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@ 我认为长寿不仅仅是延长生命，更重要的是提高“长寿智力”。这包括了解影响寿命的各个因素，例如遗传、生活方式、疾病风险、生物年龄和生物标志物。我的祖父因为缺乏这方面的知识，在36岁时不幸去世。如果他能更早地进行筛查并采取健康的生活方式，结果可能会有所不同。因此，我认为提高长寿智力对于预防疾病和延长寿命至关重要。
我们常说，生命等同于时间。的确，生命的长度直接反映了我们生存的时间。很多人认为时间等同于金钱，因此生命也等同于金钱。金钱固然重要，但它并不能直接延长寿命。你可以雇佣最好的医生，但真正需要的是长寿智力。
这是我提出的一个概念，类似于情商、智商等。在谈及长寿时，“长寿智力”至关重要。它包含影响寿命和健康的诸多因素：遗传、生活方式、疾病风险、生物年龄、生物标志物，以及我称之为的“长寿视野”——几十年来健康状况的轨迹。
我的祖父36岁便因结肠癌去世，这让我深刻体会到长寿智力的重要性。当时，他生活在苏联占领下的爱沙尼亚，人们对癌症预防知之甚少。而结肠癌如果早期发现，治愈率很高。可惜，他从未做过结肠镜检查、血液检查或基因检测，也有一些不健康的生活习惯，例如吸烟和饮酒，最终导致了他的早逝。
世界卫生组织列出了全球十大死因：缺血性心脏病、中风、慢性阻塞性肺疾病、下呼吸道感染、新生儿疾病、各种癌症、阿尔茨海默病和神经退行性疾病、腹泻病、糖尿病和肾脏疾病。西方和工业化社会的大多数人死于这些非传染性疾病，而这些疾病大多与生活方式有关。
对于追求长寿的人来说，预防这些疾病至关重要。这些疾病的发生也遵循一定的规律。例如，50岁之前，患心脏病、癌症和阿尔茨海默病的风险很低，但50岁之后，特别是60岁之后，风险开始呈指数级增长。阿尔茨海默病等神经退行性疾病的风险增长稍晚一些，在70多岁或80岁左右。
心脏病和癌症仍然是主要杀手，也是寿命的瓶颈。想要活到70岁，就要避免60多岁时患心脏病；想要活到90岁，就要避免80多岁时患阿尔茨海默病或其他神经退行性疾病。延缓这些疾病的发生是关键。
美国心脏协会列出了八个降低心脏病风险的关键因素：充足的睡眠、体重管理、控制胆固醇、血糖管理、血压管理、健康饮食、积极运动和戒烟。这些都是最容易改变的生活方式风险因素。同时，他们也承认年龄和衰老是心脏病的最大风险因素。减缓生物衰老速度也能降低所有慢性疾病的风险，尤其是心脏病。
对心脏有益的也对大脑有益。降低心脏病风险的同时，也降低了神经退行性疾病和阿尔茨海默病的风险。认知储备是一个关键概念，它描述了大脑应对各种压力源和衰老的能力。认知储备高的人，神经退行性疾病症状较轻，发病时间也可能延后。而认知储备低的人，疾病进展则更快。认知储备并非指智力，而是指大脑的使用程度。阅读、学习新语言、解谜等都能提高认知储备。
百岁老人也会患上各种疾病，只是发病时间比普通人晚几十年。这暗示了普通人如何延长寿命：通过健康的生活方式延缓心脏病和神经退行性疾病的发病时间，并终生监测健康状况。75岁以后，跌倒成为一个新的重大风险因素。
“长寿视野”指的是几十年来健康和功能性结果的变化。每个人健康状况的轨迹都不同。普通人可能在30多岁或40多岁就开始快速衰退，而健康的人则能延缓这些并发症，保持更好的健康状态。延缓生物衰老速度，延长健康寿命是目标。
例如，肌肉量从30多岁就开始下降，保持肌肉量至关重要。终生运动是关键。VO2max（最大摄氧量）也在18岁后开始下降，延缓其下降速度对长寿有益。内脏脂肪从20多岁就开始线性增加，随着年龄增长，人们往往会积累更多内脏脂肪。血糖水平也随年龄增长而升高。目标是保持血糖水平、肌肉量和VO2max等指标维持在20多岁时的水平。
评估生物年龄的一个便捷且有临床意义的方法是观察生物标志物。一些生物标志物会随着年龄增长而恶化，如果能保持在更年轻的范围内，就能延缓生物衰老，延长健康寿命，降低患糖尿病和心脏病的风险。
例如，空腹血糖高于100毫克/分升就会增加患心脏病和全因死亡的风险；甘油三酯高于100毫克/分升就会增加心脏病风险；CRP（C反应蛋白）高于0.5毫克/升就会增加心脏病和死亡风险；血压越高，患心脏病和死亡的风险越高；胆固醇水平过低也可能与更高的死亡风险相关，这可能是由于其他疾病导致的。
体重和腰围也是重要的指标。男性需要保持较低的体脂率（低于15%），女性则相对宽松一些。腰围越小，风险越低。
了解遗传风险因素也能帮助我们做出更明智的决定。例如，APOE基因是阿尔茨海默病的最大遗传风险因素；LPA（脂蛋白A）是心脏病的遗传风险因素；家族史也是重要的参考。
长寿智力并非一个完美的指标，但我们可以通过了解自身遗传、生物标志物、生活方式和疾病风险因素，以及长寿视野来提升它。定期进行体检，监测关键生物标志物，并根据结果调整生活方式，才能更好地预防疾病，延长健康寿命。 最终目标是理解自身的生物年龄，并积极采取措施延缓衰老进程。 这才是真正意义上的长寿之道。
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00:22 生命等于时间。
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00:51 长寿需要长寿智力，它比金钱更重要。
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01:16 长寿智力包括遗传、生活方式、疾病风险、生物年龄、生物标志物和长寿视野等因素。
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01:41 我将解释如何提高你的长寿智力。
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02:07 我祖父早逝很大程度上是因为他的长寿智力较低。
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02:39 早期发现结肠癌并采取健康的生活方式可以预防死亡。
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03:00 世界卫生组织列出了全球十大死因。
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03:28 在西方工业社会，大多数人死于与生活方式相关的非传染性疾病，预防这些疾病是延长寿命的关键。
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03:54 心脏病、癌症和阿尔茨海默症的风险随年龄增长呈指数增长。
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04:25 推迟这些疾病是延长寿命的关键。
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04:49 美国心脏协会列出了降低心脏病风险的八个生活要素。
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05:09 年龄是心脏病的最大风险因素，减缓生物衰老速度也能降低慢性病风险。
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05:35 对心脏有益的也对大脑有益，降低心脏病风险也能降低神经退化和阿尔茨海默症的风险。
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05:53 认知储备描述了大脑的弹性，较高认知储备的人神经退化症状较少。
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06:22 认知储备与智力无关，主要指大脑的使用情况，如阅读、学习语言和解谜。
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06:49 从事认知要求高的工作和社交也有助于提高认知储备，降低神经退化的风险。
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07:21 百岁老人只是比其他人晚几十年患上同样的疾病，通过适当的生活方式和健康监测可以延长寿命。
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07:48 75岁以后，跌倒是导致死亡的额外风险因素，因为衰老和虚弱导致跌倒后骨折。
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08:18 75岁之前，死于其他事故的风险较高；75岁之后，预防跌倒成为关键。
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08:41 每个人都有不同的健康轨迹，目标是延长健康寿命，延缓衰老。
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09:10 通过减缓生物衰老的速度来延长健康寿命。
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09:35 维持肌肉质量的关键在于终身锻炼。
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10:05 减缓VO2max的下降对长寿有益，较高的VO2max是长寿的重要预测指标。
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10:32 内脏脂肪和血糖水平随年龄增长而增加。
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10:47 保持年轻时的生物标志物水平可以降低生物年龄。
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11:15 通过生物标志物评估生物年龄是一种便捷且临床相关的方法。
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11:45 APOE基因是阿尔茨海默症的最大遗传风险因素，E4风险最高，E2风险最低。
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12:09 拥有两个E2等位基因的人患神经退化症的风险最低，预计寿命更长。
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12:39 不同APOE基因组合的人口比例不同，了解自己的APOE基因可以帮助做出更明智的生活方式决策。
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13:05 了解高风险基因变异可以帮助采取更积极的生活方式，控制其他神经退化风险因素。
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13:36 脂蛋白A（LPA）是心脏病的重要遗传风险因素，了解LPA水平有助于更好地管理其他风险因素。
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13:52 通过一次血液检查即可了解LPA和APOE基因的情况。
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14:21 家族性高胆固醇血症患者患心脏病的风险显著增加。
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14:50 长期保持较低的胆固醇水平通常与较低的心脏病风险相关。
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15:21 APOE E4与神经退化相关，LPA、MTHFR、高胆固醇血症、血色素沉着症和FTO等基因也与心脏病、铁代谢和肥胖相关。
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15:41 家族慢性病史可能表明遗传风险较高，特别是早发性疾病。
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16:12 了解生物标志物的参考范围和最佳范围非常重要，因为参考范围可能不适用于健康人群。
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16:37 目标是将生物标志物维持在最佳范围内，以降低慢性病和死亡风险。
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17:02 血糖水平高于100毫克/分升会增加心脏病和全因死亡率的风险，最佳范围为80-94毫克/分升。
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17:15 甘油三酯的正常参考范围可能具有误导性，高于100毫克/分升即增加风险，最佳范围应低于50毫克/分升。
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17:43 即使在正常参考范围内，甘油三酯水平升高也会增加心脏病风险。
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18:13 CRP炎症水平越低越好，血压越高，心脏病和死亡风险越高，应保持在120/80以下。
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18:44 低胆固醇有时与较高的心脏病死亡率相关，但这是由于反向因果关系，即低胆固醇是由于癌症或其他疾病引起的。
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19:11 营养不良是导致低胆固醇水平的常见原因，控制这些变量后，总胆固醇高于180毫克/分升与较高的心脏病死亡率相关。
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19:28 在考虑糖尿病、肝癌等因素后，总胆固醇高于180毫克/分升与较高的心脏病死亡率相关。
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19:54 年轻人群的总胆固醇最佳水平为150毫克/分升，较低的胆固醇水平似乎更有利于降低心脏病死亡率。
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20:21 女性的体脂率在35%以下时，死亡风险没有明显增加，但男性的体脂率需要低于15%才能有最低的风险。
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20:44 女性的平均寿命比男性长，男性需要保持非常低的体脂才能长寿。
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21:10 腰围是测量内脏脂肪的有用工具，腰围越低风险越低，男性最佳腰围为85厘米，女性为65厘米。
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21:40 测量越多的血液测试和指标，你的长寿智力就越高，但成本也会更高。
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22:04 通过少数关键生物标志物可以获得80%的健康知识，至少每年测量一次这些关键指标。
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22:34 长期保持正常甚至最佳的生物标志物水平可以显著降低患病风险。
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22:51 长寿智力包括了解遗传、血液检查、生活方式、疾病风险和长寿前景，通过生物标志物减缓衰老。
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23:13 长寿智力越高，对健康的理解越深入，能够更好地预防慢性疾病。
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23:39 了解健康知识、进行血液检查并理解基本知识是提高长寿智力的步骤。
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24:05 了解遗传风险因素和慢性疾病风险因素是提高长寿智力的重要组成部分。
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24:34 了解生物年龄、基因、血液指标、健康指标并定期跟踪是最高水平的长寿智力。
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NaN:NaN 结束语。
00:00
I think every one of us has heard the saying that life is equal to time. And it basically is in a literal sense because how long you're alive just reflects to how much time have you spent alive and how much time are you alive. 语法解析
00:22
And many people say that time is equal to money and therefore life is equal to money. Of course, money is very important, but money isn't going to extend your lifespan directly. Of course, you can hire good doctors, but what you need is longevity intelligence. And this is a concept that I've coined, and you might have heard about emotional intelligence, social intelligence, those kind of things. But when we're talking about longevity, then I think longevity intelligence is a good concept. 语法解析
00:51
concept to use. So what does it consist of? It basically consists of many factors that affect your longevity and health. They are your genetics, your lifestyle, your disease risks, your biological age, your biomarkers, and also what I call the longevity horizon, which refers to what happens to your health in decades. 语法解析
01:16
And in my presentation, I'm going to go through these components and explain to you how you can increase your longevity intelligence. Before that, a quick example of my grandfather, who unfortunately died at the young age of 36 to colorectal cancer. And, you know, of course, life is unexpected. There are many things that contribute to a person's death. 语法解析
01:41
but a great deal of that was because of his lower level of longevity intelligence. Now, it wasn't his fault. He lived in the Soviet-occupied Estonia at the time, so no one really knew about how do you prevent cancer or how do you prevent other chronic diseases. But colon cancer is one of those types of cancer that you can pretty much treat completely if you detect it early enough. And the gold standard… 语法解析
02:07
diagnostic tool for detecting colon cancer is the colonoscopy. And if you detect the cancer early enough, then yeah, you can cure it completely. Unfortunately, he never did a colonoscopy, he never did a blood test, he never did a DNA test, and he also followed some unhealthier lifestyle habits, such as smoking and alcohol, which ultimately led to his death. So let's start with some of the lifestyle and disease-related risk factors to your longevity. The World Health Organization has 语法解析
02:39
has outlined the top 10 causes of death worldwide and they are ischemic heart disease, stroke, chronic obstructive pulmonary disease, lower respiratory infections, neonatal conditions, different cancers, Alzheimer's and neurodegeneration, diarrheal diseases, diabetes and kidney disease. So most people 语法解析
03:00
in the Western and industrial societies will die to some of these non-communicable diseases, such as heart disease, cancer, neurodegeneration and diabetes. And these are predominantly lifestyle-related diseases. And as people who want to live a long time, our main goal is to pretty much focus on preventing these diseases because they're going to give the biggest bang for your buck in terms of extending your actual lifespan. 语法解析
03:28
And these diseases also follow a certain timeline. For example, before the age of 50, your risk of heart disease and cancer and Alzheimer's is very low. But after the age of 50, and especially after the age of 60, your risk of heart disease and cancer starts to increase exponentially. Now, Alzheimer's and other forms of neurodegeneration start to increase slightly later, so late 70s and early 80s. 语法解析
03:54
and heart disease and cancer are still like the first of the main killers for most people, and it's almost like the bottleneck as well, because you can't reach the age of 100 if you get a heart attack and die at the age of 60. So therefore, if you want to reach the age of 70, you need to make sure you don't get a heart attack in your 60s. And if you want to reach the age of 90, you need to make sure that you don't get some form of Alzheimer's or neurodegeneration in your 80s. So postponing these diseases is the key. 语法解析
04:25
The American Heart Association has outlined some of these eight life essential components or factors that reduce the risk of heart disease. And they are, number one, get healthy sleep. Number two, manage weight, control cholesterol, manage blood sugar, manage blood pressure, eat healthy, be more active and quit tobacco. So these are the easiest factors. 语法解析
04:49
most modifiable lifestyle risk factors as well that will reduce the risk of heart disease. At the same time, they also acknowledge the fact that age and aging is the biggest risk factor for heart disease. The older you get, the higher your risk of any form of chronic disease becomes. So therefore, you need to also 语法解析
05:09
look at some of the hallmarks of aging, which I'm not going to go into the details in this presentation, but essentially slowing down the speed of your biological aging will also reduce the risk of all these chronic diseases, especially heart disease. Now, what's good for your heart is also good for your brain. So if you reduce the risk of heart disease, then you're also reducing the risk of neurodegeneration and Alzheimer's. Now, there is one 语法解析
05:35
key concept that specifically refers to the brain and neurodegeneration and its brain or cognitive reserve. And it essentially describes your brain's resilience. Its resilience against different kinds of stressors and aging and people who have a higher cognitive reserve 语法解析
05:53
they also experience less symptoms of neurodegeneration, and they might even delay it. Whereas people who have low reserve, their decline in neurodegeneration and Alzheimer's is also much faster. Now, the cognitive reserve doesn't reflect to your intelligence, it doesn't mean how smart you are, it mostly refers to just using your brain in some shape or form. And using your brain can involve reading, learning new languages, 语法解析
06:22
solving puzzles, so if you have a very cognitively demanding occupation, you work at a job for decades that requires using your brain, then you have a higher cognitive reserve as well and therefore you have a lower risk of, let's say, accelerating the development of neurodegeneration. And even socializing is also very beneficial for increasing your cognitive reserve, so social skills. 语法解析
06:49
The centenarians, people who live to the age of 100, they get the same diseases as everyone else, they just get these diseases a few decades later. And this is also a clue to how the average person can extend their lifespan. You delay heart disease, you delay neurodegeneration with a proper lifestyle, and also monitoring your health status over the course of your entire life. But after the age of 75, 语法解析
07:21
there's an additional risk factor that can cut your life short, and that is frailty. So people after the age of 75 have a significantly higher risk of dying to falls. So they fall, they break a hip, and they die after that, and that is because of frailty. Low muscle mass, low strength, just aging and frailty. But before that happens, 语法解析
07:48
Before the age of 75, your risk of dying to falls is pretty low, but your risk of dying to other accidents, like traffic accidents or overdoses, is much higher. So if you're younger than 75, then you need to be more careful with some of these other accidents. But after the age of 75, the risk of dying to falls becomes one of the biggest preventable things you can focus on. 语法解析
08:18
So now let's talk about the longevity horizon. So this refers to the idea of what happens to your health and your functional outcomes in decades. For example, every one of us follows a different trajectory with our health and health span. So the average person might start declining quite rapidly already in their 40s or 30s. 语法解析
08:41
whereas the healthier individuals, they delay these comorbidities and they maintain better health. So this is the goal of extending your longevity horizon. You slow down the speed of biological aging, and therefore you're extending your health span as well. So a few examples of this: muscle mass declined with age already starting in your 30s, and there's a huge range between individuals who have higher muscle mass, 语法解析
09:10
and individuals who have lower muscle mass, and more importantly, how do you maintain it? Because it doesn't matter how much muscle mass you have in your youth, it matters more, okay, how do you slow down the decline? And the most important thing for that is just lifelong exercise. It doesn't matter if you're an athlete in your 20s, you need to stay physically active pretty much the entire lifetime. The EO2 Max… 语法解析
09:35
is another marker that follows a similar trend starting to decline already after the age of 18. So slowing down this decline will also have just benefits to your longevity. And a higher VO2max is one of the biggest predictors of longevity. Visceral fat starts to increase linearly in both men and women already in your 20s. So visceral fat is this fat around the organs. 语法解析
10:05
and with age people tend to store or start to accumulate more visceral fat. Blood sugar levels also increase with age. In your 20s they're relatively low, but in your 80s they start to reach the pre-diabetic levels. So the goal with this is to keep our blood sugar levels, keep our muscle mass, keep our VO2max and other markers 语法解析
10:32
in the level of someone who is in their 20s. So we might be chronologically 50 years old, but if our BIO2 max is that of a 20-year-old, or if our blood sugar levels are that of a 20-year-old, then we are with a lower biological age. 语法解析
10:47
And that is, in my opinion, one of the most convenient and most clinically relevant ways to assess your biological age as well, to look at your biomarkers. Because some of the biomarkers get worse with age, and if you keep them in the more youthful range, then you are also slowing down the biological age and extending your health span and reducing the risk of diabetes and heart disease, for example. Next up, we'll cover some genetic risk factors. 语法解析
11:15
The biggest genetic risk factor for Alzheimer's is APOE gene. For example, people with the APOE E4 allele have the highest risk of neurodegeneration and Alzheimer's. E3 has an intermediate risk and E2 is the lowest risk. Interestingly, people who have the E2 allele also have a lower risk of mortality in general, so they have a lower risk of any disease, whereas people with the E4 allele have a higher risk. 语法解析
11:45
And the amount of people who make up the E2 allele is also very small. So only about 0.5% of the population has two E2 alleles. So these are the genetically lucky ones. They have the lowest risk of neurodegeneration and they are expected to also have greater longevity because of genetics. And people who have one copy of E2… 语法解析
12:09
they make up about 11% of the population. People who have two copies of E3 make up 61% of the population, which is where I'm at as well, so these are the kind of average genetics. Then E3 and E4, 25% of people, and E4, E4, the highest risk of neurodegeneration, about 2-3% of people belong in this category. Now, you can't control your genetics, you can't change your APOE gene, but knowing it, 语法解析
12:39
can help you to make more informed decisions with your lifestyle. So you see you have this high risk variant in your genes, so you can make better decisions with your other lifestyle habits and you can be more aggressive with some other risk factors for neurodegeneration, such as diabetes and inflammation, for example. Heart disease, lipoprotein A, LPA, is also a 语法解析
13:05
a big genetic risk factor for heart disease, you can't change it. You can modify it slightly with your lifestyle, but not a lot. And the higher your LPA levels, the higher the risk of heart disease is. Now, the range can be huge. Some people can have an LPA level of three milligrams, which is the lowest risk. Some people can have up to 150, which is a much higher risk. So you can't control it that much. But knowing it, again, can help you to make better decisions with your other risk factors. 语法解析
13:36
And this, you can do it with a blood test. You just do it once in your life. Okay, where is my genetic predisposition for LPA? You don't need to do it like, you know, several times. And the same with the APOE gene. Cholesterol is a controversial topic. 语法解析
13:52
But people who have severe familial hypercholesterolemia, which is a genetic condition where the body produces more cholesterol or they're less able to clear it from their blood, these people have a significantly higher risk of heart disease as well because their bodies are exposed to higher amounts of cholesterol for decades, and they get heart disease much faster, and they generally have a higher risk of mortality as well. Whereas people who have genetically lower levels of LDL cholesterol 语法解析
14:21
these individuals have a much lower risk of heart disease as well because their body is exposed to lower levels of cholesterol for decades. So as you can see from the graph, most people are somewhere in the middle. They have either slightly elevated cholesterol because of genetics or slightly lower cholesterol because of lifestyle or genetics. And the lower the cholesterol over decades, then typically in the general population you find that the risk of heart disease is lower. 语法解析
14:50
So here's an overview of some of the genetic risk factors, the main ones. So I mentioned APOE, E4 for neurodegeneration, LPA for heart disease, MTHFR, a methylation gene also linked to heart disease, hypercholesterolemia, heart disease, hemochromatosis, so that refers to iron metabolism. Some people have genetically higher iron levels, so these individuals also have a higher risk of heart disease and liver disease. FTO is an obesity gene, 语法解析
15:21
And if you have people in your close family who have died to the same chronic disease, so everyone in your family has gotten heart disease or diabetes, then it kind of goes to show that you might have a genetically higher risk of those diseases as well. So it's just good to know your family history of different chronic conditions. 语法解析
15:41
And if some of your relatives got diagnosed early in life, so before the age of 55 with Alzheimer's or heart disease, then that could also indicate some genetic risk. Let's move on with biomarkers. So one key thing to understand with biomarkers is that there's the reference range and there's the optimal range. The reference ranges used in your lab tests, usually they're derived from where 95% of the population falls into. 语法解析
16:12
But the problem is that 95% of the population isn't that healthy. So we don't want to necessarily make our decisions and conclusions based on that. So what we want to do is look at what's the optimal range for the lowest risk of a particular chronic disease or the lowest risk of mortality. And that's what our goal to be with our blood work. So with glucose, fasting blood sugar, 语法解析
16:37
It's pretty linear. Everything above 100 milligrams per deciliter starts to increase the risk of heart disease and all-cause mortality. And the optimal range for the lowest risk is somewhere between 80 to 94 milligrams per deciliter for blood sugar levels. And pre-diabetes is already 115 milligrams per deciliter, but anything above 100 already increases the risk significantly. 语法解析
17:02
Triglycerides, this is an excellent example of the reference range being misleading. So the reference range, the normal range for triglycerides is anything below 150 milligrams per deciliter. 语法解析
17:15
But everything above 100 already increases the risk, and even 50 milligrams, everything above 50 milligrams already increases the risk of heart disease with triglycerides. So the normal reference range of 150 milligrams is misleading because it already increases your risk of heart disease quite a lot compared to having your triglycerides in the 50s and below that. CRP inflammation, another example of that. So the normal reference range for CRP is 1.5 milligrams per liter 语法解析
17:43
but anything above 0.5 already increases the risk of heart disease and mortality. So CRP inflammation levels, the lower it is, the better for mortality and longevity. Blood pressure as well, pretty linearly, the higher the blood pressure, the higher the risk of heart disease and mortality. And hypertension, elevated blood pressure, is categorized with a systolic blood pressure over 120%. 语法解析
18:13
and diastolic over 80, so we're going to keep the blood pressure below 120 and 80. Cholesterol, this is interesting. In some of the studies, they find that low cholesterol is sometimes linked to higher risk of heart disease mortality, but this phenomenon is called reverse causation, which refers to the idea that sometimes the lower cholesterol levels being associated with increased risk are because people who have very low cholesterol levels 语法解析
18:44
have cholesterol levels that low because of cancer or some other disease. Malnutrition is a very common reason for low cholesterol levels. So people who have low nutrient intake, they're frail, elderly people especially, they have a higher risk of mortality and their cholesterol also drops low. And the studies that control for these variables, so this particular study on over 4 million US veterans followed up for several decades, 语法解析
19:11
did control for these variables, so they controlled for diabetes, liver cancer, some 11 other comorbidities, and they found that if you consider those factors, then anything above 180 milligrams for cholesterol, LDL cholesterol, 语法解析
19:28
sorry, total cholesterol is linked to higher risk of heart disease mortality. So anything below 180 milligrams is going to be optimal. And if you look at the younger population, so 18 to 45 years of age, then it's actually 150 milligrams per deciliter. So different age groups can skew some of the results as well. So if you're younger, then lower cholesterol appears to be better for reducing heart disease mortality at least. Body fat is 语法解析
19:54
So, this is something that has a pretty interesting sex difference. Women don't appear to see any increased risk to mortality up until the point of 35% body fat, which is more like severe obesity even, and anything below that is very stable. There's almost no difference between having a body fat of 20% versus 29% or 32% for women. But for men, it's very linear. 语法解析
20:21
you need to have your body fat very low, below 15% as a man to have the lowest risk. And anything above 30% increases the risk pretty exponentially. So there's about eight times more women who are over the 100 years of age than men. So like there's eight women centenarians and one centenarian man, typically. 语法解析
20:44
And based on this graph, then that one centenarian man has a six pack because he needs to be very lean and healthy. Waist circumference refers to the visceral fat. It's a very useful tool to measure your visceral fat. So you measure your circumference around the belly button. And for both men and women, the lower the waist circumference, the lower the risk. And the higher it is, the risk increases linearly. 语法解析
21:10
For men, the lowest risk is 85 centimeters waist circumference, and for women, 65 centimeters. So, of course, the more of these blood tests and markers you measure, the higher your longevity intelligence is going to be, because if you have more information about your health, you can do the full body MRI, colonoscopy, CT scan, all these other 200 biomarkers, whatever, the higher your longevity intelligence is going to be, but it's also going to, of course, cost a lot, and 语法解析
21:40
you can still get like 80% of the knowledge from just a few key biomarkers. So I've just outlined a few of these key biomarkers that you want to like measure once a year at least, okay, are these markers elevated or are these something that I need to work on? Because all these diseases, heart disease, diabetes and neurodegeneration, they're not going to happen in years, they're going to happen typically in decades. 语法解析
22:04
But if you maintain normal and even better, like optimal biomarkers for decades, then it's very low, like you're reducing the risk of these diseases a lot just by following your blood work. So I've outlined some of the key components of the longevity intelligence. You need to understand your genetics, you need to understand your blood work, your biological age in the sense that trying to mimic lower chronological age with your blood work 语法解析
22:34
lifestyle and disease risk factors and longevity horizon, which means that everything gets worse with age. Your VO2 max goes down with age, your visceral fat increases with age. You can only slow it down and potentially maintain more youthful levels with these biomarkers. 语法解析
22:51
as a conclusion, what is your longevity IQ? Like, it's obviously not a perfect metric. We don't have any biomarker to measure your longevity IQ. But let's say if you have no idea about what's healthy, you have no idea what is cholesterol, what is inflammation, what is APOB, whatever, then your longevity IQ is pretty low, number one. Number two, 语法解析
23:13
You understand your health superficially, you know, okay, I have a little bit of extra body fat, I know my blood pressure is high, or something like that. It's still better than nothing, but it's still a low level of longevity IQ. Number two. Number three, you've taken a blood test, you understand some of the basics, like don't smoke, don't drink too much alcohol, but you don't know how do you interpret your blood test results. So you don't know what is the optimal range. 语法解析
23:39
Number four, you know your genetic risk factors and you also know your risk factors for different kinds of chronic diseases. You know that your blood pressure is high. You know that heart disease runs in your family. You know you have a particular gene for neurodegeneration or something else like that. And lastly, number five, what we want to aim for is understanding our biological age. Like we know our different genes. 语法解析
24:05
blood markers and how do they correlate with our peers. We know our fitness scores, we know our VO2max, we know our body composition stats and those kind of things. And we're also tracking these things regularly. This is where we want to be at. At least like level four and five is where you want to be at because then you're at least, you have the information what you need to do and you're not getting surprised by a chronic disease like my grandfather did, for example. 语法解析
24:34
And that's it for my presentation. If you have any questions, then this is my email. And you can also pre-order my new book, The Longevity Leap, at thelongevityleap.com. Thank you. 语法解析
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生命与时间及金钱与长寿智力 演讲者开场指出“生命等于时间”这一普遍认同的观念，强调存活时长即生命时长。随后，他引出“时间等于金钱，因此生命等于金钱”的说法，承认金钱的重要性，但点明金钱无法直接延长寿命。相较于聘请名医，他提出了一个自己创造的概念——“长寿智力”（longevity intelligence），认为这在追求长寿方面比金钱更为关键，类似于我们熟悉的情绪智力或社交智力。
长寿智力的构成 长寿智力涵盖多个影响寿命与健康的因素，具体包括：个体基因、生活方式、疾病风险、生物学年龄、各项生物标志物，以及一个被演讲者称为“长寿视野”（longevity horizon）的概念，它指的是个体未来数十年的健康发展轨迹。
以祖父为例阐述长寿智力的重要性 演讲者将详细解析这些构成要素，并指导听众如何提升长寿智力。他以自己祖父为例，其祖父年仅36岁便因结直肠癌去世。尽管生命无常，多种因素可能导致死亡，但演讲者认为，祖父的早逝在很大程度上与其较低的长寿智力有关。他强调这并非祖父的过失，因为当时祖父生活在苏联时期的爱沙尼亚，社会对癌症及其他慢性病的预防知识匮乏。
结肠癌若能早期发现，几乎可以完全治愈，而结肠镜检查是其金标准诊断方法。遗憾的是，祖父从未进行过此类检查，也未做过血液或DNA测试，加之吸烟、饮酒等不良生活习惯，最终导致了悲剧。
全球主要死因与生活方式疾病的预防 演讲者接着列举了世界卫生组织发布的全球十大死因，包括缺血性心脏病、中风、慢性阻塞性肺病等。在西方工业化社会，多数人死于心脏病、癌症、神经退行性疾病和糖尿病等非传染性疾病，这些疾病主要与生活方式相关。因此，对于追求长寿的人而言，核心目标在于预防这些疾病，以期获得最大的寿命延长效益。
疾病风险的时间规律与推迟策略 这些疾病的发生具有时间性。50岁前，心脏病、癌症和阿尔茨海默病的风险较低；50岁后，尤其是60岁后，前两者风险呈指数级增长；阿尔茨海默病等神经退行性疾病的风险则在70多岁末至80多岁初开始显著上升。心脏病和癌症是主要的“生命瓶颈”，若想活到100岁，必须避免在较早年龄（如60岁）因此类疾病夭折。因此，关键在于推迟这些疾病的发生。
降低心脏病风险的生活要素与年龄因素 美国心脏协会提出了降低心脏病风险的八大生活要素：健康睡眠、体重管理、胆固醇控制、血糖管理、血压管理、健康饮食、积极运动和戒烟。这些是最易于调整的生活方式风险因素。同时，年龄是心脏病最大的风险因素，年龄越大，患慢性病风险越高。因此，减缓生物学衰老速度同样能降低慢性病风险。
心脏与大脑健康的关联及认知储备 有益于心脏健康的生活方式同样有益于大脑，降低心脏病风险即降低神经退行性疾病和阿尔茨海默病风险。针对大脑与神经退行性疾病，存在一个关键概念——“大脑或认知储备”，它描述的是大脑抵抗压力源和衰老的能力。认知储备高的人，神经退行性疾病症状较轻，甚至可能延缓疾病发生；反之，则恶化更快。认知储备与智力无关，主要指大脑的使用程度，如阅读、学习新语言、解决谜题等。长期从事高认知需求工作或积极参与社交活动均有助于提升认知储备，降低神经退行性疾病风险。
百岁老人的启示与老年期跌倒风险 百岁老人也会患上与常人相同的疾病，只是发病时间晚了几十年。这启示普通人可通过健康生活方式和终身健康监测来延长寿命。然而，75岁后，“衰弱”成为一个额外的致死风险因素。此年龄段人群因跌倒（如髋部骨折）死亡的风险显著增高，主要原因是衰老导致的肌肉量减少、力量下降和整体虚弱。75岁前，死于其他事故（如交通事故、药物过量）的风险更高；75岁后，预防跌倒成为首要任务。
长寿视野与健康轨迹的维持 “长寿视野”关注的是个体未来数十年的健康与功能状态。每个人的健康轨迹各异，有些人在三四十岁便开始迅速衰退，而健康者则能延缓合并症，保持良好状态。延长长寿视野的目标在于减缓生物学衰老，从而延长健康寿命。例如，肌肉量从30多岁开始下降，维持肌肉量的关键在于终身锻炼，而非仅年轻时是运动员。
关键生理指标随年龄的变化与目标 最大摄氧量（VO2max）从18岁后开始下降，减缓其下降对长寿至关重要，高VO2max是长寿的重要预测指标。内脏脂肪从20多岁起在男女两性中均呈线性增加。血糖水平也随年龄升高，20多岁时较低，80多岁时可能接近糖尿病前期。我们的目标应是将这些指标维持在20多岁时的水平，这样即使生理年龄增长，生物学年龄仍可能较低。
生物标志物在评估生物学年龄中的作用 通过监测生物标志物来评估生物学年龄是一种便捷且临床相关的方法。某些生物标志物随年龄恶化，若能将其维持在年轻状态，即是在延缓生物学衰老，延长健康寿命，降低疾病风险。
APOE基因与阿尔茨海默病风险的关联 APOE基因是阿尔茨海默病最重要的遗传风险因素。E4等位基因携带者风险最高，E3中等，E2最低。E2携带者通常总体死亡风险也较低。拥有两个E2等位基因的人（约占人口0.5%）在基因上最为幸运。了解自身的APOE基因型有助于制定更明智的生活方式决策，以应对潜在的高风险。
脂蛋白A(LPA)与心脏病风险及胆固醇问题 脂蛋白A（LPA）是心脏病的另一重要遗传风险因素，其水平主要由基因决定，生活方式影响甚微。LPA水平越高，心脏病风险越大。了解自身LPA水平有助于更好地管理其他心脏病风险因素。LPA和APOE基因检测均只需一生进行一次。胆固醇问题则较为复杂。
家族性高胆固醇血症与低胆固醇水平的影响 患有严重家族性高胆固醇血症的个体，因体内胆固醇水平长期偏高，心脏病风险显著增加，且发病更早，总体死亡风险也更高。相反，基因决定的低LDL胆固醇水平与较低的心脏病风险相关。多数人介于两者之间，总体而言，长期保持较低的胆固醇水平与较低的心脏病风险相关。
主要遗传风险因素总结与家族病史的重要性 演讲者总结了几个主要的遗传风险因素，包括APOE E4（神经退行性疾病）、LPA（心脏病）、MTHFR（甲基化基因，与心脏病相关）、高胆固醇血症、血色素沉着症（铁代谢异常）和FTO（肥胖基因）。若近亲中多人患有同种慢性病，或有亲属在55岁前早发相关疾病，可能提示个体存在较高的遗传风险，了解家族病史至关重要。
生物标志物的参考范围与最佳范围的区分 理解生物标志物时，需区分实验室报告中的“参考范围”与“最佳范围”。参考范围通常基于95%人群的分布，但这部分人群并非都健康。我们应关注能带来最低疾病风险或死亡风险的最佳范围。
关键生物标志物的最佳范围举例
通过生物标志物监测提升长寿智力 测量的指标越多，长寿智力越高，但成本也越高。通过少数关键生物标志物仍可获得约80%的健康信息。建议至少每年检测一次这些关键指标。慢性病（心脏病、糖尿病、神经退行性疾病）通常是数十年发展的结果，长期维持正常甚至最佳的生物标志物水平能显著降低患病风险。长寿智力包括了解遗传、血液检查、生活方式、疾病风险和长寿前景，并通过生物标志物减缓衰老。
长寿智商的层级与目标 演讲者提出了“长寿智商”的五个层级：
目标是达到第四、五级，这样至少拥有了行动所需的信息，避免像其祖父那样被慢性病突然袭击。
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引言：生命、时间与金钱
长寿智能的构成
长寿智能包含影响长寿和健康的多个因素：
演讲者将逐一解释这些组成部分，并说明如何提高长寿智能。
案例：演讲者的祖父
一、生活方式与疾病相关风险因素 (Lifestyle and Disease-Related Risk Factors)
* 这些是最容易改变的生活方式风险因素。
二、长寿视界 (Longevity Horizon)
三、遗传风险因素 (Genetic Risk Factors)
四、生物标志物 (Biomarkers)
长寿智能的组成要素回顾
理解遗传、血液检查、生物学年龄（通过血液检查模仿年轻人的生理状态）、生活方式、疾病风险因素以及长寿视界（所有指标都会随年龄变差，只能减缓并努力维持年轻水平）。
结论：你的长寿智商 (Longevity IQ) 是多少？
这不是一个完美的指标，没有生物标志物能直接测量长寿智商，但可以分级：
* 目标是达到至少Level 4和Level 5，这样至少拥有了采取行动所需的信息，不会像演讲者的祖父那样被慢性病“突袭”。
结尾与推广
演讲者提供了提问邮箱，并推广了他的新书《The Longevity Leap》。
核心观点总结： 演讲者提出了“长寿智能”的概念，强调通过理解和管理遗传、生活方式、疾病风险、生物学年龄（通过生物标志物反映）、以及长期的健康趋势（长寿视界），可以主动延长健康寿命并推迟慢性病的发生。他通过具体案例、疾病数据、关键生物标志物的最佳范围等内容，阐述了如何提高个体的长寿智能，最终目标是让人们能够更主动、更明智地管理自己的健康，避免过早死于可预防的慢性疾病。
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Edit:2025.06.10
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