Is 50 the new 30? Or is 30 the new 50?
A New York City–based biotech company, Elysium Health, believes it can help you figure that out with unprecedented levels of accuracy using a simple, though spendy ($500) at-home saliva test called Index. You spit in a vial, send the sample back to Elysium, wait four to six weeks for processing, and—voilà!—receive a report indicating whether your biological age is younger, older, or the same as your chronological age.
Chronological age is, of course, all those trips you’ve made around the sun. Biological age, on the other hand, is how well you’ve held up during those trips—a measure of your physiological health. Scientists have been trying to determine biological age for at least 50 years, using various biomarkers (like cholesterol, blood glucose, skin elasticity, and vascular function, to name a few) and mathematical modeling. Only recently have researchers started using our DNA to evaluate age.
Elysium’s Index calculates your biological age by looking at DNA methylation (DNAm), which is one of the ways genes are turned on or off. Methylation occurs when methyl groups—clusters of hydrogen atoms surrounding a carbon atom—attach to the DNA and prevent their expression. Some patterns of methylation are inherited and occur naturally with age, but others are triggered by environment and lifestyle factors, like smoking, stress, exercise, and exposure to chemicals. DNAm isn’t the only way genes may be modified, but it is the most common and has become an important player in the broader field of epigenetics, the science of gene expression. Epigenetic researchers have found that DNAm profiles correspond remarkably well with age-related biomarkers. So a researcher looking at a blind DNAm profile sample could conclude that it represents someone who is 50 years old—although the actual subject might be 40 or 60.
“Index came from asking two questions,” says Elysium CEO Eric Marcotulli. “First, can you measure aging itself? And second, what is the most accurate way to do that?”
The answer to that first question appears to be yes, and the science behind it gained a lot of ground in 2011, with the creation of the “epigenetic clock.” That clock was actually a formula for calculating age based on cellular health using DNAm data, which was then correlated with large data sets like the National Health and Nutrition Examination Survey, the largest study ever conducted on population health. By comparing new DNAm samples with established patterns drawn from large studies, scientists could estimate biological age, give or take a few years.
To answer the second question—how to measure biological age with enough accuracy to be relevant for individuals—Marcotulli tapped Morgan Levine, an assistant professor of pathology at Yale and a rising star in the field of aging research, to lead the Index project for Elysium. As a postdoc at UCLA, Levine worked with Steven Horvath, a human-genetics and biostatistics professor largely credited with creating the first epigenetic clock. With Horvath’s help, Levine developed a more advanced version of the epigenetic clock. Where early versions gathered data from a few hundred DNAm sites on the genome, Levine’s was able to read data from 100,000 sites (Elysium is heralding this as “revolutionary”), allowing them to more reliably and consistently pinpoint biological age, along with your “cumulative rate of aging”—that is, how fast you are getting old.
Levine says she has put Index to the test herself, but her initial results weren’t as good as she’d hoped, even though she’s a lifelong runner with a pretty healthy lifestyle. She believed she could score better and decided to add high-intensity and strength training to her workout regimen. When she retested six months later, her biological age had improved. “Strength and high-intensity training is one thing I thought might make a difference,” she says. “That’s not a scientific study, because it’s n of one, but in my own life, I want to figure out how to take control of aging and stay physically functioning for as long as possible.”
Currently, Index only offers basic information on biological age—a kind of overall health score. But future editions, says Levine, will be able to highlight different biological systems, where you may want to apply more effort toward improvement, like certain types of exercise or diet. Traditional health care may only flag a health issue once it becomes a problem, like the onset of disease. Levine says Index may help people get a jump on health issues before they occur.
It’s hard not to approach a new biotech product making grandiose claims with a large beaker of skepticism. The field is swamped with hucksters and marketing hype, forever stigmatized by megascandals like that of Theranos, the infamous biotech company that falsely claimed it could conduct advanced blood tests with tiny samples. Elysium insists it’s bringing new standards of scientific rigor and legitimacy to the marketplace, but there’s reason for pause.
To date, Elysium has released just one other product: Basis, a supplement that increases NAD+, a molecule essential for cellular health that diminishes with age. Basis was developed by MIT heavyweight Leonard Guarente, an Elysium cofounder. Since its release in early 2015, Basis (which costs $50 a month) has received mixed reviews from consumers, who have reported everything from renewed energy to side effects like sleeplessness and body aches. Elysium has conducted several double-blind, placebo-controlled clinical trials—the gold standard—and shown that the supplements raise NAD+ as much as 40 percent. But molecular science is exceedingly complex, and the notion that a single supplement will provide miraculous anti-aging benefits is itself a large pill to swallow. It’s worth noting that neither Basis (a supplement, not a pharmaceutical) nor Index required FDA approval.
Still, consumers are increasingly interested in taking more control of their health, and biotech companies are eager to provide tools that, they claim, will help them do so. The problem is that the line between science and marketing gets squishy fast. Index not only complements Basis, it drives sales of the supplement: Doubt our claims? Take our test to see if it’s working!
And if it does work, then what? Like a lot of biotech for consumers, a central question is what to do with the information. Index results will come with some lifestyle recommendations, though it’s unclear what those will look like exactly. Will they be any different than general advice we’ve already heard? Move a lot, hydrate, eat whole foods, get some decent sleep, go outside, spend time with loved ones. You know the drill.
Whether consumers will embrace their own epigenetic clock in a box is anyone’s guess. The novelty alone may give it at least an initial splash; you can almost imagine a new crop of younger-than-their-chronological-age bio influencers popping up on social media (save us now). But who knows. The science is certainly compelling, and Index could prove to be an insightful way to test lifestyle tweaks, dietary experimentation, and other interventions that might improve health. And if it does really make 50 look more like 30, five hundred bucks may seem like a bargain.
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