Book Review

Cheating Time: Science, sex, and aging

N Engl J Med 1997; 336:592-593February 20, 1997

Article

Cheating Time: Science, sex, and aging
By Roger Gosden. 427 pp., illustrated. New York, W.H. Freeman, 1996. $23.95. ISBN: 0-7167-3059-6

Great title. For that matter, great chapter titles: “Mating Madness,” “A Dog's Life,” “The Gland Grafters,” “A Very Infertile Species.” Meant for the general reader, this lively and good-humored book by a well-known professor of reproductive biology at the University of Leeds contains many fascinating tidbits about aging, death, and hormones. The bibliography lists most of the classic gerontologic references, and the many entertaining factoids have a solid scholarly base.

We learn that some male marsupials die after nonstop copulation at a single session; that male and female Pacific salmon, but not rainbow trout, die after spawning; that if all robins lived to the age of 11 years, a mating pair would have 24 million descendants after 10 years; that the megavitamin fad has produced “the most expensive urine in the world”; that Saint Jerome said, “He who loves his wife to excess commits a mortal sin”; and that Brown-Séquard injected himself with testicular fluid, with perceived antiaging effects. We also learn about the comparative longevity of various species.

The history of endocrinology, which makes up most of the book, takes us from the transplantation of monkey testicles to hormone-replacement therapy, menopause, and the actions of male and female sex hormones. With all these fascinating nuggets incompletely pulled together, however, the discussion often lacks a coherent theme. The trade-offs between reproduction and aging are well discussed, but the author does not draw out many of the evolutionary implications for the adaptation of species to changing environments.

Gosden sees aging and natural death as an accumulation of subclinical diseases, not the progressive frailty and musculoskeletal disability now seen so frequently by geriatricians, although he presents the familiar data about declines in organ function after the age of 30 years. The Gompertz equation is well described, but the implications are less so. Gosden does see a natural life span for different species and discusses the implications quite well. The discussion of apoptosis is well developed for the general reader, but the discussion of “death genes” such as p53 in humans and age-1 in the nematode has a less secure foundation.

It is not until page 368 that we read, “Except for those who begin at the back of the book, as I sometimes do, readers will know that this one is a description of living systems rather than a prescription for a long life.” The punch line appears to be that the “replacement of male and female sex hormones is a successful story of controlling aging,” a sweeping statement with which not everyone would agree. Gosden avoids a discussion of methods of increasing longevity but believes that wise manipulation of exogenous hormones may increase the quality of life. He is not, however, enthusiastic about growth hormone, testosterone, melatonin, or dehydroepiandrosterone. The envisioned “brave new age” includes the storage of eggs and sperm for later use and perhaps gene therapy. In short, there is no progression of arguments that might justify the title of Cheating Time. Gosden avoids a discussion of lifestyle factors such as exercise and diet and their role in maintaining vigor in later life. The conclusion that “biology gives us hope of organic improvement and plenty of food for thought” is certainly true but has a rather anti-climactic ring.

This book is immensely entertaining, a smorgasbord of small delicacies that, taken together, do not quite make a full meal.

James F. Fries, M.D.
Stanford University School of Medicine, Palo Alto, CA 94304