现代长寿科学出了问题
Morbid: Debunking Modern Longevity Science

原始链接: https://www.newyorker.com/magazine/2026/07/06/morbid-saul-justin-newman-book-review-eat-your-ice-cream-ezekiel-j-emanuel

现代关于长寿的讨论已经转向了对健康潮流、可穿戴设备和实验性补充剂的个人化痴迷。尽管网红们将这些趋势推广为个人的生活方式选择,但作者认为,寿命从根本上来说是一个集体的社会学问题,而非个人问题。 借鉴阿道夫·凯特勒的“社会物理学”概念,文中强调预期寿命是由可衡量的社会条件(如犯罪暴露、环境毒素和经济不平等)决定的,而不仅仅是个人的习惯。尽管如此,“长寿工业复合体”仍在不断兜售剥离了背景的科学主张,以及如白藜芦醇和雷帕霉素等未经证实的奇迹分子。虽然个人仍需做出健康决定,但作者警告不要盲目地追求“生物黑客”。归根结底,我们必须超越对个人优化的关注,认识到社会结构而非补充剂方案才是健康的主要决定因素。正如作者所指出的:“社会铺就了寿命的基石,而个人则在其中生活。”

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原文

One hardly needs a list of blue zones to think of commonsense ways to improve life span. We can invest in biomedical research and enact laws and regulations to reduce pollution, design walkable neighborhoods, establish safe public spaces, create affordable housing, and curb smoking. Such strategies might not trend on TikTok, but they would be more effective than the latest juice cleanse. Unfortunately, the pursuit of longevity—like so much else in American life—is increasingly an individualistic endeavor. We adopt new health fads as though they are forms of personal expression, experimenting with cold plunges and red-light therapy, wearable devices and peptide injections. Though it’s nice to think that striving to be healthy is cool or popular—it wasn’t always—the quest for extending life can become monomaniacal, and we easily forget that one’s life span is not, by and large, a life-style choice. Instead, longevity has always been a communal affair.

In the early eighteen-hundreds, a Belgian astronomer named Adolphe Quetelet coined the term “social physics” to describe a method for modelling human development. Stargazers often made small errors when recording the position of planets; the individual errors were unpredictable, but, in the aggregate, they followed a pattern. We now call this pattern a Gaussian distribution, for the astronomer Carl Friedrich Gauss, or, more commonly, a bell curve. Quetelet showed that similar patterns could be found in social phenomena, including births, deaths, marriage, and crime. There was some variation—and, of course, each year there were different people being born, dying, marrying, and committing crimes—but over-all rates were remarkably stable. These occurrences could not be chalked up to individual choices. They were products of measurable—and modifiable—social conditions. A historian later summarized Quetelet’s thesis: “Society prepares the crime, the criminal commits it.”

Not all of Quetelet’s ideas were good ones; he also contended that a person’s physical traits determined social outcomes. Still, it is unfortunate that today’s longevity discourse has become so fully untethered from his sociological point of view. Influencers who peddle supplements and squats are ignoring the enormous role of societal conditions. During my medical residency, in Boston, I spent some of my time seeing patients from Roxbury, Dorchester, and other low-income neighborhoods, where they were more likely to be exposed to crime, drugs, stress, and toxins such as lead. Other weeks, I’d work at a hospital in Newton, a wealthy suburb a few miles away, where kids grew up in large homes on tree-lined streets. In both places, I could offer patients the same basic advice on healthy habits. But it would be absurd to think that my advice helped some Newton residents live into their nineties while many of my less affluent patients might barely make it to seventy. Society prepares the life span; the individual lives it.

Of course, we still have to make decisions about our health. We can’t wait around for governments and institutions—especially this government and these institutions—to bring about the conditions for a wholesome and prosperous society. So what, exactly, should we do? The longevity-industrial complex tends to frame this question in oddly specific ways. Should you eat or avoid eggs? Seek out or shun coffee? Exercise in the morning or the evening? Walk seven thousand steps a day or ten thousand? Nowadays, influencers often invoke scientific research, but it tends to be stripped of context and caveats; they might cite small-animal studies to justify bold recommendations for humans, or argue that everyone can benefit from treatments that are approved for narrow applications. We keep hearing about the new drug that will change our lives. In the two-thousands, David A. Sinclair, a Harvard biologist and a co-author of “Lifespan: Why We Age—and Why We Don’t Have To,” declared that resveratrol, a compound found in grape skins and red wine, was “as close to a miraculous molecule as you can find.” He sold a resveratrol-focussed startup to GlaxoSmithKline. But a researcher at the National Institute on Aging later told the Times that the molecule’s “actual use for humans still needs to be discovered,” and G.S.K. eventually abandoned work on the compound. More recently, in “Outlive: The Science and Art of Longevity,” Peter Attia promoted rapamycin, a molecule that was first sampled on the South Pacific island of Rapa Nui and developed into an immunosuppressant for organ-transplant patients. Laboratory studies have shown that rapamycin could extend the life spans of yeast and mice—but, in a recent randomized human trial, older adults on the medication didn’t seem to experience any physical gains. If anything, they benefitted less from exercise and had more side effects than those who didn’t take the drug; one participant developed a serious infection. Attia and other influencers have said that they have stopped taking the drug, owing to mouth sores, infections, and other complications.

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