Andrew Lacy, Founder and CEO, Prenuvo Dr. Daisy Robinton, Co-founder and CEO, Oviva Therapeutics Alina Su, Co-founder and CEO, Generation Lab Moderator: Alexa Mikhail, Fortune
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00:00 >> Thank you all again so much for being here.
00:02 So while we cannot change our chronological age and
00:05 our birthdays the day we were born, we're learning now that there's so
00:08 much we can do before we get sick to change our biological age and
00:13 our pace of aging and extend our health span,
00:16 which is how long we live in good health.
00:19 So I wanna ask each of you to briefly give us an overview.
00:21 And Andrew, I'm gonna start with you and go down the line.
00:24 How are we rethinking this road to 100 and even 150, let's say,
00:28 to close the gap between health span and lifespan?
00:32 >> Sure, well, it's great to be here.
00:34 My name is Andrew, I'm CEO of Proneuvo.
00:36 I can say probably the single biggest change that's happening in the last few
00:40 years is we're starting to get a lot more data about how the way we're living our
00:44 lives or how the way we're living our lives impacts the underlying physiology
00:48 of our bodies.
00:49 And at Proneuvo, we do that with imaging.
00:51 There are other folks that are doing that with blood or epigenetics.
00:54 And I think that information really helps give us all as individuals a lot of
00:59 agency over the way we live our lives and hopefully leading to a better health
01:04 outcomes for us as individuals and society at large.
01:06 >> Interesting, Daisy.
01:08 >> Hi, everybody, it's so great to be here, thank you.
01:11 So from my perspective, I'm really focused on ovarian health and
01:14 how that influences female health and health span.
01:17 And I think what we're increasingly coming to appreciate is that,
01:20 while we know that women tend to live longer lives than men,
01:22 a great proportion of those years are actually spent in poor quality of life.
01:27 And that's in part because our ovaries age at an accelerated rate relative to
01:31 the rest of the body, and they're also the pacemaker of aging for women.
01:34 So the lens that I bring is really that of women's health and
01:37 how ovarian function is really the seat of health and well-being for women.
01:41 And how if we can improve and/or extend the function of the ovaries,
01:45 that ultimately will lead to more quality years of life for women and
01:49 potentially also greater longevity.
01:51 >> Great, Alina.
01:52 >> Great to be here, thanks for inviting.
01:54 Hi, everyone, my name is Alina, the CEO of Generation Lab.
01:58 What we are doing in Generation Lab is we're aiming to extending the health span
02:02 of what people are currently living up to.
02:05 So we are the first world's expansion on the health span
02:08 that can measure the biological age and also the fitness level of your organ,
02:12 down to 19 different organ functions that in your body.
02:16 So what we are believing is measuring the biological age, but
02:19 not only the biological age, also the how you're aging, what is causing aging,
02:24 what is the efficacy of the supplements, medicines,
02:26 treatments that you are currently doing to your body, is the most important way for
02:30 us to get in touch with how is the best way for you to expand your health span.
02:34 >> Definitely, and there's a lot of noise in this space, but
02:38 there's not a silver bullet, right, or magic pill to extend our life.
02:42 So for our audience, Daisy, I wanna ask you, can you help us decipher
02:45 the difference between research-backed longevity science and pseudoscience?
02:49 >> Yeah, I think that we live in a day and age where there's a lot of marketing
02:53 that's pushing out products that make claims that aren't substantiated.
02:57 And I think because wellness has become such a cultural,
03:02 hip thing, longevity is very much bucketed into that.
03:05 We have a lot of companies out there that are selling vitamins and supplements and
03:08 interventions with claims that aren't really supported.
03:11 And so I think what's important for the consumer and for
03:15 people that are making decisions is that you really look underneath.
03:18 Because even a lot of these companies will say,
03:19 we have scientifically backed whatever the thing is.
03:23 Ingredients, and as a pregnant lady, I was doing a big deep dive into
03:28 prenatal vitamins to see what companies were out there and how they're formulating.
03:31 And what are the ingredients and
03:33 what's the literature that's supporting those ingredients?
03:35 I mean, a lot of the time,
03:36 there's just not literature to support even some of the products.
03:39 So while there might be a study here or there that says, this particular thing
03:43 influences mitochondrial metabolism, it's not necessarily to
03:49 the degree of the claims that are being made.
03:52 So I think the thing that I really often like to put out there is just to
03:57 increase your skepticism like 10 to 100 fold.
04:00 And try to do some legwork on where the claim's coming from,
04:03 really understanding that and unpacking that and
04:04 recognizing that a lot of people are making a lot of money.
04:08 And selling you what I think lots of us like to call expensive urine products.
04:12 >> [LAUGH] >> Well, that's a really interesting
04:14 point.
04:15 Alina, I wanted to bring you back into the conversation.
04:17 Your company uses data to assess people's biomarkers and therefore pace of aging.
04:21 And then it gives people specific lifestyle recommendations.
04:26 At the same time, right, we know that the cornerstones of healthy aging are
04:29 exercising, eating well, maintaining social connections.
04:32 And when we think of the blue zones where people live the longest,
04:35 we think about community and purpose.
04:37 So I wanted to ask you, right, in this age of longevity,
04:41 how do you balance precision medicine using the data that you just talked about
04:45 with, again, these very basic cornerstones of aging?
04:49 >> Yeah, we always go with the four pillars of the health, which is eat well,
04:53 sleep well, exercise well, and take care of their mental health.
04:56 But what we are seeing is people actually doesn't do that at all,
04:59 because they don't know where to start from.
05:01 Even that getting hydrated is something that we know that's very important.
05:05 But people are not drinking seven cups of water per day.
05:08 And we know that we need to constantly reminding them,
05:10 give them a launch pad, where exactly do they need to start from.
05:13 So this is what we're aiming for, to actually guide them to a path that
05:17 this is the way that you're getting healthier.
05:19 And this is the way how you're doing it, based on your epigenetic.
05:22 So that's the way that we are trying to tell them, your body is behaving good, or
05:26 which part of your body do you need to care more,
05:28 even though you're not having any of the disease?
05:30 Cuz if it's disease already, we're calling that as sick care,
05:34 not healthcare anymore.
05:35 >> Yeah, you mentioned giving them a launching pad,
05:37 which definitely brings me to you, Andrew.
05:41 Proneuvo's full body MRI scan has gotten very popular.
05:45 There's a wait list, and you're opening up clinics.
05:47 And at the same time, I think some skeptics might say that a lot of this
05:53 over testing could cause undue psychological harm if you're getting
05:56 an indeterminate finding or a minor finding.
05:58 So can you speak to some of that, and
06:01 why you think this is an important tool for longevity?
06:04 >> Yeah, sure.
06:05 I mean, there are a lot of people talking about screening right now.
06:07 And I would say you'd be really hard pressed to find a physician that has
06:11 first hand knowledge about what we're doing at Proneuvo that isn't referring
06:14 as patients.
06:15 So really the challenge is education about how these scans are different,
06:18 and perhaps attempts at doing this in the past.
06:22 What we're finding both in clinical practice and
06:25 in clinical trials that we're running is that the accuracy of these scans,
06:31 if anything, sort of are equivalent to and
06:33 may well over time exceed what we're seeing in standard of care screening.
06:37 That's not to say it's a replacement, but to say that these are pretty phenomenal
06:41 results given that we're not screening just for one cancer or one disease.
06:44 But we're screening for most anything that we can see physiologically,
06:47 from cancer to the very early stages of chronic disease.
06:52 So to go back to the blue zone sort of question in some ways,
06:57 I mean this is such a crude way of trying to understand longevity.
07:00 We're finding these little patches where people are living longer, and
07:03 then we're trying to work backwards and
07:04 figure out, well, what are the drivers of that long life?
07:07 And we would say, well, there's a much better data-driven approach here,
07:11 which is why don't we just look inside each one of us and understand and
07:15 look at each of the organs and understand how they're aging.
07:18 How does my liver look compared to someone of my age?
07:21 How does your brain look compared to someone of your age?
07:24 And each of us, what we find, has something that we individually might need to work
07:28 on, either because of the way we lived our lives, or our genetics, or
07:32 just pure chance.
07:35 And the knowledge of that is what empowers us to then live the best life possible.
07:39 >> Definitely, really interesting point.
07:42 I'm gonna come to the audience after this next question, so
07:44 keep any questions top of mind.
07:47 But Daisy, you mentioned this at the top,
07:48 you're particularly focused on extending the health span of women,
07:52 researching prolonging ovarian health.
07:54 You even once said that menopause may be optional and a choice.
07:58 So what therapeutic interventions should we be prepared for
08:02 that can extend women's health span?
08:04 >> Yeah, the field itself is sadly sort of early still, so
08:09 most of the things are quite far from being approved in clinic.
08:12 But at Oviva Therapeutics, what we're working on is an intervention that would
08:16 slow down how quickly the ovarian reserve is depleted.
08:19 That's the number of eggs a woman has at any given point in time, and
08:22 it's one of the core determinants of when you
08:24 undergo ovarian decline at what's now middle age.
08:26 So what we're bringing to market, or what we're bringing to clinic, I should say,
08:31 is a therapeutic based on a naturally occurring hormone called
08:34 anti-malarian hormone that basically slows how quickly we lose our ovarian reserve.
08:38 And in doing so,
08:38 extends the runway to menopause, pushing that out to a later date.
08:43 And there's so much that we don't know, so
08:45 the comment of menopause could be optional,
08:47 I genuinely think that's biologically possible.
08:50 We haven't shown that ever.
08:52 In fact, very, very few animals actually go through menopause, so
08:54 it's something you can't really test pre-clinically in any really strong or
08:59 compelling way.
09:00 But in terms of how we understand the function of the ovary,
09:03 there's no reason to assume that we can't allow it to function for
09:06 a greater number of years, at least on a small scale,
09:09 commensurate with what's currently out there, things like HRT or whatnot.
09:12 But there's other strategies that people are starting to ideate around,
09:17 which I think are really interesting.
09:18 And I think that in the next ten-ish years, we're gonna start seeing some real
09:23 optionality for women to have some interventions that allow them to
09:27 extend ovarian function.
09:28 And I do wanna just quickly make the comment, a lot of people,
09:31 like the first thought that they go to is like, well,
09:33 then women will get pregnant when they're really old.
09:34 That's not the purpose of,
09:37 that's not the goal of what we're trying to achieve, really.
09:39 It's to offer agency and to correct for the fact that we experience really
09:43 significant inequality as women because we have accelerated aging at the midpoint
09:47 in our lives.
09:47 And we know that not only is this a significant driver and
09:50 declines in quality of life, but it also declines in our broader economy and
09:55 our social connection and all the aspects, actually,
09:57 of the four pillars of health that Alina mentioned.
09:59 It's disruptive to sleep and mental and physical health and
10:02 emotional health and the connectivity we maintain.
10:04 So I think that we can do better.
10:08 There's a lot of interesting mechanisms that we can innovate around to
10:11 generate solutions to this strange biological phenomenon that we
10:15 uniquely experience along with whales.
10:18 And it'll be really interesting to see how it comes forward.
10:22 >> We'll have to have you back on the stage in ten years to find out.
10:24 >> I'll be there.
10:25 >> So I wanna go to the audience.
10:26 Are there any questions that we have?
10:27 Have any?
10:32 No?
10:33 Okay, well, I have a lot of questions.
10:35 So I wanted to talk a little bit about this concept of over-optimizing
10:40 with these technologies.
10:42 Is there any extent to which we are willing to compromise quality of life when
10:46 it comes to what we're tracking, what we're monitoring,
10:48 having to go to these scans every six months, right?
10:51 I mean, what is the line?
10:52 Are we drawing a line?
10:53 Anyone can jump in.
10:55 >> So I mean, my perspective is this question is best addressed at some
11:00 of the people at the very sort of extremes of the longevity spectrum.
11:04 The Brian Johnsons that are sort of like spending millions of dollars on
11:08 hundreds of different interventions.
11:10 I would say that the challenge that we face as a health system
11:14 is that we are taught that we are normal until we all of a sudden are diagnosed
11:19 with advanced disease, whether that's cancer or sort of a chronic health
11:24 condition, and then obviously our health declines pretty precipitously at that
11:29 point, and then we're spending an awful lot of money trying to keep us alive
11:32 with poor health.
11:33 And as physicians and as patients, we know that's not true.
11:36 We know that this is a steady process of decline.
11:39 We know cancer can be growing asymptomatically for a long time.
11:47 And so the average person has literally no information about their health.
11:53 And the starting point here should be providing folks with some,
11:58 a comprehensive look inside.
12:01 And it's only through that that we can actually sort of really understand
12:06 what it is that we can do as individuals to improve our health span and lifespan.
12:10 So I don't think we're close to a problem of too much data,
12:13 if I'm being totally honest.
12:14 I think that the challenge is there's not enough data.
12:16 >> Yeah, comments on that.
12:18 Actually health span is very different from lifespan.
12:20 When people are thinking about longevity,
12:22 they're like, I don't want to live up to 150 years old.
12:25 But it's impossible if you're having a body that you're having right now and
12:28 doesn't do any of the intervention that you can live up to 150 years old.
12:32 That's one.
12:33 And second is what we are trying to do, for the people who is on the stage,
12:37 is really to bring the accessibility and also the knowledge of the power.
12:40 Bring to the audience, so everyone is having the right to be healthy again.
12:44 And this should be the right that everyone is having,
12:46 rather than giving that to the doctor.
12:48 And this is really what we are trying to do, healthcare rather than sick care.
12:51 It's not curing disease, it's actually be healthy and
12:54 maintain health as long as possible.
12:57 That is what we call as increasing of the health span.
12:59 >> One thing that I'd like to add to that is I think that we really have this
13:06 aspiration around how these data will inform personal choice and
13:10 give us agency in doing so.
13:11 But we're really severely limited by that quality of data and
13:15 the diversity of that data.
13:16 And so, obviously being someone who speaks for women's health,
13:19 we know that there's a historic under-representation of females across
13:24 our understanding of biology.
13:25 But that's also true of people of color,
13:26 people from different regions of the world.
13:28 And so the averages that we might use to guide clinical decisions,
13:32 certainly in our healthcare system today, but even at the personal level,
13:35 are really limited by our ability to really understand on that bell curve,
13:39 what actually is normal for you and the background that you bring to that.
13:43 That's something that I think more of us in the field really increasingly recognize
13:48 and are bringing forward and certainly pharma companies and others as well.
13:51 Because they recognize that if we want the outcomes that we're trying to achieve,
13:55 we need to really diversify that.
13:56 We need to put effort and innovation and money and attention into that.
14:00 So I think that's something in the near term, I'd say over the next five to ten
14:03 years, we're gonna see a lot of change to repopulate the data landscape.
14:08 To help inform how we actually understand human health and
14:11 then how we make decisions based on that new understanding.
14:14 >> Yeah, I mean, really interesting point you made too,
14:15 that the average person does not know much about their health.
14:18 I mean, yeah.
14:19 Daisy, you also have been outspoken about brain span and
14:24 this idea of extending our cognitive health.
14:27 You once said our negative thoughts are slowly killing us.
14:31 Pretty sure we've all had that, even in the last maybe ten minutes.
14:34 So what are some pearls that you can share just about extending brain span,
14:38 cognitive health?
14:39 >> Yeah, I think it's probably unsatisfyingly a lot of the things
14:44 that you've heard, we know that maintaining equanimity,
14:50 for lack of a better word, is better for your health.
14:52 When you have high levels of stress, chronic stress, and
14:55 you get stuck in those sort of mental traps of getting stuck on that,
15:00 it really is not good for you.
15:02 It spans physical ailments.
15:04 And so things like meditation, even a short five minute practice every day,
15:09 breathing exercises, just a few deep breaths can help reset some of that.
15:13 And the data that are out there, which are really interesting,
15:16 there's a couple studies out of Yale and Harvard and
15:18 some other centers that have been done over the last, I wanna say, 15 years or so.
15:22 Really demonstrate that if you can orient yourself to have more of a positive
15:26 outlook and what's called a growth mindset, then that actually can
15:31 be influential to your physical health and the biomarkers within your body.
15:36 It's actually quite powerful, and I think there is an increasing effort to
15:39 understand the mind-body connection and how mindfulness and
15:42 bringing mindfulness into your daily routine and into the way that you
15:46 react to or interact with stressors in your life can really make a significant
15:51 difference to your short and long-term health.
15:53 >> Yeah, interesting.
15:54 Did anyone else wanna add to sort of the idea of brain span?
15:57 >> Another thing is brain is aging in a different way than
16:00 any other organs in our body, and people doesn't seem to recognizing that.
16:04 And brain is a very significant organ in our own body that, for example,
16:09 in the study that we did in UC Berkeley Convoy Lab, is using therapeutic plasma
16:13 exchange or therapeutic plasma dilution to see how inflammation itself is able to
16:18 be impacting the brain, and how is that able to impact in the brain function and
16:22 also other organs function.
16:24 So measuring the efficacy of before and after, I think,
16:27 is what is lacking right now in the entire,
16:29 what we are aiming to do to expanding the health span.
16:32 What is actually working, what is not?
16:34 What is the snake oils and what's not?
16:36 Telling the efficacy and truly guiding people of what needs to be done
16:40 is the most important thing right now.
16:43 >> Definitely, and I wanted to also mention this push to live longer and
16:47 even forever for some can feel inaccessible to the broader population as many tests and
16:51 subscriptions require people to shell out a great deal of money.
16:55 Andrew, I'll just ask you this.
16:56 What is your responsibility to ensure that the healthcare access gap
17:00 doesn't continue to widen as longevity becomes more in the mainstream?
17:05 >> Sure, I mean, we take our responsibility as an actor in this space
17:09 really seriously.
17:10 We are now doing cancer screening for under $1,000 for
17:16 people in all of our clinics.
17:18 We're focusing really hard on bringing the cost down even further to the low
17:21 hundreds of dollars.
17:22 And we're doing that through scaling up what it is that we do,
17:26 through speeding up the time it takes to image people.
17:28 Because these machines are so expensive that the faster we can image them,
17:32 the more we're able to get people through those clinics faster.
17:36 And then finally, the use of AI, because AI really can help us address
17:39 the single biggest hurdle and cost in radiology, which is the radiologist time.
17:45 And then finally, what we're doing today in imaging folks is really collecting
17:49 evidence that we can then present back to insurance companies and health systems.
17:54 So that we can demonstrate the effectiveness of these techniques
17:59 over the long run with a view to having these covered by insurance and
18:03 health systems and therefore accessible hopefully for everyone.
18:06 >> Definitely, so we're coming up on time.
18:08 I wanted to ask each of you a very quick question.
18:11 Just give me one number.
18:13 I'm gonna start with Alina.
18:14 [LAUGH] How long do you expect to live?
18:16 >> Man.
18:18 >> [LAUGH] >> Well, 120 years old.
18:22 >> Okay. >> I think it's, yes.
18:23 >> [LAUGH] >> Expect, I hope to break 100.
18:29 And my goal is really to be able to dance the whole time.
18:33 >> Love it.
18:34 That's a real health span, yeah.
18:36 [LAUGH] >> If I'm being totally honest,
18:38 I take it a day at a time.
18:39 So I get into what I do because I work very hard building companies
18:46 to create a better future.
18:48 And I remember waking up one day and looking in the mirror and saying, well,
18:50 hang on a sec, how do I know I'm gonna be around for that future?
18:54 And so for me, a lot of these longevity interventions, including PRONUVO,
18:58 is sort of insurance to know that things are going okay today.
19:01 And I can keep working on being a little bit better about my health tomorrow.
19:05 >> Great, we'll take that.
19:06 [LAUGH] >> Thank you.
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