Saturday, May 7, 2022

HEALTHSPAN: Living Longer with Quality of Life (feat. TELOMERES EXPLAINED)

By Dr. Roberta Kline

Thanks to the many advanced health solutions and wellness resources available, our concept of aging and lifespan continues to evolve.  Our new generations who boast about "50 is the new 30" is no longer content with hoping to add a few years to their existence- instead seek true QUALITY OF LIFE even in the advanced years.  This means feeling healthy and vibrant and running at optimum performance as long as possible. 

RE-DEFINING TIME
A person’s chronological age describes how long a person has been alive. The biological age describes how well they are aging at the cell level.  HEALTHSPAN (years of good health) is now replacing LIFESPAN as the ultimate goal. This has spawned a huge global industry with people spending hundreds of billions of dollars on services ranging from aesthetic products and procedures to complementary and alternative therapies to optimize mental and cellular health, and that is only expected to grow with an aging population. [1] Grandview research

Knowing how to objectively measure the impact of these strategies to increase a person’s healthspan is a key driver behind development of technologies from lab tests that evaluate biochemical pathways to ones that look at biological aging. Two tests that evaluate biological aging are telomeres and DNA methylation.

TELOMERES EXPLAINED
DNA exists in our cells as tightly coiled sequences called chromosomes. Each cell has 23 pairs. Every time our cells divide to create new cells, our DNA also has to get divided and replicated. In order to do this, the chromosomes have to unwind and become vulnerable. 

Telomeres are specific sequences of DNA on the ends of our chromosomes that are designed to protect them from getting tangled or damaged during this process. This minimizes the risk of large-scale errors in the DNA when the chromosomes get transferred to the newly created cells.

But telomeres also have another function: they are a cell’s biological clock. Telomeres shorten over time, and one of the main ways this happens is when cells divide. Eventually the telomere becomes too short to protect the chromosomes reliably, and so the cell dies. In this way, the length of the telomeres can provide a good estimation of how many times the chromosomes have been replicated to form new cells. [3] 

It is also possible increase telomere length, thus resulting in the interaction of multiple factors such as female sex and genetics. Estrogen tends to be associated with longer telomere length. Errors in a person’s genes, whether due to rare inherited genetic mutations or more common smaller changes called SNPs (single nucleotide polymorphisms) can lead to shorter telomere. [4] 

To review the telomere length, shorter telomeres are associated with an increase in the risk for many diseases associated with aging, including cancer, heart disease, diabetes, osteoporosis, and Alzheimer’s Disease.[5]  Though studies have shown that telomere length is typically longer in cancer cells, because they have hijacked the normal internal clock. This is one reason why cancer cells can continue to multiply much faster and longer than normal cells.  But cancer is not the only way to lengthen telomeres. Dietary and lifestyle factors have also been shown to affect the length of telomeres. Chronic stress, poor diet, environmental toxins (including smoking), and lack of adequate exercise have all been linked to shorter telomeres, primarily by increasing the levels of oxidative stress. [4] 

Not everyone who experiences these stressors ends up with the same length telomeres, however. All of these interactions are under the control of genes, and having multiple errors in these genes called SNPs (single nucleotide polymorphisms) can make a big difference in how much these factors affect telomere length. 

The good news is that a person’s short telomere length is not irreversible. Recent studies have shown that providing the right dietary, lifestyle and nutritional supplements to reduce oxidative stress can reverse this process of telomere shortening over time. [5] 

DNA METHYLATION
Diet, lifestyle, stress and environment also affect our DNA in another way called EPIGENETICS. More broadly termed as epigenomics, this literally means “above the genome”. Epigenetics provides a way for genes to quickly adapt to changing environments, without changing the actual DNA. Epigenetic changes can turn genes on and off, modifying a person’s biochemistry without changing the DNA code itself. Because of this, these changes can be easily reversible if the situation calls for something different. [3] While there are several mechanisms to accomplish this, one of the best-studied is called DNA methylation.

DNA methylation works by utilizing a specific chemical your body produces to run your biochemistry: a methyl group, composed of carbon and hydrogen molecules. These methyl groups are used in thousands of biochemical processes throughout multiple biological systems every day. When a methyl group is added to a specific place on the DNA, it turns the gene “off”. This same methyl group can also be removed through a process called demethylation, and that turns the gene on. This is a normal process that controls everything from fetal development to how various cells can function differently even though they have the same DNA and the same genes. [7]

Researchers have discovered that over time, the natural course of aging results in fewer genes having these methyl groups attached to the DNA. [8] But, like the telomeres, this is a dynamic process that is also influenced by a number of different factors, including genes, diet, lifestyle, environment, and exercise. 

As with every biochemical process in the body, genes themselves control the whole process of methylation and demethylation. SNPs in these genes can impact a person’s ability to efficiently regulate DNA methylation. One of the best known genes is involved in producing the methyl groups necessary for DNA methylation, and is called methylenetetrahydrofolate reductase – or MTHFR for short. People with this SNP are predisposed to producing fewer methyl groups, and this is even more significantly impacted by diet and lifestyle factors. 

Aging is a natural process, and yet we are learning that the diseases commonly associated with aging may not be inevitable. As science continues to progress, it is providing clues as to how we can stay healthier longer. Telomeres and DNA methylation are two technologies to help people know how they are doing in the quest for a longer healthspan, so they can enjoy their later years to the fullest.


1)  https://www.grandviewresearch.com/industry-analysis/medical-aesthetics-market 
2) https://www.grandviewresearch.com/press-release/global-alternative-complementary-medicine-therapies-market 
3) Genome.gov
4) Tsoukalas, D et al Association of nutraceutical supplements with longer telomere length. Int J Mol Med. 2019 Jul; 44(1): 218–226
5) Gruber HJ et al. Telomeres and Age-Related Diseases. Biomedicines 2021, 9, 1335.
6) Masood A. Shammas Telomeres, lifestyle, cancer, and aging. Curr Opin Clin Nutr Metab Care. 2011 Jan; 14(1): 28–34.
7) https://www.cdc.gov/genomics/disease/epigenetics
8) Heyn H et al. Distinct DNA methylomes of newborns and centenarians. PNAS June 26, 2012 vol 109 no 26




ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group)
Dr. Kline is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/


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