General

Longevity: Aging With Grace

By Brittany Burns MD

8 min read
“Longevity”--what does this mean. I like to think of this as aging slowly while living with grace & vitality.
 
Life-span: how many years you live….vs Health-span: how many years you live with health quality (physical, emotional, and cognitive robustness). “Die young as late as possible!”
 
“BLUE-ZONES”:
-Blue zones are locations where populations are less burdened by mid-life “western” illness such as cardiovascular disease and diabetes, less frailty and dementia, and have exceptional density of centenarians.
-Genes, geography, and financial wealth does not appear to play a role to longevity in these regions.
- Dan Buettner a National Geographic fellow and author has spent his life studying “Blue-zones” such as Okinawa Japan, Sardinia Italy, Nicoya peninsula Costa-Rica, Icaria Greece, and Loma Linda California.
-Observation trends from these 5 zones include:
   1) Healthy involved community, family & neighbors.  Nurture & invest in relationships and human connection. Creating/fostering a tribe or network of people who care and look out for one-another.
   2) Reverence for and strong bonds with family.  Parents and siblings living near to their family (not isolated). Family caring for aging loved ones, dining together, connecting, socializing, being cared for and loved.  Elders are treasured and their wisdom sought after.
   3) Mindset.  Common advice themes from centenarians: Laugh, sing, dance, have fun.  Don’t live in anger, forgive. Gratitude (hardships such as world-war 2 seem to foster resilience and a gratitude of life there-after).  Interviewing >300 centenarians, Mr. Buettner reports that there was not a grumpy one in the bunch! “the happiness is palpable”.
   4) Spirituality and faith.  Likely polyfactorial through community, support network, peace of mind, stress coping strategies.  Variety of modes of resilience through mindfulness, meditation, prayer, and contentment.
   5) Live a life that has mission and purpose.  Service to others.  Volunteer to efforts beyond ones-self.  “Ikigai”a Japanese concept that combines the terms iki, meaning “alive” and gai, meaning “benefit” or “worth”….together meaning “life’s pupose”.
   6) Lack constant or chronic stress in day to day lives. Healthy coping strategies that help resolve stressors within your control, adds to stress resilience.
   7) Preventative health promotion. Costa-Rica health professionals visits every citizen once annually for preventative health care and coaching.  Loma Linda prioritizes routine health care for their communities and has build world renown health clinics and scientific research.
   8) Active movement daily Walkable neighborhood/communities, steep roads/steps through the village, squatting/sitting on the ground, outdoor sport, gardening/harvesting….all contribute to gentle regular activity, functional strength, and balance practice.
   9) Intermittent fasting— best seems to be starting the day with a good breakfast, and eating again early evening ~4 pm then having extended fasting of 14 hours through sleep time.  Traditions that do not promote excess or indulgent food quantities, such as eating with family amongst conversation. 
   10) Diets rich in nutrient dense plants— that are rich in flavonoids, anti-oxidants, minerals, and fiber. Fruits, vegetables, mushrooms, legumes, complex grains, nuts, tea.  Diet low in caloric dense nutrient void foods that translate to less obesity and nutritional diversity that lends to health resilience.
 
Lifestyle promotion of lengthening health-span:
The new science of Longevity focuses on optimizing wellness to prevent illness and disease, as opposed to traditional western medical approach of waiting to treat disease.  2/3rds of people die prematurely due to preventable disease.  How can we prevent disease that lends to frailty and extend vital quality years? What are lifestyle practices that lend to aging with physical, emotional, and cognitive robustness…living a long life worth living?
 
Genotype vs Phenotype and the regulators known as the “Epigenome”:
Very few genes are deterministic, but rather may increase or decrease risks or vulnerabilities with different penetrance levels that depend on our epigenetics. Our phenotype is how you display your genetic potential.  This concept is most impressively demonstrated with identical twins that have been separated early in life, and ultimately display very different phenotypes despite their identical genotypes.  It is our life exposures that influence our epigenome and how our genes translate to our phenotype.  80% of how our genes play out are based on our epigenetics.
 
Systems that control the genes and switch them on and off are influenced by our environment, nutrition, and exposures.  Chemical markers— such as methylation that helps to activate or silence certain genes.  As we age we can lose some of this mapping, sort of like when we Xerox a master copy too many times…..often referred to as DNA “scratches”.  
 
Exercise—
-180 min exercise (50% aerobic+40% muscle+10% stability) translates to 50% all-cause mortality reduction!
-Continues to show the largest impact on delaying disease and promoting longevity.
-Preserves independence, prevents fall, reduces isolation, translates to better quality of life into later years!
-Aerobic capacity and muscle mass are direct predictors of longevity (by a hazard ratio of 5!)
-It is estimated that you gain ~2 hrs of life for every hour of exercise you invest in your health!
 
Nutrition—
Difficult to study and lots of confounders….but things that we can all agree on include:
   -Too much AND too little nutrition are risk factors
   -Sufficient protein to support adequate muscle mass & bone health(whey, beans, legumes, egg whites, lean meat and fish)
   -Metabolic health (1/3 of thin, 2/3 of obese are metabolically unhealthy)
   -High plant base phytonutrients, “eat the rainbow”, flavonoids (natures bio-modulaters—anti-oxidants, anti-cancer, anti-aging, etc….dark chocolate, berries, apples, grapes, red-kidney beans, sweet potato, spinach, tomatoes, etc
   -Avoid processed foods, added chemicals, micro-plastics
   -Reduce processed sugars (better through fruit & honey) and simple “white” carbohydrates (better to get through nutrient dense veggies and complex grains that have much higher nutrient and mineral density!).
 
Intermittent Fasting—
   -Intermittent fasting to decrease insulin levels (lowers blood sugars and improves insulin sensitivity so less is required when feeding our body), aiming for 14-16 hrs fasting (eating earlier in evening or later in morning).  
   -Intermittent fasting “turns on” our longevity genes, and “turn down” some of the pro-inflammatory genes.
   -“Pulsing”….human hunter & gatherers for most of our existence subsisted in feast or famine
 
Sleep—
-Essential— you die sooner from sleep deprivation than food deprivation
-We spend a 1/3 of our time sleeping, and we can not cheat sleep.  7-9 hours sleep/night optimal for health
-Cheating ourselves of restorative sleep increases stress hormones and decreases resilience & immune health
 
Neutriceuticals/Pharmaceuticals—
-There is a time and a place for pharmaceuticals (antibiotics for serious infections), and a time where we need to go back to the fundamentals of health rather than just patching  symptoms of a deeper issue with pills.  
-Smart supplementation can address deficiencies or individual vulnerabilities as well as augment potential!
    *Vit D3— 2,000-5,000 IU improves bone & immune health, reduces fall risks, and promotes healthy moods.
    *Flavanoid— such as Curcumen, Grape seed extract, Quercetin, Fisetin, Green tea extract, Ginsing (Senolytic Synergy by DFH!) or from whole foods (berries, grapes, spinach/kale, apples, dark chocolate). Natural anti-oxidants, removes senescent cells, activates sirtuin longevity genes, and reducing cancer risks.
    *CoQnol (CoQ10)—a coenzyme that declines with age and depleted by oxidative stress, shown therapeutic benefit in anti-aging disorders particularly cardiovascular and metabolic diseases.
    *Berberine— reduces insulin resistance w similar efficacy to Rx Metformin w impressive longevity benefits.
    *Mito-PQQ—promotes mitochondrial health in aging cells, adaptogen supporting cardiovascular & brain.
    *NMN— (1,000 mg/day in AM as affects circadian rhythm)—Regenerates NAD+ that declines w age and positively impacts our epigenome. NAD helps to activate the sirtuin genes which we have linked to longevity.
    *Resveritrol— (1,000 mg 3x/wk) and or grape-seed extract shown protective & promotes longevity.
    *Mushrooms—contains compounds such as ergothioneine and Spermidine shown to promote longevity
    *TMG (Trimethylclycine)— an amino acid known as “Betaine” (1.5-3 g/day or from whole foods: beets/asparagus/avocados/spinach/fish).  Improves methylation that helps regulate gene expression.  Helps ion controlling increasing Homocysteine levels that start to rise in middle age and are linked to development of stroke and heart disease, lower blood sugars, and improve cognitive function.
 
***Dr. Burns recommendations: Vit D3 + Senolytic Synergy (flavonoids) by DFH + NMN w Resveritrol/green tea by Cymbiotika + CoQnol + Berberine (if pre-diabetic) + plenty of daily colorful nutrient dense whole foods that grow from the earth!***
 
Mental health/resilience—
-Important to differentiate between efforts at delaying dying with efforts at living our best quality of life—if you are not happy and living a life worth living and sharing with others, lifespan loses its appeal.
-Trauma is a tree metaphore…there are the parts we see, but much that is vital below the surface that others can’t see.  We have to address and process the root cause of our traumas and stress!
-Quality of relationships and human connection with both others and ourselves!
-Mindset is important. Practice appreciation and gratitude and find purpse to fuel a life that feels worth living.
-Harvard men's study looking across socioeconomic diversity— showed the highest factor predicting longevity was holding valuable relationships and feeling connected.
 

Resources:
Docuseries on Netflex:
     -“Live to 100: Secrets of the Blue Zones” with Dan Buettner author
Books:
   -“Outlive.  The Science and Art of Longevity.” by Peter Attia, MD
   -”Young Forever” by Mark Hyman, MD
   -”Lifespan: Why We Age and Why We Don’t” By Dr. David Sinclair
    -”The Longevity Matrix” by Michael T. Murry, ND
Podcasts:
   - “The Biology of Slowing & Reversing Aging” (Dec 2021) Dr. Andrew Huberman & guest Dr. David Sinclair.
   -“Lifespan” with David Sinclair
Meditation Applications:
   -“10 Percent Happier Meditation” Application 
   -“Headspace: Mindful Meditation” Application

September 26, 2023

Located in the heart of downtown Coeur d’Alene, Coeur Vitality unites the complementary visions of traditional, functional, and alternative medicine integrating many modalities to achieve better overall health while aiming to minimize prescription burdens and invasive medicine.

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