BY THERESE REVITTE, MNT & TRACY McCUBBIN, MD, ABOIM, ABEM

What does aging healthily mean to you? Is it living a long life, living a life in good health, or both? Understanding the difference between lifespan and healthspan is crucial when approaching this question. 

Lifespan refers to the number of years we live, while healthspan refers to the number of years we spend free from chronic illness, pain, and disability. Our goal is to extend both. 

To extend healthspan and lifespan, we should aim to “compress morbidity,” – meaning reduce the time spent in poor health towards the end of our lives. 

When reading about health online, it can be hard to sort the facts from fiction. Today, we’ll look at some hot topics in healthy aging, like exercise, intermittent fasting, NAD, anti-aging medications like metformin and rapamycin, sauna and cold therapies. Let’s dive in. 

Exercise: How Much, How Often, and What Kind?

You might have heard that regular exercise helps to extend healthspan and compress morbidity – but picking the right activities can be tricky.

Research emphasizes that aerobic activity, commonly known as “cardio,” is critical to supporting cardiovascular health. Resistance training, like weight lifting and bodyweight exercises, is vital for preserving bone density, building muscle mass, and preventing chronic orthopedic pain. And lastly, engaging in activities that improve flexibility and balance, like yoga or dance, may help us to avoid injuries as we age.

However, determining how often you should engage in each type of exercise – cardio, resistance training and stability training – depends on various individual traits. Consider your prior injuries, medical conditions, what you can stick to, and what you find enjoyable. We recommend a combination of these workouts every week, especially weightlifting for women over 40.

Intermittent Fasting: Yay or Nay? 

Intermittent fasting, the practice of eating only during specific, compressed windows of time throughout each day, has recently gained popularity. Research suggests that the strategy may extend healthspan by improving insulin sensitivity, decreasing inflammation, and regulating body composition in some cases. 

While intermittent fasting may benefit certain groups significantly, its effects are likely individual. If you’re thinking about intermittent fasting, consider your age, weight, A1C levels, medical conditions such as diabetes, and mental relationship to food restriction. We do not recommend fasting for everyone – especially if you are under stress or are experiencing hormonal imbalances. We do like time-restricted feeding, 12 hours between dinner and breakfast. Our Nutrition Therapists are well-versed in creating a customized nutrition plan to meet your goals. 

How Do We Boost NAD?

NAD+ (Nicotinamide adenine dinucleotide) is a coenzyme that plays a crucial role in the metabolism of cells. By improving cellular metabolism, NAD+ may prevent the accumulation of cell and DNA damage over time. Cell and DNA damage can contribute to aging and age-related diseases. 

Recent studies’ findings have shown that NAD+ supplementation may extend healthspan. NAD+ levels decline as we age – by the time we are middle-aged, we have about half the NAD+ we had as kids. The idea is that replacing it may help us to restore some vitality. For example,  supplementation improved cognitive function in older adults with age-related memory decline and improved physical performance and energy levels in older adults.

There has been some controversy over which form to use: NADH or NAD+.  Both can be administered orally as a supplement or sublingually (under the tongue) for faster absorption.  Determining the appropriate dose and administration route should be up to you and a trained healthcare provider. 

Anti-Aging Medications?: Metformin, Rapamycin 

Medications like metformin and rapamycin have become renowned for their “anti-aging” effects. Let’s take a look at why they may extend healthspan.

Metformin is a medication commonly used to treat type 2 diabetes. Certain studies show that it can compress morbidity and extend lifespan. For example, it may reduce cancer risk and all-cause mortality in patients with type 2 diabetes. It seems to work by activating AMPK, a key energy sensor in cells that regulates cell metabolism and aging-related biochemical pathways. 

Rapamycin is an immunosuppressant medication that has also been found to have anti-aging properties. Rapamycin seems to extend healthspan by inhibiting the mTOR pathway, which regulates cell growth, metabolism, and aging. An overactive mTOR pathway leads to a high level of cell growth and proliferation, which can accelerate aging by increasing the accumulation of DNA damage and other forms of cellular stress. 

Though these medications sound promising, don’t jump the gun just yet – they aren’t ready for primetime!  There are animal studies, but human trials are lacking.  Stay tuned for more information, but for now, lifestyle measures win over medications. 

Temperature Therapy: Sauna and Cold Plunges 

Sauna and cold plunges are all the rage these days – let’s look at why. 

The body temperature increase experienced in the sauna may cause the release of heat shock proteins (HSPs), which protect cells and tissues against stress and DNA damage associated with aging. Infrared heat is completely safe and healthy for all living things. Infrared is a naturally occurring sun output, but it does not contain the harmful UV rays associated with unprotected sunlight. In fact, infrared’s gentle heat is used in hospitals to warm newborn infants. Call our office to schedule your infrared sauna session!

Cold plunges may enhance metabolic health by activating brown fat activity thermogenesis pathways, decreasing inflammation, and improving our stress response, all of which are important for a long healthspan.  I end my shower with cold water for 30-60 seconds!  

Conclusion

Do you feel older than your stated age? Are you less vibrant than last year? Let us remind you how to shine! Attitude plays a big role in the aging process. Your thoughts and emotions factor in a great deal. Additionally, lifestyle is the most important step in the aging process. How you choose to live your life is impactful.

  At Radiance Functional Medicine, we will educate you and help you make the best choices. We hope that you will allow us to help you find your personal Fountain of Youth by extending your healthspan! Schedule an appointment to get started. Whether you are looking for a Functional Medicine Doctor in Denver or your local area, we see patients in person and virtually. Call our office at 303.333.1668 to schedule your Healthy Aging Initial Consultation.