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Aging Gracefully

Healthy Aging Healthy Aging

Patients want to live their best lives but may need to manage health challenges. Here’s how to help.

Although Ponce de Leon’s mythical Fountain of Youth has yet to be found, research is discovering how accelerated aging may be slowed down if not prevented. Patients choose to work with naturopaths as they already have the mindset of proactive health promotion. Even if nothing is “wrong” per se, they can elevate their mental and physical function no matter their current age to better ensure that their future years are lived in relatively good health.

Your consults are likely already anchored in practices and supplements to focus on healthy aging. According to the National Institute of Aging, the goal of healthy aging is not just being free of chronic disease, but to maintain a high quality of life so that those years may be enjoyed in a productive and vital way.

Tim Hammond, vice president of sales and marketing, Washington-based Bergstrom Nutrition, opined, “Aging is a complex interaction of genetics, chemistry, physiology and behavior, but it is behavior where practitioners may have an opportunity to provide positive impact for their patients, especially when it comes to each individual’s ability to reduce pain and inflammation, enhance mobility for active living and look as good as they feel.”

Nutritional deficiency, say some experts, can accelerate aging. Stacey Smith, DC, marketing & communications manager, NORAM with Gnosis by Lesaffre, believes that some of the largest issues affecting aging populations are in bone and cardiovascular status, and these, she stated, “are the result of a nutrient deficiency: Vitamin K2 as MK-7. By correcting that deficiency, we are simultaneously supporting both our bone and heart health, allowing us to remain more mobile and vital as we age.”

Senescence is a more precise term gaining ground to distinguish between healthy aging (innocuous changes, such as hair greying), and poor health in aging. “‘Senescence’ more accurately describes the process of the deterioration of bodily functions over time,” commented Kim Plaza, technical advisor, ADM Protexin (Bio-Kult), Florida. “Previously, scientists would look for a single all-encompassing theory that could explain senescence, however, it has become clear that there are multiple processes, interacting on many levels that are involved in the aging process.”

Cambria Glosz, MS, RD, nutrition advisor, California-based ProHealth, Inc., agreed, explaining that removing senescent cells can positively influence aging and longevity. This, she stated, can be achieved with senolytic treatments, including naturally occurring molecules like quercetin and fisetin.

There are three prominent theories of aging that Plaza finds very compelling—the program theory, the damage theory and the combined theory. The program theory discusses the evolutionary benefits of having a limited lifespan, where the body’s cells are programed to function for a limited time, before biological aging occurs.

The damage theory is based on the damaging impact of oxidative stress on proteins, lipids and DNA. Several age-related structural and functional changes are believed by researchers to be the result of reactive nitrogen species (RNS) and advanced glycation end-products (AGEs). “Collectively, they are thought to be associated with alterations in sleep homeostasis, psychological problems, cognitive impairment, as well as diabetes and cardiovascular diseases,” she said.

The combined theory is what is now more commonly used, according to Plaza, as it incorporates aspects of the biological, chemical, environmental and electrical factors involved in aging.

As Jolie Root, LPN, LNC, senior nutritionist and educator, Illinois-based Carlson Laboratories, said she sees it, “aging is driven by three main processes that cause cellular destruction: glycation, oxidation and inflammation. Glycation is driven by excess sugar consumption and a consistent state of hyperglycemia. Glycation creates advanced glycosylated end products (AGEs), compounds that promote vascular inflammation, endothelial dysfunction and an unhealthy prothrombotic state.

“Hyperglycemia and AGEs promote generation of reactive oxygen species (ROS) which in turn increase AGE and oxidized low-density lipoproteins formation,” Root explained. “These pathways are all involved in the development of atherosclerosis and blood vessel plaque progression.”

She advised practitioners to pay close attention to Omega-3 Intake and Omega-3 Index scores, as a 2021 study in the American Journal of Clinical Nutrition found that having higher levels of omega-3 fatty acids in the blood is associated with a life expectancy of five years longer compared to individuals with low omega-3 intake.

Similar to senescence, the theory of telomere shortening impacting life span is increasingly being explored and validated. Said Glosz, “maintaining telomere length—the repetitive sequences of DNA that protect the ends of our chromosomes—is a compelling theory for promoting longevity. Telomeres shorten with each cell division, and once telomeres reach the end of their ‘rope,’ so to speak, they can trigger aging at the cellular level, causing senescence and accelerated aging.”

Julia Craven, vice president of education, Enzyme Science, Florida, elaborated, “Telomerase is an enzyme that influences a cell’s ability to lengthen telomeres and prevent their shortening. When cells don’t have enough to maintain optimal length, it accelerates cellular aging. Activating telomerase helps maintain telomere length, delaying aging and possibly even reversing tissue degeneration.”

Craven also pointed to the stem cell theory of aging as having credibility to address. She explained that stem cells are the foundation for all organs and tissues. They can uniquely self-renew through cell division—but they can also develop into more specialized cells (e.g., muscle, brain or red blood cells). Our bodies form stem cells during different life stages. Embryonic stem cells form in utero, but adult stem cells form early on and remain with us. Adult stem cells are tissue-specific. They concentrate on repair and maintenance within a tissue or organ. Stem cells naturally allow damaged cells to be replaced with healthy ones but as the body ages, its stem cells slow down—along with their ability to self-renew, regenerate and perform specific tasks.

Yet another biochemical pathway contributing to accelerated aging is NAD+ depletion, a state that plays a critical role in several pathophysiological conditions, including neurodegenerative, metabolic and progeroid disorders. NAD+ helps the cells convert glucose to energy, playing a vital role in metabolic processes, according to Guillaume Bermond, founder of Seneque, Lausanne, France.

Human cells mostly rely on intracellular generation of NAD+ to fuel NAD+ levels. One primary way to bolster NAD+ biosynthesis is through dietary supplementation with a direct NAD+ precursor, NMN.

All processes within the body rely on cellular function, and all cellular function relies on NAD+, he explained. Without adequate levels of NAD+, the cells wouldn’t be able to generate energy, and the body wouldn’t be able to function properly. As we get older, NAD+ levels decline. The drop in NAD+ that occurs with age has been associated with age-related changes in the body, such as slowed metabolism and lower energy levels.

Several clinical and preclinical studies have demonstrated that NMN-C has beneficial pharmacological activity on multiple critical elements of health, including energy metabolism and physical activity, glucose tolerance and insulin sensitivity, cardiovascular health, neuro protection and cognitive functions and inflammation.

“Incorporating these theories into patient analyses could be helpful as they encourage the practitioner and the client to consider holistic perspectives when devising and following a therapy protocol,” suggested Plaza. “One of the main reasons for utilizing the damage theory of aging is that it specifically considers the accumulation of damage over a lifetime that is genetically and environmentally modulated. This therefore directs the practitioner to assess the genetics, epigenetics and nutrigenomics for a given client, along with environmental exposures—toxins, free radicals, reactive oxygen species from stress, as well as AGEs from the diet.”

She added that aging and lifespan are particularly affected by metabolism, itself impacted by deterioration in the maintenance of homeostatic processes over time. This leads to functional decline and is accompanied by many metabolic changes, such as mitochondrial dysfunction, a decline in insulin sensitivity and changes in hormone levels. “These changes contribute to the physical signs of senescence and predispose an individual to age-related conditions,” Plaza said. “Assessing the epigenetic factors of aging for your client could provide a valuable resource for informing your recommendations and ensuring that you are providing personalized advice.”

However, Daina Parent, ND, naturopathic liaison, Standard Process, Wisconsin, pointed out, “while many theories of aging exist, there is not a single identified cause that has been established and instead the process itself is multifactorial and multifaceted.”

Supplements Supporting Healthy Aging

The basic vitamins and nutraceuticals can’t be ignored to promote healthy aging, according to Root, who pointed out that vitamins E and C reduce glycation and oxidation. The antioxidant alpha-lipoic acid (ALA) reduces oxidative stress and the formation of advanced glycation end products (AGEs) and improves insulin sensitivity in skeletal muscle and liver. Vitamins E and D, omega-3s, curcumin and GLA all help to manage reduction of inflammation. “Also, coenzyme Q-10 reduces post-prandial glucose and oxidation. Daily intake of 100 mg CoQ10 supplements among patients with MetS for eight weeks had beneficial effects on serum insulin levels, HOMA-IR, HOMA-B and plasma TAC concentrations,” she reported.

As individuals age, they become more concerned about what they don’t feel—bones losing density and arteries becoming stiff. According to Dr. Smith, MenaQ7 Vitamin K2 as MK-7 is clinically proven to improve the functional equilibrium in the skeletal and cardiovascular systems—both critical to support robust, active health.

She explained that it achieves this support simultaneously by activating K-dependent proteins that help the body to properly utilize calcium: osteocalcin, when activated by K2 as MK-7, binds calcium to the bone mineral matrix (where it is needed); and matrix Gla Protein (MGP), when activated by K2 as MK-7, inhibits calcium in arteries and soft tissues (where it can cause harm). “This impact was shown in human clinical studies using our MenaQ7, the only vitamin K2 as MK-7 clinically proven to support bone and cardiovascular health,” she underscored.

Seneque’s Longity NMN-C, a proprietary form of NMN (nicotinamide mononucleotide), has been shown to increase NAD+ biosynthesis and yield beneficial pharmacological activity on multiple critical elements affecting health and aging: age-associated weight gain, energy metabolism and physical activity, glucose tolerance and insulin sensitivity, cardiovascular health, cognitive functions, acute and chronic inflammation, according to Bermond.

Longity’s bioavailability technology directly targets NMN uptake in the small intestine where NMN’s transporter is expressed. This proprietary delivery system enables a greater bioavailability and a higher absorption level, increasing Longity’s efficacy.

Longity is designed to leverage a direct uptake pathway that transports NMN across cell membranes directly into the cell via the Slc12a8a enzyme. Bermond said, “Our proprietary NMN-C delivery system was developed in collaboration with Dr. Alessia Grozio, who co-discovered the breakthrough Slc12a8a NMN transporter. Slc12a8 is a gene encoding NMN transporter with a critical role in regulating intestinal NAD+ metabolism.”

Several clinical and pre-clinical studies have demonstrated that NMN is able to improve energy metabolism and physical activity, glucose tolerance and insulin sensitivity, cardiovascular and cognitive functions, inflammation and many other critical conditions related to aging and diet.

In studies, systemic supplementation with NMN has been demonstrated to increase NAD+ biosynthesis and to improve age-related adipose tissue inflammation, insulin insensitivity, glucose intolerance, mitochondrial dysfunction and more. In one study of adults aged 22 to 64, supplementing with only 250 mg NMN daily for four weeks substantially increased blood NAD+ levels.

Similarly, ProHealth Longevity’s flagship product is NMN. Glosz elaborated, “The primary role of NAD+ is working as a coenzyme, helping other enzymes to function correctly. These enzymes aid hundreds of processes inside our bodies, ranging from brain cell growth to repairing DNA to supporting mitochondrial function. NAD+ plays a critical role in maintaining cellular and metabolic functions, which translates to better health and longevity of our cells, organs and bodies as a whole.”

NAD+ levels begin to decline gradually as early as age 30—and, by age 60, NAD+ levels drop by roughly half of what they were in young adulthood. Therefore, said Glosz, recommending precursor compounds like NMN to your patients who are in their 30s and 40s can help them bolster NAD+ levels to fight back on multiple aspects of aging when they reach their 60s, as well as preserve reproductive health, improve physical performance and endurance, support cognition, and maintain healthy skin.

Enzyme Science’s Stem XCell Pro and Telomere Pro offer support for healthy aging at the cellular level. Stem XCell Pro promotes the health, proliferation and maintenance of stem cells. This polyphenol-rich formula contains a patented blend that promotes general health, cognitive function and supports the body’s natural repair processes, Craven described.

Stem XCell Pro includes NT-020, a patented blend developed at a leading university in Florida, to promote the growth and health of stem cells. According to Craven, researchers analyzed more than 100 natural compounds and discovered that the combination of blueberry and green tea extracts, L-carnosine and vitamin D3, demonstrated a synergy in increasing the number of adult stem cells.

“This unique combination blends vitamin D3, herbal ingredients and plant extracts. It is a polyphenol-rich formula promotes general health, cognitive function and supports the body’s natural repair processes,” she said.

Enzyme Science’s Telomere Pro is a botanically based formula (with astragalus root, broccoli seed extract, rhodiola extract and vitamin D3) that supports telomerase activation and healthy aging.

“We include vitamin D3 and the blend Telomerin, which Enzyme Science developed based on a study in the journal Alternative Therapies,” Craven pointed out. “After thorough research, the scientists found that certain combinations increased telomerase activity by 51 percent to 290 percent, compared with controls. Telomerin includes astragalus root, broccoli seed and rhodiola extracts, all proven ingredients that promote telomerase activity. The formula helps maintain telomere length to encourage cellular rejuvenation and healthy aging.”

According to Hammond, the concept of active aging primarily involves two categories. The first is about aesthetics, as consumers in their 30s and 40s try to maintain their vibrant, youthful look. The second category consists of maintaining the ability to function normally, even with the significant decline in muscle, joint and cognitive function that aging brings.

“OptiMSM methylsulfonylmethane (MSM) provides multiple healthy-aging benefits that address both categories,” he commented. “MSM has a 30-year history of providing nutritional support for healthy joints, mobility and connective tissue helping people continue enjoying the activities they love. Research also suggests supplementing with MSM reduces muscle soreness associated with exercise or following strenuous activity.”

As a multifunctional ingredient, OptiMSM is also known to support the body’s glutathione production, an antioxidant essential for healthy immune function. As such, it may help reverse chronological decline by managing the body’s overall inflammatory response. MSM also supports immunomodulation by conserving the body’s ability to respond to threats when the immune system is suppressed. Conversely, when the immune system overreacts and produces excessive inflammation, OptiMSM can mitigate the inflammation.

Probiotics are a key tool for healthy aging as they work by helping to inhibit pathogens, maintain the health of the gut-lining, produce beneficial compounds/metabolites (some of which help digestive motility and communicate with the brain), and help to regulate the immune system, according to Plaza. Research has revealed that the gut microbiota has a powerful impact on aging, due to its role in modulation of the immune system, inflammation, metabolic processes and nutrient absorption.

“Supporting the health of the gut by taking a multi-strain probiotic supplement such as Bio-Kult is therefore recommended,” she said. The strains within Bio-Kult have been found to be helpful in stimulating the innate immune system, reducing intestinal inflammation, decreasing the severity of symptoms in irritable bowel syndrome and improving self-reported questionnaire scores for low mood. Many of these studies are relevant to aging, she emphasized; digestive and immune function decline with age, while the potential increase in comorbidities may impact mood and psychosocial health.

As an example, Plaza provided, one study using a Bio-Kult strain (B. subtilis PXN21) found that supplementation was able to prevent and reduce the accumulation of a protein called α-synuclein, which has been implicated in the pathophysiology of Parkinson’s disease.

She elaborated, “Probiotic supplementation with Bio-Kult may be helpful for a range of aspects related to aging, whether it be digestive and immune function, or cognitive and mood-related support. Additionally, there is some evidence to suggest that digestive function may be related to cognitive function, with some preliminary research highlighting the role of the endotoxin lipopolysaccharide (LPS) and cognitive decline. LPS has been described as a gut microbiota-derived marker of gut permeability, more specifically derived from less beneficial bacterial species. Modulating the microbiota with more beneficial species may therefore be useful.”

Regeneplex by Standard Process is a cellular rejuvenation supplement shown via studies to support the body’s tissue-healing processes associated with the normal effects of aging, according to Dr. Parent. It targets all three layers of skin, the circulatory and digestive systems, and cellular structure and functions. It also provides a supportive nutritional foundation for healthy skin.

“Regeneplex supports skin elasticity and appearance while helping address fine lines around the eyes and provides support for cellular rejuvenation,” she described. “Regeneplex was found to decrease the number of wrinkles around the peri-orbital area and the treatment group participants were also found to be happier with their skin at the end of study as compared to the placebo group.”

Gotu Kola Complex by MediHerb, also from Standard Process, is another product Dr. Parent believes is an attractive option for overall healthy aging. Gotu kola has been used traditionally in herbal preparations to promote healthy tissue function, promote and support health skin tissue, support healthy peripheral circulation as well as enhance the body’s natural ability to adapt to temporary stress. “Research shows that Gotu kola can stimulate fibroblast proliferation and increase type I collagen synthesis,” she reported. “It has also been found to be helpful for wound healing, improving circulation and promoting the repair of connective tissue including the hair and nails.”

Of course, most if not all supplements can be considered for healthy aging, but as we get older, specific needs for health support vary between individuals. For example, one post-menopausal woman may need to focus more on joint health than another. A 45-year-old man may have more need to support his cardiovascular function than another, due to diet, weight and cholesterol levels.

To summarize, healthy aging, so unique for each individual patient, can be accomplished through the diverse array of dietary supplements along with your prescribed protocol.

Healthy Take Aways

• Aging is a complex interaction of genetics, chemistry, physiology and behavior.
• Senescence is a more precise term gaining ground to distinguish between healthy aging (innocuous changes, such as hair greying), and poor health in aging.
• Aging is driven by three main processes that cause cellular destruction: glycation, oxidation and inflammation.
• Once telomeres reach the end of their “rope,” they can trigger aging at the cellular level, causing senescence and accelerated aging.
• The gut microbiota has a powerful impact on aging, due to its role in modulation of the immune system, inflammation, metabolic processes and nutrient absorption.

For More Information:

ADM Protexin (Bio-Kult), www.bio-kult.com
Bergstrom Nutrition, www.optimsm.com
Carlson Laboratories, www.carlsonlabs.com
Enzyme Science, www.enzyscience.com
Gnosis by Lesaffre, www.gnosisbylesaffre.com; www.menaq7.com
ProHealth Inc., www.prohealthlongevity.com
Seneque, www.seneque.life
Standard Process, www.standardprocess.com