Super Agers is a detailed guide to a revolution transforming human longevity. This is a breakthrough moment in the history of human health care. The person making that bold claim is one of the most respected medical researchers in the world, Eric Topol.
Dr. Topol’s unprecedented, evidenced-based guide is about how you and your family and friends can benefit from new treatments coming available at a faster rate than ever. From his unique position as a leader overseeing millions in research funding, Dr. Topol also explains the fundamental reasons—from semaglutides to AI—that we can be confident these breakthroughs will continue. Ninety-five percent of Americans over sixty have at least one chronic disease and almost as many have two. That is the essential problem this revolution is solving. He explains the power of the new approaches to the worst chronic killers—diabetes/obesity, heart disease, cancer, and neurodegeneration—and how treatments can begin long before middle age, and even long after. In thirty years, we will have five times as many people at least one hundred years old and they will be healthier than ever because of the breakthroughs Dr. Topol describes.
The amazing discoveries Topol brings into sharp focus are deeply inspiring about our human potential. We can now realistically see how we can make considerable headway for preventing age-related diseases and may one day be able to slow the body-wide aging process itself.
How science is looking into what helps us live longer In Super Agers cardiologist Eric Topol explores improving not just lifespan but health span. He defines and discusses in depth five critical dimensions : lifestyle, cells, omics (the study of the full complement of biological molecules in an organism), artificial intelligence, and drugs/vaccines. The book description is likely to make potential readers think this is a book of advice on how technologies can help us live longer, and I feel this will set up the wrong expectations. This is definitely a science book, a fairly sophisticated one, with a lot of information on where science stands now and where researchers are trying to go, not a book for a general audience of people looking for ways to improve their aging. To help you decide if you are in the target audience, here is a typical passage: Like sugar, there is a dedicated gut-brain reward circuit for fat intake conveyed through the vagus nerve. Separately, the fat circuit encourages more caloric intake, but it is synergistic with the sugar reward circuit for promoting dopamine release and overeating. Single-cell studies identified that the vagal neurons involved in the circuit, when silenced, abolished fat intake preference. I would guess a large proportion of readers would respond with a “wow” to this passage. For some it will be “Wow, fascinating”, but for many more, I think it would be, “Wow, what the heck does that mean?” If you are among the latter, this is not a book for you. For those who do find scientific explanations like the one above interesting, there is a lot to like and to learn in this book. In addition to the more important discussions, I learned about things like “crapsules”, pills that people can take to get a fecal microbial transplant! I especially enjoyed the discussion of AI use in the research, such as the AI’s ability to screen a person’s history and make connections and assess risks better than a human is likely to do faced with large amounts of data and how AI can be superior to humans in screening mammograms. Science fans will find a lot to enjoy and to learn in this book; readers less inclined towards detailed scientific exploration will probably be disappointed. I received an advance review copy of this book from Edelweiss and Simon and Schuster.
Eric Topol, one of the most prominent physician-scientists in the world and the founder and director of the Scripps Research Translational Institute, has authored his fourth non-fiction book for lay readers, Super Agers. Super Agers examines current trends in longevity research, specifically focusing on approaches that can extend the healthy periods of people's lives, healthspan, rather than a narrow focus on just extending life itself, lifespan.
Topol introduces a five dimensional approach to medically approaching healthy aging: Lifestyle+ (diet, exercise, sleep, environmental exposures), Cells (especially cells of the immune system), Omics (the molecular information of the whole organism), artificial intelligence (AI), and drugs/vaccines (aka therapeutics). These dimensions are interrelated and interdepending, and Topol has seemingly ranked them according to how he views their importance, Alternatively, these dimensions could be described as prevention, diagnosis and prognosis, and treatment. Despite the early attention to these dimensions, Topol's overall focus throughout is only modestly organized by them. After two early chapters that myopically undersell the importance of genetics and oversell the impact of lifestyle choices and environmental exposures (neither of which are independent of genetic influences), the book adopts a somewhat ad hoc structure, feeding readers a series of loosely connected literature reviews made more understandable to non-experts. This meat of this concerns the four major chronic killers: metabolic disease, cardiovascular disease, cancer, and neurodegeneration. Only the final two chapter directly address themselves to tackling aging in a proactive way, providing little in the way of actionable insights and highlighting few exciting innovation on the longevity front.
The anticlimactic nature of Super Agers isn't surprising. Medical science has very little to offer in the way of significant advances in aging at this time. Lifestyle choices are the most accessible levers available to pull for everyday people, but the ability for people to pull those levers concerns forces that are largely out of their control, specifically genetic predispositions and their social niches and resources. This unfortunate constraint is hardly acknowledge by Topol. Even when lifestyle factors are maximized most of these gains will be marginal at best. This doesn't mean they're not worthwhile to some, but many people will simply not care enough to be overly invested in building healthy habits and this is a sensible tradeoff. Ultimately, it is mostly about avoiding the penalty of really damaging behavioral patterns or the dysfunctional physiological states they can induce and seeking proper medical care at the right moments.
There were a number of important bright spots in the book. Topol heartily embraces polygenic risk scores to guide care as well as a number of other emerging precision approaches. He also celebrates the advances observed in the GLP-1 agonist class of drugs. These were great albeit obvious inclusion in my view. The book would have also benefitted from a more urgent tone concerning the need for more rigorous research. I was a bit concerned how eagerly Topol championed findings from observational work or loosely controlled, underpowered clinical studies.
All in all, this is solid work covering some of the latest medical research on conditions that shorten lifespans and provides some insights into the future ways that medical science may tackle aging so as to extend healthspans.
*Disclosure: Received this book as an ARC from NetGalley
Super Agers was much better than expected. Eric has written extensively about patient empowerment, personalized medicine, and the advent of wearable devices and tracking and artificial intelligence enhancing medical diagnostics and treatment. I thought this might be a bit of a lightweight topic for him, but he has taken it on quite seriously.
He has also taken on a few of the people who are aggressively promoting a good number of changes to achieve longevity. Some of these individuals do sell services and products that they say will enhance longevity and health. But sometimes the experiment and go down some awkward and nonproductive roads. An example would be one of the most prominent physicians advocating, many changes, including lifestyle, changes for Jeopardy and increasing health span advocated three day water only fast for a long time. He also did keto for a considerable period of time, but has given up on that also. Eric appears not to be a fan of non-Plant based keto however, I personally have found that to be quite successful in altering my A1c fasting glucose and essentially reversing values that were consistent with diabetes type two. Often this diet was told to be bad for your lipid profile and not sustainable, but I have sustained it and maintain a low A1c value of 5.2 for last six years.
But Eric seems to be quite right on many of the other topics that he’s covered and I recommend this for a scientifically literate individual as he doesn’t spend a lot of time going over the basics. And 20% of the book is relegated to footnotes for the right reader. This is definitely a five star book for others. It may only be a three star book.
For me, one of the highlights of Twitter, is to be able to read Eric’s thoughts on different aspects of medicine every day.
DNF - I did something I consider to be a cardinal sin while reading books, halfway through I ditched it and ChatGPTd the remaining half with a 3 page summary request and a few deep dives. The book contains a rambling bunch of stats and charts and studies that might suit clinicians or scientists , but unfortunately he’s targeted the book towards the common reader.
Virtually zero actionable suggestions for practical implementation, the few that were there were common sense and taken from “How Not to Die” (a much more informative read). Skip skip skip.
DNF@ 35% I absolutely loved his previous book about AI in medicine, but after going through more than a third of this one, I was sadly not impressed. Up until this point, it was simply a run down of studies and their findings. I'd like to see his recommendations clearly laid out with studies supporting each one so there is more of a practical structure instead of having a section on MI, a section on diabetes, etc etc. It was very disconnected because of this structural organization choice.
Possibly he gets into his recommendations later? Disappointing. Maybe I'll give it another try in the future.
Dr. Eric Topol a prominent physician-scientist, cardiologist, prolific writer, and founder and current director of the Scripps Research Translational Institute. As a fellow physician and big picture thinker who shares Dr. Topol's passion for connecting trends before they hit the mainstream, I've very much enjoyed Dr. Topol's prior books, especially 2019's Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. That said, the challenge with this genre is built into the premise: futurist medical books tend to age about as gracefully as unrefrigerated dairy. Once the predictions either pan out or don’t (like Dr. Topol's now-regrettable sunny-eyed take on disgraced biotech company Theranos -- though to be fair, many smart people were hoodwinked), their shelf life gets… compressed.
Dr. Topol's latest book, 2025's Super Agers, is no exception. Clocking in at 464 pages (or 15 hours in audiobook format), it’s a densely packed, occasionally repetitive, and highly technical look at the science of aging—squarely aimed at a healthcare-literate audience. Topol dives into the difference between lifespan (how long we live) and healthspan (how long we live healthily without significant quality of life impairments), and as someone in his early 70s himself, there’s a certain urgency to the discussion. He synthesizes a lot of peer-reviewed literature in discussing how we age—and how we might do so better. For the most part, the analysis is measured and grounded (thankfully the extreme antics of the likes of Bryan Johnson and the Biomedical Research & Longevity Society, formerly the Life Extension Foundation, aren't lauded). But at times, especially when he ventures into genomics (the field I work in) and polygenic risk scores, the optimism feels a bit premature. I’d call myself cautiously curious; Topol is quite bullish.
Overall, this is an engaging if hefty read, best suited to healthcare professionals or science-minded readers who plan to tackle the content soon, before the inevitable obsolescence kicks in. If you’re new to Dr. Topol’s work, I’d actually recommend starting with some of his earlier titles, which are tighter, more accessible, and still at least somewhat relevant.
I’m a sucker for wanting to live a long and healthy life. So, this book is admittedly right up my alley! Dr. Topol summarizes and synthesizes the latest medical research on conditions that influence human health and longevity. The content is presented in a clear, actionable format, with compelling arguments that inspired me to make several life changes. I find myself quoting and referencing relevant passages almost daily.
Who is this book for? 1 The layperson seeking to live their healthiest life. 2 The advocate or caregiver searching for additional guidance. 3 The medical professional or researcher looking to stay informed about the latest data.
Your approach to the book may differ depending on your background. While it contains dense sections of supporting data—a minimum standard in scientific works—these can be skipped by lay readers and caregivers, whereas technical readers will appreciate diving deeper into the weeds.
Last, but most importantly: Can you trust Dr. Topol? My research shows that he is a highly experienced, respected, and ethical medical professional.
Thanks to Eric Topol, Simon & Schuster and NetGalley for the Advance Reader Copy (ARC)!
The author of this book is a physician and, although marketed to the general public, this book would be more useful to those in the medical community. He discusses a number of ways to increase lifespan including lifestyle, supplements and drugs. There are numerous research studies summarized with a good number of charts included. The book is organized into chapters that discuss various aspects of the study of aging including genetics, lifestyle, cardiovascular disease, cancer, neurodegeneration and others. One concluding statement was hopeful: "We are going to see major progress in prevention of age-related diseases and preserving organ-specific health". As a nutritionist and one who believes in the powers of diet, exercise and other lifestyle habits, I agree with one of Topol's conclusions. "We need to maintain our healthy aging, predominately by focusing on lifestyle plus means, so that we can get to the next phase of digital biology deliverables". If you are interested in a book that gives a rather comprehensive summary of the current research this book would be for you. I received a complementary copy of this book from the publisher via NetGalley.
I’m giving this 4⭐️ and not 3 because I believe the fault lies with me. I didn’t know what I was getting in to and that is on me for just jumping in with not much knowledge.
It was dry, technical, and dense. A lot of the ideas and medical breakthroughs were very interesting, but it wasn’t information that I could take and implement in my own life. I do worry it’s being mis-marketed - it is not a “how-to” guide. It is a summary of various medical studies and research about how medicine will be used in the near future for things like obesity, cancer, and Alzheimer’s. It did not have any new tips someone could use to age better right now.
The most well-researched and thoroughly evidence-based work about longevity I’ve read. Incredibly data dense, but super approachable and accessible, even for a dumdum like me.
I learned a lot of simple, common sense lifestyle shifts I’m actively making to try to increase my own healthspan, as well as good questions to ask and tests to request when speaking with medical providers.
I hope not only to live long, but also to live well - if that’s also a goal you share, I really cannot recommend this book enough. I listened to the audiobook and it felt like having a long conversation with a physician who really cared about me.
Appreciate the data driven approach. Some points, including the title, seemed gimmicky but the focus on prevention and healthy lifestyle was more motivating than I expected. The discussion on access and affordability and social determinants of health was also really interesting.
There were things I already knew about, other things I don’t care to know about, and other things that I found highly annoying, e.g. avoid highly processed foods but embrace taking many medications that have not been subject to long-term studies (I’m looking at you GLP-1’s). References to diagnostic tests that could be done to prevent the onset of disease, but who is getting tested for things they show no symptoms of? I’m not, and I receive some of the best healthcare ever offered in the history of mankind. So yeah, go get yourself tested for something you might one day have and freak yourself out while you do whatever you can to prevent its onset. Sheesh. No thanks. Exercise, eat nourishing and nutritious meals, and go enjoy life.
Basandosi sulle intuizioni del Dott. Eric Topol, rinomato cardiologo e scienziato, e sui concetti esplorati nel suo nuovo libro "Super Agers" e nella sua newsletter "Ground Truths", ecco dieci consigli essenziali per promuovere un invecchiamento sano e migliorare la qualità della vita, attingendo alla vasta collezione di fonti a disposizione. Il Dott. Topol e la sua analisi approfondita delle evidenze scientifiche suggeriscono che l'attenzione a questi aspetti del "lifestyle+" può avere un impatto profondo sulla nostra salute.
Ecco i dieci consigli fondamentali:
1. Limitare drasticamente gli alimenti ultra-processati (UPF). Eric Topol li definisce "alieni, prodotti industrialmente, sostanze innaturali" che non sono nemmeno vero cibo. Questi alimenti sono legati a un rischio significativamente maggiore di malattie cardiovascolari e metaboliche, diabete di tipo 2, ipertensione, obesità e deterioramento cognitivo. È fondamentale leggere le etichette ed evitare prodotti con additivi, zuccheri aggiunti o falsi e con troppi ingredienti.
2. Adottare un modello alimentare mediterraneo. Questo approccio alimentare è ampiamente supportato da studi che ne dimostrano i benefici per la riduzione della mortalità per tutte le cause, le malattie cardiovascolari, il cancro e le malattie neurodegenerative. Si concentra su frutta e verdura, legumi, cereali integrali, noci e semi, grassi sani come l'olio d'oliva e gli avocado, e pesce grasso ricco di omega-3.
3. Praticare esercizio fisico regolare e diversificato. Come evidenziato da Eric Topol e dal Professor Euan Ashley, l'esercizio può essere considerato "il singolo intervento medico più potente mai conosciuto". Ha un impatto favorevole su tutti i sistemi d'organo, compresi il sistema cardiovascolare, il cervello, i muscoli e il sistema immunitario. È consigliabile combinare attività aerobica e allenamento di forza/resistenza, oltre a lavorare sulla flessibilità e l'equilibrio. Anche un'attività frammentata e di breve durata è utile per iniziare.
4. Dare priorità a circa sette ore di sonno di qualità. Il sonno è uno stato biologico non negoziabile, essenziale per la salute. Durante il sonno, in particolare nella fase non-REM (sonno profondo), il sistema glinfatico del cervello elimina i prodotti di scarto metabolico, comprese le proteine tossiche come il beta-amiloide, precursore della malattia di Alzheimer. La deprivazione del sonno o un sonno di scarsa qualità sono associati a un aumento del rischio di demenza. Mantenere una regolarità negli orari di sonno-veglia, evitare pasti tardivi, alcol prima di coricarsi e la luce blu dei dispositivi elettronici sono pratiche cruciali.
5. Moderare il consumo di sale, bevande zuccherate e alcol. Le bevande altamente zuccherate sono costantemente associate a un aumento della mortalità. Sebbene un consumo moderato di sale sia accettabile (1-2 cucchiaini al giorno), livelli superiori a 5 grammi al giorno aumentano il rischio cardiovascolare. Il Dott. Topol sottolinea che "sia il consumo moderato che quello pesante [di alcol] non fanno bene" e che le bevande alcoliche sono classificate come cancerogene.
6. Minimizzare l'esposizione a tossine ambientali. La definizione di "lifestyle+" del Dott. Topol include l'attenzione alle condizioni ambientali. Questo significa essere consapevoli dell'inquinamento atmosferico e, in particolare, delle microplastiche e delle "sostanze chimiche per sempre" (PFAS). Le microplastiche, ubiquitarie nel nostro ambiente, sono state trovate in vari tessuti umani, incluso il cervello, e sono associate a gravi rischi per la salute. Per limitare l'esposizione, Topol consiglia di evitare contenitori di plastica per alimenti, fast food e cibi ad alto contenuto di grassi, preferendo bottiglie in vetro o acciaio e utensili da cucina in legno o acciaio.
7 Scegliere carboidrati di alta qualità e grassi sani. Il tipo di macronutriente è fondamentale. Privilegiate i carboidrati non trasformati come amido resistente, fibre alimentari, verdure non amidacee, legumi, frutta e cereali integrali. Per quanto riguarda i grassi, preferite i grassi insaturi mono- o polinsaturi di origine vegetale, poiché il passaggio dai grassi saturi e trans è associato a una sostanziale riduzione del rischio di malattie cardiovascolari e diabete di tipo 2.
8. Essere scettici nei confronti della maggior parte degli integratori alimentari. Il Dott. Topol consiglia di prenderli "con un pizzico di sale", poiché ci sono "poche o nessuna prova concreta del beneficio di assumere vitamine o integratori", specialmente per coloro che seguono già una dieta sana. Alcuni, come il calcio con la vitamina D o la niacina, sono stati addirittura associati a potenziali rischi.
9. Coltivare forti connessioni sociali. La solitudine e l'isolamento sociale sono riconosciuti come gravi problemi di salute pubblica, associati a un aumento significativo della mortalità per tutte le cause, cardiovascolare e legata al cancro. Coltivare relazioni e l'impegno nella comunità è una componente vitale di uno stile di vita sano.
10. Considerare gli approcci alla nutrizione personalizzata, come la "dieta AI", con consapevolezza**. L'idea di una dieta universale "taglia unica" è considerata "ingenua" a causa dell'unicità biologica di ogni individuo. Il Dott. Topol sottolinea come l'intelligenza artificiale e la proteomica ad alto rendimento stiano avanzando la nostra comprensione della nutrizione personalizzata, basata su genoma, metabolismo e microbioma intestinale. Sebbene sia ancora nelle fasi iniziali, strumenti come i sensori di glucosio continuo possono aiutare a comprendere le risposte individuali al cibo, all'esercizio e al sonno.
Questi consigli, tratti dal lavoro del Dott. Topol, sottolineano l'importanza di un approccio olistico alla salute e all'invecchiamento, che va oltre le cure mediche tradizionali e abbraccia l'empowerment individuale attraverso scelte di vita informate.
This was a cool textbook masquerading as a gen market book. HEAVY on the evidence-based in the title.
Going to go ahead and say that this is not very accessible to anyone not at least tangentially connected to the medical/biological research field. If you're looking for a gen pop exploration of longevity, "Outlive", although probably already outdated, is probably more what you're looking for.
There is very little discussion of how the super agers become super agers. There isn’t enough here about what we can adjust in our lifestyle to become super agers. There is a lot of writing about all the potential medical treatments that may benefit us in the future. A better read is Michael Gregeor’s “How Not to Die”
The author offers an engaging and optimistic synthesis of cutting-edge biomedical science, but its central weakness lies in its techno-centric bias and uneven treatment of feasibility. While Topol compellingly translates advances in genomics, AI, and precision medicine into an accessible narrative, the book tends to overstate the near-term scalability and equity of these innovations, underplaying structural constraints such as cost, healthcare system fragmentation, and global disparities in access. Moreover, the emphasis on individualized, data-driven longevity solutions occasionally crowds out deeper discussion of social, behavioral, and environmental determinants of healthy aging—factors that remain empirically more impactful for most populations. The book, however, is a visionary roadmap for what could be possible, but less convincing as a balanced guide to what is broadly achievable in real-world aging societies today.
Very optimistic and detailed look at aging and health. Lots of mention of the benefits of AI for drug discovery and extending human health. Lots of biochemical details were above my head.
Favorite quote on some of the crazy health trends the rich are pursuing: "When they were young they wanted to be rich. now that they are rich, they want to be young."
I was disappointed in this book, maybe because it was not what I had anticipated. It would be perfect for a medical school student wanting to know possible future pharmaceuticals and procedures for mitigating or eliminating the effects of diseases and conditions that impact our health span. A lot of focus on genetic editing, stem cell research and drugs. The author seemed to especially have a proclivity for glp1 agonist drugs.
Very very dense and goes into a lot of technical detail. If you're going to read it, read it now. It will be out of date relatively soon as the science is moving quickly.
Recommendations, however are much the same as we've heard for years: exercise, sleep, and eat a diet with a lot of vegetables and little processed junk.
This is a very intense read. It is super scientific and really gets into the details. I think that he highlights the issue about health inequity, who will be able to afford these $2 million treatments? Also, we’re not changing all of the things that are causing these problems like a bad diet, pollution and micro plastics. I’ll stick with broccoli and going for a walk in nature!
The information in this book is fascinating but a bit dense for the average reader. I learned so much about the things that cause us to age and the research into how to slow down the aging process, but i also had no idea what i was reading at times. Very academic in nature and not being a medical professional was very detrimental for me as a reader at times.
A very uplifting book reporting on scientific achievements that are helping people live longer healthier lives. He gives a lot of credit to AI for aiding in the progress. He also holds out hope that the GLP1 drugs will be found to be helpful in the treatment of more chronic diseases in addition to Diabetes.
Discover how revolutionary new treatments are transforming the fight against chronic diseases and extending healthy lifespans. This informative, evidence-based guide explores breakthroughs in diabetes, heart disease, cancer, and neurodegeneration, offering hope for a healthier future for you and your loved ones. The book is easy to understand and founded on the latest medical discoveries.
Thanks, NetGalley, for the ARC I received. This is my honest and voluntary review.