Live Long Enough to Live
by Ray Kurzweil
and Terry Grossman M.D.
Can Live Long Enough to live Forever
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
don’t want to achieve immortality through my work. I want
to achieve immortality through not dying.”—Woody Allen
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.
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.
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.
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
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.
Is within Our Grasp
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.
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.
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.
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.
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.
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
21st Century Is Worth Living to Experience
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
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.
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
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.
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.
Decades-Long March to Health—or Disease
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
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
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
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.
Is the Enemy?
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
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.
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.
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.
Health Recommendations Are Compromised at the Start
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.
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
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
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
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).
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.
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?
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.
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)
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.
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.
Pillars of Our Longevity Program
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
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.
with Your Health Professional
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.
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
Fantastic-Voyage.net.) 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
Most Important Principle: Continual Exploration
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 Fantastic-Voyage.net) and through future editions of this
book. A list of resources also appears on the site.
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
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.
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
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.
Bridges to Come
expectancy will be in the region of 5,000 years . . . by the year
—Aubrey de Grey
systems are remarkable in their cleverness. In the 15th century,
Leonardo da Vinci wrote, “Human ingenuity may make various
inventions, but it will never devise any inventions more beautiful,
nor more simple, nor more to the purpose than nature does; because
in her inventions nothing is wanting and nothing is superfluous.”
We share da Vinci’s sense of awe at the designs of biology,
but we do not agree with him on our inability to improve on nature.
Da Vinci was not aware of nanotechnology, and it turns out that
nature, for all its apparent creativity, is dramatically suboptimal.
For example, the neuronal connections in our brains compute at
only 200 transactions per second, which is millions of times slower
than today’s electronic circuits.
the elegant way our red blood cells carry oxygen in our bloodstream
and deliver it to our tissues, it is still a slow and cumbersome
system, and robotic replacements (respirocytes) already on the
drawing board will be thousands of times more efficient than red
blood cells. The reality is that biology will never be able to
match what we will be capable of engineering once we fully understand
biology’s principles of operation.
major component of the coming revolution is molecular nanotechnology,
which will ultimately enable us to redesign and rebuild, molecule
by molecule, our bodies and brains.1 The timing of these two revolutions—biotechnology
and nanotechnology—is overlapping, but the biotechnology
revolution is leading the full realization of nanotechnology by
a decade or two. That’s why we describe these as the second
and third bridges, respectively, to radical life extension. Most
of the material in this book is Bridge One material—ways
to take maximum advantage of the most advanced diagnostic testing
and preventive strategies currently available so you can get to
Bridges Two and Three.
Bridge to a Bridge to a Bridge
book describes three bridges.
The First Bridge—Ray & Terry’s Longevity Program—consists
of present-day therapies and guidance that will enable you to
remain healthy long enough to take full advantage of the construction
of the Second Bridge.
The Second Bridge is the biotechnology revolution. As we learn
the genetic and protein codes of our biology, we are gaining the
means of turning off disease and aging while we turn on our full
human potential. This Second Bridge, in turn, will lead to the
The Third Bridge is the nanotechnology-AI (artificial intelligence)
revolution. This revolution will enable us to rebuild our bodies
and brains at the molecular level.2
emerging transformations in technology will usher in powerful
new tools to expand your health and human powers. Eventually,
the knowledge represented in this book will be automated within
you. Today, however, you have to apply that knowledge yourself.
We will talk about each of these three bridges as they relate
to the topics under discussion. In each chapter, we will begin
with Bridge One strategies that you can apply starting today.
Where relevant, we will include a tantalizing look at what Bridges
Two and Three have to offer in the near future.
we learn how information is transformed in biological processes,
many strategies are emerging for overcoming disease and aging
processes. We’ll review some of the more promising approaches
here, and then discuss further examples in the chapters ahead.
One powerful approach is to start with biology’s information
backbone: the genome. With gene technologies, we’re now
on the verge of being able to control how genes express themselves.
Ultimately, we will actually be able to change the genes themselves.
are already deploying gene technologies in other species. Using
a method called recombinant technology, which is being used commercially
to provide many new pharmaceutical drugs, the genes of organisms
ranging from bacteria to farmyard animals are being modified to
produce the proteins we need to combat human diseases.
important line of attack is to regrow our cells, tissues, and
even whole organs, and introduce them into our bodies without
surgery. One major benefit of this therapeutic cloning technique
is that we will be able to create these new tissues and organs
from versions of our cells that have also been made younger—the
emerging field of rejuvenation medicine.
we are learning about the information processes underlying biology,
we are devising ways of mastering them to overcome disease and
aging and extend human potential. Drug discovery was once a matter
of finding substances that produced some beneficial effect without
excessive side effects. This process was similar to early humans’
tool discovery, which was limited to simply finding rocks and
natural implements that could be used for helpful purposes. Now
that we can design drugs to carry out precise missions at the
molecular level, we are in a position to overcome age-old afflictions.
The scope and scale of these efforts is vast; the examples in
this book are only a small sampling of the most promising ideas.
We’ll provide additional compelling examples in the chapters
Just Designer Babies, but Designer Baby Boomers
technologies will comprise three stages: (1) influencing the metabolic
expression of genes, (2) blocking or modifying gene expression,
and (3) somatic gene therapy. Let’s discuss how these imminent
technologies might impact your personal voyage into the future.
the metabolic expression of genes. Science does not yet have the
ability to change your genes (although this is starting to work),
but by knowing what genes you have, you can make appropriate lifestyle
choices and engage in preventive strategies to influence their
impact. As we’ll discuss in chapter 11, you already have
the tools to read a portion of your personal genetic makeup and
use this information to guide your lifestyle, nutritional, and
supplement choices. You can use this information to design an
individualized protocol to avoid diseases and progressive degenerative
conditions for which you are genetically predisposed.
Blocking or modifying gene expression. Although we do not yet
have the means to alter genes themselves, we are beginning to
be able to alter their expression. Gene expression is the process
by which your genetic blueprint is read and its instructions are
implemented. Every cell in your body has a full set of all your
genes. But a specific cell, such as a skin cell or a pancreatic
islet cell, gets its characteristics from only a small fraction
of all the genetic material it carries—the portion of genetic
information relevant to that particular type of cell.3 Since it
is possible to control this process outside the cell nucleus,
it’s easier to implement these genetic blocking strategies
than therapies that require access to the inside of the nucleus.
expression is controlled by peptides, molecules made up of sequences
of amino acids and short RNA strands. Scientists are just beginning
to learn how these processes work.4 Many new therapies now in
development and testing are based on manipulating this gene expression
process to either turn off the expression of disease-causing genes
or turn on desirable genes that may otherwise not be expressed
in a particular type of cell.
evolving therapies for blocking or modifying gene expression are
antisense therapy and RNA interference. The target of this therapy
is the messenger RNA (mRNA), which is transcribed (copied) from
DNA and then translated into proteins. For damaged or mutated
genes, researchers are exploring ways to block the mRNA created
by these genes so that they are unable to make undesired proteins.
The repair process uses mirror-image sequences of RNA, called
antisense RNA. These sequences stick to the abnormal protein-encoding
RNA, preventing it from being expressed.5
the RNAi (RNA interference) approach, researchers construct short
double-stranded RNA segments containing both the “sense”
and “antisense” strands. These match and lock on to
portions of the RNA that are transcribed from mutated genes. This
blocks the native RNA segment’s ability to create proteins,
effectively silencing the defective gene. In recent tests, using
both RNA strands in this way has been dramatically more effective
than using just the antisense strand. In many genetic diseases,
only one copy of a given gene is defective. Because you get two
copies of each gene, one from each parent, this approach leaves
one healthy gene to make the necessary protein.6
gene therapy. This is the holy grail of bioengineering. This third
stage will effectively change the genes inside the nucleus by
“infecting” the nucleus with new DNA, essentially
creating new genes.7 The concept of changing the genetic makeup
of humans is often associated with the idea of “designer
babies.” But the real promise of gene therapy is to actually
change our adult genes.8 These new genes can be designed to either
block undesirable disease-producing genes or introduce new ones
that slow down and reverse aging processes.
studies began in the 1970s and 1980s, and now a range of “transgenic”
animals, including cattle, chickens, rabbits, and sea urchins,
has been successfully produced. The year 1990 marked the first
attempts at human gene therapy. The challenge remains to transfer
therapeutic DNA into target cells so that the DNA will then be
expressed in the right amounts and at the right time.
look first at how transfer of new genetic material occurs. A virus
is often the vehicle of choice. Long ago, viruses developed the
ability to deliver their genetic material to human cells, often
resulting in disease. Researchers now simply remove the virus’s
harmful genes and insert therapeutic genes instead, so the virus
then “infects” human cells with these beneficial genes.
This approach is relatively straightforward, but viral genes are
often too large to pass into many types of cells, such as brain
cells. Other limitations of this process include the length of
DNA that can be transferred. The precise location where the new
viral DNA is integrated into the target cell’s DNA sequence
has also been difficult to control. In addition, such “infections”
can trigger an immune response, resulting in rejection of the
new genetic material.9
deaths of two participants in gene therapy trials a few years
ago caused a temporary setback, although research has since resumed.
One patient died from an immune response to the virus vector.
The second patient, suffering from “bubble boy” disease—essentially,
he was born without an immune system—developed leukemia,
which was triggered by the improper placement of the gene transferred
into his cells.10 This second death points to two major hurdles
that must be crossed for gene therapy to succeed: how to properly
position the new genetic material on the patient’s DNA strands
and how to monitor the gene’s expression. One possible solution
is to deliver an imaging “reporter” gene along with
the therapeutic gene. The reporter gene provides image signals
that allow the gene therapy to be closely monitored. The process
is permitted to proceed only if the placement of the new gene
is verified as correct.11
injection (microinjection) of DNA into cells is possible but prohibitively
expensive. Exciting advances have recently been made in other
means of transfer. For example, fatty spheres with a watery core,
called liposomes, can be used as a molecular Trojan horse to deliver
genes to brain cells. This opens the door to treatment of disorders
such as Parkinson’s disease and epilepsy.13 Electric pulses
can also be used to deliver a range of molecules, including drug
proteins, RNA, and DNA, to cells.14
option is to pack DNA into ultratiny (25-nanometer) nanoballs
for maximum impact.15 This approach is already being tested on
human patients with cystic fibrosis. Researchers reported a “6,000-fold
increase in the expression of a gene packaged this way, compared
with unpackaged DNA in liposomes.”
another approach uses DNA combined with microscopic bubbles. Ultrasonic
waves are used to compress the bubbles, enabling them to pass
through cell membranes.
Technology: Betting the Family Pharm
are already using gene therapy in other species. By modifying
the genes of bacteria, plants, and animals, we can cause them
to create the substances we need to combat human diseases. Recombinant
proteins made by combining DNA from more than one organism are
now being manufactured by bacteria, a novel biotech appropriately
referred to as pharming. In recombinant technology, the genetic
material that codes for a desired protein is spliced into the
DNA of certain species of bacteria, which then go to work making
this protein. Given how fast bacteria multiply, it’s easy
to create significant amounts of proteins this way. Insulin was
the first molecule to be created synthetically by recombinant
technology, so that insulin-dependent diabetics are no longer
reliant on injections of beef or pork insulin. Many diabetics
developed allergic reactions or high levels of antibodies against
the foreign proteins found in the beef- and pork-derived insulin
preparations. With recombinant human insulin, this is no longer
Children with growth hormone deficiency (dwarfs) used to rely
on injections of hGH (human growth hormone) derived from the pituitary
glands of human cadavers. It took a lot of cadavers to provide
enough hGH for just one child for a year. There was also the risk
of certain infections. Recombinant hGH has solved this problem
and substantially lowered the price of this therapy. It has enabled
adults with growth hormone deficiency to be treated as well.
from proteins have also been spliced into “immortalized”
human kidney cells and are now being pharmed to create proteins
found useful in treating patients who have suffered strokes, as
well as numerous other illnesses.16 Patients with chronic kidney
disease are deficient in a protein made by the kidneys called
erythropoietin. Without erythropoietin, severe anemia results
and frequent transfusions are needed. By inserting the genes that
code for this protein into hamster cells, drug companies have
been able to create enough erythropoietin to avoid the need for
transfusion for many dialysis patients.
methods involving traditional farm animals are also being found.
Cows produce large amounts of milk, so splicing DNA into the genes
that code for milk is a valuable technique. The DNA that codes
for egg protein is now being used so that the eggs of transgenic
(containing a gene or genes artificially inserted from a different
species) chickens will contain useful proteins. In the near future
we will have pharms where the animals have had their genes altered
so that their milk, eggs, or even semen will produce recombinant
proteins to help treat currently untreatable or only partially
treatable conditions, such as multiple sclerosis, Parkinson’s
disease, Alzheimer’s disease, hepatitis C, and AIDS.
won’t be restricted to using animals. Plants, particularly
types with high protein content such as corn or tobacco, can be
reprogrammed to produce substances of great value. In Japan, for
instance, a strain of genetically modified rice contains a protein
that will kill the hepatitis B virus.
of the most powerful methods of applying life’s own machinery
to improve and extend life involves harnessing biology’s
reproductive mechanisms in the form of cloning. Cloning is an
extremely important technology, not for cloning complete humans
but for life extension purposes. Therapeutic cloning creates new
tissues to replace defective tissues or organs.
responsible ethicists, including these authors, consider human
cloning at the present time to be unethical, yet our reasons have
little to do with the slippery (slope) issues of manipulating
human life. Rather, the technology today simply does not yet work
reliably. The current technique involves fusing a cell nucleus
from a donor to a recipient egg cell using an electric spark and
causes a high level of genetic errors.17
is the primary reason most of the fetuses created in this way
so far have not made it to term. Even those that do survive have
genetic defects. Dolly the Sheep developed an obesity problem
in adulthood, and most of the cloned animals produced thus far
have had unpredictable health problems. Scientists have a number
of ideas for perfecting this process, including using alternative
ways of fusing the nucleus and egg cell without the destructive
electrical spark. Until the technology is demonstrably safe, however,
it would be unethical to create a human life with such a high
likelihood of severe health problems.
the most valuable applications of cloning technology are not for
the purpose of cloning entire human beings but to create human
organs, such as hearts or kidneys. This uses germ line cells—those
in the prefetal stage (before implantation of a fetus). These
germ line cells go through differentiation, which can then be
developed into specific organs. Because differentiation takes
place during the prefetal stage, most ethicists believe that this
process does not raise ethical concerns, although this issue has
been highly contentious.18
team of researchers led by Woo Suk Hwang and Shin Yong Moon of
Seoul National University in South Korea has taken an important
step forward toward perfecting this technology. In an article
published in Science, they announced they had successfully cloned
a line of human pluripotent stem cells, the type that has the
potential to turn into any type of cell the body needs. Their
cell line had already undergone 70 reproductions without incident.19
This research paves the way for significant gains in the production
of healthy human-replacement tissues and organs derived from a
cloned stem cell line.
programmed cell death. Therapeutic cloning relates to telomeres,
which are strings of a repeating code at the end of each DNA strand.
These repeating codes are like a string of beads, in which one
“bead” falls off each time a cell divides. This places
a limit on the number of times a cell can replicate—the
so-called Hayflick limit. Once these DNA beads run out, a cell
is programmed for death. Recently, it was discovered that a single
enzyme called telomerase can extend the length of the telomere
beads, thereby overcoming the Hayflick limit. Germ line cells
create telomerase and are immortal. Cancer cells also produce
telomerase, which allows them to replicate indefinitely. The identification
of this single enzyme creates important opportunities to manipulate
this process to either extend the longevity of healthy cells or
terminate the longevity of pathological cells, such as cancer.
is interesting to reflect on the remarkable stability of the immortal
germ line cells, which link all cell-based life on Earth. The
germ line cells avoid destruction through the telomerase enzyme,
which rebuilds the telomere chain after each cell division. This
single enzyme makes the germ line cells immortal, and indeed these
cells have survived from the beginning of life on Earth billions
of years ago. This insight opens up the possibility of future
gene therapies that would return cells to their youthful, telomerase-extended
state. Animal experiments have shown telomerase to be relatively
benign, although some experiments have resulted in increased cancer
are also challenges in transferring telomerase into cell nuclei,
although the gene therapy technology required is making solid
progress. Scientists such as Michael West, president and CEO of
Advanced Cell Technology Inc., have expressed confidence that
new techniques will provide the ability to transfer telomerase
into cell nuclei and overcome the cancer issue. Telomerase gene
therapy holds the promise of indefinitely rejuvenating human somatic
(non–germ line) cells—that is, all human cells.
in growing new tissues and organs from stem cells is developing
rapidly. Robert Langer’s team at MIT has grown primitive
versions of human organs such as liver, cartilage, and neural
tissues. Their technique involves growing cells on specially designed
biodegradable polymer scaffolds, which are spongelike structures
with the approximate shape of the desired organ. Langer and his
team wrote, “Here we show for the first time that polymer
scaffolds . . . promoted proliferation, differentiation and organization
of human embryonic stem cells into 3D structures.”
One of the challenges in growing new human organs in this way
is creating a functioning system of new blood vessels. Researchers
at MIT and Harvard Medical School have constructed a working synthetic
vascular system using two computer-etched biodegradable polymers
sandwiched together to create capillaries only 10 microns (millionths
of a meter) wide, as well as arteries and veins up to 300 times
exciting approach that bypasses the ethical controversy of using
fetal tissue, while also providing a substantial source of stem
cells, which are currently limited in quantity, is parthogenesis,
or so-called virgin birth. Adding certain chemicals to unfertilized
human egg cells can turn them into embryos, which might then act
as a source of new stem cells.21 These embryos, called parthenotes,
can never become babies, so there should not be an ethical issue
in destroying tissue that is destined for destruction anyway.
Another intriguing idea is for a woman to create parthenotes from
her own egg cells to create stem cells with her own DNA, thereby
avoiding potential rejection of foreign cells by a patient’s
Human somatic cell engineering. This is an even more promising
approach that entirely bypasses the controversy of using fetal
stem cells. These emerging technologies, also called transdifferentiation,
create new tissues with a patient’s own DNA by converting
one type of cell (such as a skin cell) directly into another (such
as a pancreatic islet cell or a heart cell) without the use of
fetal stem cells.22 There have been recent breakthroughs in this
area. Scientists from the United States and Norway have successfully
converted human skin cells directly into immune system cells and
nerve cells.23 Hematech, a biotechnology company, has reprogrammed
fibroblast cells back into a primordial state where they can be
converted into other types of cells.
the question: What is the difference between a skin cell and any
other type of cell in the body? After all, they all have the same
DNA. As noted above, the differences are found in protein signaling
factors. These include short RNA fragments and peptides, which
we are now beginning to understand. By manipulating these proteins,
we can turn one type of cell into another.24
Perfecting this technology would not only defuse a contentious
ethical and political issue, it would also offer an ideal solution
from a scientific perspective. If you need pancreatic islet cells
or kidney tissues—or even a whole new heart—to avoid
autoimmune reactions, you would strongly prefer to produce these
from your own DNA, not the DNA from someone else’s germ
line cells. And this approach uses your own plentiful skin cells
rather than your rare and precious stem cells.
process would directly grow an organ with your genetic makeup,
and the new organ could have its telomeres fully extended to their
original youthful length, effectively making the new organ young
again.25 That means an 80-year-old man could have his heart replaced
with the same heart he had when he was, say, 25.
The master gene that enables stem cells to remain youthful and
pluripotent (able to differentiate into virtually any type of
other cell) has been discovered and named nanog by a team at the
Institute for Stem Cell Research in Edinburgh, Scotland.26 “Nanog
seems to be a master gene that makes embryonic stem cells grow
in the laboratory,” says Ian Chambers, one of the team’s
scientists. “In effect this [gene] makes stem cells immortal.”
The insight is a big step in being able to turn any cell, such
as a skin cell, into a pluripotent cell, which can then be transformed
into any other type of cell.
understanding of the principal components of human aging is growing
rapidly. Strategies have been identified to halt and reverse each
of the aging processes. Perhaps the most energetic and insightful
advocate of stopping the aging process is Aubrey de Grey, a scientist
with the department of genetics at Cambridge University. De Grey
describes his goal as “engineered negligible senescence”—stopping
us from becoming more frail and disease-prone as we get older.27
to de Grey, “All the core knowledge needed to develop engineered
negligible senescence is already in our possession—it mainly
just needs to be pieced together.”28 He believes we’ll
demonstrate “robustly rejuvenated” mice—mice
that are functionally younger than before being treated, and with
the life extension to prove it—within 10 years, and points
out that this demonstration will have a dramatic effect on public
opinion. Showing that we can reverse the aging process in an animal
that shares 99 percent of our genes will profoundly transform
the common wisdom that aging and death are inevitable. Once demonstrated
in an animal, robust rejuvenation in humans is likely to take
an additional 5 to 10 years, but the advent of rejuvenated mice
will create enormous competitive pressure to translate these results
into human therapies.
in the evolution of our species (and precursors to our species),
survival was not aided—indeed, it would have been hurt—by
individuals living long past their child-rearing years. As a result,
genes that supported significant life extension were selected
against. In our modern era of abundance, all generations can contribute
to the ongoing expansion of human knowledge. “Our life expectancy
will be in the region of 5,000 years . . . by the year 2100,”
says de Grey. By following the three bridges described in this
book, you should be able to reach the year 2100, and then, according
to de Grey, extend your longevity indefinitely.
Grey describes seven key aging processes that currently encourage
senescence and has identified strategies for reversing each. Here
are four of de Grey’s key strategies:
(nuclear) mutations and “epimutations.”29 Almost all
of our DNA is in our chromosomes, in the nucleus of the cell.
(The rest is in the mitochondria, which we’ll come to in
a moment.) Over time, mutations occur, that is, the DNA sequence
becomes damaged. Additionally, cells accumulate changes to “epigenetic”
information that determine which genes are expressed in different
cells. These changes also matter because they cause cells to behave
inappropriately for the tissue they’re in. Most such changes
(of either sort) are either harmless or just cause the cell to
die and be replaced by division of a neighboring cell. The changes
that matter are primarily ones that result in cancer. This means
that if we can cure cancer, nuclear mutations and epimutations
should largely be harmless. De Grey’s proposed strategy
for curing cancer is pre-emptive: It involves using gene therapy
to remove from all our cells the genes that cancers need to turn
on in order to maintain their telomeres when they divide. This
will not stop cancers from being initiated by mutations, but it
will make them wither away before they get anywhere near big enough
to kill us. Strategies for deleting genes in this way are already
available and are rapidly being improved.
cells. Occasionally, cells get into a state where they’re
not cancerous, but still it would be best for the body if they
died. Cell senescence is an example, and so is having too many
fat cells. In these cases we need to kill those cells (which is
usually easier than reverting them to a healthy state). Methods
are being developed to target “suicide genes” to such
cells, and also to make the immune system kill them.
the telomerase enzyme is one of many strategies being pursued
against cancer. Doing this would prevent cancer cells from replicating
more than a certain number of times, effectively destroying the
cancer’s ability to spread. There are many other strategies
being intensely pursued to overcome cancer. Particularly promising
are cancer vaccines designed to stimulate the immune system to
attack cancer cells. These vaccines could be used to prevent cancer,
as a first-line treatment, or to mop up cancer cells after other
treatments.30 We’ll discuss Bridge Two strategies against
cancer in more detail in chapter 16, “The Prevention and
Early Detection of Cancer.”
mutations. Another aging process identified by de Grey is accumulation
of mutations in the 13 genes in the mitochondria, the energy factories
for the cell.31 The mitochondrial genes undergo a higher rate
of mutations than those in the nucleus and are critical to the
efficient functioning of our cells. Once we master somatic gene
therapy, we could put multiple copies of these 13 genes within
the relative safety of the cell nucleus, thereby providing redundancy
(backup copies) for this vital genetic information. The mechanism
already exists in cells for nucleus-encoded proteins to be imported
into the mitochondria, so it is not necessary for these proteins
to be produced in the mitochondria itself. In fact, most of the
proteins needed for mitochondrial function are already coded by
the nuclear DNA. There has already been successful research in
transferring mitochondrial genes into the nucleus in cell cultures.
loss and atrophy. Our body’s tissues have the means to replace
worn-out cells, but this ability is limited in certain organs,
says de Grey. For example, the heart is unable to replace cells
as quickly as needed as we get older, so it compensates by enlarging
surviving cells using fibrous material. Over time, this causes
the heart to become less supple and responsive. A primary strategy
here is to deploy therapeutic cloning of our own cells, as described
on page 22.
Evidence from the genome project indicates that no more than a
few hundred genes are involved in the aging process. By manipulating
these genes, radical life extension has already been achieved
in simpler animals. For example, by modifying genes in the C.
elegans worm that control insulin and modifying sex hormone levels,
the life span of the test animals was expanded sixfold, the equivalent
of a 500-year life span for a human.32 As we gain the ability
to understand and reprogram gene expression, reprogramming the
aging process in humans will become increasingly feasible. The
idea that aging and dying are inevitable is deeply rooted, but
this age-old perspective will gradually change as gene therapies
are successfully demonstrated over the next two decades.
Three: Nanotechnology and Artificial Intelligence
we “reverse engineer” (understand the principles of
operation behind) our biology, we will apply our technology to
augment and redesign our bodies and brains to radically extend
longevity, enhance our health, and expand our intelligence and
experiences. Much of this technological development will be the
result of research into nanotechnology, a term originally coined
by K. Eric Drexler in the 1970s to describe the study of objects
whose smallest features are less than 100 nanometers (billionths
of a meter). A nanometer equals roughly the diameter of five carbon
Freitas, a nanotechnology theorist, writes, “The comprehensive
knowledge of human molecular structure so painstakingly acquired
during the 20th and early 21st centuries will be used in the 21st
century to design medically active microscopic machines. These
machines, rather than being tasked primarily with voyages of pure
discovery, will instead most often be sent on missions of cellular
inspection, repair, and reconstruction.”35
points out that if “the idea of placing millions of autonomous
nanobots (blood cell–sized robots built molecule by molecule)
inside one’s body might seem odd, even alarming, the fact
is that the body already teems with a vast number of mobile nanodevices.”
Biology itself provides the proof that nanotechnology is feasible.
As Rita Colwell, director of the National Science Foundation,
has said, “Life is nanotechnology that works.” Macrophages
(white blood cells) and ribosomes (molecular “machines”
that create amino acid strings according to information in RNA
strands) are essentially nanobots designed through natural selection.
As we engineer our own nanobots to repair and extend biology,
we won’t be constrained by biology’s toolbox. Biology
uses a limited set of proteins for all of its creations, whereas
we can create structures that are dramatically stronger, faster,
and more intricate.
application we’ll discuss further in chapter 7, on digestion,
is to disconnect the sensory and pleasurable process of eating
from the biological purpose of obtaining optimal nutrition. Billions
of tiny nanobots in the digestive tract and bloodstream could
intelligently extract the precise nutrients we require, call for
needed additional nutrients and supplements through our body’s
personal wireless local area network (nanobots that communicate
with one another), and send the rest of the food we eat on its
way to elimination.
If this seems particularly futuristic, keep in mind that intelligent
machines are already being injected into our bloodstreams today.
There are dozens of projects under way to create bloodstream-based
biological microelectromechanical systems (bioMEMS) with a wide
range of diagnostic and therapeutic applications.36 There are
already four major conferences devoted to these projects.37 BioMEMS
devices are being designed to intelligently scout out pathogens
and deliver medications in precise ways.
example, nanoengineered blood-borne devices that deliver hormones
such as insulin have been demonstrated in animals.38 Similar systems
could precisely deliver dopamine to the brain for Parkinson’s
patients, provide blood-clotting factors for patients with hemophilia,
and deliver cancer drugs directly to tumor sites. One new design
provides up to 20 separate reservoirs that can release the different
substances at programmed times and locations in the body.
Kensall Wise, a professor of electrical engineering at the University
of Michigan, has developed a tiny neural probe that provides precise
monitoring of the electrical activity of patients with neural
diseases.40 Future designs are expected to deliver drugs to precise
locations in the brain as well. Kazushi Ishiyama at Tohoku University
in Japan has developed micromachines that use microscopic spinning
screws to deliver drugs directly into small cancerous tumors.
A particularly innovative micromachine developed by Sandia National
Labs has actual microteeth with a jaw that opens and closes to
trap individual cells and then implant them with substances such
as DNA, proteins, or drugs.
Complex structures at the molecular level have already been constructed.
In some cases, building blocks are borrowed from nature. In fact,
copying or manipulating naturally occurring molecules to accomplish
specific goals is a cornerstone of present-day nanotech research.
DNA turns out to be a useful structural tool because the unzipped
strands can be organized into structures such as cubes, octahedrons,
and more complicated designs. A team at Cornell University used
portions of a natural enzyme, ATPase, to build a nanoscale motor.
Another team at the CNRS Institute in Strasbourg, France, has
successfully used carbon nanotubes to deliver a peptide into the
nuclei of fibroblast cells. Many approaches are being developed
for micro- and nanosize machines to perform a broad variety of
tasks in the body and bloodstream.
blood. One pervasive system that has already been the subject
of a comprehensive conceptual redesign is our blood. In chapter
15, “The Real Cause of Heart Disease and How to Prevent
It,” we will discuss a series of remarkable conceptual designs
by Freitas for robotic replacements of our red blood cells, white
blood cells, and platelets. Detailed analyses of these designs
demonstrate that these tiny robots would be hundreds or thousands
of times more capable than their natural counterparts.
Developing power sources for these tiny devices has already received
significant research attention. MEMS (microelectronic mechanical
systems) technology is being applied to create microscopic hydrogen
fuel cells to power portable electronics and, ultimately, nanobots
that will be introduced into the human body. One strategy is to
use the same energy sources—glucose and ATP—that power
our natural nanobots, such as macrophages, a type of white blood
cell that is designed to destroy harmful bacteria and viruses.
A Japanese research team has developed a “bio-nano”
generator that creates power from glucose in the blood. Another
team at the University of Texas at Austin has developed a fuel
cell that uses both glucose and oxygen in human blood.
Continual monitoring. Sensors based on silicon nanowires have
shown the potential to detect disease almost instantly.44 Using
any bodily fluid, such as urine, saliva, or blood, diseases including
cancer can be detected at very early stages. According to the
study leader, Charles M. Lieber, professor of chemistry at Harvard
University, this technology will enable you to “give a drop
of blood from a pinprick on your finger and, within minutes, find
out whether you have a particular virus or genetic disease, or
your risk for different diseases or drug interactions.”
This approach can also be used for detection of bioterrorism threats.
several years, we will have the means of continually monitoring
the status of our bodies to fine-tune our health programs as well
as provide early warning of emergencies such as heart attacks.
The authors are working on this type of system with biomedical
company United Therapeutics, using miniaturized sensors, computers,
and wireless communication. Researchers at Edinburgh University
are developing spray-on nanocomputers for health monitoring. Their
goal: a device the size of a grain of sand that combines a computer,
a wireless communication system, and sensors for heat, pressure,
light, magnetic fields, and electrical currents. In another development,
a research team headed by Garth Ehrlich of the Allegheny Singer
Research Institute in Pittsburgh is developing MEMS-based sensor
robots that can be implanted inside the body to detect infection,
identify the pathogen, and then dispense the appropriate antibiotic
from the device’s internal containers.
One application they envision is preventing bacterial infections,
a major cause of hip joint replacement failure. Ehrlich points
out that today, “the only recourse for such patients is
the traumatic removal of the implant, which results in additional
bone loss, extensive soft tissue destruction, months of forced
bed rest with intravenous antibiotics, and significant loss of
quality of life due to complete loss of mobility.”
Nanobots will make great surgeons. Teams of millions of nanobots
will be able to restructure bones and muscles, destroy unwanted
growths such as tumors on a cell-by-cell basis, and clear arteries
while restructuring them out of healthy tissue. Nanobots would
be thousands of times more precise than the sharpest surgical
tools used today, would leave no scars, and could provide continual
follow-up after certain surgical procedures. Nanobot surgeons
could even perform surgery on structures within cells, such as
repairing DNA within the nucleus. These nanobots will require
distributed intelligence. Like ants in an ant colony, their actions
will need to be highly coordinated, and the entire “colony”
of nanobots will need to display flexible intelligence. Distributed
systems that display intelligent coordination is one of the key
goals of research in artificial intelligence—developing
computers that emulate human intelligence.
of Freitas’s more advanced conceptual designs is a DNA repair
robot. Billions or even trillions of such robots could go inside
all of your cells and make repairs as well as improvements to
the DNA in the genes. Freitas points out that it may be more efficient
to just replace all the DNA in a gene with a new corrected copy
rather than attempt to make changes to individual nucleotides.
an original idea: replace the genetic machinery altogether (the
cell nucleus, ribosomes, and related structures) with a small
computerized robot. The computer would store the genetic code,
which is only about 800 megabytes of information, or about 30
megabytes using data compression. The computerized system replacing
the nucleus would then perform the function of the ribosomes by
directly assembling strings of amino acids according to the computerized
genetic information. These computers would all be on a wireless
local area network, so improvements to the genetic code could
be quickly downloaded from the Internet. It would not be necessary
for the computer replacing each cell nucleus to have a complete
copy of the genetic code, since these computers will be able to
share their information. One major advantage of this approach
is that undesirable replication processes—for example, of
pathological viruses or cancer cells—could be quickly shut
cells. A hybrid scenario involving both biotechnology and nanotechnology
contemplates turning biological cells into computers. These “enhanced
intelligence” cells could then detect and destroy cancer
cells and pathogens, or even regrow human body parts such as organs
and limbs. Princeton biochemist Ron Weiss has modified cells to
incorporate a variety of logic functions that are used for basic
computation.47 Boston University’s Timothy Gardner has developed
a cellular logic switch, another basic building block for turning
cells into computers.48 And scientists at the MIT Media Lab have
developed ways to use wireless communication to send messages,
including intricate sequences of instructions, to computers inside
modified cells.49 By attaching gold crystals comprised of less
than 100 atoms to DNA, they were able to use the gold as antennae
and selectively cause the double-stranded DNA to unzip without
affecting nearby molecules. The technique could ultimately be
used to control gene expression through remote control. Weiss
points out that “once you have the ability to program cells,
you don’t have to be constrained by what the cells know
how to do already. You can program them to do new things, in new
are also making exponential progress in understanding the principles
of operation of the human brain. Our tools for peering inside
the brain are accelerating in their price-performance, and the
ability to see small features and fast events. An emerging generation
of brain-scanning tools is providing the means for the first time
to monitor individual interneuronal connections in real time in
clusters of tens of thousands of neurons. We already have detailed
models and simulations of several dozen regions of the human brain,
and we believe that it is a conservative projection to anticipate
the completion of the reverse engineering of the several hundred
regions of the brain within the next two decades. This development
will provide key insights into how the human brain performs its
pattern recognition and cognitive functions. These insights in
turn will greatly accelerate the development of artificial intelligence
in nonbiological systems such as nanobots. With a measure of intelligence,
the nanobots coursing through our bloodstream, bodily organs,
and brain will be able to overcome virtually any obstacle to keeping
us healthy. Ultimately, we will merge our biological thinking
with advanced artificial intelligence to vastly expand our abilities
to think, create, and experience.
fight a disease after it has occurred is like trying to dig a
well when one is thirsty or forging a weapon once a war has begun.”
—The Yellow Emperor’s Classic of Internal Medicine
we embark on our Fantastic Voyage together, beginning with chapter
4, we would like to reveal a bit of our personal histories. In
this chapter, we each explain how we arrived at the point where
sharing this health information became a priority for us and how
our lives intersected to create this book.
My story begins on the outskirts of Vienna, Austria, in 1924,
with the death of my paternal grandfather from heart disease when
my father was 12. My father carried on with his two passions:
the Boy Scouts and music. In 1938, my father’s musical talent
came to the attention of an American patron of the arts, who helped
sponsor his escape from Hitler’s Europe. This enabled my
father to immigrate to America, where he developed a national
reputation as a brilliant concert pianist, conductor, and music
came along in 1948 and had the opportunity to study music with
my father from the age of 6. When I was 15 he also developed heart
disease. My father was the kind of person who, when he encountered
(then novel) health ideas, such as cutting down on salt, adopted
them immediately without a second thought. Unfortunately, we had
very little insight into heart disease in the 1960s, and he died
of a heart attack in 1970 at the age of 58. I was 22 years old.
remained painfully aware of this family health legacy, which hovered
over me like a cloud on my future. At the age of 35, I was diagnosed
with type 2 diabetes. I was prescribed conventional treatment
with insulin, but this only made things worse by causing substantial
weight gain, which in turn created an apparent need for more insulin.
As is typical in someone with type 2 diabetes, I already had high
insulin levels, so this was a very bad idea indeed.
digression is in order here. Starting at the age of 8, I became
a passionate fan of Tom Swift Jr. and read all of the available
books in this popular series. In each volume, Tom Swift and his
friends would get into a terrible jam (and usually the rest of
the world along with them). Tom would retreat into his lab and
think about how this seemingly impossible challenge could be overcome.
Invariably, he would come up with a clever and ingenious idea
that saved the day. The moral of these tales was simple: there
is no problem so great that it cannot be overcome through the
application of creative human thought. That simple paradigm has
animated all my subsequent endeavors.
in the spirit of Tom Swift, I decided to take matters into my
own hands, approaching the issue of diabetes from the perspective
of the available scientific literature. I tried to engage my doctor
in a discussion of the issues, with only limited success. While
he talked to me to some extent, he clearly had little interest
in doing so, and admittedly, I was unusually demanding. Finally,
exasperated with my persistent questions, he said, “Look,
I just don’t have time for this; I have patients who are
dying that I have to attend to.”
one to be easily put off by attempts to appeal to my sense of
guilt, I couldn’t help but wonder whether any of these dying
patients might have benefited from earlier explorations into ways
to prevent disease. I decided to change doctors and, fortunately,
found a physician, Steve Flier, M.D., with an open mind and, since
he was just setting up a new practice, some time on his hands.
My personal exploration, assisted through my dialogue with Steve,
led to a set of health ideas that enabled me to get off insulin
and control my diabetes simply through nutrition, exercise, and
stress management. I lost more than 40 pounds and never felt better.
I went on to articulate these ideas in The 10% Solution for a
Healthy Life (Crown Books) in 1993, which became a best seller.
ideas in the book kept me in good health and off diabetes medications
for the next decade. Then, in 1999, I met a brilliant and open-minded
fellow traveler, Terry Grossman, M.D., at a futurism conference
organized by the Foresight Institute. Terry and I struck up a
conversation and discovered a wide range of common interests,
particularly in health and life extension. Our discourse quickly
evolved into a close friendship and an intense collaboration on
a wide range of health issues, with a sprinkling of other futurist
issues thrown in as well, which has lasted and grown to this day.
I’ve learned a great deal from Terry and hope that I’ve
contributed ideas and insights to our partnership in return.
can say that our relationship has been a uniquely fruitful intellectual
journey of exploration and discovery. For one thing, I find the
scientific issues underlying human health fascinating, particularly
now that we are beginning to understand genetic and metabolic
pathways in the language of information science. And for someone
who has a keen interest in the 21st century and all of the marvels
it promises to bring, I particularly appreciate the potential
of this knowledge to enable us to actually live to see (and enjoy!)
the remarkable century ahead.
This book represents the results of our collaboration, which in
turn has built upon each of our decades of study of health issues.
It is necessarily a work in progress and will always remain incomplete.
My own work on technology trends indicates that human knowledge
is growing exponentially and that the pace of progress is accelerating.
Nowhere is this insight more evident than in the field of health.
It seems that Terry and I discover at least one exciting new health
insight each week (perhaps we are now down to one every six days!).
It is fair to say that a number of our ideas have evolved significantly
during the two-year period it has taken to produce this book.
continue to devote a significant portion of my intellectual and
physical energies to the pursuit of my personal health and health
insights. I am able to use the same scientific method and information
science skills in this endeavor, and I find the subject as intellectually
satisfying as my other career as a pattern recognition scientist
the way, I have encountered two unexpected conflicts. If you see
someone standing precariously on a ledge, oblivious to the danger
of a great fall, you feel a sense of obligation to inform that
person of his or her unrealized plight. If the person is someone
you care about, the urgency is even greater. I have not had to
look very far to find many others who are desperately in need
of the knowledge I have gained. Typical are adult male friends
with elevated cholesterol, strong family histories of heart disease
(or diagnoses of their own heart disease), and perhaps a few extra
inches around the middle. Others include adult female friends
with family histories (or their own diagnoses) of cancer.
I get drawn into extended conversations on the topic of preserving
health and well-being through nutrition and lifestyle. Often,
these turn out to be longer conversations than either of us expected.
To make the case, I feel compelled to go through a lot of the
evidence. Then there are more subtle issues. Why aren’t
the standard medical recommendations good enough? This is mostly
genetics anyway, isn’t it? What happened to moderation?
I make it through these issues, I’m inevitably asked to
address the big question of palatability. Sure, you’ll live
a long time, but who wants to live that way? If you eat this way,
maybe it just seems like a long time! I maintain that this can
be an enjoyable, even liberating way to eat and live, but it takes
a bit of explanation.
The second conflict has to do with proselytizing. Being a scientist
and a trained skeptic, I was always turned off by people with
singular agendas. People out to save my soul or even just my health
and well-being were strongly suspect. I have felt very uncomfortable,
therefore, in this role myself, telling other people how they
should eat or live. Recognizing my own resistance to these types
of messages, I also realize what I am up against in terms of getting
people to take these ideas seriously.
I feel a responsibility to share my knowledge on these issues,
but I also need to achieve a certain loving detachment when it
comes to people choosing their own eating and living styles. This
is not an easy balance to achieve. It is hard not to feel some
pride if someone accepts our ideas and then shares with me their
excitement at 30 lost pounds or 50 lost cholesterol points. If
nothing else, such experiences demonstrate that I was successful
in communicating my thoughts.
I have come to consider it my responsibility to empower people
to set their own priorities and to make their own compromises.
That’s what I object to in the public health recommendations.
They come precompromised, as if the American people were incapable
of making their own decisions on these matters. As it has been
said, “Lead me not into temptation, I can get there on my
own.” We can deliver a complete message, and readers can
consider it on their own terms and in their own time. Any follow-up
is up to you.
this limited goal of effective communication is a challenging
one. We have all, by necessity, erected formidable barriers to
messages on health. We could hardly survive if we allowed all
of the thousands of messages that bombard us daily to get through.
It’s particularly difficult to penetrate the subtle yet
common misconceptions, fears, and folklore—not to mention
conflicting advice from experts—that underlie the public
understanding (and misunderstanding) of nutrition and health.
Food and its images are deeply interwoven in our rituals, fantasies,
and relationships. While most people profess ignorance of nutrition
and health, almost everyone maintains strongly held views on the
subject and its relationship to the rest of our lives. Getting
people’s attention, let alone truly broadening someone’s
perspective, is not an easy task. But that is the challenge of
I have now influenced many people to adopt our ideas for improving
their health, while Terry influences many patients through his
longevity-oriented medical practice in Denver. The physical and
medical results that friends, relatives, associates, and many
others have achieved have been deeply gratifying.
myself, I feel that the cloud that I so strongly perceived during
my 20s and 30s has dissipated, and I look forward to a long and
healthy life, indeed to seeing (and enjoying) the century ahead.
It is too bad that I cannot go back and share this knowledge with
my father. Unlike many people, he accepted health and nutritional
advice readily and easily. Unfortunately, the knowledge was not
available in time to help him. If it were, he could be alive today.
I began my medical career some 24 years ago as a conventional
physician. But after 15 years in practice, I found myself being
drawn toward “integrative” medicine, “the field
of health care that focuses on how biochemical individuality,
metabolic balance, ecological context, genetic predisposition,
lifestyle patterns, and other factors have the potential to strongly
influence human physiology and the push-pull dynamics of health
and disease.”1 As I began to study health from an integrative
perspective, I became fascinated with the prospects for correcting
imbalances in human physiology on a more individualized level.
In 1994, I came to the realization that there were avenues available
for me to help my patients in addition to conventional medical
care. Focusing primarily on control of a patient’s symptoms,
which is the fundamental basis of what I had been taught in medical
school, was no longer enough.
completing medical school in Florida, I did my residency in Colorado
and then moved to the mountains west of Denver. During the 15
years I practiced there, I worked as a young version of an old-fashioned
general practitioner. I delivered babies at the local hospital,
was the doctor for the local jail, and gave the annual talk about
the “birds and the bees” to all the fifth-grade boys.
I practiced medicine like a typical small-town GP and, by and
large, felt satisfied with the care I was providing. I realized
that most people I “treated” weren’t really
getting better, but they were receiving high-quality conventional
care. Through prescription drugs, I was quite adept at bringing
symptoms of high blood pressure, diabetes, or heart disease under
“control.” While this meant my patients’ numbers
were better—blood pressure or blood sugar was lower, or
there was less chest pain—the underlying disease processes
continued unchecked. This bothered me.
is a continual learning experience and, as a physician, I have
come to regard pain as among the sternest but most effective of
life’s teachers. Thanks to a major knee injury suffered
on a local ski slope some years ago, I found myself in the formal
role of patient for the first time in my life, and I sought conventional
medical care. I went to the best orthopedic surgeon I knew, a
colleague I held in enormous respect.
several modalities of conventional treatment still left me with
constant residual pain in my knee, I did what I have since discovered
many of my patients have been doing for years: I began to look
at alternatives. Along with life’s teachers are life’s
angels, who show up in most unexpected places at most unexpected
times. My angel appeared in the form of a patient advocate of
alternative medicine. Through his persistence, this individual
forced me to open my eyes to an entirely new, to me, parallel
world of medical alternatives.
In my family, medical doctors were treated with a certain amount
of reverence, and conventional medical care was the only alternative.
Yet, my patient advocate of alternative medicine—and angel—taught
me that there was an entirely different paradigm of medical care
available, completely separate from the world of prescription
medications and surgery in which I had lived for so many years.
I learned that vitamins and herbs could actually be used to treat
diseases. He convinced me to try to treat my painful knee condition
with a specific herbal concoction derived from the inner bark
of a certain type of pine tree that grew only in the south of
like something of a traitor—perhaps a bit like Adam and
Eve nibbling at the prohibited fruit—I squeamishly began
to take pine bark capsules. It took more than three months but,
much to my surprise and gratification, the pain in my knee that
I had been experiencing for over a year and a half went completely
away. Being a scientist, I decided to perform an experiment to
see if my improvement was really the result of the herbal concoction,
a placebo effect, or simply a coincidence. I quit taking it. My
knee pain returned with a vengeance. I restarted the pine bark
extract and, within a few weeks, the pain went away. I repeated
the sequence once again: I quit taking the nutritional extract
and the pain returned. I restarted it and the pain resolved. As
a physician, I am well aware of placebo effects, but these generally
go away after a limited period of time. I continued taking the
extract, and after a few years I noticed that the pain was gone
whether I took it or not. I suspected this was probably just the
natural course of the healing process; nevertheless, the nutritional
extract seemed to have given me pain relief earlier on, and my
interest in alternative medicine was piqued.
undertook a serious study of integrative medicine with an emphasis
on nutritional medicine. I began to learn how to treat diseases
with vitamins and other nutrients rather than, or in addition
to, prescription drugs. And the more I learned, the more I wanted
to know. I went to numerous complementary medicine conferences
and read everything I could find about nutritional medicine. There
was so much to learn, I felt like I was back in medical school
my knowledge and understanding increased, I slowly began to offer
my patients the option of continuing with the conventional treatments
they had been receiving from me (in most cases, prescription drugs)
or the opportunity to try treatments involving dietary changes
or nutritional supplements, either in place of or in addition
to conventional care. I was surprised to find that the overwhelming
majority of my patients wished to take advantage of these options.2
My patients did far better on combined care than they had on prescription
medications alone. Over the past 10 years, I have treated thousands
of patients who had serious chronic illnesses with nutritional
protocols that I have learned and modified for my practice. For
example, I see a large number of people with coronary heart disease.
Most of these patients come to me looking for an alternative to
some type of heart surgery that has been recommended to them.
For some, I concur with their cardiologists and recommend immediate
surgical intervention because the disease is too far advanced.
Yet, for the significant majority, I find that the nutritional
and lifestyle program I recommend for heart disease, involving
diet, exercise, aggressive supplementation, detoxification, and
stress management—as well as prescription drugs when needed—staves
off heart surgery. At the same time, I am able to document quantifiable
improvements in these patients’ conditions, such as going
from abnormal to normal cardiac stress tests, eliminating angina
pain, and improving exercise endurance.
derive particular satisfaction from successfully treating people
with diseases for which conventional medical practice has little
to offer. Age-related macular degeneration (AMD) is the leading
cause of vision loss in older individuals in this country, yet
presently there are no prescription drugs or surgical procedures
that can help prevent the inexorable decline toward blindness.
To their credit, conventional ophthalmologists have recently begun
to recommend multivitamin/mineral supplementation for their AMD
patients based on the AREDS (Age-Related Eye Disease Study) sponsored
by the National Institutes of Health.3
Yet, like Ray, I find the conventional supplement recommendations
pre-compromised or too watered down, particularly since I have
a family history of macular degeneration, and I don’t feel
that slowing down the rate of visual decline is enough. I want
my patients’ vision to improve. This requires a more aggressive
nutritional approach: combining dietary strategies with much larger
doses of vitamins and minerals and working to correct digestive
disturbances that inhibit absorption of nutrients. Using this
approach, it is possible for patients to stabilize and even improve
their vision.4 This is rarely seen with one- or two-pills-a-day
the greatest devastations for young parents is learning that their
child suffers from one of the autistic spectrum disorders. Yet
I get enormous satisfaction treating children diagnosed with such
diseases. I have nothing but admiration for the dedicated pediatricians,
allied health personnel, and special education teachers who have
devoted their lives to working with these children. I am saddened,
however, by the ineffectiveness of their approaches, which rarely
alter the progression of these disease processes.
program involves a special diet (avoidance of wheat and dairy
products), aggressive nutritional supplementation, correction
of digestive disturbances, and detoxification strategies.5 The
majority of children we treat under the age of 6 experience some
degree of improvement on this regimen.
is a long list of ailments for which conventional medicine alone
provides limited benefit: chronic degenerative neurological diseases
such as Parkinson’s disease and multiple sclerosis; digestive
disturbances, including irritable bowel syndrome, colitis, and
Crohn’s disease; and multisystem diseases such as fibromyalgia
and chronic fatigue syndrome. For these, an integrated approach,
using complementary therapies, is of considerable benefit. Tens
of millions of American adults suffer from type 2 diabetes, obesity,
high blood pressure, and elevated cholesterol. In the majority
of cases, it has been my experience that where our program is
followed strictly, the prescription drugs used to treat these
conditions can be either reduced or eliminated entirely.
the years passed and I gained more experience with nutritional
medicine, I decided to write a book to share what I had learned
with people outside of my practice. With the assistance of several
physician colleagues and friends, I completed The Baby Boomers’
Guide to Living Forever in April 2000.
the course of researching the topic of nanotechnology for this
book, I met Ray at the 1999 Foresight Institute Conference in
Palo Alto, California. He was there as one of the nation’s
foremost futurists. Overhearing Ray discuss his interest in nutritional
supplementation and other life extension therapies, I struck up
a conversation. I asked him to look over the manuscript of my
book and write a “testimonial” paragraph for the back
cover, which he kindly agreed to do. A few months later, he flew
from his home in Boston to my clinic in Denver to undergo one
of the comprehensive health assessments and longevity evaluations
My nutritional medical practice in Denver has its share of celebrity
patients, and Ray Kurzweil is one of them. Ray is unique in that
I devote more of my time attending to his health concerns than
any dozen of my patients, celebrity or otherwise, put together.
But, then again, Ray is quick to admit that he is unusually demanding.
I am not surprised that Ray became frustrated with a previous
physician who preferred to spend his time on patients who “were
my part, I have no regrets whatsoever about the amount of time
I spend working with Ray on his personal health issues, or the
fact that I have to defend every single opinion or suggestion
I offer to him. Ray is another of the angels who have entered
my life to guide me in the right direction. I feel a special sense
of mission in helping him remain alive and well for many years
into the future, as this unusually creative and gifted individual,
who has already brought so many wonderful insights and inventions
to the world, has much yet to share. He has also helped me to
refine my focus and leave no loose ends in any medical endeavor.
Moreover, a number of other benefits accrued from the process
of working with Ray. In the course of refining his personal health
program, he and I began to explore numerous health-related topics,
including diet, nutritional supplementation, exercise, detoxification
therapies, hormone replacement, and even protection from NBC (nuclear,
biological, or chemical) terrorism. We’ve both learned a
great deal from our intense collaboration on health issues. Our
dozens of e-mails back and forth turned into hundreds and now
number in the tens of thousands. So much information was passed
between us that we decided to organize it as the basis for a book.
members of the baby boomer generation, Ray and I have more than
a casual interest in our program. Since we are both now in our
mid-50s, demographic analysis would ordinarily suggest that we
each have perhaps 25 years left, with gradually declining vitality
and health. By following the advice presented in this book, and
with some help from the accelerating technologies that Ray speaks
about, we hope to be not only alive but vital and “young”
a quarter century from now—right at the time corridor when
the prospects for truly radical life extension are likely to occur.
It is our fervent hope (bolstered by extensive research) that
by following the suggestions offered in Fantastic Voyage, we and
our readers will be able to significantly increase our chances
of being alive when extreme longevity becomes commonplace. To
that lofty goal, we raise a toast—of freshly squeezed organic
vegetable juice—in the hopes that we can join together with
our readers to celebrate the 22nd century.