Think “longevity” and a particular type of person comes to mind. A biohacker, covered in smart devices tracking their every move, earnestly discussing supplement stacks between sets at the gym. Probably a man. Possibly specifically Bryan Johnson, the American tech entrepreneur who has developed a $2 million-a-year protocol involving everything from blood transfusions to penis shockwave therapy in pursuit of his one goal: “Don’t die.”
It’s this association that has led Dr Sabine Donnai, founder and chief executive of private health clinic Viavi, to dislike the term “longevity”—even though that’s exactly what her practice focuses on. “For me, longevity is about prevention, in the main, of chronic diseases and functional decline,” she tells me in a room at Viavi’s clinic, which occupies one of the grand terraces on Devonshire Place, one street along from London’s renowned Harley Street. Her take may not be as sexy, but it does sound eminently reasonable. She likes to frame it as “healthy longevity”—”Because what’s the point of living long unless you have all your functionality there?”
Originally from Belgium, Donnai’s interest in longevity began when she qualified as a doctor and felt disillusioned with how much medical practice focused on matching symptoms of ill health with diagnoses and then treatments. Wouldn’t it make more sense to keep people healthy in the first place? She travelled to different countries, including Australia, India, Sri Lanka, and South Africa, to learn about different approaches to healthcare, and moved to the UK 28 years ago. She held various roles, including at Bupa and Nuffield Health, before setting up Viavi in 2009, offering bespoke plans to live healthier for longer. Her elite client list includes the likes of Chris Rokos, founder of Rokos Capital Management, and Edmund Reed, managing partner of law firm Travers Smith.
With a cropped bob and wearing a striped grey blazer, Donnai exudes a no-nonsense attitude, speaking matter-of-factly about her view on proactive health management. She has a refreshingly balanced perspective, emphasising the joy of living as well as the importance of a healthy lifestyle. “I don’t want to disenfranchise our clients that are biohackers, but it’s not very sensible,” she says. “It’s an extreme that clinically doesn’t make sense.”
Getting obsessive about longevity can be counterproductive
She might go further than most of us to improve her own health—intermittent fasting, cold baths, hyperbaric chambers. But getting obsessive about longevity, she says, can be counterproductive. It can cause stress, which is negative for health—not to mention, it takes the fun out of life in the first place. “Do I want to go to an extreme and say, I will definitely never have a croissant? Nah, I don’t want to do that.”
A while later she turns to me, looking slightly worried. “Are you a biohacker?” she asks. I reassure her I’m firmly on Team Croissant.
Clients at Viavi start by having a battery of tests to identify any current or prospective health issues, with a focus on the major ageing-associated diseases like cancer. These include looking at a person’s genetics to see if they may be predisposed to particular problems, their lifestyle, and their epigenetics (which considers how environmental factors impact gene expression), and can take the form of blood tests, saliva swabs, stool tests, urine tests, or medical imaging. After ruling out any current disease that needs addressing, clinicians come up with a personalised lifestyle plan based on the results.
It’s this bespoke treatment that is so important, says Donnai—and which is why she doesn’t rate biohacker manuals like Bryan Johnson’s “blueprint,” which has been developed largely around one individual and may not have the same effect on another. She gives the example of cholesterol: Two of her clients may have the same high level of cholesterol, but one may be able to get away with it if they’re fit, have healthy blood vessels, and have negligible risk factors for cardiovascular disease. Another may need to address the issue with more urgency. “So it’s not about the results per se,” she says. “It’s about the results within the context of you as an absolute totality.”
Crucially, strategies are also based on compromise with clients. If someone absolutely does not want to change a particular aspect of their diet, for instance, clinicians will look at alternate suggestions—increasing exercise, or taking a supplement, perhaps. The key, says Donnai, is finding the few specific lifestyle changes that work for an individual and that bring noticeable results. “Most people do not want to change the complete course of their life,” she says. “They’re happy just to do one or two things in particular if they feel it makes a difference.”
Donnai characterises her clients as “clever people—people that think ahead.” Many of them are busy executives who don’t want to compromise on performance and who feel they can’t afford for something to go wrong with their health. “They live hard, they play hard, and they don't want to pay the price,” she says. They’re also necessarily rich people: The first year of membership with Viavi (usually the most expensive as it involves DNA testing, which only needs to be done once) starts at £22,000 and can go up to £50,000.
Most of Donnai’s clients don’t come to Viavi specifically looking to live longer. Often, they’re motivated by having witnessed a friend or family struggle with health issues. Sometimes it’s because they start feeling less energetic or healthy than they used to. A common scenario is businesspeople starting to notice their high-stress lifestyle catching up with them. “Often it is the wife that says ‘I’m worried about my husband,’” Donnai says.
When Donnai founded Viavi, she expected her clients to be mainly men, even choosing colour schemes based on that assumption. In fact, she says, there’s an equal gender split—though it’s often the men who come first and then bring their wives. She believes the more macho side of longevity, and particularly the biohacking strand, has roots in weight training, also a male-dominated domain. Not one of her female clients identifies as a biohacker. Indeed, it’s hard to think of female longevity influencers who aren’t more on the Goop-y lifestyle side of things.
But if you reframe the idea more as preventative medicine, and take a more balanced approach, the appeal is broader. There are also aspects of health that can’t be so easily quantified or addressed by biohacker types. One thing many people miss, says Donnai, is the importance of emotional wellbeing for overall health. “Our emotional energy is a massive driver of ill health,” she says. She rates “meditation and calm” up there with nutrition and exercise in its importance for a healthy lifestyle. It’s not something you can track immediate changes from, she says, but is more like “building up a savings account.” She looks disapproving when I admit I don’t meditate and entreats me to try something—yoga, mindfulness, even doing jigsaw puzzles. “I struggle to see how one can achieve saying ‘I'm robust’ without something in that area,” she says.
