Slowing down aging: what works and what doesn’t

Aware that ‘there is a day to be born and another to die’, the history of human beings is marked by the tireless search for the ‘miracle’ against mortality; an obsession that has gone hand in hand with achieving ‘eternal youth’. Today, it comes to everyone’s mind how billionaires undergo ‘dubious’ treatments to achieve this goal. This is the well-known case of Bryan Johnson, the wealthy 45-year-old tech guy who invests two million dollars a year to slow down his biological clock. His daily, spartan regimen includes more than a hundred pills, LED light therapies, and calorie restriction. And not only: he carries out plasma transfusion therapy for his 18-year-old son, a treatment that the US Food and Drug Administration (the famous FDA) neither recognizes nor approves. Aside from particular cases, the world is looking at the emerging anti-aging industry, whose global value is estimated at 610,000 million dollars in 2025 (more than 557,000 million euros), which seeks to find solutions to delay, slow down or even reverse the diseases, injuries and disabilities associated with age. On the other side of the scale are anti-aging medical centers, whose number continues to increase in Spain. In aesthetic care alone, there are already more than 7,000 health centers that have medicine units, more than establishments where Pediatrics, Ophthalmology or Traumatology are practiced, according to the General Registry of Health Centers, Services and Establishments (Regcess). And every year they increase in number. But is all that glitters gold? Alfonso Galán, from the Neolife Clinical Group medical team, clarifies it: «Age management medicine, ‘antiaging’ medicine or preventive anti-aging medicine, well practiced, is based on using all the means that science puts at our disposal up to date. today to diagnose and optimize the health status of patients. The objective is to minimize the damage that the passing of the years produces in our systems and our capabilities. More than 10 years ago, we brought this concept to Spain, initially to Madrid and later to Marbella. We learned in the US about hormonal optimization protocols, about supplementation, about how we can act on aging mechanisms at a cellular and molecular level, etc… and we combined them with our own clinical experience and strength in various areas of all the professionals”. In his opinion, “it is a fascinating discipline, which attracts many doctors and diverse professionals who want to practice it.” He insists that on the other side of the mirror, unfortunately, not everyone is trained in the appropriate way for this, and these are the things that give a bad name to a way of understanding medicine and the patient that is wonderful, effective and safe. . . «A little trick for when you visit one of these clinics: anyone who tells you that they are going to make you perfect, as if you were 20 years younger, with a new method that does not involve your effort and commitment… doubt! In Medicine, in the management of age, without patient proactivity there is no success, or not complete success, it would be better to say,” he recommends. Abuse of the term “Giving society a little more health and a little more life.” This could be the ‘slogan’ of the statements of Carlos López Otín, professor of Biochemistry and Molecular Biology at the University of Oviedo, who currently works in a laboratory in Paris, who is skeptical of ‘antiaging’ medicine. López Otín’s main interest is basic research and the translation of the advances achieved through public health. «For this reason I do not closely follow the work of these ‘anti-aging’ clinics, except in some very specific cases due to the trust that those responsible generate in me. In fact, the abuse of the term ‘anti-aging’ seems inappropriate to me as it fosters confusion, because, in my opinion, it is a normal biological process, the study of which should aim, first of all, to understand the many diseases associated with it. “This would achieve something as important as giving society a little more health and a little more life,” he concludes. The reality, according to the data handled by the expert, is that in Spain there are already close to 20,000 centenarians and, in fact, in terms of longevity, the country is very well placed. “The transition from centenarians to supercentenarians with ages over 110 years is already much more complex, and everything points to the existence of biological limits characteristic of each species,” he emphasizes. However, the professor emphasizes the “serious error of continuing to insist on accounting for the chronology of life when there is still much to deal with common and very frequent diseases that are the ones that truly diminish our future.” The expert discusses in an article he has just written about the “health of the future” to commemorate the 100 years of the ‘Western Magazine’, founded by José Ortega y Gasset, about “the need to advance in education and co-responsibility “taking care of our own health and our environment as central elements to progress towards living a little longer and a little better.” If we manage to progress in these directions, I think we should already be happy and grateful. I leave the improbable dreams of immortality and eternal youth to others, he concludes. In this sense, Emiliano Corpas, director of the book ‘Endocrinology of Aging’ (in its version in both English and Spanish prepared by specialists from different countries), wishes to emphasize: The first thing that must be said is that aging is physiological, irreversible and inevitable “. And the mirror of the reality of anti-aging medicine is one. This is what Dr. Elisa Pinto, head of the Dermatology Service at the Ruber Juan Bravo Hospital, defends. «The concept of anti-aging medicine is real, and is oriented in two senses. First, orient ourselves towards healthy living habits: preventing solar radiation, improving diet by reducing saturated fats, increasing foods rich in vitamins and antioxidants, encouraging physical exercise but oriented according to our structure. body and our needs. Secondly, acting proactively in those changes that accelerate aging and occur naturally with age, such as hormonal changes. At this time it is possible to achieve partial replacement of reduced hormones with bioidentical hormones. The controversy However, hormone replacement remains a controversial topic. On this last point there are discrepancies among specialists. «The latest clinical studies in this regard give a guarantee of five years, during which its use does not increase the incidence of breast cancer. It is possible that these figures relating to temporary data will be increased (when the number of patients treated allows for more information on long-term therapies), but at the moment it seems to be proven that its use is safe for five years, and the benefits in the future are obvious. prevention of aging, from such important aspects as osteoporosis, fat metabolism, the risks of arteriosclerosis… to others such as the reduction in collagen synthesis with increased skin sagging, mucosal atrophy, reduced libido,” insists the expert. . In this sense, Galán recalls that the evidence associated with its health benefits has been accumulating for more than 50 years. «Hormonal optimization therapy with bioidentical hormones (molecularly identical to those that our body no longer produces well) despite the bad reputation that, unfortunately, accompanies them, does nothing more than demonstrate study after study as low mortality, morbidity (getting sick) and improves the quality of life for all its users. If we go to therapies that people read or see in the media and are interested in, newer, less proven, such as the use of Rapamycin, for example, the evidence is already scarcer and more fragile,” he maintains. she. Professor López Otín documents: «Personally, I would reserve hormonal and growth therapies to deal with endocrine-type diseases and always under the supervision of expert endocrinologists in each case. “There are some hormonal factors that have certain promising effects in the area of ​​healthy aging, but we should always be very cautious before venturing into treatments whose scientific validity has not yet been demonstrated except in experimental models.” The decrease in, for example, hormones is a regulatory process that the body carries out to self-regulate over time. “Its unnecessary use, when there is no pathology, will lead to the reverse process: accelerate aging.” Hyperbaric chambers, rapamycin and other promises The same thing has happened with one of the ‘promises’ in antiaging medicine: stem cells. «It opened hope at the beginning of this new century, which generated immense expectations about its use in the prevention of skin aging and other organs. However, currently it has not yet been possible to materialize these expectations in practical therapies, for daily use and with demonstrated scientific results, which sufficiently surpass other simpler techniques. “Although expectations remain high and are still pending the publication of new data that support these therapies,” clarifies dermatologist Pinto. On the horizon of this specialty there are many open fronts currently whose effectiveness remains to be demonstrated. «There are various projects in which a huge investment has been made by some of the greatest fortunes to accelerate the arrival of results. Topics such as cellular reprogramming, the rapamycin mentioned above, the use of hyperbaric chambers, the rejuvenation of specific organs, etc.,” adds Alfonso Galán. On the contrary, what has been demonstrated and what all the experts consulted agree on is that in any case, while knowledge about aging and its mechanisms advances, moderate physical exercise, a natural diet and a lifestyle harmonious and healthy as possible will continue to be the safest, most effective and cheapest elixirs. “I know that it is more shocking to say more striking things, but I work on these issues and that is what I think: we are not immortal, nor will we ever be as long as we maintain a minimum of biological matter in our bodies,” defends Carlos López Otín. What does work It is well known that aging is influenced by genetic factors, but then also by environmental factors, related to our diet, lifestyle habits… We cannot modify the former of a genetic nature (at the moment) but we can influence the factors The external factors that mark our aging and we can make decisions regarding them, reminds dermatologist Elisa Pinto. And she points to the need, in relation to food: “It is essential to provide vitamins, especially from fruits and vegetables, such as A, C, E, as well as omega 3 fatty acids.” The same thing happens with the protein intake, trying to ensure that the source is not red meat or fat, but resorting to dairy products and fish. And not only. «It is also essential to dedicate enough hours to rest and sleep, to guarantee that during this period all our organs ‘reset’ and recover. In the case of the skin, reduced sleep reduces the formation of collagen and elastin and therefore promotes anti-aging, recalls the expert. On the other hand, strategies such as calorie restriction have given a lot of talk in recent years as a formula to slow the passage of time. In Dr. Galán’s opinion, “obviously there are several types of fasting. And you have to understand them all and see how they work for each individual in particular, to be able to recommend or avoid them. We know that fasting periods help with the control of satiety and appetite signals, we know that they help to have a healthier microbiota, we know (although now we are rethinking it a little) that they enhance cellular recycling mechanisms that we call autophagy…But “They can have a dark side such as the loss of our precious muscle mass as we age and even, in some patients, a deterioration in the sugar profile.”