Measuring and Reversing Biological Age

The EGYM© versus The Longevity Lunatic Fringe©

A few days after turning 69 the skeptical cardiologist walked into the Magadalena Ecke YMCA and began a wellness program called EGYM.

I'd seen banners advertising this program and was intrigued to try out this "comprehensive training option that takes the guesswork out of exercise." Although I'd love to take the guesswork out of pretty much everything in life, exercise was something I heretofore felt I had a handle on..

However, according to the online description, "EGYM smart circuit machines automatically adjust to your custom settings for weight, range of motion and cardiovascular exercise, guiding you through a full-body workout in as little as 20 minutes" which sounded very appealing.

The YMCA website has this slick video accompanied by a highly irritating soundtrack which indicates that the EGYM's interface "feels more like a game than a workout."

I probably would have just kept on with my own weirdly idiosyncratic independent workout program but the promise of a complete biometric evaluation triggered me to pay the $49 one-time fee and sign up for a one-hour onboarding session.

Yes, EGYM would calculate my "BioAge."

Your coach will determine your BioAge by conducting a combination of strength, cardio and metabolism assessments. Your EGYM BioAge metric shows how you're doing compared to the typical, average values of those in your age group. The BioAge metrics are a great way to easily track your workout progress.

BioAge, biohacking, geroprotection, and the longevity lunatic fringe

The older the US population gets, the more interest there is in not accumulating the disease and disabilities of aging. As a result, a whole cottage industry has grown up which makes money off anti-aging gimmicks, gimcrackery, supplements, and books.

In addition, people really want to know their "biological" as opposed to chronological age and they want that biological age to decrease, thereby escaping the universal fate of humanity.

The basic things that most doctors with expertise recommend (things I discussed here) to forestall aging are very effective but require time and effort. The players in the anti-aging cottage industry promise easier and quicker methods to stay young.

I have been tremendously interested in minimizing my biological aging since college when I decided that my life work would be to find a cure for aging. I gave up on that idea by the time I entered medical school but did enter a field where I could become an expert in preventing the leading cause of death, cardiovascular disease.

The heart is a wonderful organ and arguably there is a way to measure your cardiovascular age but one (semi-lunatic) doctors claim to be able to measure the age of each of your body organs (who knew there were 81) and track and reverse that age.

If you are willing to wait 7 years for any proof that this actually works and have centi-millions of disposable income then you, like Bryan Johnson, can have a team of 30 doctors poking, prodding, and pushing you to reach the reboot they are all sure is likely to occur.

Oliver Zolman, the longevity lunatic behind Bryan Johnson is certifiable. He has posted himself on his "Longevity Leaderboard" and described all of his "longevity interventions" which include taking 25 supplements a day.

Cardiovascular parameters that might yield a "biological cardiac age"

There are two measurements listed under Zolman's "key biological age data" which are cardiovascular measurements: PWV (pulse wave velocity) and "Whoop HRV (heart rate variability). I did research involving both of these measurements during my years at The Ohio State University.

One of the pioneers in HRV wrote in 2006

 Although HRV and RSA are not quite the same, these terms are often used interchangeably and both are widely believed to reflect changes in cardiac autonomic regulation. The exact contributions of the parasympathetic and the sympathetic divisions of the autonomic nervous system to this variability are controversial and remain the subject of active investigation and debate

There has been no change in the field of HRV since then which would suggest it is a pure and clinically useful measure of parasympathetic autonomic tone since then. Like many cardiac parameters (maximal heart rate, diastolic function), HRV changes with age but there is nothing to support the idea that it works as some sort of clock of the cardiovascular system. Even more puzzling is the incorporation of HRV into fitness devices to measure stress.

Folks, no actionable information on your health is derived from HRV!

The same can be said of pulsed wave velocity. This parameter indirectly measures compliance of your arteries. As we age and develop atherosclerosis all of our arteries stiffen. PWV is not a particularly easy or accurate way of measuring atherosclerotic changes in our arteries.

For many years I supervised a lab that estimated vascular/arterial age by measuring carotid intimal-medial thickness (CIMT). When this ultrasound-based test is performed in a lab with exacting standards, high-quality equipment and personnel, and passionate attention to detail it can be useful in younger individuals who are at high risk for heart attack or stroke.

Individuals with higher thickness for age, gender, and race have increased risk. Alas, I had to move on and in my current practice I don't have that capability and I am unable to recommend any sites that do.

Atherosclerosis, the major killer of Americans, increases directly with age. If we had a way to measure that, perhaps that could predict cardiac age.

We do, actually, have a wonderful test for checking on how much atherosclerotic plaque build-up you have! I wrote "How Old Is my heart" on that topic.

The EGYM Approach

Having onboarded with the EGYM program and spent a week evaluating it I can reassure you that the EGYM program is not part of the longevity lunatic fringe. It utilizes well-established methods for estimating your cardiac age, metabolic age, strength age, and flexibility age.

I've written about ways to measure your cardio-fitness age and the EGYM used a similar protocol to measure mine.

In subsequent articles, I'll describe the EGYM's method for measuring and improving metabolic age, flexibility age, and strength age.

Gerolunatically Yours,

-ACP