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Newman (1) highlights a challenge faced by studies seeking to measure aging: How to distinguish the process of aging from its causes. This is simple enough when causes originate outside the organism (e.g., environmental toxicants). But what about conditions inside the organism? Are age-related diseases the cause of biological changes in aging? Or is aging the root cause of age-related diseases? Our study (2) attempted to: (i) disentangle aging from age-related disease by studying young people in their 20s and 30s, decades before age-related disease onset; and (ii) disentangle aging from specific pathologies of individual organ systems by tracking coordinated change over time across several different organ systems. We tracked 18 biomarkers of the cardiovascular, metabolic, and immune systems, kidneys, liver, lungs, gums, …

Reply to Newman: Quantification of biological aging in young adults is not the same thing as the onset of obesity