The World of Longevity
Patients are spending time, energy and money to live as healthily as possible for as long as possible. Research shows that 41% of Americans are willing to take preventative measures, including adequate sleep, healthy meal planning and taking supplements and vitamins to solidify living as long as 
conceivable.1 “The desire for increased longevity is driven by a globally connected world offering more opportunities for personal growth and exploration,” shared Rahi Sarbaziha, MD, an integrative aesthetics physician in Beverly Hills, Calif. “As science and technology improve, and the collective understanding of interconnected possibilities grows, patients have more tools to prolong life.”
According to Mark Tager, MD, chief executive officer (CEO) of ChangeWell Inc. (San Diego, Calif.), baby boomers have adopted healthier lifestyles. “They are maintaining their fitness and are concerned with diet. They are not going quietly into the night.” With that stance on aging comes a major money dump into the age-reversing industry, with the U.S. investing an estimated $5.2 billion into longevity in 2022.2
A Multi-Billion Dollar Industry
Over the last five years, the anti-aging field has witnessed heavy research, the advent of start-ups, and an increase in dedicated conferences on the topic. “Beyond living longer, the common objective is to reduce the number of illnesses,” said Virginie Couturaud, scientific communication director at Christian Dior (Paris, France). “Researchers have demonstrated that biological age fluctuates, and it is reversible whether naturally or with the help of molecules.”
Physicians and the medical community are working to slow aging, so patients feel and look better. According to Pamela Smith, MD, founder and director of the Center for Precision Medicine (Gross Pointe Farms, Mich.), the American Academy of Anti-Aging Medicine (A4M) is leading global physician education on reversal of aging.
“Several companies are investing in various aspects of healthy aging, including advanced diagnostics, which involve the microbiome, genetics, genomics and lab-developed tests and panels on autophagy, neurotransmitters and detoxification,” Dr. Tager pointed out. “Many nutritional companies are making advancements in formulations, which include digestive enzymes, probiotics, senolytics, collagen, hormonal support for estrogen dominance, sleep and cognition.”
There is also Altos Labs, Amazon CEO Jeff Bezos’ anti-aging start-up, which is set on finding ways to extend human life, slow biological aging and create eternal living by biologically reprogramming cells in the lab.3
Even prestige beauty giants like Dior are claiming their piece of the pie. “Dior Science, with LVMH Recherche, has been a pioneer on markers of aging,” Ms. Couturaud shared. “Dior Science discovered that the anchoring proteins of epidermal stem cells in the dermalepidermal junction decrease with age, leading to a slowdown in cell renewal and an acceleration of the signs of aging.” A pioneer in inflammaging, she added that Dior Science has made it possible to understand the role of immune cells and the consequences of their activation. Dior’s approach is to connect the territories of longevity research to reach new milestones, transforming scientific promises into future solutions for beauty and health.
Human Aging 101
The inherent aging process affects every individual, yet this complex and multi-factorial progression consists of biological and physiological changes, including permanent shifts in metabolism, hormone levels, sleep patterns, well-being and the skin.
Genomics
Every patient’s genetics and deoxyribonucleic acid (DNA) patterns account for about 25% of aging and life span. Lifestyle choices influence the remainder. “The most commonly echoed phrase is that ‘genetics loads the gun, but lifestyle pulls the trigger’,” Dr. Tager shared. “Genes need to be turned on to have an effect. This is the role of epigenetics and how stress, diet and lack of exercise switch genes on or off.”
Dr. Smith explained that genomics influences aging in several ways. “The most important factor is the ability of the body to methylate properly, which is inherited by several genes,” she mentioned. “Approximately 50% of the world’s population are poor methylators. Fortunately, nutritional therapies and other treatments improve methylation.”
Epigenetics
Genetics are responsible for certain age-related hereditary conditions. However, when physicians dial into behavioral and environmental influences, they can alter the genome through epigenetics to control and improve aging, Dr. Sarbaziha shared.
Popular epigenetic therapies include DNA methylation, histone modification, chromatin remodeling and ribonucleic acid (RNA) modification to slow aging and thwart certain diseases by reversing genome function. “Epigenetic studies have shown positive for altering patient behavior and improving their environment to decrease the risk of developing diseases,” Dr. Smith stated.
The Endocrine System
The endocrine system may be the most instrumental bodily system for aging and longevity. It is responsible for various life processes such as memory, decreasing the risk of diseases like cancers, diabetes, heart disease, vision, mobility, adequate sleep functionality, libido and energy levels. As Dr. Sarbaziha explained, diet, lifestyle and genetic predisposition can influence the dysregulation of the endocrine system. With age, decreased hormone secretion levels impact the endocrine system, affecting homeostasis.
“Naturally occurring hormonal declines affect physiological and biological aging externally and internally,” Dr. Smith said. “Hormonal aging on the skin causes thinning, atrophy, dryness, wrinkling and delayed wound healing. A decrease in sex steroids also reduces skin functions under hormonal control, including keratinocytes, Langerhans’s cells, melanocytes, sebaceous glands, collagen content and hyaluronic acid synthesis,” she added. “The most important thing patients can do to improve their skin is implement customized bio-identical hormone therapy. It is the key component in helping patients age gracefully.”
According to Dr. Tager, more recent advancements include advances in hormone testing – a key metric in aging. “Companies like Ayumetrix now offer salivary hormone and fingerstick nutrient tests. Precision Analytical employs dried urine to measure hormone metabolites in their Dutch test, and Prolon, which pioneered the fasting-mimicking diet, is paving the way with therapeutic approaches to healthy aging.”
Gut Health
“Your gut is the second most important bodily system that maintains health as patients age,” Dr. Smith said. “The gastrointestinal (GI) tract comprises 70% of the immune system and makes 90% of the body’s serotonin. Biotin, the vitamin B, responsible for healthy hair and nails, is also made in the GI tract.”
Over time, the healthy microbes that live in the GI tract can become diluted, making it difficult for the body to defend itself and limiting the production of essential vitamins and other vital chemicals. Ultimately, an imbalance in the gut microbiome negatively impacts the immune system’s ability to function correctly.
Gut health is pivotal for nutrient absorption and well-being, and to maintain it, a wholesome, clean diet with fiber-rich whole foods, as well as fermented foods and probiotics in pill or powder form, improves the gut for prolonged healthy aging. A study in Nature Metabolism revealed that adults with a diverse mix of gut microbes over their lifetime displayed lower cholesterol levels, reduced frailty and more beneficial blood chemicals, contributing to increased longevity.4
The Next Wave of Aging Research and the Future
Aging research continues to forge forward. The fundamental solutions to living a healthier, longer life are still popular, albeit improved. Stem cell and gene treatments continue to be prevalent, yet are more accessible with broader applications, and new innovations continue to gain recognition.
Ms. Couturaud said age-related interventions, such as Yamanaka factors, which reverse aging without cells losing their identity, and Metformin, which limits the incidence of cancer and Alzheimer’s disease, prove that molecules seem promising for reversing cellular aging.
In addition, senolyctic drugs are on the horizon, eliminating cells that no longer divide and function properly. Dr. Tager cited reprogramming strategies and aging vaccines as emerging interventions. “Other interventions include the nicotinamide adenine dinucleotide (NAD+) precursors in epigenetic regulation and DNA repair, sirtuin-activating compounds, resveratrol and rapamycin.”
Integrating Age-Reversing Treatments into a Medical Practice
Patient demand for age-reversing treatments and therapies prompts practitioners to incorporate them into their aesthetic practices. In Feed Your Skin Right by Dr. Tager, he defined a new type of practice – integrative aesthetics – which consists of “personalized assessments, treatments and counseling that recognize skin health and beauty as highly dependent upon multiple organ systems that are affected by ‘omics,’ lifestyle, and environment. Cash-pay patients are interested in more whole-person / root-cause healthcare and want to look good as they age.”
An easy starting point is suggesting diet, exercise and stress management changes. Then, Dr. Tager recommends personalized nutritional supplementation via advanced diagnostics. To grow a practice, physicians can learn about integrative medicine or, as Dr. Sarbaziha shared, partner with other practitioners and adopt the ‘blue zone lifestyle’ as part of their brand to position themselves as holistic health advocates.
“With the new wave of integrative aesthetic practices, practitioners recognize the significance of internal and external aging processes for comprehensive well-being,” Dr. Sarbaziha elaborated “The connection between reversing aging and aesthetics is evident in the shared interest in addressing internal and external aspects of aging.”
References:
- Mikhail, A. (2023, August 16). Wealthy Americans will go to the extreme to live longer, from downloading their brains to taking risky drugs. Fortune Well. https://fortune.com/well/2023/08/10/ wealthy-americans-extreme-measures-to-live-longer/
- Annual longevity investment report archives. Longevity. Technology. (n.d.). https://longevity.technology/investment/ report/annual-longevity-investment-report/
- Jimenez, D. (2021, September 16). Billionaires are betting on anti-ageing research, but can ageing really be cured? Pharmaceutical Technology. https:// www.pharmaceutical-technology.com/features/ billionaires-anti-ageing-research/?cf-view
- Godman, H. (2023, July 18). Healthy Gut, healthier aging. Harvard Health. https://www.health.harvard.edu/stayinghealthy/ healthy-gut-healthier-aging#:~:text=In%20a%20 study%20published%20online,change%20in%20their%20 gut%20microbiome
Mikhail, A. (2023a, April 6). Dior is getting into the trendy reverse-aging business. here’s how its team of expert researchers plans to help people look younger. Fortune Well. https://fortune.com/well/2023/04/06/dior-reverse-skin-aging/
