It’s Time to Reimagine Our View of Healthy Aging

One of the most interesting questions we can ask ourselves is: What does getting older mean to me? Is it something I hide, actively fight, merely resist, and eventually accept? Based on the 20 years I’ve been researching this field, I believe we must fundamentally change the way we think about aging, and how we can move toward living a healthier life for longer.

Aging is an ongoing process of damage that is occurring within the body. Aging is the number one risk factor for all disease. Although we can’t change the number of times we’ve gone around the sun during our lifetime, what we can change is the rate at which our bodies experience the inexorable process of damage. Changing this rate can give us a sense of control over aging. It means there are steps we can take to lower the likelihood of a whole host of diseases, especially chronic diseases, such as decreasing the risk of death from cancers, Alzheimer’s, heart disease, and more. But we must first transform the way we view our health: from managing and treating disease to proactively improving our health, which increases our health span and reduces the risk of chronic diseases in the first place.

Advances in genomics and in understanding the molecular basis of both wellness and disease continue to be instrumental in optimizing our health (1). One key is to address the hallmarks of aging, among them, DNA repair and cellular senescence (2-3). For example, NAD+, a coenzyme that is responsible for making the 30-40 trillion cells in our bodies carry out many day-to-day functions, plays an important supportive role for effective DNA repair (4). Everyone’s level of NAD+ declines with age, which, in turn, plays a crucial role in the development of age-related conditions like diabetes and heart disease (5). Scientists are exploring how boosting NAD+ levels in the body might delay the onset of disease and contribute to a higher quality of life. NAD+ supplements don’t make it through the body’s gastrointestinal tract (and therefore aren’t efficacious), which is why the focus is on nicotinamide riboside (NR) supplementation, a naturally occurring form of vitamin B3 that triggers the body to replenish a depleted level of NAD+.

Another key hallmark of aging is the buildup of senescent cells – worn-out cells – that need to be cleared from the body. The polyphenol quercetin has been shown to accelerate the clearance of senescent cells in a variety of settings (6-8). Metabolic health is another major factor in healthy aging, which is most favorably altered through diet and exercise, but can also be improved through targeted interventions with berberine, a natural product analog of metformin(9,10).

It is also important to understand the state of evidence around healthy aging as it relates to newer discoveries (11). Definitive long-term studies in this area take years, even decades, to conduct to prove their efficacy for extending human health span or lifespan, given how long the average person lives. Therefore, the evidence base surrounding healthy aging for new approaches generally comprises: (i) interventions showing a positive effect on health span and/or lifespan in multiple shorter-lived animal models; (ii) interventions shown to be safe in humans; and (iii) seeing the biological effects of compounds affecting the systems they are targeting and their effect on validated clinical biomarkers. 

And when it comes to optimizing a person’s health span, it’s important to take a comprehensive and personalized approach based on body needs. That means testing and understanding biological age, the health status of the different organs and processes in the body, and then targeting as many of these hallmarks of aging as possible with specific solutions. We should always be wary of any single product being pushed as a singular or universal cure; we want to look at the complete picture and what fits our individual needs. For this reason, monitoring your health progression through testing is critical, including when you might be overdoing an intervention.

We also should pay close attention to proven efficacy and look for what is credible, fully vetted, and triple tested. In addition to diet and exercise as a foundation, it’s vital to remember there is a range of targeted interventions that can be performed based on precise and deep measurements. That is how we get personalized recommendations and can know, for example, whether the gut microbiome is or isn’t metabolizing whatever solution it’s being served. Before a problem can be prevented or fixed, we must understand its context, how the pieces come together, and what can best support its solution. This is why personalized testing will prevent you from buying a so-called remedy for years that isn’t working.

At Thorne, we are bringing rigor and precision to healthy aging. Our mission is simple: we empower individuals to take control of their health and help them make informed decisions, backed by robust data and science. There is power that comes from knowing, on an individual level, how aging affects your body and what to do to lower your risk for chronic diseases. Collectively, we believe we have a shared responsibility to make healthy aging a reality for more people. We can only get there if others, across health care and beyond, join us to chart this next frontier for all our benefit.

References

1.        Price, N.D. et al. A wellness study of 108 individuals using personal, dense, dynamic data clouds. Nat Biotechnol 35, 747-756 (2017).

2.        Lopez-Otin, C., Blasco, M.A., Partridge, L., Serrano, M. & Kroemer, G. The hallmarks of aging. Cell 153, 1194-1217 (2013).

3.        Lemoine, M. The Evolution of the Hallmarks of Aging. Frontiers in genetics 12, 693071 (2021).

4.        Covarrubias, A.J., Perrone, R., Grozio, A. & Verdin, E. NAD(+) metabolism and its roles in cellular processes during ageing. Nat Rev Mol Cell Biol 22, 119-141 (2021).

5.        Yoshino, J., Baur, J.A. & Imai, S.I. NAD(+) Intermediates: The Biology and Therapeutic Potential of NMN and NR. Cell metabolism 27, 513-528 (2018).

6.        Zoico, E. et al. Senolytic effects of quercetin in an in vitro model of pre-adipocytes and adipocytes induced senescence. Sci Rep 11, 23237 (2021).

7.        Jiang, Y.H., Jiang, L.Y., Wang, Y.C., Ma, D.F. & Li, X. Quercetin Attenuates Atherosclerosis via Modulating Oxidized LDL-Induced Endothelial Cellular Senescence. Front Pharmacol 11, 512 (2020).

8.        Kim, S.R. et al. Increased renal cellular senescence in murine high-fat diet: effect of the senolytic drug quercetin. Transl Res 213, 112-123 (2019).

9.        Xu, X. et al. Therapeutic effect of berberine on metabolic diseases: Both pharmacological data and clinical evidence. Biomed Pharmacother 133, 110984 (2021).

10.      Wang, H. et al. Metformin and berberine, two versatile drugs in treatment of common metabolic diseases. Oncotarget 9, 10135-10146 (2018).

11.      Blagosklonny, M.V. The goal of geroscience is life extension. Oncotarget 12, 131-144 (2021).