Longevity: adding more healthy years

In this guest article by Avea you will find information on the current state of ageing research, which factors influence ageing and what you yourself can do to stay healthy for longer.

The wish for a long life is as old as humanity itself. Modern medicine, with its many new findings, is making an ever longer life possible for us. But that also brings the disadvantage that for many people the state of health deteriorates during these additional years.

Ageing processes are the number one risk factor for developing chronic illnesses and eventually dying from them. The current challenge, however, is that so far there has been only limited interest in preventing these chronic diseases.

Longevity medicine, which is not (yet) an independent medical discipline, is about developing effective primary and secondary prevention strategies in order to promote longevity in the sense of healthy ageing.

The main concern here is the healthspan, in other words that we spend as many years of our life as possible in good health and free of limiting illnesses.

20 to 35 % of human ageing is due to the genes. Accordingly, 65 to 80 % of ageing is attributable to a person’s own lifestyle and to environmental factors. A great opportunity for every individual therefore lies in preventive measures.

As we get older, many molecules in our cells begin to break down. They are no longer formed in sufficient quantity or their functionality is restricted, which can lead to health complications.

These include tiredness and a lack of energy, poor sleep quality, reduced cognitive performance, stress and anxiety as well as problems with weight, the skin or the cardiovascular system. Our lifestyle, meaning food, exercise, sleep and emotional experience, therefore has a considerable influence on how short of these molecules we are.

Since 2013 the researchers around López-Otín have now been able to identify
12 hallmarks of ageing (Hallmarks of Ageing) that are caused by a lack of important molecules in our cells:

1. Genomic instability
2. Telomere wear and shortening
3. Epigenetic changes
4. Loss of proteostasis
5. Disabled macroautophagy
6. Deregulated nutrient sensing
7. Mitochondrial dysfunction
8. Cellular senescence
9. Stem cell exhaustion
10. Altered intercellular communication
11. Chronic inflammation
12. Dysbiosis

Four basic hallmarks count among the causes of damage, as also shown below: the insufficient repair of our genes, the shortening of the gene caps (telomeres), the changes to the activating and deactivating structures around our genes (epigenetics), as well as the functionality of our body proteins, which act like cogs in the biological processes.

These four hallmarks then influence the work of our mitochondria, put them under increased stress, the metabolism no longer regulates itself adequately and ageing cells no longer die, which reduces the organism’s ability to function. Our stem cells become exhausted and the whole of cell communication is impaired.

In recent years three more have joined these nine hallmarks: disabled macroautophagy, in other words how well damaged cell components are disposed of or not, the development of a chronic inflammatory constellation and the imbalance in our gut flora, which in turn has a negative influence on our entire organism.

In short: yes, we can.

When we at Avea talk about healthy longevity, our focus is on extending the healthspan. The healthspan describes the period within a person’s lifetime in which they are healthy, and represents the time in which they live in good health and free of limiting illnesses.

If we extend these healthy years, this can, besides increasing quality of life, also lead to a longer lifespan. In Western Europe the average life expectancy is currently around 80 years, while the average healthy life expectancy is only about 65 years. That means we spend on average 20 % of our life in poor health.

When we look at the chronological age, those are the years you have already spent on earth, in other words your age as you know it. As for your biological age, that can differ from the years of life you have actually lived. The biological age is an assessment, in years, of the actual state of the body, its organs and its cells.

In summary it can be said that the biological age gives information about how quickly the body is ageing at a cellular and molecular level, while the healthspan concentrates on increasing the number of healthy, functional years in a person’s life.

The two are therefore inevitably connected. Both concepts are essential for understanding and promoting healthy ageing and general wellbeing.

Fortunately the healthspan and the biological age are not fixed and we can influence them positively. Various studies have shown that we can actively extend them. The reason for this lies in various cellular processes or pathways, longevity genes and epigenetic structures that are promoted or activated.

They bring it about that, for example, DNA repair is maintained or the mitochondria are protected from oxidative stress. These cellular processes or pathways, longevity genes and epigenetic structures include, among others, mTOR, sirtuins and Klotho.

The genes we have inherited from our parents stay with us for a lifetime. Even so, it is in our own hands how long we stay healthy. Environmental factors largely influence our epigenetics, which in turn determines whether certain genes are switched on or off.

By fine-tuning our epigenetics we can age healthily and enjoy every moment of this journey. Every person has a unique genetic and epigenetic profile.

Our longevity genes are more likely to be expressed if we supply our cells with what they need most.

As already mentioned, lifestyle can make the decisive difference to how long we stay healthy.

1. Diagnostics and analysis
Blood biomarkers, genetic tests, physiological tests, data from wearables

2. Lifestyle measures

• • An adequate amount of exercise in the form of endurance and resistance training (at least 150 minutes per week)
  • Stress and recovery training
  • Promoting sleep quality
  • A health-promoting diet, for example a Mediterranean diet, intermittent fasting, caloric restriction
  • Non-physical aspects: personal characteristics and environmental characteristics

3. Specific molecules in the form of supplements

Compounds that activate impaired cell processes and compounds that inhibit the main causes of ageing: NMN, apigenin, NR, resveratrol, spermidine, ubiquinol, fisetin, quercetin, ergothioneine, PQQ etc.)

4. Non-pharmacological: microdosing and measures
such as hyperbaric oxygen therapy, infrared light, cold therapy, blue light blockers etc.

In future, experimental strategies and measures will be developed to influence the healthspan actively, such as CRISPR-CAS genome editing, special peptides or mitochondria transplants. This will certainly still require the legal framework.

At a cellular level both fasting and NMN supplementation raise the NAD+ level and activate the sirtuins, our longevity genes. Sirtuins react to these changes by promoting cellular processes that improve cell survival and repair, for example DNA repair, autophagy and mitochondrial biogenesis.

This leads to less inflammation, improved mitochondrial function and a reduction in oxidative stress. On top of that, fasting can lead to weight loss and improved insulin sensitivity and can even reverse the biological age when it is carried out correctly.

Fasting stresses the body, but in a positive sense. Hormesis is a state in which something challenging, in the right amount or intensity, stimulates the organism and does it good. Through the (positive) stress that is triggered, the body becomes stronger, healthier and better prepared to cope with more later on.

Think of a basil plant from the supermarket and compare it with one from your own garden: the one from the garden has developed thick stems because it was exposed to wind and weather at all times.

Fasting is a form of hormesis that can promote adaptation and resilience. When nutrients and energy are withdrawn from the body, various adaptive stress response pathways are activated, which leads to improved general health and longevity. Diet and fasting go hand in hand.

You can start so-called intermittent fasting by eating within a 12-hour window every day. For example, you can eat from 8 in the morning until 8 in the evening and fast for the remaining 12 hours.

Taking NMN acts here like a fasting mimetic, a natural molecule that, by raising the NAD+ level, offers metabolic benefits similar to those of fasting. An NMN supplement induces hormesis and so provides insulin sensitivity, increased fat burning and protection of sensitive cell processes.

Ageing and lifestyle are closely linked with one another and are also the reason why we develop illnesses and become frail in old age. At the same time we can influence our healthy years, right into old age, to a high degree through our lifestyle.

With healthy routines, such as regular exercise, a Mediterranean and time-restricted diet, healthy sleep and targeted supplementation. In this way we influence important cell processes and activate longevity genes, which can extend our healthspan as well as our quality of life.

You will get to know all these healthy routines and the right diet for a long life in the Longevity Challenge. In just 10 weeks you will become an expert in your own longevity and find out how to gain many healthy years of life.