Hey HoH readers!

Welcome to this week's edition of Healthcare and Innovation at the Crossroads.

I spent this week traveling to meet with clients in Hamburg and Nuremberg, Germany. Hamburg took some time to grow on me, but I eventually came to love the city. Nuremberg, on the other hand, is much closer to my home of Frankonia, which I adore. On this note, here comes the shocker: it’s just 6 weeks out to Dec 1st! And the first day of Nuremberg Christkindlesmarkt!

Despite the usual workload, which never seems to end, we have also entered our year-end review cycle. Although it adds to the pile, I find this part of my job important and meaningful as it allows me to help people achieve their full potential. Collecting feedback, drafting dossiers, and aligning career guidance in committees - here I come!

You bet, I still managed to find some time to delve deep into some healthcare topics and will share my thoughts and musings here. Please feel free to leave your comments and feedback below, as I am still experimenting with the content and format.

I hope you enjoy reading this newsletter.

Take care,

Andre

Dan Buettner has spent 20 years investigating why people thrive in 5 longevity hotspots. He says it has pushed him to eat more soup and enjoy pickleball with friends. and How to Live to 100, Wherever You Are in the World 

In a world where healthcare and technology are constantly advancing, with the goal of prolonging life, I found a refreshing perspective in the new Netflix documentary "Live to 100: Secrets of the Blue Zones". The documentary revealed communities where people have lived naturally for over a century, thanks to simple yet wise lifestyles and practices.

The Netflix documentary is based on Dan Buettner's book (The Blue Zones) about his research on the regions where people live long and healthy lives. It brings Buettner's findings to life on screen, taking us on a journey through the harmonious lifestyles of the Blue Zones. The documentary offers a vivid tapestry of stories and wisdom from these remarkable communities, giving us a glimpse into their secrets for longevity.

The journey began as a National Geographic expedition, led by Dan Buettner, to uncover the secrets of longevity. It eventually led to the discovery of five places around the world where people consistently live over 100 years old (aka centenarians).

These areas in the world known as Blue Zones: Loma Linda, CA, USA; Nicoya, Costa Rica; Sardinia, Italy; Ikaria, Greece; and Okinawa, Japan. These areas were identified using epidemiological data, statistics, and birth certificates, among other sources.

Dan and his team of demographers, scientists, and anthropologists distilled the evidence-based common denominators of these Blue Zones into nine commonalities, which they call the Power 9:

1. Move naturally.

The individuals who inhabit areas with the world's longest lifespans do not engage in rigorous exercise, such as weightlifting, marathon running, or gym memberships. Instead, they reside in environments that encourage movement as a routine and require minimal effort. They cultivate their own gardens and do not use mechanical devices for household and yard work.

2. Purpose.

The Okinawans describe it as Ikigai, while the Nicoyans refer to it as plan de vida. In both cultures, it means "why I wake up in the morning." Understanding your sense of purpose can extend your life expectancy by up to 7 years.

3. Down shift.

Although people living in the Blue Zones are known for their longevity, they still experience stress. Unfortunately, stress can lead to chronic inflammation, which is associated with many age-related diseases. However, the world's longest-lived people have developed routines that help them manage their stress. For example, Okinawans take a few moments each day to remember their ancestors, Adventists pray, Ikarians take a nap, and Sardinians enjoy happy hour. These routines help them shed their stress and maintain a healthier lifestyle.

4. 80% Rule.

Before meals, the Okinawan people recite a 2500-year old Confucian mantra that reminds them to stop eating when their stomachs are 80% full — Hara hachi bu. This practice is crucial because the 20% gap between not being hungry and feeling full can make all the difference between losing weight or gaining it. In the Blue Zones, people eat their smallest meal in the late afternoon or early evening and then refrain from eating for the rest of the day. This helps maintain a healthy weight and promotes overall well-being.

5. Plant slant.

Most centenarians consume beans including fava, black, soy, and lentils. Pork is the primary source of meat, but it is only eaten about five times per month. Serving sizes typically consist of 3 to 4 oz (85 to 115 grams), which is about the size of a deck of cards.

6. Wine @ 5.

In all Blue Zones, except for Adventists, people drink alcohol moderately and regularly. Studies show that moderate drinkers tend to live longer than nondrinkers. The key is to limit yourself to 1-2 glasses of alcohol per day, preferably Sardinian Cannonau wine, and to enjoy it with friends and/or food. It's important to note that you can't save up all your drinks for the week and consume them all on one day.

7. Belong.

All except five of the 263 centenarians interviewed were affiliated with a faith-based community, regardless of denomination. Research indicates that attending faith-based services four times per month can increase life expectancy by four to fourteen years.

8. Loved Ones First.

In the Blue Zones, successful centenarians prioritize their families above everything else. They make sure their aging parents and grandparents are either kept nearby or in the same household. This not only reduces the risk of diseases but also lowers the mortality rate of children living in the same household. They also remain committed to their life partner, which can extend their life expectancy by as much as 3 years. They invest their time and love in their children, knowing that they will be the ones to take care of them when they grow old.

9. Right Tribe.

Longevity is often associated with healthy habits and behaviors. The world's longest-lived people seem to have chosen, or were born into, social circles that support such behaviors. For instance, Okinawans created moais, which are groups of five friends that commit to each other for life. Research from the Framingham Studies have shown that smoking, obesity, happiness, and even loneliness are contagious. Therefore, the social networks of long-lived people have positively influenced their health behaviors.

Dan and team have since taken these principles into communities across the United States, working with policy makers, local businesses, schools, and individuals to shape the environments of the Blue Zones Project Communities.

Through policy and environmental changes, these communities have been able to increase life expectancy, reduce obesity, and make the healthy choice the easy choice for millions of Americans. It has been found that putting the responsibility of curating a healthy environment on an individual does not work, but the Blue Zones Project's approach has been successful.

To simplify, it all comes back to the basics:

→ Move your body

→ Eat wisely

→ Connect

→ Right outlook and recharge

Many times, we come across attractive and flashy solutions that are built on the foundation of such findings or quick remedies that promise longevity. However, the one thing they all have in common is that someone is trying to make a profit. Don't get me wrong - as someone who helps build businesses, I am happy to brainstorm ways to make it simpler for people to follow these teachings. But, I recommend focusing on the basics before diving into fancy and complicated things.

Let's explore the wisdom of these fascinating regions and incorporate their secrets of health and longevity into our lives.

As always, I would love to get your thoughts and comments!

Pharmaceuticals

• Weight loss: Contract drug manufacturers are investing billions in expanding or building fill-finish facilities specialized in manufacturing injection pens used in obesity treatments, like Novo Nordisk's Wegovy and Eli Lilly's upcoming Mounjaro. The fill-finish process involves filling syringes in sterile conditions assembling and packaging the pens for shipment. The surge in investment is driven by the promising sales of Wegovy and the expected approval of new drugs like Mounjaro. The market for these drugs, GLP-1 agonists, is expected to reach up to $100 billion within a decade. Hence, contract development and manufacturing organizations (CDMOs) are accelerating their capacity expansion projects. Despite supply constraints and quality issues, companies like Catalent and Thermo Fisher are leading the market due to their existing capabilities. Expanding this sector is also seen as a strategic move to offset the potential loss from COVID-19 vaccine contracts in the future. → Reuters

• Opiods: The Irish pharmaceutical company Mallinckrodt has been granted court approval for its bankruptcy plan. The plan significantly reduces the amount of debts and settlements the company owes. $1 billion owed to opioid crisis victims will be cut, and almost $2 billion in other debts will be eliminated. Despite a previous bankruptcy in 2020, the company faced financial difficulties due to litigation over its involvement in the opioid crisis and declining sales of crucial drugs. The new plan, approved by U.S. Bankruptcy Judge John Dorsey, enables Mallinckrodt to emerge with around $1.75 billion in debt, with company ownership being transferred to its lenders. The resolution aims to position the company more robustly for the future by focusing on delivering therapies for severe and critical medical conditions. → Reuters

Biotechnology

• Alzheimers’s: AstronauTx Ltd, a biotech firm focusing on developing treatments for Alzheimer's and other neurodegenerative disorders, has successfully raised £48 million ($61 million) in a Series A financing round. The financing was led by Novartis Venture Fund, with contributions from global venture investors such as Brandon Capital, Bristol Myers Squibb, and others. AstronauTx's goal is to develop drugs that correct disrupted brain physiology, focusing on improving astrocytes' support function. The funds raised will advance the company's portfolio of small-molecule drugs, emphasizing conducting clinical studies for Alzheimer's treatments. The company aims to provide symptomatic and disease-modifying benefits through oral drugs. AstronauTx has also made progress in partnerships and grants, including collaborations for identifying new treatments and receiving grants for preclinical work. → PR Newswire

• Vaccines: MinervaX ApS, a Danish biotech company, has successfully raised EUR 54 million in financing their prophylactic vaccine against Group B Streptococcus (GBS). The funding round saw contributions from both new and existing investors, including EQT Life Sciences and OrbiMed. GBS is a major cause of severe infections in newborns, leading to adverse pregnancy outcomes, and highlights the urgent need for a vaccine. MinervaX's vaccine has shown promising initial data from two ongoing Phase II clinical trials, indicating safety, high immunogenicity, and the production of functionally active antibodies. This new funding will support the vaccine's advancement into Phase III clinical trials, scheduled for 2024. → PR Newswire

Medical Technology

• Neuroscience: Arctop, a neurotechnology company, has raised $10 million in Series A funding from investors such as Fifth Growth Fund and Supermoon Capital. The funding will accelerate the commercial release of Arctop's brain decoding software. The innovative technology translates real-time brain activity into information that can be used by third-party applications. This paves the way for personalized skill training and emotion-adaptive experiences. The software has been designed with a focus on user privacy. Individuals can maintain control over their data by managing permissions and deleting data whenever required. Arctop has been founded by experts in neuroscience and software engineering. The company is working with prestigious institutions such as Stanford Medicine to explore applications in the medical field. The goal is to enhance communication, learning, and overall human experiences. → PR Newswire

Healthcare Services

• Outsourced services: Envision Healthcare, a provider of outsourced emergency department services to hospitals, has been approved by the U.S. bankruptcy court to split into two companies, eliminating over $7 billion in debt. The restructuring plan, supported by private equity firm KKR, was authorized by Judge Christopher Lopez in Houston. The legal team of Envision was recognized for their efforts in managing the complex financial arrangement without any negative impact on the patients or the over 20,000 doctors of the company. After the restructuring, Envision will separate into two companies: Envision Physician Services (EVPS) and AMSURG. The former will provide physicians to various hospital departments, and the latter will manage outpatient surgical centers. Following the restructuring, KKR will no longer own the company, and distinct groups of lenders will hold AMSURG and EVPS. AMSURG will carry a debt of $1.875 billion with an equity value of roughly $1.675 billion, while EVPS will have $250 million in debt and about $550 million in equity value. The company's bankruptcy in May was attributed to rising interest rates, increasing labor costs, and conflicts over payments with health insurance providers. Envision also pointed to the U.S. ban on unexpected medical bills, which worsened their financial situation. → Reuters