Thought Leadership: Chris Mirabile, Founder & CEO of NOVOS
What is health? Depending on who you ask, you’ll get different answers.
Ask a doctor, and they may say health is normal physiological function with the absence of illness or injury.
Ask a biohacker, and they may say health is leveraging toolsets to maximize biological capacities.
Or, ask the World Health Organization, which states, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
But is health really that simple? What does “well-being” even mean, anyway? Are there degrees of well-being? Are they subjective or objective? How should I think about health in the context of physical, mental, and emotional capacities? What about short-term, mid-term, and long-term health? Or, put another way, can something that’s good for me today be bad for me tomorrow?
The short answer to these questions is implicit in the first question: health is far more complex than the simple monosyllabic word would imply.
And to that point, there’s no way I can scratch the surface of the complexities inherent to such a loaded word as “health,” but I will attempt to bring a dose of clarity, particularly as it relates to longevity.
The Western Medical Establishment’s Definition of Health
The West’s modern medical establishment is a system of disease care. We place minimal emphasis on wellness and preventative medicine and spend more than $4.1 trillion annually on coping with disease in the U.S. alone (2020 figure).
The problem is that once a disorder like cardiovascular disease, cancer, type-II diabetes, dementia, and other illnesses of aging take hold, it’s often too late to reverse, and others quickly follow suit; the momentum and entropy are too great to counteract.
When financial incentives are structured so that pharma, hospitals, doctors, nurses, insurers, and administrators all benefit from caring for the sick rather than preventing its onset, it’s a monumental task to move the establishments toward emphasizing preventative medicine in a whole-hearted, effective way. As such, it becomes necessary for new players to disrupt the market.
The Short-Sightedness of “Health”
The medical definition of “health” is too often short-sighted. We look at therapies that mask or minimize the side effects of a broken biological process (disease), rather than working feverishly at preventing it (ideal) or addressing its root cause after it has taken hold.
The Western medical establishment is particularly good at coping with a large number of diseased states acutely. I’ve experienced it firsthand and owe my life to it, with the successful removal of and recovery from a brain tumor.
Extend the time horizon, though, and Western medicine is severely lacking. Prevention of disease (the entire time period prior to the disease taking form) and long-term consequences (the time period after coping with the disease, which is typically treated in isolation of the full body systems) are neglected by most doctors.
For example, we prescribe drugs that may partially cope with symptoms or the non-causal but correlated disease biomarkers in the short- to mid-term, rather than addressing the actual causes. In the process, these drugs typically disrupt other biological processes and homeostasis. In other words, we solve one problem in the short term only to provoke multiple others in the long term.
Take, for instance, drugs like the commonly prescribed proton pump inhibitors (PPI’s) designed to cope with acid reflux and ulcers. Although not intended to be taken over the long term (years), they typically are since root causes are not addressed for the vast majority of users. Long-term use can result in kidney disease, gastric cancer, vitamin deficiencies, fractures, and a higher propensity for infections and pneumonia.
Rather than examining the dietary patterns or nutrient deficiencies (which can be further compounded by the PPI) that commonly lead to acid reflux and ulcers, the modern medical establishment stands behind Nexium, a prescription-strength drug that’s available in the U.S. over-the-counter.
Anecdotally, I can speak of friends and family members who have been taking this drug for years, with no end in sight and no prior knowledge of the long-term risks — risks that their doctors should be consistently cautioning about and simultaneously advising lifestyle changes to eliminate the need for the PPI. Further, doctors rarely, if ever, urge PPI users to supplement with vitamins and minerals to compensate for the deficiencies that can result from its usage and more often erroneously declare that vitamin and mineral supplements do not confer any health benefits.
Even Wellness Advice Can Lead Us Astray
This short-term focus on health doesn’t only apply to the medical establishment. At times, it can also apply to the wellness world — despite their best efforts — though far less often.
Take sun exposure, for example. Vital throughout evolution for humans to produce the essential hormone vitamin D, while providing additional benefits like nitric oxide (vasodilation for cardiovascular health) and endorphins (positive mood), the sun is a prototypical example of something that can be biologically good for you in the short term yet come back to harm you in the long term.
More specifically, the early benefits of the sun outweigh the long-term costs, but that’s largely from evolution’s perspective (reproductive fitness). From your or my longevity perspective, in which we want to avoid disease and maintain health until our final few days, the later-life costs could be dire.
In the case of sun exposure, UV rays cause countless mutations to your DNA every minute. When we’re young, this is manageable: our bodies have the biological machinery needed to repair most of this damage as it happens, via proteins like sirtuins. However, the damage accumulates, and years or decades later, your risk for certain forms of melanoma multiplies.
(Ironically, too little sun exposure, as Western medical establishments have advised for decades [“*Always* wear sunblock on any exposed skin,” “Wear long sleeves in the sun,” etc.], has been found to increase the risk of other forms of melanoma. The dose makes the poison, and the answer lies somewhere in between!)
So, what’s one to do? Fortunately, there’s a simple solution. Moderate (but don’t wholly eliminate) your UV exposure, and take advantage of modern advancements that our ancestors didn’t have access to: supplement with vitamin D3.
What We Evolved With Is Not Necessarily Ideal
Examples where a singular focus on short-term health can come back to bite you don’t end with UV exposure. Take diet. The paleo diet — a way of eating that I spent years following — argues that we should only eat the foods of our paleolithic ancestors, because we evolved with them and are therefore biologically attuned.
This is a logical perspective and is what initially attracted me to the diet. And although this ruleset will lead to far more healthy food choices and phenotypes (health manifestations) than the Standard American Diet, it can also lead us astray if the ultimate goal is maximizing health span and lifespan, aka longevity.
The flaw in the paleo diet reasoning is that evolution has little interest in seeing us live beyond procreation and perpetuation of the species. In other words, evolution wants us to be smart, virile and fertile enough to avoid predators, survive, and procreate. Then, as long as we live long enough to care for those children and pass on wisdom for their and future generations’ survival — approximately our 30s — evolution no longer has a vested interest in seeing most of us live (some academics argue that evolution wants a few very old people in order to provide wisdom and advice, and perhaps that is explained by supercentenarians and their fantastic genetics).
So, the typical paleo diet, which tends to be very high in mTOR-stimulating animal proteins and LDL cholesterol-fueling saturated fats, while being low in iodine, calcium, and sodium, might be conducive to muscle gain, sexual function, and other short-term outcomes but is not necessarily ideal for maximizing health span and lifespan in our later decades. Yet, most would consider these short-term outcomes (muscle strength, virility, and fertility) to encompass what it means to be healthy.
And to some degree, they are. But it’s only part of the picture; additional consideration must be made for maximizing both short- and long-term health, and by extension, maximizing lifespan (more on this in a bit).
Maximizing Performance: The Epitome of Health, or Prototypical Antagonistic Pleiotropy?
Along the same theme as the paleo diet’s short-term health focus, we have another perspective on what it means to be healthy: exhibiting superhuman performance.
It’s one thing to maintain cellular and physiological function and to call that health. It’s another to take it to the extreme — to maximize your physical, mental, cognitive, or sexual function. If you do, you may be the envy of all your friends and a shining example of our homo sapien species’ capabilities. But at what cost?
Maximizing human performance without an eye on longevity will cost you.
While anabolic steroids may give you the edge you need to become the star athlete, the hyper-function they enable comes at the cost of a significantly higher likelihood for health complications, ranging from high blood pressure to blood clots, heart attacks, stroke, arterial damage, decreased sperm production, enlarged breasts, shrinking of the testicles and testicular cancer, male-pattern baldness, decreased breast size (females), coarse skin, excessive body hair growth (females), male-pattern baldness, liver tumors, severe acne and cysts, and ultimately, a shorter lifespan.
A recent Hollywood trend, growth hormone (GH or HGH), IGF-1, and testosterone replacement therapies (TRT) might bring back your mojo, but not without a higher incidence of cancer and a greater chance for a shorter lifespan.
Adderall may enable you to outwork your peers, but at the expense of your cardiovascular health, dysregulation of your neurotransmitters and with a greater risk of psychological dependence or addiction.
Running ultramarathons may be your passion and a showcase of what the combination of human physiology and relentless psychology are capable of, but not without inflicting undue stress and inflammation upon the body, well beyond hormetic levels. In fact, longtime endurance athletes have been found to have 2x the risk of pancreatic cancer, immune systems comparable to extreme trauma patients, and inflammation and oxidative markers up 250% from baseline.
While society may reward and praise those who maximize their performance to achieve superhero status, if done so without consideration for long-term consequences (as is typically the case), it will come at a cost that you’ll be paying in the later years of your shortened life
The Ultimate Perspective on Health: Longevity
As someone who has spent more than 2/3 of his life focused on maximizing his health, with at times an emphasis on performance (especially during my biohacking phase), I had a deep realization once I learned about longevity and the biological causes of aging: longevity is the lens through which we should look at our long-term and short-term health, as well as anything we do to maximize our performance.
The biological mechanisms of aging, for which there are 10, are the fundamental biological processes that begin to go awry as we age. On the flip side, they are the biological processes that, when properly maintained, maximize our health and performance (within reasonable limits).
If we care for these processes, don’t over-stress them, and provide them the inputs needed to slow their degradation, we’ll not only extend our health spans and lifespans but also optimize our biology in the here and now — without going over the top, as performance-enhancing approaches like HGH and Adderall do.
When we adhere to a lifestyle that science has found to slow aging and its biological root causes, we stand to benefit from improved cognition (focus, memory, mood, lucidness, etc.), aesthetics (more youthful appearance, better metabolism), performance (energy, physical capacities, ability to build and maintain muscle), health span (years lived before a chronic disease), and lifespan (years lived).
Are There Costs to a Longevity Focus?
In the above Venn diagram, I highlight less-than-ideal aspects of a myopic longevity focus: prolonged hypocaloric (low-calorie) diets, extended water-only fasts (72+ hours without food), severe limitations on white-listed foods, etc.
Although these approaches will most likely extend health span and lifespan, they can also do so with short-term costs to health, performance, and lifestyle, depending on your physical health status and how far you take them.
For example, prolonged hypocaloric diets and fasts for many people can lead to poor mood or depression, low libido, fatigue, weaker bones, nutrient deficiencies, and other consequences (including psychological disorders, at the extreme end of caloric restriction), not to mention the tax they can have on our psychology, social life, and personal enjoyment.
For most people, it’s important that we strike a balance between longevity, short-term health, and performance, and to do so with an affordable impact on quality of life.
Maximizing Longevity While Minimizing Cost
It’s through this narrow lens that I focus my approach to health, and by extension, have designed the consumer longevity biotech NOVOS.
NOVOS is not about short-term health at the expense of longevity.
Nor is NOVOS about maximizing performance at the cost of longevity.
Rather, NOVOS finds itself hyper-focused on the absolute center of the Venn diagram, where longevity, performance, and short-term health all intersect. This translates into maximizing longevity without a cost to your short-term health or performance — and minimal burden to your lifestyle.
NOVOS is the consumer resource for knowledge regarding all things longevity — everything demarcated by the orange circle. At times, we’ll discuss common “health” advice that falls in the gray buckets — advice that will tax your longevity — and will use that as an opportunity to educate and inform you on how to get back into the orange sweet spot.
When it comes to NOVOS’ products, we may at times emphasize specific short-term health or performance goals (e.g., improving energy, skin health, physical performance, etc.), but we will always play within the constraints of maximizing longevity. In other words, we will leverage our powerful R&D resources and team of scientists to ensure we stay as close to the center of the intersecting circles as possible, with longevity as the primary endpoint that we will never stray from (i.e., we’ll always be within the orange circle).
Longevity Is a Lifelong Journey
Longevity is a lifelong journey that, if played right, will be a long and rewarding one. The scientific field is rapidly advancing, and a lot of promising insights and discoveries are being made that are suitable for consumer application.
At the same time, in the months and years ahead there will be many pseudo longevity companies entering the field, those that will carelessly advise extreme and unsustainable approaches to longevity based on poor interpretations of research, as well as antiquated “health” and wellness companies co-opting the term “longevity” by their marketing teams.
Through it all, you can trust that NOVOS will remain the go-to resource for thought leadership that will — along with its esteemed team of scientists and longevity MDs — identify the signal from the noise and equip you with the knowledge, toolsets, and formulations you need to maximize your longevity journey in a way that fits your individual needs and preferences.