[Podcast] How to live well for longer
Ageing may come with its challenges, but there’s so much we can do to live better, for longer. Here, I chat to Bupa’s Lifestyle Physician, Dr Sherina Fernandes. We discuss longevity hot spots and medicines that may delay ageing processes. We’ll also share simple lifestyle changes you can start today, to future proof your health for tomorrow.
Speaker 1, Julia:
Hi and welcome to this month's episode of our healthy me podcast. My name is Julia Ebbens and I am a Health Content Editor here at Bupa. This month our focus will be on healthy aging. We will explore the concept of health span, we're going to look at the myths around longevity and we'll also share some top tips to help you future proof your health whatever your current age.
I will be talking to Dr Sherina Fernandez who describes herself as a lifestyle medicine physician and coach. She has a wealth of clinical experience dealing with patients from all walks of life. More recently she has completed a diploma in lifestyle medicine and she encourages her patients to take control of their health through simple lifestyle adjustments.
Hi Sherina and thank you for joining us.
Speaker 2, Dr Sherina Fernandez:
Hi Julia thank you for inviting me.
Julia:
So, I think many people are afraid of getting older which is a great shame. They associate old age with a kind of inevitable decline of both physical and also maybe mental well-being or vitality. But the good news is there is a really strong evidence base to suggest that we can really increase our chances of reaching an advanced age in better health.
How much power do you think we have to live healthier for longer?
Sherina:
Oh well that that's a huge topic isn't it. So absolutely we have such power, but coming back to what you said about this association of old age and decline, and I think there is something to do with cultural variations. So in the west that's what we think don't we fear aging we associate it with the loss of youth and kind of the best part of our life which isn't really the best attitude to have.
If you want to have a longer health span if we think about I often talk about, I do menopause group consultations and if we look at the research with the menopause we know that in cultures where aging is feared less and sort of elders are respected for their wisdom so places like Japan indigenous cultures, women have fewer menopause symptoms than in sort of the west where aging is feared.
So, I think I think there's a lot to do with attitude, but we do have a huge amount of influence over how we age, and it is possible to live healthier for longer so this really is in terms of how much we exercise what we put into our body in terms of nutrition and even conception of kind of you know, social media things like that they all play a part how much sleep we get and our connections and sort of how we manage stress.
So, as you said I am a lifestyle physician I've been doing it for quite some time now so I've seen it it's not just in the research, but I've seen it in my own patients how really powerful small changes can be to impact markers that we know potentially will help lead to longer term health.
Julia:
That's so interesting I hadn't realized there was this different interpretation or view towards aging in some cultures so thank you for sharing that. Previously there's been a big focus around longevity so simply how long someone is living for but now or in more recent times there seems to have been a shift so this recognition that our health span is just as important if not more important than how long we live.
How would you define health span?
Sherina:
Okay so yes I can define health span, it’s easy to talk about lifespan so lifespan is quite simply how long we live for and we know modern medicine has meant that we are living longer and increasing our lifespan so when you think we were previously dying young from infectious diseases and then we've developed antibiotics etc and modern medicine has been amazing from that point of view.
But now we're tending to suffer more from what we call non-communicable diseases, so you know your heart disease lung disease cancers. So, we're living longer but we need to be careful that we're not losing that quality of life so health span is how long you're living and you're staying healthy for so you can go about your daily activities and have a decent quality of life.
If you think about the World Health Organization definition of health, it's a state of complete physical mental and social well-being not merely the absence of disease or infirmity so I think that's really important to remember because we want, we don't want to live forever if we're stuck in bed and we have no quality of life so it's something that we're really looking at the minute.
Julia:
So, it's basically being able to enjoy the last years of your life and still do the things that give you kind of satisfaction and pleasure without sort of suffering unnecessarily and struggling to do things.
Sherina:
Absolutely.
Julia:
So when we read about people who are on kind of a quest for longevity they tend to be quite extreme and we hear sort of examples of crazy routines so people are getting up 4 am, they're jumping into an ice bath maybe they're taking up to 25 different supplements and these type of routines uh can be expensive. They can involve a lot of technology and time. Do you think that healthy aging is actually accessible to you or me and also to our listeners?
Sherina:
Absolutely I'm sure there's some listeners that would be bulking at waking up at 400 a.m. and even having ice baths aren’t everybody's cup of tea no but yeah but I think health has definitely been over complicated and you know why while it's important to embrace technological advances we need to make sure we're getting the simple things right and there's so much that we can do to prolong our life that isn't complicated it doesn't need to involve lots of money and the latest gadgets .
I do think healthy aging is accessible to most. It would be a different topic and I don't want to get too political but there are large proportions of society at a disadvantage so we are now looking sort of the British Society of Lifestyle medicine and you know within the NHS we are really looking at health inequalities so things like access to affordable healthy foods, good medical care, the education to know how to look after yourself - what care is available and even clean air you know varies so these factors do come in but I would say you know for the majority of people listening to us the answer is yes healthy aging is possible for the vast majority of us and you don't need sort of money or time.
There are things you can do to help yourself to age healthfully.
Julia:
Oh, that's good news but yeah you made a really great point in terms of there are these sorts of systemic issues that we do as a society need to address to try and equal out some of these health inequalities. But you're right that's a different conversation. Recently there's been a lot of interest around the blue zones this was made more popular after a Netflix documentary.
I know some of the evidence is a little bit sketchy or might need a bit more examination, but it is notable that people living in these hotpots these longevity hotpots do tend to share some key lifestyle choices or habits. Could you explain a little bit about what these are?
Sherina:
Yes, I absolutely I absolutely love talking about the blue zones. It's really interesting so for those who may not have heard of the blue zones these are pockets of the world where people are living longer sort of up to 100 years and over, they've got the biggest number of people living past 100 and it's not just their lifespan it's their health span so they have you know hundred-year-olds walking to the market and carrying the shopping home.
So, the blue zones are listed so there's Okinawa in Japan there’s the Nicoya peninsula in Costa Rica there's Ikaria in Greece there’s a province in Sardinia, and Loma Linda in California these are the main ones that that are talked about and what these places all have in common there are a number of things. The first thing I would say is that they all have a very strong sense of community and we know from research that strong social connections are one of the most important factors that contribute to sort of good health and longevity.
So there is you may have heard of the Harvard study of development that's one of the longest running longitudinal studies that's been going on in America and yes it started back in the 1930s so sort of spanned three generations and they have shown it's not really about kind of what these people have been eating or exercising actually when they when they are looking it's the strong family connections or social connections and this sense of purpose they're finding that people have a better quality of life and a living longer and so this is reflected in the blue zones.
So many of them have a strong faith so they're you know they they're Greek Orthodox in Ikaria, the people in Loma Linda are seventh day Adventists. It’s not necessarily that they're religious but more the fact that they're coming together there's a sense of community they're having time to stop you know days of rest, self-reflection prayer meditation and then family life where elders I think because we're looking at aging - elders are looked after and they're not isolated they're respected and they're part of the community.
Yes, I mean so that is one aspect that they all share uh there are a few more so how they move so in all these areas they are active throughout their life, so they don't stop as they get older so again it's not that's what I was saying before it's not it's not their paying for a gym membership it's natural movement that they're doing regularly.
So, any of these areas are quite hilly so in Sardinia you've got shepherds hiking daily in the hills and you know some of them are doing that into their 90s but again it's that sense of purpose that keeps them going you’ve got the Okinawans who spend hours in their Gardens growing food.
You’ve got the Adventists in Cali they tend to get together and go for daily nature walks so all of them are moving on a daily basis and its natural movement and it's also outdoors. They're all getting outdoors and then how they eat so; this is a big one so the in all those areas they tend to grow their own food, so the majority of their diet is what they've grown its fresh product produced or it's local if they're buying and eating local food.
The bulk of their diet is sort of plants fruits vegetables whole grains beans nut seeds herbs spices they do eat meat in in those areas but not to the extent we do in the west and if they are having it it's fresh and it's not processed it’s the same you know the the fishermen are catching fish it's fresh it's non processed foods in Loma Linda the seventh day Adventists they are completely plant-based so they don't eat any meat at all, but we do know that they are known for eating lots of nuts.
Nuts are known to be cardioprotective so in Sardinia they have they're known for their dur wheat and then in Okinawa they eat a lot of sweet potatoes and it's not that one particular thing but what we do know is that in those places where they're having like very plant predominant diets they're getting plenty of fibre and that comes back to the gut microbiome they're feeding their gut microbiome which we know is linked with our health and that's something that many of us lack in the west so we should be getting about 30 grams a day.
But in the west the average is about 18 grams of fibre we're just not getting enough and it's not just how they're eating in those areas they eat together they eat intentionally they take time to savour and enjoy their food they're not eating on the run and in Okinawa they have that phrase which means that they stop eating when they are 80% full so yeah I mean there's a lot there their pace of life is obviously very different to ours and I think there's a lot we can learn from the blue zones and as you can see it's complicated.
Julia:
No that's so fascinating and like you said it's a very different lifestyle whereas we tend to do things like go to the gym or follow a diet it seems for them it's more a way of life and actually they're getting these incidental benefits. So they want to go and visit their neighbours or their friends and through doing that they're climbing a hill they're getting some movement or they enjoy tending to a garden but the result of that is they're getting all this nutrient-dense fresh locally grown food so it is a really inspiring thing to look at when we're examining our own lifestyle and what we can learn from that so thank you for that.
Sherina:
Absolutely yeah and it's sustainable like a lot of what they do it's not that they're trying it's just natural it's sustainable small changes that that can do.
Julia:
Yeah it's very impressive yeah there are some more interesting terms when it comes to aging well one of these is the concept of inflammation and this refers to the increased risk of chronic inflammatory processes that is unfortunately linked to getting older and this is also correlated to our risk of many chronic diseases that we tend to be more susceptible to as we age.
The other one is known as cell senescence and this basically means at a certain point our cells have a reduced ability to replicate and divide as we get older and this can have negative effects on our immune system and other processes in the body so is there anything we ourselves can do to mitigate the impact of these processes on the human body?
Sherina:
Yes so as you've explained there are a number of processes that are going on as we age and we can't really stop the aging process even though many are trying but I think we can slow it down to an extent and so you were talking about inflammation and I mean things like inflammation oxidative stress these are all processes that are brought about by our behaviours and drive aging.
So again, lifestyle medicine it looks at six pillars it looks at what we're eating it looks at how we're moving how much sleep we're getting sort of how much stress we're experiencing what we're doing about that the connections we have and whether we're avoiding risky substances and behaviours - things like smoking, alcohol, gambling, and social media all fall into that category and all of those if you start if you start targeting them you can start finding ways to reduce inflammation and help sort of defer these processes as it were so for example when it comes to diet we know that a polyphenol rich diet improves our immunity and lowers levels of inflammatory markers.
So you know when we say eat the rainbow there's a reason behind eating the rainbow if you if you think about a sort of reds contain lycopene, in tomatoes and watermelon and then you've got orange foods have beta carotene these are really good for your immune system, resveratrol like the blue purple foods red grapes blueberries these things that they're really helpful with just not just health but sort of prolonging life.
Thinking about exercise there's so much research into exercise and people would say that is the longevity drug and yeah that's thought to delay aging via a number of mechanisms.
So for example one of the other things that happens as we get older we get shortening of our telomeres, so telomeres are parts of DNA at the end of our chromosomes that actually protect them from damage and as we age they get shorter but exercise is being shown in studies to increase the length of our telomeres so that's one way another way is exercise decreases DNA damage and it increases our resistance against oxidative stress so exercise is super important.
Sleep - sleep I think probably could delay the aging process, when we sleep we get we get DNA regulation we get repair we get a secretion of sort of anti-cancer cytokines, so these cytokines, interleukin, 1 and 2 and TNF Alpha we know that we secrete them when we when we are in a good sleep we get you know reduction of inflammation there's hormone regulation there's a whole host of benefits that happen when we sleep.
And then similarly you know we could go on with which each of these pillars looking at stress and how we manage stress can decrease inflammation I don't have to say we know that smoking and you know alcohol excess will lead to disease and problems and you know doesn't help to prolong life so there there's a lot that we can do.
Julia:
That's great and we're coming back to these key pillars again and again which is really nice to see so it's like moving well, sleeping well rest and recovery and honestly it sounds like exercise is as close as we can get to like a magic pill that's going to help us in all these areas.
If someone was a little bit sceptical about their ability to positively influence how they age because for example they might feel that or they might I've heard that aging is just down to good luck, it's down to our genetics it's down to how our parents aged what would you say to them?
Sherina:
Well I would say we're not a slave to our genes and we now know about epigenetics and epigenetics is important it looks at how the environment and our behaviour can affect the expression of our genes so basically that we can inherit these genes but they can be switched on or Switched off so yes while we need to consider what we're inheriting just because you know there's a long family history of say heart attack or something happening it doesn't necessarily mean that that's going to happen to you.
And we've seen that in twin studies this whole thing of nature versus nurture that like both play a part so yes there's a lot of research looking at how we can modify genes and sort of looking at sort of fasting and cold water therapies but at the end of the day and again without sounding like a broken record yeah we can modify this with what we eat you know what's coming Julia how we exercise how we sleep of stress because these environmental factors really do affect what genes are switched on or off.
And it's really important that we're looking at that so if you know you're prone to cardiovascular disease start looking at at these just simple pillars to make sure that you are minimizing your risk of these genes being switched on.
Julia:
Yeah, that sounds super positive to me, but would you say there's a particular age when we can best influence our will we age is it for example ever too late to improve our health span or longevity?
Sherina:
Absolutely not it's never too late to start to improve your health span and I think that's a really important message because there will be people sort of into their 50s 60s 70s and might think oh it's too late for me.
But you know even into your 70s you can still gain muscle mass and strength if you're doing sort of progressive resistance training sort of with your own body weight sort of at least twice a week in the same way dietary changes obviously all of these are much better to do if you start as early as possible but you can still increase your life expect expectancy even if you start making dietary changes at 60 so the message would be that the earlier you start the better but it's never too late to start so the best time to start is now.
Julia:
Exactly don't put it off any longer and just get going so let's break down some of these core areas that we've talked about a few times now so starting with movement I think lots of people are slightly afraid of exercising as we get older it can be a bit daunting maybe they maybe people haven't been very active up until now and because of this unfortunately people can end up quite frail and a mobile once they reach their 70s and 80s and actually even before that is the truth of it but there are exceptions to this for example my dad, he's turning 80 this year he still bikes regularly and good distances too so what do you think is the key to preserving physical strength and mobility as we age?
Sherina:
Well first of all good on your dad so he sounds like an inspiration to those around him and yeah no so the key to preserving physical strength and mobility as we age well.
First of all we need to know that as we age we start to lose bone mineral density and muscle mass and unfortunately this does start from around our 30s if we think about bone mineral density in particular we have this balance of sort of we talk about osteoblasts that build up bone and osteoclasts that take it away and when we when we get older this balance kind of reverses so we get this gradual decline it's really important that women in particular are looking after their bones because oestrogen actually supports those osteoblasts so as our oestrogen levels drop into perimenopause menopause we start to lose that protective effect of oestrogen which means that one in two women post menopause end up with osteoporosis.
Julia:
Wow
Sherina:
So yeah, exactly but we really can do something about this so resistance training we know that healthy bone will remodel and adapt to the load it's placed under so this means that if we start doing resistance exercise if you build up just from your own body weight to what you're comfortable with it's a great way for you to preserve your bone strength and obviously when you're resistance exercise you're helping to preserve your muscle and potentially build it up too so in that sense resistance exercise is really import important when it comes to longevity as well you know looking at muscle mass we live longer if we can preserve our muscle mass so that's where resistance exercise comes in hugely important and then of course we've got cardiovascular exercise so we need this to preserve our lung function and again we know that lung function is going to naturally decrease as we age so cardiorespiratory fitness is really important this is where it is better the earlier you start the better but again if we if we can preserve that we are going to preserve our health span.
And then the other thing would be in terms of exercise balance exercise and core strength becomes essential as we get older so yes it's really important to sort of follow exercise guidelines are there for a reason so many people may have heard that we should all be doing 150 minutes of sort of moderate intensity exercise a week so moderate intensity is where you can talk but you can't sing or you can do 75 minutes of vigorous exercise and as expected that's when you can't talk as well as sing but yes the key thing that many people don't do is this resistance training at least twice a week which is really important for men and women.
Julia:
Yes I yeah I know there's lots of examples of people who get older they might continue to do some walking but they're not doing any kind of muscle activation or other kind of strength training work so in an ideal world what would a weekly exercise routine look like for example would it include running or Taiichi or strength training? How would you kind of get all of these requirements into an average week?
Sherina:
So I think and again it's very much I think we need to look at personalizing all of this advice to individuals because what works for one won't work for another and I think when you're when you're younger it's all well and good to sort of you know get the running and that type of exercise in as you get older and many sort of you know again because I'm used to talking to perimenopausal women sometimes it's all well and good if you're getting up at 6:00 am and going to the gym and you're doing all this exercise but you need restorative practices as well so yes I mean in terms of it could be just going for a 30 minute brisk walk through the day I mean it's 15 minutes so it's not it's not too much if you spread that into seven days it's not a lot 150 minutes there of a moderate walk and then there are again yoga I think is an amazing discipline to take up because it encompasses you can do a lot of resistance with body weight you know when you're thinking of planks and various things you are using your body weight.
Then so resistance exercise strength training whether you, don't have to go to a gym again you can use your own body weight at home if you go online there are there are sort of lots of advice now on resistance exercise you can try at home I think Dr Rangan Chatterjee has some videos you know using tins of beans these kind of things and I think it depends on where you at and where you're starting from as to what you do and I think it needs to be personalized to each individual.
Julia:
Absolutely he has some really good like kitchen routines so can do when the kettle's boiling and that type of thing so it's super accessible and a good start for most people so yeah sounds good moving on to eating well I know this can get very controversial there is also a mixed consensus about the perfect diet if that even exists but when you look at the countries with healthier aging populations you do tend to find some common themes so I think most people agree that it's good to maximize your intake of vegetables fruits plant-based Foods healthy fats obviously getting enough protein is important as we age from an immune system perspective as you mentioned earlier fibre is often something we're you know lacking in and also so important for the microbiome and all its corresponding effects we kind of end up around the Mediterranean style diet quite often because it encompasses a lot of these benefits are there any specific dietary interventions you would recommend for people wanting to age well?
Sherina:
Well so as you said it's a very sort of emotive topic I think diet and everybody has their sort of specific what they feel is best there's lots out there when you look at the research papers I think the specific diet that comes out time and time again is this Mediterranean style diet like examples would be there is the dietary approaches to stop hypertension that's the DASH diet that's almost a Mediterranean style diet when you're looking at food and mood so there's a lot about nutritional psychiatry now but when you look at the smiles trial and all the different trials looking at how you influence your mood and depression.
Again It's Mediterranean style diet that they're using so I think rather than saying a specific diet it's important to look at good eating habits so we need to be avoiding processed foods and stick with real foods and I know in our time poor lives this can be hard but you know we need to look at our priorities so avoiding processed foods eating fresh foods when you look at the American College of Lifestyle medicine the international Board of Lifestyle medicine and the British Society of Lifestyle medicine they're all in agreement that we should be focusing on a diet that's predominantly plant-based.
Plant-based doesn't mean the convenience stuff you get that you buy in packets we're talking about real fruits vegetables beans leges whole grains nut seeds herb spices it's coming back to what we were talking about in the blue zones but also going back to this whole you know losing muscle mass as we age it's really important that we have a good amount of protein in our diet we need protein to build up muscle and at this point it's worth me saying that I am I am actually plant-based not just it's a personal thing for me.
Not just for my health and that's what I was saying it can be quite emotive but you can and I think I think as I live this way it's important for me to speak this you can get enough protein on a plant-based diet you just need to know how and to plan well so things like tofu, tempeh, beans quinoa the these things you know when if you just incorporate different foods into your diet you can get it enough but again it's not for everyone and diets are really individualized so most diets work do you know what most of us are eating such rubbish that if we if we go whether it's low carb or what whatever we do if we're eating real food we tend to get results so absolutely and then you said about dietary interventions there's also this whole subject of time restricted eating so that that could go off into another territory tree itself.
But to make life simple often if you try and have your evening meal as early as possible and your breakfast later but you know you may have to adapt that but that that can also be helpful in terms of aging well because it helps your body to sort of restore itself that there whole other process that we could talk about there so it's again I said in the blue zones it's not just what you eat it's how you eat and I think that that comes in here too.
Julia:
Definitely and I think what you've touched on there is really interesting because whatever your personal preference whether you choose to eat fish or some degree of dairy or meat we can all benefit by increasing our fibre our phytonutrient intake our vegetable intake our you know legume intake so it's quite realistic for a lot of people to improve their diet that's by adding things in even if they still want to add some of these other elements you know from a personal perspective point of view just quickly to touch on the processed food because I know there's a lot of confusion around this, I think people get fearful that things like chopped tomatoes which just can be categorized as processed food would be harmful, I think it's more to make the point that ultra processed foods are what we really want to swerve if you could speak to that a little bit?
Sherina:
Absolutely yes so ultra processed foods you should know what what's in you know if you're if you're looking at something and it's full of chemicals and you don't actually you know what you're eating that's different if you if you can physically look and this contains tomatoes when you're saying about chopped tomato contains tomatoes that's fine you know like tins of beans and you know these things it's more looking at you get you get packaged foods turn it over and look if it's just a mixture of chemicals that's probably not going to be the best thing for you to eat
Julia:
Yeah so, it's like these unrecognizable names things you wouldn't have in your kitchen and also emulsifiers thickeners all these kind of agents that are added in basically we just don't know enough about their effect on human health at the moment so we need to tread carefully with that
Sherina:
Absolutely
Julia:
Okay and what is your opinion on the role of supplements if there is one?
Sherina:
So, I'm of the opinion that we should and can get most of our nutrients from the food we eat and you know we I think people in the blue zones are evidence of that I don't I don't think they're taking supplements but we do need to accept obviously that our environments are different so we’re both in the UK and as we know it's not known for its year round sunshine so we in the winter months we do need to take a vitamin D supplement because obviously there's not enough sun so we can't synthesize it for ourselves and we can't get enough from diet.
So vitamin D is one of the supplements I would recommend and then again it's a personalized choice when it comes to omega-3 we can get so the types of Omega-3 so ALA that's the essential one and we have to get it from our diet so we get it from nuts and seeds the body can convert this ALA into two other types DHA and EPA DHA and EPA we can also get from fish what we find as we get older that our rate of conversion of the ALA to DHA and EPA decreases with age so potentially you might want to take an omega-3 supplement if you are not eating fish.
Fish Actually obtain it from marine algae and now there are supplements based from Marine algae so an omega-3 supplement might be something you want to take as you get older vitamin B12 so that's not made by plants or animals it's actually made by microorganisms in the soil absorption of B12 does decrease with age as well so I would say that if you're not eating meat dairy or eggs it's important that you try and eat sort of B12 fortified Foods so there's Nutritional yeast it's found in certain cereals and the milks but actually sometimes it's worth taking a supplement if you might not be getting enough of that but generally if you are having a wide range of sort of fruits vegetables leges Etc you're getting out getting as much sun as you can it really will minimize the need for any supplements.
Julia:
That sounds very sensible I suppose there's instances where someone an older adult has like arthritis or some kind of inflammatory condition and maybe they'd be more interested in like you said considering the additional omega-3 or some curcumin from turmeric so like you said it's personalized specific and just trying to meet that person's needs rather than like a catch all for everybody exactly so there's been some speculation recently about the role of certain medications in our quest for uh living longer in better health one example of this is there's a specific immunosuppressant and there's some tentative research into its ability to delay the menopause in women and I know there's some stuff around other chronic health risks what do you think about these types of interventions?
Sherina:
Okay well I have to say you being a menopause person I hadn't actually heard of it being used in menopause but I believe the longevity drug you're talking about is Rapamycin.
Julia: Yeah
Sherina:
And so it's a drug that's often used in transplant patients so post-transplant it prevents them from rejecting their organ because it has immune suppressing properties so it was isolated from a bacteria found on Easter Island and it's been found to extend the life of mice in studies and it's thought it will slow down the aging process and there's a whole different host of mechanisms that that it sort of does this by but as far as I'm aware there aren't any results yet from human trials probably because there hasn't been enough time so there I often feel that we try and package things up from nature into drugs and then we end up with side effects when maybe we should sort of just keep things simple again.
I know so I'm not a longevity doctor but I know things like metformin is being looked at because obviously we know again going back to inflammaging if we have persistent high blood sugars that causes inflammation etc so metformin works in many different ways and they're looking at that as well as a way of sort of longevity a longevity drug so there are things out there but I personally would stay away from medications and again stick to the basics I think people might want to wait for the research before going down that route absolutely.
Julia:
It's interesting what you said about met for and I know it's used for sort of insulin resistance stuff is that kind of the angle with the aging uh angle?
Sherina:
Yes and I think I think it as well targets some of the things that rapamycin targets it targets those areas too so yeah that they really are like in the in the longevity space metformin is something that has been looked at that's super interesting.
Julia:
I'll have to look into that more thanks I think regarding the rapamycin with the menopause it's you're absolutely right it's only been done in mice I think they are planning to do an upcoming trial on women looking at a slightly repackaged format of the drug and the idea is to see if it improves ovarian function so kind of preserving women's fertility and kind of delay the menopause for long but we'll have to watch the space on that one.
Sherina:
Interesting
Julia:
So, we've covered movement diet medications moving on to stress which I think is a core issue many of us including myself struggle with how would you explain the role of stress in aging well?
Sherina:
Yeah it's probably why we in the west don't age as well as these blue zones isn't it so stress I think if most of us have heard of this fight or flight reflex you know our stress response and we do need it we we've needed it in the past when we were cavemen running from danger and we do still need it at times now because again it still helps us if we're in trouble or even if we need to perform under pressure.
It can be a good thing the problem is the prolonged stress so if we think about in the wild there's a book called why zebras don't get ulcer which is on my list to read but basically if you think about how zebras behave so they can be grazing and then along Comes the lion running towards them so they shift into that sympathetic drive you know and they run for their lives and what happens they either get away or you're The unlucky one and you get caught and you get eaten by the lion but once these zebras are away they just go back to grazing and they you know the switch response the stress response switches off just like that this doesn't happen with us.
And now you know we've got chronic stress we've got small stresses from you know if you're using an alarm clock your alarm clock goes off you're rushing to get dressed you're getting the kids dressed there a school run the commute you’ve got deadlines there there's always these constant stresses and we don't often stop so our sympathetic drive it's almost in overdrive as it were.
So this can lead to sort of elevated cortisol levels and you know this is where you start getting glucose intolerance and you're more prone to get diabetes we know cortisol promotes this central obesity inflammation we've discussed it before so again this leads to aging faster as it were so we need to if we want to age well we need to find ways to deal with stress minimize stress and even maybe just reframe things in our head like when we are getting stressed about things do we really need to be getting stressed about.
Julia:
That’s’ a good question and it sounds like the zebras have got it figured out quite well so exactly be more zebra aside from stress one of the key areas that you mentioned associated with longer healthier lives in places such as Japan is this idea of meaning purpose and connection to others which maybe in the west we've lost sight of a little bit why do you think these factors can impact both our health span and potentially even our longevity?
Sherina:
So yeah so I mean I spoke before didn't I about the Harvard study and this whole thing about connection and then also having a purpose.
I do wonder if it comes back to this primitive feeling of safety and sense of security we know that loneliness is similar to smoking in terms of years of life lost which is really sad and that you know you can see that MRI changes someone who's lonely is equivalent to sort of you know stress it's really it really has an effect on us so connection nurturing this kind of activates our parasympathetic nervous system coming back and looking at more social support you probably are less likely to experience stress because you've got people there to depend on so I think I think it all comes into play and I think we underestimate the power of connection and purpose and again you know there's a lot of research into positive psychology and how this affects our health things like gratitude come in here there's so much that has an impact on kind of how we feel our well-being which then impacts our health span.
Julia:
I think yeah that that sounds really interesting and I think we do tend to reduce health to exercise and diet but as you've said there's all these other core elements that we must consider when we're looking at our overall well-being and happiness and also aging processes as well so we've covered quite a lot in this podcast I'd like to leave our listeners with some practical tips that they can take out into their lives immediately and hopefully start using on a daily basis what would be your top three tips for how to age well?
Sherina:
Okay so I think I think number one is treating your food as medicine I think we can have such an impact on our health with what we put in our body so start being more meaningful with what you eat I think we kind of you know grab an eating on the go or what's convenient I'm in a rush or I'm too tired put something in the microwave start looking at what you're eating and what you're putting in your body will this nourish me look at your plate you know could you add something to it you know if you're if you're having a curry could you put some fresh coriander on there small changes. so that would be tip number one treating your food as medicine number two I would go with the movement so I think moving every day naturally.
Making sure that you are getting outside can I because I know what my third one is so I'm going to put a caveat with this so it's kind of two one for number two with within that you also need to make sure though that you're getting rest and restoration so sleep is really underestimated and the thing that we I think neglect the most so you know getting that balance of movement with the rest and the sleep is really important I think if you get good sleep you're going to want to move in the day and you're going to have more energy to do that so I've kind of cheated and put two in one there.
and then the third thing which we've covered at the end and we underestimate is nurture our relationships make time for the people that you care about people that make you happy spend time with them I mean it’s all well and good isn't it Julia you can you can eat healthily and exercise and do all these things but if you're not sharing your life and enjoying your life with others what's the point?
Julia:
Absolutely yeah I think you've hit the nail on the head there and the good thing is these sound like fairly achievable goals obviously they might take a little while to integrate into your lifestyle but for most people hopefully they are something they could slowly consider of adding into their day-to-day lives. for you personally is there anything you prioritize or focus on specifically for healthy aging or longevity purposes?
Sherina:
Yeah well so for me personally so I am a 47y old female perimenopausal woman so for me it's particularly important that I am getting enough sleep which I'm finding much easier to do in the winter I'm actually going to bed earlier than I would normally do and enjoying that so prioritizing sleep has become something I need to do when I wake up in the morning.
I meditate and I find that that helps me through the day so that's something that's helped me deal with stress better I always make sure I get outside on a daily basis and have at least a 10-minute walk I'm very lucky that I walk my seven-year-old to school, so yeah exactly so walking is really important and yeah that they are the main things in terms of food, again because I'm perimenopausal I'm making sure that I'm getting enough protein.
I've really prioritized soy isoflavones and actually because then I'm getting phytoestrogens as well as my oestrogen levels are decreasing so these are the things that I focus on at the minute.
Julia:
Amazing sounds like you've got a comprehensive personalized plan that you're following and that's working for you so that's really inspiring to hear thanks very much for a super interesting conversation hopefully everyone listening will be inspired to control what they can in order to age better for longer thanks a lot Sherina.
Sherina: Thank you.
What does it mean to age well?
Ageing well is equally, if not more important, than living for a long time.
The goal is to spend as much of your life as possible being active and engaged in things you enjoy. You might still have some health issues, but they aren’t interfering with your enjoyment of life too much. You would feel energetic, enthusiastic, and have lots to look forward to.
Ideally, we wouldn’t fear ageing, but instead be inspired by cultures that focus on the positives of growing older – such as having more time for hobbies, friends, family, and enjoyment.
What can we learn from people who age well?
People living in longevity hot spots (areas of the world with a higher-than-average number of people living to 100) usually share the following traits. They:
- move as part of their daily life. While they might not have a gym membership, healthy older adults usually move daily – walking up hills in their village, carrying shopping home from the market, or tending to their garden. This type of regular movement helps to keep people physically stronger for longer.
- eat a nutrient dense diet low in ultra processed foods. Healthy diets can look different in various cultures. But most experts agree we can all benefit from increasing our intake of brightly coloured fruits and vegetables, legumes, and healthy fats such as olive oils. Additional benefits may come from nutritious compounds in green tea, coffee, dark chocolate, and fermented foods such as kimchi.
- manage stress through hobbies and socialisation. Doing things you enjoy can keep your mind and body active. Hobbies can also keep your mind focused on the present moment and may reduce stress. Staying social has numerous benefits as you get older and can reduce the loneliness that’s linked to many health conditions.
- have a sense of purpose. Doing things you find meaningful is important at any age. But as you get older, it can help to have a reason to get up in the morning. This could be spending time with your family, travelling, growing vegetables, or any project you enjoy.
What can I do to age better in the future?
We all have different genes – which can impact how well we age. But how we live can affect whether these genes get turned on or not. Focusing on the following key areas can positively influence your ability to age well.
1) Keep your muscles strong
Whilst cardiovascular exercise is important, many of us forget to strengthen our muscles as we get older.
In older age our muscle weakens, and postmenopausal women can also be at an increased risk of osteoporosis. Make sure you fit in at least two sessions of resistance training each week, in addition to cardiovascular activities.
This could include bodyweight movements such as squats and push ups, as well as weight training. And don’t forget to practice balance exercises either - they offer protection against falls and immobility too.
2) Get enough of the right nutrients
As you age your protein needs increase. Protein not only helps to keep your muscles strong, but also plays a key role in immune function – which can weaken over time. So, try to include a good source of protein with each meal or snack.
It’s also time to increase your intake of antioxidants (protective compounds found in green tea, berries, and other nutritious foods). This can help to protect you against cell damage and may reduce your risk of chronic disease.
Having enough anti-inflammatory fats is helpful too, so eat plenty of oily fish, or take algae supplements. Omega 3 fatty acids can help to counteract processes such as inflammation (chronic inflammation associated with getting older).
3) Stay engaged with life
It can be easy to think healthy living is just diet and movement. But other factors can be just as important. This means we should try to stay engaged with activities and people as we age. So continuing hobbies, travel, exercise routines, and social activities can help you to stay both physically and mentally fit.
4) Monitor stress
Stress can increase premature ageing through inflammatory processes. Sleeping well and doing cortisol (a stress hormone) lowering practices such as deep breathing, yoga, and meditations can all help. Avoiding isolation by attending local groups and activities can help you stay connected and make you feel less alone with any worries too.
Can any medical treatments slow ageing?
We currently don’t have quite enough concrete evidence to prove that specific medicines should be recommended for healthy ageing.
But there have been some interesting mice studies. These studies looked at drugs such as immunosuppressants (medicines used after organ transplants), and blood sugar medications. Initial results suggest such medicines may be able to target inflammation, and other processes linked to ageing.
Future studies will include the use of immunosuppressants in women to see if we can preserve ovarian function for longer. But for now, it’s best to control what we can with healthy lifestyle changes.
What does a healthy ageing routine look like?
It’s never too early, or too late to think about age proofing your current routine. A healthy ageing routine has many aspects but these are easy to achieve. They don’t need to involve 5am wake ups or ice baths (unless you want to!)
Here are some habits to add into your routine if you haven’t already.
Prioritise sleep
Sleep is so important for healthy ageing. Good rest helps us to restore and repair both physically and mentally. So, improving your sleep quality is a good place to start. Studies have shown that the following can help:
- waking at the same time each morning
- having early morning light exposure
Go Mediterranean
Focusing on a Mediterranean style diet with a wide range of plant-based foods is another easy way to help you age better. Try to:
- mix and match your fruit and vegetable intake to support a healthy gut microbiome
- eat together with friends or family in a relaxed state for added benefit
Keep moving
If you’re not a fan of the gym, consider finding movement you do enjoy. This could be anything from dancing and tai chi, to yoga or power walking. Just remember to add a mix of cardiovascular and strength activities for added healthy ageing effects.
Do you know how healthy you truly are? Bupa health assessments give you a clear overview of your health and a view of any future health risks. You'll receive a personal lifestyle action plan with health goals to reach for a happier, healthier you.
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