Science is bringing us closer and closer to slowing and reversing aging—a remarkably complex and poorly understood process that all human beings undergo, albeit often reluctantly. And breakthroughs can't come soon enough. According to the United Nations World Population Prospects, by the year 2050 over 2.5 billion people on the planet will be 60 years old or older, which means figuring out how to age "successfully"—living well into one's eighties and nineties in good health—is a top global priority for scientists and health care providers.
In December 2016, an article in Cell magazine turned the scientific community on its ear, citing a study where aging mouse and human cells were rejuvenated by "reprogramming" them with something called Yamanaka factors—proteins that normally help duplicate DNA information, but that also have the capacity to convert mature cells into stem cells—mitigating aging and extending the lifespan of the mouse.
This cellular reprogramming also improved the regenerative capacity of the pancreas and muscles of aging mice after injuries. The takeaway? We may now have the potential to reverse the time-dependent deterioration of cellular structures (called 'senescence'), DNA damage, and epigenetic changes (altering the rate at which genes are converted to proteins, based on environmental influences) that are some of the primary causes of aging.
The many ways we age
We age in many ways for many reasons. Our DNA is a repository of some 20,000 functional genes ('protein-coding DNA'), along with millions of additional genetic sequences ('non-coding DNA') whose function is not yet well understood, that instruct every cell in the body how to construct and maintain our physical form. Like thread around a spool, DNA is wrapped around proteins called histones in the nucleus of every cell to form chromosomes. With every cell division, the chromosomes are copied in a process called DNA replication, passing on the complete genetic code to each new cell.
Each chromosome has a protective 'end cap' made of non-coding DNA called the telomere, and every time the chromosome is 'unspooled' to be copied, the telomere gets a little bit shorter. The shorter the telomere, the more times a cell has divided and the 'older' it is. Other factors, such as emotional, oxidative and inflammatory stress, can also shorten telomeres.
When the telomere wears away completely, the DNA is no longer protected from the cellular environment, like fraying at the end of a rope. This can lead to errors in the replication process, which in turn cause cell death or even a transformation in the cell's behavior—often in the form of cancer—that can threaten the wellbeing of the whole organism.
DNA methylation is another critical process in the body that changes with age. This is the mechanism by which a 'methyl' molecule (a carbon atom surrounded by three hydrogen atoms) attaches to the DNA strand and acts like a roadblock to prevent a particular gene from being used. This process of 'gene silencing' stops the cell from being able to create all the proteins it needs to function correctly, contributing to age-related diseases such as cancer, osteoarthritis, neurodegeneration and dementia.1
Then there is DNA oxidation, where reactive oxygen species (ROS)—chemicals containing highly reactive charged oxygen atoms such as peroxides, superoxides and hydroxyl radicals— damage the mitochondria and DNA, resulting in a multitude of problems often associated with aging, including cancer, insulin resistance, diabetes, atherosclerosis and heart disease, along with impaired immune defense, vascular health and intracellular signaling.
As we get older, the creation of stem cells—the undifferentiated cells necessary for organ and tissue repair—also slows down. Mitochondria, the tiny power packs in every cell that manage cellular respiration and generate all the energy the body needs to function (in the form of a kind of molecular currency called ATP), also become less efficient as we get older, although it is still unclear whether this change in mitochondria is a cause or a symptom of the aging process.
Many common drugs have been linked to mitochondrial dysfunction, including statins, antibiotics, acetaminophen (paracetamol) and nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen, to name only a few. Without ATP, a cell simply cannot survive, and decreased mitochondrial function has well-established links to cellular degradation, chronic inflammation, decreased stem cell activity and age-related diseases.2
Then there is the decrease in hormone production as we age. As levels of the sex hormones estrogen, testosterone and their precursor DHEA (dehydroepiandrosterone) decrease, so does sexual desire and potency. Melatonin, the hormone that regulates our sleep cycles, also declines.
Whether caused by a lack of melatonin or the result of other issues like anxiety or working late hours, sleep problems and sleep deprivation lead to increased stress and the release of the stress hormone cortisol—one hormone that never decreases with age. Cortisol actually breaks down body tissues, reducing muscle mass, contributing to osteoporosis and increasing the retention of abdominal fat.
The production of growth hormone (GH) is another critical process in aging. GH is responsible for maintaining lean body mass and bone mass and the regulation of carbohydrate metabolism, cardiovascular function, cognitive function and many other regulatory processes in the body. Also GH declines with age as well as with stress and environmental triggers.
"Gerontogens"—external insults such as industrial pollutants, arsenic in groundwater, toxic chemicals in the soil and food supply, ultraviolet radiation, processed foods, alcohol, medicinal and recreational drugs, childhood abuse and trauma—are all enormous contributors to aging through their various effects on all the above-mentioned physiological systems and more. In fact, only about 25 percent of the variation in human longevity is actually due to genetic factors—the rest is down to our behavior and environment.3
Studies also show that aging seems to be a matter of synergy—the combination of multiple influences, none of which is particularly relevant in itself until combined with other causes. But the good news is that it's possible that health and lifespan can be significantly extended if even one of these causes is mitigated or eliminated.4
Western medicine has been trying to slow down or reverse aging for centuries, but so far, its best options haven't been very effective.
Hormone replacement therapy (HRT) was introduced in the late 1960s as a method of mitigating difficult perimenopausal and menopausal symptoms for women, such as hot flashes, night sweats, vaginal dryness and debilitating mood swings. Unfortunately, even though scientists admit it isn't even clear yet whether a decline in hormone levels is part of healthy aging or not,5 HRT and off-label hormone supplementation have now become one of the primary 'go-to' anti-aging strategies to counter skin aging and decreases in sexual function, bone mineral density and lean body mass.
And yet studies show that there are considerable risks involved. In 2002, a randomized controlled trial—part of the US National Institutes of Health's ambitious Women's Health Initiative—compared the standard medical approach of estrogen plus progestin replacement therapy against a placebo in 16,608 postmenopausal women. The study revealed a higher risk for breast cancer, stroke, cardiovascular disease and thromboembolic events (blood clots), and was discontinued after five years because of the perceived dangers of keeping the study going for the planned eight-and-a-half-year duration.6
Since then, the breast cancer risk of HRT has been confirmed in a number of additional studies involving tens of thousands more women,7 and several other cancers including ovarian cancer, meningioma and some forms of skin cancer have also been linked to the regimen.8 Nevertheless, the US Food and Drug Administration (FDA) still recommends HRT for vaginal dryness, hot flashes and the prevention of osteoporosis.
The more recently developed 'bioidentical' hormones progesterone and estradiol, which have also been approved by the FDA for the relief of menopausal symptoms and to reduce osteoporosis risk, are widely hyped as safer alternatives to traditional HRT drugs because their active ingredient is identical to the hormones produced by the human body. But there have yet to be any large, long-term trials conducted to show whether this is true. It's possible that altered physiological exposure to hormones—any hormones—causes the health risks of HRT, or that they are triggered by the 'inactive' ingredients in the drugs, which are necessary to get them absorbed into the bloodstream. In either of these cases, there's no reason to assume that bioidentical hormones are safer just because their chemical structure is slightly tweaked. 9
And it's not just women who are at risk from hormone replacement therapy. Testosterone supplementation has been growing rapidly in popularity among aging men to treat so-called 'low-T' symptoms like fatigue and decreased sex drive, but the long-term safety and effectiveness of the treatment haven't been established.
In a clinical trial of testosterone replacement in 60 older men with low circulating testosterone levels, it was found to be effective for mitigating loss of muscle mass and bone density, and aiding cognitive function, but it was also linked to prostate enlargement, which can come with negative symptoms like difficulty or urgency urinating.10 A recent meta-analysis uncovered worrying links between testosterone replacement, especially at high doses, and cardiovascular disease risk,11 while another study found that testosterone replacement sped up the growth of plaques in the coronary arteries—a major cause of heart attack.12
Calling the long-term benefit of testosterone replacement into question, a three-year clinical trial of 156 older men with low or low-normal testosterone levels found that testosterone supplementation had no effect on sexual function or health-related quality of life compared to placebo.13 Overall, it's far from clear whether the benefit of the drug outweighs the risks.
Supplementation with GH is also marked by risks and complications that appear to exceed any possible benefits, which have been marginal at best in clinical studies. Elderly people taking GH supplements have a higher incidence of carpal tunnel syndrome, gynecomastia (enlarged breasts in men), fluid retention and possibly increased insulin resistance.14
Although GH declines sharply with age, in parallel with other signs of age-related deterioration throughout the body, studies in mice have shown that GH deficiency leads to an exceptionally long life expectancy, while long-term GH supplementation accelerates aging.15 The evidence suggests that the age-related decline in GH is far more complex than a simple 'deficiency' warranting a replacement therapy.
Considering the pros and cons of pharmaceutical interventions for aging, it's clear that we just don't know enough yet about the intricacies of how the human body functions or how and why it ages to expect that medicine will find a 'Fountain of Youth' solution any time soon. Thankfully, there is scientific evidence for many natural solutions to age-related problems for those who want to avoid drugs and synthetic hormones.
If 75 percent of "successful" aging is attributable to environment and lifestyle choices, it's only logical to turn to lifestyle changes rather than medical solutions to live longer and better.
For example, in a recent study on how lifestyle changes affect telomere length, 10 patients went on a plant-based, low-fat, low-carb diet high in fruits, vegetables and unrefined grains. They practiced yoga and meditation for stress reduction, participated in a weekly support group and walked 30 minutes a day, six times a week. Over five years, these patients experienced significant increases in telomere length. And the better they stuck to the diet and lifestyle changes, the more dramatic the improvement in telomere length.16
The production of GH can be naturally stimulated by ingesting supplements such as l-arginine, GABA, l-ornithine and alpha-GPC (see sidebar, page 53). Mitochondrial health and ATP production can be strengthened by taking antioxidant supplements such as coenzyme Q10.17 As Dr Richard F. Walker, founding editor of Clinical Interventions in Aging, puts it, "With continuing research into the consequences of aging, it is becoming apparent that medical practice must evolve from this disease-oriented model to one that is health-directed so as to ensure quality of life with longevity."
An increasing number of practitioners interested in integrative medicine agree. Functional medicine practitioner Phil Meyers, founder of Phi Wholeness, a "reverse aging center" in Missouri, offers a reverse aging program that starts with a consultation inevitably leading to dietary changes focused on gut health, eliminating inflammatory substances and neurotoxins from the patient's diet.
This means going on a whole-food regime, removing all the usual suspects—sugar, refined and processed foods, artificial ingredients, GMOs, artificial sweeteners, fluoride, mercury fillings in the teeth—plus becoming an avid label reader in order to dodge hidden neurotoxins like sodium caseinate, calcium caseinate, hydrolyzed vegetable protein and yeast extract found in everything from energy bars to protein supplements.
Dr Patricia Sylwester, a functional medicine specialist in Olympia, Washington, agrees it's not technology that makes a person stay healthy longer. "I was a traditional physician for 25 years and prescribed meds," she says, "but changing how people live their lives is way more powerful than any medication or technology in terms of maintaining cognitive function and good health to an old age."
Sylwester does an initial consult, runs lab tests to get solid baseline readings, takes a hard look at a patient's stress system and hormone production, and then gets into analyzing their food and sleep habits. "I usually find inflammation and blood sugar regulation issues that are rampant," she says. "On top of that, we have too much stress and nobody is sleeping, and those are all the things that lead to premature aging and death."
Both Sylwester and Meyers believe the biggest hurdle people face is the time it takes to make the enormous shift in lifestyle habits necessary to see real regenerative changes.
Meyers explains that sometimes people come to see him thinking that they can make a few quick, simple adjustments and end up with the results they desire. "This whole 'I'll try eating no wheat for a week and see how that goes,' just doesn't work," he says. "It's going to take three, six, nine months to maybe a year for someone to really reboot their entire system."
The payoff, however, is well worth it for those who stick with the changes. "Doing this, you literally reverse the aging process," he says. "To what degree will always be dependent on your age, how long you've had the degenerative process, what degenerative process you're dealing with and how much of a shift in lifestyle you need to make."
Lorraine C., 44, from St. Louis, Missouri, became a patient of Dr Meyers after she started noticing signs of aging—a slower, more painful body, less energy and enthusiasm for life, excess belly fat, cellulite, wrinkles and jowls on her face, a sagging neck, and deep lines on her chest. "I wasn't happy about it," she says. "I thought I was a fairly healthy eater already. But I finally realized just how much of the protruding belly and body pain came from the 'healthy' food I was eating. There were hidden toxins I was dealing with that I didn't even know existed."
Since making a number of dietary and other lifestyle changes, she says she feels stronger, her body moves better, and she has more energy and excitement for life. "Now I don't even see lines on my chest, it's smooth, despite the fact that I get plenty of sun. The skin on my neck went from sagging to smooth, and the jowls and wrinkles on my face are so diminished that one day I looked in the mirror and said to myself, 'I look like someone else. Who do I remind myself of? Oh yeah,
me. . . from a decade ago!'"
Supplements that can turn back the clock
Functional medicine practitioners recommend the following supplements, which have been shown to reverse aging in a number of ways.
To stimulate the production of growth hormone:
l-arginine is an amino acid used to synthesize proteins in the body. l-arginine ingestion can enhance the growth hormone response, and the combination of arginine plus exercise increases growth hormone levels.
Suggested daily dose: 2-3 grams three times a day
GABA is an inhibitory neurotransmitter that affects the central nervous system. It elevates growth hormone levels both at rest and after exercise.
Suggested daily dose: 800 mg
l-ornithine is an amino acid that promotes growth hormone release after exercise.
Suggested daily dose: 2-6 grams
Alpha-GPC is a chemical found in the brain that augments growth hormone production, especially when combined with exercise.
Suggested daily dose: up to 1,200 mg
To stimulate healthy mitochondria and ATP production:
NAD (nicotinamide adenine dinucleotide) is a coenzyme that can be found in all living cells. It is involved in many functions such as ATP synthesis, mitochondrial function and DNA repair. NAD supplementation is relatively new on the anti-aging scene, and optimum dosages have yet to be determined.
Suggested daily dose: some products recommend 100 mg daily
MitoQ is a modified form of the mitochondrial antioxidant coenzyme Q10, which is smaller and able to pass more easily through biological membranes, including the mitochondrial wall.
Suggested daily dose: 2 capsules each morning on an empty stomach
Alpha-lipoic acid and acetyl-l-carnitine are powerful antioxidants that increase mitochondrial ATP production.
Suggested daily dose: 200 mg alpha-lipoic acid and 500 mg acetyl-l-carnitine
Glutathione is a crucial antioxidant in the body that helps prevent cellular damage from free radicals and reactive oxygen species, as well as supporting the liver in its detoxification of the blood. It helps reduce wrinkles and age spots.
Suggested daily dose: 250 mg
Resveratrol is a grape-based compound that enhances mitochondrial ATP production and protects cells from reactive oxygen species.
Suggested daily dose: 150 mg
An anti-aging cleanup
Aside from exercise, lifestyle, nutrition and mindfulness, Dr Phil Meyers recommends the following supplements for cleaning up the gut ecosystem to aid in leading a healthier, happier, longer life:
Restore: A mineral supplement (available at shop.restore4life.com) derived from soil that strengthens the cells lining the intestinal tract to improve digestion, mitigate leaky gut symptoms and help strengthen the gut-brain connection.
Suggested daily dose: 15 mL; if there is a reaction, reduce to 5 to 15 drops a day and see how your body responds, gradually increasing the dosage until you reach 15 mL/day
Molecular hydrogen: This neutralizes reactive free radicals by turning them into water.
Suggested daily dose: one pill in 16 to 32 oz (1/2 to 1 L) of water
C60: This form of carbon is a powerful antioxidant and free-radical scavenger (see WDDTY August 2018) sold as a nanoparticle suspension in various types of oil, including olive, coconut, avocado and sunflower.
Suggested daily dose: one dropper
Superfoods to slow down skin aging
Collagen is the most abundant protein in our bodies, and the body's ability to form new collagen is essential for firm skin and wound healing. Studies show that supplementation with a specific type of collagen hydrolysate (CH), or gelatin, significantly increases skin elasticity and aids in skin moisture with no side-effects.1
To stimulate collagen production, eat fish high in omega-3 fatty acids, such as tuna and salmon. Or you can take fish oil supplements. Hemp seeds are also high in omega-3 and -6 fats.
Bone broth helps aid collagen production, builds and repairs muscle tissue, supports bone mineral density, boosts nutrient absorption and synthesis, and helps strengthen and maintain muscle and connective tissues. It also improves the body's use of antioxidants.2
Recipe: To make bone broth, boil three pounds of beef bones, cut so the marrow is exposed, and add one pound of chicken feet. Add 1-2 tablespoons of apple cider vinegar. Bring to a boil and simmer on low for 12 hours. Strain, season and drink at least 1 cup per day and/or use in recipes.
Vitamin A helps scavenge free radicals. It's found in broccoli, carrots and apricots.
Vitamin B2 aids in cell respiration. It's found in beef liver, lamb, milk, mushrooms, soybeans, eggs, unsweetened yogurt, spinach, almonds and sundried tomatoes.
Vitamin B3 is a natural skin elasticity booster. It's found in turkey, chicken, tuna, peanuts and liver.
Vitamin B5 is anti-inflammatory. It's found in oily fish, mushrooms, avocados and eggs.
Vitamin B6 is a skin hydrator. It's found in pork, fish, eggs, soybeans and whole-grain cereals like oatmeal.
Vitamin B7 (biotin) moisturizes skin from the inside out. It's found in egg yolks, avocado, milk, royal jelly and soybeans.
Vitamin C helps guard the skin against UV radiation. It's found in fruits like oranges, grapefruit and kiwi.
Vitamin D aids in cellular repair. It's found in fatty fish, milk products, beef liver and egg yolks.
Dr Phil Meyers, Phi Wholeness: www.phiwholeness.com
Dr Patricia Sylwester, Vital Rejuvenation: wellnessolympia.com