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True Age: Cutting-Edge Research to Help Turn Back the Clock
Cutting-edge research shows how to determine and decrease your true biological age.
What if there was a way to measure our biological age? And what if there were strategies to slow down—or even reverse—the aging process? The answers to these questions lie at the heart of the groundbreaking work Dr. Morgan Levine is doing in her lab at Yale.
True Age introduces readers to the latest developments in the science of aging and longevity. It provides an in-depth understanding of biological age and the methods now available to estimate our own. It helps us target an individualized plan to eat, exercise, and sleep, as well as pointing to other lifestyle practices like intermittent fasting and caloric restriction that have been shown to slow or reverse the aging process.
The goal is to guide every reader toward a personal regimen to keep them as youthful as possible—both inside and out—with low risk, data-driven biohacking. The book gives readers and their doctors unprecedented ways to identify their personalized aging process and increase not only their lifespan but also then their healthspan.
What if there was a way to measure our biological age? And what if there were strategies to slow down—or even reverse—the aging process? The answers to these questions lie at the heart of the groundbreaking work Dr. Morgan Levine is doing in her lab at Yale.
True Age introduces readers to the latest developments in the science of aging and longevity. It provides an in-depth understanding of biological age and the methods now available to estimate our own. It helps us target an individualized plan to eat, exercise, and sleep, as well as pointing to other lifestyle practices like intermittent fasting and caloric restriction that have been shown to slow or reverse the aging process.
The goal is to guide every reader toward a personal regimen to keep them as youthful as possible—both inside and out—with low risk, data-driven biohacking. The book gives readers and their doctors unprecedented ways to identify their personalized aging process and increase not only their lifespan but also then their healthspan.
- GenresHealthScienceNonfiction
304 pages, Hardcover
Published May 3, 2022
52 people are currently reading
408 people want to read
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Displaying 1 - 22 of 22 reviews
May 13, 2022
Disappointing - 300 pages saying there is a lot of research but not any breakthroughs on the science of ageing
Nothing new. Plant Based diet, moderate exercise, meditation, intermittent fasting / calorie restriction, maintaining BMI below 25, no smoking, no alcohol may extend your lifespan and health span.
Nothing new. Plant Based diet, moderate exercise, meditation, intermittent fasting / calorie restriction, maintaining BMI below 25, no smoking, no alcohol may extend your lifespan and health span.
May 8, 2022
Cutting age research is repeating the same mantras: eat less yet nutritiously, exercise, sleep well, eliminate and then rest from remaining stresses. Diet and exercise repeated, yet the book cover is inviting.
May 13, 2022
I learned about Dr. Levine's book, shortly before it released this month, when I heard her being interviewed by Dr Rhonda Patrick. The book is fascinating and I was sorry when it ended. She simplifies cutting edge research, and suggested lifestyle practices, by using lay terms, some humor, and many relevant analogies. Dr Levine provides other wonderful resources for personal exploration and application.
This is a book that I am happy I purchased, instead of reading a library version. It will be kept in my collection for re-reading sections and as a resource.
This is a book that I am happy I purchased, instead of reading a library version. It will be kept in my collection for re-reading sections and as a resource.
February 1, 2024
In my opinion, True Age takes too many pages to make a small number of suggestions, none of which were new to me. I think this might be a good book to read if you are completely new to the topic of Longevity and science related to improved health span, but only if you can wade through an onerous amount of science and historical science.
September 12, 2022
3.6 stars.
Another year, another book on aging. This one comes close to saying important things about how to slow down aging, then chickens out just before reaching the finish line.
This review will focus on complaints, because there were a handful of problems which bothered me enough to write about. That feels a bit unfair, since my complaints focus on relatively small parts of the book. Much of the book is fairly good. The good parts just didn't impress me enough to want to write much about them.
Epigenetic Clocks
Levine is best known for developing an improved epigenetic clock, PhenoAge. Where previous clocks tried to identify the methylation locations that are most strongly connected to aging, Levine used a larger set of methylation locations. Instead of just selecting locations that correlated with chronological age, Levine looked for locations that correlated with age as estimated by blood test results.
Early in the book, Levine writes:
My intuition does hint that it's important, but the book does little to confirm that intuition, and didn't even look like Levine was trying to do so until much later in the book.
Epigenetic clocks correlate with age-related deaths, more so than does chronological age.
Adopting a healthier lifestyle causes epigenetic clocks to report a lower biological age.
Does that imply that we should use epigenetic clocks to evaluate changes in our lifestyle? It's certainly suggestive.
But there's plenty of room for doubt. Most biomarkers turn out to be less valuable than they originally look. E.g. amyloid beta is somewhat helpful at identifying Alzheimer's, yet a focus on reducing it has led researchers down a dead-end path.
Epigenetic clocks seem more promising than amyloid beta, but I don't have an easy way to compare their value to those of better-known age-related biomarkers. E.g. a1c results give me more actionable advice, since they tell me more about which set of lifestyle mistakes I'm making, and which dietary changes will fix them.
Epigenetic clocks show some hope of providing more complete feedback about rates of aging than other biomarkers. They might even be measuring the root causes of aging. But I haven't quite been convinced to replace my standard blood tests with epigenetic tests.
Programmed Aging?
Like many books about aging, True Age comments on the polarizing issue of whether aging comes from accumulated damage, versus being actively programmed.
Levine finds a middle-ground position which feels unsatisfying: aging is the default, and there's some programming to counter it. Evolution selects for as much programmed maintenance as is justified by the benefits.
I'm left wondering whether the key parts of that reasoning are tautological truths, or whether Levine is hinting at substantive claims that I suspect are false.
There's evidence that aging contributes to a large fraction of wild animal deaths. The energy costs of delaying aging don't look large enough to offset the obvious costs of those deaths. So I'm pretty sure there are effects that Levine glosses over.
Levine also mentions that individual cells can be rejuvenated using Yamanaka factors. This evidence seems more likely in a world where a program actively creates aging, than in a world where programming is simply repairing damage.
I wonder whether Levine is hinting at a stronger version of programmed aging than she feels it's safe to advocate? Maybe it's better not to take a strong stand here, as it seems to only have weak effects on research strategies.
Growth Hormone
I'm concerned by Levine's somewhat cryptic claim that "growth hormone ... and IGF-1 have been shown time and again to also promote aging and, specifically, cancer".
This seems to be a misleading exaggeration.
I'm paying close attention to this because I just finished being treated with growth hormone in the TRIIM-X trial, and because I've invested in Intervene Immune (the company running the trial).
Intervene Immune's phase 1 trial based on growth hormone showed signs of reversing aging, including a reduction in age as measured by Levine's PhenoAge test.
That trial was inspired by rat studies which showed evidence that growth hormone reverses aging.
What could Levine mean about "promoting aging"? What evidence conflicts with this PhenoAge result? The only answers I can see involve diabetes and cancer. Did I miss some other evidence?
Diabetes is certainly influenced by aging, but the evidence from cultures that don't get diabetes suggests that it's mostly a lifestyle problem that deserves to be classified as somewhat separate from aging.
The main issue seems to be cancer.
From Risk of cancer in patients treated with recombinant human growth hormone in childhood:
It looks like the only human study showing increased cancer risk from growth hormone treatment is Swerdlow 2002, reporting 2 cancer deaths out of 1848 young patients.
Levine cites a paper that she co-authored, Low Protein Intake Is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population, which seems somewhat relevant here. It reports correlations which suggest that high growth hormone levels before age 65 cause cancer, but high growth hormone levels after age 65 reduce cancer rates. It seems like less direct evidence than Swerdlow 2002, since protein intake affects more than just growth hormone. I suspect the results are also confounded by other dietary differences. See also my comments on similar claims in Longo's book.
In sum, there are decent reasons to be concerned about taking growth hormone before age 65, and the preponderance of the evidence weakly suggests that it reduces cancer risk after age 65. There's likely harm from diabetes, especially in older patients, from naive use of growth hormone. A lot is known about how to avoid diabetes, but please don't try growth hormone without expert advice about diabetes.
Practical Advice
Much of the book describes practical steps we can take today to slow aging. It's mostly solid, but not novel, advice to lead a healthy lifestyle.
Her advice about food is quite similar to Longo's Longevity Diet (Longo co-authored the protein paper I mentioned above).
Levine does a slightly better job than Longo about hinting that methionine might be a key part of why protein restriction sometimes improves health.
Levine has a mostly good section on calorie restriction, but I'm disturbed by this claim:
Barzilai's Age Later reported that, for the key University of Wisconsin calorie restriction study on which Levine relies, a caretaker fed the monkeys extra, unrecorded, food that likely altered the study significantly. Why is Barzilai's report being ignored?
The rest of Levine's practical advice is about exercise, relaxation, and a little bit about Quantified Self approaches.
Conclusion
Levine has done good research, but seems not quite visionary enough to write a great book.
That comes just two pages after mentioning the ~300 year lifespan of Greenland sharks (which I previously mentioned as a food that I'm unlikely to try). Combine that with the evidence from the Yamanaka factors research, and I see a vision of postponing age-related decline forever.
When Levine writes about specifics of her research, I see small steps leading in the general direction of such a vision. Yet her more abstract descriptions seem to assume that aging research is poised for the kind of great stagnation that we see in many other parts of medicine.
Another year, another book on aging. This one comes close to saying important things about how to slow down aging, then chickens out just before reaching the finish line.
This review will focus on complaints, because there were a handful of problems which bothered me enough to write about. That feels a bit unfair, since my complaints focus on relatively small parts of the book. Much of the book is fairly good. The good parts just didn't impress me enough to want to write much about them.
Epigenetic Clocks
Levine is best known for developing an improved epigenetic clock, PhenoAge. Where previous clocks tried to identify the methylation locations that are most strongly connected to aging, Levine used a larger set of methylation locations. Instead of just selecting locations that correlated with chronological age, Levine looked for locations that correlated with age as estimated by blood test results.
Early in the book, Levine writes:
I hope by now I have conveyed to you the importance of knowing your biological age.
My intuition does hint that it's important, but the book does little to confirm that intuition, and didn't even look like Levine was trying to do so until much later in the book.
Epigenetic clocks correlate with age-related deaths, more so than does chronological age.
Adopting a healthier lifestyle causes epigenetic clocks to report a lower biological age.
Does that imply that we should use epigenetic clocks to evaluate changes in our lifestyle? It's certainly suggestive.
But there's plenty of room for doubt. Most biomarkers turn out to be less valuable than they originally look. E.g. amyloid beta is somewhat helpful at identifying Alzheimer's, yet a focus on reducing it has led researchers down a dead-end path.
Epigenetic clocks seem more promising than amyloid beta, but I don't have an easy way to compare their value to those of better-known age-related biomarkers. E.g. a1c results give me more actionable advice, since they tell me more about which set of lifestyle mistakes I'm making, and which dietary changes will fix them.
Epigenetic clocks show some hope of providing more complete feedback about rates of aging than other biomarkers. They might even be measuring the root causes of aging. But I haven't quite been convinced to replace my standard blood tests with epigenetic tests.
Programmed Aging?
Like many books about aging, True Age comments on the polarizing issue of whether aging comes from accumulated damage, versus being actively programmed.
Levine finds a middle-ground position which feels unsatisfying: aging is the default, and there's some programming to counter it. Evolution selects for as much programmed maintenance as is justified by the benefits.
I'm left wondering whether the key parts of that reasoning are tautological truths, or whether Levine is hinting at substantive claims that I suspect are false.
There's evidence that aging contributes to a large fraction of wild animal deaths. The energy costs of delaying aging don't look large enough to offset the obvious costs of those deaths. So I'm pretty sure there are effects that Levine glosses over.
Levine also mentions that individual cells can be rejuvenated using Yamanaka factors. This evidence seems more likely in a world where a program actively creates aging, than in a world where programming is simply repairing damage.
I wonder whether Levine is hinting at a stronger version of programmed aging than she feels it's safe to advocate? Maybe it's better not to take a strong stand here, as it seems to only have weak effects on research strategies.
Growth Hormone
I'm concerned by Levine's somewhat cryptic claim that "growth hormone ... and IGF-1 have been shown time and again to also promote aging and, specifically, cancer".
This seems to be a misleading exaggeration.
I'm paying close attention to this because I just finished being treated with growth hormone in the TRIIM-X trial, and because I've invested in Intervene Immune (the company running the trial).
Intervene Immune's phase 1 trial based on growth hormone showed signs of reversing aging, including a reduction in age as measured by Levine's PhenoAge test.
That trial was inspired by rat studies which showed evidence that growth hormone reverses aging.
What could Levine mean about "promoting aging"? What evidence conflicts with this PhenoAge result? The only answers I can see involve diabetes and cancer. Did I miss some other evidence?
Diabetes is certainly influenced by aging, but the evidence from cultures that don't get diabetes suggests that it's mostly a lifestyle problem that deserves to be classified as somewhat separate from aging.
The main issue seems to be cancer.
From Risk of cancer in patients treated with recombinant human growth hormone in childhood:
Whilst the strength of evidence for a relationship between GH/IGF-I axis and cancer risk is high in both cellular and animal models, data in humans are scarce and conflicting.
It looks like the only human study showing increased cancer risk from growth hormone treatment is Swerdlow 2002, reporting 2 cancer deaths out of 1848 young patients.
Levine cites a paper that she co-authored, Low Protein Intake Is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population, which seems somewhat relevant here. It reports correlations which suggest that high growth hormone levels before age 65 cause cancer, but high growth hormone levels after age 65 reduce cancer rates. It seems like less direct evidence than Swerdlow 2002, since protein intake affects more than just growth hormone. I suspect the results are also confounded by other dietary differences. See also my comments on similar claims in Longo's book.
In sum, there are decent reasons to be concerned about taking growth hormone before age 65, and the preponderance of the evidence weakly suggests that it reduces cancer risk after age 65. There's likely harm from diabetes, especially in older patients, from naive use of growth hormone. A lot is known about how to avoid diabetes, but please don't try growth hormone without expert advice about diabetes.
Practical Advice
Much of the book describes practical steps we can take today to slow aging. It's mostly solid, but not novel, advice to lead a healthy lifestyle.
Her advice about food is quite similar to Longo's Longevity Diet (Longo co-authored the protein paper I mentioned above).
Levine does a slightly better job than Longo about hinting that methionine might be a key part of why protein restriction sometimes improves health.
Levine has a mostly good section on calorie restriction, but I'm disturbed by this claim:
The other, and possibly most important, advantage of using nonhuman primates versus humans is that the scientists know exactly how much each animal is eating.
Barzilai's Age Later reported that, for the key University of Wisconsin calorie restriction study on which Levine relies, a caretaker fed the monkeys extra, unrecorded, food that likely altered the study significantly. Why is Barzilai's report being ignored?
The rest of Levine's practical advice is about exercise, relaxation, and a little bit about Quantified Self approaches.
Conclusion
Levine has done good research, but seems not quite visionary enough to write a great book.
But imagine living to see one hundred or beyond in good health and then slowly declining over the remaining five to ten years. That is ideal, and that's what our goal should be.
That comes just two pages after mentioning the ~300 year lifespan of Greenland sharks (which I previously mentioned as a food that I'm unlikely to try). Combine that with the evidence from the Yamanaka factors research, and I see a vision of postponing age-related decline forever.
When Levine writes about specifics of her research, I see small steps leading in the general direction of such a vision. Yet her more abstract descriptions seem to assume that aging research is poised for the kind of great stagnation that we see in many other parts of medicine.
November 2, 2023
This book presents cutting-edge research to help turn back the clock.
In an era where the pursuit of longevity and gracious ageing has become a universal aspiration, Dr. Morgan Levine’s book, True Age, emerges as a guiding light through the complex landscape of ageing research and its practical applications. As our understanding of biological ageing deepens, so does the potential to harness this knowledge for healthier and more extended lifespans. True Age delves into this fascinating journey, offering readers profound insights into the science of ageing while providing actionable strategies to slow down, and even reverse, the process.
Author’s background
Morgan Levine holds the role of a founding Principal Investigator at Altos Labs.
Her primary research area centres on the study of biological ageing, with a particular focus on utilising bioinformatics to quantify the ageing process and assess how lifestyle choices and pharmaceutical interventions can influence the pace of ageing. Regarded as a prominent figure in the field of ageing and longevity science, she has garnered media attention from prominent outlets such as CNN, The Guardian, Time, Newsweek, The Huffington Post, the BBC, and various others.
What is the book about?
True Age by Dr. Morgan Levine delves into the exciting world of ageing research, offering readers insights into the science of biological ageing and how to harness this knowledge to improve their healthspan.
The book begins by posing two intriguing questions: Can we measure our biological age, and can we slow down or reverse the ageing process? Dr. Levine provides answers by introducing readers to the latest advancements in the field of ageing and longevity science. She explains the concept of biological age and presents accessible methods for estimating one’s own biological age.
True Age goes beyond theory, guiding readers toward personalised strategies for maintaining youthful vitality. Dr. Levine emphasises the importance of tailored plans for diet, exercise, sleep, and lifestyle practices like intermittent fasting and caloric restriction. These strategies, backed by scientific research, are designed to slow or even reverse the ageing process, ultimately leading to a longer and healthier life.
Three key takeaways from True Age
1. Caloric restriction and fasting slows down ageing
True Age delves into the fascinating world of caloric restriction (CR) and its profound effects on the ageing process. Through a historical journey that highlights the scientific foundations of CR dating back to the early 20th century, the author unveils compelling evidence supporting the notion that CR can significantly slow down the ageing process.
The groundbreaking Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE) study takes centre stage, revealing that those who embraced CR aged a staggering 87.5% slower than the average person. The implications are profound, as the book illustrates with the story of Isabel, who, by adopting a CR lifestyle, could potentially maintain a biological age significantly younger than her chronological age, emphasising the transformative potential of caloric restriction in promoting longevity and healthier ageing.
2. Physical activity is inherent to human nature and serves as an anti-ageing mechanism
This book underscores the fundamental connection between physical activity and human evolution, demonstrating that our ancestors’ physical prowess was not only instrumental in their survival but also a defining characteristic in our DNA. While humans might not match other predators in sheer speed, our skeletal and muscular systems evolved for endurance running, enabling us to pursue prey over long distances. However, modern lifestyles have shifted from this active heritage to one marked by prolonged periods of sitting and inactivity. This shift has dire consequences for our physiology, accelerating the ageing process and inviting disease.
Exercise emerges as a compelling strategy to combat ageing and disease by inducing favourable adaptations in various organs and systems within the body. The cardiovascular system, in particular, undergoes substantial improvements, enhancing oxygen delivery and utilisation, as measured by VO₂ max. Maintaining high levels of VO₂ max through regular aerobic exercise can significantly offset age-related declines and contribute to overall health and vitality, reducing the risk of heart attacks and other diseases. In essence, this book convincingly establishes the irreplaceable role of physical activity in our lives, aligning our modern behaviours with our evolutionary heritage to promote healthier, more vibrant ageing.
3. Quality sleep promotes brain rejuvenation
Diet and exercise are crucial for health, but other factors like sleep, stress, and socioeconomic circumstances also profoundly impact ageing and well-being. Sleep, in particular, plays a vital role in maintaining both physical and mental health.
Quality sleep is a fundamental aspect of well-being, often overlooked in our busy lives. Despite its vulnerability aspect, sleep has evolved as a critical physiological process. During sleep, cerebrospinal fluid (CSF) washes over the brain, clearing waste products. This mechanism, enhanced during deep sleep, contributes to physical revitalisation. The importance of sleep is further underscored by its potential role in mitigating neurodegenerative diseases like Alzheimer’s. Disrupting sleep patterns can exacerbate Alzheimer’s markers, suggesting a bidirectional relationship between sleep disturbances and cognitive decline.
Strengths and weaknesses, according to readers’ reviews
Strengths:
• Dr. Levine simplifies cutting-edge research and lifestyle practices using accessible language and humour, making complex topics easy to understand.
• The book offers valuable additional resources for personal exploration and practical application, enhancing its real-world relevance.
Weaknesses:
• The absence of chapter conclusions can be a drawback for non-medical readers who rely on such summaries to better grasp the content.
Best quotes from True Age
“According to results, those assigned to a CR [calorie-restricted] diet only gained about three months of biological age over the entire two-year period. They were aging 87.5 percent slower than we would expect for the average person.”
“Sleep problems may actually drive disease progression. Studies are showing that disrupting sleep or stimulating excitatory neurons that control arousal promote the accumulation of various Alzheimer’s markers in mice. Similarly, sleep deprivation seems to do the same to humans. This can create a compounding effect if ailments of aging, including cognitive ones, cause sleep disturbances, which in turn further drive degenerative declines.”
“Physical activity also seems to boost vaccine response in the elderly. Among those aged sixty-five and older, a significant proportion do not respond to vaccines, like the annual flu shot. This means that even though older adults get vaccinated, their bodies don’t initiate an antibody response, leaving them susceptible to infection. This creates a major dilemma, given that these same individuals are often the ones most at risk of serious complications if infected with something like the flu virus.”
Final takeaway
True Age by Dr. Morgan Levine is an enlightening journey into the realm of ageing research, offering a profound understanding of biological ageing and how to apply this knowledge to enhance one’s healthspan. With a focus on caloric restriction, physical activity, and the importance of quality sleep, the book provides readers with actionable strategies to slow down or even reverse the ageing process. Dr. Levine’s ability to convey complex scientific concepts in an approachable manner, sprinkled with humour, is a significant strength.
True Age is highly recommended for those seeking to unlock the secrets of longevity and healthier ageing.
In an era where the pursuit of longevity and gracious ageing has become a universal aspiration, Dr. Morgan Levine’s book, True Age, emerges as a guiding light through the complex landscape of ageing research and its practical applications. As our understanding of biological ageing deepens, so does the potential to harness this knowledge for healthier and more extended lifespans. True Age delves into this fascinating journey, offering readers profound insights into the science of ageing while providing actionable strategies to slow down, and even reverse, the process.
Author’s background
Morgan Levine holds the role of a founding Principal Investigator at Altos Labs.
Her primary research area centres on the study of biological ageing, with a particular focus on utilising bioinformatics to quantify the ageing process and assess how lifestyle choices and pharmaceutical interventions can influence the pace of ageing. Regarded as a prominent figure in the field of ageing and longevity science, she has garnered media attention from prominent outlets such as CNN, The Guardian, Time, Newsweek, The Huffington Post, the BBC, and various others.
What is the book about?
True Age by Dr. Morgan Levine delves into the exciting world of ageing research, offering readers insights into the science of biological ageing and how to harness this knowledge to improve their healthspan.
The book begins by posing two intriguing questions: Can we measure our biological age, and can we slow down or reverse the ageing process? Dr. Levine provides answers by introducing readers to the latest advancements in the field of ageing and longevity science. She explains the concept of biological age and presents accessible methods for estimating one’s own biological age.
True Age goes beyond theory, guiding readers toward personalised strategies for maintaining youthful vitality. Dr. Levine emphasises the importance of tailored plans for diet, exercise, sleep, and lifestyle practices like intermittent fasting and caloric restriction. These strategies, backed by scientific research, are designed to slow or even reverse the ageing process, ultimately leading to a longer and healthier life.
Three key takeaways from True Age
1. Caloric restriction and fasting slows down ageing
True Age delves into the fascinating world of caloric restriction (CR) and its profound effects on the ageing process. Through a historical journey that highlights the scientific foundations of CR dating back to the early 20th century, the author unveils compelling evidence supporting the notion that CR can significantly slow down the ageing process.
The groundbreaking Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy (CALERIE) study takes centre stage, revealing that those who embraced CR aged a staggering 87.5% slower than the average person. The implications are profound, as the book illustrates with the story of Isabel, who, by adopting a CR lifestyle, could potentially maintain a biological age significantly younger than her chronological age, emphasising the transformative potential of caloric restriction in promoting longevity and healthier ageing.
2. Physical activity is inherent to human nature and serves as an anti-ageing mechanism
This book underscores the fundamental connection between physical activity and human evolution, demonstrating that our ancestors’ physical prowess was not only instrumental in their survival but also a defining characteristic in our DNA. While humans might not match other predators in sheer speed, our skeletal and muscular systems evolved for endurance running, enabling us to pursue prey over long distances. However, modern lifestyles have shifted from this active heritage to one marked by prolonged periods of sitting and inactivity. This shift has dire consequences for our physiology, accelerating the ageing process and inviting disease.
Exercise emerges as a compelling strategy to combat ageing and disease by inducing favourable adaptations in various organs and systems within the body. The cardiovascular system, in particular, undergoes substantial improvements, enhancing oxygen delivery and utilisation, as measured by VO₂ max. Maintaining high levels of VO₂ max through regular aerobic exercise can significantly offset age-related declines and contribute to overall health and vitality, reducing the risk of heart attacks and other diseases. In essence, this book convincingly establishes the irreplaceable role of physical activity in our lives, aligning our modern behaviours with our evolutionary heritage to promote healthier, more vibrant ageing.
3. Quality sleep promotes brain rejuvenation
Diet and exercise are crucial for health, but other factors like sleep, stress, and socioeconomic circumstances also profoundly impact ageing and well-being. Sleep, in particular, plays a vital role in maintaining both physical and mental health.
Quality sleep is a fundamental aspect of well-being, often overlooked in our busy lives. Despite its vulnerability aspect, sleep has evolved as a critical physiological process. During sleep, cerebrospinal fluid (CSF) washes over the brain, clearing waste products. This mechanism, enhanced during deep sleep, contributes to physical revitalisation. The importance of sleep is further underscored by its potential role in mitigating neurodegenerative diseases like Alzheimer’s. Disrupting sleep patterns can exacerbate Alzheimer’s markers, suggesting a bidirectional relationship between sleep disturbances and cognitive decline.
Strengths and weaknesses, according to readers’ reviews
Strengths:
• Dr. Levine simplifies cutting-edge research and lifestyle practices using accessible language and humour, making complex topics easy to understand.
• The book offers valuable additional resources for personal exploration and practical application, enhancing its real-world relevance.
Weaknesses:
• The absence of chapter conclusions can be a drawback for non-medical readers who rely on such summaries to better grasp the content.
Best quotes from True Age
“According to results, those assigned to a CR [calorie-restricted] diet only gained about three months of biological age over the entire two-year period. They were aging 87.5 percent slower than we would expect for the average person.”
“Sleep problems may actually drive disease progression. Studies are showing that disrupting sleep or stimulating excitatory neurons that control arousal promote the accumulation of various Alzheimer’s markers in mice. Similarly, sleep deprivation seems to do the same to humans. This can create a compounding effect if ailments of aging, including cognitive ones, cause sleep disturbances, which in turn further drive degenerative declines.”
“Physical activity also seems to boost vaccine response in the elderly. Among those aged sixty-five and older, a significant proportion do not respond to vaccines, like the annual flu shot. This means that even though older adults get vaccinated, their bodies don’t initiate an antibody response, leaving them susceptible to infection. This creates a major dilemma, given that these same individuals are often the ones most at risk of serious complications if infected with something like the flu virus.”
Final takeaway
True Age by Dr. Morgan Levine is an enlightening journey into the realm of ageing research, offering a profound understanding of biological ageing and how to apply this knowledge to enhance one’s healthspan. With a focus on caloric restriction, physical activity, and the importance of quality sleep, the book provides readers with actionable strategies to slow down or even reverse the ageing process. Dr. Levine’s ability to convey complex scientific concepts in an approachable manner, sprinkled with humour, is a significant strength.
True Age is highly recommended for those seeking to unlock the secrets of longevity and healthier ageing.
March 8, 2023
Morgan Levine's "True Age: Cutting-Edge Research to Help Turn Back the Clock" is a breathtaking exploration of the science of aging and how we can take control of our health span. With a deft hand, Levine seamlessly weaves complex scientific concepts into a beautifully accessible narrative, bringing readers along on an inspiring journey of discovery.
Levine's expertise in longevity research shines through every page of this remarkable work, as she reveals the latest cutting-edge research in the field. But what truly sets this book apart is Levine's focus on practical recommendations that can be implemented by anyone, regardless of their background or experience. By offering actionable steps to take today to maximize our health span, Levine has written a book that truly has the power to change lives.
It's rare to find a book that combines the rigor of top-notch scientific research with the warmth and accessibility of a good friend's advice. But that's precisely what Levine has achieved in "True Age." With this book, readers can feel confident that they're getting the latest, most accurate information about how to take control of their own health and longevity. For anyone interested in living their best life, "True Age" is an absolute must-read.
Levine's expertise in longevity research shines through every page of this remarkable work, as she reveals the latest cutting-edge research in the field. But what truly sets this book apart is Levine's focus on practical recommendations that can be implemented by anyone, regardless of their background or experience. By offering actionable steps to take today to maximize our health span, Levine has written a book that truly has the power to change lives.
It's rare to find a book that combines the rigor of top-notch scientific research with the warmth and accessibility of a good friend's advice. But that's precisely what Levine has achieved in "True Age." With this book, readers can feel confident that they're getting the latest, most accurate information about how to take control of their own health and longevity. For anyone interested in living their best life, "True Age" is an absolute must-read.
May 11, 2022
somehow both way too sciencey and way too babied. some of the metaphors were unnecessary, and then there were parts where i was just like .. wtf is that???
would've liked conclusions at the end of each chapter; a lot of science books do that and i find it really helpful to understanding what i read, esp for non-medical folks like me.
would've liked conclusions at the end of each chapter; a lot of science books do that and i find it really helpful to understanding what i read, esp for non-medical folks like me.
June 24, 2023
Made it to the end.......but there are much better longevity books out there.....albeit I suspect the author would say their claims are overstated...but they do better job of educating what might be on the horizon..
This says
Track your biological age
Exercise
Eat healthy
And it takes 266 pages to do that...
This says
Track your biological age
Exercise
Eat healthy
And it takes 266 pages to do that...
May 9, 2022
The author has a knack of explaining complicated biological processes in an understandable way. One of the better popular science books.
September 29, 2023
Heavy on metaphors, light on citations. Much of it reads as a personal memoir of the author and their friends rather than a practical or scientific review.
The anecdotes and ostensibly cutting-edge research based on the author’s current (though unsubstantiated and not peer-reviewed) work is interesting.
The general thesis of the book (besides being a memoir) is that measuring/quantifying “biological age” is a robust way to study outcomes of aging-related clinical trials (and also in the individual). Overall, I find that idea compelling, but due to a lack of citations to the literature in this book, I’m not yet convinced of the precision/accuracy of our current models. Will need to do some follow-up research before delving into this myself. In particular, it’s not clear if any of these “biological age” estimates are actually a reasonable proxy for expected healthspan or, if they are, whether they respond correctly to interventions, i.e., maybe they are “correct” for an average human in the “default” case but decouple from observed healthspan given certain treatments. The reason this is such a big deal is because the proposal is to substitute short-term interventional trials for long-term lifespan trials.
The author promotes calorie restriction diets “independent of obesity”, but concedes that there appears to be a floor as to how much can be cut. At the end of the day, I’m unconvinced that this is any better than direct maintenance at a “healthy” weight, where that weight mostly depends on body composition.
Overall, this is a decent introduction to recent developments on aging. Most of the advice itself is well known and should it change much, but the main thing it opened my eyes to is the notion of quantifying biological age. If you trust the author’s biological age offering (or any other bio-age metric), then you can in principle use this to run some medium- to long-term tests on yourself to evaluate the efficacy of various interventions. I like the idea of this, but I’m not entirely convinced that these metrics are necessarily measuring the correct things in this case. I’ll be watching this space in the future.
EDIT:
Turns out only the first bit really felt autobiographical. Later chapters less so.
Overview of different dieting methods is hodgepodge and feels unguided and sometimes self-contradictory. I’m not aware of any fasting diet studies that demonstrate a benefit over plain old CR, but several claims in this chapter suggest that there’s something magic about fasting diets (without explicitly citing studies or methodologies). Take this section with a grain of salt.
Overall, the book was an interesting overview of the anti-aging options, but it did not go into a ton of technical detail or provide protocols for the suggested n=1 self-testing.
EDIT 2:
Turns out all of the citations live at the very end of the book, but are not linked to the core text itself. This makes it very inconvenient to cross-reference.
The anecdotes and ostensibly cutting-edge research based on the author’s current (though unsubstantiated and not peer-reviewed) work is interesting.
The general thesis of the book (besides being a memoir) is that measuring/quantifying “biological age” is a robust way to study outcomes of aging-related clinical trials (and also in the individual). Overall, I find that idea compelling, but due to a lack of citations to the literature in this book, I’m not yet convinced of the precision/accuracy of our current models. Will need to do some follow-up research before delving into this myself. In particular, it’s not clear if any of these “biological age” estimates are actually a reasonable proxy for expected healthspan or, if they are, whether they respond correctly to interventions, i.e., maybe they are “correct” for an average human in the “default” case but decouple from observed healthspan given certain treatments. The reason this is such a big deal is because the proposal is to substitute short-term interventional trials for long-term lifespan trials.
The author promotes calorie restriction diets “independent of obesity”, but concedes that there appears to be a floor as to how much can be cut. At the end of the day, I’m unconvinced that this is any better than direct maintenance at a “healthy” weight, where that weight mostly depends on body composition.
Overall, this is a decent introduction to recent developments on aging. Most of the advice itself is well known and should it change much, but the main thing it opened my eyes to is the notion of quantifying biological age. If you trust the author’s biological age offering (or any other bio-age metric), then you can in principle use this to run some medium- to long-term tests on yourself to evaluate the efficacy of various interventions. I like the idea of this, but I’m not entirely convinced that these metrics are necessarily measuring the correct things in this case. I’ll be watching this space in the future.
EDIT:
Turns out only the first bit really felt autobiographical. Later chapters less so.
Overview of different dieting methods is hodgepodge and feels unguided and sometimes self-contradictory. I’m not aware of any fasting diet studies that demonstrate a benefit over plain old CR, but several claims in this chapter suggest that there’s something magic about fasting diets (without explicitly citing studies or methodologies). Take this section with a grain of salt.
Overall, the book was an interesting overview of the anti-aging options, but it did not go into a ton of technical detail or provide protocols for the suggested n=1 self-testing.
EDIT 2:
Turns out all of the citations live at the very end of the book, but are not linked to the core text itself. This makes it very inconvenient to cross-reference.
May 31, 2023
The book was much more heavily into the "research" part of the subtitle and much less about how to "turn back the clock".
If you enjoy health trackers or bio hacking this may be the book for you. The main solution revolves around tracking your personal epigenetics. Then over time you observe what changes you make improve the readouts of these tests. Apparently anyone can do this, BUT Levine points out (correctly - she has the science backing it up) that what works for one person may not work for another. The problem is that it leaves one a bit unclear what any particular reader should do. The studies she cites about these differences among people use sophisticated testing that seem to not be available to someone who is not a professional scientist. So I personally don't want to just try different things for years and track test results. I am not someone who is into tracking my life anyway.
Also for example, she explains the importance of exercise but shows very little in the way of options on what kind of program to actually look for.
The best practical advice she gives is about calorie restriction. It has been proven to extend the lifespan and the vigor of animals in studies. But few people who have been studied for the effects of it can stick with it as a lifestyle. So Levine does explain alternatives that are both easier to do and also have very similar benefits to calorie restriction.
If you enjoy health trackers or bio hacking this may be the book for you. The main solution revolves around tracking your personal epigenetics. Then over time you observe what changes you make improve the readouts of these tests. Apparently anyone can do this, BUT Levine points out (correctly - she has the science backing it up) that what works for one person may not work for another. The problem is that it leaves one a bit unclear what any particular reader should do. The studies she cites about these differences among people use sophisticated testing that seem to not be available to someone who is not a professional scientist. So I personally don't want to just try different things for years and track test results. I am not someone who is into tracking my life anyway.
Also for example, she explains the importance of exercise but shows very little in the way of options on what kind of program to actually look for.
The best practical advice she gives is about calorie restriction. It has been proven to extend the lifespan and the vigor of animals in studies. But few people who have been studied for the effects of it can stick with it as a lifestyle. So Levine does explain alternatives that are both easier to do and also have very similar benefits to calorie restriction.
June 7, 2023
The author has devised an epigenetic test to determine one's biological age as opposed to chronological age.
This test is important because it indicates our body's "true" age and as a measure can be used to test the efficacy of healthspan interventions without waiting long periods of time to gauge its effects.
This is all great except she doesn't state that the current test costs $299 (https://www.elysiumhealth.com/product...) which prices it out for most people to take as a regular measure.
The second half of the book covers similar ground to other books in this genre: caloric restriction, diet, fasting, exercise, sleep and stress.
This test is important because it indicates our body's "true" age and as a measure can be used to test the efficacy of healthspan interventions without waiting long periods of time to gauge its effects.
This is all great except she doesn't state that the current test costs $299 (https://www.elysiumhealth.com/product...) which prices it out for most people to take as a regular measure.
The second half of the book covers similar ground to other books in this genre: caloric restriction, diet, fasting, exercise, sleep and stress.
April 23, 2025
The book focuses primarily on the concept of biological age—contrasted with chronological age—and its measurement and tracking. This emphasis makes perfect sense, given that the author is one of the leading global authorities in the field.
It’s the only book I’ve read so far that provides a proper summary of all major developments in aging without promoting personal theories. Rather than proposing a new framework, it serves as a clear and comprehensive literature overview for those outside the academic niche.
It’s the only book I’ve read so far that provides a proper summary of all major developments in aging without promoting personal theories. Rather than proposing a new framework, it serves as a clear and comprehensive literature overview for those outside the academic niche.
November 9, 2023
I enjoyed reading the book, more than Young Forever. Nothing new though, especially if you have already read content on this topic — caloric restriction, plant-based diet, HIIT, mindfulness, etc, etc. I liked the introduction to epigenetics. This idea is not that common in the country where I live. I hope I can measure it someday and make adjustments based on my own experience.
November 16, 2022
A little wonky and difficult to read at times. Calculating biological age does not seem to be an easy task. Few of the required bloodwork parameters were covered in my standard tests. An extra star off for having a strong pro-veganism bent. No mention at all about healthy fats and the pros of appropriate meat eating.
May 22, 2023
Interesting research interspersed with the fact the author has financial ties with products mentioned in the book…This is mentioned at the very end of the book. A lot of interesting information regardless.
July 15, 2023
Really interesting. Although there is an incredible amount of research going on in this area, I think it will be a long time before we see anything viable. Ultimately eat a plant-based diet and exercise, you can’t go wrong with that!
October 9, 2022
I take Elysium products including Index so I wanted to read this book. It improved my understanding of what it takes to improve lifespan and healthspan.
August 23, 2025
some useful longevity material, overly promotional, poor writing style - could have gotten the info from a better written and more focused book
January 9, 2026
A good book for those with a science background, but great reminder of the importance of fasting
July 29, 2023
Really enjoyable read. Liked the close proximity to the science. Also like the honesty - we don’t know a lot. Very logical sequence in the book.
I like the enunciation of a chronological v biological age distinction and practical approach on how to test (p74).
To get the most benefit from biological age you would need to measure semi-regularly, and ideally incorporate lifestyle changes periodically with the view to reducing it.
Like the idea of lab test to gene saliva test. Author touts her DNA methylation test but I like the blood-based phenotypic test as it’s easy to do with standard bloods.
In terms of practical action, the usual roundup: sleep (7 hours ideally), fasting/caloric restriction (science still equivocal though promising - FMD, 5:20, ERT), exercise (all but ideally with subfocus on V02 max, and HIIT), reduce stress, cut down on basically anything but plants and never touch a refined object again (equivocal but very promising).
Future science to watch out for:
1. More certainty on CR benefits - ask the monkeys again
2. Rapamycin - cure in a pill?
3. Senescent cell targeting? Let’s stop Alzheimers
4. Yamanaka factors and reprogramming cells to be young stem cells
I like the enunciation of a chronological v biological age distinction and practical approach on how to test (p74).
To get the most benefit from biological age you would need to measure semi-regularly, and ideally incorporate lifestyle changes periodically with the view to reducing it.
Like the idea of lab test to gene saliva test. Author touts her DNA methylation test but I like the blood-based phenotypic test as it’s easy to do with standard bloods.
In terms of practical action, the usual roundup: sleep (7 hours ideally), fasting/caloric restriction (science still equivocal though promising - FMD, 5:20, ERT), exercise (all but ideally with subfocus on V02 max, and HIIT), reduce stress, cut down on basically anything but plants and never touch a refined object again (equivocal but very promising).
Future science to watch out for:
1. More certainty on CR benefits - ask the monkeys again
2. Rapamycin - cure in a pill?
3. Senescent cell targeting? Let’s stop Alzheimers
4. Yamanaka factors and reprogramming cells to be young stem cells
This entire review has been hidden because of spoilers.
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