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No magic solution for longevity

Noel Low, Low De Wei on 27 May 2018

The Straits Times


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All kinds of "magic" solutions have been lauded as a secret to longevity, from a diet of Okinawan sweet potatoes to antioxidants.


But there are no easy answers when it comes to prolonging one's health into old age, say experts The Sunday Times spoke to.


Experts cite nutrition and regular exercise as the main factors in prolonging one's health.


Eating the right food in the right portion to maintain one's weight is important, says Associate Professor Reshma A. Merchant, head of geriatric medicine at National University Hospital.


She says weight loss is a symptom of frailty and a major concern for older people, as it "makes your body weaker".


On the other side of the coin, obesity is a no-no too as it leads to metabolic diseases such as diabetes.


Prof Merchant cites a Japanese concept called Hara Hachi Bu, which means "eat until you feel 80 per cent full".


This prevents overeating as the brain receives a signal that the stomach is full only after 20 minutes, she explains.


Professor Brian Kennedy, director of the Centre for Healthy Ageing at the National University of Singapore (NUS), says what is considered a healthy diet can vary depending on a person's lifestyle.


But most studies generally point to a diet with less red meat and processed sugar products, with more fruit and vegetables as ideal for prolonging one's health, he adds.


On top of this, Dr Anis Larbi, principal investigator at the Agency for Science, Technology and Research (A*Star), says any type of nutritional intervention is more effective when combined with exercise.


Prof Kennedy says any form of moderate exercise three to four times a week, for 30 to 60 minutes, is beneficial especially if sustained over the long term .


Staying active in other aspects is also important.


"Never retire", says Prof Merchant, "Start volunteering or learn a new skill. Go out and meet people."


She recalls a patient who lived till 102 and picked up a new language at 90.


She notes that sticking to a routine is important.


"Once you stop doing things, you spiral downwards," she says, adding that keeping busy makes a person feel useful.


Socialising regularly with friends also makes for happier days and likely, longer lives.


Dr Larbi says expanding one's social network leads to motivation, and reduces depression.


He cites the Harvard Study of Adult Development, one of the world's longest studies of adult life, which showed that one's happiness level at age 50 was the most important parameter determining a person's health at 80.


Dr Larbi says ageing intervention should ideally start at around 30 to 40 years old, as problems start to surface around this age, which "turn into more serious problems later".


While everything people do involves stress, he notes that the key lies in how the body copes with and recovers from stress.


Using the analogy of a water pit, he says: "Every time you face stress, the water level decreases. If you cannot refill the water fast enough, disease strikes."


Prof Merchant notes that it is crucial to control chronic diseases and cites Malaysian Prime Minister Mahathir Mohamad, 92, who suffered from heart disease, as an example of someone who did just that.


Dr Larbi says that it is important to understand which parts of the body needs help and tailor treatment accordingly.


Ageing is not a disease, but an adaptation to the environment, he adds.


"There is ageing, and there is misman-ageing."




Experts have advised consumers to be wary of myths or products that are said to have special anti-ageing powers, such as pills containing stem cells. Associate Professor Reshma A Merchant says her patients who live past 90 or 100 rely on simple and natural techniques such as staying active, rather than taking any special products.


Does cosmetic surgery keep one young?


Cosmetic changes are just skin-deep, says Prof Merchant Reshma. "Botox is just aesthetic. What you see externally does not represent what is in your body. The most important thing is to prevent changes on the cellular level, in the body and brain," she adds.


Is taking supplements the way to healthy ageing?


Supplements are not magic elixirs, says Dr Anis Larbi, principal investigator at the Agency for Science, Technology and Research (A*Star). "If the supplement contents can be found in an apple, just eat the apple. Eating gives you happiness as well."


However, supplements are important to address specific deficiencies.


Do stem cell products have anti-ageing effects?


It is too early to tell, says Dr Larbi. Stem cell research remains controversial due to ethical concerns about the use of DNA from other organisms, he adds.


Does intermittent fasting help?


Some try a routine of eating normally for two days and then fasting for a day. Experts say the results appear promising.


Dr Larbi says fasting activates biological pathways that are good for the body. But it is not pleasant to go hungry. He points to meal solutions being developed that trick the body into thinking it is fasting.




More people will stay healthy in old age in future, given more research into this area, experts predict. Average life expectancy has risen in the last century, particularly in the last decade. But as Professor Brian Kennedy notes, it is only in recent years that there has been more focus on treatments to prolong health rather than lifespan alone.


Here are four promising medical treatments:




Few will dispute that prevention is better than cure. Researchers are trying to come up with supplements to prevent diseases linked to old age, such as Alzheimer's, says Prof Kennedy. Many new drugs could potentially be developed in the next decade.




A study by NUS and A*Star has found that a type of white blood cell, called Gamma Delta T-cells, does not show signs of ageing. This discovery enables further research on what causes cells to age and how ageing can be delayed.




A small clinical trial led by Stanford neurologist Sharon Sha suggests that blood plasma, or blood from which red blood cells have been removed, can reverse the effects of dementia when transferred from a young person to an old person. Larger clinical tests are being run now.




The human microbiome, which includes microorganisms such as bacteria in the gastrointestinal tract, changes with age, says Dr Anis Larbi. Finding out if the change is a cause or effect of ageing could lead to the development of an intervention strategy.


Noel Low and Low De Wei


Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission.



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