How to Age Well

Unfortunately, we have been ingrained as a society to expect an inevitable health decline as we age. This ‘expectation’ for illness and immobility is hardly inspiring and in fact encourages an entirely negative approach to growing old, saturated in fear and often a sense of hopelessness.

However, it is worth reminding ourselves that we have so much power to influence the state of our later years. With 80% percent of chronic illnesses such as cardiovascular disease involving modifiable lifestyle factors (1), we can influence our genetic jackpot in a real, tangible way, to positively influence how well we age.

We may think of longevity as the ultimate measure of ‘health’ but in reality, and as with most things in life, it is more helpful to think about quality and not just quantity. This doesn’t mean that we shouldn’t aim to increase our overall lifespan, but it may be more beneficial to focus on maximising our number of ‘healthy’ years instead.

We Can Influence How Well We Age

Of course, it is true that certain factors are stacked against us, for example our muscle mass does slowly decline, our immune system becomes less primed for invading threats and as our internal organs do age, however, we have enough understanding of the human body now to counteract many of these processes such that they don't cause us ill health. 

What Does Healthy Aging Really Look Like

We can often set the bar too low when we consider what it means to age well.

We should not just aim for the absence of severe or chronic illness, but also to include the other markers of wellbeing including our energy levels, our vibrancy, and our general joie de vivre! 

Shockingly, under 20% of people are considered to ‘age successfully’ (2), which again, is not simply the absence of chronic disease, but also, the capacity to live as you want to, by exercising, socialising or travelling.

Clearly, there is much to be achieved from our efforts to promote healthy aging.

‘Inflammaging’

One of the key issues underpinning multiple chronic disease states is inflammation (3). However, when we age, we are also prone to ‘inflammaging’ (4) the unhelpful combination of both aging and inflammation processes. However, by moving our lives more in an anti-inflammatory direction, we can counteract this effect.

In fact, studies conducted on centenarians, some of the oldest living people (often found in Blue Zones - longevity hot spots), showed that such long lifers are not immune from aging associated inflammation, however, they appear to be able to ‘anti-inflame’ - more efficiently, showing the huge merit in prioritising an overall anti-inflammatory lifestyle.

How To ‘Anti-Inflame’

  • We can tackle any untreated ongoing infections, for example by screening for parasite infections/ bacterial overgrowth in the gut (5)
  • By establishing and removing any food allergens we are diagnosed as sensitive to via Ig(E) testing (6)
  • Managing autoimmunity via Autoimmune Protocol (7) regimes
  • Being a healthy weight - as excess weight increases pro-inflammatory cytokines (8)
  • Enjoying a balanced Mediterranean/Asian/Indian style diet with an emphasis on omega 3 fatty acids (9) western diets are most commonly linked to poor health and malnutrition during aging (10)

Blood Sugar Control

As we age, unbalanced blood sugar starts to show up in more unhelpful ways, whether as pre-diabetes slowly progressing into full blown diabetes type 2, or by increasing our propensity to gain weight through poor eating habits.

But the great news is that by stabilizing blood sugar - and reversing type 2 diabetes if necessary - we not only improve our mood, energy levels and immune system day to day, but we also reduce the risk of all the myriad chronic diseases associated with insulin resistance including cardiovascular disease, cognitive decline, and even cancer (11).

We can stabilize our blood sugar by:

  • Eating complex carbs in combination with healthy protein and fats
  • Sleeping sufficiently to reduce our cravings for highly palatable foods
  • Considering a 16-8 hour intermittent fasting regime to promote lower insulin levels (12)

Muscle Mass & Bone Health

We do tend to lose muscle mass via natural decline from our 30’s onwards, however we compound this by being inactive, avoiding resistance exercise, and in some instances, by becoming deficient in Vitamin D3, Calcium and Magnesium (14).

In men, depleted testosterone can also reduce muscle hypertrophy growth (15), but helpfully, vitamin D and Zinc act as the precursor to testosterone production (16).

  • More movement will encourage muscle hypertrophy especially when in the form of weight bearing exercise (17).
  • A nutrient dense diet rich in micronutrients and targeted supplementation will support both muscle mass and bone strength.
  • Maintaining a healthy weight will also reduce the chance of testosterone deficiency which impacts both bone and muscle strength in men (18).

Optimising Nutrition

Malnutrition as we age, is surprisingly common (19).

Whilst caloric intake requirements are usually met, we may frequently find that being overfed still amounts to being undernourished, i.e., by eating plenty of high calorie low nutrient foods but failing to achieve optimum nutrient coverage.

This is easily solved by prioritizing the intake of 30 different plant-based foods per week, filling up on fibre, omega 3 fats, and healthy proteins, before turning to the less nutritious refined foods which can often make up the majority of our dietary intake. 

The Way We Handle Stress

Chronic stress, especially as we age, has the potential to dysregulate our hormones, lead to a propensity to weight gain (20), and is also associated with other unhelpful health behaviours, whether in the form of inactivity, poor sleep and binge eating episodes (21).

Conversely, once we get a handle on our stress, we are much more likely to take up other health promoting activities, including regular movement, socialising and the prioritisation of healthy eating.

If we look at a longevity hotspot - Okinawa in Japan, here local communities create supportive networks who meet regularly to discuss life or offer each other a listening ear, all whilst drinking  antioxidant rich green tea (22).

Perhaps it is time to re-evaluate our isolated TV dinner rituals and focus on the type of multi beneficial activities which yield huge rewards for us as we age.

Key Takeaways

  • Aging is inevitable, disease is not.
  • We don’t need to accept that with age, comes decline, instead, by maximising the key health behaviours of healthy diet, activity, moderate alcohol consumption and socialising, we can hope to add an additional 10-17 years of healthy lifespan.
  • Inflammation is a process associated with both aging and disease - so promoting an anti-inflammatory lifestyle is encouraged.
  • Blood sugar imbalance can predispose us to the type of metabolic diseases which threaten our future health, conversely, insulin sensitivity via blood sugar management can prevent many chronic diseases.
  • Finding beneficial activities such as supportive social groups can boost our healthy aging process - as demonstrated by longevity hot spots .

References:

  1. Hindawi. Cardiovascular disease and longevity.
  2. Jeste D V., Depp CA, Vahia I V. Successful cognitive and emotional aging. World Psychiatry. 2010. doi:10.1002/j.2051-5545.2010.tb00277.x
  3. Furman D, Campisi J, Verdin E, et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019. doi:10.1038/s41591-019-0675-0
  4. Franceschi C, Campisi J. Chronic inflammation (Inflammaging) and its potential contribution to age-associated diseases. Journals Gerontol - Ser A Biol Sci Med Sci. 2014. doi:10.1093/gerona/glu057
  5. Fasano A. All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases. F1000Research. 2020. doi:10.12688/f1000research.20510.1
  6. Zeng MY, Inohara N, Nuñez G. Mechanisms of inflammation-driven bacterial dysbiosis in the gut. Mucosal Immunol. 2017. doi:10.1038/mi.2016.75
  7. Chandrasekaran A, Molparia B, Akhtar E, et al. The Autoimmune Protocol Diet Modifies Intestinal RNA Expression in Inflammatory Bowel Disease. Crohn’s Colitis 360. 2019. doi:10.1093/crocol/otz016
  8. Wellen KE, Hotamisligil GS. Obesity-induced inflammatory changes in adipose tissue. J Clin Invest. 2003. doi:10.1172/JCI20514
  9. Dinicolantonio JJ, O’Keefe JH. Importance of maintaining a low omega-6/omega-3 ratio for reducing inflammation. Open Hear. 2018. doi:10.1136/openhrt-2018-000946
  10. Noble EE, Hsu TM, Kanoski SE. Gut to brain dysbiosis: Mechanisms linking western diet consumption, the microbiome, and cognitive impairment. Front Behav Neurosci. 2017. doi:10.3389/fnbeh.2017.00009
  11. Frost G, Wilding J, Beecham J. Dietary Advice Based on the Glycaemic Index Improves Dietary Profile and Metabolic Control in Type 2 Diabetic Patients. Diabet Med. 1994;11(4):397-401. doi:10.1111/j.1464-5491.1994.tb00292.x
  12. Patterson RE, Sears DD. Metabolic Effects of Intermittent Fasting. Annu Rev Nutr. 2017. doi:10.1146/annurev-nutr-071816-064634
  13. Heikinheimo RJ, Inkovaara JA, Harju EJ, et al. Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int. 1992. doi:10.1007/BF00298497
  14. Volpe SL. Magnesium and the Athlete. Curr Sports Med Rep. 2015. doi:10.1249/JSR.0000000000000178
  15. Ferrando AA, Sheffield-Moore M, Yeckel CW, et al. Testosterone administration to older men improves muscle function: Molecular and physiological mechanisms. Am J Physiol - Endocrinol Metab. 2002. doi:10.1152/ajpendo.00362.2001
  16. Pilz S, Frisch S, Koertke H, et al. Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res. 2011. doi:10.1055/s-0030-1269854
  17. Volek JS, Duncan ND, Mazzetti SA, et al. Performance and muscle fiber adaptations to creatine supplementation and heavy resistance training. Med Sci Sports Exerc. 1999. doi:10.1097/00005768-199908000-00011
  18. Vermeulen A, Goemaere S, Kaufman JM. Testosterone, body composition and aging. J Endocrinol Invest. 1999.
  19. Hickson M. Malnutrition and ageing. Postgrad Med J. 2006. doi:10.1136/pgmj.2005.037564
  20. Chao AM, Jastreboff AM, White MA, Grilo CM, Sinha R. Stress, cortisol, and other appetite-related hormones: Prospective prediction of 6-month changes in food cravings and weight. Obesity. 2017. doi:10.1002/oby.21790
  21. De Macedo IC, De Freitas JS, Da Silva Torres IL. The influence of palatable diets in reward system activation: A mini review. Adv Pharmacol Sci. 2016. doi:10.1155/2016/7238679
  22. Oyetakinwhite P, Tribout H, Baron E. Protective mechanisms of green tea polyphenols in skin. Oxid Med Cell Longev. 2012. doi:10.1155/2012/560682



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