Can we stop ageing?

According to many observers we are standing on the precipice of yet another revolution in lifespan modification. It is universally agreed that access to sanitation, waste removal, electricity, refrigerators, vaccinations and our constant improvements in healthcare are singularly responsible for increases in average population life expectancy. Among the expanding elderly population there are growing numbers wanting to avoid the frailties and comorbidities associated with ageing – they will not go quietly into that good night.

With few scientifically recognised treatments available to counter the inevitable effects of ageing many are resorting to lifestyle modification. We mark here conclusion of the clinical phase of the MID-Frail study, which is looking at ways of modifying disease in old age, and the first phase of the Frailomic initiative, investigating inherent markers for the development of frailty by taking a snapshot of current development in the science of ageing. Both initiatives are funded by multimillion Euro grants from the European FP7 Framework and being run by Niche Science & Technology Ltd.

When faced with the impending consequences of old age many look for solutions that can counter any decline in functionality. Exercise has long been heralded as the go-to solution. We have all heard stories of 90-year-old marathon runners and great-great grandma’s competing in triathlons. In these ‘extreme’ cases it is difficult to know whether their ability is a consequence of them maintaining a life-long active lifestyle or an inherent predisposition for mobility. However, for the general population the question is how much exercise will provide protection against the ravages of time and when should you start? It may not be necessary for each of us to adopt extreme exercise routines in our teens. It would be good to know who is most likely to experience the frailties associated with ageing and thus benefit most from intervention – and this is one purpose of the Frailomic initiative – a large scale research project aiming to identify the factors that turn frailty into disability. 

The Physical Activity Guidelines for Americans recommend that all adults engage in at least 150 minutes of moderate physical activity, or 75 minutes of intense physical activity to access reductions in risk of premature death, cardiovascular diseases (such as coronary heart disease and stroke), cancer, type 2 diabetes and osteoporosis. The Guidelines also emphasize that "some physical activity is better than none" – and a new study further strengthens this message. The research focused on the most common and accessible form of physical activity, walking, and found that even levels of walking that do not meet the national recommendations still lower the risk of premature death. The authors of the study concluded that walking is the 'perfect exercise' because it is simple, free, convenient, doesn't require any special equipment or training, and can be done at any age. It also has only a low risk of injury for the ageing compared with more intensive physical regimens.

Eating is one of the great pleasures of life. But eating too much puts you at risk of chronic illnesses and shortens life expectancy. In many Western societies around 50 – 70% of people are either overweight or obese. Most often these people don’t realise that they are overweight. Those interested in healthy ageing recognise the benefits of adopting a carefully managed diet. It has long been known from animal studies that fewer calories equal better health and longer life. Scientists continue to replicate these animal studies in their quest to understand how diet contributes to aging. We know that older animals (including humans) are less efficient than younger animals in processing energy – metabolism runs down during life. This was underlined again recently in an experiment in which diet restricted lab mice (30% reduced calorie intake) were not only healthier but lived longer.

We are what we eat and our diets can reduce the risk of life-shortening comorbidities commonly associated with ageing.  A low-calorie diet appears to reset circadian rhythms, from which comes health and longevity. This is quite the carrot-on-the-stick for people wanting to stave off ageing – but how much should we reduce our intake and at what age should we start? Human clinical trials involving low-calorie intake are rare so it is difficult to answer these questions. We know that it is unlikely to be the same for everyone – as a population we are genetically diverse and only now are we seeing the impact of genetic and epigenetic factors on our phenotype. There are still no black or white answers.

The media is always awash with accounts of anti-ageing diets and super-foods. The main target of most published research during the 1960s, the 1970s and even the 1980s was the effects of individual macronutrients (i.e. carbohydrates, protein and different types of fat). During the late 1980s and early 1990s the interest shifted to micronutrients with a predominant emphasis on vitamins and antioxidants (carotenoids, tocopherols, vitamin C, selenium). More recently we have been looking at our microbiome and how it works in conjunction with our diets. Of the modifiable dietary factors, nutritional content appears to be one of the most influential factors. The theoretical advantages of the Mediterranean and Japanese diets compared with the Western diets are multiple. The high fruits (daily intake should reach 200 g), vegetables (daily intake should not be lower than 400 g), soy products and green tea intake, add to the diets high antioxidant load and other benefits provided extra-virgin olive oil and red wine. Dietary supplements are not believed to offer the same health benefits as a diet rich in fruit and vegetables and low in salt (5–7 g daily) and sugar. It is agreed that the sooner in life an individual adopts such diets the better the long-term health benefits.

Good mental health contributes to the way we age. It is generally assumed that when you age, it’s time to slow down. However, medical science begs to differ. In fact, research shows that staying active can help you stay healthier and happier in your ‘golden years’. For example, one study investigated the associations of medical and lifestyle factors with the mental health of men in their 80s. It was clear from the findings that you have more chance of reaching your 80s if you can achieve good mental health. Factors associated with successful mental health aging included education and lifestyle behaviours such as physical activity. Lifestyle modification by means of increasing physical activity and reducing saturated fat intake proved to be a safe, inexpensive, and readily available strategy to help maximize the successful mental health ageing of the population. New research, published in the journal PLOS One, shows that keeping strong friendships into old age may also stave off mental decline. The study examined the social network and cognitive abilities of a group of so-called ‘Super Agers’ – people who are in their 80s but have the mental agility of those in their 50s or 60s [ref X https://www.medicalnewstoday.com/articles/319978.php]. The episodic memory of participants, who were at least 80 years old, was said to be at least as good as middle-aged peers who they were compared against. The Super Agers had more friends. The investigators are noted as concluding "It's not as simple as saying if you have a strong social network, you'll never get Alzheimer's disease." Still, having friends may work as a great prevention factor.

Recent research strongly suggests that lifestyle changes can turn back the biological clock, and reverse aging on a cellular level. From such effects on mortality we might also assume benefits on morbidity related to frailty. Is it possible therefore to reverse the pathologies associated with disease? The Mid-FRAIL study, which has recently completed its clinical phase, is a major new international research study examining the effectiveness of combining optimised medical management with exercise and dietary programmes to maintain function and quality of life in people aged 70 years and over who have Type 2 diabetes. If data from the study confirms that it can be achieved it further raises the possibility of reversing some of the consequences of ageing.

In conclusion, the message emerging from the growing body of work on ageing strongly suggest that there are numerous different techniques we can adopt to counter the influence of time. Since smoking was recognised as being a major influencer on how we age (and so became a major target for modification) it seems that diet and exercise have been identified as the main factors we can address ourselves that will not only increase your chances of living longer but will also ensure that we live better. The search for the fountain of youth continues.

 

New Balance