Fall of 2022, I attended a very thought-provoking conference/meeting that was promoting LONGEVITY, sponsored by an organization called ABUNDANCE 360. Although many of the participants spoke about extending their lives into the 100's or even 120's, the message I took away is this: 

We have, through modern medical advances over the past several decades, successfully extended our lifespan from the 70's into the early or late 90's - for many of us; what we have perhaps not done so well is to ensure that our Healthspan will equal our Lifespan. However, there is a path to achieve that Healthspan, and describing what we know about that path is my goal in this paper, in order to help myself and others achieve that Healthspan is my goal in life and profession! 

THE BIG QUESTION:

HOW DO WE EXTEND OUR HEALTHSPAN TO LAST THE DURATION OF OUR LIFESPAN?

 First, we must examine our MINDSET.   

When I introduce the idea that we can anticipate living into our 90's or even 100’s, there is often a sense of panic. The vision that many of us currently hold is of a several years of disability, of pain, of needing to be cared for physically, and the dreaded dementia at the end of that time. Unless a person is already there, or is healthy and almost there, or, has close relatives who have attained their 90's in relatively good health, the reality of living that long has been a shocking and fearful realization for many. 

Instead, I am challenging every one of us to imagine that we need to feel productive into our mid 90's. Imagine what we can do with 10, 20, 30 more years of productive life. And then, we need to decide it is important enough that we do not want to be a "burden" if we can prevent it, no matter how long our Lifespan turns out to be. 

My perspective on productivity and mindset: How many of us have anticipated retiring from our "productive" work life at about 65, after about 35 years of working life, and then coasting into a life of relative leisure? Now, imagine that you will live that next chapter approximately as long as your working life. Many people do not realize that when they stop their "job", they now have 2000 hours per year that needs to be filled. When it is hard to fill an 8-hour day, 260 of those days is a lot. Many of you have heard me say that "As long as I am your doctor, you are not allowed to retire 'from' something; you have to retire 'to' something".   

Thus, we need to ensure that our Healthspan equals our Lifespan. 

Regardless, since we may well live that long, so we must ask ourselves: 

What are we prepared to do now to ensure we remain highly functioning, productive, and forward looking for all those years? How do we make 100 the new 60!? 

There is no question that we will age, but we now have the knowledge and the tools to slow, and soon may have some tools to reverse, many of the aging processes. There is much we can (and must) do to delay aging and be ready for the tools that might reverse at least some of it. 

*** If you can imagine that you have been given one vehicle to last your whole life, and if you let it rust, run out of oil or coolant, or allow anything else preventable that puts it in the garage, perhaps with no way to repair it – that is a bit like how we might end up if we don’t take care of our body/brain, rusting out in care! At least, we can try, so we have no regrets if we know what to do… 

And Remember: It is FUN to be HEALTHY, at any age! 

************** 

Once we have really struggled with that mindset, and are really prepared to do something about it, here are the key points:

KEY CONCEPTS – this is what we need: 

Healthy brain (physical, intellectual, emotional) 

Healthy blood vessels (to every organ in our body) 

Healthy gut 

Healthy muscles and bones 

THE SOLUTION: …. For almost all the above, 95% of the prevention of the diseases and afflictions of aging is accomplished by our Lifestyle/Life Choices!  

The Acronym - for Better Brain (and Body) Health - Dr. Rudy Tanzi: "SHIELD": 

S - Sleep - get 7-8 hour per day (does not have to be uninterrupted if we have enough sleep "cycles" - the brain pros call them "rinse cycles") 

H - Handle stress - develop a formal meditation/mindfulness practice. 

I - Interact with and be interested in others 

E - Exercise - Both moderate cardio and muscle building something at least 5 days per week, but not to excess or to injury! 

L - Learn something new - increase the brain synapses 

D - Diet - 5 simple rules: 

1. No sugars or starches most of the time (use the 90:10 rule) - this includes anything with sugar added, anything made with flour, and any alcohol. Dr. Sinclair's lab has shown that we have enzymes that do 2 things: repair damaged DNA (which happens every time our cells multiply, divide and regenerate), or they can deal with sugars/digestion. Thus eating a high sugar diet, having high sugars our system, or eating too much in general will distract these enzymes from repairing the minute damage to our DNS (and thus lead to ageing).  
2. Intermittent fasting (do not eat 3 meals per day; go hungry often). See 1. above.
   https://www.hopkinsmedicine.org/health/wellness-and-prevention/intermittent-fasting-what-is-it-and-how-does-it-work 
3. Mediterranean/MIND/Anti-inflammatory Diet (real food - not processed or chemically derived; little red meat; more fiber, vegetables, fruits, nuts, leafy greens, olive oil; some whole grains; antioxidant foods)
   https://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/what-is-dr-weils-anti-inflammatory-food-pyramid/ https://www.healthline.com/nutrition/mind-diet 
4. Supplement those things that are not adequate for us in our diets (due to increased need, decreased absorption, decreased nutrient density in our foods)
   https://aileenburfordmason.ca/eat-well-age-better
5. Maintain hydration

AND:  No smoking, breathe clean air, drink clean water, get fresh air, and control risk factors with medically proven therapies and medications: for diabetes, high blood pressure, high cholesterol, vascular (heart and brain) disease. 

To know how we are doing: 

MONITORING HEALTH MARKERS: 

All the longevity/age reversal scientists insist that unless we are measuring our progress, we will not know how we are doing (how much sleep, how much activity, how many hours fasting, etc.) we will not be able to adjust our program. We need to regularly measure these and our biomarkers (blood pressure, heart rate, oxygen levels, blood sugar levels, blood count, liver, kidney, and Vitamin levels, to name a few…) to know how our unique body is responding to what we have already done to it, and how it responds to any changes we make. Without measurements, we cannot know. 

There are several ways to measure our behaviors/lifestyle in use now: FITBIT, OURA RING, APPLE WATCH, InsideTracker, BioButton and many more technologies that are emerging as “wearables”, all linked through AI and data analysis. 

Additionally, our usual lab testing of various types will measure the metabolic functions: HbA1c (average blood sugar over 90 days), liver and kidney function, thyroid, vitamin levels, etc. 

 SCREENING for EARLY DETECTION of any DISEASE: 

Whether imaging, lab, or interventions such as colonoscopy, these are imperative. Their frequency is determined first by “average risk”, then modified depending on previous experience, and genetic factors. 

As the most important member of your health care team, you have the choice to participate and take action to extend your Healthspan.  

BOTTOM LINE: There is a good chance we will live far longer than we have ever thought likely. IF we take care of our body and brain – by taking care of our DNA, our cells, and our neurons – we will make that Lifespan a Healthy one! My role, as your physician, is to help monitor, to educate, and to cheer you on, so that you have the best chance of achieving that goal. Thank you for giving me that opportunity. 

ADDITIONAL INFORMATION: 

Because this subject can take up several books, I have added the following for additional information and details. I continue to study all of these and will eagerly share my learnings as more information becomes proven. 

Please meet some of the people who are leading these studies, and some of the more advanced information that is being developed: 

 Dr. David Sinclair (Author of “Lifespan; Why We Age and Why We Don’t Have To”): 

I was fortunate to meet and hear Dr. David Sinclair speak. His research lab at Harvard Medical School has been recognized as being at the forefront of understanding the concept of ageing, how it may not be inevitable, and how we might prevent it. Among other progress, he has been able to reverse Macular Degeneration in mice, is currently working on other mammal models, and soon believes he can start testing on humans. IF he succeeds, it will be an amazing proof of concept that will lead the way to reversing many other age-related diseases. 

Here is link to a presentation he made at Harvard: 

Dr. Rudy Tanzi (Preventing Alzheimer’s Dementia): 

One of the foremost authorities on Brain Health- he believes we should not just have a Body Health measure, but also a “Brain Health Score” done annually. (I am looking into a tool that be useful.) He Director of Genetics and Aging Research at the McCance Center for Brain Health in Boston, and has prepared these papers and the YouTube interview to explain his findings, especially regarding Meditation (interviewed by Deepak Chopra): 

https://www.massgeneral.org/neurology/mccance-center/research/shield

https://www.aging.senate.gov/imo/media/doc/SCA_Tanzi_09_25_19.pdf

https://www.youtube.com/watch?v=QcMGYcu2j34

Some Extras for Prevention: 

MICROBIOME SUPPORT: 

We have all heard about PROBIOTICS - which are designed to temporarily replace missing or insufficient Gut Bacteria. These are still very important as a supplement especially for almost anyone with a "leaky gut syndrome", recent antibiotic use, recent illness, or taking some medications. More and more, however, PREBIOTICS are recognized as vitally important. These are what allows our own guts to nurture the good gut bacteria and organisms (and fight the overgrowth of others - the "bad" bacteria, etc.). 

Number one PREBIOTIC: Fiber! Our modern diets are extremely low in fiber compared to traditional or evolutionary diets. Just think how little we need to do any chewing. 

Number two PROBIOTIC support: fermented foods - pickled cabbage (unpasteurized sauerkraut), olives, kefir, probiotic yogurt, kimchi, miso, kombucha (but watch the sugars!), tempeh, natto.  

https://www.hsph.harvard.edu/nutritionsource/microbiome/ 

ANTIOXIDANTS/ANTI-INFLAMMATORY FOODS: 

Like most things, always best in your diet where possible, as they come with the phytonutrients that naturally allow them to be more useful in your body. Berries (especially dark pigmented blue and black berries), Dark chocolate, Green tea, Tomatoes (lycopene), Watermelon, Cauliflower, Carrots and Leafy Greens, Nuts and seeds (via Omega-3's) 

https://aileenburfordmason.ca/eat-well-age-better  

ANTIOXIDANTS/ANTI-INFLAMMATORY SUPPLEMENTS: 

These have been somewhat controversial, but increasingly proven to be helpful. 

OMEGA-3 Fatty Acids: Many, many benefits: EPA 750 mg; DHA 500 mg daily seems good for most unless you are on blood thinners, then may increase bleeding 

RESVERETROL, VITAMIN C, VITAMIN E (Mixed tocopherols and tocotrienols), Co-Q10, QUERCETIN, Green Tea Extract 

https://aileenburfordmason.ca/eat-well-age-better 

HORMONES:   

There is a growing philosophy among those who study aging that we were not meant to live half our biological lives without some reasonable level of reproductive hormones (Estrogen for women; Testosterone for men). The thinking is that in an evolutionary sense, we were not meant to live much longer than our reproductive years (age 50's). Now that we are far outliving that, perhaps we should ensure we maintain sustainable levels … not reproductive levels, but supportive levels. 

****We need to be aware that there is a risk that we may encourage reproductive organ malignancies - breast and uterine cancers, prostate cancer. Current research still suggests the risks of long-term hormone replacement outweigh the benefits. This is a longer conversation! 

METFORMIN: 

Several intriguing studies are showing that this medication - which we commonly use as first line for anyone with rising blood sugar levels, or type 2 Diabetes - has a very important anti-inflammatory effect, as well as some other yet to be determined mechanism, in increasing health span in almost everyone as they age. 

 *** currently being studied (TAME Trial) for anti-aging, so not yet for general use, and thus I am not prepared to prescribe it solely for "anti-aging". However, if your sugars are on the high side (HbA1c over 5.7), it might be worthwhile for blood sugar control reasons. Again, this is a longer conversation! 

OTHER COMPOUNDS: (being studied, but not yet approved for general use): 

NAD (or NMN) - see Dr. Sinclair's book 

RAPAMYCIN - see Dr. Sinclair's book 

Personalized approaches: 

PERSONAL GENETIC TESTING: 

A rapidly growing and useful tool! When the first human genome was sequenced in 2003, it took 15 years and cost approximately 2.7 billion dollars - and that was only 90% of it; today, technology has advanced to the point where it can be done in a matter of weeks at a cost of $200-$500! What we are mostly looking for is "Mutations of Significance" - meaning individual mutations which could lead to a higher (or lower) risk of certain conditions and diseases. Previously, family histories and data generalized from the "general" population were the only useful tools to advise us on the correct screening intervals for certain tests (mammograms, PSA tests, colonoscopies, for example). Now, a genetic profile allows us to move to personalized screening and intervals for individuals and their family members. 

GENETIC TOOLS CURRENTLY IN USE: 

Additionally, genetic profiles are being used extensively in cancer treatment (where the cancer's unique genetic profile is dictating the exact anti-cancer drugs used to treat it). 

Such tools as CRISPR and AAV(Adeno-Associated Virus) Vector are already identifying and replacing faulty genes in order to cure some serious genetic diseases - for example a genetic disorder that causes young children to lose the ability to walk: Spinal Muscular Atrophy. Many more are in the works. 

 GENOMICS: 

Different than GENETICS, Genomics science looks at all of a person’s genes, including interactions of those genes with each other and with the person’s environment. This knowledge is expanding very rapidly, so that we are discovering markers that help us understand how we uniquely metabolize the things we put into our bodies - whether food or chemicals/medications we ingest, or the air and "pollution" we breath. Emerging tools looking at our genome and what our environment has done to our genome (Epigenome) will allow us to personalize our approach to diet, exercise, diagnostics, medication, and treatment. 

Tests such as 23 and me, Ancestry DNA, Color Genetics, Genecept, and Nutrigenomics are all consumer products that have some usefulness. If you are interested, let me know as I am gathering information about these all the time.