Covering the anti-aging movement

By Arlene Weintraub

The news hit the anti-aging movement like a bombshell. On Aug. 29, results from a 25-year National Institute on Aging study showed that monkeys who ate 30 percent fewer calories didn’t live longer than monkeys who ate normally. That seemed to contradict earlier animal studies, which suggested that “calorie restriction” has a life-extending effect. And it cast doubt on some extreme anti-aging groups, such as the 5,000 members of CR Society International, who starve themselves in the quest to live past 100. (Related: Calorie restriction stories highlight best practices when writing about research)

The development has wide implications for the anti-aging industry, which markets a host of supplements that proponents say mimic the life-extending benefits of calorie restriction — most notably resveratrol, the substance found in red wine. Some scientists believe that both resveratrol and calorie restriction switch on the same longevity-promoting genes. (This has not been definitively proven.) Hundreds of resveratrol supplements are sold over the counter, and the hype prompted GlaxoSmithKline to shell out $720 million for Sirtris Pharmaceuticals, one of the leading start-ups pursuing longevity science. Yet resveratrol’s supposed anti-aging powers have not been convincingly demonstrated, not even by Glaxo, which had to halt a trial of super-concentrated resveratrol when some patients developed dangerous side effects.

The term “anti-aging” often conjures up visions of L’Oréal face creams and Botox, but today’s anti-aging industry encompasses much more than that. Most anti-aging doctors promote a regimen that includes dietary supplements like resveratrol, plus a host of hormone products, such as estrogen, progesterone, testosterone and human growth hormone (HGH). The scientific validity of claims attached to these substances is highly questionable, yet the anti-aging industry continues to bring in an estimated $88 billion a year in sales.

The seemingly endless search for the fountain of youth offers a host of story ideas for enterprising health journalists.

For example, hormone replacement continues to be a hot topic among aging baby boomers. When the Women’s Health Initiative studies raised questions about the safety of popular menopause remedies such as PremPro, millions of women turned to anti-aging doctors, who prescribe “bio-identical hormones,” which are concoctions of estrogen and progesterone that are made by largely unregulated compounding pharmacies. Thanks to high-profile fans of bio-identical hormones, including actress Suzanne Somers — who is debuting a talk show about living an “ageless” life on Lifetime this fall — sales of bio-identical hormones continue to soar.

Even though many of these products contain hormones found in menopause remedies that are made by large, highly-regulated drug companies, they don’t have to include the same warning labels that those products do—a continuing source of annoyance for the U.S. Food & Drug Administration, which has tried unsuccessfully to put a halt to improper marketing claims by compounding pharmacists. The FDA’s continuing efforts in this area are well worth following. In the aftermath of the current meningitis outbreak traced to a compounding pharmacy, at least two legislators have said they will draft legislation to give the FDA more oversight of compounding pharmacies.

Even Big Pharma is getting into the anti-aging game. The most prominent example is AndroGel, the testosterone-replacement product made by Solvay Pharmaceuticals, a unit of Abbott. Backed by an aggressive ad campaign, sales of AndroGel have surpassed $1 billion a year and are projected to rise further with the company’s recent introduction of a concentrated formulation of the hit drug. This is despite a dearth of controlled, scientific studies proving that the benefits of testosterone replacement outweigh potential side effects.

Websites pop up all the time purporting to offer information about healthy aging — and reporters should be skeptical about all of them. Many of these sites are maintained by anti-aging doctors or pharmacists looking to sell products, and it’s unlikely their marketing messages are regulated by the FDA or backed up by rigorous science. That said, these sites do offer a wealth of story opportunities for enterprising investigative reporters who are looking to uncover the latest anti-aging scams. (And the resource list below provides some good sources of reliable, scientifically sound information on the anti-aging industry.)

Hot topics in anti-aging:

What’s next for calorie restriction: Animal trials, as well as uncontrolled human trials, are proceeding despite recent research that cast serious doubt on the value of calorie restriction in fending off aging. Proponents argue that there’s strong evidence for the idea that calorie restriction extends “healthspan,” or the number of healthy years in one’s life, and is therefore worth studying, as this Wired story pointed out. But is it ethical to subject animals to calorie restriction for years on end? And what’s the endgame anyway, in light of the fact that a calorie-restricted lifestyle is unreasonable for most people and magic pills purporting to mimic calorie restriction have so far proven useless? These may be questions worth exploring.

The continuing labeling debate over bio-identical hormones: Several members of Congress have introduced bills that would amend the Dietary Supplement Health and Education Act (DSHEA). The goal, generally, is to give the FDA more control over compounding pharmacists and the drugs they make, including anti-aging supplements. But strong lobbying by the compounding-pharmacy industry has felled these attempts. Most recently, an effort by Sen. Dick Durbin (D-Ill.) to significantly increase government oversight of dietary supplements was voted down. It may be worth looking at the latest efforts to amend DSHEA as well as simultaneous efforts in other countries to more tightly regulate supplements and hormones made by pharmacists. For example, a group of doctors in Brazil has proposed labeling requirements for anti-aging hormone products.

Resveratrol vs. other polyphenols: As some of the shine comes off of resveratrol as an anti-aging wonder supplement, there’s increasing interest in the potential benefits of other substances found in red wine that are being studied for their anti-aging properties. In the meantime, studies of resveratrol continue to be published in reputable journals, as this Harvard Health writer points out. A skeptical look at the continuing hype over wine-related supplements may be in order.

Testosterone replacement: In 2009, the National Institute on Aging began a national trial of testosterone replacement in healthy men. Data from this trial, which is partially sponsored by Abbott — the maker of the heavily advertised testosterone product AndroGel — could be great fodder for stories as the results are released. In the meantime, prescriptions of AndroGel and other testosterone products are expected to triple in the next few years (see this report from ABC News). Health journalists should be asking whether the benefits of these products have been proven and whether their risks are being properly communicated to consumers.

Promoting exercise: Exercise is the only anti-aging measure that has proved time and again to be effective. Yet it continues to be nearly impossible for physicians to persuade their patients to engage in this activity. Some communities and organizations have experimented with programs designed to promote exercise. These programs include the American Cancer Society’s Active for Life, the CDC’s Physical Activity for Everyone, and North Carolina’s Eat Smart Move More workplace initiative. But did these programs succeed in getting people to exercise more? And did the participants in the program continue to practice healthy habits after the programs ended? These are questions worth exploring.