“Aging is a choice,” declares board-certified women’s health expert, Jennifer Pearlman MD. When I heard Dr. Pearlman make this proclamation at a recent aesthetics conference, my ears perked up and my eyebrows raised.
Dr. Pearlman claims that only 20% of aging is predetermined. The rest is within our control. “Aging is akin to software, not hardware and you can provide a reboot. The power is within you,” says the internationally recognized leader in regenerative and aesthetic medicine.
That’s down to the emerging science of epigenetics which studies the interplay between gene and environmental factors in determining health outcomes. In other words, it not “nature vs. nurture.” It’s both, but mostly nurture, which affects a person’s so-called health span.
There are 12 recognized hallmarks or manifestations of aging.
Below in Part I, Dr. Pearlman focuses on four areas which are especially actionable in terms of slowing and even reversing the aging process. And that’s not all.
Exciting new breakthroughs are on the horizon that promise to tackle most if not all of these hallmarks simultaneously. In Part II, eminent Stanford University scientist, Dr. Vittorio Sebastiano unveils recent advances which allow for epigenetic reprogramming on a more universal level.
But first, the here and now …
(1) The problem: telomere attrition
15 years ago, Nobel Prize-winning scientist, Dr. Elizabeth Blackburn, discovered telomeres – protective caps at the ends of chromosomes (like shoelace caps) that preserve genetic information. “They shorten over our lifetime and their shortening predicts disease risk and aging,” explains Dr. Pearlman. There are many factors that control the length of telomeres including genetics, estrogen (women have telomeres that are about 20% longer than men) and lifestyle.
When it comes to lifestyle, it turns out that one of the most profound factors that shorten or fray telomeres is psychological stress. As Dr. Pearlman notes, Dr. Blackburn arrived at this conclusion by studying telomere length in groups of highly stressed individuals – mothers who care for children with chronic disease and spouses of those with dementia, among others. It turns out that women who were caretakers of chronically ill children had the highest levels of stress and the shortest telomeres of all – shorter, for example, by at least a decade of additional aging compared to their low-stress counterparts.
The solution: Stress management
It is possible to rebuild telomeres. “Dr. Blackburn’s most robust intervention to preserve and elongate these shortened, damaged telomeres was,” reveals Dr. Pearlman, “no magic pill, just evidenced-based stress management: mindfulness, meditation, deep breathing practices, tai chi and yoga. This is how she elongated the telomeres.”
It is not a matter of avoiding stress, however, emphasizes Dr. Pearlman. It’s not the stress itself that’s the problem, but rather “the stress response that becomes maladaptive as opposed to helping us overcome and deal with the pressures at hand. What doesn’t kill you makes you stronger.”
(2) The problem: mitochondrial dysfunction
Every cell contains organelles called mitochondria which produce energy. Loss of function in mitochondria is a characteristic of aging and essentially, of all chronic diseases including neurodegenerative, cardiovascular and autoimmune disorders.
The solution: exercise and supplements
“Exercise touches on almost every hallmark of aging,” states Dr. Pearlman. Not only does it protect your telomeres, but it is vital to the production of energy. It promotes the production of mitochondria so the more you exercise, “the more densely-packed your cells become with these organelles and the more efficient they become,” explains Dr. Pearlman. “Therefore, you get more mitochondria and they become better at producing energy.”
Supplementation plays a role in mitochondrial vitality too, specifically NAD+ (nicotinamide adenine dinucleotide) and NMN (nicotinamide mononucleotide), the precursor to NAD+. Numerous studies show that NAD+ is an essential coenzyme which extends lifespan by regulating metabolism and repairing DNA and the immune system. Yet, by middle age, our NAD+ levels plummet to half that of our youth. The administration of NAD+ via IV drips increases the levels of this coenzyme as does NMN which, when taken orally, is converted into NAD+. So, nutraceuticals + exercise = better mitochondria, concludes Dr. Pearlman.
(3) The problem: deregulated nutrient sensing
As we age, we become less efficient at absorbing nutrients from the foods we eat. “We don’t pull it out of our food and translate it into building blocks for the functions we need as effectively as we once did,” says Dr. Pearlman. Consequently, “nutrition and nutrient status becomes a very important intervention and signal of how well we’ll age.”
Amazingly, as Dr. Pearlman reveals, our grandmother’s nutritional status predicts our own health status. That’s because women are more susceptible than men to epigenetic influence and epigenetics is transgenerational, passed on to future generations, through maternal exposures. Thus, “through epigenetics, women can affect the health and longevity of future generations.”
The solution: proper diet and supplements
Dr. Pearlman advises sticking to a plant-based diet while avoiding processed foods, refined sugars and excessive amounts of animal fat. The adequate intake of lean protein, minerals and nutrient-density via colorful vegetables is likewise essential. In addition, the longevity expert also recommends some key supplements which are typically insufficient even in an optimized diet: vitamin D3, B vitamins (in methylated form), magnesium, omega 3 fatty acids, iron (for menstruating women), zinc, and anti-oxidants like quercetin, flavonoids and beta carotenes.
Ultimately, according to Dr. Pearlman, diet depends not only on what you eat but when and how much you eat, too. This is where intermittent fasting comes into play. Intermittent fasting not only promotes weight loss but may also slow aging through its promotion of autophagy, a clean-up process whereby cells clear away their debris and damaged parts.
(4) The problem: hormone depletion
While hormone depletion is not a hallmark of aging per se, hormones are an overarching factor affecting all the indications of aging, especially the intrinsic or chronological ones as opposed to extrinsic ones like pollution, according to Dr. Pearlman. Estrogen (present in both men and women), for example, is geroprotective meaning it protects against aging, positively affecting these hallmarks. But in women, with the precipitous decline of estrogen during menopause, those benefits dissipate. Women experience a rapid shortening of telomeres in mid-life, for instance.
For men, the issue is somewhat simpler as they don’t have a steep drop in testosterone during middle age. For them, it’s more of a dwindling effect throughout their adult lives, becoming more evident in their 40s. “But hormones are a big part of men’s health and aging too and they need to think about their androgen health” says Dr. Pearlman. Higher testosterone levels, for example, have been linked to, among other things, better cognitive function.
The solution: hormone optimization
Needless to say, the subject of hormone regulation is enormously complex and unique to each individual (and beyond the scope of this article). It requires, as Dr. Pearlman points out, an individual plan, crafted by an expert, that evolves with the patient over his or her lifetime.
Beyond that, Dr. Pearlman recommends avoiding hormone disruptors such as endocrine-disrupting chemicals, and excess alcohol. She advocates that we begin monitoring our hormones in our 40s and “consider hormonal therapy as a proactive approach to aging, midlife and menopause.”
“Your DNA is not your destiny,” asserts Dr. Pearlman. “This is a really profound idea, counter to so much of what I was taught in medical school: one – that our DNA is hardwired and not modifiable and two – that aging is inevitable. Each of those ideas, we’ve turned on its head.”
