A scientific approach to "anti-aging"

by Dr. Joseph Debé

Anti-Aging is the newest specialty in healthcare. With scientific knowledge doubling every four years, some experts predict that this generation will have an average lifespan of about 120 years. Probably more important than extending lifespan, however, is the prospect of prolonging healthspan. We have seen significant increases in average life expectancy in the twentieth century but with it has come prolonged disability due to degenerative diseases. Who wants to live to be 120 if forty of those years are spent with serious physical and cognitive impairment? The main focus of Anti-Aging health care therefore, should be on promoting optimal physical and mental-emotional functioning.

Although high-tech interventions will play a role in Anti-Aging, lifestyle and environmental factors are of utmost importance. It is estimated that genetic make-up only contributes twenty-five percent of our state of health after age forty; lifestyle and environment account for seventy-five %. The trick is to match the right lifestyle and environment to the individual’s genes. Each person has different genetic susceptibilities and therefore needs a somewhat different health promotion program. The benefits obtained by following generic public health recommendations pale in comparison to those that can be achieved by tailoring programs to each individual. For example, individuals who, due to genetic factors, develop elevated tissue levels of the toxic amino acid homocysteine are at increased risk to heart disease, stroke, dementia, arthritis, osteoporosis, and cancer. These individuals (representing at least ten % of the population) need much greater intakes of folic acid, and/or vitamins B6 and B12 in order to maintain normal levels of homocysteine. By measuring homocysteine in the blood or urine, we can identify those individuals who need more of these nutrients and thus reduce development of degenerative diseases and premature death. It is estimated that over the past thirty years, one and a half million Americans died prematurely because they were not getting enough B vitamins to keep their homocysteine levels in check.

There are many theories of aging. Some involve processes over which we presently have no control. There are however, a number of well-accepted mechanisms of aging that are modifiable by different interventions. What’s more, these processes can be measured with special laboratory tests. A few of these contributors to the aging process are:

The mitochondrion is commonly referred to as the "powerhouse" of the cell. It is in the mitochondria that food is combined with oxygen to produce energy. This energy is used for all the body’s diverse activities. Mitochondria are important in the aging process for two reasons: their role in energy production and generation of free radicals.

Although we cannot survive without oxygen, it is also oxygen that contributes to our demise by forming free radicals, which are unstable and highly reactive molecules that alter metabolism and damage physical structures. The mitochondria are the major site within the body for the production of free radicals. In a healthy state, about twenty percent of the oxygen we breathe forms free radicals. When the mitochondria are malfunctioning, more free radicals are formed. Toxicity, stress, and nutrient inadequacy adversely affect mitochondrial function.

Mitochondria possess DNA (genetic material), which is very vulnerable to mutation (damage) from oxidative stress (free radicals). When mutation of this DNA occurs, mitochondrial function may be severely damaged. It is easy to get into a cycle of poor mitochondrial function, oxidative stress, mitochondrial mutation, further impairment of mitochondrial function and so on.

Not only does mitochondrial impairment contribute to aging by increasing free radical production, but reduced generation of energy plays a role as well. The second law of thermodynamics basically asserts that everything becomes disordered over time. As applied to the human body, we undergo degenerative changes with age; loss of normal structure and function. This natural trend is combated by the combination of organizational information (DNA) and energy. As our cells "run out of gas" due to mitochondrial failure, degeneration and eventually death result. Mitochondrial impairment is often first observed in the cells that contain greater numbers of mitochondria: the cells of the heart, brain, muscles, liver, immune system, and gastrointestinal lining. For instance, mitochondrial malfunction within brain cells results in cognitive impairment and death of those cells, contributing to Alzheimer’s and Parkinson’s diseases.

What can be done to protect the mitochondria? We need to reduce oxidative stress and assure adequate nutrition. Common sources of oxidative stress are: toxicity, chronic inflammation, glycation, stress, excessive exercise, some medications, alcohol, cigarette smoke, and dietary factors such as consumption of refined carbohydrates (white sugar and flour), saturated fat, and fried oils. Overeating may be another source of oxidative stress, as more food burned within the mitochondria results in more free radical production. Animal studies have actually demonstrated that caloric restriction extends lifespan. Many nutrients are critical for proper mitochondrial function and protection from oxidative stress. The diet needs to supply quality proteins, fats, carbohydrates, and antioxidants. Antioxidants are found in abundance in unprocessed plant foods. Supplemental nutrients of particular importance to mitochondrial function include coenzyme Q10, creatine monohydrate, alpha lipoic acid, vitamin E, N-acetylcysteine, N-acetyl carnitine, NADH, ipriflavone, reduced glutathione, vitamin B2, sodium succinate, zinc, copper, selenium and manganese. Aerobic exercise also improves mitochondrial function and increases the body’s antioxidant defenses.

In any given case of mitochondrial dysfunction, other nutrients may be required in greater concentration. Two particularly good tests for assessing mitochondrial health are the Oxidative Stress Analysis and the Organix™ (Organic Acid Analysis). The Oxidative Stress Analysis is a laboratory test performed on blood and urine specimens to evaluate levels of oxidative stress and adequacy of the body’s antioxidants. The Organix™ utilizes a urine sample to measure concentrations of compounds produced by the body’s metabolism. Several of these organic acids are produced within mitochondria. Abnormal levels of mitochondria-derived organic acids signify altered mitochondrial function. This information can be used to tailor therapy for the individual to improve mitochondrial function.

Dysglycemia is basically abnormal fluctuations in levels of blood sugar. Dysglycemia accelerates the aging process in a number of ways. It raises levels of insulin, which contributes to obesity, hypertension, atherosclerosis, and accelerated tumor growth. Dysglycemia produces pro-aging imbalances of other hormones as well. Some of these hormonal abnormalities in turn lead to further dysglycemia. Dysglycemia impairs immune function, increases inflammation and leads to increased protein glycation. Dysglycemia is the metabolic precursor of impaired glucose tolerance and adult-onset diabetes. Diabetes complications include vascular disease, and eye, nerve and kidney damage.
Glycation, which is the combining of glucose with proteins, occurs continuously throughout the body. The higher the levels of glucose in the blood and the longer they stay elevated, the more glycation occurs. Insulin resistance, which results from prolonged dysglycemia, allows blood glucose to rise to abnormal levels. Glycation results in altered structure and function of the protein. Glycation also contributes to inflammation and to increased oxidative stress and mitochondrial damage. The rate of protein glycation has been found to correlate with biological aging. Skin aging, loss of flexibility, periodontal disease, and cardiovascular disease are a few of the conditions that can result from protein glycation. Like oxidative stress, glycation is something we cannot eliminate. We can however, slow it down.

Blood sugar levels are influenced by many factors. Dysglycemia and glycation can be controlled by: eating a balance of unrefined carbohydrate, fat and protein at each meal; eating smaller more frequent meals; limiting intake of excessively-cooked animal products (The higher the cooking temperature and the longer the cooking time, the more advanced glycation endproducts [AGEs] form in the food. Dietary AGEs are partially absorbed, with adverse consequences.); supplementing with benfotiamine, carnosine, taurine, chromium, zinc, magnesium, vanadium, B vitamins, vitamins C and E, arginine, taurine, alpha lipoic acid, coenzyme Q10, borage oil, fish oil, and herbs such as Gymnema sylvestre, Fenugreek, Bitter melon, and Siberian ginseng; regular aerobic and resistance exercise; assuring balance of other hormones such as cortisol, DHEA, estrogen, progesterone, insulin-like growth factor-1, and thyroid hormones; and in resistant cases, medication.

Dysglycemia and glycation can be measured by laboratory tests. Dysglycemia is best assessed by a Carbohydrate Challenge Test, which tracks glucose, insulin and cortisol levels for three hours, while fasting and after eating a high carbohydrate meal. This type of evaluation can identify blood sugar abnormalities ten years before the onset of diabetes. Glycation is evaluated by measuring levels of the glycated proteins hemoglobin A1c and/or fructosamine from blood specimens.

Inflammation is the immune system’s proper response to tissue injury or infection. Inflammation does more harm than good, however, when it is prolonged. Chronic inflammation contributes to a variety of degenerative diseases, including Alzheimer’s disease, arthritis, cardiovascular disease, osteoporosis, and metastasis of tumors. 
A number of factors can result in chronic inflammation. Allergens, toxins, free radicals, chronic infections and stress can all lead to chronic inflammation. The diet one consumes can also contribute to inflammation in a variety of ways.

Chronic inflammation can be assessed by tracking blood levels of inflammatory markers such as C-reactive protein. When chronic inflammation is identified it should prompt a search for the underlying causes. The gastrointestinal tract is the site of much inflammation due to parasitic bacteria, maldigestion, leaky gut syndrome, and abnormal food reactions. Gastrointestinal health can be assessed by way of a Comprehensive Digestive Stool Analysis. Blood specimens can be checked for signs of additional bacterial and viral infections. Next, urine porphyrin testing can be performed to check for toxic metal (mercury, lead, aluminum, etc.) burden. Blood testing for food intolerances can also be revealing. Finally, the diet should be checked for a variety of factors, including excessive sugars and its make-up of fatty acids, which are the precursors to some of the body’s most important inflammatory compounds. Fatty acid balance can be most precisely assessed by blood analysis. Evaluation and treatment for mental-emotional stress is also necessary. A variety of nutritional supplements can also play an important role in reducing chronic inflammation. Perhaps the most complete product is Metagenic's medical food called Ultra InflamX.