Anti-aging – proactive interventions
Can we influence and monitor our aging?
“You are as old as the oldest organ in your body. Anti-aging is not just about rejuvenating your physical appearance but is perhaps more importantly about enhancing the length and quality of life, free of age-related degenerative diseases. And although I advocate for and support all aesthetic procedures, it does not make sense to be, for example, a 50 year- old with a face of a 40-year-old but a heart or kidney of a 70-year-old!” explains Dr. Nedic, one of SA’s pioneers in anti-aging.
Aging is often perceived to be an inevitable process that we must accept, and anti-aging interventions are viewed as a means to address our vanity. This is both vague and untrue. Aging is a biological process during which an organism undergoes varying degrees of structural and operative changes in proteins, gene expression, metabolites, cells, and tissues. This leads to a significant functional decline in all bodily systems. When all our bodily systems are affected such as the nervous, endocrine, cardiovascular, respiratory, digestive, urinary, motor and immune systems, our appearance changes and we look older, we feel older but more importantly, we develop age-related degenerative disorders that affect our quality of life. Age-related diseases include atherosclerosis, type 2 diabetes, insulin resistance, osteoporosis, arthritis, muscle mass weakness, cancer, and neurodegenerative diseases such as Alzheimer’s and Parkinson’s. These diseases predispose an individual to severe morbidities and contribute to a shorter lifespan. When we begin to age we are more concerned about changing our physical appearance without being aware of how incapacitating the outcomes of age-related disorders could be. Moreover, age-related disorders are often not thought about until they become fully apparent. Additionally, conventional medicine, which is disease orientated and not prevention orientated (except for cancers where there is preventative screening), does not offer defined preventive anti-aging measures.
In one study, individuals with the highest level of inflammatory biomarkers at the beginning of the study revealed a greater decline in cognitive function over a 20-year period, compared to those with low inflammatory biomarkers. Systemic inflammation during midlife highlighted the importance of early prevention of cognitive decline, which was seen to worsen progressively over the 20 years.
Aging that happens gradually and insidiously has complex underlying causes of which one is Inflamm-aging. Inflammation, if moderate, actually has a beneficial function in the body. It is only when in excess, that the inflammatory response becomes harmful. With aging, our immune system becomes weaker and it remarkably influences and perpetuates inflammation. Persistent inflammation during the inflamm-aging process may cause various conditions that are very stubborn to treat and can be progressively debilitating. Factors that contribute to inflamm-aging affect each person differently and these are stress, oxidative damage, upregulation of cytokine pathways, autophagy, stem cell aging and the presence of pro-inflammatory genes. In simple terms, if the individual leads an extremely stressful life, eats inflammatory food like fast food, has a sedentary lifestyle during midlife and perhaps has pro-inflammatory genes it will lead to premature aging and most likely inflamm-aging related diseases (table 1.) Typically, many years before these diseases become apparent a person will present with tiredness, joint pain, generalized muscle pain, inability to lose weight and have increased inflammatory biomarkers that are easy to check. Integrative anti-aging physicians routinely check these biomarkers as part of a preventive anti-aging workup. If trained in personalised anti-aging they can prescribe tailored lifestyle changes including eating plans, exercise regimes and nutrigenetic interventions whilst treating nutritional deficiencies and correcting inflammation etc. In the long run, they will all attenuate premature aging.
There are many theories of aging, but the hormonal theory of aging is the most accepted and studied in various publications. Over time, our hormones decline to cause many physical, mental and physiological changes Some of the hormones such as Growth hormone start to decline at age of 20 and already excessively decline in the late thirties, estrogen and testosterone in fifties, thyroid in any age from forty to sixty and further etc. Cortisol, on the other hand, tends to increase as we age contributing to the accumulation of visceral fat and building-up of the waistline that is regularly seen in the aged population. Estrogen, for example, governs 400 functions in the body and all these functions will be affected. The most annoying one is hot flushes, but cognitive decline, osteoporosis, increased insulin resistance, higher predisposition for stroke etc. are much more serious. Similarly, low testosterone in males, although seen as a major concern with regards to libido, it can have many serious outcomes such as increased risk of heart attack. Synergistically, when all hormones are low it affects the quality of life of an aging individual in all aspects.
Additionally, most of the postulated causes of aging such as excessive free radical formation, glycation, accumulation of waste products, inadequate repair systems, and deficient immune system may be as a result of hormone deficiencies. Even genetic causes such as premature telomere shortening and poor gene polymorphisms may be linked to hormone deficiencies.
Bioidentical hormone replacement prescribed by an integrative physician is an essential part of the anti-aging aim to restore the quality of life, prevent senescence and extend lifespan.
The biological age can be different from the chronological age that is determined by our date of birth. Apart from our genetic makeup, our aging is extensively influenced by our lifestyle. Lifestyle can influence our biological age in a positive or negative way making us actually older or younger than what we are! Checking if the biological age is in line, lower or higher than the chronological age it will help us to fully understand whether or not we are living a favorable anti-aging lifestyle. After the test is done we recommend personalised lifestyle changes that will modify the speed of aging and repeat the test after a suggested time frame to see how this slowed the aging process. (table 2.)
Individuals that are experiencing signs of premature aging or if they worry that aging is happening faster than expected can request this special test and take an active role in slowing down aging and age-related degenerative diseases.