You know from past BLOGS that I believe most of you will be able to live well beyond age 100 with all your faculties intact. We’ve just begun the longevity revolution that I expect will be the next great disruptor—we’re in the chip era, that followed the energy era and someplace back there were fire, the wheel, and the steam engine. We’ve gone from a life expectancy of 47 in 1900 to 77 in 2000 to 83+ today. You may have heard that life expectancy just declined for the second year since 1970. Do not be fooled. This decrease was caused by people not taking care of themselves, gaining weight and earning diabetes, of suffering from drug abuse and overdoses. But for those who take care of themselves, life expectancy now exceeds 95. The good news is we’re making progress on not just illness treating, but on life-extension, too, and I expect you to be able to live past 110 by the year 2030. Let me give you an example of how science is learning to make your repair systems work much better

Prevention is critical, no doubt. But it’s not the only way to approach aging. Your goal should be to nurture your body so that it can repair itself expeditiously when it breaks. Accidents and illness happen. Stuff breaks. Cars, computers, and relationships all have their own breaking points. And to suggest that stuff will not break either through acute injury (a five alarm fire or a torn knee ligament) or from wear and tear over time (a fifty-year old roadway or an overused back) would be misleading. While it’s obviously important to keep your biological systems from breaking down, the real secret to longevity isn’t whether or not you break; it’s how well you recover and repair when you do. Our bodies, in fact, weren’t designed not to break down (legs as thick as redwoods may not break, but they wouldn’t be very nimble). They were designed with a great efficiency and ability to repair themselves.

As with a car, you’ll get a lot more mileage out of your body if you perform routine maintenance. Aging is essentially a process in which your cells lose their resilience; they lose their ability to repair damage because the things you might never have heard of (until now), like mitochondria and telomeres, aren’t working the way they should. But it’s within your power to boost that resilience and keep your vehicle going an extra couple hundred thousand miles. And here is one indication research is progressing fast enough that you may have adjuncts to help you repair your mitochondria (your energy factories in each cell) even before 2030. Yes, you may get the energy you had when you were 20 or 30 back again—that level. Imagine having that amount of energy daily. Scientists tended to view mitochondria as low-IQ biological drones that take glucose and turn it into ATP. You can think of ATP as tiny molecular batteries that fuel your body. This is clearly an important role. Complex life forms like you couldn’t exist without mitochondria.

And recently, the view of mitochondria’s role in biology has begun to increase in importance. When we are old, we lack at least one thing that mitochondria need to perform and communicate optimally. That’s nicotinamide adenine dinucleotide (NAD). NAD is a coenzyme found in all living cells. It is critical for enzymes that fuel reduction-oxidation reactions, carrying electrons from one reaction to another in the production of energy in your mitochondria. Cellular NAD+ concentrations decrease during aging. Without sufficient NAD, mitochondria can’t make the ATP energy our cells need. Aging researchers are talking seriously about boosting this NAD with it’s precursor, NR (nicotinamide riboside); at an aging conference I was at last year, two-thirds of the researchers said they were taking NR already although human trials have just begun.

Here are some data on that one supplement; NR may help you repair your mitochondria and you gain more energy. In a Nature article this past month, Dr. Auwerx and colleagues showed that animals with Alzheimer’s lack sufficient NAD. Mitochondrial energy output is reduced, and damaged mitochondrial proteins are not recycled. Knowing that NR increases NAD levels, they gave the vitamin (NR is a form of niacin but without the itching or flushing) to animals. The result was reduced amyloid deposits, higher energy levels, and improved memory. NR didn’t cause these improvements by directly attacking the pathology of Alzheimer’s disease. Rather, it improved mitochondrial function. That resulted in more efficient and healthier systems overall. This reduced Alzheimer’s disease, at least in animals. Also last month in the journal Circulation an article titled, “Nicotinamide Riboside Preserves Cardiac Function in a Mouse Model of Dilated Cardiomyopathy,” indicates this benefit of NR on mitochondrial energy function may affect the energy to pump of your heart muscle. This study showed that mice with heart problems have lower NAD levels. This includes dilated cardiomyopathy (enlarged heart) and cardiac hypertrophy caused by constriction of the transverse aorta. They also confirmed that low NAD levels are typical of humans with heart diseases.

So we now know that NR can improve the health of mice with at least two age-related conditions–memory impairment and inability of the heart to pump adequately–presumably by restoring NAD levels to improve mitochondrial function.

And we know that NR increases NAD levels in people. As stated above, cellular NAD+ concentrations decrease during aging. But what is new in addition to Dr Auwerx work on Alzheimer’s and the Circulation study on cardiac function is that modulation of NAD+ usage or production can make the animal’s RealAge younger and prolong (in animal studies so far) life span substantially (by 20 to 80 percent). We don’t yet have evidence that it increases human health and lifespan, or fights or prevents specific human diseases. But, we should know soon. Several human trials are underway — you can find those trials at Search for nicotinamide riboside for information. In the meantime, you’ll understand that restoration of mitochondrial function is just one of 14 areas where aging research is progressing quickly. We’ll talk about some in this column in this blog in the next several years. And that research and that progress is why I am so optimistic about your (and my) chances of living a lot longer with great health.

All these developments are wonderful news from a human standpoint, but also economically. Think of all the potential genius and innovation the world never sees because disease robs it from us. By preserving these lives, this research can enhance everyone’s life.

But you got to make it to 2030 or so to benefit from these aging research advances–so we’ll continue to present in this column the medical news and our action tips based on that research for doing just that. I’m not talking immortality – a five-alarm fire can happen or you can step in front of an RTA (Cleveland Metro) bus. Stuff happens. And, yes, I have thought a lot about how people will react when they realize they can actually be 150 years old in a youthful body that will have an extremely young RealAge. And, yes, I really have no clue how individuals and society will handle these transformations. But that is one of the things I’m looking forward to finding out. We’ll just have to live through the changes to figure them out. Hope you choose to do the steps now that will help you live at the top of your curve till 2030.

Thanks for reading. Feel free to send questions—to [email protected]

Dr Mike Roizen

You can follow Dr Roizen (and get updates on the latest and most important medical stories of the week) on twitter @YoungDrMike, or download and rate his podcasts released every Tuesday at 7 am on (That podcast is also available on and

Michael F. Roizen, M.D., is chief wellness officer at the Cleveland Clinic.