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This article talks about one of the very first practical steps I’m taking in helping people reach a healthspan of 100 years or more: creating Dondy, the first online consultation platform, with a bunch of fellow entrepreneurs, exclusively dedicated to longevity and preventative health.

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My own longevity journey

I’ve been followed for a while now by 2 medical doctors with expertise in preventative health and longevity, one in France, and one in the United States. I’ve learned a great deal about my body, my health, and my biggest risk factors when it comes to my genome. But having access to such experts at a reasonable price hasn’t been an easy feat:

-the standard primary care medical doctors, the ones you visit when you have a flu or a minor infection, were frustrated with me visiting them and having no specific problem (other than being healthy and aiming at staying like that as long as possible).

-there are luxury longevity clinics, such as Clinique La Prairie, mostly dedicated to celebrities such as Carla Bruni.

-there are private doctors such as Peter Attia, charging around $ 100 000 / year for his longevity expertise.

-there are more accessible longevity clinics, but only in the US, Israel, Dubai and other destinations, but none in France.

Long story short, none of them seemed to fit my need, which was to take care of my long term health through – 1. efficient, 2. informative and 3. self-empowering 4. no BS – longevity consultations at an affordable price. After searching a lot, I’ve found out the 2 doctors I’ve mentioned earlier, but what a challenge to get there! What a bumpy road! Only warriors and/or people with a lo(ooooooo)t of free time can get there!

Dondy: the idea and vision

Once upon a time, Bill Gates had a vision: “Early on, Paul Allen and I set the goal of a computer on every desk and in every home. It was a bold idea and a lot of people thought we were out of our minds to imagine it was possible”.

The audacity of Bill’s vision, but also the quality of the execution which came afterwards and turned his vision into reality inspired me. I said to myself: there are roughly 8 billion people on Earth, out of which 3 billion are older than 40 years old. Each one of these 3 billion people should have access to 1 longevity consultation per month. I would aim for the stars, but have my feet well on the ground on a daily basis to execute the plan.

I’ll be here to execute upon this vision on the long term, maybe 20 years, maybe more. I’m not here for short term profit or fame. I’m here to fix healthcare at global scale.

Practical aspects of Dondy

This is where the idea of creating a large global and affordable online longevity service came to my mind like a no-brainer: living the whole experience as an insider allowed me to imagine how this service should work:

-it would be a mix of medical expertise, life coaching and AI assistance. You see, optimizing your healthspan requires 5 levels of intervention: physical activity, food, sleep, mental health and supplements/drugs. It seems easy, but being specific about the details in each one of these aspects requires medical expertise, and differs greatly from person to person. Also, medical expertise is not enough, as lifestyle changes need self-discipline and dedication. Knowing what you have to do does not mean you’ll do it. This is where coaching and AI assistance comes into play: understand the kind of personality you have, and pushing for the right measures, at the right time, not too hard because you’ll quit, not too easy because it’s going to be insufficient. We’re dealing with medical expertise, but also with behavioural change. AI would “understand” patients and push only as much as needed.

-it would target from the start patients all across the world, no country boundaries, the world would be our playground from day 1.

-because of how sick care works nowadays, public welfare would not pay for these kind of preventative medical services, so first they would be targeting people who accept to pay for them from their pockets. Later on, we would convince health insurance systems to pay for it, and lower the price. We would be strong advocates of transitioning from sick care (go see the doctor when you’re sick and you have symptoms) to health care (avoid being sick in first place through pro active measures).

-we would measure biomarkers and progress, on a regular basis, and give people data on how they’re improving (or not), no BS, no stories, no make believe attitude. Just help people to the extent of how much they’re willing to put into living longer healthier. The most persistent and determined of us would have full programs, with physical activity, food restrictions, etc. However, the most comfortable would have light recommendations, just to make sure they stick to the program permanently. We would be accountable (and hold our patients accountable) for how much we improve their long term health.

-as medicine and science move forward at a breakneck pace, we would integrate new recommendations, new supplements/drugs, to always be at the edge of what is possible in longevity.

Business is business

No matter how well intentioned I am, on the one hand, CASH IS KING and on the other hand “Ideas are nothing, Execution is everything”. Profit makes the difference between a failure and a success, so the venture needed to be sustainable from the business point of view. This is where the uniqueness of France came in handy:

– France has a rich and untapped academic community, with excellent scientists, doctors and engineers. I would fully leverage this unique advantage.

– France has a very generous public funding system for innovation in AI and health, under the form of non-dilutive funding. I would fully leverage this advantage also.

For the first time in my life, creating a startup in France would not only not be a drawback, it would be a terrific advantage. However, instead of limiting myself to small niche local markets, as many startups do, I would target all the countries in the world, from day 1.

The service would use a freemium SaaS business model, because it is so strong, so resilient, and so scalable.

The dream team

This project is not an individual project, it needs an army of dedicated and mission-driven people. Along the way, I was lucky enough to meet the right people to start this venture:

–Guillaume Agis . Great technical skills, great experience as an entrepreneur. Swiss knife, doing everything quickly and well.

–Maxime Kamrani . Visionary AI engineer, with long term views on longevity. Great networker, knows everyone in Longevity worldwide. Attends all the events all the conferences in the field, everyone likes him.

–Denys Coester . One of the very first medical doctors and experts in Biohacking in France. Extensive and practical experience in behavioural change in patients. Medical doctor, but also coach and hypnotherapist.

–me 🙂

What’s next?

In the very next weeks, we will focus on the following very practical goals:
– incorporate the startup
– create am MVP (Minimum Viable Product)
– integrate into a startup incubator
– get the first financing (from public non-dilutive subsidies)
– onboard the very first few customers

By the way, if you’re interested in the initiative, please sign up to our waiting list, so that we’ll be able to let you know as soon as our service becomes available!

This article is the 2nd part of an article I’ve written a couple of months ago, where I have explained why I was sequencing my DNA, which you may read here. Since then, I got my results sent to me by Dante Labs, so the purpose of this 2nd article about the same topic is to explain what I’ve learned from it.

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Practical aspects

In theory the process is very simple: you spit in a tube, send that tube by postmail to the DNA sequencing company, and then you get your results. However, in practice, things have been longer and more complicated than expected: although the sample has been sent in a timely manner, the DNA sequencing process took roughly 3 months, and needed some back and forth messaging between my assistant and Dante Labs. After months of waiting, their messages sounded pretty unconvincing and automatic, telling me that “my DNA is still being processed”.

Once I finally got the results, I got a 2nd surprise: they have indeed disclosed some results, but are asking me to pay another $199 to get the full package. I most likely will pay for these additional $199, because I’m so committed to exploring everything around longevity. If I find out meaningful things about me, interesting enough to share with you, I’ll probably post a 3rd part of this DNA sequencing series.

Overall, the customer experience has been somehow suboptimal. I’m so committed to making progress in my longevity journey, and finding as many things as possible about my body, that these minor hurdles did not stop me from doing it. However the “average” customer may be less positive, so there’s work to do in this area!

At the end of the day, knowing what is written in your genome is well worth some minor glitches!

Caveats, limitations and interpretation of the results

Before jumping into the specifics, I need to point out some facts about the results of DNA sequencing :

– your DNA is highly intricate, multifactorial and there’s much we haven’t discovered yet. Indeed there are 2 interesting notions: pleiotropy which means that a single gene codes for multiple phenotypes, and polygenic inheritance, which means that multiple genes code for the same phenotype. Well, there are plenty of those, which makes the DNA interpretation highly complex. Because of these limitations and intricacies, we just can’t be sure of what our genotype says about us.

– DNA decoding is not 100% reliable as of today. Your DNA code 3 billion base pairs long (like a very long word containing 3 billion letters among these – A, G, C, T). Because the DNA molecule is so tiny, and because of its length, there is a high likelihood of making mistakes in those 3 billion letters. Because of that, laboratories today scan it multiple times, just to make sure they haven’t made a mistake in reading some letters. My DNA has been read 30 times, but the gold standard is 100 times. Of course, the more passes you make, the more expensive it gets.

– most importantly, your DNA is NOT you. Because of the fascinating recent research in epigenetics in the last 15 years or so, we know today that whole portions of your DNA may be silenced by what is CH3 groups which stick to the portions of the DNA strand and prevent it from being expressed (so called DNA methylation). Well, depending on your environment and your lifestyle choices (the so called “exposome”), some genes will be over-expressed, and some other silenced, so having specific genes which increase the likelihood of some diseases does not mean they will necessarily be expressed.

Long story short, the results of DNA sequencing must be considered as a mere tool to add data points and fine tune your “risk profile” a little bit more, and hedge yourself against the most important risks, “just in case”. For example, having a gene that increases the risk of ASCVD (cardiovascular diseases) does not mean you’ll have it, but it may push you towards taking some more preventive measures against it, or maybe testing yourself more frequently against it, to detect it early and receive treatment against it as soon as necessary.

The results

Let me share the most salient results when it comes to my own DNA sequencing, and what actions I’m taking based on these new pieces of information.

I’ve found out a lot of good news, great genes (memory, speed of processing, etc…) but for the sake of keeping this article as short as possible, I won’t elaborate on them. Let’s just say that there are many aspects where I have very good genes (everyone has), and these areas won’t be factors of risk for me. The main focus needs to be on the higher risks, which we have to systematically mitigate :

– predisposition to weight gain (2 alleles of the FTO gene – TA and GG genotypes, both associated with weight gain and high BMI – body mass index + CT genotype of the CLOCK gene – associated with higher waist circumference). People who know me may consider this as laughable, because I’m slim, but my mom and my paternal grandmother are overweight. I mitigate this risk by practicing IR (intermittent fasing, eating 2 meals / day), roughly measuring my caloric intake (nothing extreme, but still keeping an eye on it), and regular physical activity (more or less 1h / weekday – excluded weekends when I spend time with family)

– obstructive sleep apnea (1 genotype GA of the TNF gene). Sleep apnea consists in short periods of time when you stop breathing during your sleep. This makes total sense since my father suffers from this conditions. This apparently benign condition can have serious and multiple long term effects: decrease the quality of your sleep, increase insulin resistance, and risks of cardiovascular diseases. The way I mitigate this risk is by monitoring it (my Oura ring and my Garmin watch monitor sleep apnea, but also oxygen blood saturation during sleep, which needs to be above 95% if no sleep apnea occurs). I have also learnt how to sleep in positions which do not obstruct my breathing.

– higher late onset Alzheimer’s disease (APOE genotype e3 & e4, e4 being the one which increases the risk by a factor 3 compared to the average population). Neuro-degenerative diseases are running in my family, my maternal grand-mother has dementia, so it makes totally sense that I’m exposed to it. Officially, Alzheimer’s disease has no cure as of today. However, the very last research is starting to show correlation between Alzheimer’s disease and metabolic syndrome (diabetes type 2) and arterosclerosis. Also, I’m confident that in the next 30-40 years, medicine will discover new treatments agains this disease, so I’m trying to keep myself informed about this topic.

– insulin resistance and metabolic syndrome (I have the CA genotype of the ENPP1 gene + AG genotype of the PNPLA3 gene associated with NAFLD – non alcoholic fatty liver disease). Discovering that I have this genotype was the final confirmation that I have to take aggressive preventive measures against this: wearing a CGM showed abnormal glucose levels (at the very limit between normal and abnormal values to be precise, I’ve written an article here about this), my blood tests showed the same congruent alerts (OGTT, HBA1C and fasting glucose levels). What I’m doing to mitigate this risk: I’ve stopped sugar altogether (except on trips and social events), I’ve significantly reduced my carbohydrates intake, taking measures to increase my muscle mass – because muscles absorb glucose. I’m also considering taking small quantities of metformin to further lower my glucose levels. I’ll soon write a new separate and dedicated article about this topic because it is such an important and common condition, which obviously concerns me, but may concern some of you also.

Conclusion

If you want to live more than 100 years in good health, DNA sequencing is a mandatory checkpoint. Knowing so much about yourself may seem daunting and stressful, you can choose to be ignorant, close your eyes and hope for the best. Or you can learn as much as possible about your risk factors, and aggressively hedge against these risks.

For the craziest of us, the way to mitigate those risks is not only by using DNA sequencing and all the other tools at our disposal already (as mere technology users), but also by pro-actively participating in financing and pushing anti-aging science forward (technology creators). Stay tuned, I’ll elaborate much more on this topic in the very next couple of months!