When we ask researchers when, in their opinion, the cures for aging will be ready, we often hear an optimistic answer: 20-25 years. As a well-informed optimist, I add another 10 years to this number, because wherever the therapies appear, it will take time for them to be distributed to other countries and become affordable. I will be happy if it takes less time, but what if it doesn’t? I am nearly 40, and when I add 35 years to my current age, I vividly imagine how my reflection in the mirror will show a 75-year-old lady. Honestly, I don’t want to see my body change, and it can explain why I aspire to get first-hand information about any means to slow down aging as soon as possible. Evidence-based information, of course.
Before I tell you my story of discovering how to control my aging, I must provide a disclaimer. This article does not contain any medical recommendations. The websites of the projects I will tell you about, once again, do not contain medical recommendations and cannot be independently used to make health decisions. The experience I will share, and the activities of the projects I will tell you about, are aimed at teaching you about the existing scientific knowledge about aging and interventions that have the potential to change the way we age. Whatever you decide to implement in your everyday life, please talk to your medical advisor first.
I am always looking for the means to keep myself as young as possible. Luckily for me, in Russia, there is a project focused on collecting this kind of information and making it publicly available. It is Nestarenie.ru (translation: “not aging”), an online encyclopedia created by professional sports trainer, valeologist and citizen scientist Dmitry Veremeenko. The amount of information that Dmitry has managed to process is hard to imagine; it consists of more than 70,000 scientific papers. The development of this database took him several years of work. Each article of his encyclopedia summarizes a specific drug, food or lifestyle element that can slow down or even reverse age-related changes, with a deep explanation of the underlying mechanisms. Each of his information-dense articles has lots of internal links to actual scientific papers (including the freshest meta-analyses) and finishes with a list of additional references.
Last year was marked by a very productive collaboration of Nestarenie.ru with Open Longevity, which was started by Mikhail Batin, the President of the Science for Life Extension Foundation, and developed by Nastya Egorova, its talented executive director. The main goal of the Open Longevity project is to organize patient-funded clinical trials of the most promising anti-aging therapies. However, in order to convince more people to take part in these trials, it was necessary to prove to them that is it truly possible to control the way they age. This is done by educating people about the available interventions and helping them to measure crucial parameters before and after each intervention to determine the real difference.
First, this amazing longevity duo supported Dmitry to develop a diagnostic profile consisting of biomarkers that would be most strongly connected to the risks of mortality from specific age-related diseases. Here is the Open Longevity Diagnostic Profile composition, which is the list of biomarkers they chose (You can use Google Translate to read the explanation of why these biomarkers were chosen here on Nestarenie.ru):
- Alanine aminotransferase
- Vitamin B12 (cyanocobalamin)
- Vitamin D (25-OH) (calciferol)
- Glycated hemoglobin (HbA1)
- The HOMA-IR index
- Interleukin 6
- Potassium (K+), Sodium (Na+), Chlorine (Cl-)
- Uric acid
- General blood test without leukocytes
- Somatomedin C (IGF-1)
- C-reactive protein (ultrasensitive)
- Free T3
- Free T4
- Thyroid-stimulating hormone
- Total cholesterol
- HDL cholesterol
- LDL cholesterol
- ECG (with decoding)
- Duplex scanning of carotid arteries in order to measure the thickness of the intima-media complex
This whole diagnostic profile is provided by the Moscow laboratory DNKOM, but these tests can be performed in any other diagnostic lab, as they are quite ordinary with a very few exceptions; the only novel part is using them in combination to assess the nature of your aging. Open Longevity developed its own up-to-date reference ranges for some of these tests.
Now, this is intriguing. I did my first test in November 2017, a couple months after the panel was made available. I was pretty sure that it would show that I am quite skilled at maintaining my health. This was mostly found to be true. Of course, there were surprises. For instance, my levels of B12 and D3 were found to be too low, despite the fact that I was taking supplements to maintain them! D3 deficiency is related to a number of age-related diseases, including cancer of different organs and metabolic diseases. Oops! B12 deficiency can affect brain health quite significantly. The biomarkers of inflammation were slightly elevated; IGF-1, on the contrary, was too low, and despite the fact that the other parameters were fine, it was yet another magic kick to motivate me to improve my lifestyle.
The beginning of the year 2018 was pretty intense here at Lifespan.io, as there were many conferences to attend and many things to do; still, the small changes that I have made after talking to a doctor, a bit more physical activity and a course of telmisartan, aspirin, new D3, and K2 (MK7), resulted in the reduction of my arterial stiffness and the improvement of my intima-media complex, as was shown by the analysis I did in February. My inflammation decreased as well. I managed to normalize my levels of D3 with a water-soluble form of this vitamin and slightly improved the situation with B12.
It was my first achievement and served as proof that once people see the before-and-after differences that they can make, they can get addicted to exercising deliberate control over their aging. I definitely wanted more health and less aging. However, I realized that I didn’t really know how to improve my metrics even more. I needed to get into the details, and I needed a coach.
Luckily for me, Mikhail and Dmitry have another great project: the Open Longevity School, a set of lectures to share the most up-to-date and practical information about the ways to keep your biomarkers within healthy values. Early morning on June 27, I joined a group of 50 other longevity fans to get to a tourist camp in the forest near Kostroma (~300 km from Moscow), where this year’s School was taking place. Why the forest? As I found out later, this was to ensure a natural “digital detox”, as the wi-fi and mobile communication there were quite unstable, and our smartphones temporarily became useless shiny accessories. That is a joke, of course.
Dmitry’s lectures (alternated with physical activity of different sorts) began with an explanation of the main paths to control aging: the effects of insulin and IGF-1. The principle is quite simple. When you eat something, the glucose enters your blood; the peak of glucose elevates insulin, which is necessary to help glucose enter your cells, and insulin stimulates the secretion of IGF-1. The main threat of high insulin and IGF-1 is their effect on proliferation: chronically elevated levels increase the risk of cancer as well as all-cause mortality. High insulin spoils the sensitivity of our insulin receptors, contributing to the development of metabolic diseases such as type 2 diabetes.
Additionally, when the glucose peaks are too regular and too high, insulin resistance develops via a number of pathways, and it leads to chronically elevated blood pressure, which itself is a risk factor for a number of health issues related to accelerated aging, including kidney diseases. However, this effect on blood pressure was proven to be reversible by a low-carb diet.
Interestingly, animals with naturally low or suppressed levels of IGF-1 live longer, as do animals that are genetically predisposed to be insensitive to IGF-1. This is exactly the reason why Andrzej Bartke’s mice, which had their growth hormone receptors knocked out, lived so long.
The conclusion of this section is simple. One of the most effective ways to prevent insulin and IGF-1 from harming your health and accelerating aging is to keep your glucose level within the reference range, as stable as possible, and without any peaks. Through a number of examples, including his own, Dmitry illustrated that not only it is possible, it does not take too much effort to achieve it.
However, there is a sad part. You must remove all fast carbs from your diet in order to turn it into one with a low glycemic load. Sweets; cakes; bread; sugar; sweet fruits (which are still allowed in small quantities after exercise); fruit juices; dried fruits; boiled, fried, and baked vegetables (because their glycemic indices jump after cooking), especially potatoes; vegetable soups; and pasta are harmful, because all of them cause glucose to peak and insulin and IGF-1 to react accordingly.
Additionally, one should exclude other harmful products, such as refined butter; trans fats; sausages; red meat in any form; and all fried, grilled, and baked food (because of AGEs – advanced glycation end-products). Milk is allowed, but only in small quantities, as it can suddenly increase the level of insulin in some people.
The 28-day low-glycemic-load diet in obese adults led to 43% lower glucose levels, 27% lower insulin, and 4% lower fasting concentrations of IGF-1. So, it really does work. This diet has properties similar to fasting but is devoid of the discomfort of hunger.
The diet that could make your level of glucose look like a straight horizontal line somewhere under 5.0 should mostly consist of:
- 600 grams per day of raw vegetables, with broccoli, tomatoes, and avocado as the most useful foods in your diet
- Green salads and edible herbs of all sorts
- Raw nuts (preferably almonds, cashews, hazelnuts and peanuts, as they are the most beneficial for health) and seeds, such as linen, chia, and pumpkin
- Vegetable oils, preferably olive oil and other oils with a similar proportion of fatty acids. Oleic fatty acid should dominate the composition, and linoleic, palmitoleic, myristic, erucic, and palmitic fatty acids should be in the minority. Click the link and use Google Translate to learn why
- Modest amounts of whole grains and beans, preferably not boiled but poured into boiled water and left to soften; this causes their glycemic index to raise less than if they were boiled
There are many other foods that you can also eat with no harm, but they should not dominate the first five categories:
- Cocoa, coffee, and chicory
- Small amounts of lard
- Boiled chicken
- Boiled eggs (4 per week)
- Kefir or yoghurt (preferably with raw oatmeal flakes in it), obviously not a sweet one
- Sauerkraut (without sugar)
- 2-5 grams of salt per day (not more, not less)
- Fruits in a very modest amount after exercise and other meals.
If you believe that you cannot possibly survive on this type of diet, the 50 longevity fans kept in the forest in a “metabolic jail” prove you wrong. The camp cooks were feeding us with the food promoted by the Open Longevity School for 5 days, and most of us considered it diverse, tasty and quite sufficient. After I got back, I decided to stick to the same diet as much as possible, and after being on it for 2 weeks, I have had my blood glucose and blood insulin tested and my insulin resistance calculated. Here are the results:
February 2018: glucose 5.0, insulin 7.8, HOMA-IR index 1.73
July 2018: glucose 4.5, insulin <2.0, HOMA-IR index 0.40
I guess the numbers speak for themselves. If you want to know more about this diet, have a look at this section on Nestarenie.ru (the automated translation is fairly good).
However, this was only the part of the School’s topics. After we learned about the benefits of a slow carb and non-ketogenic diet (while a ketogenic diet can slow down the progression of cancer, it is not generally good if you want to live longer), Dmitry shared his experience as a professional sportsman and trainer in order to explain how we can use physical activity to slow down aging even more while protecting ourselves from overwork.
He started with a set of slides illustrating that several hours per day of intense physical activity lead to significant damage to the heart, blood vessels, and other organs. Part of this damage is direct and due to oxygen deficiency and an excess of lactic acid; another part is indirect and caused by hypertrophy of the heart muscles and the deformation of its ventricles. In multiple studies, it was shown that the cardiovascular health of professional sportsmen was significantly poorer than the health of a control group of the same age who did not play sports at all. Among marathon runners, there are many sudden deaths from cardiac arrest, which can even happen several days after a marathon during medium-intensity training.
The reason for all these negative effects is that an intense and too frequent workload does not allow the heart to rest and recover from the damage that it might have received during the exercise. Small traumas are easy to repair, and they go away without leaving a trace. However, if we don’t let them be repaired and if we keep loading the heart, it can lead to chronic inflammation and even more damage, fibrosis, and scars. The relationship between physical activity and health is a U-shaped one: too little is bad, but too much is bad as well.
The optimal regime of physical activity consists of at least 10000 steps per day and at least 150 minutes of aerobic exercise per week, including exercises to maintain flexibility and balance. There should also be 2-4 short power load sessions per week. 150 minutes of physical activity per week is also the lowest norm suggested by the World Health Organization.
For people who are only beginning to engage in regular physical activity and for advanced practitioners, the way to measure the optimal load is the same: they should use the formula (220 – age) x 0.85 for the maximum heart rate allowed and (220 – age) x 0.6 for the minimum, which are the values within which the body is not overloaded yet engaged enough to become stronger and more enduring. Each session should begin with a warm-up, the maximum workload should happen in the middle, and you should drink enough water to help your body deal with heat. If done correctly, physical activity can decrease the risks of many types of cancer, slow down aging of the immune system, reduce your arterial stiffness, improve your lipid profile, improve your insulin sensitivity, prevent cognitive decline, and, of course, reduce the risk of sarcopenia and related problems. All of these effects are proven in studies in humans. Impressive?
Here, I will make a side note. I am a relatively frequent guest of the fitness club, but I didn’t previously realize that the workload I chose could be harmful to my body without me noticing it. I often run on the ellipse; this machine can measure your heartbeat (more or less), but as I was only doing that a few times per training, I didn’t get the full picture. Even with this limited data at hand, when I calculated my norms using the formula suggested by Dmitry, I realized that I sometimes exceeded my maximum allowed heartbeat by 15-20 beats per minute! This is a situation in which perseverance can work against you.
After the first lecture dedicated to these rules of safe training, I asked a few other members of the School what they did to keep track of their heartbeat. I have heard of heart trackers before, but I honestly find it uncomfortable to wear a device glued to my chest in order to track my heartbeat 24/7. How am I supposed to sleep with it on, for example? I was looking for something more unnoticeable, something that I could get used to relatively easily.
One of the students demonstrated his fitness bracelet, which I fell in love with instantly. It was the Huawei Honor Band 3, a simple and (luckily) cheap fitness tracker that has a number of useful functions, including monitoring your sleep patterns and sounding an alarm if your heart rate exceeds your maximum. One more fun function is that if you stay inactive for an hour or so (typing is considered a very sedentary activity), it vibrates and shows you a human figure doing aerobic exercise as a hint that you have to go stretch your legs.
The device collects the data in an application, and if some parameters do not look well, the application shows you information about how to get back to normal, including a list of scientific publications at the end (!!!). Not only does this system track what happens to your body, it also educates you on how to become better at useful activities such as sports, meditation and healthy sleep. Needless to say, I got one right after getting back to Moscow, and I’m currently testing it in different situations and exchanging experiences with other students. This might not be the best fitness tracker, but it’s good enough, to begin with.
At the end of the School, Dmitry presented us with the most important information, which he was apparently saving as a take-home message. On one chart, he compared rats that were fed normal diets and given no special physical activity; rats with normal diets combined with healthy physical activity; fasting rats without any special physical activity, and rats that underwent a combination of fasting and physical activity. Guess which group lived the longest?
It turns out that the effects of a slow-carb diet and a healthy amount of physical activity are additive. Slow carbs provide a safe fuel for the body, keeping glucose, insulin, and IGF-1 under control. Moderate exercise, on the other hand, supports the effects of this diet and reduces the risks of multiple age-related diseases (including sarcopenia, by supporting the functions of mitochondria and motor neurons, maintaining balance, and reducing the risks of falls and trauma). The synergy of these positive effects allows animals to live the longest, and there are grounds to believe that we humans can benefit from this combination as well.
Every day after the lectures and a number of exercises, the students had some free time to digest the presented information. Most of all, I was thinking about how to implement all this in my life and also how to help my relatives, friends and colleagues to do the same. As I said in the beginning, I am a well-informed optimist, and I think that it will take quite a lot of time to get to our dream of an unlimited healthy lifespan. For many people, the only chance to live long enough to receive rejuvenation biotechnologies is to begin controlling their aging right now, implementing all the methods that are available. Another important thing is to consider taking part in patient-organized, patient-funded clinical trials of anti-aging interventions, which I am actually planning to do once Open Longevity trials launch, as it will give everyone more tools for extending healthy life.
I am immensely grateful to people like Dmitry and Mikhail (and of course the team that helped them to organize the School and keeps helping them to develop the Open Longevity project) for promoting an evidence-based approach to diagnostics and healthy life extension that the general public can understand. One can argue that there are imperfections, and I agree that there are. Of course, the diagnostic profile and the encyclopedia will be gradually updated and refined as they get more data. Over time, there will be more doctors able to interpret the data as well as a special mobile application. However, without pioneers like Dmitry and Mikhail, we would not have this awesome starting point at which the transition to practical aging control actually begins.
There are lots of things that we were taught from a very young age that are simply wrong when it comes to extending life. There is an old saying in Russia, “Bread is the head”, meaning that eating bread is very important. Right. Bread is a fast carb, and, as such, it is not a longevity food! This is one example of an outdated belief among many others. Forget these beliefs. Ditch them. To overcome this limitation of 122 years, we must change the ways we used to think and the ways we used to live.
To be a life extensionist means to learn new things and deliberately take more responsibility for your body than usual. It is not an obsession, not a weirdness, and not a symptom of hypochondria to drop a harmful habit in order to develop a healthy one, nor is it bad to change your opinion about an ordinary thing when you are presented with enough evidence. Instead, it expresses your love for life.
Here is what I took from this forest camp. If you truly want a longer life, then regular (and quite sophisticated) diagnostics, medical coaching, self-control concerning diet and exercise, adherence to a prescribed treatment, wearables to quantify yourself, and lots of analysis are your norm. My norm. This is who I am, this is who I want to be, and this is who I have the right to be: the slender tall woman who wants to be free from aging.
Photos by: Katya Rush, Marat Aynabekov, Dmitry Ukhanov, Maria Vlasova, and the Open Longevity team.
To prepare this article, I have used materials from Nestarenie.ru and slides made by Dmitry Veremeenko for Open Longevity School 2018.
If you wish to learn more about the patient-organized, patient-funded clinical trials of interventions against aging that the Open Longevity project has planned, please contact Nastya Egorova.