“Does This Intervention Reverse Aging? Or Extend Lifespan? Or Both?”
by Nils Osmar. Updated October 3, 2022. Medical Disclaimer
A lot of the confusion we run into in our community tend to come from a confusion about what aging is and its relationship with lifespan.
We tend to think of the terms “anti-aging” and “life extension” as if they were interchangeable. Even anti-aging researchers tend to speak of them as if they were the same. But they’re far from it.
The aging process
Aging has specific physiological effects on the body. They include things such as:
- the age-related loss of muscle as the years go by
- the age-related loss of resilience in our skin (leading to wrinkling)
- the age-related loss of strength and flexibility in our bones (leaving us with brittle, easily shattered bones and joints); poorly functioning immune systems
- the age-related loss of mental acuity and a drift toward dementia
- the age-related collapse of our immune systems, leaving us more vulnerable to the “diseases of aging”, including cancer, heart disease and diabetes
- the downward spiral in our levels of NAD+, glutathione, hGH and the sex hormones
- and of course many other sorts of decline
Aging can of course lead to death, but it’s not the only thing that kills us. And extending our lives without reversing aging is not a scenario that personally appeals to me.
Examples of anti-aging
Anything that reverses the items I listed above can legitimately be called anti-aging, even if it doesn’t add an extra day to our lifespans.
So in that sense, building muscle and stamina through exercising is anti-aging. So is taking supplements which increase our bone strength and density — even if the result is not an increase in longevity.
So is eating more protein, or more leucine, to support muscle growth and the activation of mTOR — even if animal studies show that at least some lab animals actually live longer if their protein and leucine are restricted. (To be more accurate, they live longer at the expense of the immune systems; their immunity is very poor, meaning they could not survive on diets like that in nature; they only survive because the lab environment protects from diseases and predators.)
Examples of life-extension
Anything that extends the lifespan can (by definition) be called life-extending, even if our extra years of life are spent in a demented state, frail and broken, unable to stand or walk anymore, in a nursing home. (This happened to a relative of mine by the time he had reached 70; it happens to many people in their 80s.) (It often does represent life extension, but not the healthy kind.)
The goal
The goal for many of us, of course, is both: To reverse aging and live longer. (Some people have their eye on living to be 500, or 1,000, or even living forever).
Doing so would involve reversing any aging that has already taken place; slowing any aging currently going on; and (if possible) finding an approach that might prevent further aging. I..e.: “Healthy Life Extension.”
My criteria
When I consider whether or not to make a change in my lifestyle or add (or subtract) a supplement, I check to see:
- Does this intervention reverse, slow, or prevent specific signs of aging?
For example, if I take a supplement, will it slow prevent macular degeneration? (For this, I take lutein and zeaxanthin). Will it make the skin more flexible, resilient and less wrinkled? (For this, I take high molecular weight hyaluronic acid) Will it prevent age-related memory problems? (For this, I take phosphatidyl serine). Will it reverse, slow or prevent sarcopenia? (For this, I take creatine.)
None of these interventions will necessarily make me live longer, but they are pushing back against the aging process and so improving my quality of life. If a supplement or practice does this, I’ll often do it.
People who ridicule exercise as an intervention often say, “Well, sure, it might help you gain muscle, but there’s no proof that it’ll help you life longer.” They’re missing the point though that reversing aging is always desirable, whether or not the result is an increase in lifespan. - Does it extend lifespan in both lower life forms, i.e., worms or fruit flies, and mammals? (We can’t know in humans, but we can look at animal studies.) If it does, there’s a good chance, though no guarantee, that it will also do so in humans. (If it only extends lifespan in fruit flies, it’s not tops on my list.)
- Does it both reverse aging — or some signs of aging — in humans and animals, and,extend lifespan? If so, I’ll almost always take it. Compounds that show signs of both reversing aging and increasing lifespan include rapamycin (most effective when taken with metformin); AKG (which can be taken plain or as a salt of calcium, arginine or ornithine); fucioidan and cyanidin (sirtuin 6 activators (which are most effective if taken along with NMN or another NAD+ booster); GlyNAC (glycine plus NAC, taken in roughly equal amounts.
- Ambiguous approaches. Some approaches, for me, are judgement calls.
For example, testosterone levels sink as we age; some supplements boost testosterone to youthful levels; having higher testosterone is associated with longer and healthier lifespans, but also with slightly higher odds of cancer. (i.e, we might in theory live to the age of 90, then die with cancer, instead of living to the age of 80 and dying without cancer). I take supplements to boost testosterone, but I consider them quality of life supplements, not the most effective life extending supplements.
Growth hormone is even more ambiguous. There’s some evidence that it reverses many of the signs of aging, restoring youthful vitality, mental clarity, sexual energy, and musculature, but that injections of recombinant hGH, may actually shorten the lifespan. But there are also signs that hGH injections, if given with metformin, zinc, vitamin D and DHEA, can reverse epigenetic aging, as demonstrated in the first TRIIM trial. (The second TRIIM trial, now underway, may clarify the situation.) For the moment I’m not getting hGH injections, but I do take some supplements such as beta alanine that increase hGH not to super-high levels, but closer to those in healthy young adults.
P.S. Maturing (while growing up) is not “aging”
Another point of confusion is that people also tend to confuse aging with maturing. The word “older” is used to describe two categorically opposed biological processes.
A two year old whose body changes as they grow and mature into a four year old may be two years “older”, but has not “aged”. His or her body has not gone downhill. His or her skin is not becoming more wrinkled. His or her bones and muscles, while maturing, are growing bigger and stronger.
Human beings spend around 20 or 22 years maturing; they stay in a kind of steady-state for 8 to 10 years; they they start “aging”, in the sense that the term is commonly used in the medical community, around the time they turn 30.
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Other resources
You’re welcome also to check out my Youtube channel (Pathways to Longevity) — and the Anti-Aging and Life Extension Facebook group.