The wellness industry, driven by consumer anxieties and a desire for extended lifespan, often promotes products with dubious scientific backing, according to Dr. Xand van Tulleken, a doctor and broadcaster.
Van Tulleken's new book delves into supplements, wearable technology, and health screenings, aiming to demystify the industry's claims. He highlights that while healthcare aims to prevent illness, the wellness sector seeks to elevate human potential, making longevity a particularly marketable concept due to the inherent difficulty of scientifically evaluating its claims.
Supplements like nicotinamide adenine dinucleotide (NAD) and its precursor, nicotinamide mononucleotide (NMN), have gained popularity, partly fueled by endorsements from public figures. NAD is a molecule essential for energy production and DNA repair within cells. However, its precursor NMN is more easily absorbed. David Sinclair, an anti-aging researcher at Harvard, has been a prominent advocate, particularly for resveratrol, a compound found in grape skins. Sinclair reported that resveratrol could activate genes associated with delaying cellular aging, leading to widespread media attention and product sales. However, clinical trials on resveratrol have yielded disappointing results, and its "miraculous" status has largely faded.
Sinclair's work with NMN in mice showed promising results, and his public self-experimentation, including taking NMN and reporting younger-looking blood test results, further boosted its appeal. Despite these claims, Van Tulleken notes that robust, large-scale studies demonstrating NMN's ability to extend life in healthy humans are lacking.
Wei Zhu, CEO of SyncoZymes, a company that manufactures NAD, observed a surge in demand for NAD and NMN from the U.S. following research into their potential anti-aging effects. Zhu himself began taking NMN, reporting improved sleep quality and energy levels. While animal studies suggest benefits for NMN, human trials have produced mixed results. A 2020 study focused on safety, finding no serious adverse effects. A 2021 randomized controlled trial involving postmenopausal women with pre-diabetes showed modest improvements in insulin sensitivity with NMN supplementation, but other metabolic markers remained largely unaffected. While some small studies suggest improvements in subjective fatigue and sleep, no study has demonstrated a reduction in mortality, delayed onset of age-related diseases, or lifespan extension in humans. Furthermore, while NAD fuels DNA repair, it may also promote cell division, potentially increasing cancer risk, a point acknowledged by manufacturers who caution about its use in pregnant women or those with cancer.
The wellness industry's success is significantly driven by consumer anxiety, compounded by shifts in medical consensus over time. This anxiety fuels demand for health screenings, which often blur the lines with legitimate healthcare.
The Prostate-Specific Antigen (PSA) test, used for prostate cancer screening since the 1980s, exemplifies this complexity. While it can detect elevated protein levels that may indicate cancer, numerous non-cancerous conditions like benign prostate enlargement, infections, or even cycling can also raise PSA levels, leading to false positives. A significant number of men with elevated PSA results do not have cancer, while conversely, some men with normal PSA results may still have prostate cancer that is not detected. The challenge lies in managing detected cancers, as many are slow-growing and may never cause harm, while aggressive cancers can be missed in early stages.
Private blood testing services have expanded over the last decade, partly due to difficulties accessing healthcare and extensive social media marketing. These services encourage testing numerous biomarkers, often leading to the discovery of