It was on my 42nd birthday that I learnt I was 71. Forty-two was already a depressing age. Forty-two is when you start to think that soon you won’t be able to say you are in your early forties. Forty-two is when you begin to accept that being in your fifth decade is actually some sort of inevitable consequence of the continued orbit of the Earth around the Sun, rather than a mistake that will soon be reversed.
But then I get a message from the company that, for the past week, has been analysing my blood, and I start thinking about a different decade entirely. “It’s not good news,” the consultant says. It certainly isn’t. My “biological age” is 71.
It feels odd. On the outside, I am fine. I am the same person I was the day before. I am my ideal weight. I am not obviously sick. I am still a non-smoker, moderate drinker and regular exerciser. I still sleep well.
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Inside, though, she tells me, a clock is ticking faster than it should. Biologically, I am a pensioner. That night, I sleep a little less well.
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The next day I meet the woman whose test has just told me this. Nikolina Lauc, the 32-year-old CEO of GlycanAge (she is 20 years old biologically, I later find out), is brisk and slightly scary. A Croatian-Briton and serial entrepreneur, she has the air of someone who would hold back her own meeting with the Grim Reaper simply through intimidation alone. She asks me how I am. “I am just enjoying the time I have left,” I joke. She doesn’t smile. “It doesn’t mean you have fewer years,” she corrects me. “Just that they might be less enjoyable.” It means that my old age might, instead, be blighted by decades of chronic illness.
Our immune systems, she tells me, mature at around the time we turn 20. Then they age. It is the change in the immune system that her test, GlycanAge, measures. And in my case? “There has been 22 years of something going wrong.” It feels like her bedside manner could use some work.
What is ageing? To most of us it is the price of living. It is inevitable deterioration, the wear and tear of life. It is the build-up to the punchline “death and taxes”.
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And to biologists? Increasingly, they see ageing as a molecular process. Or, in fact, a set of molecular processes. It is the way your body stops getting rid of senescent cells; the way your DNA gains markers and mutations; the way your stem cells deplete — and the way your immune system changes. Ageing is not merely like a disease; it is the ultimate disease.
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Curing that disease is also the ultimate business. “There are more than 700 companies in this field and they have no problem attracting money,” says Venki Ramakrishnan, a scientist at the MRC Laboratory of Molecular Biology in Cambridge, who has written a book about ageing called Why We Die. “We’re all worried about growing old. We’re especially worried about becoming debilitated. We’re obviously worried about dying ― this is the life we lead and we don’t want to leave that life. A lot of companies capitalise on this anxiety.”
This doesn’t at all mean that the science is necessarily bad, he says ― just that the money going into it is, for scientists used to fighting for every grant, startling.
From ― at the pharmacological end ― drugs that mimic fasting to ― at the vampiric end ― blood transfusions from the young, there are lots of approaches to defeating ageing, many backed by Silicon Valley billionaires who, he says, aren’t used to meeting a problem they can’t solve. “When they were young they wanted to be rich, and now that they’re rich they want to be young,” he writes in his book.
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Before we can find the secret to eternal youth, though, it helps to define it. Given the length of a human lifespan, science will never progress if we have to wait until people die to know whether anti-ageing interventions worked. It makes sense, Ramakrishnan says, to find markers of “true” ageing so that we can hone treatments more rapidly.
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This is where companies like GlycanAge come in. There is a booming market in tests of biological age. Partly they are for people who want to study ageing. Mainly they are for curious consumers. Perhaps the most famous adherent is Bryan Johnson, a 46-year-old tech entrepreneur with the sheeny face of a shop mannequin, who is spending millions to reverse his ageing clock to 18. But he is far from alone. Halle Berry, Nikolina informs me cheerily, is a GlycanAge customer who has (unlike me) an excellent biological age. I am also beaten, she tells me, by Tim Spector, the King’s College London epidemiologist and television bowel-botherer whose face adorns the goji berry aisle at Marks & Spencer.
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What biological age tells you, adherents claim, is how you are doing in life’s journey ― and in your battle against its ultimate destination. Are the supplements and kale smoothies working? Is the exercise keeping you youthful or wearing you out?
GlycanAge looks at a process known as glycosylation. Most proteins in the body, including those in the immune system, have carbohydrates that attach to them, which can change their function. As we age, the pattern of these carbohydrates ― glycans ― on our antibodies alters. This pattern in turn, has been linked to some diseases, especially those caused by inflammation.
Gordan Lauc, professor of biochemistry and molecular biology at Zagreb University, chief scientific officer at GlycanAge and father of Nikolina, has a neat way of describing how this works. Proteins are the little atomic machines that power everything that goes on inside us, but the protein bit just provides the basic structure. Glycans are like the feathers that go on that structure. They are small but important, and change its function. A bird without feathers can only walk. A bird with feathers can fly. Does it matter that mine are those of a pensioner?
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“When we talk about all the different metrics for ageing, glycans are the one that is most obviously mechanistic,” Gordan says. As you age, the glycosylation pattern of antibodies changes, he says, in a functional way. They become more likely to promote inflammation ― the overactivation of the immune system. That inflammation in turn promotes many of the diseases of old age: heart disease, stroke, diabetes.
This is not mere theory. Studies of population levels have shown an association between glycosylation patterns and disease ― often before other signs of illness appear. “The good thing about glycans is we can see them change before diagnosis,” Gordan says. “We see changes in glycans five to ten years before heart attack or stroke.” On its website, GlycanAge identifies this as a root cause of ageing. “Ageing, while a natural process, is the accumulation of damage in your body over time caused by a long-term overactivation of the immune system.”
It’s a bold statement. Far too bold for Ramakrishnan. “The idea that a complex marker like age can be attributed to a single cause? I don’t buy it.” When he sees my results he is even more sceptical. “Unless you have some obvious symptoms of a 71-year-old, I would take this more as an indication of the usefulness of the test than of the condition of your body.”
When I pass on this opinion to Nikolina, she is unimpressed. “He knows nothing about glycobiology,” she says of the Nobel prizewinning molecular biologist and past president of the Royal Society, who has just spent a fair bit of time talking to me about glycosylation. Then she adds, “It’s really tough when you get a high result. Sometimes people take it as a personal insult. The conversion to you being a believer takes a long time.”
She is right about that. I don’t want to believe. I want to find fault in the science ― to poke at the weak spots. And with science there are always weak spots. The biggest of which here is the idea that a number averaged across the population ― higher GlycanAge correlating with higher disease risk ― translates to a number relevant for an individual.
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Anne Dell, professor of carbohydrate biochemistry at Imperial College, says that this distinction may be key. “You are right to be suspicious.” She asks me to consider another proxy for age ― height. “Every adult gets shorter as they get older. It could be argued that if you measure your height, you can get an age.” But it would obviously be nonsense to claim that a man who is 5ft 8in at the age of 25 has, through being shorter, a biological age of 75.
The immune system is immensely complicated, contains a phenomenally intricate set of internal checks and balances and much of it remains mysterious. Dell says that the glycosylation patterns my test looked at are just a small subset of what is going on in the immune system, and there is huge variability between people ― without it being clear, just as with height, that this variability does them harm. Some of the variability might even just be related to my having a cold.
“Gordan Lauc has done really solid research in this area,” she says. “A large body of rigorous glyco-science is indirectly correlated with GlycanAge… But using it as a commercial test is a step too far. I think this is exaggerating what can be done.”
The test was just meant to be a bit of fun. In the days after receiving it, I oscillate between dismissing it and thinking I’m an idiot for dismissing it. I start examining myself. Do I really feel well, or am I ignoring illness? Is that a headache? An irritable bowel? Or life?
Shortly after this, I go ice-climbing on Cairn Gorm. I console myself that if I am indeed a pensioner, I’m a sprightly one. “Be careful,” my wife says before I leave, as she always does before climbing trips. Then she adds, “Although better to die falling off a mountain in your prime than a few months later as an old man.” I don’t completely find it funny. Nor am I completely reassured by my chats with other scientists.
The same is true for James Marriott, my baby-faced colleague, who is told his biological age is double his chronological age of 31. Given he began his career in rare books and writes about the arts, however, this makes sense. His most logical life trajectory was always that of a tragic consumptive Romantic poet. All he needs to do now is find someone out of his league to pine over and then go to Venice to write bad verse until he dies.
I, however, had always intended to have a few more decades of healthy living. If this test really is worrying, what can I do about it? Nikolina says I should grasp the opportunity. “We say that bad news is good news because you have plenty of time to change,” she says. But how?
The problem with biological age tests is they are a fire alarm without a fire engine. They can smell the smoke (or can claim to), but can neither put out the fire nor even find it.
Perhaps the problem is I exercise too little or, Nikolina suggests, too much. Maybe I should fast more? Or eat more protein? She says I should get some more at-home tests, from another company, to see if they find anything.
This is how I enter the world of the worried well. I google “blood test” and for days afterwards it is clear my ad cookies have clocked me as someone who is potentially good for a lot of spending. There are entry-level tests for £100. There are pricier tests with euphemistic names like “Discovery” (what will it discover?). There are even pricier tests with names like “Signature Premium Plus” (£3,900) that will do everything short of delivering the results by butler. There are tests that offer a discount ― if you sign up to take them monthly.
Margaret McCartney, a GP and senior lecturer at the University of St Andrews, has written to the Competition and Markets Authority asking them to look into this whole sector. “People don’t get good-quality independent evidence before they take the test,” McCartney says. “Then no one independent explains the results. It’s a sales pitch, not a patient-doctor relationship.”
She says that the key problem is that the companies don’t explain why it is that the NHS doesn’t offer these tests ― which is often because the evidence base isn’t there ― and then expect NHS GPs to explain the results to worried patients. They don’t do the NHS any favours.
“The bottom line is that it’s no secret what is most strongly associated with longer, healthier lives,” McCartney says. “No smoking, no excess alcohol, a varied, plant-heavy Med-style diet, exercise, work and hobbies you enjoy, good social networks and, of course, probably most important, don’t be poor.”
After buying my supplementary blood test from a company called Thriva I am, on the last of these points, £126 down and, I find, no better informed. I try to draw enough blood with three fingerprick lances but fail. The company sends another kit and, despite star jumps, putting my hand in warm water until it’s a prune and ― a hurried breakfast innovation ― using a dressing-gown belt as a Trainspotting-style heroin-addict tourniquet, I fail again.
Finally, I resort to meeting a doctor in person. Our work insurance policy offers a private health MOT, which I have always ignored because I have never been worried about my health. Now I am. For two hours they ask questions, take blood, make me do unpleasant things like touch my toes ― and occasionally mutter, “71!” while chuckling. Like a plumber dealing with a previous workman’s mess, the doctor seems to enjoy it immensely.
Then I get the results, graded on a traffic light system. I am, on almost every metric, given a green. My cholesterol and BMI are good; my body fat is excellent. GlycanAge says there is good evidence its markers predict, in particular, cardiovascular problems. After my MOT, combining standard measures such as weight and cholesterol, it is predicted I have a near zero per cent chance of diabetes in the next decade, 2 per cent for heart problems ― and a “heart age” of 44.
“You don’t seem to be 71,” the doctor says. The only cause for concern is that my blood pressure seems a bit high. Maybe I am stressed? Maybe, in fact, the GlycanAge test has spotted something important that this one has only hinted at?
And so I find myself getting more stressed. I have, it appears, a choice. I can get a subscription to blood tests by post. I can exercise more. I can exercise less (the doctor did not endorse this suggestion). I can try fasting. I can try not fasting. I can pursue a solution but without understanding the problem. Or I can ignore it. I can eat healthily, exercise and hope. Because life is a fatal condition. I have no idea what is wrong, if anything. And neither do they.
James Marriott. Age: 31. Bio age: 62
If you study the wizened photo of me that accompanies this article, it all makes sense. Of course my biological age is 62. Just look at the sunken eyes, the furrowed brow, the drawn cheeks, the eyes haunted with thoughts of approaching mortality.
I wish. I’ve spent most of my 31 years on this planet wishing I looked older. If you think I look baby-faced now, imagine what I looked like when I was 15. I was slightly nervous the GlycanAge test would reveal that I have started ageing backwards à la Benjamin Button and that my cheeks were destined to get ever plumper, my lips ever more cherubic, my eyes ever more sparklingly boyish. Knowing that I am at least old on the inside has provided me with a certain manly self-esteem. I wonder if I can use my test to acquire some of the other benefits of being 62, like buying a house for very little money in the Eighties.
In my consultation with GlycanAge’s Aleksandar Vojta, we attempt to discover the sources of my prematurely geriatric condition. I am pleased to report that I am a healthy weight, the consumer of a balanced diet, a heavy sleeper, a moderate drinker and an intermittent jogger. If my lifestyle has one flaw it is probably stress. Writing a column is a weekly psychodrama. Getting cancelled on X is never relaxing. But then again, it’s not as if I’m running a FTSE 100 company or teaching in an inner-city school or something. I’m probably not that stressed in the grand scheme of things.
One possible solution, Vojta suggests, is to nourish my gut microbiome with probiotic drinks, which seems too easy. The other remedy, apparently, is to take up weight training, which I’m definitely not going to do as it would be bad for my image as a weedy intellectual.
Vojta assures me that being biologically 62 is “by no means a predictor of mortality”. So what would I worry about? Biological age is just a number! And frankly my thoughts are running in the opposite direction. If my biological age is 62 and I still look about 12, what biological age do I have to reach to look 31? Perhaps a “health plan” consisting of cigarettes, whisky and drugs could boost my biological age into the nineties, at which point I might finally begin to look my age.
Robert Crampton. Age: 59. Bio age: 54
I can’t deny I feared the worst. My two colleagues got their results back before I did and the news wasn’t good. Both came out 30-plus biological years above their actual age. Neither Tom nor James smokes, nor are they overweight, nor do they drink to excess. I, on the other hand, have smoked for 40 years and until relatively recently I drank heavily and, partly as a result of that, weighed in at the border where overweight meets obese. At 59, and based on their scores, I was thinking any biological age not in three figures would be a bonus. “I’ll be happy with anything under 120,” I told my wife. “Or frankly if it doesn’t just say, ‘You are dead.’ ”
Credit to Paula Francekovic, 29, the nutritionist who did my big reveal on a Zoom call. Like at the Oscars, you’re only interested in one thing, but unlike Al Pacino, Paula had the wit and timing to let a certain amount of tension build before giving me the news. The result would be governed by genetics (the luck of the draw) and lifestyle factors such as diet, sleep patterns, stress levels, alcohol and nicotine intake. The rough split was about 40-60 in favour of the variables you can control as opposed to those you inherit.
In which case, I owe my mum and dad big time because I came out as 54. Fifty-four! That’s a modest but hugely welcome five years less than my real age. The self-discipline and abstention of recent times have paid off. I dread to think what I would have clocked at when I was, say, 55, 15 stone and guzzling rampantly seven days a week. As it is, I’m the “youngest” of the three of us, despite being the oldest by almost 20 years. Age, eh? It’s just a number.
I was sceptical about this experiment before we did it. Now, of course, I firmly believe it’s absolute gospel. Two reasons. First, the sub-metric that shows up the effects of habitual smoking came back as way worse than the others. While I was above averagely healthy in most respects (thanks in large part to a top-notch diet), the fags seriously reduced my score in precisely the way Paula said they should. That suggests the methodology is sound.
And second? Duh, the test yielded an excellent result. For me, if not the other chaps. Therefore, with the application of just a smidgin of self-servingly back-to-front logic, the science must be solid gold.
