“Given that it is the start of 2024, it is timely to assess trends and developments to ascertain if the wild predictions made in 2017 need to be adjusted, eliminated or emphasized,” he said.
In his original article, Dr. Miller intended to encourage conversation, dreaming, creativity and exchange, and upon review, he said he’s sticking with his bold predictions. “In many cases, I double down on the vision,” he added.
Chimeras & cyborgs
2017 prediction: Most of the current millennials will become a blend of chimeras and cyborgs in 5O years. By that I mean that they will be a blend of machines, which incorporate their own artificial intelligence, and humanized organs and body parts created in labs using a blend of 3D printing and stem cell technology. These “Chimeras” will use their own DNA or those of close relatives, to create organs and explants in labs. This will be routine. In essence, once an organ, say a liver, takes on the appearance of wear and tear, it will be removed and replaced.
Another way of thinking of it is that managing aging-related organ damage will be akin to an oil change in your car or replacing the battery. These new organs will still be you, just constructed with your own DNA and stem cells and fashioned into an organ or tissue using 3D printing. That will include vanity and cosmetic surgery where you can ask for a smaller, straighter nose, for example.
It will also include frank use of machine parts, with heightened functionality based on sensory enhancement. Imagine eyes that “see” beyond the visible spectrum.
2024 update: Autophagy will be a routine target for healthy aging. While it is discussed now in 2024, using various botanicals and biochemicals, it will be refined in detail by 2067. Old, damaged cells and organelles will be taken offline and new components regenerated. Autophagy augmentation will be delivered by a range of interventions—nutritional and viral—in a hunter-seeker modality.
Artificial intelligence technology will drive “improvements” depending on job functions. That may include new eyes sensitive to wavelengths outside the visible spectrum. The insertion of “machine parts” will become a prerequisite for certain jobs and tasks.
2017 prediction: Finally society will appreciate that bacteria can be our friends. No longer are they “germs”. We will have a personalized array of bacteria taken as a daily supplement every day, and they will expand from gastrointestinal to site specific for skin, lungs, urogenital and basically all points in between.
So routine supplementation of your microbiome will become a daily feature as brushing your teeth. But monitoring will be the feature that truly advances actions in the future. Smart toilets will give feedback as to your gastrointestinal microflora in real time, and by the time you reach the kitchen, robots will have created your own supplement cocktail to balance your current microbiome. At the same time, a report will be sent to your centralized “cloud-based” health compendium. Similarly for microbial assessments from other sites, “smart” devices will be constantly watching what species are populating you along with their metabolic activity. Watches will do more than time, but constantly monitor your metabolism from your own cells and the microbiota that lives on and in you.
If there is a major microbial imbalance, then a series of bacteriophages (bacteria-killing viruses) will be included in this cocktail to achieve balance. Antibiotic drugs will be considered as horrid and inappropriate as we consider “blood letting” in the Middle Ages.
Included in this daily supplement package will be a mixture of prebiotics to nurture and feed the good bacteria as well as “diversifiers” which are natural chemicals that interact with bad bacteria to limit their adhesion or function, either directly or indirectly through metabolites (revealed in the growing science of metabolomics that emerged in the 2020s). Examples may include polyphenols originally derived from wine and the Mediterranean diet.
2024 update: Microbiome balancing and interventions will be routine and reflective of daily routine feedback from multiple sensory devices. These “Corrective Procedures” go beyond bacteria to include yeasts and bacteriophages. Microbiome components will be enhanced to deliver valuable postbiotics that dictate form, function and wellness.
On the dark side, if a pathogen is detected, isolation may be demanded and its severity depending on the nature of the threat. This process is intended to negate the spread of infectious diseases. Failure to comply will result in substantial loss of “Corporate Coupons” that dictate your health and wellness options. These credits largely replace currency and health insurance. Poverty will be measured by your corporate credit status.
Wastewater monitoring for pathogens will be expansive. Communities that harbor pathogens and fail to comply with interventions will become isolated. These actions resulted from a wave of microbial and viral pathogens that came in the 2030s following the failure of antibiotics to control a series of global pandemics.
2017 prediction: Sources of food constituents will become very blurry. The early 21st century movement against genetically altered food and genetic engineering petered out in 2030 after the famines following world military conflicts and antibiotic-resistant infections plagued global commerce early in the 21st century. From that point onwards, demand combined with technological advances in production, quality, phytochemical optimization and purity led to public indifference. In essence, with technology food tastes better, transports better, looks better and so people became indifferent after the long periods of inadequacy.
Going to the supermarket will be largely a thing of the past. Drones will deliver virtually all food to you. Selections will be based on personal preferences, shopping history and linked to your genome. Protein will be largely insect-based. Land available for meat production will be limited, and meat will be only affordable when you use certain "Corporate Coupons" that are achieved by sticking to an adequate program validated by monitoring. These insect proteins will come formed to look like meat, if and so desired. Indeed, flavoring and textural science will make it largely indistinguishable from real meat, so most are happy with the cheaper source of protein.
Food produced from tightly regulated renewable processes—algae and fungi—will be the routine. These will be grown in cultivars under high growth rates and negligible carbon footprints. Some will be made in “orbiting farms”, earth orbiting cultivars using the constant energy from the sun. Specialty plants for food will be grown in each home reflection an allowance for self-farming. This allows some freedom of choice in the process of nutrition. Micro-production fun will be designed to keep creativity ongoing. Nevertheless, nutrition will be still dictated by the extensive monitoring programs. Self-farming hydroponics will earn more “Corporate Coupons” for other specialty items like certain more expensive food and supplements, or alternatively vacations on orbiting cruise ships. Can anyone say Fhlostan Paradise?
2024 update: Non-traditional food sources will expand. Originally the focus was on insects but will include all fast-growing options e.g., algae, seaweed, fungi and by-products of fermentation. Food production location will be diverse and non-traditional, including the oceans and space as the global impacts of climate change force changes.
Health & supplementation
2017 prediction: Health monitoring, done daily as Personal Health Reports or PHRs, will be intimately tied to supplementation and merged with an understanding of dietary choices made in the drone-delivered food. Imbalances are collated, reported and corrected with supplements. Everything will be personalized based on your PHRs. Compliance will determine how many "Corporate Coupons" you earn for high-level products, organ renewal or vacations. Chronic abusers may become ineligible for organ renewal chimeras or cyborg implants. Conformity leads to longevity. Those who struggle with adaptation to change and loss of choice will not do well. But hey this is a projection 50 years into the future, so the discussion will not include them (or me).
2024 update: The current assessments of health and wellness used in the late 20th and early 21st centuries will be regarded as woefully inadequate. For example, they will look back at measuring blood lipids (good and bad cholesterol even though cholesterol is a steroid not a lipid) as misguided. The true metric focuses on whether the lipids are oxidized (rancid) or not, as that dictates pathology like atherosclerosis.
Metabolomics will become a major and critical tool. Measuring the thousands of biochemicals in fluids and tissues will provide a far more meaningful insight into health and wellness, and what interventions are needed. Metabolomics will become the dominant data mine for health.
While monitoring metabolomic and microbiome balance will greatly augment and direct interventions and supplementation, the widespread sharing of this data will pose ethical problems for society. With compliance driving rewards and punishment, this will take on a “Brave New World” feel as information dictates all aspects of life.
The genome & epigenome
2017 prediction: Your genome will be assessed annually, but the more flexible and adaptive epigenome, the software of your genome, will be assessed continually and also linked to supplements, food and microbiome analysis, and documented along with occupational hazards. Metabolomics will measure microbial metabolism and used to adjust epigenetic tags and switches as necessary. Antioxidants will be appreciated with substantially greater sophistication than in 2017, and linked to the epigenome, transcriptome and metabolome (concepts that will be routinely discussed and appreciated in 2067). With space travel and its burden of cosmic radiation, antioxidant supplementation will not only be more important but vital. Emerging from that heightened understanding of radiation and free radicals will be the new science of mitochondrome, which is the specialty science of the cellular powerhouses, the mitochondria. Given that mitochondria have their own DNA (inherited from mothers only), it forms a specialty science of great reverence.
Cleaning your genome for mutations, or the milder polymorphisms, will be routine and easy. Detected errors, noted on annual assessments, will be removed by advanced CRISPR technology that emerged in 2017. Erroneous DNA code will be removed and replaced with the correct code or a superior code.
The result of all of these programs is that most “disease” will be eliminated. Your health and longevity is linked to your ability to sustain the programs of nutrition, organ renewal and replacement. Longevity is linked to Conformity.
In essence, death follows your inability to generate “Corporate Coupons” necessary to keep you running like a Chevy in Cuba. Failure could result in your body being transformed into a cyborg for work programs on other planets and sundry orbiting celestial items. At this stage, humanity is staring at the abyss of when the machines rule and biological systems become enslaved.
2024 update: Correcting genomic problems will become easy and routine, set up by diagnostics and implemented by CRISPR inspired actions. Nevertheless the major changes in health management will arise from controlling our genetic software (epigenome) and the new science of mitochondrial genomics/epigenomics. Long put on the back burner, understanding the impact of maternal-derived mitochondrial DNA will result in superior revelations on longevity.
And a 2024 addition to the list:
Influence of society, corporations and global stressors
Climate change and its impacts on vulnerable populations will have a substantial impact on reproduction rates. Populations will level and decline, with developed countries leading the way. Expanding the healthspan, as well as lifespan, will be the focus. Large families required to continue the work as it was in agrarian societies, will become a historical anecdote. Diagnostics, artificial intelligence and sophisticated, directed interventions will drive this altered focus.
To that end, corporations will dictate how society functions. The pharmaceutical industry stopped its emphasis on research and development early in the 21st century, morphing into a sales-based industry. Biotechnology took on the risks of innovation which were cherry picked by pharmaceutical companies. As the 21st century moved on, this dominance was made redundant by the teaming of diagnostics, food and nutraceutical interventions into new corporations. This change was accelerated by pandemics and antibiotic resistance, with societies seeking alternatives given the failure of pharmaceutical industry to adapt and vulnerable to merger and acquisition.
The DARK SIDE of informatics, diagnostics and new interventions is the loss of personal choice. Compliance is the ticket to Health. There is a strong likelihood of populations breaking down into two classes. One that is healthy, nourished and compliant where PHRs (personal health reports) dictate actions that drive an extended healthspan as well as longevity. Those societies that cannot afford the use of these technologies will be left in a challenging world that has its foundations in the past, but its future uncertain. Interactions between these societies will become more and more limited. Maybe H.G. Wells was thematically correct as he defines the separation of the Morlocks and the Eloi in The Time Machine.