I received many questions after my recent article on aging in the February 24th issue of this newspaper. People would like to know more about the biology of aging and of a healthy lifestyle. They want to know more about what happens in our cells; how the components of our daily living reflect in what happens in billions of our cells; what are the cellular mechanisms involved in nutrition, exercise, sleeping patterns, social interactions, attitude and spirituality. Some mechanisms we already know and for some we have only animal data. I hope that soon we’ll be able to translate animal data to humans; still, a human is not a mouse.
Currently, with artificial intelligence, we are discovering new possibilities on how we can prolong our lifespan – better yet, our healthy lifespan. Indeed, the answers are hidden inside our cells. Let’s look at them briefly. According to the latest (May 12, 2017) data from the “Annals of Human Biology,” our body consists of 37.2 trillion cells forming 200 different cell types that are specialized to perform the unique and special functions we need in our daily living. The cells take nutrients from our food and convert them into energy for performing these specialized functions.
Even if cellular anatomy is very complex, one doesn’t need a PhD in biology to understand cellular structure and function.
There are at least twelve organelles in our cell. Let’s look at some of them. Every human cell has a cellular membrane surrounding cytoplasm, a jelly-like fluid where other parts of the cell are located. The most prominent organelle is the cellular nucleus, containing chromosomes where most genetic material is located. We have 23 pairs of chromosomes for a total of 46 chromosomes; we inherit half of them from each parent. Even though all humans have similar genes we are all different. In all eight billion of us, not two humans are genetically the same due to differences in the sequence of DNA from one person to the next. Only identical twins of the same sex have all of their genes the same. In contrast, fraternal or dizygotic twins result from the fertilization of two separate eggs during the same pregnancy.
At the end of each chromosome is a telomere, that is the protective DNA protein. A cell can divide only about forty to sixty times, and with every cell division the telomere gets shorter until finally the cell can no longer divide and dies, undergoing autophagy, or programmed death. The telomere’s length decreases with age, to the point that it could even be a marker determining a person’s lifespan. The longer the telomere length, the longer is our lifespan. We are not there yet, but hopefully soon we’ll be able to determine biological age with a simple blood test measuring the telomere’s length in our white blood cells. Just a word of caution: sometimes a telomere can grow from an unknown cause and if telomeres get too long, then the cells can become cancerous.
Mitochondria, another essential component inside the cell, convert the food we eat into energy that the cell can use. We inherit our mitochondria only from our mothers. Mitochondria have their own DNA, different from other cellular components. Mitochondria are considered the powerhouse of our cells; they generate most of the cell’s supply of adenosine triphosphate, ATP, that is utilized as a source of chemical energy in our body. There are about 2,000 mitochondria in every cell. The more active are the cells, the more numerous are the mitochondria; thus, brain, muscle, kidney and liver cells have higher numbers. Unfortunately, like many other biological processes in our body, there are byproducts generated during ATP energy production called ROS, for reactive oxygen species; these highly charged ROS particles can potentially damage our DNA, proteins and fats. Fortunately, we can counteract the negative impact of ROS with antioxidants coming from healthy nutrition, like lots of vegetables, fruits, fish, olive oil, dark chocolate and, if you like, one glass of red wine (white wine has no antioxidant resveratrol) during dinner. Exercise and sound sleeping habits can also improve our mitochondrial health, although the precise mechanism is not known.
We also have lysosomes, cellular cleaners responsible for breaking down cellular waste. When invaders such as bacteria and viruses enter our cells, lysosomes destroy them as well.
We should not forget ribosomes, the site where proteins are produced. They read the sequence of the messenger RNA by using the genetic code, translating the sequence of RNA bases into a sequence of amino acids, forming proteins.
Finally, we need to know the conductor inside the cell: the epigenome activates or silences the genes for the different functions that our daily activity requires. While our genes are completely under epigenomic control, we are fortunately able to control the epigenomes through our lifestyle.
Enough of torturing your mind with basic bioscience and biostatistics. Now we can better understand how different parts of the cells are involved in the functioning of our daily activity. As I mentioned before, our lifestyle is key to our health and longevity. It is time now that we move from basic science to daily living.
Our lifestyle is the most important factor determining how healthy we are, what kind of diseases we’ll get, and how long our lifespan will be. Lifestyle includes nutrition, physical activity, sleeping, social interactions, spirituality, and attitude. Many times, when my patients learned their diagnosis of cancer or some other disease, they would say that they were not surprised; that their parents had cancer. “It’s all in my genes,” they would say to me. Yes, genes are important but only for about ten percent of diseases; most of the rest is dependent on a patient’s lifestyle. And, yes, some very small percentage depends on a person’s luck (car accidents and similar mishaps).
Let’s now briefly go to our lifestyle, how it impacts our bodies on a cellular level through nutrition, exercise, sleeping, social interaction, attitude, and constant learning.
Nutrition: My advice: eat less and eat slowly. The Japanese would say hara hachi bu, stop eating while you are about eighty percent full. You can eat almost every food you like. You read correctly, I said almost. Still, I would suggest concentrating on lots of vegetables, fruits, fish; reduce, don’t eliminate, sweets and red and processed meats; too much alcohol could shorten your telomeres. Enjoy the food you eat. There is a connection between the brain and the gut; about 95 percent of serotonin, the hormone that makes you happy, is produced in your gut. People on a Mediterranean diet have longer telomeres. Step on the scale in your bathroom every day and you’ll keep your weight under control. I should not forget water: drink as much as you can; eight glasses a day that will keep you young and less wrinkly. Vitamin supplements in general are not necessary. If you eat healthy, they are all in your food. For special needs, ask your doctor.
Any kind of physical activity, from low to high intensity, is beneficial for our health. Walk daily for thirty minutes. Three to four thousand steps are enough; eight to ten thousand is not necessary. Exercise increases the length of telomeres. Don’t forget, longer telomeres prolong our healthy lifespan.
Sleeping is detoxifying and cleansing our brain and thus preventing cognitive decline. The quality of our sleep is essential for our cognition. Harmful beta-amyloid proteins causing Alzheimer’s disease get washed away with a good night’s sleep. Sleep is our brain’s rinse cycle that clears its waste. If we don’t sleep well this process is not taking place and our cognition suffers. Poor sleeping also affects our immune system, leading to persistent inflammation and potentially to cancer, especially cancers of breast, colon, ovaries and prostate. Melatonin, which is produced during sleep, has antioxidant properties that prevent cell damage. So, sleep better and you’ll make melatonin – good night!
Social interaction is important – the more, the better. A rich social network can be a source of support, combats depression, reduces stress and improves our cognition and prevents memory decline. It also allows you to confide in your friends and let them confide in you. Many studies showed that the lack of social interaction may be a risk factor in disease progression. Also, social interaction can act to a degree as disease prevention behavior. People with strong social interaction live longer and are generally healthier. By staying socially engaged, you protect yourself and can help protect others. We indeed need each other. We know that positive social interaction of a pregnant woman has already a beneficial impact on her child. So, it’s never too early to cultivate a rich social interaction.
Positive attitude has a beneficial impact on cellular activity as well. The prefrontal cortex is the anatomical area where positive thoughts are generated. A positive, optimistic attitude improves our ability to pay attention, to solve problems faster. It also improves our resilience, the capacity to recover faster from difficulties. So, cultivate positivity; your glass should be half full, not half empty. Be open to the world around you. Try new things.
Finally, we should not forget the impact of spirituality on our health. Spirituality has a biological dimension; it helps you to recover from disease faster and live longer. I usually advise my patients to cultivate spirituality: if they are religious, they should pray; if they are not, they should meditate, if possible twenty minutes a day. We all need spirituality in our life.
In summary, I hope I have convinced you that lifestyle matters. Become your doctor’s partner in your health care: follow your doctors’ regular visits, listen to their advice, ask all the questions. Be positive and enjoy life, be resilient and have fun every day. If you follow these suggestions, you have a high chance of living a long and healthy life, maybe you might even join the centenarians. Good luck!
Dr. Ciril Godec is Professor of Urology at Downstate Medical Center and was chairman of the Department of Urology at Long Island College Hospital for thirty years. He recently retired and is an honorary staff member at Maimonides Medical Center, where he served as Urology Residency Director and later Deputy Director of Urology since 2013.He is also a Board member at Cobble Hill Health Center.
Dr. Godec, who just celebrated his eighty-fifth birthday this past Valentine’s Day, is currently co-authoring his third book, “How to Declare Aging a Disease.”
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