Prevention of aging: methodological recommendations

Irina Reznik, Mednovosti 

The Council on Public Health and Demographic Problems, with the support of the National Health League, presented the book "Prevention of Aging for All". One of the authors of the manual, associate professor of the Higher School of Health Management of the I.M. Sechenov First Moscow State Medical University, member of the Cochrane Collaboration for Evidence-based Medicine, Ph.D. Artem Gil, told Mednovosti about scientifically proven methods of preventing aging and the principles of transition to an anti-aging lifestyle. 

– Artem Yurievich, the principles of a healthy lifestyle – proper nutrition, physical activity, rejection of bad habits – are as old as the world. What new things did you tell in your book?

– In this book, we have reviewed domestic and foreign scientific publications devoted to the research of various methods that affect the aging process. Science has already accumulated a lot of knowledge about the biological processes that cause the aging process of the body, this knowledge is constantly expanding. But we still have very limited information about what can slow down this process and prolong life. All our medicine is traditionally aimed at the prevention of diseases and their treatment, and aging, as such, is not considered as a disease. But back at the beginning of the century, Mechnikov said that aging should be treated as a disease that causes the development of numerous age-dependent diseases. That is, by preventing aging, it is possible to prevent related diseases.

"Anti-aging lifestyle" 

– Are there any methods of preventing aging that have strict scientific evidence behind them?

– Let's start with the simplest – technologies of a healthy lifestyle, which in our book is considered precisely from the perspective of prolonging life, and not preventing diseases. First of all, the "anti-aging" lifestyle includes proper nutrition. To date, the so-called Mediterranean diet has been best studied. This is the consumption of a large amount of vegetables and fruits, nuts, cereals, fish and seafood, olive oil and very small consumption of meat, especially red meat of skeletal muscles of animals, refined foods and so-called fast carbohydrates – simple sugars. It has been proven that this diet prolongs life. There are certain regions on the planet, these are completely different parts of the world, but people's nutrition there can be compared with the Mediterranean type, and the proportion of centenarians – people who have crossed the 90-100-year mark – in these geographical areas has significantly increased. These include the island of Okinawa (Japan), the island of Sardinia (Italy), the city of Loma Linda (California), the island of Ikaria (Greece) and the Nicoya Peninsula (Costa Rica).

Regular physical activity slows down the aging process of cells. Physically active people have a telomere length of 200 nucleotides longer than those who move little or lead a predominantly sedentary lifestyle. The length of telomeres – the end sections of human chromosomes – is interrelated with human aging. The older a person is, the shorter these end sections of chromosomes are (even the age of a person can be determined by them) and the higher the probability that the chromosome will be damaged. There will be some damage and breakage of DNA, and the cell may be reborn into a tumor cell, or its premature death will occur, and it will lose its functionality. Aerobic physical activity of moderate intensity, lasting at least 15 minutes a day, even in elderly people with chronic diseases gives a significant reduction in mortality and an increase in life expectancy.

In addition, centenarians always have a positive attitude, an active life position, certain life goals. But this is no longer a medical, but a social, psychological feature.

The anti–aging lifestyle completely excludes the use of alcohol and tobacco - these are two risk factors that cause cell aging and cause supermortality of Russians at working ages. Smoking increases DNA damage, shortens the length of telomeres, leads to systemic inflammation, inflammation of tissues, especially the respiratory system, oral cavity, gastrointestinal tract, where nicotine, combustion products, resins, which accelerate the aging processes of cells, organs and tissues, get into.Gorenje. Alcohol accelerates the oxidation of cell membranes, damages DNA, causes oxidative stress of tissue cells, increases systemic inflammation. And inflammation is one of the mechanisms of aging. Any inflammatory process is accompanied by damage to tissues, cellular structures, DNA, the accumulation of these damages, which leads to cell death and tissue atrophy. 

The World Health Organization defines alcohol abuse as the consumption of more than 60 ml of pure ethanol (anhydrous alcohol) for men and more than 50 ml for women at least once a month per event. This corresponds to 150 ml of vodka, 500 ml of wine, and 1.3 liters of beer for men and 125 ml of vodka, 417 ml of wine, and 1.1 liters of beer for women. Those who consume more than 100 ml of ethanol at a time (250 ml of vodka, 0.83 liters of wine, 2.2 liters of beer) are at very high risk of morbidity and mortality. Finally, a deadly dose of alcohol is a one-time intake of 400 ml of ethanol, which corresponds to 1 liter of vodka, 3.3 liters of wine and 8.9 liters of beer. The consumption of vodka by Russians in the way it is customary to use it in Russia – not often, but a lot for one drinking event – shortens life by an average of 9-10 years, which has been shown in a number of studies. 

You can also prolong your life through proper sleep and rest. There are studies that have shown that night shift workers have a lower life expectancy, and they are more at risk of developing cancer. This is due to a violation of the circadian production of melatonin, a substance that is produced in the epiphysis of the human brain at night in the absence of light and is responsible, among other things, for the quality and duration of sleep. In a person who is awake at night, the production of melatonin is blocked. Normally, in a healthy person, the peak of melatonin production falls on the period from 12 a.m. to 4 a.m., so it is very important to go to bed no later than 11 p.m. and sleep 7-8 hours and, most importantly, in a completely dark room.

Today, light pollution is a very serious problem for our cities. Therefore, it is recommended to sleep in a room with thick curtains, to abandon night lights. And elderly people who, due to an age-dependent decrease in melatonin in the body, the duration and depth of sleep decreases, it is recommended to take additional melatonin (after consulting a doctor) in order to improve the quality of sleep and at the same time prevent oncological diseases.

And what other drugs have such properties?

– There are certain medicinal substances that have long been produced by the pharmaceutical industry for the treatment of any diseases. But, recently, they have also been found to have the ability to slow down the aging process. The same melatonin, originally created as a drug for the treatment of insomnia, especially after jet lag, when it is necessary to quickly normalize the circadian rhythms of the body.

The drug metformin, which has long been used to treat type 2 diabetes mellitus (and this is also an age-dependent disease), has now aroused increased interest among scientists due to its ability to inhibit the process called protein glycation in the body. Protein glycation is also one of the mechanisms that cause cell aging, tissue aging, and a decrease in their functional activity. And now the possibility of using metformin as a substance that can prolong the life of people who have impaired glucose tolerance and are already experiencing prediabetes is being studied. In the future, it is planned to conduct studies of this substance on volunteers who have neither prediabetes nor diabetes in order to find out its ability to prolong life in healthy people.

The benefits of various immunizations have also been proven, in particular, influenza vaccination, because influenza is one of the main seasonal killers of the elderly and people with weakened immunity.

In addition, the geroprotective (slowing down the aging process) properties of various vitamins are being studied. At the moment, it has been proven that vitamin D3 has such properties, additional intake of which reduces overall mortality and mortality from various causes, increases life expectancy. In our latitudes, where the intensity of solar radiation is quite low, even in the summer months, people do not receive enough vitamin D, and therefore additional intake is required. It is important to note that the effect of prolonging life and reducing mortality was observed only among people with a reduced level of vitamin D concentration in the blood, therefore, its additional intake is recommended only after consultation with a doctor and under the control of vitamin D concentration in the blood. The same applies to a number of other vitamins and medicines with geroprotective properties, considered in our book - their reception is possible only after consultation with a doctor to eliminate the risk of adverse side effects.

– There is a section in your manual dedicated to genetic testing. 

– Awareness about your health, about your genetics is also part of an anti-aging lifestyle. Those who want to become a long-lived person are recommended to undergo genetic testing, determine their hereditary risks, and, based on this, "lay a straw for themselves" by changing their lifestyle.

For example, for people with hereditary connective tissue pathology, with a predisposition to osteoarthritis, to osteoporosis, physical activity is recommended a little different than for most people. For them, swimming in the pool is more suitable than running, fitness classes or heavy weight training in sports clubs. Given the hereditary risk, it is worth protecting your cartilage and joints that have a limited resource and doing physical exercises in water in a suspended state.  At the same time, such people really need physical activity, they should lead a more mobile lifestyle, walk more, use a car as little as possible, monitor the level of vitamin D in the blood and, if necessary, take it additionally so that bone mineral density does not decrease with age. At the same time, such people can take another substance-a geroprotector – glucosamine, which is used for the synthesis of synovial fluid of joints and to strengthen articular cartilage.

With the help of genetic testing, you can determine whether you and your partner carry any genes of hereditary diseases and plan healthy offspring. For example, spouses with a predisposition to some serious hereditary disease have a chance to give birth to a healthy child with the help of an IVF procedure, before which a preimplantation diagnosis of the embryo is performed, which allows you to choose a healthy embryo completely devoid of hereditary risks.

New technologies

– And what other medical innovations that preserve youth and health will become available in the coming decades?

– The same preimplantation diagnosis is already physically available today, but for many people it is not yet affordable. Any new technologies, as a rule, are expensive at first, but then their cost decreases. If we talk about scientific achievements, then 3D bioprinting is a very promising direction. The design, printing and transplantation of artificial organs will solve the problem of the shortage of donor organs, their rejection. In the spring of this year, a functioning mouse thyroid gland was printed on a three-dimensional bioprinter made of cellular microspheres and a special hydrogel in Skolkovo. And I think that in the next three years it will be possible to print a bioprint of the human thyroid gland.

Another promising technology is the nanodelivery of medicines. Treatment of, for example, oncological diseases involves the use of toxic chemotherapy drugs that have a systemic toxic effect on the entire body, while it is impossible to bring a high dose of a chemotherapeutic drug to the tumor itself, which does not allow to completely get rid of it during treatment. Nanodelivery, in which medicinal substances on nanoparticle carriers will be delivered only to tumor cells, accumulate in them without having a toxic effect on healthy organs and tissues, can significantly improve the prospects for the treatment of malignant oncological diseases.

Now, prostheses and implants are actively used in various fields of medicine for people who have lost, for example, a limb. Several companies around the world produce advanced bionic limb prostheses with multiple degrees of freedom. In Russia, one of the companies produces acceptable quality prosthetics of the foot, lower leg, hip. Currently, electric-powered prostheses are being manufactured, which are controlled by reading the electrical activity of muscles or muscle tone, which allows complex movements to be performed with the help of a prosthesis. Owners of modern bionic prostheses are able to fully return to normal life. Artificial arms and legs allow you to cope with household chores, ride a bike, drive a car. There are prostheses specially designed for sports and even swimming.

Also, such operations as knee and hip replacement are already performed on a routine basis, and these operations in Russia are available to everyone who needs them.

And finally, I would like to mention gene therapy, which will enable or disable certain genes that regulate the processes associated with aging and the development of age-dependent diseases. To date, less than a dozen gene technologies have been created so far aimed at treating various serious diseases. The necessary tests have been passed and only three technologies have been registered to date. One of these technologies is registered in Russia for the treatment of an age–dependent disease - lower limb ischemia of atherosclerotic genesis.

An interested reader can get acquainted with a more detailed and complete description of other anti-aging technologies in our book.

On the website of the Council for Public Health and Demographic Problems, you can download the full text of the book for free (121 p. pdf, 4.5 MB) – VM.

Portal "Eternal youth" http://vechnayamolodost.ru

28.08.2015