April 21, 1995

LIFE EXTENSION FOR THE 21st CENTURY:

THE VIEWS OF UCLA PROFESSOR ROY WALFORD, M.D.

by

L. Stephen Coles, M.D., Ph.D., Co-Founder

Los Angeles Gerontology Research Group

While we draw closer to the reality of genetic intervention as a means toward life extension, Prof. Roy Walford, one of the key researchers in dietary restriction, chronicles the mythologies and classical failures of those who, in the past, sought their own magical anti-aging elixirs. Walford then explores the promise of the real anti-aging revolution to come.


Editor's Note: Roy L. Walford, M.D, Professor of Pathology in the UCLA School of Medicine Center for the Life Sciences, has been a world-renowned gerontologist for over 30 years. Coauthoring four books on aging and over 250 scientific articles, he is a member of the National Academy of Sciences Committee on Aging, a delegate to the last White House Conference on Aging, and a Scientific Advisor to Longevity Magazine. For more than 20 years, Walford's life work has been the study of the effect of calorie-restricted, nutrient-rich diets for rodents housed in a colony at his Lab in UCLA [1-5]. In 1993 he completed two straight years of studying the effects of diet on aging in humans in "Biosphere 2," as published in the Proceedings of the National Academy of Sciences.


In all forms of biomedical research we often ask the question, "How do we know that interesting results obtained in mice will apply to men?" Critical differences in rodent physiology or embryogenesis may trick scientists into a sort of false reasoning by analogy. Prof. Roy Walford is the first research scientist to demonstrate convincingly that dietary interventions that significantly extend the longevity of mice actually apply to humans as well. Ironically, he used himself as a test subject along with seven others, and the data to support this remarkable conclusion happened by accident. Later, we will see how this happened.

INTRODUCTION

 The following review is based on a talk given by Prof. Walford as keynote speaker at the Awards Banquet of The 2nd Annual Conference on Anti-Aging Medicine and Biomedical Technology for the Year 2010 on December 5th of last year in Las Vegas, Nevada. He reported on his experiences as the physician member of an eight-member team that emerged last year from being sealed for two years in a closed ecological space known as Biosphere 2. He provided evidence that humans on a calorie-restricted, nutrient-dense diet show the same physiological changes (in cholesterol levels, fasting blood sugar, blood pressure, white blood cell counts, glycated hemoglobin, insulin, and cortisol levels) as do rodents on a similar diet. This strengthens the conclusion that similar age retardation and enhanced disease resistance might also be obtained in humans, providing that they agreed to comply with such a diet.

Although calorie-restriction may be the first known method used to enhance human life span, its stringency will undoubtedly make it unsuitable for the general population. However, rapid advances in our understanding of the underlying mechanisms of dietary restriction will be forthcoming in the near future. These mechanisms may include (1) the postponement of sexual maturation, (2) the biological clock located along the neuro-endocrine-immune axis, or (3) the free-radical/oxidative-stress damage that occurs secondary to the accumulation of waste products from active metabolism. Thus, the 21st Century may become the century of "the long-lived society."

THE MYTHOLOGY OF ANTI-AGING RESEARCH

Prof. Walford began his discussion with a lively review of a number of the historical myths and classical failures associated with the practice of gerontology. The myths tended to fall into three categories: Long Ago (Golden Age), Far Away (Shangri-La), and Contemporary Apologism (Natural Law).

Mythology serves to catalog the dangers involved in a "fruitless" quest for immortality. These myths include-

For another class of myth, Prof. Walford coined the phrase the Struldbrugg Obsession (a phrase derived from an unfortunate people in Swift's Gulliver's Travels [17]). If you continually age but never die, you get older and older, finally condemned to perpetual frailty and/or senility. According to the Greek legend of Eos and Tithonus, Eos, goddess of the dawn, requested Zeus to bestow eternal life on her mortal lover Tithonus. The request was granted, but with a Catch-22. Tithonus became more and more decrepit, because she forgot to ask for eternal youth, having asked only for eternal life (Sigh!). Eventually, Eos had to shut Tithonus away in a room, where he presumably still lies paralyzed and babbling. The 1974 movie Zardoz [18] and the 1992 movie Death Becomes Her [19] explored this theme further, as did Oscar Wilde's, The Picture of Dorian Gray and Aldous Huxley's, After Many a Summer Dies the Swan. Unfortunately, certain biologists have been known to shy away from experimental gerontology, perhaps because of an unconscious desire to avoid the Struldbrugg Obsession.

Of course, variations on this theme are stories of alleged "accelerated" aging, typically once the secret voodoo-elixir (or whatever) has run out. Of course, there really are such progeria syndromes in modern medicine (such as Hutchinson-Gillford Syndrome or Werner's Syndrome), but they are more accurately to be thought of as "cartoons" or simulations of aging rather than a true acceleration of a cellular aging clock (however, a relationship to the shortening of chromosomal telomeres during mitosis has been suggested. See [20], p. 108).

Next came a second category of so-called Hyperborean myths. Even if the solution to the problem did not happen a long time ago, it certainly must have been discovered in places far away. For example, Shangri-La is the tale of an intriguing mountain utopia [21]. Greek legend held that those who lived there lived for thousands of years-- free from all natural ills-- in a land of perpetual sunshine beyond the North Wind. Real places in which excess numbers of centenarians per capita were supposed to be living include: (1) the isolated village of Vilcabamba, Peru high in the Andes Mountains; (2) Azerbaidzhan high in the Caucasus Mountains of Russia; and (3) Hunza high in the Karakoram (Himalayan) Mountains of Pakistan. Unfortunately, with the careful investigation by scientific researchers, these claims were subsequently proven to be false. (See references: [22] Chapter 2, pp. 11-23, [23] pp. 81-86, and [20] pp. 196-203).

As we get closer to our own time and place, we still encounter a number of contemporary myths, the third Walford category. Prof. Walford coined the phrase "Star-Trek Inconsistency" in which Captain James Kirk appears to age in precisely the usual way over a 30-year period. Even though we can supposedly travel at warp speeds in the 22nd Century and future medicine has provided us with scanners that physicians can point at us to make us instantly better, no progress whatsoever appears to have been made in the longevity sciences. Why not? What people frequently say when confronted with the Star-Trek Inconsistency for the first time is "Yes, you're right! I never thought of that." How can you explain this? It may simply be a failure of nerve on the part of the writers. Or perhaps it's because we have been culturally conditioned to think of life-extension research as a fraudulent scientific activity.

Next, Dr. Walford listed some of the more recent failures of pseudo-gerontology research, all of which have given the field a bad name:



Along these same lines, Betty Friedan recounts in her recent best-selling book The Fountain of Age [24] that many of the attendees of a meeting of the American Gerontological Society at which Prof. Walford spoke found the very idea of anti-aging research to be "strangely threatening." Indeed, it was felt that such research could possibly lead to a "Gerontological Winter." "Of course," said Walford, "such an idea is absolute bologna."

Why are we so hung up on the validity of gerontology research? The answer may lie in the fact that "thinking about death is unpleasant." Therefore, we've skillfully invented ways to avoid thinking about it. The long list of false myths and failed searches has conditioned us to trivialize the quest for immortality into a form of "apologism." Apologism, of course, is the categorical belief that longevity research must fail in principle. Objections come in many forms:



Famous apologists throughout history include Aristotle, Titus Lucretius, Marcus Tullius Cicero, and Marcus Aurelius. Conversely, Roger Bacon, Francis Bacon, Paracelsus, René Descartes, and Benjamin Franklin have composed powerful prolongevity arguments. More recently, Alan Harrington's The Immortalist [26] begins "Death is an imposition on the human race and is no longer acceptable." Obviously, there are a variety of opinions on this subject.

Another more insidious form of contemporary apologist literature documents just how many old people are highly accomplished in their respective professions, not just consigned to nursing homes [24, 27, 28], with the implicit aim of helping us feel good about growing old -- the rationalization of transforming an apparent necessity into a virtue. No matter how inferior one may consider it, the horror-story literature cited earlier at least has the virtue of serving to warn us that those who seek to intervene in their mortal destiny will be punished by the god(s) for their hubris. The lesson is that those who strive to contradict the classical Aristotelian syllogism starting with the premise "All men are mortal" will ultimately meet a fate worse than death.

All of this mythology is due for a radical shake-up according to Walford. It's time to appreciate the implications of the immortalist doctrine before we are caught by surprise. Significant progress in gerontology is happening as we speak, and it is likely to reach fruition in our own life times. Just because we haven't done it, doesn't mean it can't be done. Maybe it's just that no one has done it yet.

DIETARY RESTRICTION AND BIOLOGICAL SCIENCE

Walford next asked the question, "How can we know if we've succeeded?" The answer is complicated by the difference between "average life expectancy" and "maximum life span" for any given species. If all we do is increase average life expectancy without increasing maximum life span, sometimes called "curve-squaring" or "rectangularizing" interventions, we will not have achieved our ultimate goal, as worthwhile as that might be. A true "right-shift" of the mortality curve, sometimes called "span extending" interventions, are really what is being sought. Therefore, for any given species, only a complete, time-consuming, life-span experiment is sufficient to answer this sort of question. Furthermore, a sufficient number of animals must be enrolled into each group (experimental and control) to establish the results as statistically significant, which makes this form of experiment expensive as well as time consuming for the experimenter.

Orr and Sohal's genetic-manipulation experiments with Drosophila (fruit flies) reported last year in Science [30] were cited by Walford as the first "opening of the door" in the right direction. They "upregulated" SOD (Super Oxide Dismutase) and catalase genes in certain artificially-mutated strains of fruit flies and saw an unprecedented increase in maximum life span. Although Prof. Michael Rose of UC Irvine, another well-recognized researcher in fruit-fly longevity, has challenged the methodological integrity of the results as claimed, everyone agrees that these experiments must now be carried out with mammals in order for the claims to be acceptable to the larger scientific community-- first in rodents and then later in primates.

In the mean time, the real question is "Do right-shifting methods obtained in one part of the phylogenetic zoological tree generalize to other parts?" There are enough idiosyncratic differences in the metabolic physiology of insects to cast suspicion on any attempt to claim more than what was observed with the species in question.

Walford then explained that caloric restriction experiments repeated in his laboratory at UCLA on congenic colonies of mice and rats over the last two decades show that significant benefits obtain when animals are rigorously maintained on a calorie-restricted, but nutrient-rich, diet throughout their lives. Furthermore, these effects are directly proportional to the degree of restriction (up to a certain point). That is to say, maximum life span is extended more and more as the level of restriction is increased from 10 percent to 20 percent, to 50 percent, and even to 60 percent! More than that, however, and the effects of real starvation set in, causing a plateau and then a decline in benefits. Paul Segall of UC Berkeley has shown that reproductive competence is also extended proportionally.

Walford then presented laboratory data in rodents to show that blood cholesterol and fasting blood sugar are both decreased in calorically-restricted animals. Also, physical skills, like "log rolling" in water were preserved in tact in the mice. Finally, intellectual skills, like running a maze, were preserved at youthful levels in mice 39-40 months old, the equivalent of 90 to 100 years for humans. Walford showed photographic evidence for a more youthful appearance in a group of experimental vs. control mice that was conspicuous, even to a casual observer. Therefore, the data demonstrate that the long-feared Struldbrugg Obsession is actually contradicted for these animals. They live longer and remain youthful at the same time!

When all the mice had died of whatever causes, autopsies were performed on both the restricted and control groups with the overall effects summarized as follows:



Moreover, the average age of onset of these diseases, when they did occur, was postponed. Finally, rodent laboratory results revealed a favorable alteration in a wide variety of biochemical, immunological, and physiological (endocrinological) measurements, including hGH, thyroid, PTH, and cortisol.

 BIOSPHERE 2

How do we know that similar results will obtain in humans? The recently-completed two-year $100 million experiment conducted on three acres of desert near Tucson, Arizona by eight humans (4 men and 4 women [all unmarried]) inadvertently shed some light on this question [31-35]. Biosphere 2 was created to be a tightly-sealed (less than ten percent atmospheric leakage per year compared to a 25 percent per day exchange in a typical closed office building) environment with the aim of prototyping a hypothetical space colony to see if a small number of humans could be fully self-sufficient over a long period of time without direct human contact with the outside world (except for energy [electricity] and bilateral information transfer [cable TV, phone lines, etc.]). According to the ground rules, there was to be an absolutely minimal transfer of physical molecules during the experiment. [However, when one of the women lost the tip of her finger in threshing-machine accident early on, she was released for reattachment microsurgery outside the biosphere and then readmitted a few days later.] The biosphere was further subdivided into separate physical habitats: ocean, rain-forest, savanna, desert, and human living quarters, as well as an infrastructure subunit underneath. The human living quarters included sleeping quarters, a kitchen/dining area, library, workshops, a medical facility equipped with minimal operating room, laboratory equipment (gas chromatograph, microscope, etc.), x-ray, and dental equipment, while the infrastructure subunit included all the equipment needed to recirculate air and trap excess carbon dioxide. It was sort of like "the Garden of Eden located on top of an aircraft carrier," said Walford. One of the habitats included goats, chickens, and pigs. Agriculture, however, was the primary means of generating food.

Because they couldn't grow as much food as they projected they would be able to, they were forced onto a calorie-restricted dietary regime of about 1800 calories per person per day. This was really quite little, considering the amount of physical work they had to do to grow the crops they needed. The physically-demanding workload had to be shared by all (sort of like sending university intellectuals into the fields during the Chinese Cultural Revolution), and it added up to more than 65 hours per week per person! Everyone had to learn how to thresh wheat, butcher animals, cook for eight persons, etc. Walford, as the resident physician was not excepted from this rigorous work schedule, even though he was the oldest member of the team at 67. At one point he injured his back, and it took a long time to recover. Walford admitted that one of his more onerous tasks, as a pathologist by specialty training, was the retaking of his general medical-board exams for the State of Arizona!

However, as Walford showed in photographs taken at the end of the experiment, all of the biospherians looked like they had come through a "concentration-camp" experience. Nevertheless, they were otherwise healthy and happy. The men lost 18 percent of their normal body weight, while the women lost 10 percent, just the point where bone resorption would normally begin to take place, given that one wasn't overweight to begin with. There was no evidence of starvation, however. For example, there was no peripheral edema, and none of the females experienced amenorrhea (loss of their menstrual periods), even though this would have been expected under the same weight-loss circumstances without the rigorous daily activities.

The following Biosphere 2 human laboratory results were then presented by Walford:



Obviously, we cannot yet measure the increase (or decrease) in life expectancy for these eight humans, since they're all still alive! Further, they were only on this diet for two years, and it is doubtful that they would have wanted to continue on it any longer anyway. And there weren't any sex/aged-matched controls to compare them with. But, for each of the eleven laboratory parameters regularly measured, they were all consistent with the rodent experiments described earlier (in terms of percentage of youthful values). Therefore, at least in so far as nutrient-rich caloric restriction is concerned, it is suggested that the analogy between rodents and humans holds true. We are both mammals, even if it is not the case that we are both primates.

Dr. Steven Harris, who works with Prof. Walford at UCLA, interjected that there are at least some recognized differences between rodent and primate physiology. For example, there may be a different trade-off between the benefits of dietary restriction and the benefits of exercise, since exercise may help primates more in achieving cardiovascular conditioning than it ever could in rodents. Also, Harris noted that there are two areas of great uncertainty with respect to these caloric restriction experiments in mice: First, no one has looked at the question of the potentially increased susceptibility of restricted rodents to infectious disease in their native habitat, i.e., in vitro immunological competence vs. in vivo competence. Some have even suggested that caloric restriction may degrade wild-type immune response, which is never observed in the nearly-sterile, controlled conditions of the laboratory, despite the fact that restricted laboratory values do appear to show improvement over controls. It would be considered only a curiosity if laboratory mice could never leave the lab while still preserving the benefits of caloric restriction; and secondly, no one has yet studied the implications of dietary restriction on rodent fertility; we observe an age-shift in the onset of puberty, but the implications of this for total life-time reproduction are unknown.

The mechanism of action of nutrient-rich, caloric-restriction interventions in mammals is consistent with various proposed theories of aging, such as the free-radical/oxidative-stress theory, the DNA-repair theory, the neuro-endocrine theory, and the immunological-incompetence theory. More experiments will have to be conducted to tease out the distinguishing features of each theory subject to dietary restriction.

Obviously, Walford was sensitive to criticism that he was a radical among serious medical scientists, so on one slide he presented a political spectrum of relative positions which showed him in the middle as a "moderate" with a prediction of "120+" year lifespans in the next century. On the right-hand side, epitomizing the "conservative>"position, was Prof. Leonard Hayflick of UC San Francisco, whose position was described as believing that life-extension was not only impractical, but actually undesirable! On the far left, epitomizing the "radical" agenda was Prof. Marvin Minsky of MIT, whose position was described as a compleat immortalist, proselytizing a doctrine of molecular nanotechnology that will soon allow for the complete replacement of physical human bodies and brains by robots and computers, as described in a recent Scientific American article [36].

SOCIAL EFFECTS OF SUCCESSFUL INTERVENTIONS

Walford next asked, "What will the effects be on society that would derive from the discovery of techniques for significantly prolonging human life span?" Gazing into his crystal ball, Walford saw that under the new demographic boundary conditions:



As a corollary, there would be a corresponding remodeling of the educational system, as well as a closing of the so-called "generation gap;"



According to Walford, there has been almost no professional thinking in the area of speculation as to what would happen if prolongevity research were successful. The work of Prof. Lawrence Koplekoff, an Economist at Yale University, was cited as an exception. Koplekoff predicted that in the next decade "rectangularization-only" interventions (in which the number of old old members of the population would increase significantly) would have certain adverse side effects on the U.S. economy. In particular, Koplekoff forecast a 5 percent decrease in GNP, a 32 percent decrease in new housing starts, a 126 percent increase in unemployment, and a 157 percent increase in requirements for unemployment benefits. On the other hand, if "lifespan-extending" interventions were to be discovered instead, we could expect positive benefits in the form of a 12 percent increase in capital utilization and a sharply-rising increase in productivity of the labor force.

In terms of the traditional developmental stages of life, Prof. John Riley [37] forecasts a favorable re-integration of many of the economically-dictated phases of social development, including education (during youth), productive work (during middle years), and leisure (during retirement or old age). In other words, individuals would be far more free to move between educational, work, and leisure activities on a full-time basis, as they so desired, rather than being restricted by age and financial circumstances.

Prof. Walford stated in conclusion that for the first time in human history, a significant number of individuals born in the next few years will have the nearly unique opportunity to live in three different centuries: The Twentieth, the Twenty-First, and the Twenty-Second (post 2100). However, if that is really going to happen, we will need to take better care of Biosphere 1 (our own Earth).

 REFERENCES

1. Roy L. Walford, Maximum Life Span (W.W. Norton & Co., New York,; 1983).

2. Roy L. Walford, The 120-Year Diet: How to Double Your Vital Years (Simon and Schuster, New York; 1986).

3. Roy L. Walford and Richard Weindruch, The Retardation of Aging and Disease by Dietary Restriction (Charles C. Thomas, Springfield, Illinois; 1988).

4. Roy L. Walford and Lisa Walford, The Anti-Aging Plan: Strategies and Recipes for Extending Your Healthy Years (Four Walls Eight Windows, New York; 1994).

5. Roy L. Walford, The Interactive Diet Planner for Windows (Longbrook Company, 1015 Gayley Avenue, Suite 1215, Los Angeles, California 90024; 310-392-8208; 1994).

6. Genesis, Chapter 3, Verses 22-24, The Old Testament.

7. The Mummy's Tomb, staring Lon Chaney, Jr. as Kharis (Universal Pictures, 1942).

8. Hans Biedermann, Medicina Magica: Metaphysical Healing Methods in Late-Antique and Medieval Manuscripts, Translated from the German (The Classics of Medicine Library, Gryphon Editions, Inc., Birmingham, Alabama, 1978).

9. Gerald J. Gruman, "A History of Ideas about the Prolongation of Life," Transactions of the American Philosophical Society, Vol. 56, No. 9, pp. 1-102 (1966).

10. Dracula, staring Bela Lugosi (Universal Pictures, 1931).

11. Francis Ford Coppola's Bram Stoker's Dracula (Columbia Pictures, 1992).

12. Frankenstein, staring Boris Karloff as the monster (Universal Pictures, 1931).

13. Kenneth Branagh's Mary Shelly's Frankenstein, staring Robert DeNiro as the monster (TriStar Pictures; 1994 with screenplay published by Newmarket Press, New York; 1995).

14. The Wolf Man, staring Lon Chaney, Jr. as Lawrence Talbot (Universal Pictures, 1941).

15. The Golem, staring Paul Wegener, German, Silent, B&W (1914).

16. F ritz Lang's Metropolis, staring Brigette Helm as Maria, German, Silent, B&W (1926).

17. Jonathan Swift, Gulliver's Travels, Chapter X, pp. 124-129 (Great Books, Chicago, Illinois; 19 52).

18. Zardoz, British science-fiction film starring Sean Connery set in the year 2293 (1974).

19. Death Becomes Her, staring Meryl Streep, Goldie Hawn, Bruce Willis, and Isabella Rossellini, an Oscar-winning special-effects, dark-humored tale about two rivals obsessed with staying young (1992).

20. Leonard Hayflick, How and Why we Age (Ballantine Books, New York; 1994).

21. James Hilton, Lost Horizon (1933).

22. James F. Fries and Lawrence M. Crapo, Vitality and Aging: Implications of the Rectangular Curve (W. H. Freeman and Company, San Francisco, California; 1981).

23. Alex Comfort, The Biology of Senescence, 3rd Edition (Elsevier North Holland, Inc., New York; 1979).

24. Betty Friedan, The Fountain of Age (Simon & Schuster, New York; 1993).

25. Betty Friedan, "Why Men Die Young," Playboy Magazine, pp.62-66, 86, 151-152 (April 1995).

26. Alan Harrington, The Immortalist (Random House, New York; 1969).

27. Alex Comfort, Say Yes to Old Age: Developing a Positive Attitude Toward Aging (Crown Publishers, Inc., New York; 1990).

28. Horizons, To Add Another Candle: The Secrets of Living Longer, 30-minute Audio Tape (National Public Radio, 635 Massachusetts Avenue, N.W., Washington, D.C. 20001-3753; November 3, 1992).

29. Arthur L. Caplan, "Is Aging a Disease?" Chapter 12, pp. 195-209, If I were a Rich Man, Could I Buy a Pancreas? and Other Essays on the Ethics of Health Care (Indiana University Press, Bloomington, Indiana, 1992).

30. William C. Orr and Rajindar S. Sohal, "Extension of Life-Span by Overexpression of Superoxide Dismutase and Catalase in Drosophila melanogaster," Vol. 263, pp. 1128-1130, Science (February 25, 1994).

31. Carol Kahn, "Eat Less, Live Longer," Longevity, pp. 46-48, 90-97 (April 1995).

32. Gary Taubes, "Biosphere 2 Gets New Lease on Life from Research Plan," Science, Vol. 267, p. 169 (January 13, 1995).

33. Science, p. 1368 (March 11, 1994).

34. John Allen, "Biosphere 2," Science, Vol. 267, p. 1407 (March 10, 1995).

35. John Allen, Biosphere 2: The Human Experiment (Penguin, New York; 1991).

36. Marvin Minsky, "Will Robots Inherit the Earth?" Scientific American, pp. 108-113 (October 1994).

37. John Riley and Riley, Gerontologist, Vol. 34, pp. 110-115 (1994).