Why We Die: The New Science of Aging and the Quest for Immortality
By Venki Ramakrishnan
Hodder Press
ISBN: 978-1-529-36924-3
310pp.

There would hardly be a person who wouldn’t wish to live longer than his or her expected lifespan. Research to increase human lifespan has been under way for a long time, even though humans now live twice as long as they used to a century or two ago.

Present-day medical interventions to treat ailments such as heart and kidney diseases, diabetes etc have improved life expectancy, yet aging is a biological phenomenon and, even if human lifespan is increased and all diseases are eradicated, it does not seem possible to stop the process of aging.

However, for a long time, research is also going on to see what really causes aging and death. Venki Ramakrishnan’s book, Why We Die: The New Science of Aging and the Quest for Immortality, analyses the various research done over the years in this regard.

Ramakrishnan is a molecular biologist, who shared the 2009 Nobel Prize in Chemistry. Why We Die is his second book, the first being a scientific memoir, Gene Machine (2018).

In Why We Die, Ramakrishnan takes a look at the underlying biology of aging and death, current efforts to combat aging, and the culture and social consequences of the efforts to extend human lifespan. It begins with the basics of cell biology, defining death: “When they [the collection of cells that form our tissues and organs] no longer work together as a unit, we die.”

A book by a Nobel Prize winning molecular biologist about the biology of aging and death offers fascinating insight into the science and the social consequences of efforts to extend the human lifespan

The author poses the question: “Why does death even exist? Why don’t we simply live forever?” and then explains the role of gene mutation in reproduction, moving on to the question why some species live longer than others and the relationship between the species size and its lifespan.

The discussion moves on to the key genes and cellular processes that are believed to be involved in aging, DNA damage and repair, epigenetic regulation/changes, telomeres and their role in cancer, stem cells and proteins.

Explaining the formation and function of proteins, Ramakrishnan writes that Alzheimer’s/dementia and other neurodegenerative diseases have two things in common: age and a malfunction of proteins; and explains the formation of protein chains and how cells have a mechanism to destroy defective proteins, and that “unwanted protein [that] hang around the cells can cause problems.”

He hopes that, as more is learnt about the underlying biology involved, more ways to prevent, diagnose early, and treat such diseases would be found. He mentions that, “Today more than 50 million people suffer from dementia and, as the proportion of older people in the population is increasing in almost every country in the world, the number is expected to grow to 78 million by 2030 and 139 million by 2050.”

Science and scientists work in strange ways; people follow their curiosity and one thing leads to another. For instance, an expedition by a group of Canadian scientists to a remote island, to know why the inhabitants did not develop tetanus even though they walked around barefoot, led the scientists to isolate a compound Rapamycin, a potent immunosuppressant that stopped cells from multiplying. Further work by a different set of researchers revealed one of the cell’s most important pathways, with connection to both cancer and aging.

While some anti-aging supplements are becoming available, attempts have been made at transfusion of blood plasma from younger people to older to enhance life. Writing about the various ways being experimented with for enhancing lifespan, Ramakrishnan mentions that some billionaires are drawn to “Dracula-like young blood”, and cites the example of American entrepreneur and venture capitalist Bryan Johnson, who “spends $2 million a year on his anti-aging regimen” and was transfused with blood from his 17-year-old son.

The book also delves into the ways certain individuals and institutes are attempting to cheat death; however, the author points out that “supercentenarians are hardly as fit as they were in their twenties.” He notes that our cognitive abilities, particularly creativity and regarding learning something new, irreversibly decline with age, even with perfect health.

He emphasises that the human organism is too complex and, hence, interfering with a drug that targets a single biochemical pathway is destined to fail. He cites the example of the French woman Jeanne Calment, who died at the age of 122 in 1997. “While Calment’s robust physical condition even late in life was extraordinary, it did not mean that she did not age; for instance, she was blind and deaf for many of her final years.”

After going through the science of longevity and aging, in the last chapter, the author covers the consequences of lengthening the average lifespan. “What might some of the consequences of life extension be?” he asks. And then proceeds to answer: “One of them is even greater inequality. There is already a wide gap in life expectancy between the rich and poor. Even in England… the poor not only live shorter lives but also spend more of it in poor health.” Another concern is “over population… at a time when there are already too many people on Earth.”

Ramakrishnan says that, while ways to extend life are being experimented with, we should increase our chances of living a long, healthy and fulfilling life through diet, exercise and sleep.

“Exercise and sleep… affect a large number of factors in aging, including our insulin sensitivity, muscle mass, mitochondrial function (mitochondria are small structures that convert the energy from food into forms that cells can use), blood pressure, stress and the risk of dementia. These remedies currently work better than any anti-aging medicine on the market, cost nothing, and have no side effects,” he writes.

To engage the readers and keep it reader-friendly, the author begins most of the chapters with some personal comment or humorous anecdote. For instance, the chapter titled ‘Aches, Pains and Vampire Blood’ starts out with how he set out on a 200-mile coast-to-coast walk that ends near “Whitby, Dracula’s English port of entry in Bram Stoker’s novel… I figured when I finished it I could get an ‘I Did the Coast-to-Coast Walk’ T-shirt and wear it in the United States to impress people.”

But due to his arthritis he could not finish. From here, he moves on to the subject of inflammation, particularly the less obvious one that affects our health as well as our response to disease.

As he proceeds with the scientific research, Ramakrishnan gives brief biographies of the scientists who have made major breakthroughs in longevity research. They are not directly relevant, but provide an insight into their personalities.

There is a lot of discussion on crucial biological and genetic concepts of aging and the current research being conducted which, to a lay person, can sometimes become overwhelming. The author makes an effort to try and simplify things, yet one needs to have some background in biology and DNA and genetics so that processing the information presented does not become difficult.

There are also extensive notes given at the end of the book, which not only show the extent of research done on the part of the author while writing this book, but would also be of help to anyone who wants to delve deeper into the subject.

The reviewer is a freelance journalist. X: @naqviriz

Published in Dawn, Books & Authors, December 22nd, 2024