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From the Townsend Letter
November 2011

Anti-Aging Medicine
To Live Long and Well, Embrace the Anti-Aging Lifestyle
by Ronald Klatz, MD, DO, and Robert Goldman, MD, PhD, DO, FAASP
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Anti-aging medicine is a clinical specialty is founded on the application of advanced scientific and medical technologies for the early detection, prevention, treatment, and reversal of age-related dysfunction, disorders, and diseases. Based on principles of sound and responsible medical care that are consistent with those applied in other preventive health specialties, the goal of anti-aging medicine is not to merely prolong the total years of an individual's life, but to ensure that those years are enjoyed in a productive and vital fashion.

The exponential growth in the popularity of anti-aging medicine is largely a result of the global demographics shift towards a swelling aging population. The United Nations observes: "The world is in the midst of a unique and irreversible process of demographic transition that will result in older populations everywhere. As fertility rates decline, the proportion of persons aged 60 and over is expected to double between 2007 and 2050, and their actual number will more than triple, reaching 2 billion by 2050. In most countries, the number of those over 80 is likely to quadruple to nearly 400 million by then."

Around the world, people are seeking medical guidance for ways to stay healthy, active, and vital well into their older years. As a result, the principles of the anti-aging medical model are gaining rapid and widespread acceptance as a framework for lifelong habits for healthy living. Anti-aging medicine is a lifestyle; there are no "magic bullet" medicines. As we age, a series of biological changes takes place in the body. Anti-aging physicians seek to understand these age-related declines in order to enables a better grasp of the potential for contemporary medical discoveries and applications of biomedical technology to retard or reverse the otherwise inevitable process of senescence. In this column, we review recent studies that document simple and actionable approaches to keep the human body functioning at its peak, ultimately to extend and maximize the healthy human lifespan.

United Nations. Ageing [Web page].

Anti-Aging Lifestyle Extends Productive Lifespan
Making positive and sustainable changes in one's daily routine can result in measurable improvements in quality of life. Florence Clark and colleagues from University of Southern California (USC; California, US) enrolled men and women aged 60 to 95 years in a five-year long study during which, at six-month intervals, licensed occupational therapists assisted the subjects to develop sustainably healthful lifestyles and assess subsequent changes to the participants' overall quality of life. The team found that subjects who maintained active social, spiritual, and physical lives were at reduced risks of developing health declines. Commenting, "A lifestyle-oriented occupational therapy intervention has beneficial effects for ethnically diverse older people recruited from a wide array of community settings," the researchers urge: "Because the intervention is cost-effective and is applicable on a wide-scale basis, it has the potential to help reduce health decline and promote well-being in older people."

Clark F, Jackson J, Carlson M, et al. Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: results of the Well Elderly 2 Randomised Controlled Trial. J Epidemiol Community Health. 2 June 2011.

Positive Attitude Promotes Well-Being
Aging successfully has been linked with the "positivity effect," a biased tendency toward and preference for positive, emotionally gratifying experiences; now German neuroscientists reveal the physiological basis for this correlation. Stefanie Brassen and colleagues from University Medical Center Hamburg-Eppendorf (Germany) used neuroimaging to evaluate brain engagement in young and old adults while they performed a specialized cognitive task that included supposedly irrelevant pictures of neutral, happy, sad, or fearful faces. During parts of the task when they didn't have to pay as much attention, the elderly subjects were significantly more distracted by the happy faces. When this occurred, they had increased engagement in the part of the brain that helps control emotions, and this stronger signal in the brain was correlated with those who showed the greatest emotional stability. As well, the team found a relationship between rostral anterior cingulate cortex activity and emotional stability, which they say further strengthens the hypothesis that this increased emotional control in aging enhances emotional well-being. Writing that their study elucidates "how the brain might mediate the tendency to preferentially engage in positive information processing in healthy aging," the researchers submit: "These findings are of particular relevance regarding implications for the understanding, treatment, and prevention of nonsuccessful aging like highly prevalent late-life depression."

Brassen S, Gamer M, Buchel C. Anterior cingulate activation is related to a positivity bias and emotional stability in successful aging. Biol Psychiatry. 15 July 2011;70(2):131–137.

Vitamins and Minerals May Prevent Age-Related Diseases
Whereas severe deficiency of vitamins and minerals required for life is relatively uncommon in developed nations, modest deficiency is very common among residents of the US and Europe. Joyce C. McCann and Bruce N. Ames, from the Children's Hospital Oakland Research Institute (California, US), examined moderate selenium and vitamin K deficiency to show how damage accumulates over time as a result of vitamin and mineral loss, leading to age-related diseases. Compiling and assessing several general types of scientific evidence, the team tested whether selenium-dependent proteins that are essential from an evolutionary perspective are more resistant to selenium deficiency than those that are less essential. They discovered a highly sophisticated array of mechanisms at cellular and tissue levels that, when selenium is limited, protect essential selenium-dependent proteins at the expense of those that are nonessential. They also found that mutations in selenium-dependent proteins that are lost on modest selenium deficiency result in characteristics shared by age-related diseases including cancer, heart disease, and loss of immune or brain function. Explaining that their results should inform attempts to locate mechanistic linkages between vitamin or mineral deficiencies and age-related diseases by focusing attention on the vitamin and mineral-dependent proteins that are nonessential from an evolutionary perspective, the researchers conclude: "Modest [selenium] deficiency is common in many parts of the world; optimal intake could prevent future disease."

McCann JC, Ames BN. Adaptive dysfunction of selenoproteins from the perspective of the triage theory: why modest selenium deficiency may increase risk of diseases of aging. FASEB J. 2011;25:1793–1814.

Strength Training an Anti-Aging Essential
While people typically lose 30% of their muscle strength between ages 50 and 70 years, it is critically important to maintain it as we age, to preserve mobility and independent living. Frank Mayer and colleagues from the University of Potsdam (Germany) reviewed recently published studies about strength (resistance) training in elderly persons, and which intensities of exercise are useful and possible in persons older than 60 years. The team found that regular resistance training increased muscle strength and reduced muscular atrophy, and that tendons and bones adapt too. These successes in turn had a preventive effect in terms of avoiding falls and injuries. Greater intensities of training yielded greater effects than moderate and low intensities. In order to increase muscle mass, an intensity of 60% to 85% of the 1-repetition maximum is required. In order to increase rapidly available muscle force, higher intensities (greater than 85%) are required. The optimum amount of exercise for healthy elderly persons is 3 to 4 training units per week. The researchers urge: "Progressive strength training in the elderly is efficient, even with higher intensities, to reduce sarcopenia, and to retain motor function."

Mayer F, Scharhag-Rosenberger F, Carlsohn A, Cassel M, Muller S, Scharhag J. The intensity and effects of strength training in the elderly. Dtsch Arztebl Int. 2011;108(21):359–364.

Happiness Starts in Youth
British researchers report that a positive adolescence promotes well-being in midlife. Marcus Richards and colleagues from the University of Cambridge (UK) utilized information from 2776 individuals who participated in the 1946 British birth cohort study, to reveal associations between having a positive childhood and well-being in adulthood. A "positive" childhood was based on teacher evaluations of students' levels of happiness, friendship, and energy at ages 13 and 15, with a positive point assigned for specific happy and sociable behaviors, and ratings noted for discontent or disobedient conduct. The researchers then linked these ratings to the individuals' mental health, work experience, relationships, and social activities several decades later. They found that teenagers rated positively by their teachers were significantly more likely than those who received no positive ratings to have higher levels of well-being later in life, including a higher work satisfaction, more frequent contact with family and friends, and more regular engagement in social and leisure activities. Happy children were also much less likely than others to develop mental disorders throughout their lives – 60% less likely than young teens that had no positive ratings. The team concludes: "Childhood well-being predicts positive adult well-being, and not merely the absence of mental ill-health."

Richards M, Huppert FA. Do positive children become positive adults? Evidence from a longitudinal birth cohort study. J Positive Psychol. January 2011;6(1):75–87.

A prolonged healthy lifespan – and the practice of the anti-aging medical specialty – beneficially affects the economic framework of nations around the world. Until we've eradicated the age-related decline in health that leads to many of us becoming dependent and disabled in our older years, society will bear increasing financial costs to sustain the older population. In the absence of scientific solutions that halt the onset of the degenerative diseases of aging, the elderly support burden may swell and compromise the economic and social frameworks of many industrial nations. On a societal level, the most important contribution of the anti-aging medical specialty is in the reduction of disabilities, diseases, and dependencies otherwise associated with aging and graying populations.

To stay updated on the latest breakthroughs in natural, nutritional and lifestyle approaches to optimize how well, and how long, you live, visit the World Health Network (, the official educational website of the A4M and your one-stop resource for authoritative anti-aging information. Be sure to sign up for the free Longevity Magazine e-journal, the A4M's award-winning weekly health newsletter featuring wellness, prevention, and biotech advancements in longevity.


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