The Fountain of Youth
By: Dr. Deborah Gordon, January 31, 2023
In honor of our virtual operations manager, Rachel Lee (well-known to many of you, who moved to Florida but luckily has stayed connected with our practice), let’s talk a minute about Florida. Old Florida of course had an indigenous presence long before the arrival of Ponce de Leon, so while he was once credited for “discovering” Florida, he is now credited with being the first European to reach Florida, landing in April 1513.
In April 1513, Juan Ponce de León landed on the coast of Florida at a site between Saint Augustine and Melbourne Beach. He named the region Florida because it was discovered at Easter time (Spanish: Pascua Florida).
For some reason, he is reported to have encountered Florida and explored it because he thought it would be the site of the Fountain of Youth.
Humans have dreaded aging as the “downside of a long life” as long as we have done our best to have healthy and long lives. (Nice article here 3 free National Geographic articles a month.) Turns out de Leon didn’t find what is now designated as his Fountain, and drinking its sulfurous waters (Lithia Waters, anyone?) doesn’t prolong life or restore youthful vitality.
Not easily discouraged, many modern seekers, especially approaching and passing our later birthdays, wonder if there is a healthy way to prolong not just our lifeline but also our healthy years. Can we increase our “Healthspan” as well as our “Lifespan”? Let me start by saying this is a HUGE body of interest claiming the attention of scientists, entrepreneurs, investors and the general public. If you start nosing around, you will find WAY more written than I could possibly know about or reference in this single article.
Such a topic has been the work of David Sinclair, Ph.D., who wrote a great book called Lifespan and hosts a limited-episode podcast of the same name. Sinclair does an excellent job writing about and subsequently discussing the science and the promise of caloric restriction, healthy sleep and exercise habits, and the intricacies of “intermittent fasting” or “time-restricted feeding,” and each topic deserves even more attention than the podcast-discussions he hosts so adeptly. The podcasts, though, are a great place to start.
Let me use his work as a springboard and take off on a few specific topics:
- Caloric restriction, specifically protein-calorie restriction has been confirmed in multiple settings as a reliable way to extend the lifespan and healthspan of … laboratory rodents. While the concept and practice appear to hold promise for human longevity as well as rodents (see the work of Walter Longo who counsels those < 65 to eat a mostly vegan, low-protein diet), a real-life risk exists that I can’t wrap my head around. EVERY older person is at risk for loss of muscle mass (sarcopenia) and loss of bone density (osteopenia and osteoporosis). Longo acknowledges the potential hazards of protein restriction with advancing age, and gets a little closer to what I think is indicated. To quote Longo from the same page, “Over age 65, you should slightly increase protein intake but also increase consumption of fish, eggs, white meat, and products derived from goats and sheep to preserve muscle mass.” Young and old, however, he thinks MOST protein should come from nuts and legumes. I would agree that caloric limitations can be helpful but believe they are best accomplished by increasing your available protein (first animal sourced–meat, fish, eggs, dairy–and secondarily nuts, and maybe some legumes) to control appetite while enabling muscle and bone maintenance and even repair. Or, as I’ve said before a million times: Eat More Protein.
The easiest dietary restriction and clearly of benefit: eat 3 meals a day, and confine your eating to a 10-12 hour window, while still getting the protein you need.
- Other lifestyle choices are key, besides what you eat. Everyone agrees, it’s helpful to get 7-8 hours of high quality sleep on a regular basis, some good exercise, as well as both a sense of purpose and connection in your life. What I mean by those terms are, starting with good quality sleep:
- 7-8 hours of sleep starting at least 2 hours before midnight
- No food or alcohol for 3 hours before bed
- relying primarily on natural sleep aids (melatonin, 5-hydroxy tryptophan, glycine, l-theanine, what are your favorites?)
- If a medication is necessary, chat with your docs about the safe-for-sleep prescriptions (trazodone or gabapentin):
- Good exercise of course has to be individually matched to your body’s abilities and capacities, but basically aims to include
- some low-key (aerobic, allows for conversation) gentle and steady exercise for 20-30 minutes on a near-daily basis, as well as
- a couple days a week where whatever you do includes some high-speed mini-sprints (an “interval” is all-out exertion, just 15-30 seconds at a time, repeated several times, each repetition after a good span of recovery time)
- a couple days a week using your muscles to “lift something heavy” whether it’s your own body weight against gravity or some free weights or exercise machines with built in resistance.
- Supplements for longevity, let me mention four:
- Vitamin D, taken with vitamin K2 to achieve blood levels of 50-70 nmol/mL will help keep your brain, bones and the rest of your body strong and healthy.
- Longevity-supporting Omega 3’s (EPA, DPA and DHA) can be obtained from fish, fish oil, and for some genetically lucky people, from nuts and seeds as well. Most people benefit from supplements on top of food sources, and I encourage you to look for brands that caretake the fragile fish oils as transparently and consistently as possible. (My current faves are Nordic Naturals and Barlean’s, which do you like?)
- A combo supplement of nicotinamide riboside and resveratrol (each enhancing the absorption and benefit of the other) helps protect the integrity of your chromosomes, so that they don’t go astray in their constant work to keep your body functioning optimally. (I like Thorne’s ResveraCel, other companies make this supplement as well.)
- Final supplement suggestion is for Fisetin. Fisetin is present in strawberries, apples, persimmons, grapes, onions, kiwi, kale, etc., albeit in VERY low concentration and has been found to help clean away dysfunctional and “senescent” cells, protect against malignancies, obesity and type 2 diabetes, and protect the brain in models of neurodegenerative disease. Extensively studied in laboratory animals and cell cultures, fisetin has attracted enough attention and confidence that it is undergoing human clinical trials
- A couple medications have been studied and applauded for extending lifespan. My thoughts about these drugs (nutshell version) is that I think Rapamycin has more to offer than Metformin and would be happy to discuss with any of my patients interested in adding it to their regimen.
- Metformin, developed as a treatment for type 2 diabetes, obesity and metabolic syndrome, was found to have such side effects as reduced cancer risk and longer lifespan. My concern with metformin are several less optimal side effects including reduced response to exercise, possible B12 deficiency and adverse cognitive side effects ( a fairly new concern, still under investigation ). The drug is in a category of drugs termed mTOR inhibitors, where mTOR stands for “mammalian target of Rapamycin” which brings us to …
- Rapamycin, a drug with a strange but promising history. Both rapamycin and metformin are mTOR inhibitors, and both exhibit anti-aging, anti-cancer, and anti-heart disease benefits, metformin used in the treatment of diabetes and rapamycin more historically used for its immune suppressant activity following kidney transplant! Rapamycin has its fierce adherents (check out crowd-sourced Rapamycin Newsand/or the work of Alan Greene ) as well as having attracted some mainstream medical attention here .
Last little note about Rapamycin: I learned about it from one of its most experienced researchers, Dr. Matt Kaeberlein, speaking as a guest on Peter Attia’s podcast, episode #175. In addition to being interested in the drug’s application at a human level, he is directing a research project in which rapamycin studies will be elevated from rodents to mammals, to our friendliest mammals: family dogs. If you actually come to the office, you have met Fiona—an always delightful dog who has become MUCH more healthy in the 16 months since we adopted her, and might be interested to know that I am taking steps to enroll Fiona as a subject in Dr. Kaeberlein’s Dog Aging Project . (I hope she’s not in the placebo arm of the trial!) And finally – yes, I have been taking Rapamycin myself!