What do we mean when we talk about ageing? Read on for an in-depth, expert-led guide to growing older, what it means, and how to own it.
Wherever we’re from, human beings (all beings, actually, unless you're an 'immortal' jellyfish...) are bound by one truth: we all grow older. And, almost universally, none of us want to. We’re so keen to stay youthful that (according to Precedence Research), the global anti-ageing market is expected to be worth $119.6 billion by 2030 – that’s roughly the GDP of Kuwait.
As the figures demonstrate (in the West, at least), ageing is seen as a problem to be solved, rather than a part of life. We’re scared of wrinkles, nervous about gaining weight, fearful of losing the mobility that keeps us active. So we exercise and moisturise and try not to get too stressed out.
But, really, how much do we know about ageing? What does it actually mean at a biomechanical level, and, knowing that, can we dispel the myths around it and learn to safeguard ourselves against its worse effects so that as we get older we can stay healthier for longer?
We put these questions to some of the best ageing experts in the world. This is what they came up with – a deep dive into everything you need to know about healthy ageing.
“Ageing is a process that we still do not understand well at the molecular level,” explains Dr. Gordan Lauc, Professor of biochemistry and molecular biology at the University of Zagreb, and the chief scientific officer at biological age app GlycanAge. “We do not know why some organisms live for hundreds of years, like turtles, while others, like mice, only live for a few months, or years.”
In other words, ageing has an elastic definition, but in humans, Professor Lauc says we can narrow it down to a key biomechanical process. “In humans, we know that inflammation correlates with ageing and the ‘inflammaging theory’ suggests that excessive inflammation is an important element of age-related deterioration of organ systems,” he explains.
Professor Lauc goes on to explain that at the molecular level, inflammation is “a process of destruction and repair that occurs at the site of real or perceived invasion by pathogens”, occurring when our bodies detect an infection. “If the infection is real, this is the life-saving process,” says Professor Lauc. (It’s important to add here that inflammation as the result of an infection can cause death, and that inflammation can also be from consuming "harmful"/pro-inflammatory molecules, from injury, or even exercise).
“However, if the infection is only a false perception of our immune system, then this process is very expensive and harmful in the long term because in some cases repair is not perfect and small molecular “scars” remain,” Professor Lauc continues. “Accumulation of these scars leads to tissue deterioration, which we interpret as ageing. With ageing this vicious circle of low-grade chronic inflammation is accelerating, but the pace of this is very individual.”
With us so far? Alongside this molecular damage, Professor Lauc explains that at the cellular level, the most prominent biochemical change is the shortening of ‘telomeres’, which you may have heard of. “This is an evolutionary mechanism to limit cellular division or the capacity for cell division.”
That’s a (very brief) exploration of the deep science, but how do we interpret ageing on a functional level? “On a mechanical level, we normally associate ‘getting old’ with a reduction in functional capacity,” adds Anthony Fletcher, a biomechanics coach who has worked with Olympics hopefuls and lectured at Southampton Solent University. He is currently head coach of precision run at Equinox UK, and the founder of running platform Onetrack.
“On a larger scale, our muscles are interwoven with bonds or cross-links which make up the extra-cellular matrix,” he says. "These bonds allow for force to be distributed vertically and diagonally away from the muscle fibre that is producing the force, protecting it.
“Through vigorous muscle contractions, we break these bonds. If we stay sedentary then we accumulate new bonds which creates less elastic muscle that is more tenuous in nature. Maybe a good reason to stay active for as long as possible.”
More on that later.
Of course, ageing is primarily the result of time passing. As Fletcher just illustrated, sitting still won’t save you from age-related deterioration. We can’t escape the passage of time, but it pays to better understand it.
Dr. Qian Xu is an expert in aesthetics, an area we often notice as the frontlines of ageing (hello, crow’s feet). As founder and medical director of Skin Aesthetics, she outlines to her patients that there are actually two types of ageing, and that understanding them can be useful in slowing the damage we see on our skin:
“Intrinsic ageing is the genetic process that occurs naturally through time,” she says. “As we age our hormone balances change and free radicals within our bodies begin to take degenerative effects. We start to see this damage in our skin and other organs due to the body not being able to perfectly repair the cell damage.
“Extrinsic ageing is caused by external factors that can speed up the ageing process.” This, then, should be where your focus lies. “Lifestyle choices such as smoking, stress, poor diet and excessive alcohol consumption combined with the sun's harmful rays can all contribute to the ageing process,” Dr. Xu explains. “We can’t fight our genetics, but with the right approach to our health and focusing on a healthy lifestyle we can reduce extrinsic ageing.”
“Doubtful,” says Professor Matt Kaeberlein, a biologist and biogerontologist focused on biological mechanisms of ageing at the University of Washington. “You would be in stasis if you paused all biochemical reactions, even if it were possible, so not really worth living.
“That said, it is already possible to reverse some aspects of biological ageing in tissues and organs in mice and to restore lost function: for example, short-term rapamycin treatment can improve function in an aged heart, ovary, brain, and immune system. It may someday be possible to do this for all tissues and organs in an entire animal and ultimately in humans. We’re a long way off from that, however.”
Dr. Xu has some thoughts, too. “For us to be able to pause the effects of time on our body we would have to find a way to stop the telomerase function. Telomerase is an enzyme that shortens the long strands of genetic material, the telomeres, attached to the end of DNA. The telomeres act as a sort of counter. When it runs out, the cells can no longer divide,” she explains.
“I wouldn’t like to say this is never possible, science, research, and our approach to life is always evolving, but in the immediate future I don’t see a way to safely pause brain function, let alone cell functions.”
Peddling 'healthy ageing' myths has made many people rich and left others searching for the metaphorical fountain of youth. Alexey Strygin, co-founder of longevity biotechnology company Gray Matter wants to change that by shattering key untruths.
“Ageing is natural but that does not mean we shouldn’t try to tackle it,” he says. “Cancers are ‘natural’, but it does not stop our society from spending billions on treating them and developing novel cancer therapies.” Strygin points out that targeting ageing can be seen as culturally inappropriate.
Yet, age-related illnesses account for 51.3 percent of the total disease burden globally, according to a study published in The Lancet. So, from a medical perspective, if ageing is killing so many people, shouldn’t we want to delay or combat it where possible?
“The quest for an effective ageing intervention is not new,” Strygin explains. “One of the oldest known texts, the Epic of Gilgamesh, mentions the search for the Elixir of Life. Conquistadors were looking for the fountain of youth in the jungles of Florida.
“During the last two decades resveratrol, telomerase, rapamycin, metformin, NMN, alpha-ketoglutarate, and several other drugs and supplements were propelled by media as the ultimate solution for ageing. The truth is that, as of today, we don’t have clear-cut evidence for the efficacy of any of these interventions.”
In other words, there is no secret solution. “The most robust available data on the improvement of biological age is actually for lifestyle interventions,” Strygin adds. Sorry, but hard work and sensible changes trump magic pills.
The idea that longer-living humans would be a burden to society is a big, interesting, and slightly controversial topic. Take for example, Japan, where as of 2021, 29.1 percent of the population are aged over 65.
“This myth always comes about because most people assume (falsely) that targeting ageing implies adding years to the life of an 85-year-old with all the body and chronic diseases of an 85-year-old,” says Strygin. “However, the industry's primary purpose is to prolong health span, implying that 85-year-old person would have a 50-year-old body. In such a scenario, a person would be able to continue working and provide value to society for several additional decades.
“And I am talking about the most productive decades, when accumulated knowledge and experience are combined with high energy and charisma. British economist Andrew Scott estimates that a one year increase in life expectancy is worth $38 trillion [in the USA] and a 10-year increase, a staggering $367 trillion increase.”
“This myth has some truth behind it,” says Strygin. “Today higher income is already associated with longer lifespans: the gap between the wealthiest one percent and poorest one percent of US men is 14.1 years, whereas the wealthiest UK citizens are expected to live an additional 8 to 9 years.
“It is likely that the affluent will be the early adopters of ageing interventions, and there is the likelihood that the first generation of ageing interventions will come at a premium. However, in 5-10 years, these interventions will become affordable to a much wider audience – which is exactly what happened with medical developments like antibiotics.”
“Yes, indeed mild cognitive impairment prevalence rises with age (from 6.7 percent for ages 60–64 to 25.2 percent for 80–84),” says Strygin. “However, it is far from 100 percent and the best news is that you can do something with it.
“Interestingly, behavioural interventions are more effective than pharmacological in many cases while having no side effects. For instance, outdoor activities are more efficacious than antipsychotic drugs for ameliorating physical aggression, which often comes along with cognitive decline.”
It’s important to note with this case that the preventative action — outdoor activities — is different from the treatment — the drugs — and they're not necessarily targeting the same thing, but rather suggesting the importance of preventative measures.
“Other interventions with proven beneficial effects are exercise, cognitive training, pet therapy, music and massage,” says Strygin. “Interestingly, low muscle mass was also linked to cognitive decline.”
So, what have we learned? Our key takeaways should be that ageing is a natural process and can bring with it many advantages in terms of personal development, and the input and wisdom we have to offer society. The downside is that our bodies are slowly shutting down, which is something to be combatted.
Staying healthier and active as we age is called improving our ‘healthspan' i.e., not just living longer (lifespan) but remaining in the best condition we can. Here are the diet and lifestyle changes our experts recommend to protect your healthspan, starting today.
“The body detoxes itself at night, so if you are restless or not sleeping enough you will show signs of age faster than if you give your body the optimum time to recover,” says Dr Xu. “We should be aiming for between seven and nine hours sleep, according to a joint study conducted by researchers from the University of Cambridge and Fudan University.”
“Vitamins are closely linked to ageing and your general health,” explains Dr Xu. “We have all heard of scurvy, the sickness suffered by sailors in the past who lacked Vitamin C in their diets. But a lack of vitamins can also cause fragile skin and reduce the healing ability of our bodies.”
As a rule, aim for as many colours on your dinner plate as possible, or take the easy option and go for a Huel meal which contains 26 vitamins and minerals.
“Weight loss and exercise with sufficient recovery are known drivers of decelerated ageing,” says Lauc. This links back in with that extracellular matrix Fletcher mentioned earlier. The NHS recommends 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity a week.
“One thing we often forget is to drink enough water,” says Dr Xu. “Water in your body provides many functions, from regulating your temperature to helping your cells transport nutrients, as well as maintaining your body volume.” Per Harvard Health, you should aim for 4-6 cups (2-3 pints) of water daily in order to keep your body running efficiently (read the Huel guide on how to stay hydrated if you need some tips on this).
“No specific food has been clinically proven to slow or reverse biological ageing,” says Professor Kaeberlein. “But, caloric restriction in rodents has this effect and may have a similar effect in people. However, the side effects of caloric restriction may offset any benefits in many people and it’s clearly not a pragmatic approach.”
“Proteins are a vital ingredient to keeping your skin and body healthy and young,” explains Dr Xu. “The main function of protein is in the construction and repair of tissue. Your tissue cells are in a constant cycle of renewal, without the right protein intake the ageing process can be accelerated through slowed cell growth.
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