Who wants to live forever? 150 already in reach; end of death possible

Alec Hogg is with Derek Yach, the Chief Health Officer of the Vitality Institute, an offshoot of South Africa’s Discovery, sitting in New York. Before we get into any detail about the Vitality Institute and what you’re actually doing here in Davos, a little bit about you. I was going through your CV. You got your MBChB at UCT. Is that right?

Yes, I did medicine at UCT and then did epidemiology at Stellenbosch (so ek is ook ‘n Matie) and then a Masters at John Hopkins. I spent many years in South Africa in research before going to the World Health Organisation where I spent ten years – not far from here.

And then, a Professor at Yale.

Yes, a Professor at Yale. I can’t keep a job down. I then spent time at the Rockefeller Foundation before five years at PepsiCo and then Adrian got me to join the Discovery Vitality program.

Derek, just to go back a little bit: you were in academia for quite a long time. What incentivised you to make the shift?

I think the biggest thing was the sense that in academia, you can talk and talk whereas certainly, in the business sector you have to act and you need to see real results. I saw that frustration between fantastic research we were doing in publishing and pretty upscale journals, not really leading to the change I thought we could get at a scaled level. At PepsiCo for the first time, I saw that we’re reaching billions of people around the world and even if you lowered the salt, sugar, or fat in a tiny fraction of the products, you’d be reaching billions at a scale unparalleled. Similarly now with Vitality, the opportunity to improve health in pragmatic ways as opposed to just write about it, really drew me in.

One can understand Vitality. You’re incentivising people to get healthier, but PepsiCo is not known to be producing healthy products.

If you take the long view, I think you’ll see that the healthiest part of the PepsiCo portfolio today is actually the most profitable part and a lot of that started with R&D seven or eight years ago. Similarly, we’re seeing companies such as Unilever and even some of the tobacco companies are starting to produce reduced risk products. Long-term, this is good because if market forces start driving health behaviours and not just government laws and regulations, I suspect we’ll see a faster uptake on products that consumers are going to want and love, and that could lead to better health.

We’re talking about market forces. The World Economic Forum is a great believer in market forces and seeing the way that the market drives it. You’re involved here on quite a number of levels. It was interesting to see that you’re on the Global Agenda for Ageing or ‘what is happening with ageing’. One of the sessions that you’re involved in is looking at, “Well, what happens if we live to 150 years old – or forever?” Is that a possibility?

I think that with the technology change we’re seeing, one never wants to rule it out. Certainly, for the foreseeable centuries, we’ll be basically trying to address the question, “How can we live longer? How can we live in good health with good mental function for longer periods of time?” Thirdly, and probably most importantly, “How can we ensure that the benefits of these technologies accrue to all people and not just the wealthiest and those who are able to afford them?” All of these things are happening very fast. I chair the Agenda Council on Ageing and over the last few years, we’ve been particularly looking at the issue of cognitive decline.

What does that mean?

How mental faculties with age, generally start going down. Some of it is disease (i.e. Alzheimer’s). With some of it, we simply don’t know what is driving it but the reality is that with age, about one-quarter of people will suffer serious effects on how their thinking processes happen. The question is, “What can we do over the short-term?” Over the long-term, people are betting on pharmaceuticals and new treatments. In the medium- and short-term, we believe that the technology companies (the role of robotics, Google, and some of these software companies) are starting to provide better ways of detecting changes in your mental health and starting to intervene and support you. There are other factors, which are critical as well. The role of activity and basic food that we consume affects our mental health.

That’s going to be some of the themes that we’re addressing; both here and in a series of meetings around the world. Ask this question. How can we maintain and improve the brains of older people? It’s something we’re all too aware of as we get older.

It’s interesting. If we can just explore that a little bit further, 25 percent of people (if I read you correctly) are not going to have the same mental faculties when they die. Inverted, that says 75 percent will, when they die of old age. Why are there so many people who do not deteriorate?

It’s a great question. I think generally, in public health we don’t ask the opposite way around. When I said 25 percent, I should have said by age 70/75. By the time you get to 85/90/95, that figure is 50 percent plus. To think; that’s an absurd figure – people living to 95 and 100. Our first meeting was held in Tokyo where we had a presentation on what are called the supercentenarians. These are people over the age of 110 and about 50 percent of them are functioning pretty well. In Tokyo alone, there are 50,000 people over the age of 100 – many of them living alone in fairly independent states. The determinants of why those people are able to live independently and have reasonable function is something that we have clues about. We know that it goes back to early childhood.

For example, good quality nutrition, don’t smoke through your life, drink alcohol in moderation, strong social networks, being challenged mentally whether through instruments and social interaction. All of those things matter and the evidence is becoming stronger and stronger of their value.

What about diet? The Japanese do have a very different diet to the west.

There’ve been studies around the world looking at many places where you have a grouping of older people and the diets are generally the same. Obviously, there are local peculiarities, but they all come down to many being plant-based, many being based on a lot of vegetables and fruits. Meats and fish – sparingly – certainly not excessive meat. A diversity in the diet. A lot of fluid. Not much alcohol, but a lot of water. In many parts of the world, dairy seems protective and when you use oils, the Mediterranean diet tells us about the value of olive oil and heart-friendly oils as opposed to palm oil or some of the very unhealthy oils we have.

So there’s still lots of research, no doubt using some of those Japanese or other very old people as guinea pigs. There’s also DNA and huge advances there… the possibility of being able to go in and re-engineer what we’re made up of. Again, is that something that’s just around the corner?

I wouldn’t say it’s around the corner, but it is coming fast. The probability now of screening people who have certain nutritional problems and seeing whether these are due to genetic problems (i.e. something in the genes passed from their parents) is becoming increasingly possible particularly for very rare conditions or very particular conditions. Not yet say, for diabetes, obesity, or cardiovascular disease. That is starting to be applied today. In our own company (Discovery), we’re likely to start looking at how we can apply some of the early insights from genomics into our popular base in South Africa in partnership with the Human Longevity Institute out of California – something that was recently announced.

The big challenge as you say, is not just for the rich people to benefit from this, but everybody. Is that realistic?

I wish it was. I think in the same sitting here in Davos, we’ve had two reports coming out today. One is Klaus Schwab’s major review looking at the Fourth Industrial Revolution, painting the promise of technology. The other is an Oxfam report painting the reality of inequalities around the world and how the 62 wealthiest people have something like 50 percent of the total wealth of the planet, suggestion greater concentration of wealth. I think that we have to address this because otherwise, the benefits accruing to maybe the 15 percent at the top will simply not accrue to the 85 percent at the bottom, leading to greater social tension and greater political unrest. I think it’s a ‘must do’ and it reminds us that our technology people have really done very well.

They’ve gotten far ahead of where we ever thought science would to but now, the people who are lagging are those on the political, ethical, and social side. Those sets of values which, in the end, will determine who benefits long-term are something that we need to have stronger voices and stronger actions to address.

Klaus’s book is a classic and I hope it gets very widely read, not just hear at Davos but elsewhere as well. Derek, some practical hints and tips. South Africans, (as we’ve had this conversation before), seem to be obsessed with what Tim Noakes is preaching – high fat/low carb diet. I know you have your doubts on that but you have worked with the Clinton Global Initiative and other initiatives. Are there any guidelines that you can share?

I think the U.S. Dietary Guidelines, the W.H.O. guidelines all point in the same direction and as we said, the same determinants of longevity is the basic practical advice we should all follow. Let’s try and eat diets that are mainly plant-based. Let’s increase our vegetables, fruits, nuts, and grains and the diversity in the colour of our diet. Eat fish and meat sparingly. There’s not yet evidence that you want to take it out of your diet completely. There’s certainly evidence that you want to eat it almost totally as some would have us do. Cut back on sugary beverages and sugar in the diet. We know that’s something that can drop your calorie intake and while you’re improving the quality of diet, you’re improve the quality of your activity levels and your social interaction. Those all come together and have big impacts on your long-term longevity prospects.

Not just living longer, but living with a sharp mind and living healthier.

Exactly, Alec. What we all fear is that we’re seeing trends worldwide that whilst longevity may be going up in some places, the number of years lived in disability or with some inability to fully function mentally is really, of great concern. That’s what’s driving some of the issues we’re addressing. Again, there are some practical uses. We’ve neglected the benefits of activity and healthy diets for the brain (keeping the brain stimulated) when studies have looked at large cohorts of people ageing from birth into their 70’s. We’ve seen the determinants of keeping a sharper mind. In addition to those factors, control your blood pressure throughout age. Don’t smoke throughout age. Try another musical instrument. Keep your brain active. Strengthen your social interactions.

These things sound rather warm and fuzzy, but they show that as with our muscles; if you use it, it benefits and if you don’t, you lose it.

You’re also going to have a side event here in Davos looking at (particularly) executive health. What message are you wanting to bring across?

We might say this is a very ‘niche-y’ type of area. I was always drawn by the fact that Archimedes tried to tell us we must use levers to shift big trends in the world. One of the things we (and our CEO, Adrian Gore) believes is that if we really want to get a greater focus on workplace health, we need to address the fact that health is not yet reported by CEO’s and Chief Financial Officers on their bottom-line reporting of their companies. They’re reporting on the environment. They’re reporting on governance in South Africa and on black empowerment. Once we start reporting on the health status of employees, we will see immediately that there’s a massive preventative potential and that we’re not investing enough in the quality of prevention at work. Why should we do that?

Not just for their own health, but because it drives productivity, morale, and retention. Just over the last few months we’ve had a number of very exciting reports coming out, showing that companies with the best workplace health programs do better than those with weak programs. This is looking at the stock performance of the Dow Jones. Similar studies are going to come out of South Africa by Daniel Malan of Stellenbosch, saying the same applies on the Johannesburg Stock Exchange. The companies on the JSE with the best workplace programs outperform financially over the long-term, companies with weak programs.

We’ll be have a cluster of some leading multinationals, some major NGO’s, and some in the investor and asset management class and some thinking about ‘how can now add health to the mix of environment’s social and diversity issues’, which have actually driven the investor community to say ‘it’s not just about the finances if we’re interested in long-term profitability. It’s also about these other factors, that if we’re really interested, we can do something about’.

It’s kind of a fourth bottom-line. There are just a couple of outliers and I’d like to get your insights into them. Bloomberg has free food and free drinks for its staff, certainly at the major offices around the world. You see a similar thing at Google and there are other companies like Huffington Post who have a snooze room, so if you’re feeling tired you can go and have a kip for a couple of minutes.

Well, if you visited our Vitality offices in Chicago, which have been revamped, they have wonderful fresh fruit available for people. We have treadmills, which you can use at low pace for taking your phone conference. We have stand-up desks. The lighting is thought through very carefully. The balance between the physical environment and what you do in the physical environment and how we then incentivise individuals to act is critical. We can’t do the one without the other. It all starts with one thing, generally: the CEO and the senior leaderships saying that health is a value for the company. Not a financial value, but value. We value it in its own self. CEO’s like the CEO of Johnson & Johnson, Mick Kasson or many if the global companies where we see the best health performance all start off with the message and the power of the CEO leading the charge.

Like Adrian Gore (your CEO), who is a devout runner and very fit. Is it almost a question of ‘well, if the boss does it I’d better follow suit’?

It has a huge impact and as you know, with Discovery it’s not just Adrian. I think his entire C-suite are out-competing themselves and probably fitter than the vast majority of Sydney and the other CEO’s of C-suite in the country and that certainly permeates. I think he’s sensitive to the fact that many in the company may not be able to do all of those things, or might not have the access to all of those facilities and that’s why the workplace provides a levelling playing field where at least, when you’re at work you can have access to good activity, good food, and a stimulating and stress-free environment.

We see Fitbit, Jawbone, and some of these other wearables that monitor your health getting good traction now. Are people – at least in the Western world – starting to get healthier because they know better?

I think so. As you say, the take-off in wearables…it’s now a multibillion Dollar market. We were represented in the Las Vegas Trade Show just last week. Whether it’s the Apple Watch, the Samsung Watch, the new Fitbit under-arm embedding it in clothing; why we find this exciting is because it represents a movement where companies are seeing health – not pharmaceuticals and healthcare – but health, being something that’s demanded by consumers and that’s why we’re seeing this high level of innovation in the space. Whether wearables, activated clothing, or different types of feedback, we think that Vitality sits at the cusp of it – having this new emerging partnership with Apple.

We’re very deeply into that. We have one of the largest relationships with Fitbit but we go much further than most in saying ‘we’ve got to be sceptical about whether this really makes a difference’, and so we’re trying to do the grounded research to show ‘does it make a difference how you use your wearable’. The reason why we believe that matters is that you don’t want to sell somebody something that they merely putting it on is going to do the trick without getting them to do the activities required to get the benefit. Of course, the structure of our program gives you enormous benefits and reductions as your activity level goes up and as that happens, your overall health status improves.

It’s an incredible story – Discovery. I don’t think even your competitors would deny that. You’re in the U.S. Is it being recognised there? You mentioned those two partnerships with Apple and Fitbit. Are other companies knocking on your door?

I think there are many companies knocking on our door but I think that in 2015, the recognition that came through being on the Fortune list of some of the companies most involved in positive change. For example, the Harvard Business School is very engaged in putting us at the centre of their whole shared values, a concept where Michael Porter leads off his executive program with Discovery being stated as the purist example of shared value followed by companies we all would admire, whether it’s Novo Nordisk or Unilever. We’re kind of pleased to note that they’re below us though.

Derek Yach is the Chief Health Officer at the Vitality Institute in the U.S.