In part 3 of our series on aging and longevity, we looked at health span and the genetic basis of extreme longevity.
In part 3 of our series on aging and longevity, we looked at health span and the genetic basis of extreme longevity. In part 4, we conclude the series with a look at wellness, mind-body relationships and the personal cost of life extension.
|Wellness is the daily active pursuit of an optimal state of health with special emphasis on a highly functioning body and mind.
Dr. James Meschino is an associate professor at the Canadian Memorial Chiropractic College (CMCC) where he has taught courses in biochemistry, nutrition and natural medicine for nearly three decades. Wellness, Dr. Meschino tells us, “is the daily active pursuit of maintaining or acting to achieve an optimal state of health with special emphasis on a highly functioning body and mind.”
As a DC and ND, Dr. Meschino is well positioned to comment on the role of wellness in aging. In his estimation, “the way the body is designed for aging we become prone to age-related ailments such as cancer, heart disease and diabetes as a result of the ‘aging-clock’. After the age of 40 there are certain genetic ‘time bombs’ that are set off in the body that predispose us to decline and degeneration that leads, eventually, to death. Once we’ve lived long enough to procreate and our offspring are old enough to be self-sufficient, nature is basically done with us. At that time, these genetic markers activate setting the stage for ailments such as cartilage erosion and osteoarthritis as well as general weakening of the immune system. Over time, for example, prostate cancer increases, calcium loss from our bones may lead to osteoporosis and levels of the memory chemical acetylcholine decline, opening the door to dementia. The heart no longer has access to optimal amounts of the powerful antioxidant, Coenzyme Q10, and this may lead to future congestive heart failure and high blood pressure. These are just a few of the health-related issues stemming from aging.”
“Over the last 30 years,” Dr. Meschino comments, “anti-aging researchers have shown us what those aging markers look like and the good news is that they can be combated using targeted nutrition, exercise intervention, supplementation and some chiropractic care to have a more functional body for a longer period of time and hopefully to achieve life-extension as well.” In Dr. Meschino’s estimation, the odds for boosting longevity and being fully functional at a later age are significantly increased if we attempt to defuse these “genetic time bombs” and minimize our risk factors for vascular disease and cancer by being proactive.
HOW DOES WELLNESS RELATE TO CHIROPRACTIC PRACTICE?
The proper regimen of guided lifestyle and behavioural interventions, Dr. Meschino tells us, leads to health promotion and enhances our chances of meeting or exceeding our life expectancy and maximizing our health span. In his opinion, chiropractors are in a unique position with regard to promoting wellness – a position they often fail to take full advantage of.
“The patients who come to see chiropractors are, for the most part, not at end-stage disease,” he says. “Most functioning adults in our society, without realizing it, have health and lifestyle behaviours that are perpetuating pathways that are moving them towards cancer, heart disease, immune system decline and other degenerative illnesses. They may not be manifesting the major events yet but are somewhere in a downward spiral. Part of this spiral is that their musculoskeletal system starts to fail and they begin to exhibit pain, restricted motion or nerve impingement problems as part of daily activity or occupational hazard. The opportunity for chiropractors – because their care philosophy is holistic in nature – is not only to restore the biomechanical defects that they can treat by hand, exercise or other therapies but to identify other risk factors in an individual’s lifestyle behaviours that are setting the stage for degenerative illnesses.
“Chiropractors have the opportunity to identify these risk factors and guide those under their care toward healthier and more appropriate lifestyle behaviours that would not only reduce their risk of degenerative illnesses but would allow them to maintain a highly functional body and mind for a longer period of time. Exercise, diet, nutritional supplementation and other guided behaviours can have a profound impact on lowering cholesterol and blood pressure, maintaining bone density and other age-related disorders. Proactive lifestyle strategies are equal to any pharmaceutical medications when the objective is to maximize quality-adjusted life expectancy and chiropractors have the opportunity to include, in their mix of holistic management, the interventions that are most appropriate. That’s called quality of life.”
At the recent 2011 CMCC Research Symposium, Dr. Aviad Haramati reported on the outcomes of a mind-body program implemented to address stress-related issues among health-care practitioners. Dr. Haramati, co-director of the graduate program in CAM at the Georgetown University School of Medicine, examined the physiological implications of chronic stress and its effect on health and life expectancy. The Georgetown program was created to address the reality of physician burnout, a condition marked by feelings of emotional exhaustion, depersonalization, low personal accomplishment and an inability to express empathy. Burnout also compromises the health-care provider-patient relationship. According to Dr. Haramati, health-care practitioners experiencing burnout are more likely to commit errors and patients under their care are less likely to comply with recommended medications, exercise protocols and dietary modifications.
Stress, Dr. Haramati observed, is anything perceived to be a threat to the body and initiates an involuntary cascade of physiological responses leading to a classic “fight or flight” response. This chain of chemical and physiological reactions, crucial in an emergency response situation, can have disastrous consequences if uncontrolled. Stress, when it becomes chronic, has a direct impact on mortality. Studies have shown that persons suffering from chronic stress die significantly earlier than age-matched controls and, in one study, the chances of dying early were as much as 63 per cent greater among persistently distressed individuals.1
Why does stress kill us? A 2004 study measured telomere length in mothers who were caring for disabled children.2 Telomeres hold the chromosome coiled at the end and prevent it from fraying. With each replication, the telomere gets shorter until it reaches a point where its gets too short and the cell goes into senescence and dies – hence the impact on aging. The study found that the longer the period of caregiving by those women, the shorter the telomere length leading to impaired telomere function and accelerated cell senescence. Others have speculated on the possibility of increased oxidative damage along potential pathways by which chronic stress impacts telomere length.3
Science shows us that stress gets all the way down to the cell but where, Dr. Haramati asks us, would you intervene? Do we somehow try to augment our telomeres? Do we try to mitigate oxidative damage in some way? Or do we want to prevent or attenuate that cascade as it begins?
To combat perceived stress, Georgetown instituted a program in mind-body medicine using techniques such as meditation, imagery to induce relaxation, biofeedback, autogenic training (self-hypnosis), breathing techniques, exercise, yoga, tai chi and group support to nurture participants. So far, the results have been encouraging. Mind–body approaches appear to not only be effective in helping to reduce stress and anxiety but also teach the power of self-awareness and self-care with the ultimate goal of producing better caregivers.
Although the Georgetown experience is couched in the context of its physician training program, the lessons learned are equally applicable to all health professions – and to us all. Stress not only impacts professional performance but also has profound implications for health, well-being and longevity. Jeanne Calment, at 122 the world’s longest-lived human being, attributed her longevity at least in part to her sense of humour and unflappable approach to life.
“Newest research suggests that extreme longevity is largely determined by our genes.”4 This does not mean, however, that there are not proponents of the possibility of extreme life extension. Some believe that “people could live 1,000 years” if it were possible to eliminate all processes of aging and if oxidative stress damage could be repaired.5 According to Aubrey de Grey, chief science officer of the Sens Foundation, if a means could be found to unravel the Gordian knot that is the relationship between telomerase and cancer, aging could be stopped entirely. The same group predicts an end to aging as a cause of death this century.6
And where science beckons with the tantalizing possibility of radically extending our years, the money quickly follows. Elizabeth Blackburn, Nobel Prize laureate for the discovery of telomeres, has come up with a commercially available procedure to measure the length of telomeres.7 Others have developed the first product targeting telomeres, which at $8,000 per year is now sold as a nutritional supplement. According to the company, early adopters of the supplement – derived from the Chinese herb astragalus – report enhanced athletic, visual and cognitive performance.8,9 The same company is pursuing a separate telomere therapy aimed at fighting cancer while another is looking at a number of chemicals that turn on the telomerase gene and hopes to have an approved drug within the next 15 years.10
On the genetics front, the pharmaceutical giant GlaxoSmithKlein paid $720 million in 2008 for a biotechnology company that focused on finding sirtuin 1 (SIRT1)-activating compounds. Sirtuin genes and the proteins they encode have fascinated anti-aging researchers ever since they were first linked to longevity in yeast. But since then, results suggesting that SIRT1 affects lifespan in fruitflies and nematodes have been challenged amid claims of flawed research design and no effect of SIRT1 on longevity in mammals has been demonstrated. In February of this year, however, hopes that the crumbling empire of sirtuins – and the millions invested in them – could somehow be linked to longevity in complex organisms were revived with an announcement that another sirtuin gene, sirtuin 6 (SIRT6), appeared to extend life-span in mammals. The study, published in Nature, reported that over-expression of the SIRT6 gene lengthened lifespan in male mice by as much as 15.8 per cent.11
What all this tells us about our life expectancy, or what we can do about it, is not clear. What is clear, however, is that modern society’s obsession with aging has turned the anti-aging industry into a multimillion-dollar concern with one of the fastest growing markets in the world. All manner of laboratory tests, procedures and protocols will, for a price, be available in coming years purporting to give us a crystal ball on how long we are likely to live and what potentially lethal health issues are lurking in our genes.
But before you hop on the longevity train, ask yourself what you are prepared to do for that bonus time. Are you willing to endure a spartan dietary regimen or even semi-starve yourself depending on the prevailing wisdom of the day? Would you be willing to commit to a lifetime of structured exercise? Are you prepared to invest in a bevy of supplements – all promising a breathless array of health benefits? What would you pay to know the length of your telomeres and what, if anything, would that tell you about the likelihood of your getting age-related diseases such as heart disease, cancer and stroke? You might also want to know whose genes you’ve inherited and which components of lifestyle, diet and the environment influence their genetic expression the most.
How you answer these questions could have significant lifestyle and cost implications depending on just how much are you willing to accommodate the shifting landscape of longevity research. At the end of the day, it comes down to this: What quality-of-life sacrifices are you prepared to make and how much would you pay for a shot at immortality?
Twenty-first century research has opened the door to the enticing prospect of redefining the limits of our life-span – perhaps to immortality itself. Like the ancients’ quest for the Philosopher’s Stone, however, the search often comes with a price. Even if eternal youth turns out to be elusive, the quest itself is likely to be immortal – and not without cost. Whether it proves to be a Faustian bargain remains to be seen.
- Schulz, Richard and Scott R. Beach. Caregiving as a risk factor for mortality: the caregiver health effects study. JAMA, December 15, 1999 – Vol 282, No. 23.
- Epel, Elissa S. et al. Accelerated telomere shortening in response to life stress. PNAS, December 7, 2004, vol. 101, no. 49.
- Sapolsky, Robert M. Organismal stress and telomeric aging: An unexpected connection. PNAS, December 14, 2004, vol. 101, no. 50.
- Taubes, G. The timeless and trendy effort to find – or create – the Fountain of Youth. Discover Magazine. Oct, 2010. Available from: http://discovermagazine.com/2010/oct/12-timeless-trendy-effort-find-create-fountain-youth
- Siegel, Lee J. Are telomeres the key to aging and cancer? Genetic Science Learning Center. University of Utah. Available from: http://learn.genetics.utah.edu/content/begin/traits/telomeres
- De Grey, Aubrey and Michael Rae. A modest proposal: how to stop aging entirely. Discover Magazine, September 23, 2009. Available from: http://discovermagazine.com/2009/new-science-of-health/23-modest-proposal-how-to-stop-aging-entirely
- Greenwood, Veronique. What will our telomeres tell us? Discover Magazine, May 18, 2011. Available from: http://discovermagazine.com/2011/may/18-what-will-our-telomeres-tell-us
- Kendrick, Mandy. Anti-aging pill targets telomeres at the ends of chromosomes. Scientific American, August 17, 2009. Available from: http://www.scientificamerican.com/article.cfm?id=anti-aging-pill-targets-telomeres
- Karlin, Susan. Can a pill keep our DNA young? Discover Magazine, June 11, 2010. Available from: http://discovermagazine.com/2010/may/20-can-a-pill-keep-your-dna-young
- Kanfi, Yariv et al. The sirtuin SIRT6 regulates lifespan in male mice. Nature, March 8, 2012, 483; 218-221. Published online February 22, 2012.
Steve Zoltai is the collections development librarian and archivist
for CMCC and is a member of the Canadian Chiropractic Historical
Association. He was previously the assistant executive director of the
Health Sciences Information Consortium of Toronto. He has worked for
several public and private libraries and with the University of Toronto
Archives. Steve comes by his interest in things historical honestly – he
worked as a field archeologist for the Province of Manitoba. He can be
contacted at firstname.lastname@example.org.
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