#310 - Can We Measure Aging Well Enough to Treat It? | Dr. Nir Barzilai & Mike Haney

Aging science has gotten much better at describing who appears to be aging faster or slower. What medicine still lacks is a reliable feedback loop: a way to tell whether something we do is actually changing the biology that drives age-related disease.

Dr. Nir Barzilai argues that solving that measurement problem could turn geroscience from an interesting field of research into something doctors can actually use: measure where you are, intervene, measure again, and learn what works.

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What We Cover:

What centenarians reveal about living longer and spending less time sick
Why changing one hallmark of aging can affect several others
How TAME was designed to test metformin as an anti-aging drug and to convince the FDA to treat aging itself as an endpoint—and why it failed to get off the ground
Why metformin, SGLT2 inhibitors, GLP-1 agonists, and some osteoporosis drugs are being studied as potential gerotherapeutics, or anti-aging drugs
How FAST is searching existing clinical trials for biomarkers that change when an intervention affects aging biology
Whether aging needs continuous monitoring or can be meaningfully tracked a few times a year

🎙️ About the Guest:

Dr. Nir Barzilai is the Ingeborg and Ira Leon Rennert Chair in Aging Research and a professor of medicine and genetics at Albert Einstein College of Medicine, where he directs the Institute for Geroscience.

📍What Dr. Nil Barzilai & Mike Haney discussed:

05:10 - Aging is a condition, not just a label
05:59 - Why aging is what drives disease
08:19 - Should we call aging a disease?
10:20 - Why the species may have a ceiling around 115
14:34 - Why changing one hallmark of aging changes the others
23:08 - Metformin was anti-aging before it was a diabetes drug
31:55 - Centenarians live longer and spend less time sick
40:12 - How TAME tried to make aging an FDA endpoint
48:17 - Metformin, SGLT2s, GLP-1s, and osteoporosis drugs as gerotherapeutics
52:26 - FAST: finding biomarkers that actually change with treatment
56:49 - Whether aging needs continuous monitoring, or a few checks a year
1:01:16 - Where behavior still fits once we have anti-aging drugs

🔗 Helpful Links:

Hallmarks of Aging: An Expanding Universe (Cell, 2023) Paper
Compression of Morbidity Is Observed Across Cohorts with Exceptional Longevity (JAGS, 2016) Paper
Metformin as a Tool to Target Aging (Cell Metabolism, 2016) Paper
Geroscience-Guided Repurposing of FDA-Approved Drugs to Target Aging (Aging Cell, 2022) Paper
Biomarkers of Aging for the Identification and Evaluation of Longevity Interventions (Cell, 2023) Paper
FAST: Finding Aging Biomarkers by Searching Existing Trials FAST Initiative
ARPA-H PROSPR / FAST award ARPA-H FAST project

Watch the conversation: https://youtu.be/HbeGjwCw6vk

Find us on YouTube: ⁠⁠⁠⁠⁠⁠⁠⁠https://youtube.com/levelshealth?sub_confirmation=1⁠⁠⁠⁠⁠⁠⁠

📲 Connect:

Connect with Dr. Nil Barzilai on X: https://x.com/NirBarzilaiMD

👋 Who we are:

Levels helps you understand your metabolic health with personalized data, expert guidance, and tools that connect your daily choices to measurable changes in your body. Our goal is to help you make better decisions about food, exercise, sleep, and long-term health.

Look for new shows every month on A Whole New Level, where we have in-depth conversations with thought leaders about metabolic health.

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