Ageing is also known as senescence. In general, aging is characterised by the declining ability to respond to stress, increased homeostatic imbalance & increased risk of age related diseases.
Herbal medicine, nutritional supplementation, dietary and lifestyle approaches can address the effects of aging by activating telomerase, restoring autophagic activity and maximising digestion, absorption and assimilation of nutrients to extend life, without the use of pharmacological drugs.
Age Related Disease List
- Dementia / Alzheimer's
- Osteoporosis / Osteoarthritis
- Cardiovascular Disease: Hypertension, Atherosclerosis, Arteriosclerosis, Myocardial Infarction (MI), Cerebral Vascular Accident (CVA)
- Diabetes: a micro vascular angiopathy causing Retinopathy, Nephropathy, Peripheral neuropathy.
- Prostate Disorders: BPH, Cancer
- Erectile Dysfunction / Loss of libido
- Cancer: Breast, prostate, ovarian, endometrial, vaginal, bowel
- Diverticuli: connective tissue weakness
- Prolapse: uterus, bowel
- Eye Disease: Macular degeneration, cataracts, glaucoma, short-sightedness, eye strain, blepharitis (dry eyes)
- Hearing loss, tinnitus
Theories of Ageing
There are a number of theories as to why senescence occurs. Some propose ageing is programmed by genes, others that it is the cumulative damage caused by biological processes. Senescence is not universal, and scientific evidence suggests that cellular senescence evolved to prevent the onset of cancer. Both genetic and environmental factors contribute to ageing. In general, theories that explain senescence have been divided between the programmed and stochastic theories of aging.
Programmed theories imply that ageing is regulated by biological clocks operating throughout the lifespan. This regulation would depend on changes in gene expression that affect the systems responsible for maintenance, repair and defence responses.
The Reproductive-cell cycle theory
The reproductive-cell cycle theory suggests that ageing is caused by changes in hormonal signalling over the lifespan.
Stochastic theories blame environmental impacts on living organisms that induce cumulative damage at various levels as the cause of ageing, examples of which ranging from damage to DNA, damage to tissues and cells by oxygen radicals (widely known as free radicals countered by the even more well-known antioxidants), and cross-linking.
Failure of homeodynamics
Ageing is seen as a progressive failure of homeodynamics (old term homeostasis) involving genes for the maintenance and repair, stochastic events leading to molecular damage and molecular heterogeneity, and chance events determining the probability of death.
Shrinkage of homeodynamic space
Since complex and interacting systems of maintenance and repair comprise the homeodynamic space of a biological system, ageing is considered to be a progressive shrinkage of homeodynamic space mainly due to increased molecular heterogeneity.
Evolutionary Theories and Natural Selection
Senescence may be the product of natural selection. Ageing is believed to have evolved because of the increasingly smaller probability of an organism still being alive at older age, due to predation and accidents.
It is thought that strategies resulting in a higher reproductive rate at a young age, but shorter overall lifespan, result in a higher lifetime reproductive success and are therefore favoured by natural selection. Ageing is a result of the body investing resources in reproduction, rather than maintenance of the body in light of the fact that accidents, predation, and disease will eventually kill the body. From a naturopathic perspective, there is a higher Vital Force when young to encourage a higher reproductive rate (Biological clock).
Late-acting deleterious mutations
The geneticist J. B. S. Haldane wondered why natural selection had not eliminated the dominant mutation that causes Huntington's disease. The average onset of this neurological disease is 45, invariably being fatal within 10–20 years. Haldane assumed that few survived until age 45 in human prehistory. Since few were alive at older ages and their contribution to the next generation was therefore small relative to the large cohorts of younger age groups, the force of selection against such late-acting deleterious mutations was correspondingly small. However, if a mutation affected younger individuals, selection against it would be strong. It is these later-acting deleterious mutations that are believed to allow or even cause, age-related mortality.
Ageing is due to Cellular Senescence
Cellular senescence is the phenomenon by which normal cells lose the ability to divide, normally after about 50 cell divisions in vitro. Some cells become senescent after fewer replications cycles as a result of DNA double strand breaks, toxins, etc. This phenomenon is also known as "replicative senescence", the "Hayflick phenomenon", or the Hayflick limit in honour of Dr. Leonard Hayflick, co-author with Paul Moorhead, of the first paper describing it in 1961. In response to DNA damage (including shortened telomeres), cells either age or self-destruct (apoptosis, programmed cell death) if the damage cannot be easily repaired.
Cellular senescence is not observed in several organisms, including perennial plants, sponges, corals, and lobsters. In species where cellular senescence is observed, cells eventually become post-mitotic when they can no longer replicate themselves through the process of cellular mitosis.
Cancer cells are usually immortal
How and why some cells become post-mitotic in some species has been the subject of much research and speculation, but it is widely believed that cellular senescence evolved as a way to prevent the onset and spread of cancer. Somatic cells that have divided many times will have accumulated DNA mutations and would therefore be in danger of becoming cancerous if cell division continued.
Cancer cells are usually immortal. In about 85% of tumors, this evasion of cellular senescence is the result of up-activation of their telomerase genes (telomerase is an enzyme involved in cellular replication). This simple observation suggests that reactivation of telomerase in healthy individuals could greatly increase their cancer risk.
Life span and cellular senescence
Life span is dictated by the limited number of times a cell can divide. Though the immortal reproductive cell can divide a limitless number of times, once the human reproductive cell, in the developing embryo, turns into a developmental cell, the clock starts ticking and the cell's fate is doomed to a limited number of cell divisions, known as the Hayflick Limit (somewhere between 40-60). Once that limit has been reached, the cell and all of its progeny completely lose the ability to divide and then enter a phase called senescence. Cells lose their ability to divide after a certain number of times due to a decrease in telomerase in every division, then undergo apoptosis (programmed cell death). Apoptosis prevents/protects from genetic mutation and cancer.
Telomere length represents the biological clock
This "biological clock" is found at the tips of the cell's chromosomes in a region called the telomere. It is believed that telomeres may have evolved to prevent the unlimited growth of cells by limiting their life span. Telomeres are made up of subunits (or bases) of DNA called A, C, G, and T. In the telomere, these bases are arranged in six base repeat units of TTAGGG. When a human is first conceived, the length of the telomeres averages about 15,000 bases (up to 2,500 TTAGGG repeat units) as measured by a process called terminal restriction fragment length analysis. The length then begins to decrease at a rate of about 100 bases per cell division. By the time a person is born, the average telomere length has already dwindled to about 10,000 bases and then throughout the rest of a person's lifetime the average length of the telomeres gradually decreases to about 5,000 bases at which time the person's cells lose the ability to divide. These cells are then senescent, and the person suffers and dies of old age.
Decreased telomerase activity / Telomere Theory
Telomerase is an enzyme involved in cellular replication. This enzyme is depleted with each division of a cell, so there is a limit of the number of times a cell can divide (approx 52 – the Hayflick limit). The SIRT1/Sir2 gene causes an increase in Telomerase, which allows each dividing cell to replace the lost portion of DNA, allowing it to divide unbounded (caution – unbounded division is part of pathogenesis of cancer). SIRT1/Sir 2 gene expression requires NAD+ (B3).
Sir2 Gene regulation
Studies of the organisms including the budding yeast Saccharomyces cerevisiae to worms such as Caenorhabditis elegans and fruit flies (Drosophila melanogaster) have revealed the presence of at least two conserved ageing pathways. One of these pathways involves the Sir2 gene, a NAD+-dependent histone deacetylase. Extra copies of Sir2 are capable of extending the lifespan of both worms and flies.
By converting nicotinamide to niacin, nicotinamide is removed, inhibiting the activity of Sir2. A nicotinamidase found in humans, known as PBEF, may serve a similar function, and a secreted form of PBEF known as visfatin may help to regulate serum insulin levels.
Telomere Theory in relation to Sir 2 gene
Studies (in the 'C. elegans' worm and yeast) show that an increase the Sir2 gene (SIRT1 in mammals) causes an increase Telomerase activity which increases longevity. The expression of the SIRT1 gene is dependent on the availability of NAD+ (B3), which is also used in the krebs cycle. CR, or calorific restriction, causes a decrease in glucose in cells, which will decrease the krebs cycle needs, thus increasing the available NAD+, increasing SIRT1 expression, increasing Telomerase, and thus finally increasing longevity.
Factors that increase Sir2 activity
In yeast, Sir2 activity is regulated by the nicotinamidase PNC1. PNC1 is transcriptionally upregulated under stressful conditions such as caloric restriction, heat shock, and osmotic shock. Due to the lack of available glucose in the cells, more NAD+ is available and can activate Sir2.
Calorie Restriction CR
Calorically-restricted animals process as much, or more, calories per gram of body mass, as their ad libitum fed counterparts, yet exhibit substantially longer lifespans.
Resveratrol, a stilbenoid found in the skin of red grapes, was reported to extend the lifespan of yeast, worms, and flies. It has been shown to activate Sir2 and therefore mimics the effects of calorie restriction, if one accepts that caloric restriction is indeed dependent on Sir2.
Hormesis Theory and Ageing
Hormesis is the term used to describe biological phenomena such as toxins and other stressors, that are adverse or detrimental at high levels becoming beneficial when applied at low levels. What doesn't kill you makes you stronger. Hormesis states that stressors stimulates healing and the vital force, making the body stronger.
The hormetic phenomenon in ageing is characterised as beneficial responses to stress through the physiological adaptations, as exemplified in lifespan extension by irradiation and calorie restriction. A pollutant or toxin showing hormesis thus has the opposite effect in small doses than in large doses. Free radicals can promote healing, activating the stress response and healing/repair pathways in the body. Healthy ageing can be achieved with mild and periodic Hormesis (not severe and chronic).
Hyperglycaemia and Accelerated Ageing
Diabetes is a condition of accelerated ageing and cellular senescence.
Sugar and oxidation
There is evidence that sugar damage is linked to oxidant damage in a process termed glycoxidation. In a process called glycation, sugars such as glucose and fructose can react with certain amino acids such as lysine and arginine and certain DNA bases such as guanine to produce sugar adducts. These adducts can further rearrange to form reactive species, which can then cross-link the structural proteins, DNA or non-structural proteins. People with diabetes, who have elevated blood sugar, develop senescence-associated disorders much earlier than the general population, but can delay such disorders by rigorous control of their blood sugar levels.
Excess Sugars (glucose, fructose) cause;
- Genetic damage.
- Decrease the availability of NAD+ for SIRT1/Sir2.
- Glycation - react with Amino Acids (Arginine, Lysine) and certain DNA bases (guanine, arganine, lysine). Produces sugar adducts which form reactive oxidation species (ROS or free radicals), which crosslink structural proteins /DNA to non-structural ones, damaging proteins (in arterioles).
- Sugar damage leads to oxidative damage (glycoxidation), free radicals which damage proteins, lipids, DNA, causing lipid peroxidation.
- Damage to collagen in blood vessels leads to arteriosclerosis /atherosclerosis.
- Excess fructose results in excess advanced glycation endproducts (AGEs), which block glycolysis (glucose into pyruvate). The macrophages exposed to AGEs become dysfunctional, enter the artery wall, and contribute to plaque formation & thrombosis.
Central obesity and accelerated ageing
Central obesity is related to fat cells called visceral adipose cells. These fat cells produce significant amounts of proinflammatory cytokines such as tumour necrosis factor-alpha (TNF-a) & Interleukins 1 & 6. Proinfammatory cytokines profoundly disrupt normal insulin action in fat & muscle cells & may be a major factor in insulin resistance and accelerated ageing.
Free Radical Theory of Ageing
The free radical theory of aging (FRTA) states that we age because cells accumulate free radical damage over time. Metabolism causes chemical damage to structural proteins or DNA. Under normal aerobic conditions, approximately 4% of the oxygen metabolised by mitochondria is converted to superoxide ion, which can subsequently be converted to hydrogen peroxide, hydroxyl radical and eventually other reactive species including other peroxides and singlet oxygen, which can, in turn, generate free radicals capable of damaging structural proteins and DNA. These processes are termed "oxidative damage". From a naturopathic perspective, nutritionally derived polyphenol antioxidants protect against oxidative damage.
Effects of free radicals
Free radicals can damage proteins, lipids or DNA. Glycation mainly damages proteins. Chemical damage to structural proteins can lead to loss of function; for example, damage to collagen of blood vessel walls can lead to vessel-wall stiffness and, thus, hypertension, and vessel wall thickening and reactive tissue formation (atherosclerosis). Similar processes in the kidney can lead to renal failure.
Damage to enzymes reduces cellular functionality. Lipid peroxidation of the inner mitochondrial membrane reduces the electric potential and the ability to generate energy. It is probably no accident that nearly all of the so-called "accelerated ageing diseases" are due to defective DNA repair enzymes.
Alcohol and accelerated ageing
It is believed that the impact of alcohol on ageing can be partly explained by alcohol's activation of the HPA axis, which stimulates glucocorticoid secretion, long-term exposure to which produces symptoms of ageing.
Superoxide dismutase SOD and Glutathione peroxidase (GPX)
Glutathione peroxidase (GPX), superoxide dismutase (SOD) and catalase are the most important enzymes of the cell antioxidant defence system. GPX and SOD are made in the liver and kidneys and protects liver and kidney cells against free radical damage. These endogenous antioxidant enzymes are an important defence in nearly all cells exposed to oxygen are therefore implicated in prevented ageing. GPX and SOD have powerful anti-inflammatory activity and protect against the effects of mitochondrial free radicals and can extend lifespan.
Sedentary Lifestyle and Accelerated Ageing
According to the World Health Organisation, lack of physical activity contributes to approximately 17% of heart disease and diabetes, 12% of falls in the elderly, and 10% of breast cancer and colon cancer. Physical exercise is important for maintaining physical fitness and can contribute positively to maintaining a healthy weight, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks and strengthening the immune system.
Frequent and regular aerobic exercise has been shown to help prevent or treat serious and life-threatening chronic conditions such as high blood pressure, obesity, heart disease, Type 2 diabetes, insomnia, and depression. Studies have shown that exercising in middle age leads to better physical ability later in life.
Benefits of Exercise to Prevent Ageing
- Reduces the risk of diabetes
- Exercise reduces levels of cortisol which causes many health problems, both physical and mental. Cortisol raises blood sugar and contributes to hyperglycaemia and hyperinsulinaemia.
- Endurance exercise before meals lowers blood glucose more than the same exercise after meals. Exercise reverse insulin resistance by increasing GLT4 receptors on the cell surface to improve insulin sensitivity.
Exercise reduces the risk of cardiovascular disease
The beneficial effect of exercise on the cardiovascular system is well documented. Both aerobic and anaerobic exercise work to increase the mechanical efficiency of the heart by increasing cardiac volume (aerobic exercise), or myocardial thickness (strength training). There is a direct relation between physical inactivity and cardiovascular mortality, and physical inactivity is an independent risk factor for the development of coronary artery disease.
Exercise to prevent cardiovascular disease and diabetes
- Decreased homocysteine and increased nitric oxide
- Decreased LDL, turns VLDL into LDL, increased HDL
- Increase SHBG
- Improved circulation and elimination of toxins
- Increases insulin sensitivity by increasing GLUT4 receptors.
Exercise benefits the immune system
Epidemiological evidence suggests that moderate exercise has a beneficial effect on the human immune system. Immune cell functions are impaired following acute sessions of prolonged, high-intensity exercise, and some studies have found that athletes are at a higher risk for infections.
Exercise reduces inflammatory biomarkers including C-reactive protein
Biomarkers of inflammation such as C-reactive protein, which are associated with chronic diseases, are reduced in active individuals relative to sedentary individuals, and the positive effects of exercise may be due to its anti-inflammatory effects.
Exercise improves brain function
Some studies have shown that vigorous exercise executed by healthy individuals can increase opioid peptides (a.k.a. endorphins, naturally occurring opioids that in conjunction with other neurotransmitters are responsible for exercise-induced euphoria and have been shown to be addictive), increase testosterone and growth hormone.
A 2008 review of cognitive enrichment therapies (strategies to slow or reverse cognitive decline) concluded that "physical activity, and aerobic exercise in particular, enhances older adults' cognitive function". In addition, physical activity has been shown to be neuroprotective in many neurodegenerative and neuromuscular diseases, reducing the risk of developing dementia. Furthermore, anecdotal evidence suggests that frequent exercise may reverse alcohol-induced brain damage.
Why exercise benefits the brain
- Increases blood and oxygen flow to the brain
- Increases growth factors that help create new nerve cells and promote synaptic plasticity
- Increases chemicals in the brain that help cognition, such as dopamine, glutamate, norepinephrine, and serotonin.
Exercise treats depression
A number of factors may contribute to depression including being overweight, low self esteem, stress, and anxiety. Endorphins act as a natural pain reliever and antidepressant in the body. Endorphins have long been regarded as responsible for what is known as "runner's high", a euphoric feeling a person receives from intense physical exertion. When a person exercises, levels of both circulating serotonin and endorphins are increased. These levels are known to stay elevated even several days after exercise is discontinued, possibly contributing to improvement in mood, increased self-esteem, and weight management.
Exercise improves sleep
A 2010 review of published scientific research suggested that exercise generally improves sleep for most people, and helps sleep disorders such as insomnia.
Hyperhomocysteinaemia and Accelerated Ageing
Hyperhomocysteinaemia is a medical condition characterised by an abnormally large level of homocysteine in the blood. Simply put high homocysteine results in low levels of Nitric Oxide NO also know as Endothelial Derived Relaxing Factor EDRF. Whilst adrenalin causes vasoconstriction in peripheral arterioles and raises blood pressure, it is NO that allows these to relax resulting in a decrease in BP.
How does homocysteine decrease Nitric Oxide levels?
Homocysteine elevates blood levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase the enzyme involved in the production of NO. The effect is associated with the reduced activity of dimethylarginine dimethylaminohydrolase (DDAH), the enzyme that degrades ADMA. Homocysteine post-translationally inhibits DDAH enzyme activity, causing ADMA to accumulate and inhibit nitric oxide synthesis. This may explain the known effect of homocysteine to impair endothelium-mediated nitric oxide dependent vasodilatation.
Hyperhomocysteinaemia and Heart Disease
A high level of homocysteine in our blood makes us more prone to having blood clots which come in heart attacks and strokes.
Hyperhomocysteinaemia also damages the lining of veins and arteries which prevents build up.
Hyperhomocysteinaemia is a risk factor for coronary artery disease Coronary artery disease (plaque builds up on coronary arteries)
Homocysteine and Ageing
Homocysteine is a powerful reducing agent and, like most such agents, can induce oxidative stress through reducing molecular oxygen to its radical forms.
Causes of Hyperhomocysteinaemia
- Two Gene Defects - Hyperhomocysteinaemia usually occurs in people with at least one defective gene, which affects the breakdown of homocysteine. The first gene codes for an enzyme. This gene is known as Methylenetetrahydrofolate reductase or MTHFR. The second common defective gene is methioninesynthetase or MS.
- Dietary deficiencies of Folate and vitamin B6 and B12 - The effect upon those people is greater than the people with only one gene defect.
Insulin Resistance (IR) Metabolic Syndrome and Accelerated Ageing
Metabolic syndrome is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes. It affects one in five people, and prevalence increases with age. Metabolic syndrome is also known as syndrome X and insulin resistance syndrome. Metabolic syndrome affects 44% of the U.S. population older than age 50.
Symptoms of Metabolic Syndrome
- Insulin Resistance IR
- Dyslipidaemia (low LDL and high HDL cholesterol)
- Hyperglycaemia (which leads to decreased NAD+, so decreased SIRT1/Sir2 gene expression)
- Central obesity
Insulin Resistance and Accelerated Ageing
Insulin resistance (IR) is a condition in which body cells become less sensitive to the glucose-lowering effects of the hormone insulin. High plasma levels of insulin and glucose due to insulin resistance are a major component of metabolic syndrome.
Many people with hypertension are either diabetic or pre-diabetic and have elevated insulin levels due to insulin resistance.
Pathophysiology of insulin resistance
Commonly there is development of visceral fat after which the adipocytes (fat cells) of the visceral fat increase plasma levels of TNFα and alter levels of a number of other substances (e.g., adiponectin, resistin, PAI-1). TNFα has been shown not only to cause the production of inflammatory cytokines, but possibly to trigger cell signalling by interaction with a TNFα receptor that may lead to insulin resistance.
Insulin and Arterial Muscle Tone
One of insulin's effects is to control arterial wall tension throughout the body. Insulin forces arterial wall muscle to relax, increasing blood flow, especially in micro arteries; lack of insulin reduces flow by allowing these muscles to contract.
Insulin and the development of cancer
- ILGF + HER2 => Increases protein tyrosine kinase / employs COX2 => angiogenesis (a step in transition of tumour from dormant to malignant)
- ILGF -> RTK -> Her2 (oncogene) /+Cox2 -> cancer
Insulin and Advanced Glycation End Products (AGEs)
AGEs are proteins or lipids that become glycated after exposure to sugars. AGEs are prevalent in the diabetics and insulin resistant patients and contribute to the development of vascular disease namely atherosclerosis.
The Mitochondrial Theory of Ageing (MTA)
The Mitochondrial Theory of Ageing is considered an extension of the Free Radical Theory of Ageing. According to this theory, ageing is due to the cumulative effects of free radical damage to mitochondrial DNA and function, leading to what is termed from a naturopathic perspective, Mitochondrial Dysfunction. Mitochondrial dysfunction results in a deficiency of ATP (adenosine triphosphate), the body's primary form of energy, and ADP (adenosine diphosphate), which mitochondria use to make ATP.
Since the mitochondria are responsible for processing oxygen and converting substances from the foods we eat into energy for essential cellular functions, if there are problems with the mitochondria, it can lead to many diseases. These include Type 2 diabetes, Parkinson's disease, atherosclerotic heart disease, stroke, Alzheimer's disease, and cancer. Many medicines also damage mitochondria.
Calorific Restriction reduces mitochondrial free radical production and mitochondrial DNA oxidative damage.
Connective Tissue Weakness and Accelerated Ageing
Connective tissue is any type of biological tissue with an extensive extracellular matrix that supports, binds together, and protects organs. These tissues form a framework, or matrix, for the body, and are composed of two major structural protein molecules: collagen and elastin.
Pathophysiology of connective tissue weakness
Connective tissue weakness occurs when the body breaks down the connective tissues faster than it can rebuild them. Causes include nutritional, metabolic and endocrine. Nutrients and hormones are necessary to repair and regenerate the tissue that is breaking down each day. Nutritional deficiencies will result ion lack of regeneration of connective tissue. Medications such as NSAIDs inhibit the normal inflammatory healing response and prevent collagen synthesis.
Conditions associated with a connective tissue weakness
- Leaky gut syndrome
- Periodontal disease
- Premature ageing
Physical Factors Associated with an Ageing Digestive System
Hypochlorhydria and Ageing
Starting at about the age of 60, some people begin to lose their sense of taste and smell. Specifically, they lose the ability to distinguish between sweet, salty, sour, and bitter, which makes food less appealing and reduces appetite. Inadequate taste and smell sensations may also negatively impact the digestion of food, as the taste and smell of food stimulates the secretion of digestive enzymes in the mouth, stomach and pancreas.
A large percentage of elderly people (more than 70%) do not produce enough saliva, a condition called xerostomia. This condition is considered to be part of the normal aging process, but it is also caused by several commonly prescribed medications including antidepressants, blood pressure medications, diuretics, and sedatives. Saliva is manufactured by glands located in the mouth, and plays an important role in the digestive process. Without adequate saliva, appetite and digestion are compromised.
Hypochlorhydria, or lack of stomach acid, contributes to a variety of nutrition-related problems in the elderly. During digestion, hydrochloric acid is secreted into the stomach, which lowers the pH of the stomach, a condition necessary for the breakdown of protein and the absorption of several minerals including iron, calcium and zinc. People with hypchlorhydria, therefore, have poor digestion and poor absorption of minerals. In addition, insufficient stomach acid allows the overgrowth of bacteria in the small intestine, a condition that can reduce the absorption of vitamin B12.
Adrenal Exhaustion and Accelerated Ageing
The adrenal glands synthesise catecholamines (adrenaline, noradrenaline, dopamine), and cortisols, DHEA (an androgen which produces testosterone / oestrogen), and aldosterone (regulating water and electrolyte balance). Adrenal exhaustion increases homeostatic imbalance, increasing the risk of disease.
Decreased DHEA levels due to adrenal exhaustion
Studies have shown that levels of DHEA peak in 20s, then start to fall, and falling levels are associated with the signs of ageing. Regular exercise increases DHEA. Direct supplementation with DHEA doesn't seem to provide any benefit in the long term. Naturopathic Treatment Principles in ageing include Tonifying the Adrenal glands to increase endogenous production of DHEA. Consider adaptogens (liquorice, ginseng, Siberian ginseng, panax ginseng, damiana, ginseng – works on HPA axis).
Accelerated Ageing due to deficiency of the Vital Force due to the Hygiene Hypothesis and Molecular Mimicry
Excessive hygiene (due to the overuse of antibacterials and the lack of exposure to childhood diseases due to "successful" vaccination programmes, doesn't allow the body's natural defences to be exercised. From a naturopathic perspective, stimulating the Vital Force is done using Fever Management and supporting the natural expression of symptoms using natural medicine treatments.
Nutritional Deficiencies in Ageing
Nutritional deficiencies will lead to various dis-ease states, depending on the nutrients involved. The main nutritional deficiencies presenting in an ageing patient are due to hypochlorydria and include calcium, iron, zinc and B12.
Naturopathic Treatment Principles in Ageing
- Increase expression of SIRT1/Sir2
- Apply Hermetic Aids CR, Heat shock, Osmotic shock
- Lower Homocysteine - B6, B9(folic acid), B12, SAMe, methionine, cysteine
- Increase polyphenol antioxidants or phytochemicals in the diet.
- Increase Endogenous Antioxidants Superoxide Dismutase SOD and Glutathione Peroxidase GPX to Prevent Free Radical damage – Zinc, A, , E & Selenium, Glutathione, ALA, Manganese.
- Improve Insulin Resistance - Chromium, Mg, B6, EFA (Improve receptor sensitivity and prevents lipid peroxidation)
- Improve mitochondrial function - Mitococktail (CoQ10, DRibose, Carnitine- improves fatty acid transport across cell membrane) & NAD (B3), FAD (B2), Fe, B12, Cu
- Strengthen Connective Tissue - Vit C, glucosamine, GAGs
- Increase Digestive Absorption & Assimilation
- Tonify the Adrenal Glands to Increase DHEA (a precursor hormone)levels - Vit C, B5, Tyrosine, Adaptogens
- Tonify the Vital Force - Fever management, Applying hermetic aids.
- Replace Nutritional Deficiencies
- Tonify Yin, Jing, Yang and Blood from a TCM perspective
- Increase Expression of SIRT1/Sir2
Factors that increase expression of SIRT1/Sir2
- Resveratrol (in red wine) – its also anticancer and heart protective.
- Increasing the available NAD+ (B3)
Please note: Hyperglycaemia -> Increase ILGF and decreases NAD+ availability, so decreased SIRT1/Sir2, to decreased telomerase, thus resulting in accelerated ageing.
- Apply Hormetic Aids to Increase Expression of SIRT1/Sir2
- Calorific Restriction (CR)
- Heat Shock
- Osmotic shock
Increases reactive oxygen species (ROS / free radicals) and other free radicals, acids and aldehydes. There is 20 fold enhanced mitochondrial respiration and oxidative phosphorylation (electron transfer chain), therefore an increase in metabolic rate. Prolonged exercise is damaging due to excess acids, so need moderate levels are recommended.
Exercise activates NFKappaB, activating inflammatory cytokines, ie various kinases and Antioxidants (AOs) (SOD, etc) (upregulation), which then activates anti-inflammatory mechanisms and DNA repair (down regulation). Net result is that pathways of maintenance and repair.
Mild Stressors include
Evidence of health benefits and longer average life-span following low-dose irradiation should replace fear, "all radiation is harmful," and "the perception of harm" as the basis for action in the 21st century. Hormesis is the excitation, or stimulation, by small doses of any agent in any system. Large doses inhibit. "Low dose" is defined as any dose between ambient levels of Radiation and the threshold that marks the boundary between positive and negative effects. The sun emits healthful leveles of radiation in normal doses.
Pro-oxidants are chemicals that induce oxidative stress, through either creating reactive oxygen species or inhibiting antioxidant systems.
Hypergravity is defined as the condition where the force of gravity exceeds that on the surface of the earth. Hypergravity conditions are created on earth for research on human physiology in aerial combat and space flight, as well as testing of materials and equipment for space missions.
Recent research carried out on extremophiles in Japan involved a variety of bacteria including Escherichia coli and Paracoccus denitrificans being subject to conditions of extreme gravity. Paracoccus denitrificans was one of the bacteria which displayed not only survival but also robust cellular growth under these conditions of hypergravity.
Calorie restriction promotes longevity through the following mechanisms
The calorie restricted diet leads to:
Hypoglycaemia -> decreased ILGF -> increased NAD+ -> increased SIRT1 -> increased telomerase -> increased longevity i.e. decreased cellular senescence and neuroprotective.
Health benefits of Calorific Restriction
- Decreases BMI
- Decreases cholesterol
- Decreases LDL, increases HDL, decreases tryglycerides
- Increases DHEA, decreases glycation, decreases glycoxidation / lipid peroxidation
- Decreases fasting glucose and
- Lowers blood pressure
- Reduces mitochondrial free radical production and mitochondrial DNA oxidative damage.
Intermittent therapeutic fasting is a recommended alternative approach to CR. Please note a long term fast and a colonic every lunch time will not extend your life.
Benefits of Both fasting and CR
- Increase glucose metabolism
- Increase insulin sensitivity
- Increase stress resistance
Food with Hormetic Benefits
- Resveratrols (red wine)
- Curcumin (in turmeric)
- Lowering Homocysteine to Prevent Ageing
Deficiencies of the vitamins folic acid, B6 or B12, results in the poor methylation of homocysteine and thus accumulation. Supplementation with pyridoxine, folic acid, B12 or trimethylglycine (betaine) reduces the concentration of homocysteine in the bloodstream. Exercise lowers homocysteine.
- Increase Endogenous Antioxidants to Prevent Free Radical Damage
A polyphenol antioxidant is characterized by the presence of phenol functional groups. In humans these compounds
Combating oxidative stress, a syndrome that causes some neurodegenerative diseases, cardiovascular diseases and other symptoms of accelerated ageing. Combating oxidative stress results in anti-aging consequences such as slowing the process of skin wrinkling.
It is difficult to evaluate the effects of specific polyphenolic antioxidants, since such a large number of individual compounds may occur even in a single food. For example, over sixty different chemically distinct flavonoids are known to occur in a given red wine. Wine, although nonessential, has high polyphenol content up to two to three grams per litre in red wines obtained by traditional maceration.
There is debate regarding the total body absorption of dietary intake of polyphenolic compounds. There is evidence that some combinations of foods may inhibit efficient intestinal transfer of certain polyphenol antioxidants; refined sugars, for example, have been shown to impede this uptake under certain circumstances.
Health benefits of polyphenol antioxidants
- Scavenge free radicals
- Up-regulate certain heavy metal chelation reactions
- Promote oxidized LDL and prevent peripheral artery disease.
- Combat inflammation.
Dietary sources of polyphenol antioxidants
The main source of polyphenol antioxidants is dietary. Most legumes, fruits such as apples, blackberries, blueberries, cantaloupe, cherries, cranberries, grapes, pears, plums, raspberries, and strawberries, and vegetables such as broccoli, cabbage, celery, onion and parsley are rich in polyphenol antioxidants. Red wine, chocolate, green tea, olive oil, bee pollen and many grains are alternative sources.
Types of Polyphenol Antioxidants
Resveratrol is found in the skin of red grapes and as a constituent of red wine.
Resveratrol inhibits occurrence and/or growth of tumours.
Health benefits of resveratrol;
- Life-prolonging effects
Flavonoids are also commonly referred to as bioflavonoids. Flavonoids, including isoflavonoids and neoflavonoids, are most commonly known for their antioxidant activity. However, it is now known that the health benefits they provide against cancer and heart disease are the result of other mechanisms. The beneficial effects of fruit, vegetables, tea and red wine have been attributed to flavonoids compounds rather than to known nutrients and vitamins. Epicatechin, quercetin and luteolin are examples of flavonoids
Health benefits of Flavanoids not due to direct antioxidant value
In 2007, research conducted at the Linus Pauling Institute and published in Free Radical Biology and Medicine indicates that inside the human body, flavonoids themselves are of little or no direct antioxidant value. Unlike in the controlled conditions of a test tube, flavonoids are poorly absorbed by the human body (less than 5%), and most of what is absorbed is quickly metabolised and excreted from the body.
The huge increase in antioxidant capacity of blood seen after the consumption of flavonoids-rich foods is not caused directly by the flavonoids themselves, but most likely is due to increased uric acid levels that result from expelling flavonoids from the body. The body sees them as foreign compounds and is trying to get rid of them. But this process of gearing up to get rid of unwanted compounds is inducing so-called Phase II enzymes that also help eliminate mutagens and carcinogens.
Flavonoids could also induce mechanisms that help kill cancer cells and inhibit tumour invasion. Their research also indicated that only small amounts of flavonoids are necessary to see these medical benefits. Taking large dietary supplements provides no extra benefit and may pose some risks.
Health benefits of flavonoids
Flavonoids have been referred to as "nature's biological response modifiers" because of strong experimental evidence of their inherent ability to modify the body's reaction to allergens, viruses, and carcinogens.
- Anti-cancer activity
Quercetin is a flavonoid. In studies, quercetin is found to be the most active of the flavonoids, and many medicinal plants owe much of their activity to their high quercetin content. Quercetin directly inhibits several processes of inflammation.
Health benefits of quercetin
- Inhibits the production and release of histamine
- Inhibits other allergic/inflammatory mediators
- Exerts potent antioxidant activity and vitamin C-sparing action
Epicatechin improves blood flow and is therefore good for cardiac health. Cocoa, the major ingredient of dark chocolate, contains relatively high amounts of epicatechin and has been found to have nearly twice the antioxidant content of red wine and up to three times that of green tea in in-vitro tests.
Proanthocyanidins extracts demonstrate a wide range of pharmacological activity.
Health benefits of proanthocyanadins
Increasing intracellular vitamin C levels
Decreasing capillary permeability and fragility
Scavenging oxidants and free radicals
Inhibiting destruction of collagen
Food sources of flavonoids
- All citrus fruits
- Green tea
- Red wine
- Dark chocolate (that with a cocoa content of seventy percent or greater).
The citrus bioflavonoids include;
- Rutin (a glycoside of quercetin)
Health benefits of rutin and hesperidin and quercetin
- Increase intracellular levels of vitamin C
- Beneficial effects on capillary permeability
- Improve blood flow
- Inhibits reverse transcriptase, part of the replication process of retroviruses.
- Used to treat capillary permeability, easy bruising, haemorrhoids, and varicose veins.
Green tea flavonoids are potent antioxidant compounds and reduce incidence of cancer and heart disease.
The major flavonoids in green tea are;
- Catechins (catechin, epicatechin, epicatechin gallate
- Epigallocatechin gallate (EGCG)).
In producing teas such as oolong tea and black tea, the leaves are allowed to oxidize, during which enzymes present in the tea convert some or all of the catechins to larger molecules. White tea is researched as the least processed of teas and is shown to present the highest amount of catechins known to occur in camellia sinensis. However, green tea is produced by steaming the fresh-cut leaf, which inactivates these enzymes, and oxidation does not significantly occur.
Grape skin contain significant amounts of flavonoids as well as other polyphenols. Both red and white wine contain flavonoids, however, since red wine is produced by fermentation in the presence of the grape skins, red wine has been observed to contain higher levels of flavonoids, and other polyphenolics such as resveratrol.
Over 5000 naturally occurring flavonoids have been characterised from various plants.
Increase Phytochemicals in the Diet
Phytochemicals or phytonutrients are used to decsribe content of not only compounds, but also vitamin and mineral content. Foods known to be higheset in phytochemicals are sometimes referred to as Superfoods.
The Top 10 Phytonutrient Rich Superfoods
Soy – protease inhibitors, beta sitosterol, saponins, phytic acid, isoflavones
Tomato – lycopene, beta carotene, vitamin C
Broccoli – vitamin C, indole-3-carbinol, sulphoraphane, lignans
Garlic – thiosulphonates, limonene, quercitin
Flax seeds – lignans
Citrus fruits – monoterpenes, coumarin, cryptoxanthin, vitamin C, ferulic acid, oxalic acid
Blueberries – tannic acid, lignans, anthocyanins
Sweet potatoes – beta carotene
Chilli peppers – capsaicin
Legumes: beans, peas, lentils – omega fatty acids, saponins, catechins, quercetin, lutein, lignans
Other foods rich in phytonutrients
- Apples – quercitin, catechins, tartaric acid
- Açaí berries – vitamin C, anthocyanins, omega-3, omega-6, Beta-sitosterol. Possibly the highest scoring fruit for antioxidant ORAC value.
- Artichoke – silymarin, caffeic acid, ferulic acid
- Brassicaceae vegetables (kale, cabbage, brussels sprouts, cauliflower) - lutein,
- Carrots – beta-carotene
- Cocoa – flavonoids, epicatechin
- Cranberries – ellagic acid, anthocyanins
- Eggplant – nasunin
- Pink grapefruit – lycopene
- Red grapes and wine – quercitin, resveratrol, catechins, ellagic acid
- Green tea – quercitin, catechins, oxalic acid
- Mangos – cryptoxanthin
- Mangosteen - xanthone
- Nuts and seeds – resveratrol, phytic acid, phytosterols, protease inhibitors
- Okra -- beta carotene, lutein, zeaxanthin
- Onions – quercitin, thiosulphonates
- Papaya – cryptoxanthin
- Pomegranate - Vitamin C, Tannins, especially Punicalagins
- Pumpkin – lignans, carotenes
- Sesame - Lignans
- Shiitake mushrooms - polysaccharides
- Spinach – oxalic acid, lutein, zeaxanthin
- Watermelon – lycopene
5. Increasing GPX and SOD activity to Prevent Ageing
Beetroot increases our own endogenous antioxidants
Beetroot contains betacyanin a powerful antioxidant that increases the activity of GPX and SOD.
Nutrtional supplementaion to increase GPX and SOD
Supplementing Glutathione and selenium increases GPX and SOD activity
6. Improve Insulin Resistance to Prevent Ageing
Naturopathic treatment to improve insulin resistance
- Exercise and weight loss.
- Monounsaturated fatty acids and saturated fats promote insulin resistance, whereas polyunsaturated fatty acids such as omega-3 improve insulin sensitivity.
- Vanadium (vanadyl sulphate) and chromium (chromium picolinate) in GTF formulations improves insulin sensitivity.
- Daily administration of Magnesium contributes to improved insulin sensitivity. Those with high daily intake of magnesium have lower incidence of NIDDM.
Compounds that inhibit AGE formation to reduce risk of vascular disease include
- Benfotiamine B1
- Pyridoxamine B6
- Alpha-lipoic acid
Compounds that may prevent negative effects of AGEs include
Herbal Medicine approaches include bitter melon and Gymnema sylvestre.
7. Improve Mitochondrial Function to Prevent Ageing
As excess fructose results in excess advanced glycation endproducts (AGEs), which block glycolysis (glucose into pyruvate), causes lipid peroxidation can cause damage to mitochondrial membrane, from a naturopathic perspective, improving mitochodrial function should be considered as a therapeutic aim to prevent ageing.
A "mitococktail" improves fatty acid transport across cell membrane.
Niacinamide NAD (B3), FAD (B2), Fe, B12, Cu.
8. Strengthen Connective Tissue to Prevent Ageing
Glucosamine and connective tissue
Glucosamine is a precursor for glycosaminoglycans. GAGs form an important component of connective tissues and is essential for the secretion of the mucus that creates a protective lining on top the cells of the gut
Vitamin C and connective tissue
Vitamin C is essential for collagen synthesis.
9. Increase Digestion, Absorption & Assimilation to Prevent Accelerated Ageing
Including saliva, stomach acid and bile flow using herbal bitters which are naturally;
- Sialogogues (promote saliva)
- Cholagogues (promotes bile)
- Orexogenics (promotes stomach acid)
Short-term use of digestive enzymes such as bromelain and papain may be advisable, alternatively eat pineapple or papaya after meals as these fruits contain the proteolytic enzymes. Chew your food 32 times. Avoid excess liquid with meals as this dilutes hydrochloric acid.
For a herbal tincture to help improve digestion, absorption and elimination.
10. Tonify the Adrenal Glands to Increase DHEA & Prevent Ageing
Nutritional therapy to tonify the adrenal glands
Vit C, B5, Tyrosine.
Herbal medicine to the adrenal glands
An adaptogen produces an increase in power of resistance against stress whether it is physical, chemical, biological or emotional in origin or hermetic. Adaptogens restore and normalise physiological functions in the event of stress. Adaptogens specifically help our bodies adapt to changes in what is known as our circadian rhythm or body clock due to seasonal changes, shift work and crossing time zones. When a stressful situation occurs, consuming adaptogens generates a degree of generalised adaptation that allows our physiology to handle the stressful situation in a more resourceful manner.
Health benefits of adaptogens
- Increase DHEA levels
- Lowers cortisol levels during times of stress
- Boosts immunity
- Increase energy levels
- Improve resistance to stress
- Improve concentration
- Improves the symptoms of SAD
11. Tonify the Vital Force to Prevent Early Ageing
There are 2 ways to Tonify the Vital Force
- Fever management
- Hormesis Applying hermetic aids has already been discussed under increasing SIRT1 / Sir2.
Fevers are an expression of a healthy immune system and a strong Vital Force. A Fever is a natural response of a healthy immune system. A fever inhibits toxins and clears waste from the tissues, lymph and blood, on which bacteria feed and multiply. Killer T-cells are increased, as are neutrophils and macrophages, which are the white blood cells responsible for destroying invaders.
Fever IS NOT DANGEROUS unless the temperature is over 101°F (38.3°C) in an infant, 103°F (39.4°C) in a child or 104°F (40°C) in an adult. During a fever of 38-40 degrees celsius our immune system is down regulated. Essentially this means the immune system is disciplined so that it learns not to overreact and attack itself causing autoimmune disease. Please see also The Naturopathic Causes and Treatment of Autoimmune Disease.
From a naturopathic perspective, if you don't throw a good fever , your Vital Force is weak. Try an Epsom Salt Detox next time you have a cold or flu. Add 1 kg of Epsom salts to a very hot bath. Do not submerse your head. Get out and wrap yourself in a sheet. Get into bed. Cover yourself with bed clothes. You will sweat and stain the sheet like the shroud of Turin! As your skin is the biggest eliminatory organ you are sweating out toxins. This is not for the faint hearted. Drink plenty of water.
12. Replace Nutritional Deficiencies to Prevent Early Ageing
Ageing is associated with a variety of physiologic changes that affect nutritional status. In addition, changes in social, economic, and medical conditions often impact the amount and quality of food that elderly people have available to them. As a result, elderly people are at increased risk for nutrient deficiencies, and should ensure adequate intake of calcium, vitamin D, folic acid, vitamin E, vitamin C, vitamin B12, vitamin B6, magnesium, potassium and fibre.
These nutrients are well supplied by Mediterranean-style diet, which is likely why two studies published April 2005: the EPIC-elderly prospective cohort study of initially healthy subjects published in the British Medical Journal, and a study of patients with coronary heart disease published in the Archives of Internal Medicine, show that eating a Mediterranean-style diet extends life expectancy. Mediterranean diet increases survival among older people, whether healthy or living with heart disease.
Mediterranean Diet is characterised by;
- high intake of plant foods (legumes, vegetables, fruits, and whole grains)
- moderate to high fish intake,
- low intake of saturated fat and high intake of unsaturated fats (particularly olive oil),
- low to moderate intake of dairy products (cheese and yoghurt),
- low intake of meat, and a modest intake alcohol (mostly wine)
The following table lists the Dietary Reference Intakes, established by the Institute of Medicine at the National Academy of Sciences, for men and women over the age of 70.
Vitamin A (mcg RE)
Vitamin D (mcg)
Vitamin E (mg alpha-TE)
Vitamin K (mcg)
Niacin (mg NE)
Vitamin B6 (mg)
Vitamin B12 (mcg)
Vitamin C (mg)
13. Chinese Medical Perspective and Premature Ageing
Premature ageing is due to deficiencies of Blood, Jing, Yin and Yang.
Symptoms include constipation, palpitations, dizziness, parlour, fatigue, tachycardia, sleep onset insomnia, postural hypotension.
Naturopathic Treatment: Fe, B12, Folic Acid, Blood tonic herbs.
Symptoms include '5 hearts hot', thirst, irritable, maintenance insomnia, wasting, dry, kidney/adrenal dysfunction
Naturopathic Treatment: Tyrosine, B5, Vit C, Adaptogenic herbs.
symptoms include cold, pale, decreased HCl, aversion to cold, if kidney – copious urination, if spleen – diarrhoea, 'old cold stomach'.
Naturopathic Treatment: Angelica – a warming tonic, plus warming digestive tonics – cardamom, nutmeg, cinnamon, star anise, ginger
Causes symptoms of premature ageing, greying hair, teeth falling out, long term memory problems, bone problems, dementia.
Naturopathic Treatment: He Shou wu – stops hair from turning grey and other Jing Tonic herbs, glucosamine, boil bones (bone broths). For a herbal tonic to prevent ageing try Carahealth Healthy Ageing Kidney Tonic.
Carina Harkin BHSc.Nat.BHSc.Hom.BHSc.Acu.
Cert IV TAE. ARCHTI mem.