Introduction

As physician co-founder of the American Academy of Anti-Aging Medicine (A4M; www.worldhealth.net) with Dr. Ronald Klatz, I have the privilege of travelling to more than 20 nations a year with the specific objective to raise the awareness in, and increase the adoption of, anti-aging and regenerative medicine.  Frequent trips overseas have instituted a number of initiatives that promote innovative approaches to address the swelling aging population in nations around the world. In expanding the reach of anti-aging and regenerative medicine, A4M adopts the Olympic model for global expansion.  We aim to develop strong international partnerships with individuals placed in prominent positions in their respective nation's medical commissions, governmental bodies including the Medical Commission of the European Parliament, and academic and research-based affiliates and universities.  In doing so, we have garnered strong participation among nations in Europe and Asia, as well as in South and Central America, and Canada.  Today, 15% of A4M's membership hails from outside US borders.

I consider fitness to be a universal and leading anti-aging intervention. I co-founded the National Academy of Sports Medicine (www.nasm.org), the global leader in certification, continuing education, solutions and tools for the health, fitness, sports performance and sports medicine professionals, serving over 100,000 members in 80 countries.  As a black belt in karate, Chinese weapons expert, world champion athlete with over 20 world strength records including listings in the Guinness Book of World Records, in 2007 I was inducted into the National Fitness Hall of Fame.  In 2001, Excellency Juan Antonio Samaranch awarded me the international Olympic Committee tribute diploma for contributions to the development of sport and Olympism.

Myconcept of anti-aging medicine considers the specialty to be the next generation of sports medicine. In sports medicine, physicians aim to keep athletes in peak physical and mental condition, to maximize their performance in competition.  Anti-aging medicine seeks to keep people, as they age, in top physical and mental shape.

Make Healthy Choices

Adopt the Anti-Aging Lifestyle

Kay-Tee Khaw, from Cambridge University (United Kingdom), and colleagues, followed 20,000 men and women, ages 45 to 79, for 13 years.  They questioned the study subjects about their lifestyles and conducted blood testing to measure Vitamin C levels (an indicator of daily fruit and vegetable intake).  Those study subjects with the lowest number of healthy behaviors were four-times more likely to die, most notably from cardiovascular disease.  The team found that study participants with the lowest healthy lifestyle scores had the same risk of dying as someone with the highest healthy lifestyle scores who was 14 years older.  The lifestyle change with the biggest benefit was smoking cessation, associated with an 80% improvement in lifespan.  The second most significant change was increased consumption of fresh fruits and vegetables.  Thirdly, moderate drinking; and fourthly, staying physically active, rounded out the four most beneficial lifestyle choices to extend lifespan.  [Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N.  "Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study."  PLoS Med. 2008 Jan 8;5(1):e12. [Epub ahead of print].]

This study validates the anti-aging lifestyle, hallmarks of which include:  not smoking, eating five or more servings of fresh fruits and vegetables a day, moderate alcohol consumption, and regular aerobic exercise. Not only does the anti-aging lifestyle extend lifespan, it prolongs healthspan, the length of time that we are able to live productively and independently.  Because this study found that lifespan extension via four lifestyle choices held true regardless of age, sex, and socioeconomic status, it clearly demonstrates the applicability of the anti-aging lifestyle across a broad base of the population.

Get Quality Sleep

As a frequent overseas traveler, I have devised a practical, tried and true program that often helps me boost the quality of sleep.  Highlights include:
1.  Practice good sleep hygiene: 
a.  Where you sleep directly impacts how well you sleep:   create a sleeping environment that is comfortable in temperature, absent of distracting lighting and sounds, and serene.

• Don't become overstimulated:  keep appliances that emit electromagnetic fields (televisions, cellphones, etc.) at least 10 feet away from the bed.
• If you have allergies to airborne agents, remove plants and humidifiers (both can be sources of mold), don't let pets into your bedroom (sources of dander), and encase your mattress, boxspring, blankets, and pillows (havens for dust mites)  in allergy barrier covers.

2.  Eat for sleep:  starchy goods like breads, pastas, potatoes, and milk products help promote sleep.  They prompt your brain to generate the sleep-inducing neurochemical serotonin.
3.  Herbs help: for some people, a modest dose of valerian root, kava, chamomile, or lavender oil speed up the trip to dreamland
4.  Avoid certain medications: check with your physician to verify whether any prescription and/or over-the-counter products you take may cause you difficulty in falling asleep.  Blood pressure medicines, decongestants, nicotine, caffeine, diet pills, and some cold/cough remedies are frequent culprits.
5.  Lower your body temperature:  You reach sleep once your body temperature dips. A warm bath or shower before bedtime makes it easier for your body to cool down and the time to reach dreamland shorter.
6.  The Power Nap:  just twenty minutes of restful slumber during a hectic day not only rejuvenates your thinking, but can make it easier for you to sleep at night.

Fitness as A Universal and Leading Anti-Aging Intervention

Obesity is the second leading cause of preventable deaths. According to the American Obesity Association, about 69 million Americans are overweight and 51 million are obese. These numbers have been rising steadily, translating to 61% of U.S. adults of the age 20 years and over are overweight, and 26% are obese.  Annually, overweight/obesity causes at least 300,000 excess deaths annually in the US, burdening the nation with a healthcare tab of more than $100 billion each year.  Medical risks associated with obesity include  Type 2 diabetes, gout, hypertension, osteoarthritis, cardiovascular disease, sleep apnea, high cholesterol, cancers, gallbladder disease, impaired respiratory function, and -- in women -- an increased incidence of varicose veins, asthma, and hemorrhoids [National Heart, Lung, and Blood Institute, Obesity Research 1998; 6(suppl 2):51S-210S; Seidell JC et al, Am J Pub Health1986;76:264-69]. 

One of the most potent forms of anti-aging medicine is exercise.  Substantial health benefits occur with regular physical activity that is aerobic in nature (such as 30-60 minutes of brisk walking, 5 or more days of the week).  Additional health benefits can be gained through greater amounts of physical activity, but even small amounts of activity are healthier than a sedentary lifestyle.  Regular exercise in middle age can help men and women prolong their physical prowess as they grow older. 

Substantial health benefits occur with regular physical activity that is aerobic in nature (such as 30-60 minutes of brisk walking, 5 or more days of the week).  Additional health benefits can be gained through greater amounts of physical activity, but even small amounts of activity are healthier than a sedentary lifestyle.  Regular exercise in middle age can help men and women prolong their physical prowess as they grow older.  A study by University College London (United Kingdom), published in April 2005, found that among 6,400 adults between the ages of 39 and 63, those who could be categorized as "sufficiently active" at the start of the study were more likely to be free of physical limitations nine years later.  "Sufficiently active" study subjects were those men and women who engaged in 2.5 hours of moderate exercise (such as biking and leisurely swimming) or 1 hour of vigorous activity (swimming laps and running, for example) each week.  After nine years of regular aerobic physical activity, sufficiently active adults were less likely to have physical problems that kept them from playing sports, lifting heavy objects, or being able to perform routine activities such as climbing stairs or bathing.  The researchers conclude that: "This study shows that regular physical activity appears to be critical to preserving high physical function in relatively fit, healthy, middle-aged men and women." [Hillsdon MM, Brunner EJ, Guralnik JM, Marmot MG.  "Prospective study of physical activity and physical function in early old age."  Am J Prev Med. 2005 Apr;28(3):245-50.]

While aerobic exercise is important to keep weight within a healthy range and improve the cardiovascular system, strength training is just as important. Strength training, also referred to as resistance training, enables men and women at any age to improve their overall health and fitness by increasing muscular strength, endurance, and bone density.  This particular type of physical activity also improves insulin sensitivity and glucose metabolism.  Strength training recommendations include:

• Perform exercises 2 or more days a week
• Use handheld light dumbbells, free weights, machines, or resistance bands, or no weights at all
• If weights are used, start with 1-2 pounds and gradually increase the weight over time
• Perform exercises that involve the major muscle groups (arms, shoulders, chest, abdomen, back, hips, and legs) and exercises that enhance grip strength
• Perform 8 to 15 repetitions of each exercise, then perform a second set
• Do not hold your breath during strength exercises
• Rest between sets
• Avoid locking joints in arms and legs
• Stretch after completing all exercises
• Stop if you feel pain at any time
• Conduct strength training only after seeking a consultation with a qualified medical professional

Studies show that even men and women in their 90s who took up weight training increased muscle mass and strengthened bones, key improvements in preventing falls and injuries and encouraging continued independent living. Yet, only 11% of older adults meet strength training recommendations. The vast majority of older adults are missing opportunities to improve their health through strength training.  Fortunately, the fix is simple to execute.

A study conducted by researchers at the University of Michigan should inspire our readers in their 50s and 60s to become physically active ? especially if you have conditions or habits that endanger your hearts, like diabetes, high blood pressure, or smoking.  In this study, which involved 9,611 older adults, those who were regularly active in their 50s and 60s were 35% less likely to die in the next 8 years than those who were sedentary.  The reduction in the risk of early death was achieved in study participants who engaged in very moderate physical activity: the reduction was seen among those who walked leisurely, gardened, or went dancing a few times a week.  Even those who were obese had a lower risk of dying if they were regularly active.  Lead researcher Dr. Richardson observed that "We found across all ranges of cardiovascular risk, everybody got a benefit from regular activity, but the biggest absolute benefit, the biggest reduction in deaths, was among high risk people."  Continuing, Dr. Richardson remarked that, in people who have cardiovascular issues, "the risk of remaining sedentary" is far greater than "the risk of having an acute problem brought on by exercise."  ["Study: physical activity in middle age cuts risk of early death," University of Michigan Health Systems Press Release, Nov. 5, 2004.]

Physical exercise has also now been shown to help maintain our mental health.  Physically active adults have higher concentration skills, which may help maintain memory and combat dementia.  In a study by researchers at Northwestern University Feinberg School of Medicine (Chicago), Dr. Benloucif, and colleagues found that sedentary lifestyles directly contribute to the decline in cognitive abilities and quality of sleep as we age.  Twelve men and women, ages 67 to 86, who were functionally independent, participated in a two-week study involving a regimen of 30 minutes of mild physical activity, 30 minutes of social interaction, and a final 30 minutes of mild to moderate physical activity.  Sessions began with warm-up stretching and mild to moderate physical activity (walking, stationary upper and lower body exercises).  The final period of mild to moderate physical activity included rapid walking, calisthenics or dancing.  A 10-minute cool-down concluded the 90-minute regimen.  At the end of the two-week period, all participants demonstrated a 4 to 6% improvement in cognitive performance, and improved sleep quality (including deeper sleep and fewer awakenings).  [Benloucif S, Orbeta L, Ortiz R, Janssen I, Finkel SI, Bleiberg J, Zee PC. "Morning or evening activity improves neuropsychological performance and subjective sleep quality in older adults."  Sleep. 2004 Dec 15;27(8):1542-51.]

Exercise is a universally accessible anti-aging modality.  It's never too early ? or too late ? to start a regimen of physical activity, and the benefits of doing so are wide ranging for you and your loved ones.

Concluding Remarks

Thanks to current and future advancements in anti-aging and regenerative medicine, the American Academy of Anti-Aging Medicine (A4M; www.worldhealth.net) projects that thes human lifespan will reach upwards of 125 years and beyond by the year 2049. I expect to live at least 125 productive, healthy, and vital years. Adopt the anti-aging lifestyle, get quality sleep, and engage in regular physical activity -- and you just might accomplish the same.