John Mathers, PhD, Institute for Ageing and Health, Newcastle University, Newcastle, UK
Life expectancy in most of Northern Europe is almost double what it was two centuries ago. If ageing is considered a disease, then it surely is the most prevalent disease. Professor Mathers says "the challenge is to enhance healthy ageing and to reduce the financial and social burdens associated with chronic ill health in later life".
Animal models have revealed that ageing occurs because of the build-up of damaged macromolecules in the cell. The major causes of this cellular damage are inflammation, metabolic stress andoxidative stress/redox changes. Targeted nutritional interventions can both reduce such damage and also improve the body’s ability to repair damage. The beneficial effects of this are longer lives and reducedincidence of age-related diseases. We know that obesity and chronic adiposity are major risk factors for an early death, whilst there is some intriguing evidence (in some animal models) that calorie restriction increases lifespan. We also see evidence that certain “healthy diets”, such as the Mediterranean diet, are associated with a reduced risk of age-related diseases and longevity. Conversely, ageing can be accelerated by stress, poor diet and an adverse environment.
Trichoupoulou et al. demonstrated improved survival of the elderly who consume a Modified Mediterranean diet in an investigation of 23,349 participants of the Greek EPIC (European Prospective Investigation into Cancer and Nutrition) cohort. They determined the most important protective aspects of the diet were moderate ethanol consumption, low meat consumption and high consumption of fruit and vegetables. However high fish, whole grain cereal and low dairy consumption were not associated with decreased mortality. A large recent, multi-center trial in Spain with 7,447 participants aged 55 to 80 years who were at risk of CVD but has no existing pathology demonstrated a 24% reduction in major adverse cardiovascular events in the study arm that consumed the Mediterranean diet with additional olive oil and nuts in comparison with the control.
Cardiovascular disease causes about one in four deaths in Northern Europe and the risk is age related. The DASH diet (Dietary Approach to Stop Hypertension) is believed to reduce the risk of CVD through lowering blood pressure. The DASH diet is predominately vegetarian with a small amount of lean meats. Dairy items are low or non-fat, whilst there is a significant consumption of nuts and whole grains. A recent meta-analysisb y Siervo et al. of a total of 1,917 subjects who followed the DASH diet revealed mean reduction in systolic and diastolic blood pressure of 5.2 mmHG and 2.6 mmHG. The diet achieved an average reduction of 13% in the Framingham risk score for CVD. The benefits were particularly noticeable in the at-risk groups, e.g., the elderly.
In some of his recent work on healthy ageing, Professor Mathers has made use of a bespoke digital platform called LEAP (Lifestyle, Eating, Activity, Planning) which provides an interactive approach to healthy ageing. The platform not only covers diet, but aspects such as exercise and social interaction too, and is open to all participants in Professor Mathers trials. His group has also defined a Health Ageing Phenotype (HAP) in an attempt to provide a holistic measure of the many aspects the ageing process. It is proposed that HAP is a tool that can be used in future trials across diverse study designs and populations.
Finally, Professor Mathers reminds us that “ageing is a life-long process that begins at conception when we acquire genetic variants that will determine whether we age well”.