Aging is the process of becoming older. This process is subject to genetical influence and is modulated by lifestyle and environmental factors.

Aging is associated with a decline in overall functioning and cognition.

The decline in our biological capacity of maintaining a balance within the cells and in the complex interaction among cells and systems leads us to a weakened fighting chance to resist disease and to handle stress.

The average life expectancy has been increasing through human evolution due to medical advances as well as public health and sanitation policies. The improved lifespan (47 years in 1900, and 77 years in 2003) has not been a linear trend. In fact, there have been bumps on the road.

Paul Clayton published three papers in the Journal of the Royal Society of Medicine, where he points to the fact that life expectancy for adults in the mid-Victorian period (between 1850 and 1870) was very similar of what it is today. Why? Well, let’s look at differences between the average mid-Victorian lifestyle and the average American one: they had much higher levels of physical activity, they ate more fruits and vegetables, which were organic and with higher concentration of phytonutrients, and they remained slim. Conditions such as cancers, coronary artery disease, and strokes were rare.

Yes! Lifestyle can have a tremendous influence on aging and prevention of multiple chronic medical conditions that plague the developed world today. In fact, unhealthy choices may lead one to a biologic age equivalent of someone 15-20 years older than oneself.

Genes are important in our medical fate and lifespan, but the good news is that they can be switched on and off by lifestyle choices and environmental factors. In other words, we can “command” many genes much better that we thought. No, your genes don’t have to be stuck with your genes.

POSSIBLE MECHANISMS OF AGING

We know that aging shares these pathways with multiple chronic conditions, such as cancer, diabetes, heart disease, and dementia. Therefore, by controlling and modifying these factors not only we decrease the risks of chronic diseases, but also we modulate the rate of decline.

  • Free-radicals/oxidative stress
  • Glycation
  • Inflammation
  • Neuroendocrine imbalance
  • DNA damage/mutation
  • Methylation deficit
  • Mitochondrial energy depletion
  • Calcification
  • Fatty acid imbalance
  • Immune dysfunction
  • Excitotoxicity
  • Circulatory deficit
  • AMPK deficit
  • NAD+ age related decline

 

It is beyond the scope of this article to explain each one of the above proposed mechanisms of aging and we will discuss some of them. The main take home message is that we have tools and interventions to modify them, so you can be more in control of your own health and lifespan.

FREE RADICALS

Free radicals are molecules with an unpaired electron in the outer shell that can damage other molecules, such as cell membranes and DNA.

Free radicals try to capture the needed electron to gain stability, so they “attack “ the nearest stable molecule, “stealing” its electron. When the “attacked” molecule loses its electron, it becomes a free radical itself, and a chain reaction of destruction starts. This damage can accelerate aging and can also be associated with chronic diseases such as cancer, atherosclerosis, diabetes mellitus, neurodegeneration, and hypertension.

Antioxidants are the “heroes” that take the bullet for you. They are scavengers that donate their own electrons so the tissues don’t have to do it.

Decreasing the production of free radicals and increasing the availability of antioxidants can achieve a balance between free radicals and antioxidants.

Free radicals are produced as a result of stress, radiation, toxins, smoke, over exercise, poor diet, etc. Antioxidants can be supplemented and are also part of many healthy nutritional sources.

GLYCATION

It is the chemical process in which sugars cross-link with proteins, causing alterations in their function. It is usually caused by elevated and poorly controlled blood glucose levels and it carries a significant increase in free radical production. This leads to potentially devastating chronic diseases and premature aging.

It is crucially important to achieve optimal blood sugar levels and to optimize insulin sensitivity. Again, regular exercise is you ally. You can also control what you eat: avoiding high glycemic index foods (refined carbohydrates, fast food, sweets, etc), loosing excess body fat, and choosing healthy foods, supplements, and hormones.

INFLAMMATION

It is a natural response we have to help our body against multiple forms of stress, including acute infection, trauma, or illness.

“Controlled” and limited inflammation is therefore necessary to help us reach an equilibrium after an “attack”.

Chronic, uncontrolled, and sometimes “silent” inflammation though is a detrimental physiological situation that can be at the core of premature aging and many chronic conditions that take millions of lives in the modern world (Alzheimer, diabetes mellitus, cancer, atherosclerosis, etc.)

The aging process, by itself, may predispose to chronic inflammation, by favoring the production of proinflammatory compounds (cytokines), such as IL-6, and decreasing the production of anti-inflammatory cytokines, such as IL-10.

Chronic infections, poor lifestyle habits (poor diet, sedentary life, chronic stress) may magnify the inflammation exponentially.

The good news is that you can fight against these factors by improving your lifestyle, controlling stress, harmonizing your hormones, improving your nutrition, limiting the exposure to toxins, controlling your stress, improving insulin sensitivity, and detoxifying your body.

NEUROENDOCRINE IMBALANCE

Is it the chicken or the egg?

How many times have you heard: well… you are just getting old, and the way you fell “comes with the package”. There is no question that aging is very powerful and, so far, we didn’t find a “cure”. But from that fact to accepting that you have to accept the tyranny of aging, there is a tremendous misconception.

There is a conventional acceptance among many physicians that there are normal levels of everything according to age. That can be a misleading biological argument, like saying “osteoporosis is very common in older people, so we are not going to treat it, it is the norm with age”. The first question that comes to mind is what is the “norm”. And the second question is, even if that is the norm, would you choose “normal” or “optimal”?

Hormones are substances produce in a tissue or organ, that travel in body fluids, and which produce a physiological activity in cells which are usually remote from its point of origin.

There is overwhelming evidence in the medical literature that “optimal” hormonal levels provide numerous health benefits and are an essential tool in preventive medicine. Levels that emulate those when we are younger, and which are prescribed taking into account that no two people are equal and that the hormonal therapy has to be customized to each person, using hormonal levels before and during the therapy and with a close follow up regarding clinical response. Like with anything else in medicine, the “one size fits all” approach is archaic.

Pick the chicken or the egg, but scientific evidence is showing that hormones don’t necessarily decline with age; we age because our hormones decline.  Some hormones even increase with age, but the optimal hormonal balance is suboptimal. And we call that “normal for age”?

It is undeniable that your biological age is very tightly related to the health of your endocrine system.

If hormones need to be replaced, bio-identical hormones (hormones with the same chemical structure that the ones your body produces) have proven to have numerous advantages as compared to synthetic hormones developed by pharmaceutical companies.

In a remarkable way, controlling your hormones can definitely help controlling your life

DNA  DAMAGE

DNA (deoxyribonucleic acid) is a nucleic acid that contains the genetic code and transmits hereditary patterns. It is bound in double helical chains by hydrogen bonds, forming the material in the chromosomes.

The DNA suffers regular attacks from external and internal sources. Examples of external sources include radiation (including ultraviolet radiation from the sun, and other radiation frequencies), toxins, viruses, human made mutagenic agents, pollution, radiotherapy, and chemotherapy.

Internal sources include excessive reactive oxygen species production and free radicals, and chronic stress.

Although we also have normal mechanisms to repair the damage created to the DNA, the aging process and poor lifestyle choices impair the capacity to maintain the attack-repair balance,. This, in turn, may cause DNA to suffer damage and mutations.

It has also been proven that telomeres (the repetitive nucleotides at the end of the chromosomes) provide a protective effect to guard the DNA against damage. As the cells divide throughout life, the telomeres shorten., and many of the aforementioned factors,  may accelerate telomere shortening.

You guessed it.

We can increase telomere length by appropriate life style modifications, nutrition, supplements, stress control, and hormonal optimization.

AMPK  and NAD+ deficits

AMPK and NAD+ (adenosine monophosphate –activated protein kinase, and nicotinamide adenine dinucleotide respectively, for those who asked) are compounds of paramount importance for the cell metabolism. AMPK can trigger pathways that improve cell stress response, regulate cellular uptake of glucose, fat burning, formation of mitochondria, promote the activity of sirtuins(family of enzymes which favorably influence beneficial longevity factors), protects P53 (a tumor protective gene), suppresses an internal signal called nuclear factor-kappa beta (NF-kB), which is pro-inflammatory and it helps the cells to get rid of the debris of metabolism “cellular junk”.

NAD+ also activates sirtuins and it supports mitochondrial function.

As you can imagine, a deficit in these compounds, which is associated with aging, impairs multiple beneficial cell functions. As the products accumulate inside the cells, there is inflammation, which can lead to accelerated aging and/or multiple degenerative diseases.

Levels may be increased by reduced caloric intake. Several supplements (like gynostemma pentaphyllum and rose hip extract) and drugs, like metformin. May also increase AMPK. A form of vitamin B3 (nicotinamide riboside) could also increase intracellular levels of NAD+.

YOU DETERMINE HOW YOU AGE

You should not be a victim of the tyranny of the aging process. Even when aging is inevitable, we are aware of several mechanisms associated with aging and the common links with many chronic medical conditions. We can now intervene and modify many of these aspects associated with accelerated aging.

I believe each one of us carries a wealth of knowledge and experience as we age. Taking care of ourselves, feeling and looking better, is not simply a matter of vanity, but it places us in the best position to share our lives and to help others.

Premature aging is a matter of choice, and you are at the wheel. Improving lifestyle, choosing the right supplements and nutrition, exercising, detoxifying your body and mind, reducing stress and hormonal replacement, when indicated, are at the core of regaining life and preventing disease.

I will feel honored to help you in this path.