Longevity – what determines longevity for humans – Part I

"Who wants to live forever?
Forever is our today
Who waits forever anyway?"

sings Freddie Mercury & The Queen in one of their famous songs. Even though we should like the approach of ‘forever is our today’, meaning that we should live here and now without stressing too much about future that we cannot predict (or past that we cannot change) – more and more people are not able to stop themselves from trying to find ways ‘how to live longer’ or even better ‘how to live better life longer’, how to actively improve their longevity prospects. Including myself, of course.

That’s why the longevity topic comes back as an intriguing subject not only for me but for many of us. I was talking about longevity or aging already here from my very own perspective and here summarizing our discussion with a bunch of friends from our ManCave or here inspired by an incredible Belgian couple riding on their bicycles 30,000 km around Asia in their seventies!

Nevertheless, I recently came across a podcast by MD Peter Attia, who made it his passion and seems like an occupation too – using his words “to explore strategies and tactics to increase lifespan, healthspan, and well-being, and optimize cognitive, physical, and emotional health”. His podcast triggered renewed interest in longevity in me and hence in my typical way “trust but check” made me spend hours & hours reading various medical studies and articles. There are way too many terms – DNA methylation, NAD+ compound, Telomeres, Nicotinamide riboside (NR), Nicotinamide mononucleotide (NMN), Sirtuins, Resveratrol….. Too many scientific papers, too many supplements and too many websites that look like giving professional advice but in reality trying to sell you pills.

I wanted to dig deeper and I did. Get ready for the long read! I haven’t put together this text as a usual blog post that could be read on your cellphone screen in 5 minutes. I simply wanted to summarize all the data for myself in somewhat digestible form. Let’s see if I have succeeded… The text is split into 3 parts that will land here step-by-step.

Now, what is the truth? What is the reality? Which pill will make us live longer? Red pill or blue pill? I don’t know. There are many conflicting messages, and even if not – the science keeps developing, more studies are published every week, our knowledge improves. Perhaps the day will come when we will know everything but for sure we are not there yet. Let me share what I have learned.

First, a summary of ‘what determines longevity’ for those who don’t like to read:

  1. No pill offers a miracle solution.
  2. Promising substances are being researched but nothing firmly confirmed for humans.
  3. Good sleep is important.
  4. Exercise matters.
  5. Stress plays a role but it’s not a clear cut.
  6. Healthy nutrition is key. Get required minerals from food.
  7. Intermittent fasting may prolong age.
  8. Genetics is given so don’t worry about it – unless gene alteration possible…

Let’s dig deeper into each area.

No pill offers a miracle longevity solution

Supplements market has become a multi-billion dollar industry even though there is a mounting evidence that most of the pills don’t work and some of them may be even harmful. You can read more here about the survey done on 30 899 U.S. adults aged 20 years or older with median follow-up of 6.1 years. They haven’t found any benefits of the nutrient supplementation – the only proven way to get nutrients is from food.

Another piece of information comes from the study done by Gilbert S. Omenn et al. Early studies apparently suggested that carotenoids (Beta caroten) and retinoids (Vitamin A) are agents that may prevent lung cancer and cardiovascular disease. They started a prevention randomized trial with 18 314 people supplementing these two nutrients. The trial had to be stopped 21 months earlier than planned because the cancer rates (and consequentially mortality rates) not only did not decline, they increased! The scientist haven’t been able to identify root causes of the adverse effects, it was suggested that body simply turns antioxidants into oxidants under certain conditions.

Bottom line: be careful about supplements, be careful about pills. I am not saying that all of them are bad but it looks like there is more marketing than science behind the supplement industry. Nevertheless – let’s continue to learn more right in the following section.

Promising longevity substances are being researched but nothing firmly confirmed for humans

There is a couple of areas that are being researched in relation to longevity with massive amounts of money invested as we speak.

A prominent one is NAD+ (nicotinamide adenine dinucleotide), a molecule that is central to metabolism, namely energy transfers in cells as well as other important cellular functions, one of them being the activity of sirtuins (a kind of protein) that is suspected to affect aging. You can read more here on Wikipedia if you love science. The problem with NAD+ and its reduced form NADH is their decline with age. Authors of one of the studies talk about “lower levels of NAD+ and lower NAD+/NADH ratios are correlated with functional decline and diseases of aging and mitochondrial dysfunction, such as metabolic and neurodegenerative diseases. Enhancing NAD+ levels is sufficient to increase lifespan in worms, and in worm and mouse models”. All right, worms and mice, but what about people?

Scientists are busy trying to identify how to increase NAD+ in humans, seems like the direction makes sense, nevertheless there is no conclusive answer how to best increase its levels in a safe way. Even though some companies already started selling supplements that supposedly add NAD+ to your muscles, brain and other organs. Let’s look at some of them.

One of the nutrients that could apparently increase NAD+ levels is Nicotinamide riboside (NR), a kind of vitamin B3. Again here the research shows that “(NR) treatment increased levels of relevant proteins in young and aged mice, and quickened muscle regeneration after cardiotoxin-induced injury in both young and old mice”. Other studies indicate here and here that the therapy is safe for humans nevertheless the results are inconclusive (low number of patients) and in some cases questionable. What should be the dose? How to administer – orally or intra-venously? For how long? Are there any long term adverse effects? From my view, the jury is still out, hence I wait.

Another promising nutrient, a precursor of NAD+ seems to be Nicotinamide mononucleotide (NMN). Scientists hypothesise that supplementing NMN to humans may increase longevity, prevent onset of several age-related diseases. Again, the supplementation of NMN to laboratory mice “Increases concentrations of NAD+ in a variety of tissues, in many cases with beneficial or therapeutic effects”, however the authors also clearly warn that “It is also critical to carefully assess potentially detrimental side effects for these NAD+ intermediates (NR and NMN)….as NAD+ depleting drugs are currently under development as cancer chemotherapeutics, and there might be a risk that boosting NAD+ could drive tumor growth (Gujar et al., 2016)….It is also clear that high dose supplementation greatly exceeds the body’s requirement for niacin equivalents, and thus will result in substantial elimination through the urine….Thus, further preclinical and clinical studies are needed to establish the long-term safety of NMN and NR as human therapeutics”.

Sorry for too much difficult language here, that’s science… Again, that does not sound convincing, does it? For sure, I apply “sit, wait and observe” approach before ordering an expensive jar of pills from Amazon.

Another compound related to longevity that made it into media is resveratrol, a phenol that occurs naturally in grapes, blueberries, raspberries, mulberries, peanuts, cocoa and dark chocolate. Seems like some of us consume fair amounts already – I love dark chocolate for example! Several earlier studies have suggested that ‘resveratrol = better health’ and ‘red wine = resveratrol’, thus logically ‘red wine = better health’. Of course, the wine industry picked up the research and run with it, apparently boosting the wine market significantly after the studies were published and promoted. Also, you may find tons of supplements online offering ‘the best source of resveratrol’. Since then multiple new studies have demonstrated that positive health effects of added resveratrol are definitely questionable. You can read more here, here and here. I am not trying to take that glass of red wine away from you – that’s your choice – but don’t expect any major health benefits, actually on contrary.

Speaking of resveratrol and perhaps even other substances that are marketed to us left, right and center – let’s finalize this section citing J. M. Pezzuto (he is well-respected scientist nevertheless I find his style of writing hillarious) from his paper “Resveratrol: Twenty Years of Growth, Development and Controversy” published in January 2019. He reviewed at least 123 various medical studies on resveratrol and concludes: “For rheumatism, neuralsia, sciatica, lame back, lumbaro, contracted cords, toothache, sprains, swellings, etc. For frost bite, bruises, sore throat, bites of animals, insects and reptiles. Good for man or beast. It gives immediate relieve. It is good for everything…” These claims are from an advertisement produced by the Clark Stanley Snake Oil Lintment Company for his product, snake oil (ca. 1900). The bombastic claims of Clark Stanley are reminiscent of the multitude of advertisements regarding resveratrol that can be found on the internet and typified by the publication Natural News Report #139. World renowned doctors including Dr. Oz, Dr. Sinclair and Dr. Gruss are recommending resveratrol, the ‘miracle molecule’ saying ‘people can live to 120′; ‘resveratrol may be an incredible preventative weapon against cancer’; ‘resveratrol may eradicate brain plaque associated with senility’; ‘compound in red wine may fight Alzheimer’s’; ‘resveratrol has anti-obesity properties by exerting its effects directly on the fat cells’; ‘resveratrol protects you from head to toe!’ Given that evidence-based responses are sparse and controversial, such claims, innuendo and hyperbole are atrocious.”

Make your own conclusions.

Good sleep is important to live your life longer

Finally we are turning into something positive. Something that really works and we could influence it, both positively and negatively. Sleep. Intuitively, there is probably no question – you know for sure that if you sleep uninterrupted for 8 hours, without drinking alcohol or eating too big of a dinner before – you will wake up usually well rested, in a good mood, ready to tackle any challenges that life throws your way.

Conversely, if you have slept for meek 4 hours after finishing that super-important project late last night and now your alarm bell rings in the middle of your deep sleep phase…you are not happy, not amused and definitely still tired. What will keep you going for longer? Good sleep or bad sleep? The answer is clear.

How to make sure we sleep well? Here are several points that I try to follow:

  1. Go to bed between 22:00 and 23:00, wake up earliest at 6:00 which gives me 7-8 hours of sleep. Works different for everybody, these are my rules.
  2. Don’t use screens at least 60 minutes before bedtime. I do not always succeed here but certainly the difference is noticeable.
  3. Eat light dinner, don’t overeat. These rules are valid anytime, anywhere but are the most important in the evening.
  4. Don’t drink coffee or black/green tea (basically any caffeine) in the afternoon. Again for me, these substances (which I like) negatively impact my sleep if consumed after say 14:00-15:00.
  5. Don’t drink more that one small beer or one glass of wine or one glass of whisky – if any alcohol at all. I find small amounts of alcohol ok for me, nevertheless more makes me thirsty and often wake me up in the middle of the night. Just thinking about it… actually older I get, less I drink, it seems as if my body would tolerate alcohol less and less. As a result of ‘lack of training’ – even one beer in the evening impacts a little bit my clarity and feel-good mood next morning.
  6. Dark room. Make sure that the room is dark, without any light from outside as well as any light from electronic devices, that’s annoying and influences quality of your sleep.
  7. Open window. I find myself sleeping better with some fresh air coming in. Even if there are noises from outside. Now, if you live close to a railway station – perhaps that’s not a good idea.
  8. I have a power nap in the afternoon whenever I can. A nap works for some people and for some does not. Of course, sometimes I don’t manage even if I want to. Max 30 minutes, otherwise the nap makes me sleepy – I set an alarm on my phone for 20 or 30 minutes depending how much time I have.

Make your own list, observe what works for you and then follow it as often as you can. Don’t stress when you are not able to follow your routine once in a while, that’s normal. If you like to read more about science behind sleep – here is a good overview. Interestingly enough, major study compilation confirmed that the optimal sleep duration from the perspective of longevity is 7-8 hours. Anything shorter or even longer means increased risk of death.

A topic closely related to sleep as well as successful stress management is your morning routine. Do you have any and if yes, what does it include? I speak about healthy morning routine in another post here.

I guess you have enough to contemplate about and try, let’s pause here. If you are up to more reading – here is the Longevity – Part II for you. Part III will arrive soon. You can look forward to discussing exercise, stress and its management, healthy nutrition, fasting and more.

Does longevity matter to you? What do you do to achieve longevity – if anything? Share with me and other readers in the comments below or send me an email as usually.

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