Chapter 1

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Chapter 2
Chapter 3

Chapter 1 You Can Live Long Enough to live Forever

"Do not go gentle into that good night, Old Age should burn and rave at close of day; Rage, rage against the dying of the light."—Dylan Thomas

“I don’t want to achieve immortality through my work. I want to achieve immortality through not dying.”—Woody Allen

ritten at the height of the Cold War, Isaac Asimov’s 1966 science-fiction thriller Fantastic Voyage shifted the public’s fascination from space travel to an even more fascinating journey—inside the human body. In the novel, scientists on “our side” as well as the unnamed “other side” have developed a miniaturization technology that promises victory for whoever can perfect it first. However, the technology has a fatal flaw: the miniaturization wears off quickly.

Professor Benes has figured out a breakthrough that overcomes this limitation, but before he has a chance to communicate his crucial insight, he falls into a coma, with a potentially fatal blood clot in his brain. Against a backdrop of international intrigue, our side sends in a submarine with a team of five people using the still time-limited miniaturization technology to travel inside Benes’s body and destroy the blood clot.

The team includes pilot Owens, who helms the submarine Proteus (now blood cell–size); Duvall, a brilliant neurosurgeon in charge of the medical mission; Peterson, the beautiful surgical assistant (played by Raquel Welch in the highly successful movie version); Michaels, a human-circulatory expert; and Grant, the mission leader from central intelligence. In the course of the drama, readers and moviegoers are treated to a genuinely fantastic voyage through the human body as the intrepid crew battles enormous white blood cells, insidious antibodies, annoying platelets, and a myriad of other threats as they struggle to achieve their goal before the miniaturization catastrophically wears off.

The metaphor of Fantastic Voyage fits our book on several levels. First, we hope to treat you, our readers, to a fantastic voyage through the human body. Our understanding of the complex processes underlying life, disease, and aging has progressed enormously since 1966. We now have an unprecedented ability to comprehend our biology at the level of the tiniest molecular structures. We also have the opportunity to vastly extend our longevity, improve our well-being, and expand our ability to experience the world around us.

Asimov’s fascination with miniaturization was prophetic. We are now in the early stages of a profound revolution in which we are indeed shrinking our technology down to the molecular level. We actually are developing blood cell–size submarines called nanobots (robots whose key features are measured in nanometers, or billionths of a meter) to be sent into the human body on vital health missions. Although we won’t literally be shrinking ourselves to ride inside these nanobots, as in Asimov’s imagined tale (at least not in the next several decades), we will be able to place ourselves in virtual-reality environments and see out of the eyes of these tiny robots. We will be able to control their movements as if we were inside, just as soldiers today remotely control intelligent weapons systems.

Immortality Is within Our Grasp

Do we have the knowledge and the tools today to live forever? If all science and technology development suddenly stopped, the answer would have to be no. We do have the means to dramatically slow disease and the aging process far more than most people realize, but we do not yet have all the techniques we need to indefinitely extend human life. However, it is clear that far from halting, the pace of scientific and technological discovery is accelerating.

According to models that Ray has created, our paradigm-shift rate—the rate of technical progress—is doubling every decade, and the capability (price performance, capacity, and speed) of specific information technologies is doubling every year.4 So the answer to our question is actually a definitive yes—the knowledge exists, if aggressively applied, for you to slow aging and disease processes to such a degree that you can be in good health and good spirits when the more radical life-extending and life-enhancing technologies become available over the next couple of decades.

Longevity expert and gerontologist Aubrey de Grey uses the metaphor of maintaining a house to explain this key concept. How long does a house last? The answer obviously depends on how well you take care of it. If you do nothing, the roof will spring a leak before long, water and the elements will invade, and eventually the house will disintegrate. But if you proactively take care of the structure, repair all damage, confront all dangers, and rebuild or renovate parts from time to time using new materials and technologies, the life of the house can essentially be extended without limit.

The same holds true for our bodies and brains. The only difference is that while we fully understand the methods underlying the maintenance of a house, we do not yet fully understand all of the biological principles of life. But with our rapidly increasing comprehension of the human genome, the proteins expressed by the genome (proteome), and the biochemical processes and pathways of our metabolism, we are quickly gaining that knowledge. We are beginning to understand aging, not as a single inexorable progression but as a group of related biological processes.

Strategies for reversing each of these aging progressions using different combinations of biotechnology techniques are emerging. Many scientists, including the authors of this book, believe that we will have the means to stop and even reverse aging within the next two decades. In the meantime, we can slow each aging process to a crawl using the methods outlined in this book.

In this way, the goal of extending longevity can be taken in three steps, or Bridges. This book is intended to serve as a guide to living long enough in good health and spirits—Bridge One—to take advantage of the full development of the biotechnology revolution—Bridge Two. This, in turn, will lead to the nanotechnology-AI (artificial intelligence) revolution—Bridge Three—which has the potential to allow us to live indefinitely.

This, then, is the premise of our book and the case we will make throughout: the knowledge of how to maintain our biological “house” and extend its longevity and vitality without limit is close at hand. We will tell you how to use the extensive knowledge that we do have today to remain healthy as the reverse engineering (decoding and understanding the principal methods) of our biology proceeds.

The 21st Century Is Worth Living to Experience

Most of our conceptions of human life in the 21st century will be turned on their head. Not the least of these is the expectation expressed in the adage about the inevitability of death and taxes. We’ll leave the issue of the future of taxes to another book,5 but belief in the inevitability of death and how this perspective will soon change is very much the primary theme of this book. As we succeed in understanding the genome and the proteome, many dramatic advances in treating disease and even reversing aging will emerge. The first two decades of the 21st century will be a golden era of biotechnology.

Many experts believe that within a decade we will be adding more than a year to human life expectancy every year. At that point, with each passing year, your remaining life expectancy will move further into the future. (Aubrey de Grey believes that we will successfully stop aging in mice—who share 99 percent of our genetic code—within 10 years, and that human therapies to halt and reverse aging will follow 5 to 10 years after that.) A small minority of older boomers will make it past this impending critical threshold. You can be among them. The authors of this book are of this generation and are intent on living through this threshold era in good health and spirits. Unfortunately, most of our fellow baby boomers remain oblivious to the hidden degenerative processes inside their bodies and will die unnecessarily young.

As interesting as the first two decades of this century are likely to be, subsequent decades should lead to even more dramatic changes. Ray has spent several decades studying and modeling technology trends and their impact on society. Perhaps his most profound observation is that the rate of change is itself accelerating. This means that the past is not a reliable guide to the future. The 20th century was not 100 years of progress at today’s rate but, rather, was equivalent to about 20 years, because we’ve been speeding up to current rates of change. And we’ll make another 20 years of progress at today’s rate, equivalent to that of the entire 20th century, in the next 14 years. And then we’ll do it again in just 7 years. Because of this exponential growth, the 21st century will equal 20,000 years of progress at today’s rate of progress—1,000 times greater than what we witnessed in the 20th century, which itself was no slouch for change.

The result will be profound changes in every facet of our lives, from our health and longevity to our economy and society, even our concepts of who we are and what it means to be human. Within a couple of decades we will have the knowledge to revitalize our health, expand our experiences—such as full-immersion virtual reality incorporating all of the senses, augmented reality, and enhanced human intelligence and capability—and expand our horizons.

As we peer even further into the 21st century, nanotechnology will enable us to rebuild and extend our bodies and brains and create virtually any product from mere information, resulting in remarkable gains in prosperity. We will develop means to vastly expand our physical and mental capabilities by directly interfacing our biological systems with human-created technology.

Although human ability to take command of the course of life and death is controversial, we believe that the ability to broaden our horizons is a unique and desirable attribute of our species. And we certainly believe that it is worth the effort to remain healthy and vital today to experience this remarkable century ahead.

A Decades-Long March to Health—or Disease

The leading causes of death—heart disease, cancer, stroke, respiratory disease, kidney disease, liver disease, and diabetes6—do not appear out of the blue. They are the end result of processes that are decades in the making. To help you understand how long-standing imbalances in the metabolic processes underlying life functions can lead to disease, we have developed Ray & Terry’s Longevity Program, which is laid out over the course of this book. (Our program is Bridge One, as mentioned above; Bridges Two and Three are detailed in chapter 2.) The advice we offer on how to keep your body optimally healthy—from what to put into it (“Food and Water,” chapter 4) to how to fine-tune it (“Stress and Balance,” chapter 23)—will enable you to determine your own specific health status and teach you how to take effective corrective action when necessary. Our program does require time and commitment to implement, but the rewards are considerable:

• Significant gains in how you feel, including the alleviation of various discomforts, improved gastrointestinal functioning, reversal of fatigue, improvements in sleep, enhanced mood, and attaining your optimal weight

• A greatly improved sense of well-being and increased levels of energy

• The comfort of knowing that you’re on a path toward long-term health while significantly reducing the risk of chronic diseases such as heart disease, stroke, type 2 diabetes, and cancer

Conventional medical care is geared toward dealing with long-term degenerative processes only after they erupt into advanced clinical disease, but by this time it is often too late. It’s like approaching a cliff but walking backward. You need to recognize that you’re getting closer to the edge and stop. Once you fall off, it’s difficult to do anything about it. This is what Fantastic Voyage is all about: to provide the knowledge and the specific steps to take, sooner rather than later, to extend your life, your vitality, and your well-being.

Who Is the Enemy?

It is wise to consider the process of reversing and overcoming the dangerous progression of disease as a war. As in any war, if the enemy is at the gates—or worse, inside the gates—it’s important to mobilize all the means of intelligence and weaponry that can be harnessed. That’s why we’ll advocate that key dangers be attacked on multiple fronts. For example, we’ll discuss 10 approaches that should be practiced concurrently for preventing heart disease, particularly for people with elevated risk factors.

But if fighting disease and extending longevity and vitality is a war, who is the enemy? At the top of the list we should put ourselves. Of course, health issues get our attention the moment clinical disease strikes, but most people fail to focus on prevention and health enhancement in a timely manner before the onset of overt symptoms. Unfortunately, the medical profession is oriented toward detecting and treating these conditions only after they reach the point of crisis (symptom-control medicine), so most people receive limited guidance on disease prevention from their health professionals. You should not wait for others to show you the path to healing; the only person who can take responsibility for your health is you.

Our second enemy is the disease process itself. Our bodies evolved when it was not beneficial to the survival of the species for people to live beyond their child-rearing years and compete for the tribe’s or community’s limited food and other resources. Only a century and a half ago, life expectancy was 37 years.7 If we want to remain vital for as long as possible, we cannot simply rely on the natural order that biological evolution has given us.

The third enemy is an increasingly vocal body of opinion that opposes extending human longevity on the basis that it supposedly violates the essence of human nature. Author Francis Fukuyama, for example, considers research that might extend human longevity beyond its current fourscore years to be immoral.8 Opposition to certain biological technologies such as stem cell research is delaying vital therapies for a wide range of diseases. We should note that we don’t consider these thinkers themselves to be our adversaries but, rather, their regressive ideas. The essence of the human species is to extend and expand our boundaries. Ultimately, such opposition will end up being mere stones in a torrent of innovation, with the continued flow of progress passing around these barriers. But even minor delays will result in the suffering and death of millions of people.

Public Health Recommendations Are Compromised at the Start

Many people believe that public health recommendations, such as the Department of Agriculture’s Food Pyramid, represent our best collective wisdom.9 People typically then go on to compromise (weaken) these recommendations further to meet their own priorities and circumstances without realizing that the recommendations come already pre-compromised. The result is ineffectual guidelines and a double compromising of health.

The recommendations for vitamins, for example, continue to be dominated by the RDA (recommended dietary allowance) system. But these address only minimal levels to avoid specific vitamin deficiencies and do not begin to reflect the levels required for optimal health.12 Dietary recommendations in general are severely watered down. For example, the nutrition guidelines for people with type 2 diabetes fail to recommend sharp reductions in carbohydrates,13 and the recommendations on fat consumption are the same as for the general public.14 The guidelines from the American Diabetes Association are completely ineffective, despite the fact that the condition, particularly in its early stages, can be largely controlled through nutrition. The same observations can be made regarding dietary recommendations for avoiding heart disease, the nation’s number one killer.15

When we discuss the ineffectual nature of public nutrition guidelines with some health professionals, they counter that their patients won’t even follow these weak recommendations, let alone stricter ones. Our counter to that is that people don’t follow the weak guidelines precisely because they don’t work. Actually, following stricter recommendations is easier in many ways.

Take, for example, carbohydrate consumption. Eating carbohydrates, particularly those with a high glycemic index (those that convert rapidly into sugar in the bloodstream), causes cravings for more carbohydrates. Attempting to “moderately” reduce consumption of carbohydrates turns out to be very difficult because a moderate reduction does nothing to fend off cravings. It’s like suggesting that smokers simply reduce the number of cigarettes they smoke each day. But sharply reducing carbohydrates, particularly high-glycemic-index ones, effectively eliminates cravings, like quitting smoking altogether. It is far more motivating to follow a program that has the potential to make a dramatic difference in your immediate and long-term well-being.

As another example of compromised recommendations, the public health guideline for folic acid supplementation is 400 micrograms (mcg) per day, which may be a reasonable general recommendation. However, for someone with elevated homocysteine levels—a major cause of cardiovascular disease—the recommendation remains 400 mcg per day, which is inadequate to reduce dangerous homocysteine levels. Folic acid supplementation of 2,500 mcg or more per day, however, is safe and effective in reducing homocysteine (as are other recommendations, which we will discuss).

16 The same situation holds for recommendations on “optimal” blood lipid (fat) levels. Public health guidelines state that total cholesterol should be below 200 milligrams per deciliter and that the ratio of total cholesterol to HDL cholesterol should be under 4.6. But even people who achieve such “optimal” levels suffer heart attacks.

How often does a person who consistently maintains a truly desirable lipid profile suffer a heart attack? The answer is almost never. But are such levels really achievable by most people? The answer is yes, they are. So why not set these as the targets?

Our philosophy is to provide optimal recommendations based on the latest research. A great deal is known about ways to modify the long-term destructive health trends that result in the vast majority of deaths and chronic diseases. We’ll offer our best knowledge of effective measures, and you can decide for yourself what changes you are willing to make.

Dynamic versus Static Testing

Another unique aspect of our program is the extensive use of dynamic rather than static testing for early detection of abnormalities whenever possible. Dynamic tests measure the body’s response to changing, or “stressful,” physiologic conditions, while static tests simply provide measurements under baseline (resting) conditions. The exercise stress test, typically done on a treadmill to evaluate cardiac function, is an example of a common dynamic test. In an exercise test, the electrocardiogram (ECG) tracing is monitored both at rest and under conditions of increased workload. Many more patients with early cardiac disease can be detected by an exercise test than by a resting (static) ECG alone.

Another common dynamic test performed by conventional physicians is the glucose tolerance test for the diagnosis of diabetes, which is more sensitive than the static fasting blood sugar test. Yet, as we will see in chapter 9, “The Problem with Sugar (and Insulin),” the standard glucose tolerance test measures only blood sugar levels in response to a dietary sugar challenge (ingestion), so it still misses many early cases of diabetes. By also measuring insulin levels, using the glucose-insulin tolerance test we recommend, many additional cases of diabetes and sugar intolerance can be diagnosed. If we go a step further and add a simple insulin challenge test—a test performed by only a handful of physicians around the country—it is possible to detect numerous cases of insulin resistance, one of the most dangerous risk factors for a host of chronic diseases suffered by a significant segment of the population.

In chapter 13, “Methylation—Critically Important to Your Health,” we discuss abnormal homocysteine metabolism, a risk factor for heart disease, stroke, and Alzheimer’s disease that is carried by more than one-third of the adult population. Yet many cardiologists still don’t perform even the static test on their patients to determine risk levels, and most large U.S. cities don’t have a single cardiologist outside of a teaching hospital who performs the dynamic and far more accurate, yet inexpensive, homocysteine stress test that we recommend.

Early detection of risk factors is a hallmark of our program. By performing dynamic stress tests when appropriate, you can substantially increase the effectiveness of your screening processes.

The Pillars of Our Longevity Program

We’ve organized Ray & Terry’s Longevity Program around the activities and primary physical and metabolic processes that lead to either disease or sustained health. Our program combines the best of both conventional and alternative medicine. Many people have the view that conventional medicine is scientific, whereas alternative medicine reflects unverified folk traditions. The reality is that there are many conventional medicine practices that have not been scientifically verified, while there are many “alternative” practices supported by impressive research and verification.

Alternative medicine is not a single integrated methodology. Rather, it consists of a broad array of ideas that fall outside of conventional medical practice. Indeed, many of these ideas are not well grounded in science or in practical results. We’ve drawn our ideas from the best of conventional medicine, alternative medicine practices with convincing research on safety and efficacy, and cutting-edge developments in biotechnology and nanotechnology.

Partnering with Your Health Professional

It would be difficult to follow a program of this comprehensive nature without a personal guide. Our philosophy has been to draw upon the best from both conventional medicine and alternative schools of thought in an unbiased fashion. So to follow the ideas in our program, you will need access to both worlds.

Your personal physician is trained to deal with diagnosing and treating catastrophic illness, but most physicians are not well prepared to provide guidance in the type of aggressive illness prevention that we address in this book. Unfortunately, disease prevention is not a major focus of mainstream medicine. Moreover, the critical issue of nutrition receives almost no attention in our nation’s medical schools. An ideal approach is to find a physician who combines the best of multiple traditions.

More and more physicians have seen the limitations of practicing orthodox conventional medicine. They have begun to transcend the deep conditioning from their years of medical training, and they (and even more so their patients) have started to experience the joy that comes from thinking outside the box. Many such physicians have joined professional associations that serve as resources to train physicians in cutting-edge nutritionally based medical therapies, offering formal education and examinations to ensure competency. (For a list of certified practitioners and physicians in your area, see Even within the field of nutrition, we are dismayed by how many dietitians—people in the field of nutrition—rigidly follow the highly compromised public health recommendations.

The Most Important Principle: Continual Exploration

The knowledge represented here is inherently dynamic. This is not a fixed program that one simply adopts. The most important principle of the program is continual active exploration of new knowledge from multiple sources:

• Newly available diagnosis and treatment options resulting from the emerging biotechnology revolution

• New insights into natural therapies

• Your own growing personal knowledge of available health information

• New personal knowledge about your own condition

• We plan to update the information in this book on our Web site (see and through future editions of this book. A list of resources also appears on the site.

Most health books offer just one or two new ideas. Ours is different in that it provides dozens that are incorporated into a single integrated program. Based on our research, we believe that the recommendations in Fantastic Voyage will enable you to dramatically reduce your risk of disease in the future while quickly boosting your well-being in the present. Our core idea is that we now have the knowledge to determine where each of us is located in the progression of these decades-long degenerative processes and reverse them.

The support for this concept is rooted in decades of investigation and years of collaboration. Many of the simpler ideas presented in other contemporary health books are valid, but there is no single silver bullet that can address all of the key issues, given the complexity of our bodies and brains. Typically, other health books present one or two ideas combined with a lot of preaching. Instead, we provide a high density of ideas on how to harness contemporary longevity knowledge to transform your health.

Ideas have immense power to transform reality, but only if they are put into practice. There are two ways to use this book:

• Select ideas you find appealing and add them to your personal health program. We expect this is how many readers will benefit from this book.

• Follow all of the recommendations of Ray & Terry’s Longevity Program, which we designed as an integrated and comprehensive approach to nutrition, lifestyle changes, and cutting-edge medical therapeutics.

Health is not simply the absence of diagnosed disease; it’s a path toward ever-greater physical, emotional, and spiritual well-being. There is always the potential to improve your personal health.

Go to Chapter 2

Fantastic Voyage: Live Long Enough to Live Forever by Ray Kurzweil and Terry Grossman M.D. Rodale: 11/2004 ISBN#1-57954-954-3