been spent on medical research over several de cades trying to conquer these diseases with the same approach that succeeded so well for infectious disease.

That approach has been to work with the body, to stimulate the body's growth and inborn strength, to buttress its natural defenses. Even the reductionist tradition of Western, allopathic medicine has been influenced by the philosophy of natural medicine, working with the body instead of attempting to overpower it with technology or drugs. But what the doctors do not yet realize is that they are working with a suicidal patient.

Suicide Genes

"Man overboard!"

You run to the railing and throw him a lifeline. If only you can get the buoy within his reach, you might pull him back to safety . . .

Good toss! The life preserver is right in front of him, but he is not taking it. Is he just too weak? Has he lost the will to live? You call to him. "Go away," he answers. "Leave me alone!" And now your understanding of his situation is changed.

He didn't fall off the boat--he flung himself into the sea. To save a man from drowning is one thing; to dissuade him from suicide will require a different approach. In the immediacy of the crisis, you might take advantage of his exhaustion, jump in the water, overpower him, and carry him forcibly to safety. But next week, he might make another attempt. To help this man, you will have to get to know him, learn what is important to him, understand why he wants to kill himself, and convince him to choose life.

Doctors today are trying to help a body that does not want to be helped. Efforts to restore the body's natural balance won't work, because as we age, the body's natural metabolism is bent on self-destruction. Attempts to bolster the body's natural defenses are doomed to failure because the natural defenses are slowly being shut down with age.

Progress can be made against the Big Three diseases, and aging itself can be abated, but a different approach is required. We must be willing not just to assist the body but to coax, cajole, and even fight with it when appropriate. We must learn more about hormones and the signaling language that regulates metabolism. We must whisper the word "youth" in the body's own native language of biochemistry, a language as yet still somewhat foreign to us. But this is the language in which the entire life plan is spelled out, from development in the womb to aging and death.

Selfish Genes

The central idea of this book is that aging is built into our bodies. Aging doesn't just happen but is regulated and controlled by our genes. Our self-destruction is scheduled as much as is our development in childhood or our sexual development at puberty. Growth, puberty, and aging all unfold on a schedule programmed into the regulatory segments of our DNA.