Anti-aging Strategies

The life span of people has significantly increased in the past century. However, “successful aging” i.e. a condition when people in their sixties and above show no significant disease or disability is still a challenge. There are growing incidences of various chronic illnesses like cardiac disease, diabetes, neurodegenerative diseases, cancer and musculoskeletal disorders. These illnesses not only increase the morbidity and mortality but also affect the quality of life or activities of daily living. Researches on aging process and its remedial measures are directed towards reducing chronic ailments and improving quality of life. Slowing down the aging process or postponing the age related disorders would be of great help to the society in terms of health and cost.  

Experimental studies have demonstrated that aging or increased life span depends on genetic, environmental and dietary factors. Besides, few medical interventions have led to slowing of aging and improving the life expectancy. Some of the approaches that have shown to delay aging or improve quality of life in older population are as follows: 

Autophagy:

Autophagy is a housekeeping machinery to clear damaged cells, pathogens and misfolded proteins. It helps to preserve energy in the cells against stress. Enhancement of autophagy is one of the suggested strategies to treat metabolic diseases, cancer and neurological problems like Alzheimer’s disease and Parkinsonism. Autophagy modulates the aging process. Some of the well-known enhancers of autophagy are metformin and resveratrol. Metformin is a widely used antidiabetic drug and resveratrol is found in grape’s skin. Besides certain drugs and natural substances, calorie restriction and intermittent fasting have also shown to increase autophagy. These result into slowing down the aging process and delay the onset of various ailments. Some dietary supplements also have shown to slow down aging process by stimulating autophagy.

Removal of Senescent (aged) Cells:

Senescence is a common feature during aging process with increased number of senescent cells. There are several senolytic drugs targeting the aged cells that could be potential remedy for delaying the aging process.

Transfusion of Plasma:

Transfusion of blood from young to aged can rejuvenate the aging cells and tissues. Many studies in animals have suggested that joining an aged animal to a young animal leads to beneficial antiaging effects. It enhanced neurogenesis and neuroplasticity in aged brain.

Calorie Restriction:

The epidemiological and experimental studies have demonstrated that calorie restriction enhances longevity. People living in Okinawa, a Japanese island have nearly five times higher number of centenarians than any other part of the world. It was found that these people consumed 17% fewer calories than the average adult in Japan and 40% less calories than average adult in USA. Other beneficial effects of calorie restriction are improved gut microbiomes, reduced aging of brain cells, improved cognition and memory, protection against dementia and good cardiac and metabolic functions.

Intermittent Fasting:

Studies have shown that intermittent fasting has similar effects as calorie restriction. The beneficial effects of intermittent fasting are better cardiac function, reduced body weight, lowering of blood sugar and blood cholesterol. There are favourable effects on cognition and memory, reduced inflammatory response, and suppression of detrimental genetic pathways. Many variations of intermittent fasting are being practiced. The most popular protocol (16/8) of intermittent fasting is fasting everyday for 14-16 hours by restricting eating window to 8-10 hours. American Heart Association recommends taking food only between 6 AM to 6 PM. This results into good cardiac health and favourable effects on body weight and metabolic function. Another protocol is 5:2 plan that involves standard eating of 5 consecutive days followed by restricted calories (500-600 calories/day) in the next 2 days. Eat stop diet plan involves 24 fast once or twice in a week.    

Enhancement of Neurogenesis:

Studies have shown that neurogenesis in the brain decreases during aging. There are reductions in stem cell factors and cerebral blood flow during aging process. Neurogenesis can be enhanced by physical exercise, exposure to good and healthy environment, choline supplementation and curcumin treatment. Physical exercise provides significant benefits for cognition and memory.

Physical Exercise:

The benefits of physical exercise for favourable effects on heart, brain and musculoskeletal system is well known. There is increased blood flow to muscle and brain. Physical exercise reduces the age related deterioration of cellular system which favourably affects multiple organ functions. It increases mitochondrial levels (energy resource) in brain, heart, liver and kidney. Physical exercise increases neurogenesis and cognition. Therefore, regular exercise is a necessary life style change for maintaining good health during old age. It is important to start physical exercise early in life to avoid or postpone neurological dysfunctions. A recent study suggested that exercising for at least 52 hours over six months duration is associated with improved neurological performance in older adults.

Antioxidants & Herbal Supplements:

Oxidative stress due to the formation of reactive oxygen species (ROS) has significant effects on the development of age related problems like arthritis, diabetes, dementia, cancer, atherosclerosis, obesity, osteoporosis and metabolic syndromes. Antioxidants have beneficial effects on these disorders. They scavenge the free radicals and prevent cell damage. Dietary supplementation of antioxidants is a good strategy in slowing down the aging process. The most promising antioxidants for neurological functions are curcumin and resveratrol. Use of resveratrol with standard antihypertensive treatment has shown to control the blood pressure without the need of any addition antihypertensive drugs. Resveratrol has anti-inflammatory effects, and beneficial effects on heart by increased production of nitric oxide. It also reduced blood cholesterol and degeneration of neurological system. Long term use of curcumin has shown enhanced mood and reduced fatigue. Curcumin an ingredient found in Indian kitchen improves memory over 18 months in non-demented person. Several herbs are suggested to promote longevity.  Astragalus membranaceus, a Chinese herb has shown to increase telomerase activity (increasing life span), antioxidant, anticancer, immunomodulator and protective effects on liver.

Hormones:

DHEA (Longevity hormone):

Dehydroepiandrosterone (DHEA) is a steroid hormone that is a precursor of sex hormones (testosterone and estrogen). The blood level of DHEA decreases with age. It has been extensively studies for its effects against aging, muscle wasting, obesity, and menopausal symptoms. Research is currently focusing on its anti-aging effect, with contradictory results. The benefits of DHEA supplementation in individuals over 60 years of age (men and women combined) was studied and shown toimprove bone density, skin quality and libido, with a slight increase in sex hormones, especially in women. DHEA is beneficial for thmaintenance of muscle mass and regulates muscle gain.

Human Growth Hormone:

Human growth hormone that is secreted from pituitary gland in the brain is claimed to reverse aging, improves athletic performance, increases muscle strength, increase endurance, and decreases body weight. However, all these claims are unproven.

Melatonin:

Melatonin is a hormone produced in the brain, needed for maintaining good night sleep has a potent antioxidant properties. It protects skin damage due to UV radiation. However, the benefits of melatonin as an antiaging hormone can be achieved by its local and topical use. Oral intake of this hormone does not provide significant benefits for skin health.  

Skin Aging:

Skin aging consists of two independent distinct processes. The first chronological (age related) aging is an intrinsic process and second is extrinsic process due to external factors like sun exposure, UV radiation, smoking, pollution, sleep deprivation and poor nutrition.

Skin aging can be prevented or delayed by well-regulated life style, calories restrictions, physical exercise and avoidance of mental stress. The role of balanced nutrition is key for both intrinsic and extrinsic skin aging. Many supplements like carotenoids, Vitamin E, flavonoids, Vitamin A, C & D, omega -3 fatty acid, some proteins and Lactobacilli (probiotic) enhance skin health and beauty.

Vitamin C (Ascorbic Acid): Adequate intake of Vitamin C is essential for healthy and good skin. Natural sources of Vitamin C are fresh fruits & vegetables, citrus fruits, guava and chilli pepper. Nutricosmetic products with ascorbic acid are used as free radical scavengers. Both topical and systemic use of ascorbic acid has a good photoprotective effects. Vitamin C is frequently used for UV protection of skin. Vitamin C stabilizes the collagen for skin elasticity.   

Vitamin E: Vitamin E is like vitamin C, a naturally occurring endogenous antioxidant. The combination of Vitamin C and vitamin E act synergistically. Higher amount of vitamin E is present in vegetables, vegetable oils like wheat germ oil, sunflower oil, safflower oil, corn and soya. Intake of vitamin E is linked to slowing of skin aging.

Carotenoids & Vitamin A:

Carotenoids are vitamin A derivative and show strong antioxidant effects. It also possesses high photoprotective properties. The efficacy of Beta-carotene for protection of UV radiation has been shown in several studies. Carotenoids and lycopene modulate the skin properties for better health and aging. Carrots, pumpkin, sweat potatoes, mangoes and papaya are rich source of beta-carotene. Topical retinol (vitamin A derivative) has been linked with inhibition of collagen breakdown and delaying skin aging.         

Vitamin D:

Skin is the major site of vitamin D synthesis. Smaller amount of vitamin D is also found in animal based food like eggs and fish. Vitamin D is now considered as a hormone that is involved in many physiological functions like immunity, metabolic functions, cardiac functions, skin health and bone strength. Vitamin D supplementation is particularly valuable in elderly persons. Oral vitamin D intake is also associated with prevention of skin cancer and anti-aging effect.     

Polyphenols:

Polyphenols are being extensively studied in anti-aging research due to their antioxidant effects and preventive role in cancer, cardiovascular disease and neurodegenerative disorders. The main source of polyphenols are fruits and plant derived beverages like tea, coffee, fruit juices, red wine, vegetables, cereals, chocolate and legumes. Polyphenols improve the cell survival, induce apoptosis (programmed cell death), and prevent tumour growth. Some of the polyphenols, flavonoids and herbal extracts with promising anti-aging effects are as follows:

Phlorizin is a flavonoid found in bark of many fruit trees has shown its antiaging effects in animals. The effect in human is still not studied.

Herbal Extracts like sylmarin, apigenin and genistein have potent antioxidant and anti-aging effects. 

Green tea polyphenols protects skin from photoaging. Green tea also possesses anti-inflammatory activity. Both topical and oral use of green tea extract is associated with anti-inflammatory and anticancer properties.

Coenzyme Q10: Coenzyme Q10 is a fat soluble, endogenous substance mainly stored in the fat tissues of the body. It has an important role in cellular respiration and energy production. It is a powerful antioxidant. Main dietary source of Coenzyme Q10 is fish, meat and whole grains. It is also available as tablets, capsules and oral spray.

Probiotics: Probiotics are living organisms which provide several benefits on oral ingestion. Most commonly used probiotics are Lactobacilli, Bifidobacteria and Enterococcus which are natural host of human gut. Probiotics have shown to protect skin from photosensitivity and UV radiation.

Essential Fatty Acids (EFAs) : Essential fatty acids are taken from diet as they are not produced in the body. They are linoleic acid, linolenic acid and oleic acid. They are also known as vitamin F. Essential fatty acids are present in fish, flaxseed, soya oil, canola oil, pumpkin seeds, avocados, and salmon. EFAs favourably affect cholesterol synthesis. Study has shown that higher intakes of linoleic acid were associated with lower senile skin dryness and skin atrophy. In fact oral intake of an antioxidant mixture containing vitamin C, vitamin E, pycnogenol, and evening prime rose oil reduced the wrinkle formation due to chronic UV radiation.

There are several natural and synthetic substances claimed to slow down the aging process. Most of these have not been tested in controlled clinical studies. However, the use of few of these ingredients have shown definite advantage in slowing down the aging process.

Besides, there are plenty of topical and oral products available without prescription (OTC) to combat aging process. The use of any such product should be judicious and weighed against possible benefits vs. potential harm.