ReThinking with Adam Grant

Episode: Busting Longevity Myths with Eric Topol

Date: December 9, 2025
Host: Adam Grant
Guest: Dr. Eric Topol, Cardiologist and Author of Superagers

Episode Overview

In this episode, Adam Grant welcomes Dr. Eric Topol—world-renowned cardiologist, prolific researcher, and bestselling author—to debunk popular myths about longevity. Together, they expose pseudoscience in the anti-aging industry, clarify the real science behind living longer, and discuss the lifestyle and medical advances that can meaningfully extend our healthspan. Eric Topol shares evidence-based advice, delves into the emerging role of AI in medicine, and reflects on the limits of reversing aging.

Key Discussion Points & Insights

1. The "Welderly" Study & Genetics of Longevity

Timestamps: 04:55–07:50

• Study Overview: The “welderly” project identified extremely healthy elderly individuals (85–102 years old) with no chronic disease or cognitive decline, aiming to discover unique genetic markers for longevity.
• Findings:
  • "To our real surprise, we found nothing different about the welderly as compared to the elderly (control group with common age-related diseases). So nothing like we had suspected. And it really changed our whole view as to what the determinants of healthspan are, particularly extreme healthspan." – Dr. Eric Topol (05:13)
  • Most of these individuals came from families where relatives died decades younger, further weakening the genetic-only hypothesis.
• Implication: Genetics plays a surprisingly small role in exceptional aging; lifestyle and immune system health matter much more.

2. Pseudoscience in the Longevity and Wellness Industry

Timestamps: 07:52–12:40

• Industry Critique:
  • Topol notes a surge in snake oil sales—supplements, anti-aging remedies, and expensive “longevity clinics”—largely unsupported by evidence:

    "There's just so much complete pseudoscience not backed up by real data and evidence and claims that are just out there off the rails." – Eric Topol (08:30)

  • High-profile biotech and billionaire interest further fuel the confusion, making consumers easy prey.
• Top Pseudoscience Offenders:
  • Supplements: “[Supplements] claim anti-aging and health benefits...They haven’t had any meaningful data to support them.” (09:59)
  • Longevity Clinics: Charging up to $250,000 for dubious treatments like blood transfusions, hyperbaric oxygen chambers, and stem cells.
  • Total Body MRI:

    “If you get a total body MRI and you have a mass that turns out to be after biopsy cancer, that's not catching cancer early. There's already billions of cells.” (10:32)

    • Leads to unnecessary, risky medical procedures.
  • Rapamycin: No evidence for anti-aging in humans, real risk of immunosuppression (11:19).
  • Protein “Bro Science”:

    “These ridiculous amounts of protein...The data supports, you know, 1 gram per kilogram...when you get too high, especially animal protein, you’re going to get body-wide inflammation.” (12:01)

3. Supplements and Vitamins: What's Actually Useful?

Timestamps: 12:40–15:19

• For Healthy People:
  • “There usually is no reason to take any vitamin.” (12:47)
  • Small benefit for multivitamins observed, but negligible for most people on a good diet.
  • Exceptions: Correcting diagnosed deficiencies (e.g., vitamin D, B12), based on doctor’s advice—not routine testing.
• Risks:
  • Overconsumption (e.g., selenium) may be harmful, but most evidence points to minimal benefit or effect (14:14).
• Supplements like Fish Oil:
  • No solid evidence from supplements (vs. dietary omega-3s) in healthy people.

    “It’s going to enrich your urine...but it doesn't really...help your biology and your health.” (14:41)

• The Placebo Effect:
  • Many people persist with supplements due to perceived benefits, making it hard to persuade them otherwise (15:27–16:23).

4. Real Strategies for Extending Healthspan

Timestamps: 16:25–18:36

• Preventing the “Big Three”:
  • Alzheimer’s/neurodegeneration, cancer, cardiovascular disease.
  • Each of these “brews” for 20+ years; early identification and prevention are key.

    “If you have two decades to get ahead of one of these diseases, that’s amazing in itself.” (17:20)

• Technological Advances:
  • Use of genetics (polygenic risk scores), biomarkers, AI from retina images, and more to identify high-risk individuals for targeted prevention.

5. Early Detection vs. Over-Screening

Timestamps: 18:36–22:48

• Problems with Age-Based Mass Screening:
  • Example: Universal mammography, despite only 12% of women ever having breast cancer.
• Better Methods:
  • Partitioning risk using genetics, biomarkers, “multi-cancer early detection” blood tests (highlighting the importance of microscopic detection over imaging).
• Current Medicine Flaws:
  • Reactionary, not preventative—especially in heart disease (22:48).

6. Practical Lifestyle Recommendations

Timestamps: 23:55–25:52

• Exercise:
  • All movement is good; zones (2, 3, 4) matter less than balance across aerobic, resistance, and balance training.
  • Too much exercise can even be harmful; variety and enjoyment are key.

    “It’s not so much the zones...but you’re getting really important core and upper body strength you won’t get from walking or bicycling.” (24:18)

• Weight Training Focus:
  • Core and upper body are particularly important, especially if legs already get aerobic use (45:25–45:46).
• Balance training is essential as we age.

7. AI, Medicine, and Being an Informed Patient

Timestamps: 28:08–33:38

• Skepticism vs. Openness:
  • Importance of replication, transparency, and independent proof before accepting new findings (28:33).
• Navigating Information:
  • Internet and AI (ChatGPT, Claude, Copilot, etc.) offer multiple opinions, but shouldn’t substitute for expert human judgment.

    “Nobody in anything serious matter in medicine should go with one opinion.” (29:43)

  • AI’s rising role as a diagnostic supplement, not a replacement for doctors—likened to airplane autopilot, not full autonomy (32:30–33:38).

8. The Limits of Human Longevity

Timestamps: 33:38–37:52

• Can We Reverse Aging or Become Immortal?
  • Practically, no. Aging is a process, not a disease.

    “No, absolutely not. Aging is not a disease. It's a process...If we ever…reverse it...there'll be some risks...We can make a mouse look young...But they get tumors. That's not good.” (34:00)

  • AI-driven drug discovery will improve some outcomes but won’t “end all diseases.”
• Cryonics and Immortality:
  • Highly skeptical—prolonging life on machines isn’t meaningful.
  • A “cyborg path” (integration with inorganic organs or brains) is theoretically conceivable, but philosophically fraught.

    “If we’re walking around with artificial hearts and brains…how much of the original human are we?” (37:32)

9. Lightning Round & Notable Advice

Timestamps: 39:39–44:42

• Worst Health Advice in Cardiology:
  • “People are being told to get a calcium score for their heart with a CT scan...they have some calcium in their arteries...now are getting anxious and staying anxious.” (39:49)
• Best Health Tip (Not Yet Discussed):
  • “Sleep...the vast majority of Americans are not getting good high quality sleep...it is a really important part for all of these age related diseases.” (40:21)
• Recent Shift in Beliefs:
  • Topol was skeptical about disease prevention until recently, but is now confident it’s possible to “flip” elderly with chronic diseases to elderly (welderly) in the future (41:06).

Memorable Quotes

• On Supplements:

  “Supplements are pretty high up on the kind of irritant list of pseudoscience.” – Eric Topol (09:59)

• On Placebo Effect:

  “They get attached...there’s a lot of placebo effect.” – Eric Topol (15:27)

• On Prevention:

  “An ounce of prevention is worth a pound of cure? … I would say hundreds of pounds of cure. Because we rarely get cures.” – Eric Topol (20:58)

• On Sleep:

  “Know if you’re getting good quality and regular sleep because if you do that, everything’s going to be better.” – Eric Topol (40:21)

• On Technology Augmentation:

  “...in medicine...autonomy can work to some degree, but it’s never going to be completely covering all aspects...It’s going to be a big augmentative function.” – Eric Topol (33:16)

Additional Insights & Reflections

• Doctor-Patient Dynamics:
  • Medical professionals lag in adopting new prevention tools; consumer advocacy is key (23:07).
• Medical Error:
  • Diagnostic errors cause immense harm; psychological safety and learning from mistakes are vital (42:32–43:55, Adam Grant reflects on organizational psychology insights).
• Science Funding:
  • Threats to research funding are a grave concern at a time of unprecedented medical advances (44:07).

Summary Table: Dr. Topol's Evidence-Based Healthspan Advice

| Practice/Belief | Evidence/Recommendation | |----------------------------|------------------------------------------------------------| | Expensive longevity clinics| No evidence; many approaches are risky or pointless. | | Vitamins for healthy people| No benefit unless deficient (D, B12); multivitamin is fine but minor impact. | | Supplements (fish oil, etc)| Little solid benefit except placebo; dietary sources preferable. |
| Exercise types/zones | Move regularly; balance aerobic, resistance, and balance training. |
| Massive protein intake | Data supports moderate (1g/kg); excess is harmful. | | Sleep | Prioritize quality and regular sleep, track and optimize as needed. | | Early detection | Prefer risk-based (genetic, biomarker) over one-size-fits-all screenings. | | AI in medicine | Useful supplement, not a substitute for human expertise. | | Life extension/immortality | Not realistic; focus on prevention and maximizing quality of life. |

Suggested Action Steps for Listeners

1. Skeptically evaluate anti-aging claims and supplements.
2. Adopt a balanced, enjoyable exercise routine (aerobic, resistance, balance).
3. Prioritize regular, quality sleep.
4. Discuss personalized early detection and prevention with your doctor, focusing on family history and biomarkers rather than generic screenings.
5. Use AI tools as supplementary information, under expert medical advice.
6. Advocate for improved science funding and error prevention in healthcare.

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