It's no secret that many of us would like to live long lives, but not at the expense of our health. While the current life expectancy in the United States is about 78 years, our health span (the number of years a person can expect to live in relatively good health, free of chronic disease and disabilities of aging) is only 66 years. One of the main purposes of a longevity-based approach to healthcare is to close this gap between life expectancy and health span. It's not just about existing as long as we can; it's about preserving the quality of life throughout those years so we can remain active, healthy, and high-functioning as long as possible.
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What is Longevity Medicine?
Longevity medicine is highly personalized, preventive medicine, taking into account biomarkers of aging alongside an individual's environment and lifestyle habits. A biomarker is something that can be measured that can indicate the state of your health - like your blood pressure or blood glucose levels. By evaluating a variety of biomarkers as part of a proactive approach to health and wellness, practitioners of longevity medicine can customize health and wellness plans to help prevent chronic illnesses such as cancer, diabetes, and heart disease, all of which can impact lifespan and healthspan.
The practice of longevity medicine also includes cutting-edge research and utilization in artificial intelligence (AI) advancements, allowing practitioners to learn about the aging process and apply that knowledge in real-time.
Analysis of genetics and epigenetics, how our environment and lifestyle can influence gene expression, are also at the forefront of longevity medicine. Using all these tools allows practitioners to help individuals influence the dynamics between our genes and disease through nutrition, precision supplementation and medicine, and lifestyle habits in a highly personalized way.
Ultimately, the goal of longevity medicine is to not only extend lifespan but also health span - helping you to live longer, more active, and healthy years.
Functional Medicine Labs to Test for Longevity
When it comes to predicting longevity, functional medicine labs can be a powerful tool to help create a personalized, proactive plan to support optimal health and aging.
DNA Health
Understanding your genetics can help determine the best nutrition and lifestyle habits to support optimal health. DNA analysis via the DNA Health test can also lend insight into risk factors for cardiovascular disease, insulin resistance, and other chronic illnesses. While your genetics don’t necessarily indicate your exact likelihood to develop a disease, understanding your DNA blueprint can help you influence gene expression through epigenetics - meaning you can have more control over how you wish to experience your health.
Comprehensive Stool Test
The health of a person's gut microbiome is a key contributing factor in age-related loss of health and vitality. A Comprehensive Stool Analysis can help you understand your unique gut microbiome and identify areas you can improve through nutrition and lifestyle changes. Part of the longevity benefits of having a healthy, diverse gut microbiome may be due to the ability of the microbiome to exert epigenetic effects on our DNA - meaning your gut is in part responsible for how the environment can affect your genes (for better or worse).
DUTCH
A comprehensive hormone evaluation via the DUTCH test can also be an important test when it comes to supporting longevity. Age-related loss of hormones in both men and women has been linked to a decrease in bone mass, muscle mass, and a decline in physical fitness. Deficiencies in hormones have been shown to predict longevity and overall vitality in both men and women, so understanding how hormones are changing year to year can be an invaluable tool to not only predict longevity but also to take early action in supporting optimal hormone health.
NutrEval FMV
The NutrEval FMV is a comprehensive evaluation of antioxidants, vitamins, minerals, fatty acids, and other biomarkers to determine nutritional deficiencies and imbalances. Higher intake of micronutrients and antioxidants has continually been linked to longevity and better health outcomes as we age. Understanding your body's needs can also help drive personalized approaches to supplementation and lifestyle changes to support optimal health through the years.
Additionally, the NutrEval FMV can help provide insight into mitochondrial health. Your mitochondria are important parts of your cells that help to produce energy. As we age, these cellular organelles can produce more and more inflammatory reactive oxygen species (ROS), which can negatively impact life and health span. Increasing antioxidant and micronutrient intake is an important strategy to help keep mitochondria healthy, which is why testing these components can be such a valuable tool. Mitochondrial dysfunction is one of the root causes of cellular aging and has been linked to a higher risk of developing a chronic disease.
Boston Heart Lifestyle Panel
The Boston Heart Lifestyle Panel contains a basic lipid panel (LDL, HDL, and triglycerides), hs-CRP, the HDL Map test, and the Cholesterol Balance test. By expanding beyond the basic lipid panel, this test allows your practitioner to gain insight into particle size, how your body synthesizes cholesterol, and multiple cardiovascular risk factors. Ultimately, having better cardiovascular health is linked to a longer life expectancy and a lower risk of chronic health issues as we age.
Other Lab Test to Consider
While not required the following test can help determine if there are other areas your patients should focus on.
Telomere Length Testing
A telomere is a protective "cap" that sits at the end of DNA strands. As your cells divide as part of normal metabolic processes, the telomeres get shorter over time. Eventually, the telomere gets too short to protect the end of DNA, and that particular cell dies. Cellular death (senescence) is linked to aging over time. Evaluating via a Telomere Length test and making personalized plans to maintain that telomere length and slow telomere shortening could be a key to unlocking better life and health span.
Continuous Glucose Monitor
Increased blood glucose levels are associated with faster cellular aging and a higher risk of all-cause mortality. Using wearable technology like a continuous glucose monitor (CGM) can provide insight into an individual's blood sugar levels in response to nutrition and dietary patterns, exercise, stress, and other lifestyle-based habits. Understanding how lifestyle impacts blood sugar at the personalized level can help support behavior changes that can help improve health span while reducing chronic disease risk.
Advanced Imaging: DEXA/MRI
Evaluating body composition can be a helpful tool to support longevity. Age-related declines in muscle mass and bone mass are significant contributing factors to the gap between lifespan and health span, as loss of physical function is generally linked to poorer health outcomes as we age. Muscle mass overall is correlated with a lower risk of all-cause mortality in older adults, and the process of building and maintaining muscle is something we can all start to do to support longevity.
Functional Medicine Treatment for Increased Longevity
A functional medicine approach to creating a personalized health plan that supports longevity may incorporate nutrition, lifestyle changes, exercise, and personalized supplementation, using lab work to help individualize treatment at an individual level.
Nutrition
There's strong evidence that a Mediterranean-type diet that includes fish, lean meat, poultry, a variety of vegetables and fruit, olive oil, legumes, nuts, and whole grains is associated with a lower risk of all-cause mortality, lower inflammation levels, and a longer lifespan. Generally, diets high in processed foods, processed meat, refined carbohydrates, and sugar do not confer the same longevity benefits.
While the literature can seem conflicting at times, what we do know is that a more balanced approach to macronutrient intake (protein, carbohydrates, fats) seems to have the most significant impact on longevity.
- High intake of refined carbohydrates has been linked to an increase in mortality risk, while including dietary fats may actually reduce this risk - it's all about balance.
- As we age, increasing protein intake to combat age-related muscle loss can be an important nutritional intervention to maintain physical function and support a longer health span as well.
- Choosing a low-carb or low-fat diet doesn't necessarily reduce disease risk, but choosing high-quality food sources in either approach can reduce all-cause mortality. It's not the removal of carbohydrates or fats so much as it is removing inflammatory, poor-quality foods and replacing them with healthy whole-food options. Ultimately, the quality of the foods we eat has the biggest impact on our lifespan - choosing whole foods over processed and packaged foods.
Personalizing your nutrition approach based on your goals, current health, and functional medicine lab tests while aiming to include a diverse diet of anti-inflammatory whole foods can help support better life- and health span.
Exercise
Exercise is an important component of any healthy lifestyle. However, when considering longevity, it's important to look at the types of exercise and the duration of exercise as well. Including physical activity in your life reduces the risk of dying by about 35%. Including both cardiovascular/aerobic exercise and strength training conferred the maximum benefits for longevity - just 3 hours per week of aerobic exercise and 1-2 strength training sessions were able to show these benefits. Those who included strength training showed bigger improvements in health span, and were able to maintain physical mobility longer.
For older women in particular, more low-level movement (such as walking, household chores, and activities of daily living) does reduce risk of mortality and support a longer healthspan. As women tend to experience more severe declines in muscle- and bone mass later in life, more low-level movement likely helps to offset the effects of those losses. So, working in movement wherever we can is a simple tool that can be used to support longevity.
However, there may be a point where over-exercising (or under-recovering) can negate these longevity benefits. Chronic excessive exercise has been linked to an increase in cardiovascular risk alongside a loss of the longevity benefits from regular exercise. The threshold probably varies from person to person and may be linked more to a lack of adequate recovery time.
Herbs/Supplements
There are several herbs and supplements that have been shown to promote longevity:
- Curcumin can help to slow cellular aging by activating certain proteins in the body
- The active component of green tea, EGCG, is a polyphenol that reduces the risk of cancer and chronic disease while also restoring mitochondrial health and supporting autophagy (the "cleaning out" of damaged and old cells in the body).
- CoQ10 is a supplement that helps support mitochondrial health by reducing oxidative stress in the body and has been linked to better health outcomes in the elderly.
- NAD+ is a compound involved in many of the body's metabolic processes, such as DNA repair, energy production, and gene expression. It's been linked to better cellular aging, lower inflammation, and maintaining telomere length. NAD+ can be taken as a supplement or an intravenous (IV) infusion.
Lifestyle Changes
Fasting
Fasting is a tool that can be considered as part of an overall healthy lifestyle. Intermittent fasting has been linked to a better health span with reduced risk of overall mortality, so long as it's not overused.
Stress Management
It's no secret that chronic stress can have negative health effects and has been linked to a shorter lifespan. However, short-term stress does have the power to promote longevity. These shorter-term "hormetic" stressors may include tools like fasting, cold exposure, regular exercise, heat exposure, and others. For example, sauna use is a lifestyle practice that has been shown to extend human healthspan.
Reducing chronic severe stress and changing our perception of stress are important for longevity. Simply believing stress will negatively impact your health actually makes it more likely to occur. So while it's important to mitigate those long-term chronic stressors, it's equally as important to examine our self-talk regarding how we view stress.
Summary
Utilizing functional medicine lab tests to predict longevity and assess the efficacy of ongoing personalized health interventions can be an incredible tool for anyone looking to increase lifespan and healthspan. Lab tests can take the guesswork out of choices around nutrition, supplementation, and exercise by allowing individuals to use their own data to personalize their health plan.
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