Wednesday 31 May 2017

Aging is Almost Officially a Disease

Finally! After all of these years, aging itself is on its way to be officially classified as a disease. Of course, it's taken decades of improving life expectancy and survival rates due to better living standards and lifestyles, but we're here! This means that antiaging will be taken more seriously by the health industry and society as a whole, including insurance companies.

So, what happened exactly? Well, two years ago, researchers managed to convince the US FDA to approve a human lifespan study of metformin, which is currently used for blood sugar control. If all goes well, it will be the first drug approved specifically to treat aging. The study, known as the TAME Study (Targeting Aging With Metformin) started up in 2016, aiming to enrol 3,000 people aged 70-80 and study the effects of metformin over 5-7 years. Everyone must be at risk of or have one or more of the following: cancer, heart disease or dementia. If metformin can delay or prevent these and delay death, the next step is to test it in younger people.

But why metformin? High blood sugar and insulin resistance are key factors in aging and other complex, chronic illnesses, such as cardiovascular disease and cancer. But this is not the only way that metformin could fight aging. Metformin works by acting on an enzyme called AMPK (adenosine monophosphate-activated protein kinase), which regulates how cells process energy. AMPK boosts metabolism, which may aid weight loss by burning more sugar and fat; improves blood flow and body composition; aids cell detoxification and renewal; and has antioxidant, anti-inflammatory effects. On the other hand, unaddressed aging results in slowing metabolism and weight gain; muscle loss; poor circulation and detoxification and a vicious cycle of inflammation.

Gynostemma pentaphyllum. Source: Lioman
Is metformin really the best solution to aging? Unfortunately no. Aging is a complex disease involving chronic inflammation, so health and longevity promoting strategies that target the whole person are likely to be far more effective. As it is multifactorial, focusing on one aspect of it is probably not the best strategy, as other complex, chronic diseases do not respond to this method. Metformin is not without side effects, either. It has a black box warning for the rare-but-dangerous side effect of lactic acidosis, which is especially problematic in reduced kidney function. It may also be pro-inflammatory and increase production of beta-amyloid protein, which gets tangled in brain tissue as it accumulates and causes the symptoms of Alzheimer's disease. If you want to use pharmaceutical drugs, aspirin is an anti-inflammatory AMPK activator.

So what can we do to fight aging? There are natural antiaging therapies that also activate AMPK, without the side effects. Intermittent fasting, where food intake is confined to 8-12 hours of the day, has been shown to promote longevity and fight age-related diseases. Exercise not only keeps the musculoskeletal and cardiovascular systems strong, but also activates AMPK, especially in HIIT. Cold water immersion, especially after exercise, also enhances AMPK. There are also herbal remedies that can activate AMPK, in particular Gynostemma pentaphyllum. A human study involving diabetic patients found that this herb reduced haemoglobin A1c ten-fold, which measures the rate of glycation (a very pro-aging process), decreased insulin resistance by three-fold and did not cause dangerously low blood sugar. It has been used as a pro-longevity herb in some Chinese circles for six hundred years, but only now do we know exactly how it works and how to best use it. While metformin may be a promising treatment for aging, there are natural alternatives that could be far superior.

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