When we talk about ageing of the human being we can differentiate between chronological ageing, morphological ageing, and metabolic ageing. The major aspects of morphological and metabolic ageing are loss of lean body mass, bone, cartilage density, and water, loss of flexibility (compliance) in the blood vessels, reduction in hormone secretion, and an increase in body fat (particularly visceral fat). The end result of ageing on muscle is sarcopenia – the loss of muscle mass and the loss of strength.
However, we retain almost the same number of muscle fibres and we retain the same number of blood vessels that supply the muscles. So, the ability to bring blood to the muscle is there. But, the decrease of blood flow that is also associated with the ageing process decreases the amount of blood available to the muscles. The good news is that we can reverse all of these processes provided we don’t have advanced target organ damage or significant vascular atherosclerosis. We can improve vascular compliance, improve flow dynamics and increase blood flow to the muscles and increase lean body mass in combination with exercise and appropriate nutrition.
HEALTHY VERSES PATHOLOGICAL AGEING:
Ageing is a process that we consider to be natural, but it is fundamentally modifiable. Muscle mass decreases with age. This is a principle in classic medicine. However, we know through our experience in sports medicine that this is reversible. Ten years ago, in master categories, we used to have a category for athletes over 40 years old. Then, because the quality of our older athletes was so good, we opened a new category for athletes over 50 years old. A few more years down the line we opened a new category for athletes over 60 years old, and today there are great athletes aged 70 and over. Some of these master athletes have been competing for 40 years, whilst others only started competing in their mid-50s or early 60s. So, we now know that it is possible to reverse many of the effects of ageing with exercise and proper nutrition. Bone density decreases with age. This is partly because we lose calcium (and develop vitamin D3 deficiency) with age, and this is a significant problem for post menopausal women and older men. The end result is osteoporosis. There is a close relationship between the loss of lean body mass and the decrease in bone density because like muscle, bone can be nourished with nutrition and strengthened with exercise. What happens with the joints and the cartilage? If we take a close look at cartilage, we can see that the nucleus only makes up a small percentage of cartilage. It is the extracellular component of cartilage, which is comprised of collagen, mucopolysaccharides, and water, which is affected by the ageing process. The ageing process is associated with a loss of water and a decrease in the level of mucopolysaccharides, which results in decreased elasticity, joint pain, and inflammation (with elevated inflammatory markers like ultra sensitive “C” Reactive Protein), and eventually arthritis.
However, once again, nutrition and exercise can help to keep the cartilage and the joints in good condition. The fastest way to exacerbate systemic inflammation and age poorly is a lack of exercise. As people age their vascular system tends to lose flexibility or elasticity and the internal diameter of the vessels decreases due to atherosclerosis. This cardiovascular ageing, is often considered to be a logical consequence of the ageing process but is ACTUALLY a consequence of immobility and poor nutrition.
Cardiovascular ageing affects all of our body functions through target end organ damage and causes hypertension and rigidity of our arteries. Reduced muscular capacity and sexual dysfunction are hallmarks of early cardiovascular end organ disease.
Anti-ageing physicians are very aware of the effect that chronological ageing has upon the endocrine system. Hormone levels peak in adolescence, and then they start to decline. Many physicians believe that ageing is caused by this natural decline in hormone levels. Hormone therapy can quickly restore hormone levels to youthful levels (but data indicates hormone replacement may be associated paradoxically with increased cardiovascular morbidity and mortality), however exercise and proper nutrition can have a positive influence on hormone levels, and any hormonal therapy will be much more effective with exercise and proper nutrition.
Basically, there are three major factors that determine our life expectancy – genetic heritage, environment, and lifestyle. At present, there is very little that we can do about our genetic heritage although we CAN influence many of the metabolic genetic disorders (propensity to obesity, hypertension, dyslipidaemia, osteoporosis) by aggressive lifestyle, exercise, dietary practises and modern pharmaceuticals. With regards to our environment, most of us can do something to improve the environment in which we live. But, when it comes to lifestyle, we can make drastic changes. However, all we need to do in order to have a dramatic impact on our health and well-being is adopt a proper disciplined schedule of lifestyle exercise and nutrition. This does not mean that we need to become slaves to exercise and nutrition. All we need to do is follow a basic sports program that includes some weight training – that is all that is needed to reverse the ageing process.
REVERSING THE AGING PROCESS:
It is possible to take steps to reverse the ageing process even before setting foot in the physician’s office. The first thing that any patient who is serious about fighting ageing needs to do is analyse their lifestyle. That is the first step to reversing the ageing process. Of course you need to evaluate your genetic heritage towards risks of poor ageing and vascular disease. Good nutrition, exercise, a positive attitude, and healthy habits, all send anabolic messages to the endocrine system, and this will result in an increase in the production of testosterone and other beneficial hormones for strength and physical condition. On the other hand, a sedentary lifestyle, bad nutrition, not enough rest, poor sleep hygiene and stress, all send catabolic messages to the endocrine system. This results in an increase in the production of the catabolic hormone cortisol, which exerts a negative effect upon arteries, muscle, bone, joints and promotes poor ageing. So, it can be seen that there is a close relationship between hormonal secretion and lifestyle, and anyone who wants to reverse ageing needs to change their lifestyle in order to promote the secretion of anabolic hormones and minimise that of the catabolic hormone cortisol and the hormones of the destructive sympathetic nervous system (adrenaline and nor-adrenaline). Research has shown that it is possible for 70-year-old men who have been training with weights since their 50s to have same muscle mass as healthy young adults aged 25 to 30-years-old. Therefore, it can be seen that doing the right exercise can lead to an increase in lean body mass in older people. Much more impressive is that this has also been shown to be true in senior veterans – people aged 90-years-old and over. Research has shown that healthy veterans without previous training were able to increase their lean muscle mass and bone density by following a basic program of weight training.
What is Anti-ageing nutrition? Nutrition is an essential part of Anti-ageing medicine. It is a natural alternative and a complement to the therapeutic use of modern pharmaceuticals. Eating properly improves our quality of life because it helps us to maintain our proper body weight and prevent and reduce muscular joint and bone injuries – put simply it helps to keep us active. So, nutrition is a very important part of anti-ageing medicine. Good nutrition (next BLOG) means thinking carefully about the quality and amount of food we are eating. Healthy and active adults should be eating 35 to 40 calories a day for each kilogram of body weight. Obviously, if a patient is overweight (or underweight) they need to adapt that figure to reach the amount of calories they would need to eat if they were their ideal body weight. It is also important to remember to decrease calorie intake by 1% per year after the age of 55. It is far better to eat five small meals each day than three big meals. Protein is made from amino acids. Amino acids are present in all the cells of the body and we obtain them from the food we eat. However, supplementary amino acids can be very beneficial and studies suggest that they may have anti-ageing benefits. One of these potentially very beneficial amino acids is arginine. Arginine is a precursor of nitric oxide, which promotes dilatation of blood vessels and helps to regulate vascular tone. Thus, arginine is very useful for promoting blood flood and may help to prevent cardiovascular disease. Another amino acid of interest is tyrosine. Tyrosine helps to improve the transmission of signals in the nervous system and may exert an anti-depressant effect upon the body.
It is possible to slow, modify and even reverse pathological ageing by making lifestyle changes, exercising, eating well and where appropriate using modern Parmaceuticals. Being chronologically old does not have to mean losing lean body mass and gaining body fat. To see that this is true you only have to look at the master and veteran athletes, some of which have more muscle and better performance than the average 25-year-old.