Aging & Longevity Support Protocol: A Resource For Practitioners


fullscript-leaf-greenery

by Fullscript’s Integrative Medical Advisory Team

Over the past century, we have seen a significant increase in human life expectancy, primarily as a result of advances in the field of medicine and improvements in public health, such as environmental and food quality. (14)(16) The National Institute on Aging reported that the average life expectancy increased from 47 years in 1900 to 79 years in 1998. (16) With this increase in life expectancy, we have also seen an increased incidence of age-related chronic diseases, (19) such as osteoarthritis, atherosclerosis, myocardial infarction, Alzheimer’s disease, and Parkinson’s disease. (9)(19) It is, therefore, important to consider factors and interventions that may not only increase longevity but support healthy aging.

man and woman in embrace looking into nature

Many environmental factors, including access to social support, can impact aging and longevity.

Theories of aging

While the exact “causes” of aging have yet to be determined, physiological changes associated with the aging process have led to a number of proposed theories explaining the underlying mechanisms of aging, including:

  • Epigenetic and genetic regulation theory
  • Telomere shortening theory
  • Stem cell theory
  • Mitochondrial dysfunction
  • Metabolic and immune deregulation
  • Proteostasis loss
  • Gut microbiota regulating theory (6)
  • Free radical theory (23)

Determinants of healthy aging and longevity

Successful or healthy aging is determined by the absence of disease and disability, as well as the maintenance of physical ability, cognitive function, productivity, and engagement in social activities. (17) While healthy aging and longevity is influenced in part by genetic factors, studies have demonstrated that genetics account for only about 25% of the variation in human life expectancy. (14) Modification of certain environmental factors, such as diet, lifestyle, and psychosocial factors, may support healthy aging and longevity. Below are some examples of the environmental factors associated with healthy aging. (13)

Dietary factors:

  • Certain dietary patterns (e.g., Meditteranean diet) (13)(22)
  • The ratio of carbohydrate and fat intake
  • Nutrient status (e.g., vitamin D, vitamin A, vitamin C)

Lifestyle factors:

  • Physical activity levels
  • Gait speed
  • Alcohol consumption
  • Smoking

Psychological factors:

  • Stress and depression
  • Sleep
  • Self-esteem and life satisfaction
  • Cognitive function

Socioeconomic factors:

  • Living arrangements
  • Social activity and support
  • Health insurance
  • Education level
  • Income and economic activity (13)

Integrative protocol for healthy aging and longevity support

While diet and lifestyle may play a significant role in healthy aging, certain nutrients and botanicals may also be beneficial. The following are examples of those that research has demonstrated may positively affect aging.

salmon on a table

EPA and DHA are found in fish and seafood, particularly cold water fish such as salmon.

Omega 3 fatty acids

An essential component to cell membranes, (2) omega-3 fatty acids are a major class of polyunsaturated fatty acids (PUFAs) and required in the diet because they cannot be manufactured by the body. (1) The primary omega-3 fatty acids are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA, found in plant oils such as soybeans, walnuts, chia seeds, and flaxseeds, can be converted to EPA and DHA in the body. However, this process is limited and the intake of EPA and DHA from food or supplements is often necessary to obtain adequate amounts. Synthesized by microalgae, EPA and DHA are found in fish and seafood, particularly cold water fish, such as salmon, sardines, tuna, mackerel, and herring. (12)

In addition to their role as a structural component of cell membranes, omega-3 fatty acids are involved in eicosanoid formation and the expression of inflammatory genes. (12)(20) EPA and DHA form eicosanoids with lower biological potency, produce anti-inflammatory resolvins and protectins, and partly inhibit inflammatory mechanisms, including the production of eicosanoids derived from arachidonic acid. (1) Omega-3 fatty acids may also influence the aging process by increasing telomerase levels and lengths. (5)(15)

Research findings:

  • Omega-3 PUFA has been shown to increase telomerase levels and lengths (5)(15)
  • Omega fatty acids have shown to reduce IL-1β, TNF-α and IL-6 which contribute to the effects of inflammaging (21)

For a more detailed review of Omega 3 fatty acids, refer to the Fullscript reference sheet: https://fullscript.com/hcp/fish-oil

CAN: Search for Omega 3 fatty acids in the Fullscript catalog.
US: Search for Omega 3 fatty acids in the Fullscript catalog.

Multivitamins

First manufactured in the 1940s, multivitamin/mineral (MVM) supplements are still widely used in the U.S. More than one-third of the U.S. population reports taking an MVM. The term multivitamin/mineral is difficult to define as it refers to a broad range of dietary supplements with various characteristics and compositions. MVMs will typically contain the daily recommended amounts of most vitamins and minerals and may contain other nutrients or herbal ingredients. MVMs may also be formulated specifically for special populations (e.g., prenatal, children) or conditions (e.g., athletic performance, weight management). (11)

Individuals report using MVMs to increase daily nutrient intake, promote health and prevent disease, and/or fulfill special nutrient needs in certain individuals (e.g., pregnant women, elderly individuals, those following a vegan diet). (11) Studies have shown that multivitamin use may improve certain factors related to aging.

Research findings:

  • Multivitamin use was associated with longer telomere length in women aged 35 to 74 (24)
  • Multivitamins containing minerals and herbs were shown to decrease perceived mental stress in an elderly population several hours after intake (7)
  • Multivitamin intake in elderly women was associated with an increase in inhibitory neural processes, which translates into an improvement in neural efficiency during memory retrieval (8)
  • Multivitamins were shown to improve alertness and negative mood symptoms in men aged 50 to 69 years old (4)

CAN: Search for Multivitamin in the Fullscript catalog.
US: Search for Multivitamin in the Fullscript catalog.

Astragalus extract in tea and next to the cup of tea

Astragalus membracanus may be support healthy aging and longevity by increasing telomerase activity.

New and upcoming research:

Astragalus membracanus

Astragalus membracanus is a medicinal herb that has been used for centuries in traditional Chinese Medicine (TCM) to treat a wide variety of disorders. (6)(10) In TCM, it has been used to strengthen eliminative, immune, metabolic, and respiratory functions. (6)

To date, more than 2000 species of astragalus have been identified. (10) The primary active constituents of the astragalus plant include polysaccharides, flavonoids, and saponins. Pharmacological research examining the activity of these components suggests that astragalus may possess antioxidant, anti-inflammatory, anticancer, immunoregulatory, antihyperglycemic, hypolipidemic, hepatoprotective, expectorant, and diuretic effects. Astragalus may also increase telomerase activity. (6)

Research findings:

  • Decline in the percentage of senescent cytotoxic T cells (CD8+ and CD28-) and natural killer cells were observed in seropositive patients (3)
  • TA-65 has shown to lengthen telomerase in a clinically significant way and decrease the percentage of short telomerase (3)(18)

CAN: Search for Astragalus membracanus in the Fullscript catalog.
US: Search for Astragalus membracanus in the Fullscript catalog.

The bottom line

While aging and longevity are determined in part by genetic factors, modification of diet, lifestyle, and other environmental factors may support healthy aging and improve longevity. A protocol using natural supplements can be used therapeutically on its own or as an adjunct to existing treatment. If you are not an integrative healthcare provider, we recommend speaking with one to find out whether these supplements are right for your wellness plan.

If you are a practitioner, consider signing up to Fullscript. If you are a patient, talk to your healthcare practitioner about Fullscript!

To see our full protocol library, click here!


Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

  1. Calder P. C. (2013). Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology?. British Journal of Clinical Pharmacology, 75(3), 645–662.
  2. Cholewski, M., Tomczykowa, M., & Tomczyk, M. (2018). A comprehensive review of chemistry, sources and bioavailability of omega-3 fatty acids. Nutrients, 10(11), 1662.
  3. Harley, C. B., Liu, W., Blasco, M., Vera, E., Andrews, W. H., Briggs, L. A., & Raffaele, J. M. (2011). A natural product telomerase activator as part of a health maintenance program. Rejuvenation Research, 14(1), 45–56.
  4. Harris, E., Kirk, J., Rowsell, R., Vitetta, L., Sali, A., Scholey, A.B., & Pipingas, A. The effect of multivitamin supplementation on mood and stress in healthy older men. Human Psychopharmacology: Clinical and Experimental, 26(8), 560-7.
  5. Kiecolt-Glaser, J.K., Epel, E.S., Belury, M.A., Andridge, R., Lin, J., Glaser, R., … Blackburn, E. (2013). Omega-3 fatty acids, oxidative stress, and leukocyte telomere length: A randomized controlled trial. Brain, Behavior, and Immunity, 28, 16-24.
  6. Liu, P., Zhao, H., & Luo, Y. (2017). Anti-aging implications of Astragalus membranaceus (Huangqi): A well-known Chinese tonic. Aging and Disease, 8(6), 868-886.
  7. Macpherson, H., Rowsell, R., Cox, K.H., Scholey, A., & Pipingas, A. (2015). Acute mood but not cognitive improvements following administration of a single multivitamin and mineral supplement in healthy women aged 50 and above: a randomised controlled trial. Age, 37(3), 9782.
  8. Macpherson, H., Silberstein, R., & Pipingas, A. Neurocognitive effects of multivitamin supplementation on the steady state visually evoked potential (SSVEP) measure of brain activity in elderly women. Physiology & Behavior, 107(3), 346-54.
  9. McGeer, P.L., & McGeer, E.D. (2006). Inflammation and the degenerative diseases of aging. Annals of the New York Academy of Sciences, 1035(1), 104-116.
  10. National Center for Complementary and Integrative Health. (2016). Astragalus. Retrieved from https://nccih.nih.gov/health/astragalus
  11. National Institutes of Health. (2015). Multivitamin/mineral supplements. Retrieved from https://ods.od.nih.gov/factsheets/MVMS-HealthProfessional/
  12. National Institutes of Health. (2019). Omega-3 fatty acids. Retrieved from https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/
  13. Park, J.H., & Park, Y.J. (2018). A systematic review on factors influencing the healthy aging: A Korean perspective. The Journal of Aging Research & Clinical Practice, 7, 3-8
  14. Passarino, G., De Rango, F., & Montesanto, A. (2016). Human longevity: Genetics or lifestyle? It takes two to tango. Immunity & Ageing, 13, 12.
  15. Pawełczyk, T., Grancow-Grabka, M., Trafalska, E., Szemraj, J., Żurner, N., & Pawełczyk, A. (2018). Telomerase level increase is related to n-3 polyunsaturated fatty acid efficacy in first episode schizophrenia: Secondary outcome analysis of the OFFER randomized clinical trial. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 83, 142-148.
  16. Rafi, M. A., & Alavi, A. (2017). Debate on human aging and lifespan. BioImpacts, 7(3), 135–137.
  17. Rowe, J.W., & Kahn, R.L. (1997). Successful aging. The Gerontologist, 37(4), 433-440.
  18. Salvador, L., Singaravelu, G., Harley, C. B., Flom, P., Suram, A., & Raffaele, J. M. (2016). A natural product telomerase activator lengthens telomeres in humans: A randomized, double blind, and placebo controlled study. Rejuvenation Research, 19(6), 478–484.
  19. Sarkar, D., & Fisher, P.B. (2006). Molecular mechanisms of aging-associated inflammation. Cancer Letters, 236(1), 13-23.
  20. Sears, B. (2015). Anti-inflammatory diets. Journal of the American College of Nutrition, 34(Suppl 1), 14-21.
  21. Tan, A., Sullenbarger, B., Prakash, R., & McDaniel, J.C. (2018). Supplementation with eicosapentaenoic acid and docosahexaenoic acid reduces high levels of circulating proinflammatory cytokines in aging adults: A randomized, controlled study. Prostaglandins, Leukotrienes & Essential Fatty Acids, 132, 23-29.
  22. Vasto, S., Scapagnini, G., Rizzo, C., Monastero, R., Marchese, A., & Caruso, C. (2012). Mediterranean diet and longevity in Sicily: Survey in a Sicani Mountains population. Rejuvenation Research, 15(2).
  23. Wickens, A.P. (2001). Ageing and the free radical theory. Respiration Physiology, 128(3), 379-91.
  24. Xu, Q., Parks, C. G., DeRoo, L. A., Cawthon, R. M., Sandler, D. P., & Chen, H. (2009). Multivitamin use and telomere length in women. The American Journal of Clinical Nutrition, 89(6), 1857–1863.