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The Science & Economics of Aging

The Science & Economics of Aging

This medical doctor recently left his job as vice chairman of Pepsico to head ambitious NY startup Life Bioscience, which focuses on helping aging people to continue contributing to society. It is investing in research and therapies related to six distinct biological pathways.
The following transcript has been lightly edited and condensed for ease of reading.
 
Josh Kampel: Mehmood and I met a couple years ago when, at the time, he was serving as vice chairman of Pepsi, a small company up in Purchase, and over his ten years at Pepsi, served as the CEO of Global Nutrition Group as their chief scientific officer, and recently left Pepsi to take over as CEO of Life Biosciences—and I’ll say from their site—“a company seeking to make life longer and better.” And you gave me a data point when we were talking earlier about this is the first time in history that we have more people on the planet that are over 65 than under five. First time ever in history. Why is that an important data point to pay attention to?
Mehmood Khan: Well, it’s from several facets. Let’s take a look. It’s not only there are more over 65 than under the age of five—that under the age of five percentage will continue to decline, and over the age of 65 will continue to increase, and there’ll be a several-fold difference. Fast-forward about 15 years from now—not a long time—those over 65 will need to be taken care of by young adults, which is these under-five, which is going to be a diminishing, diminishing part of the population. Our current care system is based on the premise that the next generation, either voluntarily or through a profession, will take care of the last generation. Those of us who are Boomers, we have a problem. We’re going to have a lot of us and relatively very few of that generation. And the time to take care of it is now.
Kampel: So, let’s then talk about Life Biosciences. Why don’t we tell the audience a little bit about what it is and why this excited you to leave a company like Pepsi to take over at Life?
Khan: So, I’m an endocrinologist by background, practiced endocrinology, Mayo Clinic, was in the pharmaceutical industry. I actually was president of R&D of one—of a big global pharma company. So I’ve sort of come back to my roots—that’s the first thing. The second is, historically in medicine, we’ve been thinking about age-related diseases as individual diseases.  The reality is, whether you look at it as heart disease, high blood pressure, diabetes, dementia, Alzheimer’s, blindness—all of those go up and increase as a function of age. Medicine in general and society have sort of taken the premise, “Well, that’s just part of getting old. And nothing we can do about it, so we’ll patch up the rest of our body,” and so you’ll treat the blood sugar, you’ll treat the blood pressure. If you have a stroke, there may be not much we can do, and if you get Alzheimer’s, there’s definitely nothing we can do.
Where we’ve got to as a consequence is the fact that if you’re over the age of 65, every five years, the risk of Alzheimer’s is going to double. By the age of 85, if you’re lucky enough to live to that, one in two people in this room will have Alzheimer’s. Fifty percent of the people—so if you look at this room, divide it in the middle, half of you on one side will get Alzheimer’s if you live to 85, a quarter if you live to about 70-something. So that’s how medicine has sort of taken the approach. I practiced.
The science and the biology of aging actually tells us something very different, which is what is so exciting about how we think about it. You know, we’ve talked this morning about many global challenges, and often we don’t talk about, so what are you going to do about it? Let’s talk about what you can do about it. We know, ever since the first living organism came on this planet, that organism has used—most, 99.9%, have used oxygen for energy. They’ve been reproducing—that’s the definition of life—but what we’ve sort of omitted is ever since the first organism came, not only was it living, it also was aging. And so as we evolved as different species, just like we carried respiration and reproduction as a path across all species, we’ve actually carried aging as a cross-species, what we in biology call conserved pathways.
Why is that important? Because we can actually use other species’ models to actually interrogate, understand, and find ways of addressing aging at a biological level. The way we’ve done it in society, if I may, is, “You age as an individual, I age as an individual, and I’m going to adapt the environment around you, either through different building design, through different devices, or patch you up and give you assistance.” And see how what happens is, society has allowed us to live a little bit longer, but actually we spend 10 to 20 years actually just declining. Physically and mentally declining. So what medicine has given us is a longer life, but a relatively much, much smaller functional life expansion. That’s because we didn’t address the biology. I can talk about how to do that.
Kampel: And that has a huge—we were talking about the economic consequence of that, right? So you brought up Alzheimer’s, and you gave me another data point that Alzheimer’s is the number one cost for health services today?
Khan: Yeah, so if you actually look at the cost of health care in the United States today, and to some extent, Europe, it isn’t cancer, it’s not rare diseases, it’s not heart disease. Actually, it is Alzheimer’s and dementia, because not only do these patients live a relatively long time, they not only need medicines, but they need a lot of social care—environmental, aides, etc. That doesn’t account for the loss of productivity of the people who take care of these individuals—which, two-thirds of the time, by the way, are women, and most of those, about half the time, that’s daughters. Being a son, that’s something I should reflect on. But that is the reality, and so it is hugely burdensome.
Kampel: So you talked about, we’ve come up—
Khan: Can I just add? If you don’t—if you actually address it, this is a study done, an academic study, and it’s one estimate, but if we could prolong healthy life by 2.2 years, over a 50-year span, that’s about $7 trillion of productivity. You want to invest in something? $7 trillion return.
Kampel: So we’ve talked a lot about AI and automation removing jobs from the workforce, so we’ve talked a lot about people looking for jobs. So now we’re going to keep people in the workforce longer. Talk about those people now that aren’t forced out to retire at 65. What are they now doing that really is, again, contributing back towards the private sector?
Khan: Well, you know, many people—and I’ve heard your meetings talk about this—we have this notion that young people are the best entrepreneurs. The reality and the statistics show that an individual—an entrepreneur starting a business after the age of about 45 or 50 has a greater chance of success than a 20-something-year-old. And, they continue to build businesses. And what that tells you is, while disruption is good, experience is critical. And that combination of those two, and just because you get a little bit older doesn’t mean so you’re no longer disruptive in your thinking. You just put it better in a context. And it takes both, right? In this recent tech industry, we’ve sort of got into this thing that unless you’re a teenager or a 23-year-old, you can’t create a big, functional business. That’s not the case.
So how do you keep—and I work for one of the largest employers in the country, PepsiCo—we had a quarter of a million people work and about 300-400,000 contractors, we’re a large workforce. But we’ve got this arcane sort of societal thing that once you get to 65 you’re done. Yesterday I heard the CEO of Merck talk about where he was actually asked to retire at 65. One of the most productive periods in his life, and he was told, “Now you’re done.” So if you’re functional, capable, and we can maintain you biologically functional, there’s no reason to exit. Now, we have to rethink as employers how we employ people. Maybe you want to split the job, maybe you want to—there are—this is a German automotive company, they just realized that some of their older production line workers were some of the most productive. But they just needed to provide them with different assistance for mechanical work so that they could continue to be part of the production line. So we’re going to have to rethink.
But let me come back to the biology for a sec, which is what really excites me. This is not “Star Trek” and craziness. For those of you who are older than the age of 40, this is relevant to you. Anything less than that, you’re indestructible.
[LAUGHTER]
For the 40-plus-year-old, here’s what’s going on. As we—from the day you were born, your cells have been dividing. The old school thinking was that as each subsequent generation of cell got older and older, somehow the message from the first cell down to the hundredth generation of cell was lost, because your DNA got damaged and you got older and all the rest of it, you know, the smoking and the couch potato lifestyle and flying in too many jets and all the rest of it. Right? Well, if that was the case, by the hundredth cell generation, if the signal was getting lost, then that cell would be getting further and further away from being a human cell, right, because each subsequent generation is not the same message. That’s not true. There may be small changes, but they’re still functional—for the most part, functional cells. So what’s going on?
It’s a bit like a CD-ROM, for those of you who are old enough to remember CD-ROMs. Remember, you used to put movies on those things? Imagine the CD-ROM as you’re making copies gets scratched. As it gets scratched, its knowledge, data, is still there. You can’t read it. So we’ve been looking to find where the errors in the data were, and it’s actually—what we’ve realized is, actually our machinery in the cell to read it is not. Now, there’s some internet people in the room, right? I don’t know anything about the internet, but let me go back to Bell Labs in the 1960s. And a digital signal processing engineer back in the ’60s suggested that when something sends a signal and there’s a receiver, a transducer, if there’s any loss in signal, there’s actually a monitoring box that receives the information at the same time, and if the receiver gets an error, it goes back not to the source, but actually to this box and pulls down the rest of the information, right? And for those who invented the internet, they called that part of the internet protocol. Now we assume that’s sort of a human discovery, you know, we’re brilliant, the internet guys—and actually nature discovered it before us. That is actually what happens now, as best we understand it. When a cell divides, it not only sends a signal on, it actually monitors, and what’s happening with aging is the monitoring box no longer is able—we can’t retrieve, the cell can’t retrieve the information from the monitoring box.
That’s one of the mechanistic pathways of aging. And if we can address that—and I’ll give you an example of how powerful this is. This is a real example. You take the egg of an older woman and put it into a young woman, the fertility rate doesn’t change. The body’s young, but the egg is not. If you take the egg of a young woman and put it into an older woman, its fertility is the same of the younger woman. It’s not the host, it’s the egg. The egg has aged. And yet, what doesn’t make sense is that egg is a young egg within that older woman, because it just divided, so what has happened? So some of our scientists have taken that and said, okay, what if we could restore the ability to read the information in this new egg, and doing that, and we took two-year-old mice—that’s about an 80-year-old woman in human terms—and showed that you can actually treat the egg, and the mouse becomes pregnant and fertile at the age of 75 in human years.
Now, before you think, well, we’re not all mice and why would you want a 75-year-old woman to want to be pregnant—the number of IVF procedures in this country is going up exponentially in 35 to 40-year-old women, where the 40-year-old has a success rate of maybe one in three, With lots of procedures—If any woman knows anybody with IVF procedures, you know what I’m talking about. We’ve actually now done this with larger animals, and we’ve shown—and we’re in the process—that you actually dramatically increase the fertility by actually restoring the fertility and the programming of the egg. Not to genetically modify it, just to allow it to read its own genetic information. That’s what we call actually restoring the function.
Imagine—and I’ll stop with this—imagine if you take a blind mouse. The number one cause of blindness in this country is age-related blindness, glaucoma and macular degeneration. Imagine being able to tell the retinal cells that could regenerate when you were young and no longer can regenerate, instead of actually trying to patch it up, allow and signal the retinal cells to regenerate again. And you will be seeing a very exciting paper that’s been submitted for publication showing the results of some of that data. Let me just stop there.
Kampel: Yeah. And, you know, we only have another minute or so, but talk about the unique combination of the relationship—the theme is collaborating for responsible growth—the collaboration between academic research and the company, and we only have a half a minute or so, but talk about the unique structure of that company.
Khan: My belief in my former career at PepsiCo carries over to this company, which is, the best ideas and the best minds are distributed around the world—not just around this country, but around the world. And scientists that are doing discovery basic research in their academic labs are the engine to that. And that’s why Silicon Valley and Boston thrive, because you’re actually in close proximity. What if you now take this to the next step and say, wherever the scientist’s in the world, we’re going to leave them there in their ecosystem—Europe, Australia, Singapore, Israel, you pick it—and let them continue to innovate, and the discovery, but we now create this network of IP that’s now flowing between these labs. Because biology is a matrix. Biology is not a vertical system. We’re a wonderful matrix. But if we could come at this matrix problem with a matrix organization that’s trying to interrogate this, you’re very different in structure than the traditional technology company that says, “I’m working on this vertical, and everybody’s working on this vertical,” and that’s exactly what we’re doing at Life Biosciences. We already have research discovery labs in eight academic centers around the world, in three different continents, and growing. It isn’t going to be one, it’s going to take a village to solve this global problem, and I think we’ve just got to get over this. It’s not just going to come from the US or Europe or Australia. It’s going to come from the ecosystem of the world’s best minds.
Kampel: Mehmood, I wish we had some more time, but thank you very much, and hopefully we’ll have you back in Half Moon Bay. So great, thank you.
Khan: Thank you.

Participants

Josh Kampel

CEO, Worth Media Group

Mehmood Khan

Vice Chairman & Chief Scientific Officer, Pepsico

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