Podcast: Can Biohacking Reverse the Aging Process?

Dr. Rehka Kumar: … These are proteins and supplements that are marketed to optimizers and biohackers as things that can help with anti-aging, longevity, and health span. A few of the marketed peptides include things like BPC-157, sermorelin, and NAD boosters, and a lot of these lack rigorous human trials, but we have patients asking about them. Influencers are talking about them on social media, so they’re definitely coming up in clinical practice. [upbeat music] 

Courtney Allison: Welcome to Health Matters, your bi-weekly dose of the latest in health and wellness from NewYork-Presbyterian. I’m Courtney Allison. This season on Health Matters, we’re covering your health from A to Z, asking our experts to break down the health topics and wellness trends we’re all curious about. 

Courtney Allison: To kick us off, we’re diving into a topic that’s universal: aging. We all want to live longer lives, but what are the keys to aging well? How do we improve our health span along with our lifespan? And can we biohack our system to reverse our biological age? This week, Dr. Rekha Kumar, an endocrinologist and primary care doctor with NewYork-Presbyterian and Weill Cornell Medicine, explains the foundational behaviors we should all adopt for good health as we age. She explains the things that we can optimize that helps our longevity, as well as the biohacks and supplements that we should probably avoid. [upbeat music] Thank you so much for joining us today, Dr. Kumar. It’s wonderful to have you on the show. 

Dr. Kumar: Thank you so much for having me back on the podcast. 

Courtney Allison: So today we’re going to be talking about aging well, specifically if it’s possible to reverse our biological age through what’s known as biohacking. How do you define biohacking in simple terms? 

Dr. Kumar: When I think about biohacking, I see it as a spectrum. At its core, biohacking is the intentional use of tools, data, or behaviors to influence our biology, with the goal of improving how we feel, how we function, or how we age. 

Courtney Allison: And so biohacking is often talked about in relation to health span and longevity. Could we break down those terms, and are these general goals of biohacking? 

Dr. Kumar: Yeah, so longevity is really the number of years that you live, and health span is the number of years that you live well or live healthy without chronic disease, and many people are using biohacking as a goal to extend their health span. 

Courtney Allison: And so for examples of biohacking, are these things like fitness trackers or intermittent fasting? What kind of examples do you think of, or what are patients asking you about? 

Dr. Kumar: Yeah, so there’s many different examples of biohacking. You can think about wearables like smartwatches, fitness trackers, continuous glucose monitors, and these are devices that will provide real-time feedback on sleep, heart rate, your blood sugar levels. And it’s important to understand that the biohack isn’t the device itself, but it’s how you use that data to change your behavior. And things like intermittent fasting, that’s actually a great example of a biohack. So for some people, intermittent fasting can improve insulin sensitivity and their metabolic health, but for some people, it can be counterproductive if they get obsessive over it or if they have a history of an eating disorder, and the intermittent fasting can backfire. 

Courtney Allison: So I guess it’s unique to each person. 

Dr. Kumar: And that’s the whole thing with biohacking and longevity. It’s really a branch of preventative medicine that takes advantage of personalized medicine and precision biomarkers to make medical decisions. So there’s a big aspect of biohacking and longevity care that is very individualized and linked to the concept of precision medicine or understanding your own biology. 

Courtney Allison: So what does the science tell us about all this? What does work? 

Dr. Kumar: So this is where I think the conversation is so interesting because what really works in terms of the foundational behaviors are the things that people talk about all the time: sleep, movement, nutrition, stress management, and the quality of our relationships. Biohacking, in that sense, really refers to the optimization and metrics of all of those, so tracking those, tweaking those, sometimes pushing our biology beyond its natural rhythms. 

Courtney Allison: Could you describe the longevity pyramid and how we should be thinking about our health and longevity? 

Dr. Kumar: Yeah, sure. So this has actually been described in the literature of longevity medicine, where the foundation of the pyramid is really all of those evidence-supported interventions that we know about that I just mentioned, and as you go up the pyramid, you get into the more cutting-edge tools that might measure biological age, that may help you predict your biological age, and at the way top of the pyramid is probably where you get into those experimental peptides and supplements. 

Courtney Allison: Yeah, speaking of peptides, you see a lot of discussion about them on social media… how do they relate to this conversation about biohacking? 

Dr. Kumar: Yeah, so there are some therapies in the longevity world that are, you know, proven to reduce the risk of disease, things like metformin and GLP-1 receptor agonists. But now there is starting to be this bifurcation in this field, where there’s what’s medically proven, like metformin and GLP-1s, and what is becoming very commercialized, and the peptides are falling under this category. And these are proteins and supplements that are marketed to optimizers and biohackers as things that can help with anti-aging, longevity, and health span. A few of the marketed peptides include things like BPC-157, sermorelin, and NAD boosters, and a lot of these lack rigorous human trials, but we have patients asking about them, influencers are talking about them on social media, so they’re definitely coming up in clinical practice. 

Courtney Allison: Maybe we’re all trying to be a little younger. Is there anything we can do to change that number? 

Dr. Kumar: Yeah, so the things that we know that can impact your biological age are all of those things at the bottom of the pyramid, and those don’t really seem like hacks because they take time, and they’re not shortcuts. So do we know that optimizing sleep will improve your biological age? Yes. Will increasing resistance training and strength training reduce your biological age? Yes. Cutting back on alcohol, managing your stress better, all of these things will help your biological age. But again, there’s so many influences that, say, a 50-year-old got their biological age down to 25, that doesn’t become their destiny because there are still so many other factors, such as genetics, environment. Um, you know, you could get your biological age down to 25, but it’s not your destiny. 

Courtney Allison: So I wonder, in your opinion, what is the difference between a biohack or just trying to live a healthy life? 

Dr. Kumar: That’s a great question. So the difference between a biohack and, uh, trying to live a healthy life probably comes down to framing and intensity. So living a healthy life focuses on the foundational behaviors that we’ve mentioned a few times, whereas biohacking often focuses on optimization and metrics, so that’s where really the tracking, the tweaking, and something pushing the biology beyond natural rhythms falls. So that’s where I would say as you move up the pyramid that I described, you go from living a healthy life to versions of biohacking as you add intensity and add measurements and metrics to this framework. 

Courtney Allison: Well, I remember when I was using a fitness watch more, and it was telling me kind of not great things about my sleep, and it did encourage me to improve my sleep hygiene. But then at a certain point, to your point, you get a little obsessive about it, and I just felt like I was failing every day, so I, I put the watch away and just tried to do my best. [chuckles]

Dr. Kumar: Yeah, and I mean, there is such thing as these things causing more stress, which is then completely counterproductive. When obtaining wellness becomes stressful, it’s no longer good for your longevity. 

Courtney Allison: Let’s dive into some other biohacks ’cause I feel like some of this almost sounds like science fiction. What are nootropics? Is it just a fancy word for supplements? 

Dr. Kumar: So nootropics, which are- 

Courtney Allison: Nootropics. [chuckles] 

Dr. Kumar: Nootropics, N-O-O-T-R-O-P-I-C-S, substances that are marketed to improve cognition, so these are things that could improve memory, focus, creativity, or even mental stamina. 

Courtney Allison: Are there any that you think are worthwhile? 

Dr. Kumar: I mean, we all engage in a nootropic every day. Caffeine is one. So caffeine can help you focus. It gives you energy. Another one we’re hearing a lot about is L-theanine, which is an amino acid, and it can be found in green tea, matcha, and the reason people like it is it creates what people will say is a calm focus, whereas straight-up caffeine might cause anxiety- 

Courtney Allison: Mm-hmm. 

Dr. Kumar: … and make you feel overstimulated. 

Courtney Allison: Another biohack I’ve heard about caffeine, and I wondered if it’s true or not, is that you should wait a few hours after you wake up before having your first cup of coffee because it lets you more naturally wake up. Have you heard that? Is that a myth? 

Dr. Kumar: There are some thoughts that by delaying your first caffeine consumption, that you can sync that stimulant effect with your natural cortisol or the natural rise in your stress hormone. It’s not really very practical for most people ’cause we have to start our days. We get up, we have our coffee. Like, for me, I start patients at 8:30. For me to say that 9:00 is my optimal coffee time would be quite difficult, even if perhaps it syncs with my rise in cortisol. So you really have to do what’s practical for you, and I have heard that, but I wouldn’t say that it’s scientifically proven to be a biohack or better for you. 

Courtney Allison: OK, appreciate that. So another term I’ve heard, and I hope I don’t pronounce this one wrong, is nutrigenomics? 

Dr. Kumar: You got it right. 

Courtney Allison: OK. [chuckles] And does that have something to do with optimizing how you eat with your genes? 

Dr. Kumar: Yes, so nutrigenomics looks at how genes interact with nutrients and how individual genetic differences may influence how we metabolize food. The science here is early but very promising. 

Courtney Allison; I remember anecdotally hearing a friend years ago talking about how she got a blood test, and now she and her husband were changing their diet, and I was intrigued. So could you talk a little bit about what that means and how someone might approach this? 

Dr. Kumar: Yeah, so some gene-diet interactions are well-established, but some commercial tests that exist out there may overstate what they can actually predict. So a really well-known gene-diet interaction is lactose intolerance. So if you test somebody’s genes and you learn that they don’t make a lot of the enzyme lactase, meaning that they don’t metabolize lactose or milk sugar well, the intervention is a reduced lactose or lactose-free diet, and that makes their guts feel better. So that is one of the well-known nutrigenomic examples… one that is becoming interesting is there is a version of the APOE gene that if you have a defect in it, your cholesterol may go up more when you consume saturated fat. So those are two examples that, uh, we can, like, really grasp, but there are also many areas of nutrigenomics that aren’t well-developed yet. So these commercial tests that you can buy off the internet and test all of your food tolerances or intolerances or genetic predispositions probably aren’t quite there yet, but I’d say that the lactose intolerance example is a really good long-term example of nutrigenomics. 

Courtney Allison: Is there any other promising science around this you’d want to speak to? 

Dr. Kumar: Yeah, I think that probably gut microbiome testing falls under this category of understanding our intestinal bacteria and whether the pattern of the bacteria we have in our guts may influence our risk of disease and whether we can alter this. There’s a species of bacteria called Akkermansia muciniphila that is associated with better metabolic health. So people that have a high species of this one bacteria have less diabetes, less obesity, and this is something that has been seen over and over again in metabolically healthy people. But then also in people who take medicines like metformin, like GLP-1s, the percentage of muciniphila in their guts goes up. So by altering your microbiome, perhaps this is biohacking, you’re taking a medicine that is impacting your microbiome in a way that changes the bacteria to look like the gut of somebody that is metabolically healthier, is an example of something that falls under this category. So then the question is, can you just take Akkermansia and change your gut? And I think that that’s where the science is developing. 

Courtney Allison: Well, and so between this bacteria and these things in the gut and lactose intolerance, how can people know more about their genes and genetic predispositions? Like, what are legitimate ways to know, and what’s probably bunk? 

Dr. Kumar: So there’s many legitimate ways to know. They just sometimes are not the most accessible. We can get our genome sequenced. We can learn the entire sequence of our DNA in our body. The question is, under what conditions? Is that covered by insurance? When are you just medically curious and wanting to pay for this? And once you have the answer of your entire genome sequenced, who do you go to to discuss what you find? Because what if you find a genetic abnormality with no known clinical significance? Are you going to be someone that’s going to worry your whole life or worry your whole family that you could develop an unknown disease? So we have to really understand what the consequences of getting an abnormal result, more likely getting a result of unknown significance… And great, if you get all normal results, that you have a completely normal genome, that’s great, but, you know, most likely people are gonna find abnormalities of unknown significance, and that’s true for microbiomics, uh, genomics. There is something now called metabolomics, which looks at metabolic biomarkers or proteomics, the proteins in your body. You can almost measure anything now. The question is, what are you gonna do with that information? [chuckles] 

Courtney Allison: Yeah, ’cause it sounds like some of that information can feel terrifying, and it always makes you wonder: how much is too much information? 

Dr. Kumar: I, I think we’re probably at the point where you can get more inner information than what you know what to do with clinically and what is actionable. 

Courtney Allison: Any other shortcuts to increasing one’s longevity or health span? 

Dr. Kumar: Shortcuts and biohacks kind of sound like they’re the same, but there are no true shortcuts. I don’t think you can take anything or supplement if you’re not getting the sleep, addressing your metabolic health, avoiding smoking, managing stress, avoiding social isolation, all of the things that negatively impact what we call cellular health. So these aren’t things that just, you know, make you unhealthy looking from the outside. These are things that actually hurt your cells and hurt your mitochondria, which are like the powerhouse of our cells. We want to keep our mitochondria healthy. We want to keep producing energy, so our brains and our muscles are functioning in a healthy way. And so in that sense, I’d say there are no true shortcuts. Once you’ve mastered the foundations, do you want to try to do even better and game that biological clock by trying the perfectly timed caffeine and L-theanine and metformin? I, I think that those are all options if you have a good clinician to guide you through this. 

Courtney Allison: So it seems like the takeaway is that these are all really long-term commitments and daily habits, behavior changes that people can make, not really shortcuts. 

Dr. Kumar: I think the key is, uh, that our biology has evolved for rhythms and circadian patterns, not for constant optimization. 

Courtney Allison: Dr. Kumar, thank you so much for joining us. It was such a pleasure speaking with you about biohacking longevity. I feel like I learned so much to implement. 

Dr. Kumar: This was such a fun conversation. Thank you for having me. [upbeat music] 

Courtney Allison: Our many thanks to Dr. Rekha Kumar. I’m Courtney Allison. To learn more about Dr. Kumar’s work with patients, check out the show notes. Join us next time on Health Matters when we discuss brain health and the short-term and long-term impacts of alcohol on the brain with Dr. Hugh Cahill. That’s in two weeks right here on Health Matters. Health Matters is a production of NewYork-Presbyterian. The views shared on this podcast solely reflect the expertise and experience of our guests. NewYork-Presbyterian is here to help you stay amazing at every stage of your life. To get the latest episodes of Health Matters, be sure to follow and subscribe on Apple Podcasts, Spotify, or wherever you get podcasts.