‘Brilliantly written’
Russell Foster, bestselling author of Life Time
Hacking Humanity Lara Lewington
‘Extraordinarily helpful’
Damian Hughes, High Performance podcast host
Hacking Humanity
Hacking Humanity
How Technology can Save Your Health and Your Life
Lara Lewington
WH Allen
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First published by WH Allen in 2025 1
Copyright © Lara Lewington 2025 The moral right of the author has been asserted.
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This book covers many areas of fast-moving science, so while everything was up-to-date at the time of printing in 2025, there will inevitably be elements that date, or change, in the future. This book is not an instruction to change anything in your life. It is merely reporting on the story of where we are now, and the innovations that appear to be coming. This book does not constitute medical advice – please consult your GP or medical practitioner before trying any new diet, fitness regimen, medical test or treatment. The author has, to the best of her knowledge, accurately relayed expert opinion. The author and publishers disclaim, as far as the law allows, any liability arising directly or indirectly from the use or misuse of the information contained in this book.
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To my mother, Sonia, who taught me what matters in life, and what doesn’t.
And to my beautiful family, Martin and Sapphire. Three is never a crowd.
Introduction
The Future Starts Here
You wake up in the morning at the perfect time in your sleep cycle. Your smart mattress is syncing with your calendar to give you a gentle shake at the optimal moment, given your slumber pattern and schedule. You have started going to bed 45 minutes earlier as advised for your ‘chronotype’ and you feel good. You head to the bathroom where you clean your teeth – your toothbrush tells you that you missed a bit on the bottom left – ‘like you did yesterday, and the day before’. You’re also brushing too hard, apparently; if you thought people were hard to please, try a know-it-all AI chatbot. You tell it, ‘Go easy on the brushing advice, you’re really annoying me, and I’m tired.’ It’s not offended. It listens, and your relationship will be better going forward, on this front anyway. The coffee machine knew you were up, so a fresh brew from your selffilling coffee robot awaits you downstairs. First, though, the smart toilet shall analyse its morning findings, as your overnight sleep, heart rate, blood oxygen, blood pressure, glucose levels and temperature data syncs, and your self-making duvet tidies itself up. You glance in the mirror: it tells you your blood pressure, and your current risk of developing type 2 diabetes – fortunately, things are looking fine. Your phone buzzes to say that your smart ring needs charging; you only had the plug
space for fourteen devices last night. Then your virtual assistant pipes up, announcing that your cardiovascular age has dropped a year since yesterday – finally, months of hard work in the gym have paid off. Result. You say ‘thank you’. You’ve still got manners after all. On with the day.
This isn’t a vision of the future. You can pretty much do it all now, albeit with a few glitches, but most of us won’t bother, as this seemingly friction-free start to the day might sound absurd and unnecessary, but how about if I told you that collecting even some of this data could play a part in extending the healthy years of your life – your ‘healthspan’? The average man in England can expect to live to 79, but the issue is, he’s also likely to spend nearly 18 years1 in ‘poor health’. That’s well over a fifth of his life! Meanwhile, relatively, women fare even worse. Life expectancy stands at a grand 83 years of age, but with 20 of those years spent in suffering.2 That’s nearly a quarter of her life! It’s absurd but that’s currently what’s ‘normal’ in a high-income country. But it doesn’t have to be.
For the best part of two decades, I’ve been lucky enough to cover some of the greatest innovations on earth for the BBC . My job has always been to boil down science and technological advancement to the facts that matter to everyone. I’ve travelled the world, tasted future food, experienced rotting ruins hidden beneath perfect ocean surfaces, visited space agencies, and even been invited to the moon (by someone who could actually have taken me). And if there’s anything I’ve learnt, it’s that innovation, at its best – or worst – and the cultural and societal change it brings, is a deeply human story. But never has anything captured my imagination like what we are starting to see as the future of healthcare unfolds.
We are at the beginning of a transformation in how we approach our health, both individually, and at population
level. It’s big, it’s bold and it cannot be underestimated. Many experts believe the coming together of artificial intelligence, enhanced understanding of genetics, and the incredible amount of data we are constantly generating about our health, habits and environments is leading us into a new age of personalised, predictive and preventative medicine – healthcare that keeps us from getting sick in the first place. Through the programmes I’ve made, I’ve uncovered groundbreaking new technologies that can make a real difference to our lives: many of them not only giving us hope, but also new tools to improve our wellbeing. I write this as neither a doctor nor a scientist. I am just trying to break down a story of discovery I’ve started, which I feel needs to be shared. It is a story that affects each and every one of us.
Let’s start with the basics. In Part 1 we’ll talk tracking, and see how continuous monitoring and regular number crunching can help us observe our own bodies. We are generating information that is changing everything. We’ll look at big data on you, me, on people who do track everything, those who think they track nothing, and what that means for us all. We are at the beginning of an age where data on our behaviour and bodies, combined with that of our individual genetics and environment, can be processed by powerful AI . These tracking tools can already unlock improvements to our everyday wellbeing, to help us sleep better, understand the impact of what we consume, monitor our mood, identify our ‘normal’, recognise when things change, and even spot warning signs of disease before the symptoms reach us. As we dive deeper in Part 2, we’ll explore cutting- edge medical research and see how we are on the cusp of a healthcare revolution where we will be able to predict, delay
or – even better – prevent the onset of serious diseases. And when conditions can’t be averted, early diagnosis will be key, with new forms of kinder, more personalised medicine. The growing power of AI is allowing researchers to identify links between genetics, our lifestyles and disease like never before, helping them develop better therapies. We’ll unpack what these transformations mean for treating the most devastating diseases including cancer, heart disease, type 2 diabetes, Parkinson’s and dementia. We’ll also take a look at the medicines increasingly giving us the power to lose weight at will, what the future looks like for lab- grown organs, and how robotics and AI chatbots are hoping to support our emotional wellbeing.
The biggest risk factor for chronic diseases is ageing, so in Part 3 we’ll meet those aiming to slow down the process. In 2023, when I set out to make a BBC documentary on how technology can help us live healthier lives for longer, my mission was to decipher science from snake oil, of which there has been plenty in the world of longevity. It has long been full of unproven supplements, dodgy devices, and some ‘supercentenarians’ with questionable maths – and forged birth certificates.3 For years the longevity industry seemed full of empty promises. Backstreet placenta stem-cell treatment anyone? 4 But something has changed. Reputable health-tech and longevity research are merging. Understanding the biology of ageing and its place in the journey of prevention is crucial, and technology, data and AI are driving promising developments in how we can close the gap between our healthspans and our lifespans, to live better for longer. While I’ve spoken to some people who want to live forever and believe they can crack the code to do so (as well as a centenarian who’s having none of it), it’s not about living to wild old ages, but about
how we can reduce the emergence and impact of critical illnesses to get the most out of the years we have, and yes, that may mean an extra few years thrown in too.
The final part of the book explores how we can build all this into happy, healthy, plausible lives and societies, making sure that technology is used to educate and empower. We’ll see how health systems try and provide the best treatment within the constraints that exist, and how we need to make sure this is a journey towards health equity, rather than worsening inequalities.
Most of my research and filming has been in the UK and US , places with vastly different healthcare systems, so I have done my best to explain any challenges in a way that is relevant to all – but there will sometimes be references specific to one or the other. I’ve spent years meeting the leading and most brilliant scientists, academics, founders, inventors and innovators of our time, who are usually genuinely trying to improve the way that we live, often with incredible (occasionally tragic) stories behind their motivations. Sometimes with fast-evolving new technologies there are valid reasons for caution, and real challenges; I make no bones over raising them. With many inventions, I shall highlight opposition to these ideas too. Although many of the scientists I spoke to were quick to bring up those challenges themselves, tending to be naturally cautious and quick to share the potential shortcomings of their research. In the process of science hopes are raised and hopes are dashed all the time. New findings are constantly emerging that cause us to have to rethink everything we thought to be true, and that pace of learning is ramping up as our ability to gather data and experiment with it on a larger scale increases. AI and great computing power means scientific theories can be proven wrong quicker, but
that’s useful, because we can then move on to getting things right. Every experiment researchers do is carefully planned, measured and recorded so that the truth can arise from the accumulation of reliable evidence.
Wherever possible, I’ve tried out new gadgets (including many prototypes) and sat in on the use of medical and research equipment that doctors, surgeons and scientists are slowly adding to their arsenals. Any trials I’ve personally carried out have been entirely unscientific, and to some extent just playful, but I’ve used the tech available to consumers like anyone would, and often that’s the real test of whether it can work in our lives. This book is by no means an instruction to change anything you do or don’t do – any lifestyle changes you make need proper consideration and, in some cases, your doctor’s approval – but it will uncover the technology that is available right now that might help boost your health, and show you the emerging concepts that will change everything about how we tackle ageing and disease.
As influencers and wellness fanatics plunge into their ice baths, it’s cold hard data that I believe is truly changing the game. It is AI ’s fuel, and will power this new era of healthcare. Data has long been central to health, of course, in whatever form it has been available. In Ancient Greece, ‘data’ may have been a matter of simple observations, but by the seventeenth century, the first statistical models were being used to analyse patterns in mortality ‘data’ in and around London. 5 In the 1940s came the first randomised control trials.* We’ve always
* A randomised control trial is a study in which participants are randomly assigned to either a treatment group or a control group, to measure the effectiveness of an intervention while minimising bias.
tried to use the best information available to us; this latest iteration is one of AI and big data, and is set to be utterly transformative. AI supercharges our knowledge, and that knowledge is power. It is driving us towards an age where disease can be delayed, initially with incremental change, and eventually – possibly – to beyond our current lifespans.
It is impossible to shy away from the privacy questions that it raises for many. I literally give my DNA to any (reputable) tech company asking for it. You want my blood? It’s yours for the taking. That said, the sharing of personal data – especially health-related data – is controversial, as is the rise of artificial intelligence. Healthcare data can be the information that people are most sensitive about, yet the greatest good can be gleaned from sharing it, even when anonymised. A recent survey indicated a fifth of us are not happy for it to be used for research or to develop new medicines. It also made it clear that the public trusts the NHS with it, more than they do the government or commercial organisations.6 It seems who we are sharing it with, and what they are going to gain from it, plays a big role in how comfortable we feel about sharing our data.
I am a tech optimist, but I am by no means demeaning the risks that exist. Or the way people feel about them. It’s understandable to be kept up at night by concerns over cyber war, mass disinformation or the future of work. The headlines on AI have often frustrated me though. Stories of AI chatbots going rogue, accompanied by menacing images of robots from sci-fi movies, are confusing, and distract us from real-world worries. Robots ‘taking over’ isn’t the big threat here. Yes, there are very real dangers from ill-intentioned AI systems, especially in that spread of fake news online, national cybersecurity and automation, but there’s also huge promise.
When it comes to scientific research and medical advancements there’s enormous opportunity to better the world around us, and the bodies we live in. Perhaps unsurprisingly there is greater support for AI ’s use in medicine than there is for it in the fields of justice or the military, yet nearly a third of us perceive it as an existential threat that might take over or destroy human civilisation. 7 Meanwhile, amid the fear, analysis of public attitude suggests excitement too. A UK government study estimates that 30 per cent of us expect a negative impact, while 40 per cent expect a mainly positive one.8 I believe there are extreme pros, and extreme cons, no matter where the balance of your view lies.
The conversation has become emotive. The threat of AI has made us aware of both our mortality and our potential inferiority to machines. Yet in reality, we’ve never been more knowledgeable or powerful. Harnessed properly, AI has the potential to help us unearth so much, find solutions to the world’s biggest problems, discover drugs, identify tumours faster, predict cancer recurrence, create more efficient and less harmful treatments, and reimagine what it means to be human. But it is important to note that while AI can do a lot of things, it can’t do everything. It’s not human. It’s not magic. And it’s not new. AI in healthcare dates back to the 1970s.9 Researchers at Stanford University developed one of the earliest machine-learning systems in the world to match up patient data with information on bacterial infections. It was designed to help suggest the right antibiotics and dosage based on patients’ weight. Since then its use has expanded significantly into diagnostics, predictive analytics, and the beginnings of personalised medicine.10 While chatbots are becoming increasingly commonplace, it’s important to remember that AI isn’t just one thing. Artificial intelligence
is the machine simulation of human intelligence, and that encompasses so many different technologies. Machine learning is where computers will learn from data over time to improve performance of tasks with no need for further human instruction. In healthcare, AI systems are trained to carry out so many different tasks, such as an app monitoring moles and skin lesions for safety, a system to manage efficient distribution of hospital beds, or the analysis of data to figure who is at highest risk of disease for screening. The AI extrapolates from existing patterns to make predictions, often in game-changing ways as it can work with datasets at a scale no human could ever uncover the findings from. Perhaps though, the sort that comes to mind for many is the generative AI that can create unique art, music, video and text, which also uses machine learning to identify patterns in sets of data. This is what makes the large language models (LLM s) like ChatGPT possible, generating written responses by mathematically predicting which words would likely belong in an answer. These LLM s can collect and crunch enormous amounts of information and feed us back a synopsis that appears to make sense and be conclusive, but they are not always going to be accurate. They can get into our psyche by appearing shockingly good, human even, and seem to read well, but they don’t ‘know’ the answer to your questions, so will sometimes ‘hallucinate’, i.e. make things up – even the sources of information that they present you. They are constantly getting better, but they do not think like humans. As the renowned computer scientist Professor Stuart Russell put it to me, ‘There’s no evidence that the systems understand human physiology at all. I don’t think they even know that human beings have one body and that body has one head and two arms . . . If you say, “How many arms does
a human being have?”, the fact that they can answer that question doesn’t mean they use that information in their socalled reasoning.’ It’s important to keep in mind that when we talk about AI in the context of this book, we are most often focusing on specialised custom-built tools: those trained on specific datasets and scientific research. They tend not to be those freely available for any of us to toy with, those at risk of ‘hallucinating’ when they don’t know an answer, or with the potential to draw on questionable data in the first place. LLM s have cautiously crept into healthcare, but in specialised and secure ways, increasing efficiency, helping doctors write up appointment reports, and even for therapy. AI is doing so much more too.
I remember the first time I heard a radiologist declare that it could do a better job than the human eye. It sounded outrageous to vocalise, but exciting. This kind of statement is no longer shocking. AI is now being used to identify patterns in scans, analyse cancer recurrence risk, and identify drug targets to help develop the medicines we need. AI can be a lot of helpful things. But – and this is a really important but – it can’t be human. A computer’s advancing ability to calculate, learn, create and make decisions that would usually be the reserve of human intelligence is based on logical rules that are programmed into the system – it can’t grasp the often more nuanced emotional side of wellbeing. When it comes to our health, the human in the loop is vital. While some technologists hope to create AI s that are sentient someday, they aren’t there yet. The elusive concept of artificial general intelligence – where a machine might one day be able to do any cognitive task a human can, and switch between those tasks – continues to be out of reach. The speed of progress though, and the turning point in what generative
AI s like ChatGPT can create, has even surpassed the expectations of many leaders in the field. Doctors and patients might not all be using AI tools to comb through medical records and examine test results, but it is already playing a huge role in the research that underpins many medical marvels. Albeit not always getting the credit it deserves.
As Europe started to lock down in February 2020, I covered the story of Benevolent AI , what was a London-based drug discovery and development company. Through their AI and lab trials, they were not only developing new drugs, but also working on repurposing old ones. Their systems crunched masses of data about the unplanned impacts of medicines, to look for unexpected benefits. Their findings in this instance suggested that baricitinib, a drug licensed for rheumatoid arthritis, might massively reduce hospitalisations and deaths from Covid. If it succeeded in trials this would be a big deal. It was exciting, optimistic, and the final time I filmed anywhere ‘IRL ’ (an acronym that didn’t grace my vocabulary pre-2020?) before lockdown. By the end of the year, it was approved by the FDA for use in the US , receiving the green light in Europe the following year. As predicted, it made a material difference to sickness and survival rates in hospitals. But on the day its UK approval hit the headlines, I saw no mention of AI playing a part. I felt weirdly irritated that this wasn’t being recognised. We are all too happy to fuel the fear, but how about celebrating the benefits?
Ground-breaking innovation comes in many forms and is already reaching real people. From focused ultrasound easing Parkinson’s symptoms, to 3-D-printed skin for serious burn survivors, the progress we are seeing across healthcare is phenomenal. As ideas turn to trials and data designs drugs, we can expect kinder treatments with better results in the long
term. This isn’t just about the body – it’s about the mind, too, including our mental and emotional health, how the brain ages, our cognitive decline, and how we can prevent the cruelty of dementia and other degenerative diseases from blighting our later years. It would be impossible to give you a full round-up of everything happening in this book, so I have picked some of the most inspiring examples. Many of the innovations in the pages ahead are still under development or being trialled. We’ve a way to go to reach a future where all of these technologies are available to all of us: healthcare systems will need to embrace prevention, people will need to participate, some new technology still needs to be tested and approved, and we will need to decide how much of our health data is shared and to what ends. We are though, on the path to a better future where decades of deterioration and decline in our later years may no longer be the norm. AI can help us with this great undertaking. We must not forget why we, the humans, built this thing. It was to better our lives, not to take them over.
Covering all this has made me feel more appreciative for how our bodies function and our brains remain in balance than ever before. The WHO describes health as a ‘state of complete physical, mental and social wellbeing, rather than merely the absence of disease or infirmity’. It has set the bar high, and so should we, as the tools to help us are constantly improving. So, for the next 15 chapters, I invite you to put any fear aside, and come on a journey with me to contemplate what a better future of health could be like, and what you can do to help yourself right now. This book explores how we can reach an age of more personalised medicine and a place where treatment can come sooner, with fewer side effects and greater
efficacy. A place where we no longer spend decades in drawnout deterioration. We’ll see how all of this, with technology and data at its core, comes together to give us a better chance of battling all sorts of illness, whether that’s the transformations coming in cancer diagnosis, treatment and outcome, or overcoming heart disease. We’ll come to understand how the body is working as one – not each part in isolation – and how technology is helping us assess mental health and cognitive decline like never before. Let me show you the way to a future where we shall be hacking humanity.
part 1
It’s All About You
chapter 1
Better, Faster, Stronger
‘Why are you wearing four watches?’ was a question I was getting a lot, and happily answering, probably more fully than anyone required. It was 2015, and wearable technology was going mainstream; the Fitbit and its friends were coming of age, and we started to wonder how far 10,000 steps actually felt . Some were calling this self- monitoring mission the ‘quantified- self movement’ (a name that never quite stuck) and I was testing four of the (then) leading brands of activity tracker to see how their data measured up to each other, and reality. Short answer: not very well. One of them thought I’d burnt 3,000 more calories over the course of the week’s experiment – that’s a day and a half’s food intake for me. One thought I’d done 25 per cent more steps than another, and that wasn’t the one that thought I’d burnt the most calories.1
An interview with one of the CEO s afterwards revealed that they were ‘consistently inconsistent’, so you could test yourself against yourself week on week reliably, and the aim was to make you be the ‘best version of yourself’. It was the best PR spin I’ve ever heard, but there was also some truth to it. If you’re logging food intake versus calories burnt, exact numbers matter. But if you’re counting your steps so that
you’re motivated to walk instead of get the bus then yes, maybe the devices did the job. Those who’d never put one on thought my findings rendered them useless. But every person I found wearing one didn’t seem to care about precision, only that it had changed their behaviour for the better. These early adopters felt they showed meaningful patterns, and it motivated them. What mattered was that trackers often got them walking more, sleeping better and living a healthier life. The oft-cited target of 10,000 steps a day that some of us obsess over was not born out of precise science anyway, but a marketing campaign during the 1964 Tokyo Olympics.2 The first commercially available step counter was launched, and designer Yamasa called it ‘Manpo-Kei’. The translation? Man is 10,000, po is steps, kei is meter.3 ‘The 10,000 steps meter’. And thus our daily walking regimes were formed. Sure, there is plenty of science backing up the benefits of doing it, but at the same time, it’s a pretty arbitrary number. Moving is much better than not moving, but there’s nothing magic about 10,000 steps. In fact, one study found that older women were seen to achieve lower death rates by walking as few as 4,400 steps, compared to being more sedentary.4 For some of the heftier benefits we can glean from exercise though, you actually need to go quite hard, so it’s not all good news. There is no one size, number or effort level that fits all – but as our technology improves so too does our ability to work out what changes can make an impact on our lives, and what that impact will be.
As we headed into this decade, sensors and algorithms improved dramatically on the ones from 2015 – a similar experiment I did in 2022 showed that three of the now leading companies had cracked it. Wearing a Fitbit, Apple Watch and Oura Ring, the activity data and heart-rate differences were
Better, Fa S ter, Stro N ger negligible. The sleep stages still showed some variation, but the patterns and overall time asleep were similar. More on this where I take a deeper look at sleep in Chapter 3.
You may wonder why a book promising you mind-blowing science and technological innovation that will change the course of human health, starts here, with activity trackers. You could consider it a warm up, something we can do to help ourselves right now. Robotics, gene editing, lab-grown organs, computer vision outpowering human sight and disease prevention will follow in later chapters. As will tales of human despair, human limits, human survival, and human joy. But as well as it being something relatable, we cannot ignore the power of constantly generating data and patterns that will become ever more meaningful, and play into that bigger future health picture. Plus, there’s no shortage of people who bought into the idea. Over the past decade, wearables have exploded in popularity and proven their worth. The wearable fitness tracker market was valued at over $54 billion in 2023, with that figure predicted to top $230 billion by 2031.5 Those wearing them have changed their behaviour; on average doing an extra 1,800 steps a day, walking for 40 minutes longer, and reducing body weight by around a kilogram. This was compared to people who were self-reporting their activity while wearing hidden pedometers, in case you wondered how they counted. These are not figures to be sniffed at.6
The wearables now often have social features that allow you to share your workout data with others for an extra spot of pressure or, for some, simply to show off. That ability to compete with others seems to hold some power, not just in step contests, but real battles of stamina too. You can share Strava battles with your friends, gaining kudos – the name given to the site’s equivalent of ‘likes’ – and scaling the
leaderboards. 7 The explosion of Peloton users during the Covid pandemic showed the power of pushing yourself to the limit when you can see what others are doing, and vice versa, and technology allows us to do this remotely. But it also lets you to be up against the most important competition of all – yourself. With AI personal training apps, AI workout mirrors that watch you watching the trainer to check your squats and bicep curls are up to scratch, and smart boxing gloves that make sure you’re packing a good enough punch, there is no shortage of high- tech workout solutions that might even qualify as fun, can really quantify your progress and gamify getting exercise . Cardiologist Professor Nicholas Peters reminded me of the Pokémon Go craze – remember that? I’d never even thought about it in this context, but it got people off the sofa. It had a huge impact on a lot of folk, which may have gone unmeasured at the time, but there were, he tells me, ‘stories of people losing half their body weight’. Passively tracking your everyday activities is frictionless, and can be enough to nudge you into a lifestyle change; the power of that goes way beyond the gym class you sign up to for a few sessions. Even if you don’t have a competitive bone in your body, we know that keeping moving is critical to our health and how we age. If technology can make this a bit more interesting, or make us a bit more motivated, then great. And in the process it can teach us plenty about how well our bodies are faring. Tracking devices today do a lot more than just count your steps. All sorts of added sensors monitor your heart rate, blood oxygen content, temperature, stress, and more, allowing us all to capture a huge amount of real-time information about our inner workings. These gizmos are not just gimmicks for fitness obsessives, they are playing an increasingly critical role as we break into an era of knowing our bodies, our genes and
Better, Fa S ter, Stro N ger our disease risk like never before. We know our behaviour really makes a difference for our health and wellbeing, and I, for one, love the fact that we can now track every single bit of it. It’s more than just a log of what I have or haven’t done. By observing patterns, I can see whether I’m likely to be getting sick or am just tired, if my heart age is increasing or decreasing, and whether or not hormones are likely to be blamed for a grumpy morning.
The Whoop’s become a favourite among fitness enthusiasts as its USP is that it doesn’t just measure how much you’re moving, sleeping and shaking up your vital signs (with some pretty forensic analysis) but it also assesses your ‘strain’ exercising, both cardiovascular and muscular. Now, I’m not sporty. I have no coordination, therefore no ability to play any game involving a ball, but I discovered running. I do a gentle 5k most days, and weights a few times a week, in the peace, quiet, and lack of competition of my own world. I’m not breaking records, but I’m pretty happy with this. These devices though, tell you as it is. My regime only gets me to, at best, 13 or 14 on that ‘strain’ scale, where the maximum is 21. Maybe I need to push myself harder, or maybe I don’t. Yes we can record it all, but how much is enough ? I, like many I’m sure, would like to know. When I visited the Buck Institute for Research on Aging in California for an overview of what was going on in the field, I met Dr Eric Verdin, its CEO and president and a brilliant, charming and highly respected man who is (unsurprisingly) sprightly for his years. And of course, Eric was wearing multiple trackers: a Fitbit and a Whoop. Even in his mid 60s he easily passes the ultimate longevity test – getting up off the floor from a cross-legged seated position straight to your feet, with no hands. This utterly put me to shame, I wasn’t even close.
As we were playing around with feats of fitness, he casually mentioned that exercisers live on average seven years longer than those who don’t exercise. What?! Seven years? This is huge, but what should we be doing? What constitutes ‘exercise’ in this context? How much? And how often? I knew I had to investigate further, but our talk quickly turned to the serious quantitative research about ageing going on at the Buck Institute that goes beyond exercise, which we’ll come to later.
Back in the UK , our former chief medical officer, Professor Dame Sally Davies was reiterating the importance of exercise, stating, ‘If physical activity were a drug, we’d talk about it as a miracle cure’.8 It’s not just about the body, it’s about the mind too. Exercise has been seen to be on par with cognitive behavioural therapy (CBT) for depression, and in some cases even more powerful than medication.9 The data suggesting that 150 minutes of physical activity each week significantly reduces depression, anxiety and psychological distress. Perhaps unsurprisingly, the higher the intensity of exercise, the more beneficial it appeared to be – maybe I do need to up that ‘strain’ after all. In the short term, the boost in endorphins and dopamine released in the brain improves mood and buffers stress. It can also help you sleep – we’ll hear about the benefits of that in Chapter 3.
In the longer term, the release of these neurotransmitters promotes changes in the brain that help with mood and cognition, while also decreasing inflammation and boosting immune function. It’s a great treatment, with no side effects bar the risk of injury (and having to actually do it). But of course, we know this. Well, we know exercise is good, but what we can now do is not just quantify it, but frictionlessly track our progress and its impact on our body. This data gives
Better, Fa S ter, Stro N ger
us a clear picture of whether our lifestyle is setting us up for success, so we can make changes if we want to. No matter what the incredible founders and scientists I met were trying to build, create, or discover. No matter how inspiring, futuristic or hopeful they may have been, they all agreed on this one thing. Lifestyle is pivotal to ensuring a long healthspan (sorry).
Dr Jack Kreindler, founder of the Centre for Health and Human Performance, is passionate about tracking our physical fitness through data – for him it isn’t just about daily logging, but sometimes digging deeper too. ‘You wouldn’t get on an aeroplane that hadn’t been checked, or if aviation hadn’t benefited from the continual analysis of real-world data for the last 50 years. Yet we wake up on our 50th birthday, often without having had any checks of any kind whatsoever. So it’s unsurprising we’re starting off on the back foot’. He has the warmth and concentrated intensity of the doctor we all want to unravel our physical niggles, but his mission is out of the ordinary. Combining medicine with performance science, he helps push often quite extreme people to their limits, to live their best lives, while also trying to prevent disease. He hopes what is learnt from those at the top will filter down for the greater good.
When I first met him, his eyes lit up as he told me of a rather intense sounding expedition to Everest, pushing some usually rather stressed folk to their physical limits. He was collecting a load of data from wearables while invigorating his participants through the challenge. This is what he does. He wants to safely help those in extreme environments – playing elite sport, embarking on intense expeditions, or with highpressure jobs – get the best from their bodies, while having their greatest shot at staving off disease. I politely said the trip sounded amazing, but it actually sounded terrible to me;
I won’t even go on a rollercoaster, and the treadmill at a 3 per cent incline seems enough. My ‘limits’ are not a place I frequent. Or so I thought.
A year later, we may not have been to the Himalayas, but Jack pushed me to my limits in another way: he had me do a VO 2 max test for an episode of ITV 1’s Tonight about healthy ageing. This measure of your cardiorespiratory fitness is not only good for estimating how healthy you are, but could also suggest how long you might live. Yes, that may sound terrifying, but the results are associated with your long-term mortality. Low cardiovascular fitness has been seen to be comparable to smoking in some risk terms.10 The test can be done on a bike or a treadmill. I did it on the latter. It pushes you to your peak as you run faster and steeper uphill to capacity – with a mask tightly fitted over your nose and mouth to track your oxygen and carbon dioxide levels, and a load of electrodes stuck to your body taking readings.
The cameras were on, and it was hideous, but I was not giving up. Or sweating. I was literally trying to think myself out of sweating. Which obviously isn’t possible. The outcome? I was ‘as fit as an athletic 18-year-old’. I’d always liked Dr Jack. In all honesty, I thought the machine must have been broken, although logically, my consistent running probably helped (even if I’m never in any hurry). He tells me this is perhaps the most important test anyone can do as a measure of their overall health, it’s quick (thank heavens) and cheap. It provides an overall sense of how well your heart, circulatory system, lungs and blood oxygen delivery are functioning and assesses how you rid your body of carbon dioxide and recover. It wasn’t long after that I realised such pain could have been avoided as I tested VentriJect’s Seismofit device, which measures your VO 2 max while you lie down for a few minutes.
Better, Fa S ter, Stro N ger
Sure, the torture test is the gold standard, but suddenly a small stick-on sensor means the algorithm does more work than the patient. Microscopic cardio-induced vibrations in the chest are measured by the device, then assessed by AI that has been trained to match them to a VO 2 max score.11 The method is known as seismocardiography, which averts the need to assess all that air going in and out.12 My result showed a negligible error ratio from the full-on exercise experiment, and the plan is for doctors to use it with patients for quicker, easier, and for some with particular health issues, safer testing.13 This is an example of how AI can help us find useful patterns in extremely small measurements, in this case with non-invasive recording of cardio-induced vibrations captured with an accelerometer, allowing us to better understand our heart health without having to run as fast as we can in a lab. You can also keep taking these readings to see your VO 2 max progress or decline. It’s motivating to see the data, in this case a number that represents your fitness, knowing you can work at bettering it. I know the joy of seeing my resting heart rate go down and my step count average go up – there’s something gratifying about watching our growth. Of course it’s not always this way; we’re not all continually improving. Aside from the fact that that would be impossible, it’s not life. We’re only human, and sometimes we might not want to see what the data is showing us.
Jack splits people into three types: the ‘eagles’ who want to know everything about themselves; the ‘wise old owls’ who will figure out a balanced approach; and the ‘ostriches’ who’d rather know nothing about their body’s wellbeing. Whichever you are, it’s probably hard to change. Those on the ostrich side of the spectrum might develop a data neurosis – while our AI systems can crunch the numbers, they can’t alleviate
the anxiety that data might produce or guarantee that you’ll avoid a deadly cancer or chronic diabetes. But as Jack attests, you certainly cannot know what your blood sugar’s doing without measuring it, ‘You should do “citizen science”. You should collect as much data as you can, sensitive to the fact that anxiety will appear’, because that knowledge is power – even if you can’t bear to look at it yourself, or have no idea how to respond to the results. It creates part of that bigger picture of how your body is functioning, a quantifiable record of how ‘healthy’ your habits are, which can help a doctor guide you to the best recommendations.
I imagine Jack deals with a lot of ‘eagles’. His patients vary from super- high achievers to those with complex medical issues desperately after a solution, but the premise is the same. He, and they, believe in the power of data. About learning from what our bodies can do to best function, letting us live our healthiest lives for longer. It used to be that all this tracking was only the reserve of elite athletes, trying to perfect their bodies’ performance, but now technology is allowing more and more of us to learn about our inner workings. Leading computer scientist Professor Sir Nigel Shadbolt, who studies what happens when people interact with technological systems, also had a plane related analogy for me, ‘Rolls-Royce changed its prospects in the world [of aeronautics] when it realised . . . it could anticipate when things would fail, to the point at which it replaced them before. Predictive maintenance is as applicable to us as it is to aircraft engines at the moment.’ This (I hope) does not mean we’d be replacing our body parts, but we would be able to action further testing to identify the first signs of trouble. The data we are collecting on ourselves may initially seem to have limited value, but, Nigel says, it is actually a crucial part in a future where we