Lifestyle vs. pharmacological interventions for healthy aging

Philosopher’s stone, or an analogous mythical object to remedy the scourges of aging, has been sought after throughout the history of humankind, up to the present day. In modern times, inventing a drug that prevents the aging-linked decline in organ function, expands the years of life spent in good health, or even increases lifespan promises fame and fortune for the discoverer. Vitamins, anti-oxidants, resveratrol and other alleged sirtuin activators, caloric restriction, nicotinamide adenine dinucleotide (NAD+) and its biosynthetic precursors, young blood and growth and differentiation factor 11 (GDF 11), senolytics, rapamycin and rapalogs, metformin as well as numerous other compounds and treatments all were (or still are) considered as the magic bullet for “anti-aging” effects in the last couple of years [1]. However, for most, if not all of them, preclinical results in animal models were difficult to translate to humans, unexpected adverse effects in animals or humans were reported, and/or clinical trials showing any efficacy in healthy young and old individuals are still elusive [1]. Importantly, aging per se is not recognized as a disease, and so-called “anti-aging” effects are often difficult to disentangle from disease prevention. For example, it is not entirely clear whether Editorial