Dr. Maita sees patients in her clinic in Short Hills, NJ, and also offers telemedicine consultations. To schedule an appointment with Dr. Maita or learn more about her practice, click here.
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In our last article, we went over some of the basic anti-aging tests we often use to evaluate how well our patients are aging. We also discussed how we utilize them to tailor our approach to each individual. Testing is an important part of anti-aging medicine, as these tests can point us to individual imbalances and allow us to monitor progress and results of treatment plans.
The key to anti-aging is not a pill or a quick fix but creating a lifestyle full of healthy anti-aging habits. These lifestyle choices can help improve your health, reduce risk for age-related disease, and increase your longevity. In this article, we’ll go over some of the key lifestyle changes we often start with.
1 – Tailoring your own anti-aging diet
I am often asked to recommend the best diet for longevity, and while there are several powerful nutrients that can help with aging, we need to keep in mind that diet is not one size fits all. There are just too many variables and personal preferences we need to consider.
With that said, here are some of the basic anti-aging diet principles:
Eat more low glycemic colorful fruits and vegetables
These are loaded with antioxidants, fiber, vitamins, and minerals, but low in calories and sugar. Good options include:
- Leafy greens such as kale, spinach, and lettuce
- Low sugar fruits such as blueberries, blackberries, raspberries.
- Cruciferous vegetables such as broccoli, cabbage, brussels sprouts, and cauliflower. These can also help with detoxification and support the clearance of excess hormones.
Focus on anti-inflammatory foods
Controlling inflammation with the foods we eat is a powerful way to promote longevity, health, and wellness.
In addition to fresh low glycemic fruits and vegetables, make sure to include enough anti-inflammatory fats in your diet. Good sources include avocados, wild, low-mercury fish such as Alaskan salmon, raw nuts and seeds, and olive oil.
Also, try to limit inflammatory foods, especially processed foods, processed meats, fried foods, sugars, refined carbs, and saturated fats.
Be mindful of food sensitivities
Speaking of inflammatory foods, these are not only limited to unhealthy processed foods. Even healthy foods can trigger inflammation in some people. Here’s a common example:
You may be eating a healthy Mediterranean diet. One that is loaded with plant-based whole foods that are well known for their many anti-aging health-promoting benefits, you simply can’t get wrong, right?
Well, the Mediterranean diet does include plenty of anti-inflammatory foods that indeed, offer many impressive health benefits. But it is also high in grains. If your body is sensitive to gluten or grains, that eating plan is going to trigger an inflammatory response, causing more harm than good.
Unlike food allergies that cause an immediate often life-threatening response (think of a child who is allergic to peanuts, eating a peanut cookie at school), food sensitivities are difficult to identify because they can cause a delayed response. Over time, untreated food sensitivities can lead to gut microbiome imbalances, systemic inflammation, overactive immune system, and other health conditions.
Since food sensitivities are quite common, I often recommend many of my patients to start with a 2-week elimination diet, which eliminates common foods that are known to be problematic. Some of the foods we start with usually include gluten, dairy, soy, common allergens, artificial and processed foods.
After 2 weeks, you reintroduce some of these foods you eliminated, one food at a time, and see if any symptoms reoccur.
The elimination diet is not a diet for life, but an effective tool to identify potential food sensitivities. It allows the body to calm the inflammation down, regulate the immune response, and heal the gut.
How much protein should we eat to support longevity?
A low animal protein diet is often mentioned as a potential strategy to promote longevity. On the other hand, frailty and age-related loss of muscle mass and strength (sarcopenia), are linked to inadequate protein intake[1]. Clearly, muscle loss is not what we call “healthy-aging” or high quality of life. So, where do we go from here?
The data clearly suggests that eating enough protein is vital to maintain muscle mass, especially as we age[2]. I do find however, that many people tend to get more protein than they need. The exact amount can vary from one person to another depending on activity level, body weight, state of health, and goals.
Also, the source of the protein matters and needs to be considered as well. Plant-based protein rich foods such as beans and legumes are usually high in carbohydrates and may not agree with some food sensitivities. Animal-based proteins, on the other hand, may be higher in saturated fats and other nutrients that may also not be a great fit for others.
There’s no one ultimate anti-aging protein everyone should eat. This is a great example that demonstrates why the optimal diet should always be personalized.
2 – Best fasting protocols for longevity
Intermittent fasting and time restricted eating are very trendy these days, and indeed, they have shown a lot of anti-aging potential. Even short fasting can trigger autophagy[3], which is our body’s natural process that clears damaged cells to help regenerate newer, healthier ones.
Fasting, however, is not for everyone. Also, more, is definitely not better. You may be a competitive athlete or recovering from an injury, is now really the best time to go on a long fast or restrict your calories? Chances are, it is more important at this moment to provide your body with sufficient nutrients to support optimal healing and repair.
So, fasting is not one size fits all, but when properly done, it may offer many benefits that can help support our longevity potential. Here are some of the top evidence-based fasting protocols:
Prolon fasting-mimicking diet
(Five days a month, for three months)
Developed by Dr. Valter Longo from the Longevity Institute at the University of Southern California, the fasting mimicking diet is one of the most studied fasting protocols.
For five days, you follow a low-calorie premade meal plan that provides your body with essential nutrients but is still low enough to stop the signaling pathways that food produces, and therefore mimic a fasting state. Human trials have shown improvements in age-related risk factors such as body mass index, blood pressure, fasting glucose, IGF-1, triglycerides, cholesterol, and C-reactive protein[4].
For best results, you should continue to follow a healthy diet between periods of fasting.
Intermittent fasting and time restricted eating
With intermittent fasting and time restricted eating, you limit when you eat. Some of the common regimens include:
- Two days a week fasting (5:2 diet). For two days a week (do not have to be consecutive) you restrict your calories to 500–600 per day. This amount is low enough to trigger autophagy and other longevity pathways. The other five days of the week are normal eating days.
- Alternate day fasting. As the name suggests, you eat every other day.
- 8:16 hour fast. You eat for 8 hours and fast for 16 hours. This has been shown to increase longevity, stress resistance, and decrease the incidence of cancer and obesity by switching energy sources from glucose to ketones.
- Circadian rhythm fasting (12:12). You narrow the eating window to 12 hours during the daytime hours, and fast during the night for 12 hours. This schedule is in tune with our natural biological clocks and hormone cycles.
Does intermittent fasting work?
According to the evidence, the fasting regimens that has demonstrated the most benefits, are the fasting mimicking diet, the two days a week (5:2 diet) and the alternate day fasting.
The research on the shorter time restricted eating plans has been somewhat debunked with several studies that couldn’t show any benefits. This doesn’t mean however, that these are not effective. If you look closely at what people ate during the studies, (when they weren’t fasting), you see that they ate whatever they wanted[5]. Clearly, this may have not been an optimal approach.
As we mentioned earlier, a nutritional plan for longevity should always start with the basics, which is clean eating. In other words, what you eat between the fast matters just as much as the time spent fasting.
Caloric restriction and longevity
In theory, caloric restriction seems to be a great anti-aging strategy, but there are a few potential risks, especially when people take it too far.
Unlike intermittent fasting which has short cyclic portions where you fast and refeed, caloric restriction is a long-term approach. Over time, you may not be able to provide your body with all the nutrients it needs.
Also, you need to know how to adjust your calories based on your activities or during times where your body needs more calories for healing. For example, when you are sick, or trying to recover from an injury, your body needs more nutrition. For these reasons, it’s essential that you work with a qualified health practitioner and monitor your nutritional status to avoid potential imbalances.
The other thing to consider, is that long term calorie restriction is very hard to do. It’s much easier to fast for a day or two, especially after a big holiday feast, or to simply allow yourself some downtime, a time to reflect, rather than knowing you must keep doing it forever.
3 – Anti-aging supplements
Anti-aging supplements are very trendy, with plenty of options to choose from. It often seems there’s a new anti-aging supplement on the market every week. So, how do we know which supplements to use? Here are a few tips:
- Start with the basics. I am a big believer in nutrient testing to make sure there are no deficiencies. You can take the most advanced anti-aging supplements, but if you are low in essential vitamins, minerals, and other nutrients, you may not be able to optimize your health. In general, I find that a high quality multi vitamin and mineral, vitamins D and K2, and fish oil offer good nutritional support.
- What are we optimizing for? Rather than taking anything under the sun, you may want to target specific concerns. These may be related to aging, or your overall performance and quality of life. For example, mitochondria supplements such as l-carnitine, CoQ10, and PQQ can help with your energy levels. Or you may want to optimize your cognitive function with supplements such as phosphatidylserine and acetyl l-carnitine.
- What’s in my supplement? Dietary supplements are not regulated, and it is therefore essential to educate yourself about important factors such as the source, form, potency, purity, delivery system, and others. For example, the percentage of the active ingredient in different herbal supplements can make a big difference in their potency. Are you getting the whole plant, or is it a concentrated extract that was standardized to deliver the active constitutes of the plant?
Longevity supplements
While we still haven’t found that one magical anti-aging ingredient that seems to be the ultimate fountain of youth, there are a few nutrients that may be very helpful which I often combine as I tailor the plan:
- Sulforaphane. Naturally found in broccoli seeds and broccoli sprouts, shown to support detoxification enzymes, balance excess estrogen, and prevent DNA damage[6].
- NAD+. (Nicotinamide adenine dinucleotide). This new kid in the block is essential for cellular energy but declines with age. Restoring NAD+ levels has shown a lot of promise in reducing the risk for age-related disease, increasing both lifespan and health span in various studies[7].
You can increase your NAD+ levels with NAD injections, supplement with nutrients that boost your NAD levels such as NR and NMN, among other ways. We still need more data however, to learn which method works the best. - Resveratrol. Naturally found in grapes, chocolate, and red wine. Multiple studies have indicated that resveratrol can regulate the longevity gene SIRT1 and other longevity pathways. This regulation may extend lifespan and help lower your risk of age-related disease[8,9].
- Green tea extract. A great versatile natural ingredient with plenty of anti-aging benefits, green tea extract contains the powerful antioxidant epigallocatechin gallate (EGCG). EGCG helps reduce oxidative stress and inflammation, regulates certain hormones, and promotes heart, brain, and metabolic health[10].
4 – Exercise for longevity
A sedentary lifestyle is a major risk factor for cardiovascular illnesses, as well as an increase in all-cause morbidity and mortality. Improving physical fitness on the other hand, has shown to increase life expectancy and prevent age-associated diseases[11].
To be effective, it is important to cover all aspects of physical fitness. While many people tend to focus on strength training to support lean muscle mass and aerobics for heart health, it is important to also work on balance and flexibility, which can help prevent falls.
The good news here is that you don’t have to live at the gym to achieve these fitness goals. An evidence-based workout style that has become very popular is called high intensity interval training (HIIT). Despite being short (around 20 minutes), it has shown a lot of benefits that are comparable to longer workouts.
With HIIT, you repeat short hard bouts of exercises, followed by short periods of rest. You can combine aerobics with strength training, for example, by using your own body weight. This makes HIIT a much more efficient workout. In fact, some of the studies found that 20 minutes of HIIT is equivalent to an hour of a moderate workout. With HIIT, you get more bang for your buck.
On that note, make sure not to overtrain. A big mistake I often see, is that some people push themselves way too hard. I have been working with long-distance runners and athletes that ended up with gut dysfunction and other imbalances because of the intensity of their training. Some people’s cortisol goes up too high and this affects their ability to properly sleep and recover. Clearly, this is not a good approach for longevity.
5 – Get enough sleep
Despite the notion that we need less sleep as we age, the opposite is the case. It is very important to allow enough time for sleep and be mindful of sleep quality.
Sleep is one of the most powerful natural anti-aging tools we have access to. It is the time where most of the healing and repair occur. This is also when key anti-aging processes such as hormone regulation, brain and memory maintenance occur.
6 – Lessons we learned from the blue zones
A discussion about lifestyle for longevity will never be complete without mentioning the blue zones. According to longevity experts, people who live in these seven areas of the world have the longest life span with many of them reaching 100 years old or beyond. This is despite being located in different regions and climates around the world. These blue zones share similar lifestyle behaviors that may be the key to their long, healthy lives. The longevity of the population in these areas has generated a lot of interest in the scientific community.
So, what have we learned from these populations? Here are some of the shared traits of the longest-lived people from the blue zones. I find this information inspiring. A reminder of the importance of healthy lifestyle and a reminder of how we used to and can live[12]:
- Move naturally. The includes spontaneous movement with their everyday activities, moving about every 20 minutes. Their activities include gardening, doing manual house and yard work. When they go out for errands or other activities, it is usually by foot.
- Eat mostly plants. In fact, the researchers estimated that 95 percent of 100-year-olds ate plant-based diets.
- Eat until 80% full. This is achieved by including mindful eating practices such as praying before meals, eating slowly, and eating with other family members.
- Stress less. Practice daily rituals that help cope with stress, such as prayer, ancestor veneration, napping, and happy hour.
- Have a positive outlook and social connections. Blue zone centenarians have a sense of life purpose as well as belonging in a community. They surround themselves with supportive people and put their loved ones first.
