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.

Another Use for CoQ10: Diabetes

Coenzyme Q10 has long been known for its antiaging properties, especially in the cases of energy production and cardiovascular health. Now, it seems as though we have another use for the not-quite-a-vitamin, the prevention and mitigation of diabetes.

One little-publicised cause of diabetes may be the use of statins, marketed as "prevention" for cardiovascular events. Some statins, such as rosuvastatin, are linked with a 27% higher risk of type II diabetes! Two meta-analyses also found an elevated risk of diabetes, one with a 9% higher risk, and the other showing a 12% higher risk. This disproportionately affects the elderly, who are most likely to be prescribed statins.

So why do statins raise the risk of diabetes? Statins work by blocking an enzyme called HMG-CoA reductase, but this also blocks a precursor to coenzyme-Q10. Depletion of CoQ10 disrupts mitochondrial function, and besides affecting energy levels, this also has a negative impact on insulin signalling, which could lead to the blood glucose dysregulation known as diabetes. To make things even worse, lowering LDL cholesterol also reduces CoQ10 transport into cells, with the combination of these effects depleting CoQ10 by as much as 54%.

Even these could protect cardiovascular health
more than some drugs. Source: Evan Amos

This is why medical professionals now often recommend CoQ10 supplements to anyone taking statins. In fat cells exposed to statin drugs, the coenzyme can restore the normal glucose uptake mechanism that the drugs also disrupt. Additionally, CoQ10 has been found to reduce blood sugar and HbA1C levels in diabetic patients. Blood sugar tests only take a picture of how your glucose regulation is doing now, haemoglobin A1C gives an idea of your blood glucose regulation over the past four months, as it shows how much sugar has been tangled in the haemoglobin proteins. The root cause of many diabetes complications is loss of endothelial function (the lining of the blood vessels), which leads to poor blood flow and tissue destruction in parts of the body such as the eyes, kidneys and toes. Worse still, this can even affect the heart, causing something known as diabetic cardiomyopathy (heart muscle damage). Fortunately, supplementation with 200mg of CoQ10 has been found to significantly improve loss of endothelial function in diabetes, which may spare many from crippling complications.

But do we even need these CoQ10-depleting statins? Research has actually shown that statins may be more harmful than beneficial for the heart, even if there were no alternatives. Statins have been found to increase the risk of microalbuminuria, which is a known marker of blood vessel dysfunction. Other studies have found that some statins could worsen heart function, increase LDL oxidation (which is the cause of plaque!), cause heart failure and/or atrial fibrillation (a fluttering movement that does not pump blood!), reduce blood flow to the heart and weaken the heart muscle. The CoQ10 depletion may also be behind the increase in congestive heart failure in the USA. It is very fortunate that even "mere" diet advice can also protect against cardiovascular deaths, such as eating an apple every day - which may reduce LDL cholesterol by an impressive 40%! Overall, CoQ10 deficiency can be debilitating and even dangerous, but you don't have to suffer.

Purpose and Longevity

We know instinctively that meaning and purpose are necessary in order to live a fulfilling life, with those of us in a career we love often held in high regard. And regardless of how passionate you may be about your career, we all need a hobby - an interest outside of work that we truly love to do. The benefits of purpose and hobbies, however, go beyond quality of life and into quantity as well.

Purpose can light up your life!

Japanese culture has a concept called ikigai, which roughly translates to "purpose in life". Ikigai has traditionally been associated with health and longevity, so a recent study on over four thousand adults set out to determine if this theory was true. All participants were over 65, with over 1800 identified as at high risk of death, over 1200 at high risk of losing ability to perform activities of daily living (ADLs), and over 1100 at risk of losing their ability to perform instrumental ADLs. Data from February 2011 to November 2014 was used, which can be a long time when it comes to age-related disability. Compared to people who had both hobbies and an ikigai, having neither of these was associated with double the risk of mortality, close to triple the risk of losing ADL abilities and almost double the risk of losing IADL abilities! This was adjusted for age, gender, BMI, income, alcohol and tobacco consumption, cognitive function, depression and number of chronic illnesses. Therefore, hobbies and ikigai were linked to increased longevity and healthy life expectancy in older adults.

This was not the only study that found a link between purpose in life and longevity. An American study on 6000 adults, with a 14-year follow-up time, found that people who initially reported a strong purpose in life had a 15% lower risk of dying. In a NIH-funded study that followed people aged from 65 to 92 for 11 years, those who described clear goals and purpose lived both longer and better than those who did not. In fact, other "Blue Zone" cultures (areas with a high prevalence of centenarians) besides the Okinawans of Japan value purpose, with the Nicoyan (Costa Rica) people calling it plan de vida.

So how can you find your own ikigai, if you haven't already? A great way to start is by doing an internal inventory. Take a piece of paper, and for 20-30 minutes think of all your ideals, principles, standards and morals, then think of your physical, mental and emotional talents, strengths and abilities. It can take a while, maybe even a couple of attempts, to get an idea of what you really want, but you know you're getting close if anything brings out a strong emotional reaction. And then...put your skills into action! It's also important to build relationships with people who can help you achieve your goals. Overall, longevity is for everyone, and it turns out that some of the best ways to extend your life also improve its quality.

Could Herbal Birth Control Be Available Soon?

Natural systems of medicine, such as European naturopathy, traditional Chinese medicine and Ayurveda, are very popular among couples struggling with infertility. But what about those of us who don't want children? Conventional methods of birth control include hormonal drugs, which often cause nasty side effects, implants and surgery - but what if there was a more natural approach, one with side benefits?

It turns out that this could become a possibility. Centuries before the oral contraceptive pill was approved in 1960, women tried all sorts of methods to prevent unwanted pregnancy. Staunch supporters of modern medicine (only) like to point and laugh at use of crocodile dung and cat testicles, but there were much more pleasant remedies around. One of these is the thunder god vine, also known as Tripterygium wilfordii in scientific circles. In a research article published on the 15th of May, 2017, scientists at the University of California describe exactly how two phytochemicals present in the medicinal herb can prevent fertilisation.

Cycle tracking beads. Source: Dellex.

When a sperm cell travels through the female reproductive system, its flagellum (whip-like tail) lets it swim forward. If it finds an egg, this flagellum must go into a "drilling" mode to allow it to penetrate through the egg's jelly lining. The drilling mode is impossible without a reaction between progesterone and a protein that sperm produce called ABHD2. Pristimerin and lupeol, two phytochemicals found in thunder god vine, were able to block this reaction. Only a tiny amount of these were required to prevent fertilisation - about 10 times less than the amount of levonorgestrel in Plan B. This also explains why infertility is often reported after the herb's more common use as a natural anti-inflammatory for problems such as arthritis. In the future, these, either isolated or maybe as part of a standardised herbal extract, could become a low-dose, safer form of birth control for both genders. Unfortunately, human clinical trials are years away.

There are also other forms of "natural family planning", such as the Billings ovulation method, which are free of side effects, but may be less reliable. In a small study, 15 Turkish women monitored their fertility across 30 menstrual cycles using both the Billings method and urinary levels of luteinising hormone (LH), which spikes during ovulation. The Billings method detected a potentially fertile period of 10 days, with a "peak" in the cervical mucus sign on day 13 (as an average, day 13.65). The surge of LH that accompanies ovulation also peaked on day 13 (as an average, day 13.65), and lasted for five days. This association was deemed significant, and it was concluded that women can use this method effectively. However, it is a small study, and every woman is different. According to the World Health Organisation (1981, sourced from Wikipedia), this method is at least 97% effective with "perfect use", and 77-99% effective with "typical use". In other words, it seems best to stick to the Billings method's precise rules, and probably use a condom as well. So, in conclusion, you don't have to put up with birth control side effects just because you were born as an opposite sex-attracted woman. However, you do need the correct training to use natural family planning methods, and will probably have to wait several years for proven herbal methods.  This article is not intended to be birth control training or advice, it is just for general information.

Air Pollution May Be an Ignored Cause of Cancer

When you try to convince your chain-smoking uncle or fast food-addicted cousin to make healthier choices in order to prevent cancer and other diseases, they probably will point to a "healthy" person who did "everything right" and still got cancer. Oh, but my mum ate so healthy! Oh, but Farrah Fawcett was so fit! The truth is, however, that cancer prevention isn't totally an individual effort. There are things that we as a society must address, such as air pollution.

This lil' bug may just save your life. Source: Danrok

For this recent study, the US EPA's Environmental Quality Index, a county-level measure of over 200 environmental variables, was compared to SEER state cancer profiles. Data on cancer rates was available for 85% of the over 3100 US counties. The average age-adjusted cancer rate in the US is 451 cases for every 100,000 people. The counties with poor environmental quality had, on average, 39 more cases per 100,000 people than those with high environmental quality. The main factors linked with higher cancer rates were air pollution, the presence of highways and the availability of housing and public transport. Of course, highways, public transport and the location of houses are factors that affect air pollution too. Urban areas showed the strongest associations, most likely because there are more things like cars which consume fossil fuels. As for which cancers were most affected by air pollution, breast and prostate cancers have the strongest associations. Maybe instead of the "early detection is the best protection" line used to promote mammograms (which sounds quite like propaganda), how about "environmental protection is the best prevention"?

This is not the only study linking air pollution to cancer. In 2012, the IARC confirmed that diesel exhaust does cause cancer. In the USA alone, diesel fuel use causes over 50,000 deaths every year, and it's nowhere near as dirty as the diesel used in other countries! This doesn't just include cancer, but also emphysema, bronchitis, heart disease and severe asthma attacks. There is also a link between acute lymphocytic leukaemia (ALL) and living close to oil and gas wells. On the other hand, when air quality regulations in California caused the level of diesel pollution to drop by 68%, the risk of developing cancers from the toxins in diesel dropped by three quarters! Cancer incidence in general has declined in the USA too, due in no small part to "personal" air pollution, i.e. smoking, falling out of fashion. While 451 per 100,000 is still too many, the age-adjusted cancer rate was 511 per 100,000 in 1992, when incidence peaked. So when someone develops cancer, it may not be all their fault. It may be society's responsibility to clean up the world, so we can all live long, healthy lives, and make what diseases that would remain easier to treat.

Five Ways to Fight Wrinkles

While it isn't the worst sign of aging, as it won't kill you, wrinkles are surely the most visible sign of aging. Millions of dollars are spent every year in attempts to fight them, with varying degrees of efficacy, to the point that "anti-aging" is often shorthand for "anti-wrinkle". If youthful beauty is your thing, you don't want to waste time and money throwing everything and anything you can find at the problem. Simple, targeted approaches that benefit your overall health are best. There are many ways to fight wrinkles, and what is best depends on the individual, but here are 5 of the most basic ones, starting with...

1) Stress management: Poorly managed stress causes wrinkles in more ways than simply frowning all the time. Chronic stress, whether it be psychological or physical, will activate the fight/flight response just as acute stress (which isn't usually harmful) does. In this response, levels of adrenaline and cortisol rise dramatically in order to give you the energy needed to escape the "threat". Sustained levels of high cortisol causes protein breakdown (so it can be used as energy), and the collagen and elastin in your skin is not exempted. This leads to more wrinkles, thin skin, easy bruising and dryness. Once again, however, the best ways to reduce stress and improve stress management depend on the individual, so seeing a qualified naturopath is recommended.

2) Sleep hygiene: As if poor sleep didn't cause enough problems already, it also contributes to skin aging! Research on 60 women without chronic illnesses found that poor sleep quality and duration (less than 5 hours a night) was linked to higher skin aging scores and even poorer resilience against UV exposure. Women who slept well had a 30% better response to a skin barrier challenge.

Green tea. Source: McKay Savage (CC BY-SA: 2.0)

3) Diet: Yes, diet affects skin aging too, and those articles saying that sugar speeds aging aren't all clickbait! A diet that causes chronically elevated blood sugar increases the formation of advanced glycation end-products (AGEs), which tangle in proteins such as collagen and elastin, thus speeding up aging. They also lead to a vicious cycle of inflammation and oxidative stress (more aging!). Common herbs and spices, including cinnamon, garlic, oregano, ginger and cloves may inhibit AGE production, especially when cooking, as high-heat methods such as frying, grilling and roasting generate them too.

4) Avoid pollution: This one is taking a collective effort, with the switch to clean energy and electric vehicles from fossil fuels well underway, but even though it's not happening overnight it will be worth it in the end! In a study of elderly women, exposure to traffic-related air pollution was strongly linked with skin aging, which included more pronounced wrinkles and 20% more age spots. As exposure to pollution is still unavoidable, enhancing your detoxification abilities is important, but the best way to do it depends on the individual (again).

5) Green tea polyphenols: Polyphenols are antioxidant chemicals found naturally in green tea (among other sources), which can protect against UV-induced sunburn, skin aging and immune suppression. In a clinical study of 60 women without skin conditions, drinking a beverage with green tea polyphenols led to less UV-induced redness and better skin quality overall, compared to placebo. Elasticity, roughness, hydration, density and scaling all improved. Green tea improved blood flow and oxygen delivery to the skin, which may boost regeneration.

Like other aspects of aging, skin aging isn't something you just have to accept; there are ways to mitigate it, which benefit your overall health too. And besides, research and clinical experience related to anti-aging is building up every day - we live in exciting times.

The Benefits of Coffee Strike Again

Coffee has been conventionally seen as a vice, something that busy business types drink as a stimulant and performance enhancer, until adrenal burnout catches up with them. While yes, too much coffee can be harmful to your health, there is much research showing the health benefits of moderate consumption. The latest study takes us to Italy, and finds a relatively simple way to prevent one of the most common chronic illnesses in men.

Old macchinetta. Source: Rafiq Sarlie

The illness that I'm talking about is prostate cancer, something associated with much fear, embarrassing symptoms, and embarrassing tests to check for it. We have known for years that lifestyle changes can reduce men's risk of developing it, but whether or not coffee can help out had been up for debate. That is where this study comes in. Researchers analysed the coffee consumption and prostate cancer incidence among almost seven thousand men in Italy, where prostate cancer risk is much lower than other developed countries. Over the four-year study period, men who drank three or more cups of coffee every day had a 53% lower risk of prostate cancer than men who only had two or less.

But...why coffee? The researchers then looked at the effects of coffee extracts on prostate cancer cells in the lab. Caffeinated extracts were able to reduce the ability of prostate cancer cells to grow, divide and spread, while decaffeinated extracts could not. This is most likely caused by a synergistic reaction between caffeine and other bioactive, antioxidant compounds in coffee.

Unfortunately, however, not all coffee is created equal. Most of the men in this study would have been drinking Italian-style coffee, which is prepared differently to coffee in countries like the USA. The use of filters is common in the USA, which can reduce the amount of beneficial nutrients and compounds that actually make it from the ground beans to what we drink. As you can see in these instructions, optimal extraction of compounds such as essential oils also requires high pressure and hot to boiling water. The most expensive macchinetta machines, found in espresso bars, produce about 9 atmospheres (900kPa) of pressure, but the more traditional ones for home use go to about 1.5 atmospheres (150kPa). Boiling the water causes it to rise through the coffee grounds, extracting the caffeine and other phytochemicals, and into an upper chamber. It is not as simple as pouring water on any old instant coffee, but whether you're drinking it for the flavour or health benefits, it's worth it!