The Law of the Few Applied to Health

As promised in my previous post, this is my perspective on the few things that promote health.

Although a complex series of events define every individual’s health, one very simple approach is to examine the natural process that makes each of us less healthy: AGING.

In this paradigm, the things that lower your biological age improve health. Things that elevate your biological age lower health.

How do we measure your biological age and what are the things that may promote health and longevity?

Steve Horvath from UCLA can help us understand how we can measure biological age. He created a mathematical approach to measure wear and tear marks on top of our DNA, called methylation marks, to determine a person’s chronological age. Like rings of the stump of a tree can provide insight into the tree’s age, using his algorithm, DNA from spit, blood, or urine can predict a person’s age within three years. (See an article about Dr. Horvath’s work in Nature.)

When Dr. Horvath used this approach to age date cancer tissue, he found that many cancer tissues were significantly “older” than the age of the person from whom the cancer was removed. This finding suggests that perhaps certain tissues within our bodies are aging faster than our chronological age. This may predispose us to diseases like cancer or Alzheimer’s disease.

Because methylation of DNA is an important mechanism by which tissues form (e.g. liver, heart, kidneys, brain, etc.) and also given the fact that tissues with steroid hormone-like receptors like those found in breast tissue are associated with more methylation of DNA, these tissues may age faster than others.

Once we acknowledge that certain tissues can age faster than others and these tissues may be predisposed to diseases of aging, including cancer, let’s next turn to understand what in nature determines longevity. In other words, let’s find out how we may reverse this effect.

As far as I am aware, the only thing that has been shown to increase lifespan in living beings is calorie restriction. Given the obesity epidemic in the U.S. and worldwide, this is an issue for a majority of the population.

Although it is not entirely clear how calorie restriction enhances longevity, it is likely a conserved cellular pathway that centers on activation of the insulin receptor is important. If the insulin receptor is not activated, the cells undergo a process called autophagy, which literally means self-eating. This pathway clears cellular debris and aged cellular contents and provide for regeneration.

There are other environmental and behavioral factors to living long and well, as is outlined in the Blue Zones study. This study details how people in five areas of the world live to give us insights on what we may do.

Perhaps the most important issue that underlies longevity is maintaining a sense of purpose, or as the Japanese call it, ikigai. This is an important insight into a key driver of health and suggests that all of us should stay engaged in purpose for our entire life.

In addition to a maintained sense of purpose, there are five things that people living long and well do differently than those who don’t.

• Food. Folks in Blue Zone areas eat about 80 percent of what others eat. They eat a plant-based diet and have a glass of wine or two a day. The World Health Organization also recommends to drastically reduce sugar intake (high fructose corn syrup, cane sugar) and to always eat real food (apples instead of apple juice, real vegetables, etc.). One can of sugared cola is too much for an entire day.
• Exercise. People in Blue Zone areas move a lot. They don’t necessarily go to the gym, but they walk, bike, run, swim, and play. We recommend at least 8,000 steps a day to the optimal 12,000 steps per day of walking, or the equivalent.
• Connections/Social Networks. These folks have close friends and often live in communities with other generations of the same families. We know that social networks are powerful areas that create health. Close friends and relationships facilitate health.
• Resilience/Behavior. Having the right attitude and choosing priorities are very important. Research shows that acute stress like exercise is good for us. Chronic stress, on the other hand, can be either good or bad. It depends on how we see it. If we feel stress in the setting of chronic stress, issues indeed impact our health negatively and can even accelerate aging. On the other hand, if we do not feel stressed, there are no adverse effects on health. This is critical; understanding what is really important – health, family, independence, autonomy – allows us to deal with the daily stresses of life.
• Sleep. Aim for at least 6-8 hours a night.

Premature aging is disease. Longevity is health. To be healthy, follow these five steps.

• Eat less food and a mostly plant-based diet with less sugar.
• Exercise regularly (8-12,000 steps/day).
• Be socially connected.
• Understand what is important; be happy and grateful.
• Sleep 6-8 hours each night.