While much has been done to achieve a longer life span in the recent decades, and average life expectancy now being much higher than just a century ago, research has only just started to catch up on improving the quality of life in those years. While age-related illness such as cardiovascular disease, Alzheimer’s, type 2 diabetes have become so common that they are almost accepted as a ‘normal’ part of ageing, research in the past years has shed light onto a new fascinating area, called ‘health span’ and anti-ageing. Health span research looks into how best to keep one healthy as we get older, as to enjoy a high quality of life, void of ill health, for as long as possible.
One of the leading researchers in that field, Professor David Sinclair from Harvard Medical School, has become known for his team’s discovery of the ‘9 Hallmarks of Ageing’ (1) describing what underlies age related decline, including mechanisms like ‘zombie cells’ (senescent cells) accumulating and more. In easier words, it is damage to our cells that accumulates, and our renewal capacity not being able to keep up with housekeeping and repair, that, once it builds up, contributes to our bodily decline.
But what does that all mean in practical terms? What is one to do to extend one’s health span, and prevent age related illness and decline?
The top 6 most important strategies to prevent age related decline and to optimise health:
1. Balance your blood sugar
Chronic high sugar intake has long been recognized as a risk factor for many diseases, including obesity, cardiovascular disease, metabolic syndrome, and type 2 diabetes (T2D) (2).
But even long before, acute blood sugar spikes from your daily toasty with jam, or mid afternoon chocolate bar, can inflict damage on the body, even if you are seemingly healthy and slim.
Research indicates that dietary sugars and mixed processed foods may be a key factor leading to the occurrence and aggravation of inflammation (3).
Recent research has identified high blood glucose (hyperglycemia) and the phenomenon of insulin resistance as two of the major factors contributing to an increased risk of Alzheimer’s disease. Alzheimer’s disease has even been nicknamed as ‘type 3 diabetes’, due to its high correlation with blood sugar swings and insulin resistance (4).
While chronic inflammation is an overtly upregulated immune system, blood sugar spikes have also been shown to at the same time render other immune cells less efficient, thereby tampering with our immune system’s response to invaders such as bacteria and viral infections.
Worse yet, this reduced ‘immune surveillance’ also slows its response to tumor cells, allowing a process termed’ tumor immune escape’.
Recently, it was demonstrated that excessive consumption of high fructose corn syrup is associated with colon cancer development. In the study, mice fed with high fructose corn syrup had significantly increased tumor size (5, 6, 7, 8).
Cellular ageing via advanced glycation end products (AGEs) and free radicals
Sugar spikes also contribute to the formation of advanced glycation end products, short ‘AGEs’ – which look much like when you place a burger on a grill and get the browning. The same thing happens to our cells when we consume too much sugar! These AGEs have been linked to damage of collagen (think wrinkles, joint aches and more), free radical formation (cellular damage = ageing), arterial stiffness and increased cardiovascular risk (9, 10).
2. Live an anti-inflammatory lifestyle
As mentioned above in the section on blood sugar, inflammation has gained a tremendous amount of interest in the research community over the past decade, due to its wide ranging effects on pretty much all health outcomes, also called ‘all cause mortality and morbidity’ in more geeky terminology. Low grade inflammation has been linked to increased risk of cancers, cardiovascular disease, autoimmune disease, neurodegeneration like Alzheimer’s and Parkinson’s, and many more.
Some of the simplest strategies to keep inflammation at bay include:
- Keep your blood sugar balanced
- Get adequate amounts of omega 3 fatty acids. It might make sense to get a blood test to check up on your omega 3 levels once in a while, as despite most of my patients supplementing with fish oil, most are still on the lower end of what would be good for health optimisation and prevention, and would benefit from even higher levels (research suggests up to 4000 mg/ day, which is much more than the generally recommended dosage!)
- A word of caution: If you choose to go for the whole foods variety (ie eating fish), make sure to stay clear of tuna, shark and sword fish, for their high mercury content that in itself would contribute to cellular damage, and as such undo any benefits achieved from eating the omega 3 rich fish.
- Keep your gut healthy – see next section for easy diet and lifestyle tweaks to address that.
- Add turmeric to your daily routine. Turmeric has been shown to have wonderful anti-inflammatory effects, supporting health span on all levels.
- Focus on stress management and sleep hygiene. Research shows that just one night of lacking good quality sleep will upregulate inflammation the next day, in particular in genetically susceptible people with a mutation in their IL6 gene.
And while acute stress (ie a one-off work deadline or such) can lower inflammation and boost performance, long-term chronic stress has been shown to mess with receptors in the body that are in charge of downregulating inflammation, leading to an overall more inflammatory prone state in stressed out individuals.
3. Support your gut health
Research suggests that out ‘gut microbiome’ has a wide reaching effect on inflammation, nutrient absorption, brain health, heart health, and so much more. But first things first, what is the ‘gut microbiome’? Did you know that we have trillions (yes, trillions!) of bugs residing in our gut. Many of them are beneficial, and help our body break down certain foods, create and absorb nutrients, keep our gut barrier healthy, help to bind and transport toxins out via stool, and much more. However, there are also ‘bad guys’, including pathogenic bacteria like H.pylori, parasites or even certain types of fungi like candida albicans, they can create wide reaching havoc on our entire body, as well as not having enough of the good guys, or simply just not a wide enough variety.
Research has even coined the terms ‘gut-brain-axis’ (or ‘The Second Brain’), ‘ gut-kidney-axis’ and ‘gut-heart-axis’ in the recent years due to their important relationships and interconnectedness.
Fixing our gut microbiome can be one of the most powerful tools to have in your toolbox for health optimisation and health span extension. Some simple steps are:
- Focus on a mostly plant-based, Mediterranean style, whole foods diet. Our gut microbiome loves fiber, such as found in vegetables, nuts and seeds.
- Focus on stress management and sleep. Research suggests that being in a constant state of stress lowers nerve output to the gut (via something called the vagus nerve), and messes with its resilience to fight off the bad kind of bugs.
- Avoid processed and fake foods, as they too mess with our gut bacteria and gut lining integrity, contributing to something called ‘leaky gut’ and body wide inflammation.
- You may occasionally take a probiotic, but there usually is no need to take them on a continuous basis. If they give you digestive issues go see a practitioner experienced in SIBO or SIFO, as it may be a sign of having an overgrowth of bacteria or fungi in the gut that may need addressing in a more detailed manner.
- Two other wonderful supplements to add occasionally are berberine and butyrate. Both have been shown in research to increase the good type of bugs, and reduce the abundance of the bad ones. Win win!
4. Get adequate nutrients to support optimal cellular functioning
This should include omega 3s, protein, minerals and vitamins, such as found in a well-balanced Mediterranean style diet.
In order for everything to function as optimally as possible, and cells to be able to renew and regenerate, we need building blocks to go from. A well balanced, whole foods Mediterranean style diet includes all of the building blocks we need for optimal cellular health. Focus also on getting enough protein (and a nice variety, as both animal and plant-based protein has different building blocks needed for different cellular functioning). Recent research has emphasised the importance of keeping our muscles healthy to prevent ageing and decline- and keeping up with protein intake, in particular as we age, in addition to exercise and other factors, is one crucial building block.
5. Support the body's repair and renewal processes via strategies like stress management, sleep, intermittent fasting, adequate hydration and regular bowel movements
Right in the beginning of the article we mentioned that one of the hallmarks of ageing is ‘zombie cells’ accumulating. When our body’s housekeeping stops working efficiently, it allows old, mutated or sick cells to stick around, when it should get rid of them.
Luckily our body has some wonderful ways of dealing with them, in geeky words called autophagy and apoptosis. Intermittent fasting, sleep, and keeping our blood sugar balanced, with potentially even including intermittent periods of ketosis, have all been shown to be particularly effecting at upregulating and supporting our body’s housekeeping, and to reduce senescent (zombie) cells and age related decline.
6. Lower body burden of environmental toxins, including plastics, heavy metals and other chemicals that increase free radicals and damage ('ageing') to our cells.
Broken, mutated and sick cells accumulating is one of the problems contributing to ageing. Reducing exposure to substances that increase damage to our cells can keep us healthier for longer.