Background

In the past, there was the “anti-aging” movement which was spearheaded by fringe practitioners who would often pitch products akin to snake oil which may have a potent placebo effect, but no real science behind it. The modern evolution of “anti-aging” shenanigans has now been repackaged into a shiny new box called “longevity.” The problem is this box is not just being peddled by pony-tailed hippies. It’s being sometimes subtly and often aggressively sold by legitimate scientists who have a dual identity. By daytime they might be performing legitimate IRB-sponsored research, often in the lab of a prestigious university whose name strengthens their brand inside and outside that institution, even though there is no formal affiliation between the two as stated in their disclaimer.

However after work hours, a new persona emerges. One that plays by a different set of rules, but still uses the institutional rules to veil a different playbook. A written piece, a podcast, or some other content might be quoting articles from Pubmed which sound legitimate to a layperson’s ears. The word “science-based” is highly appealing. However, someone who is not familiar with legitimate vs illegitimate research can easily be coaxed into a protocol or supplement that not only lacks any evidence at all, but is often backed by shoddy science rife with conflicts of interest.

I’ll mention one case example of the above. A scientist I had repeatedly been asked about in the past based on podcast appearances and what appeared to be an impeccable reputation. I found many of my patients gobbling up his overpriced supplements in the name of lifespan and healthspan. I listened to this scientist on Joe Rogan and my immediate gut feeling was not good. He was incredibly bright, but there were bursts of unprofessionalism and a very strong tendency to impress Rogan and his audience. I could sense the dual identity of scientist and potential egomaniac.

Patients asked me, should I take this Resveratrol or NMN supplement and I found no convincing research to support the claim. Only studies showing molecular pathways and outcomes in animal studies that appeared to make a loose connection at best. In traditional science, you start off with a hypothesis, perform laboratory research, and then years of IRB-sponsored research before a drug comes to market. This breed of researchers however are impatient and can’t wait that long.

They tap into the intermediary, relatively unregulated black market of supplement and diagnostic company affiliate partnerships, a fast track to immediate, lucrative profits.

This arrangement preys on you, the patient/consumer. Capitalism is often based on our most primal impulse. A four letter word that starts with an F. No, not that one. It’s FEAR. This is why you buy insurance. This is why I bought an overpriced extended warranty on my new car which I fortunately was able to return once I came to my senses. At the very top of our fear list, above FOMO, above our fear of losing money and our material possessions, sits our fear of death.

One definition of longevity, coined by De Benedictis & Franceschi in 2006, is “the ability to live a long life beyond the species-specific average age of death.” To a so-called science-based capitalist, I would reframe that definition as the ability to prey on an individual’s fear of death, disease, and aging by selling supplements, tests, and protocols based on no science or poor quality science.

AI and Forever Supplements

Enter the age of AI. These dual scientists as I’ll call them, can now use AI tools like LLMs to identify potential longevity molecules, create supplements with compelling branding, create prolific content at light speed, and dupe you, the consumer, into subscribing to their lifelong supplement and diagnostic testing schemes. As a physician, I’m constantly trying to decide which medications need to be continued or discontinued in a patient. Somehow researchers and doctors who push supplements have zero expiration date on their supplement recommendations.

Hit the monthly subscription button and take the supplement forever is the default, which is an attractive, indefinite income stream that only expires when you expire.

You need to recognize the above pattern because it’s not just a potential strain to your finances. I have patients often spending thousands of dollars each year on supplements and diagnostic testing that are not based on any science. They have a continuous intense fear or even a lower level simmering anxiety about death and disease that is driving their trust in these individuals, and making them blindly purchase any products being recommended.

The other risk is the potential harm unregulated supplements can cause. This ranges from direct side effects to potential interactions with other supplements and prescription medications. Refer to Table 2 below from this study that does an exhaustive review on supplements. Many thought antioxidant vitamin supplements like Beta-carotene, Vitamin A, and Vitamin E, taken in smokers would reduce lung cancer incidence. A simple and logical hypothesis was that tobacco smoke increases free radical formation and oxidative damage to cells, thus taking an anti-oxidant vitamin should counteract this.

Look at the highlighted results below. Lung cancer incidence actually went up. Many health influencers use similar simplistic scientific hypotheses to sell supplements and products backed by little to no science, other than loosely affiliated pub med references. The result in most cases is zero protection, a placebo response, or potential harm. I’m not talking about treating a diagnosed vitamin deficiency. I’m focusing on shotgun supplementation strategies to fix an endless list of health issues.

 

 

 

The Halo Effect

So far I’ve left out names because I want you to identify patterns first so you recognize these patterns and make judicious choices. The longevity researcher mentioned above is Dr.David Sinclair. There’s no need for me to do a detailed expose since Dr.Brad Stanfield has done one on Youtube below. I do take these pieces with a grain of salt since they can be sensationalist in nature and may not report all of the facts from the other side, but there are some compelling pieces of evidence here that are difficult to refute.

I am not calling for Dr.David Sinclair to be completely excised from the scientific community. I do think research institutes like Harvard should have specific restrictions, guidelines, and ethics to prevent this type of activity from happening. At the end of the video, the former dean of Harvard medical school actually states the following in direct reference to David Sinclair on twitter, and in response to Matt Kaeberlein, a legitimate and ethical longevity researcher.

Indeed, quite sadly, there are some snake oil salesmen on the @harvardmed faculty. In the anti-aging field, the key actor (aka Dr.Sinclair) is seemingly impervious and indifferent to rational critique.

Another case study I’ve mentioned on instagram is not a researcher, but someone who has a biochemistry degree, and has paired the trust of her very large following to a supplement. Notice on her site here how research study references are peppered among attractive claims on how this supplement can improve health, while letting you eat anything you want. Do you see this disturbing duality?

I find this case study less disturbing than Sinclair, who is a real scientist from a top research institution, but the pattern once again combines your trust and your fear to sell a forever product. Just because you have created engaging content that has had a positive impact on so many lives does not give license to loosening the reins on ethical business practices and cherry picking research studies to sell supplements.

I refer to this as the “halo effect” and will use myself as an example. Perhaps I’ve created a respectable halo based on writing a book, by delivering a webinar you might have attended, a podcast episode featuring me you listened to, or even by being a patient of mine in my clinic. What if I felt I could use that “halo” to create or affiliate myself with a product that has a very limited or even dubious scientific basis to create an income stream?

Perhaps my internal moral compass might tempt me by saying, “well I have helped thousands of people through all of the free content and resources I’ve provided over the years, so now it’s time to make some real money.” There’s actually nothing wrong up to that point, but things get sticky when I start loosening my interpretation of what a legitimate product might be. There is some middle ground between legitimate scientific research and the wild west of the burgeoning longevity-wellness-holistic product industry.

“Hyperplacebo” Response

The placebo response is defined as an individual’s perception of an improvement in health due to a treatment that has no active ingredients. The response is actually not all in your head. There are physiological chemicals released in the body and brain like endorphins, enhanced by your belief in the treatment, which can impart some type of perceived benefit. When a health influencer you trust recommends a supplement that they convincingly persuade you to purchase through an advertising page, podcast mention, blog post, etc., they have already significantly increased your belief in that treatment.

In addition, health influencers recommend these supplements alongside their recommendations to exercise, eat healthy, sleep better, etc., so the combined effect of you implementing all of these lifestyle changes along with your belief that a supplement is going to help you since it is endorsed by a health influencer you trust, can result in what I call a “hyperplacebo” response because it is even more potent than the placebo response that might be experienced in a randomized control study.

In a randomized control study setting you are “blinded” so you don’t know if you are getting the actual drug or the placebo, there is a deliberate effort to remove or minimize the confounding factors I mentioned so the effect of say exercise or diet may not interfere with the true effect of the intervention itself, and there is no health influencer or attractive marketing campaign to convince you ahead of time that the treatment is going to work. The hyperplacebo response games the system completely and instead of a true randomized controlled study to test genuine efficacy, you get lists of anecdotal testimonials on a marketing page or a poor quality study that is set up for success.

Pillars Over Pills

I’m by no means saying that every health product ever created needs to be supported by an expensive multi-year IRB approved randomized control study. We know that standard process is imperfect and can also be influenced by conflicts of interest and corrupt practices. Legitimate researchers and doctors who base every single recommendation on evidence-based research and guidelines have their own blindspots. There are breathing practices, movements, and rituals I’ve adopted based on the innate wisdom of individuals from thousands of years ago, that I’ve benefited from, and that I’ve recommended to my patients and audience. I’ve lowered blood pressure and reversed cholesterol and blood sugar abnormalities in countless patients over the years by using lifestyle interventions that are underemphasized or don’t even appear in medical textbooks, the latest clinical guidelines, or our go-to references like UpToDate.

Interestingly, many modern day researchers like to rename our time-tested ancestral practices like calling yoga nidra, NSDR (non-sleep deep rest), or calling fasting, “time-restricted eating,” to give it legitimacy. That’s fine, but I’m just pointing out that the practice came intuitively from ancient humans who had no access to the internet, AI, or research laboratories. Modern day practitioners ideally blend evidence-based interventions with safe and natural ones, that have little to no downside, and have typically been practiced over long periods of times by large numbers of people across the globe.

I want to finish by saying that writing this post isn’t easy for me. I’m not the type who likes to criticize others. However, talking to countless patients, lecture audience members, and friends and family who are investing money into these longevity products, while still not optimizing their four time-tested longevity pillars (nutrition, exercise, stress, and sleep) leaves me frustrated, which is why I’m using this platform to keep you informed and to motivate you to refocus your attention on the pillars over the pills.