Can you change your health fate?
Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.
A late-spring morning; ping goes my inbox — an invitation to experience “a new era in advanced personalised and preventative” healthcare. The email is from a private clinic in Mayfair called Hooke, self-described as “the most comprehensive diagnostics, screening and health-management service currently available, we believe, anywhere in the world”. Impressive, though perplexing; two months earlier, passing through Singapore, I’d had extensive diagnostics done at the brand-new Chi Longevity clinic, which made more or less the same claim.
Both Hooke and Chi bring multidisciplinary medical teams under one (very fancy) roof to service an emerging cohort: people who want to actively prevent themselves from getting sick, growing old and having diminished brain function. These ultra-diagnostics mine the most vanguard science available to tell you everything about your health (including things you may not be sure you want to know, such as genetic predispositions to disease). The promise: armed with the results, you’re armed to change your health fate.
The diagnostics, sold as packages, harness various combinations of advanced imaging technology, DNA analysis and blood panels for hundreds of markers, as well as exhaustive functional evaluations: fitness, nutrition, musculoskeletal health. Cognition and psychological state are assessed, too. All told, the tests take days (or multiple visits) to complete. AI systems generate some results; the team analyses and reviews everything. They’re then presented to clients, along with a super-tailored programme of fitness and nutrition recommendations and, when necessary, physio or medical therapies. A follow-up support period (in Hooke’s case, with membership) gives you access to your doctors for six months, at which point you’re re-tested with many of the same protocols. The whole can be repeated annually with an ongoing membership. The prices? At Hooke, a full programme starts at £15,000; at Chi, S$15,000 (about £9,000). Hooke offers an abbreviated version of its testing and reveal for £7,500. Chi’s “Stage 1” basic intake is S$3,250 (about £1,950), and diagnostics and follow-up can be cherry-picked from a longer list.
What’s unique about Hooke, Chi and their kind is in the combination. First, access to cutting-edge science: some of the technology — MRI and ultrasound imaging, genetic testing, continuous glucose monitoring — isn’t new; it just tends to be largely the preserve of the medically unwell. Now, says Chi’s founder, Professor Andrea Maier, it’s being deployed “to optimise your body, your health, at this moment. And that leads to preventing age-related disease 20 or 30 years down the line.” Second is your team of top-tier healthcare professionals — ones who normally don’t communicate with each other, actively collaborating on your behalf and contextualising your results to create as holistic a picture as possible, after which you get them more or less on call.
And who is signing on? A lot of subscribers aren’t anywhere close to “old”; many are in their 40s. I had a 53-year-old’s curiosities: how my brain looks post-pandemic, having in that period drunk more wine than is strictly considered healthy and picked back up a smoking habit from my 20s (judge not, etc). I am also curious about my bones. And about my genes; what I might be predisposed to — whether high cholesterol, or the breast cancer and multiple sclerosis in my family tree.
These ultra-diagnostics are increasingly big business: preventative medicine has officially moved from the biohacking fringes to the moneyed mainstream. Andrew Huberman, a neuroscience professor at Stanford university, demystifies longevity science and medicine for more than 5mn followers at @HubermanLab and on a weekly podcast. Peter Attia MD, formerly of the National Institutes of Health, has his own podcast, The Drive, that examines the metrics of biological ageing; he featured alongside Chris Hemsworth in the National Geographic docuseries Limitless, and plans to be able to cross off a fit checklist (such as climbing four flights of stairs in three minutes and doing a 1.5-mile hike) when he’s 100.
Mark Hyman — Cleveland Clinic Center for Functional Medicine founder, author of Young Forever and silver-fox sexagenarian (biological age: 43) — has recently created Function Health, an online subscription with testing for 100 blood biomarkers, access to “actionable insights” and one three- or six-month follow-up session. It’s a sort of entry-level version of what Hooke and Chi do, with prices starting at (a relatively reasonable) $499 a year.
Of course, the world’s elite medi-spas — Chenot Espace, Clinique La Prairie, SHA Wellness and Palazzo Fiuggi among them — have been offering variations on diagnostic packages for years, though the six-month follow-up isn’t included in the price. Some are looking at diversifying that model: at Palazzo Fiuggi, doctors will soon “coach” and counsel patients throughout the year.
Hooke’s HQ is a blinding-white townhouse a block off Grosvenor Square; behind the door all is light timber floors, contemporary art, nubbly chenille upholstery and a big subterranean gym. Chi’s coolly neutral offices, on a high floor in Singapore’s elite Camden Medical Centre, are even sleeker. Even so, the actual assortment of diagnostic tests aren’t especially pleasant to have. Electrodes and oxygen-monitoring masks were affixed to me as I pedalled furiously on stationary bicycles. Contrast dye was injected into my bloodstream for a CT angiogram, an image of the heart and coronary arteries (“Just so you know, you may feel like you’re weeing yourself when it goes in,” warned the technician. Yep; indescribably weird). I had a DEXA scan for skeletal integrity, breast and organ ultrasounds, and a one-hour, mildly claustrophobia-inducing head, thorax, abdomen and pelvis MRI. I huffed repeatedly into spirometers to gauge my pulmonary function, and squeezed mightily over and over on a grip-strength dynamometer. I dispensed many, many vials of blood.
My Hooke reveal — part “Bioportrait”, part action plan — ran to 92 pages, with excellent layperson’s explanations of the more occult medical language. Chi sent a link to a personalised interactive Reveal Portal, a dashboard with anatomical animations, drop-down menus and scroll-over text boxes. It was dense with graphs and columns, correlating data to levels of specific risk. Some are shaded in tones of green-yellow-orange-red — an optimal-to-eek spectrum.
It opened with a diagram of my biological age, calculated across various “clocks” — epigenetic, microbiome (gut), blood and one called glycan (basically, an indicator of my inflammation and immune response). My epigenetic age is 58 — five years older than my chronological one; it relates strongly to lifestyle, however, and can be reduced with behaviour changes. My glycan age is, by contrast, just 29. Apparently, I’m genetically predisposed to combat cellular inflammation like a champ.
The Hooke report foregrounded my brain-scan results, for good reason: there were a few instances of white-matter hyperintensities. These may indicate cerebral small vessel disease (CSVD), which can eventually result in cognitive impairment (and, way down the geriatric line, vascular dementia). They’re a blanket marker of ageing — one study published in the open-science journal Frontiers found that 80 per cent of white people over 60 have them — but the Hooke team considered my instance a bit high for 53. Among the possible causes: high blood pressure (nope — mine’s always been optimal); high cholesterol (there is that, a bit) and . . . smoking. Nothing like an A4-sized image of lesions on your brain to help you quit.
And that’s the point. Because, if you’re essentially a healthy person, the life-extension onus is largely on you, not your doctors. A further reduction in my biological age could be achieved by adding a few weekly servings of fatty fish, beta glucan-rich foods (oats, mushrooms, seaweed) and cruciferous veg to my diet. They also recommended adding two high-strength nutritional supplements and a couple more strength-training sessions to my weekly schedule. The directives aimed to lower my cholesterol, redress an acute imbalance in my omega 6-to-3 ratio and slow the mild osteopenia — a precursor to osteoporosis — in my lower spine and hip. If I adhere strictly to the plans I’ve been given, the changes should be quantifiable. Hence the members’ follow-up, culminating in re-testing: the proof is in the broccoli, I guess.
A few months before meeting Hooke’s team leader, Dr David Porter, I’d been told by an orthopaedic surgeon that I’d probably need a total knee replacement within four years. Porter — who runs Opus Biological, a sports clinic in Marylebone treating joint pathologies with stem-cell therapy — aspirated my knee joint, created a targeted strength-training regimen and recommended injections combining PRP and hyaluronic acid, after which, he said, I may be able to start some (light) running again. And no, I don’t need surgery any time soon.
“We can deliver results in four to six months if we [comprehensively] onboard our clients, not just to the diagnostics but especially to the interventions,” says Chi’s Maier — whether those are drug prescriptions or joint-strengthening squats. That’s part of the value-add: the specificity, not just the sophistication, of the diagnostics. “It’s kind of like a smartphone,” she continues. “I always update my software.”
But how much do you really want to know about your future? A friend texted me about halfway through my reporting for this piece: “I’m reminded of the wise words of a physician I know: ‘A happy man is an undiagnosed man.’” I, by contrast, walked into the office of Palazzo Fiuggi’s geneticist with a detailed family-disease history and requested he test for all of it. In the event, I’ve no pathogenic indications for hereditary breast cancer or MS. I do have two for hypercholesterolemia. And — slightly chillingly — Palazzo Fiuggi’s results found a rare POLG gene mutation, which, had it manifested, could have led to an increased risk of progressive muscular weakening and even partial paralysis.
How much you want to know — and how much you’re willing to do about it — are decisions to make before you go all in on a £15,000 healthcare plan. Once in, you may well change your mind about both: but the science is compelling. Ultimately, Maier says, “It depends on the client — how much risk do you want? It’s shared decision-making, and we predict what you can get out of it, telling you what the evidence is. And then it’s your choice.”
Letter in response to this article: