Germans are getting older and older. But how can we bring more life as we grow older? This is what longevity research is concerned with. In an interview with FOCUS online, expert Bernd Kleine-Gunk reveals which measures really increase our longevity – and which can be dangerous.
FOCUS online: Longevity means that you can extend your own longevity. Is that actually possible? And what role does genetic predisposition play?
Bernd Kleine-Gunk: Genetics obviously play a role. But there are twin studies that have found that only about 20 to 30 percent of life expectancy is actually genetic. The rest is essentially lifestyle and we can influence it. People used to always say: “Age is fate, there’s nothing you can do about it.” But we’ve now learned a lot about aging processes and have also noticed that aging is definitely a process that can be shaped.
Which measures can help to increase your own longevity?
Little Gunk: What grandma always said: “Stop smoking, get moving, get off the sofa and eat your vegetables.” That’s not the latest longevity research, but It’s still the basics: diet, exercise and cutting out things that make you age faster, such as smoking.
There are now a whole host of options. When it comes to eating, for example, it’s not just important what you eat, but also that you don’t eat anything at all. This means that fasting is one of the oldest, best-researched and most effective anti-aging and longevity measures. There are different forms, from intermittent fasting to sham fasting. Both obviously have a very big effect on longevity. Eating less means living longer.
Are there certain foods that have an impact on longevity?
Little Gunk: I wouldn’t just focus on one food right now; That then becomes one-sided. You don’t have to become vegan, but ultimately when it comes to nutrition, we already know that a plant-based diet, for example, is healthy.
Broccoli, for example, contains sulforaphane. This is even a cancer protection factor. Green tea, in turn, is even referred to as “long life” tea in Japan and China. It contains a phytochemical with the unpronounceable name epigallocatechin galate, which has a very positive effect on health. Quercetin is also a plant substance found in apples and onions.
You actually eat sensibly by consuming as wide a range of nutrients as possible. We benefit from secondary plant substances; they make our fruit and vegetables colorful. My tip: Don’t just put one food on one side, but make the plate colorful.
Does this also apply to dietary supplements? Which of these should you take?
Kleine-Gunk: Of course there is a lot on offer. Not everything makes sense, some things do. Vitamin D is certainly an example of a useful supplement. There are clearly defined limits that you should not fall below. Vitamin D is essentially formed in the skin when exposed to sunlight. 70 to 80 percent of the German population suffers from a vitamin D deficiency in winter. I can’t compensate for this through diet, there’s relatively little in it. Then there are actually only two options: either go on a winter vacation in the Caribbean or at least on the Canary Islands – but this is not financed by health insurance – or take vitamin D as a food supplement.
Then omega-3 fatty acids. If I eat fatty sea fish three times a week, then I don’t need any nutritional supplements. But very few people do that. So it makes sense to possibly balance that out.
When it comes to secondary plant substances, it is important to take them in the right dosage. Curcumin, for example, is a very useful plant substance, also because it has an anti-inflammatory effect. But you would actually have to eat dishes like a South Indian. Very few people do that either. Whenever I don’t get something from my normal diet or don’t get enough of it, it makes sense to take the whole thing in the form of supplements.
Prof. Dr. med. Bernd Kleine-Gunk is the head of gynecology at the Schön Klinik Nuremberg Fürth, a doctor of nutritional medicine and a doctor of osteology. He has also been President of the German Society of Preventive and Anti-Aging Medicine (GSAAM) since 2009.
Kleine-Gunk has also written numerous books on the subject of anti-aging, including “Staying young is a matter of the mind” (2022), “Live 15 years longer” (2017) and “Preventive medicine and anti-aging medicine” (2022).
What about medications?
Little Gunk: The topic is coming up gradually now. One thing is being discussed a lot: metformin, an ancient anti-diabetes drug that was hyped two or three years ago. This has been on the market for 60 years. A number of studies suggest that metformin appears to have a life-prolonging effect. It is currently being tested in America in the large study “TAME: Targeting Aging With Metformin”.
But there are still many in the anti-aging sector who are already taking it. They argue that the drug and its range of side effects are well known and that it is well tolerated apart from a few gastrointestinal complaints. However, metformin requires a prescription. And the symptoms are dose-dependent. In a dosage of 500 to 1000 milligrams – diabetics take 2000 milligrams – it is well tolerated.
However, some stop taking it or do not take it continuously because they notice that it has a negative impact on their athletic performance. I also have a few top athletes in my practice who took it at the beginning. They naturally have a good feeling about their performance. And some of them then say that you are no longer as productive on metformin because the glycogen reserves that are mobilized decrease under metformin. They then stopped taking it or only take it on days when they are not playing or training.
But the average athlete who spends three quarters of an hour in the gym or plays doubles on the tennis court doesn’t have a major loss in performance.
Can you explain how the drug works, what it does in the body?
Little Gunk: Ultimately, it tricks our body into thinking we are restricting calories. Fasting, an overall calorie restriction, is, as I said, a good anti-aging measure. There are certain signaling pathways in the body and if I take metformin, for example, then blood sugar and glycogen are reduced.
This means that the body is now in fasting mode. This triggers all of these mechanisms, i.e. repair of DNA and structural proteins as well as autophagy, i.e. the clearance of intracellular, molecular waste. The body switches from growth to maintenance, so to speak. This is a really good measure, especially as you get older. The medication tricks the body into believing this.
And in Germany you can only get it with a prescription because it is actually a diabetes medication?
Kleine-Gunk: Of course there are side effects and metformin is very, very inexpensive. But it still requires a prescription.
Staying young is a matter of the mind: Amazing facts from aging research by Prof. Bernd Kleine-Gunk
Longevity is also about reducing biological age. What are the benefits of such rejuvenation?
Kleine-Gunk: Ultimately, we differentiate between chronological and biological age. Chronologically it is clear: look at your identity card, there is a date of birth on it, then you can calculate your chronological age. But biologically you can be older or younger.
There are big advantages to being biologically younger because the risk of illness and death increases with aging. This means: the more I rejuvenate myself biologically, the more I increase my healthy life expectancy. This is exactly what we want to achieve in longevity medicine.
We also have the great advantage that we can actually measure it relatively precisely. The epigenetic clock (“Horvath’s Clock”) is a very precise marker for biological age. And of course that also brings this whole medicine forward. This gives us a measuring instrument in our hands with which we can actually see whether we are intervening – be it dietary medication or supplements. You can measure before and after and see whether the intervention really made a difference or not. The wheat is now separated from the chaff in longevity medicine, what has an effect or what the companies’ marketing is.
How can you test your biological age, for example? Can I then just go to my family doctor and say that I would like to know how old I am biologically?
Kleine-Gunk: Not every laboratory offers this as standard. There are some companies that offer this online, where you can order it and have it delivered to your home. Then you send it back and get your results after two or three weeks.
Bryan Johnson is very prominent in the longevity sector. He is said to have reduced his biological age by up to 20 years, including through blood transfusions and infrared saunas. What do you think of these measures?
Little Gunk: He is certainly the best-known representative. He does self-rejuvenation as a high-performance sport and nothing else. What he is doing certainly makes sense. He is up to the standard of current longevity medicine and also has a good advisory team around him, i.e. doctors, nutritional therapists, personal fitness trainers and so on.
But it is a radical program. He eats two meals a day, one at 7 a.m., one at 11 a.m. and that’s it. He always eats the same thing, takes 120 supplements every day, and goes to bed at 8:30 p.m. every night so that he gets enough sleep. So you have to like that too. The whole program would be a bit too ascetic for me. There always have to be people who go too far. Of course, it becomes an obsession when I just work on self-rejuvenation every day. If at some point he stands at the meat counter in the supermarket and is given a slice of sausage, then he has overdone it. (laughs)
Bryan Johnson has his teenage son’s blood injected into him. Sounds a bit manic.
Kleine-Gunk: These are so-called young plasma therapies. There are spectacular experiments on mice, for example an old mouse is sewn together with a young mouse. Then they get a common blood circulation and the old mouse actually becomes significantly younger because it constantly has this blood exchange with the young mouse. Where many old men say: “I always said: you stay young with a young mouse at your side.” (laughs)
Plasma obviously contains substances that have a rejuvenating effect. Some get the plasma from young blood donors and use it to rejuvenate themselves. The Ambrosia Clinic was the first to do this in America. For example, one of the first customers was Peter Thiel, a multi-billionaire from Silicon Valley who is also transhumanist. He paid 8,000 euros for such a blood transfusion, probably from petty cash. Bryan Johnson gets it from his own son. These are extreme variants.
Longevity then gets a bit of a reputation in medicine as being a luxury medicine for the rich and super-rich. But as I said: You can achieve more through simple measures such as a balanced diet and plenty of exercise than by injecting yourself with Young Plasma for expensive money.
Is there a specific point at which longevity becomes dangerous or even an obsession?
Kleine-Gunk: Trying to lower the age isn’t necessarily dangerous, but of course you can turn anything into an addiction. There are eating disorders, there are people who exercise excessively. I don’t know whether it’s a personality disorder or an addiction in Johnson’s case. But obviously what he does doesn’t have a bad physical effect.
But of course you should be a little careful. An image of longevity is quickly spread that hardly any mere mortal can achieve. I can still achieve a lot with significantly less effort and go out with friends in the evening and drink red wine.
Just have a little fun.
Little Gunk: (laughs) Or have a little fun or eat something in the evening and not eat my last meal at 11 in the morning.
Measures like Young Plasma obviously work, but in your opinion what does nothing or is complete nonsense?
Kleine-Gunk: So-called stem cell therapies are often offered. Stem cells are basically the cells from which new cells and tissue continue to grow. This has been the hope of anti-aging medicine for decades. There are clinics in Asia, and previously even in Ukraine, that offer stem cell therapies. I would be very, very careful. If they are real stem cells, then there is also a certain risk of cancer associated with them. In most cases it wasn’t stem cells at all and a lot of money was spent on it that actually had no effect at all. There’s a lot of shit going on there too.
Epigenetics is something that also greatly advances longevity medicine. But then suddenly there are epigenetics coaches on every corner and on the Internet who often don’t even have a medical degree or anything similar. They read a bit themselves and then do coaching in this direction. They jump on the bandwagon of what’s currently happening and decorate themselves with terms that very few people understand correctly.
What are the current research trends in longevity? What’s the latest rage?
Kleine-Gunk: When it comes to medications, for a long time it was metformin. This is still being used a lot now. There are currently the first to take rapamycin. This is the second drug that is known to also appear to have life-prolonging effects that are stronger than metformin. But rapamycin also has stronger side effects. This is actually an immunosuppressant and we don’t necessarily want to downregulate our immune system. Some say it’s more dose dependent and if you only take it once a week then it obviously has positive effects.
People often also take their cues from opinion leaders and influencers. Now there is a longevity bestseller from Dr. Attia, who says he is taking rapamycin. People are already standing in my practice and all want to get rapamycin written down. Of course, this also requires a prescription. You then fall backwards from your stool when 100 tablets of 2 milligrams each cost 2000 euros. These are always trends.
Then there is a study that took place in America. This is the so-called TRIIM study, in which a drug mix is tested on a group. Its essential components are growth hormones, DHEA and metformin. Before and after this drug mix, the group carried out this epigenetics test – with very, very good results. The study is still being developed further with scientifically proven measures.
The interview is actually over, but another important aspect emerges in the follow-up conversation: the inner attitude.
Kleine-Gunk: The mindset, the inner attitude, how you approach aging is very important. If I now look at the aging process like a rabbit at a snake and tell myself that everything is getting more and more difficult, then the motto of the self-fulfilling prophecy is coming true. It’s a completely different approach when I retire at 65, am still fit and realize that, statistically speaking, I still have two decades ahead of me that I can still make great use of.
Are you saying that humor can also help you stay young?
Kleine-Gunk: Very important: humor and optimism. This can also be good for those who are always wondering which tablets they need to take or which Young Plasma they should get. It’s simply a matter of mental approach.
I’m 65 and have been a doctor for 40 years and of course I’m now thinking about: What will I do in the next 30 years? You still have an incredible number of options. In the past, people might have attended a community college course for Italian, but today they start a whole course of study again. And many people always say that they actually wanted to study art history or philosophy. But because you don’t make much money with it, they studied business administration after all. In their late 60s, they think they could do it again. I recently attended an art history lecture in Munich. You think that many of those sitting there have met Caspar David Friedrich personally. (laughs)
I just think that’s great: thinking about age in a new way. This “learn for 20 years, work for 40 years and then enjoy your pension for another 15 years and then do nothing” is certainly wrong. You need new challenges again. Life expectancy is there, health is mostly there, and most people are economically secure. A lot is still possible.