Why We Aren't Anti-Aging, We Are Pro-Healthy Aging

In 2020, we are officially declaring the war on aesthetic aging over. For years, people have fought wrinkles with lotions and needles, dyed-away gray hairs, and straight-up lied about their age. Slowly but surely, though, that's all changing. These fading strands and laugh lines are being accepted and embraced as signs of a well-lived life. Collectively, we're posting more makeup-free selfies, engaging in more positive self-talk, and emphasizing the role that whole foods, movement, and mental health play in both looking and feeling like the best versions of ourselves. 

Simultaneously, a new paradigm of aging is emerging in the scientific community. Researchers, like Harvard geneticist David Sinclair, Ph.D., are beginning to identify compounds and lifestyle practices that may actually counter the internal processes that contribute to aging, and the conversation is evolving from how we can add years to our lives to how we can ensure that those years are vibrant and healthy, too. Which is overall encouraging news, because, as functional medicine physician Frank Lipman, M.D., puts it, "What good is living 100 years if you're sick for half of them?" 

In many ways, these trends overlap, and emerging science on what may help counter aging on a cellular level is reinforcing many of the healthy lifestyle habits we here at mbg have long been preaching. In other ways, the boom in research is leading to novel discoveries that provide us with even more tools in our health-enhancing, life-extending box—and that prompted experts to question whether aging could actually be "treated" one day as its own health condition. 

This increased interest in healthy aging comes at a crucial time. We are currently experiencing unprecedented growth in the aging population. By 2050, the number of Americans over 65 is expected to nearly double1 to 88 million, and worldwide, this age group is projected to make up 17% of the total population. Currently, about 80% of people over 65 are living with at least one chronic disease, and 77% are living with two or more chronic diseases. 

And while modern medicine has helped extend life span, now the focus needs to be on improving the quality of those in those extra years, or "matching health span to life span," says Matthew Ehrlich, M.D., author of The Vail Method: Getting Better Not Just Older. This will not only benefit people who are entering older age but their caregivers and our overburdened health care system as well. 

For the first time, we are starting to see research that targets aging as a health condition in and of itself. Finding ways to regulate those "longevity gene" pathways referenced by Lipman above (specifically the mTOR, AMPK, and sirtuins) is central to scientists' work in identifying lifestyle habits, nutritional compounds, and future drugs that could slow and even treat (yes, treat) aging.* 

As Sinclair views it, aging is most definitely a disease, and the FDA classifying it as such will help the field move forward even faster, allowing for more research and development of drugs to target processes that lead to age-related disease. "The definition of a disease is that over time you lose function, you become decrepit, disabled, and eventually, if it's a bad disease, you die from it," says Sinclair. "That sounds a lot like aging, right? If you go to the medical dictionary, the only difference between aging and a disease is that a disease affects less than half the population—and that 50% cutoff is completely arbitrary."

How likely is that to happen? In 2018, the World Health Organization classified aging as a disease and added it to the International Classifications of Diseases system. And right now, scientists at the Albert Einstein College of Medicine are examining the anti-aging effects of metformin in the Targeting Aging With Metformin (TAME) study. If researchers can show significant benefits of metformin in delaying problems such as cancer, dementia, stroke, and heart attacks, the FDA may consider classifying aging as a treatable condition.

But why study metformin? This widely prescribed diabetes drug, derived from compounds in the French lilac plant, has been noted for its benefits beyond diabetes2—and Sinclair predicts it will be the first drug prescribed specifically to treat aging. Turns out, "metformin had a protective effect against cancer, heart disease, and frailty in patients taking the drug for long-term diabetes treatment," says Sinclair. "Which sounds a lot like a molecule that can slow aging." Animal studies have also confirmed that metformin can improve life span, and, more importantly, health span3 in mice. And, in a first-of-its-kind study in humans published in September 2019, researchers were actually able to take 2.5 years off participants' biological clock using a combination of metformin, dehydroepiandrosterone (DHEA), and growth hormone. 

Some experts believe that advances made in this field could actually lead to advances in the supplement world by helping us home in on natural compounds that have similar characteristics to these drugs. "What I've always done in my practice is I look at what the pharmaceutical companies are talking about, what they're doing, then I reverse engineer that to supplements," says renowned integrative medicine physician Robert Rountree, M.D. "Then I go, OK, is this a pathway we really need to pay attention to? Is there any research that any herbs or nutrients affect it? Berberine, for example, seems to modulate some of these nutrient-sensor pathways like AMPK4, so it's kind of a natural mimic of metformin."*

There's a growing body of research into the longevity-boosting benefits of periodically stressing out your body. Hormetic (or pulsatile) stressors, which put the body into a state of perceived adversity called hormesis and activate longevity pathways, can include things like intense exercise, exposure to cold temperatures, and—perhaps the trendiest of them all—fasting. 

Both time-restricted eating (going 12 to 18 hours without eating in a day) and fasting (periodically going three to seven days without food) have garnered the attention of longevity experts, and so far, it looks like you don't need to go to extremes to reap some benefit—Valter Longo, Ph.D., director of the USC Longevity Institute, suggests sticking to a very reasonable 12-hour eating, 12-hour fasting window. "It's really the way lots of centenarians and people who live a long life have always done it," he says. 

You may be wondering, "if I try all this stuff, how do I know if it's working to extend my health span?" Well, in the not-too-distant future, you may also be able to purchase a test that actually determines your true biological age. Recently, Sinclair and a colleague, Steven Horvath, developed what's called an epigenetic clock that's "right on the cusp of being commercially available."

The truth is, embracing aging and all the gray hairs that come with it is way easier when you feel good, healthy, and strong—and thanks to this burgeoning field of aging research, we're gaining more insight every day into the habits, supplements, and dietary strategies that may slow the aging process from the inside out so we live really, really well for longer than we thought possible.*

But just remember, cautions Lipman, regardless of how enticing any one age-countering strategy sounds, effectively boosting health span still "needs to be a multipronged approach, involving things like what, when, and how much we eat; how we exercise; how we deal with stress; the amount of good restorative sleep we get; our relationships." 

We can't wait to see where the science of aging will go in the next year, but in the meantime, let's stop the anti-aging nonsense and accept the fact that aging (i.e., living) is freakin' great—especially now that we can do it healthier and happier than ever.