Everyone will die, but we can live healthier, longer lives until that day comes. That’s the guiding principle that motivates the work and advocacy of Nir Barzilai, a longevity researcher and president of the Academy for Health & Lifespan Research.
“As a field, we are leading a revolution to target aging and prevent diseases,” says Barzilai, who directs the Institute for Aging Research at New York’s Albert Einstein College of Medicine.
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Aging drives many diseases, including heart disease, cancer, and Alzheimer’s. Many scientists including Barzilai think that the aging process can be modified and that, by doing so, diseases can be forestalled and people can stay healthier for longer. Researchers are exploring ways to alter aging, including through exercise, diet, and drugs.
As part of TIME’s series interviewing leaders in the longevity field, we spoke to Barzilai about what drew him to longevity science and some areas of anti-aging research that particularly intrigue him.
This interview has been condensed and edited for clarity.
What prompted your interest in longevity research?
It started when I was a kid, when I was about 13. I remember walking with my grandfather, who was 67 at the time, and he was telling me about all these things he had done when he was young. I remember looking at him and thinking he looked old. He was balding and was walking slowly. It just sunk in that, oh, one day I’m going to age too, and I want to be able to age in a way that I’ll still be able to do things. I became very interested in understanding the biology of aging.
Learning later that there is a difference between chronological age and biological age gave me hope that we have such flexibility [to age better].
Aging was considered inevitable. The thing that is inevitable in my mind is death, but aging can be totally modified. That was the hope, but now it’s a promise. What we’re doing now as a field is realizing that promise…how to die young at a very old age.
Are you interested in living forever?
No, no, I don’t have a fear of death, and I’m not an immortalist. I know people who are, but that’s a belief, that’s a religion. For me, I am interested in interfering with aging so that we can prevent disease. I want us to be healthy and then die one day.
Read More: How Tracking Your Health Metrics Can Help You Live Longer
Until 150 years ago, life expectancy was between 20 and 30. Today, lifespans have increased threefold. That’s a huge achievement. We harnessed agriculture so people could eat well, we cleaned water, built sewers, developed vaccination. Improving public health is what really got us through. Over those 150 years, every year we have lived a little bit longer than the year before…until we got to the age of about 60. Then all of a sudden we have diseases that never used to kill us. Over the course of human evolution, there were pandemics, there were wars, but people didn’t die from Alzheimer’s disease or diabetes or heart disease. Those are new diseases, right? Aging is what drives many diseases, so we need to interfere with aging before it causes diseases.
So, you’re confident that the aging process can be altered?
Yes, this is possible. I’ve collected data from about 850 100-year-olds and their families. We found that the centenarians got diseases 30 years later than most people. They also had what we call a “contraction of morbidity,” so they were sick only for a very short amount of time at the end of their lives.
So there is an example of people who can live healthier and longer. It’s in our capacity.
It’s true that for centenarians, it’s mainly genetics [that is driving longevity]. So people might say, oh, I’m not born with these genes, too bad. But no—when you find these genes, you can usually design a drug that will do what this gene is doing.
Read More: Unlocking the Secrets to Living to 100
I’ll give you one example. In nature, small dogs live longer than large dogs, and ponies live longer than horses. In the lab, when we knock out the growth hormone, [animals] live much longer than if we induce it. So it seems that growth hormone is playing a role [in lifespan]. About 60% of our centenarians have something on their genome that interferes with the action of growth hormone.
What we think is happening is that growth hormone is good for you when you are young. It protects you against many things. But when you are old, you’re starting to break down, and you don’t want to spend your energy on growth. You have to spend your energy on repairing, basically. That could explain why so many of our centenarians are protected: because they don’t spend that much energy on growth.
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We have taken an antibody against growth hormone, and we’ve given it to animals, and they live longer.
So we’re looking at these mechanisms, at these centenarian genes—it’s not one gene, it’s several—and we are designing therapies and giving it to animals who age like people. We’re trying to see if these therapies increase lifespans of the animals. If they do, we can move on to testing in clinical trials and develop a drug.
The American Federation of Aging Research currently has a “super-ager” study where we are recruiting 10,000 centenarians in order to validate our research and to find more longevity genes. We’re looking for people to register. It’s a cool project.
Are there already treatments or other interventions that have been proven to slow aging?
Optimizing sleep, exercise, diet, and social connectivity all have biological underpinnings, and these interventions are good for every age.
The enemy to our field right now is the noise that we hear about all the time: all the things out there that are being marketed as the fountain of youth.
Supplements are a huge, huge problem. First of all, the bottles you buy might not contain what they claim to. Also, some people are saying you should take a lot of these supplements, but there can be interactions that we don’t always know or understand. We know from a recent paper that people who took multivitamins didn’t have a lower risk of mortality.
On the other hand, there are drugs that have been approved by the U.S. Food and Drug Administration that appear to also target the biology of aging. They include [the diabetes drug] metformin, GLP-1 drugs, and bisphosphonates which are used for osteoporosis. We’re trying to determine [their safety and efficacy]. It’s a work in progress.
Read More: Want to Live Longer? First Find Out How Old You Really Are
Personally, I do intermittent fasting for my health. When I started studying the biology of aging, I noticed that the lab animals that had their calories restricted lived longer than their siblings and were healthier. People have taken that to mean that if you have less food, you live longer, but actually it’s the fasting that’s really important.
It’s not for everyone, but people who do it really enjoy it. I fast for about 16 hours every day; I start counting after I’m done with dinner. It has had a major impact on my health. I lost some weight, but I also gained muscle. I lost the fogginess that I had sometimes during the day.
Looking at the longevity field as a whole, what’s most exciting to you right now?
As president of the Academy for Health & Lifespan Research, I try not to take sides, right? But I’ll just mention three things. First of all, there’s something that I would call a left-fielder: hyperbaric oxygen. It sounds crazy…a chamber with very high oxygen for hours. But it’s actually not as crazy as it sounds. I’ve brought those chambers to my lab to understand in animals how it targets the biology of aging.
The second thing is mitochondria, the powerhouse of our cells. As people age, the number and function of mitochondria decreases. But it seems that you can replenish it by infusing the blood with mitochondria. There are companies that are now doing that.
Finally, the future of the field for me is being able to take a young person, 20 years old, and giving them a treatment and repeating it every few months or years to reverse their aging. We already know a way to partially reprogram our cells to think that they’re young again, and this is already in the works in preclinical studies and even going into humans.
Do you remember that video that went viral where the leaders of China and Russia were talking about longevity and how we can get organ transplants and live to 150 years? Well, that’s not going to happen…but there is a company that is taking organs and using partial reprogramming to rejuvenate them. The big problem with organ transplants is we don’t have enough organs, and many donated organs are discarded because they are too old and have other problems. This technology could make organ transplants much more available.
This article is part of TIME Longevity, an editorial platform dedicated to exploring how and why people are living longer and what this means for individuals, institutions, and the future of society. For other articles on this topic, click here.