Longevity roundtable — the science of aging, geroprotective molecules, lifestyle interventions, challenges in research, and more | Steven Austad, Matt Kaeberlein, Richard Miller

**Peter Attia** (0:11)
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Welcome to a special episode of The Drive. Today, we're introducing a new format to the podcast. It's our inaugural round table conversation. For this one, we have gathered three brilliant minds, all former guests of the podcast, to sit down and have a nuanced, funny, sometimes a little heated discussion about one of the most fascinating and rapidly evolving areas of medicine today, gyroscience, also known, I guess, as longevity science. So joining me for this episode are doctors Steve Austad, an expert in aging biology and author of groundbreaking research on extending healthspan, Richard Miller, pioneer of the study of anti-aging interventions through the Interventions Testing Program, or ITP, which you hear me reference a lot, and Matt Kaeberlein, whose expertise explores the intersection of genetics, aging and translational research. And Matt, of course, is famous for his work in the dog aging project. So in today's roundtable, we discuss a number of things, such as the relationship between healthspan and lifespan. And what does healthspan actually mean? Is it something we should try to define? Can you improve one without improving the other? What has caused a surge in the public interest in longevity science and what major barriers are preventing longevity research from reaching its full potential? This actually was one of my favorite parts of the discussion. How do we evaluate the effectiveness of interventions like rapamycin, senolytics or calorie restriction in humans where it's very difficult to study them for obvious reasons? Are there reliable biomarkers or aging rate indicators that can measure biologic aging, which of course is a very hot topic? What role do epigenetic changes play in aging? Specifically, are they causal? Are senescent cells a valid target for longevity interventions or has their role in aging been overstated? Are GLP-1 receptor agonists, for example, drugs like terzepotide and semaglutide, potentially zero protective beyond just their weight loss effects? How do we overcome the funding and political challenges that prioritize disease-specific research over foundational aging science? What would it take to make longevity research more mainstream and gain broader support from the public and policymakers? Anyway, this is a new format, this idea of doing a roundtable. So we really want to hear from you. Is it something you like? If so, what are other topics you would like to see for roundtables? Without further delay, please enjoy this roundtable discussion with Steve Austad, Rich Miller and Matt Kaeberlein.
Gentlemen, this is a lot of fun. I am excited to be sitting down with you guys today. Where do we want to begin? Let me start by saying the following. The term longevity, someone sent me something the other day that was like a list of, I don't know, whether it was how many times the word longevity was searched on Google or something like that, but it literally looks like Bitcoin. So, we are clearly at peak longevity in terms of public interest, which for all of you who have kind of devoted decades, plural to this, I just want to kind of get a reaction from you, each of you, on what that means, why you think it's happening and maybe even extending the metaphor a little bit. Is there a bubble going on? Let's start with you, Steve.

**Steven Austad** (4:26)
It's a surprise to me that longevity has become so big because for a long time, we tried to move away from that in the aging field because we were worried that people were thinking of longevity as well, we're going to keep frail, feeble old people alive longer. That's what longevity meant. When really what we were trying to do is extend health. So, I'm kind of surprised, but I think it's because there are certain people of a certain age who've started to think about their own longevity. Then I think there's a whole new generation of tech, entrepreneurs, that really feel like this is a problem that will allow them to live healthily for several decades at least longer than they are now. So, I think it's a combination. It's a multi-generational thing. That kind of surprises me.