Longevity, TCM and The Hallmarks of Aging

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The world’s aging population is the subject of intensive study these days since longevity is imminent for more people than ever before in history. WHO (World Health Organization) and the NIH (National Institutes of Health) estimate that by 2050 there will be 1.6 billion people on the planet that are over 65 years old. A recent study in the Netherlands proposes that there is a ceiling of about 115 years old for humans. This brings up the question about what quality of life is possible for those who are elderly? What factors affect aging populations?

Traditional Chinese Medicine Theory

When considering aging in the context of traditional Chinese medicine (TCM), we must begin with Essence/ Jīng(精). According to Chinese Medicine, Essence, Qi (氣) and Mind (Shén 神) are the three fundamental substances of a human being. Essence is responsible for the physical decay of our bodies, along with our growth, development, and our fertility. In addition, Essence is associated with our basic constitution, strength, vitality, and the fundamental resistance of our body to various stressors and diseases. Essence is aptly named as that which is essential to be human. It is inherited from our parents, and the amount and the quality of Essence we received is fixed from birth. The role of Jīng changes depending on our age. From birth it is responsible for the growth of bones, teeth, hair, all the Zang Fu, and fills the Marrow (bone marrow, spinal cord and brain). During our adolescence, it controls the puberty process. In adulthood, it controls reproductive function, fertility, conception, and pregnancy. Improper bone formation, birth defects, growth retardation, mental or physical disabilities, delayed puberty, premature aging, sterility/impotence, and genetic disorders are all symptoms of Essence Deficiency.

Essence/ Jīng is the source of Yin and Yang within the body and acts as a reservoir of both during the development, maturation, and aging of the body. Since the amount of Essence is finite, over time the Essence cannot continue to replace that which challenges and depletes Yin or Yang. Aging, therefore, is a sign of Essence depletion (Shèn Jīng Xū 腎精虛). When Essence becomes exhausted with aging, eventually Yin and Yang separate, and death is the result. Our reproductive ability, fertility, our musculature, the quality of our immune system, our blood, the function of the Zang Fu, and our cognition and mental health “wear out” as we deal with the stressors of life. What exactly wears out will be the substance of the discussion below on the hallmarks of aging. Interestingly, the hallmarks of aging represent “normal’ physiological processes that one encounters during the normal course of human events, the arc of life.

In TCM theory, two types of Essence/ Jīng are defined. Pre-natal (or pre-Heaven) and post-natal Jīng. Pre-natal Jing is passed at conception from the parents to the fetus, which nourishes the fetus with the addition of the Qi (especially her Kidney Qi) from the mother. In theory, very little can alter Pre-natal Jing after birth and it is advised that Essence should be conserved and not wasted, which is accomplished by living one’s life in harmony with the Tao. Suggested strategies, including moderation in diet, work, sexual activity, and stress reduction are recommended along with adequate rest and exercise that incorporates breathing exercises such as Qi Gong or Taiji Quan. Chinese herbs can support Pre-natal Jing but cannot replace it.

Post-heaven Essence describes the governance of development and maturation after birth. This form of Essence, building on Pre-natal Essence, is derived from the air we breathe and the food and drink we consume, that is, the Qi of the Lungs and the Spleen/Stomach.

The combination of Pre- and Post-natal Jing is sometimes referred to as Kidney Jing since Jing is stored in the Kidneys and is under the direction of the Kidney Qi. The Kidney Jing is fluid in nature and permeates the entire body, circulating in the Eight Extraordinary (Ancestral) Meridians. The Yin-like Kidney Jing provides the material basis for the production of Kidney Qi via the warming action of the Kidney Yang.

Irregularity or excesses in diet and lifestyle, inappropriate responses to stressors, and chronic illnesses deplete Kidney Jing and over time, results in Essence exhaustion/deficiency, a hallmark of dysfunction at any stage of life and particularly in one’s elder years.

Commonly, Essence depletion is preceded by chronic Kidney Yin or Kidney Yang deficiency. Long-term Liver Blood deficiency will likewise deplete Essence. Characteristically, the tongue will be red and peeled and if due to Yin deficiency, there will be little coat and if due to Yang deficiency, the tongue will be pale, rather than red. The pulse type may be Empty (Xu) or Floating (Fu). Signs of this depletion include declining reproductive function, graying and loss of hair, decline in immune response and susceptibility to disease, chronic inflammation, impairment of cognition and memory, recalcitrant obesity or loss of lean muscle mass, frequent urination or urinary incontinence, weakened bones, tendons, and ligaments, loss of skin elasticity and wrinkles, and sensory loss including vision and hearing.

After a proper differential diagnosis, illustrative herbal formulas to be considered include Wu Zi Yan Zong Wan 五子衍宗丸 (Five Ancestors Teapills), You Gui Wan 右歸丸 (Right Side Replenishing Teapills), Huan Shao Dan Wan 還少丹 (Return to Spring Teapills), Er Xian Wan 二仙散 (Two Immortals Teapills), Ba Ji Yin Yang Wan 巴戟陰陽丸 (Morinda Pills to Balance Yin And Yang), and Ge Jie Da Bu Wan 蛤蚧大補丸 (Gecko Tonic Teapills).

I have always admired and found great value in the elegant language and concepts of Chinese medicine, especially given their ancient, pre-scientific origins. In my earlier life, I was a clinical biochemist and toxicologist. Consequently, as a TCM educator, I found myself being called upon to teach biochemistry to TCM students, which I enjoyed immensely. To make the subject relevant to my students, I found myself seeking to “translate” biochemistry concepts into TCM language. Exact matches are not necessary, but I submit that it is possible to deepen one’s understanding of medicine and patient care by integrating and comparing the languages used to describe the physiology and pathology of medicine.

Genes, Chromosomes, DNA and Essence

For example, genes, chromosomes, DNA, and the genetic code can be compared to Essence, since they are the basis for human life. All the information required to create a human is contained within genetics, as we now understand it. RNA molecules read the DNA within genes to create proteins and thus play an active role within cells by catalyzing biological reactions, controlling gene expression, or sensing and communicating responses to cellular signals. Also, I like to suggest that the translation of the genetic code by RNA is Original Qi (Yuán Qì 原氣). Especially since one of the most important functions of RNA is protein synthesis, whereby RNA acts as template to direct the synthesis of proteins at the ribosomes within the cell. Every three nucleic bases represent a codon, which designates a specific amino acid. These amino acids are derived from xenoproteins catabolized by the digestive system and based on the sequence found in the structure of RNA (having complemented the DNA) human proteins are formed.

Proteins, Biochemical Reactions and Qi

I have also postulated that proteins are analogous to Qi in a broad understanding of what the polysemous word Qi encompasses. (For an expanded discussion of Qi and Qi Gong, see my article in Mayway’s newsletter archive: < href="https://www.mayway.com/articles/understanding-how-qi-gong-promotes-health" target="_blank">Understanding how Qi Gong Promotes Health) Qi is often translated as “energy” but it is that and much more; including the body’s inherent intelligence, information gathering and transmission, regulation of cellular functions via neurotransmitters, hormones, et al., Zang Fu function, and transformation and control. Human encoded proteins serve in or assist in all of these areas of physiology. Qi does not flow without proteins.

Most biochemical reactions do not occur at normal temperature and pressure (20°C, 1 Atm). However, within human cells, biochemistry describes how life literally exists. The mitochondria combine glucose with oxygen to extract the energy necessary to sustain life (remember the Citric Acid Cycle?). However, sugar in a bowl can be exposed to air and nothing happens or is transformed. That is because energy must be added to “force” the reactants to engage. This is called the energy of activation. Among the many, many functions of proteins inside human cells, biochemical reactions only occur because proteins act as a catalyst to lower the energy requirement for the reaction to take place. A catalyst composed only of protein (and if applicable, a small molecule cofactor) is termed an enzyme. An enzyme increases the rate of reaction without being consumed in the reaction by lowering the energy of activation. Instead of adding energy to make a reaction occur, protein catalysts can reduce the reaction's energy requirement. Proteinaceous enzymes can be used to promote or inhibit biochemical reactions, providing the basis of their regulatory function. Protein is not itself “energy”, but the action of proteins allows energy and living systems to be created and to flow.

Hallmarks of Aging

With this sort of “translation” in mind, let us explore how the hallmarks of aging due to depletion of Essence, loss of Yin or Yang, Blood deficiency, and disruption of the smooth flow of Qi, can be explained in terms of biomedicine. Primarily, scientific study focuses on the molecular and cellular bases of life and disease. Aging is characterized by various manifestations of the accumulation of cellular damage, which can cause diminished function, or in the case of cancer, uncontrolled growth. Here are twelve of the major characteristics of the aging process. The first five are the primary causes of damage to the organism. The remainder are responses of the damage, which are displayed in the aging phenotype. These hallmarks are interconnected, and all represent change occurring over time as one responds to various stressors and attempts to maintain homeostasis of the organism.

Genomic Instability

Genomic instability refers to the accumulation of genetic damage throughout life. Genomic instability is a feature of the genome and is not an aberration. Although there is redundancy within the genetic code and there are inherent repair mechanisms within the cell, this instability is a dynamic process that occurs continually in life, with evidence suggesting that the accumulation of damage becomes more obvious with aging.

Some of this damage is inherited, even if it only represents a potential susceptibility to disease or dysfunction. However, the integrity and stability of DNA is continuously challenged by exogenous physical, chemical and biological agents, as well as by endogenous threats including DNA replication errors, spontaneous hydrolytic reactions, and reactive oxygen species (ROS), such as the superoxide radicals produced in mitochondria. ROS can also be formed by or stimulated by a variety of agents such as environmental pollutants, heavy metals, tobacco, smoke, drugs, pesticides, food additives, carcinogens, microplastics, or ionizing radiation, (e.g., ultraviolet, X-rays, and gamma rays), et al.

DNA damage may occur in the nucleus or in the mitochondria. The genetic lesions arising from extrinsic or intrinsic damage are highly diverse and include point mutations, translocations, chromosomal gains and losses, telomere shortening, and gene disruption caused by the integration of viruses or transposons. (A transposon is a nucleic acid sequence in DNA that can change its position within a genome, sometimes creating or reversing mutations and altering the cell's genetic identity and/or the genome.) DNA alterations may affect essential genes, DNA repair mechanisms, and transcriptional pathways, resulting in dysfunctional cells that, if not eliminated by apoptosis (programmed cell death) or senescence (loss of function due to aging), may jeopardize tissue and organismal homeostasis and lead to serious disease, including autoimmunity.

Telomere Attrition

Although DNA damage occurs randomly within an organism, telomere attrition is particularly related to age-related deterioration. A telomere is a region of repetitive nucleotide sequences associated with specialized proteins at the ends of linear chromosomes. Replicative DNA polymerases lack the capacity to replicate completely the terminal ends of linear DNA molecules, a function that is proprietary of a specialized DNA polymerase known as telomerase. However, most mammalian somatic cells do not express telomerase, and this leads to the progressive and cumulative loss of telomere-protective sequences from chromosome ends. Each time a cell divides with the concomitant replication of chromosomes, the telomere region becomes shorter. DNA damage at telomeres causes a persistent type of DNA damage that leads to deleterious cellular effects including senescence and/or apoptosis. Telomerase deficiency is associated with premature development of diseases, such as pulmonary fibrosis or aplastic anemia, which involve the loss of the regenerative capacity of different tissues. Studies show that there is a strong relation between short telomeres, aging, and mortality risk.

Epigenetic Alterations

Epigenetics is the study of stable changes in cell function that do not involve alterations in the DNA sequence. Epigenetics is the study of how your behaviors and environment (internal and external) can cause changes that affect the way your genes work. Unlike genetic changes, epigenetic changes are theoretically reversible, but they can change how your body reads a DNA sequence.

Epigenetics involves changes that affect the regulation of gene expression to turn genes “on” and “off., and these changes can persist through cellular division and subsequent generations. Epigenetic alterations affect all cells and tissues throughout life. Endogenous epigenetic agents include DNA and RNA methylation and histone (proteins around which DNA can wind for compaction and gene regulation) modification. For example, in colorectal cancer, abnormal methylation at DNA regions near certain genes affects expression of these genes. Consequently, some commercial colorectal cancer screening tests use stool samples to look for abnormal DNA methylation levels at one or more of these DNA regions.

Exogenous epigenetic agents include certain antibiotics, lithium, opioids, endocrine disrupting chemicals, chronic exposure to addictive stimuli (from any source), histone mimicry of SARS-CoV-2, and more. In addition, your behaviors and environment, such as what you eat, whether you smoke, and how physically active you are can cause epigenetic alterations. Epigenetic alterations can be transmitted intact through successive generations of cells (and even offspring) and carry with them a change in the behavior or expression of a gene. Epigenetic changes as one ages can either promote health or, more commonly, be a significant factor in aging.

Loss of Proteostasis

Proteostasis or protein homeostasis refers to an array of quality control mechanisms to preserve the stability and functionality of the entire set of proteins expressed by a genome. The primary structure of proteins is a polypeptide chain of amino acids, the correct sequence of which is encoded in DNA, read by mRNA, and produced in ribosomes. The secondary structure of proteins is determined by the stereochemistry of the various amino acids and are formed into either an α helix or a β pleated sheet. However, it is the tertiary structure of proteins which is vital for their correct function. Most proteins form globulin structures based on hydrogen bonding, ionic bonding, dipole-dipole interactions, or covalent bonds formed from disulfide bridges. Every human protein formed from its proscribed amino acid sequence is created the same way every time. The active part of the molecule is always located in the same place with the same structure. If an amino acid is miscoded due to a mutation in the DNA (or mRNA), or is out of place, or missing entirely, the protein's functionality may be compromised. Physiologically, proteins require an environment of specific temperatures, pH, and protection from certain chemicals, otherwise, the protein can become denatured, losing its three-dimensional structure, and becoming non-functional. Misfolded or unfolded (due to denaturing) polypeptides must be removed or degraded completely, or the accumulation of damaged components will result in disease, chronic inflammation, and aging. Chronic expression of unfolded, misfolded, or aggregated proteins contributes to the development of certain age-related pathologies, such as Huntington’s disease, Alzheimer’s disease, Parkinson’s disease, and cataracts. Many, many, so-called autoimmune diseases are the result of the immune system doing its job by recognizing defective proteins being expressed through cell membranes as “foreign” (i.e., not the correct configuration) and destroying the cell(s), tissue(s), or organ(s) that are responsible for creating the defective protein.

Disabled Macroautophagy

Autophagy (lit. “self-digestion”) is the natural degradation of cells that removes unnecessary or dysfunctional components and promotes the recycling of cellular components including damaged organelles, cell membranes, and proteins. Defects in autophagy have been linked to various human diseases, including neurodegeneration and cancer. Insufficient autophagy is one of the main reasons for the accumulation of damaged cells, chronic inflammation, and aging. Autophagy has been shown to decrease with age and disabled autophagy is a major risk factor for osteoarthritis. Autophagy is constantly activated in normal cartilage, but it is compromised with age and precedes cartilage cell death and structural damage. White blood cells (WBC) normally activate inflammation to enhance the capacity of the immune system to clear infections and damaged tissue and to initiate the processes that restore tissue structure and function. This is coupled with other WBC serving as macrophages in the removal of cellular and bacterial debris after which the inflammatory process ends, and healing begins. When one ages, the immune system develops diminished functionality and one of the results is diminished macroautophagy. The accumulation of cellular detritus within certain tissues results in dysfunction. A prime example of this accumulation occurs in atherosclerosis. (see: “Atherosclerosis and Traditional Chinese Medicine”).

Deregulated Nutrient Sensing

Deregulated nutrient sensing occurs in the four pathways of nutrient-sensing that regulate metabolism and influence aging. These proteins are called “nutrient-sensing” because nutrient levels influence their activity. The four associated key protein groups are:

IGF-1 (insulin-like growth factor) which works with GH (growth hormone) to regulate the growth and longevity of an organism. GH and IGF-1 levels decline during normal and premature aging. Somewhat paradoxically, attenuation of IGF-1 (mostly through diet restriction) appears to improve lifespan, as one ages. In fact, when older humans have higher IGF-1 activity levels, there is an increased risk of certain cancers, with the increase in IGF-1 promoting increased cancer cell growth. Decreased activity of IGF-1 during aging is thought to be a strategy of human cells to slow down cell growth and metabolism, which lessens the wear and tear and increases lifespan.
mTOR is “mechanistic target of rapamycin”, two groups of proteins that sense amino acids and nutrient abundance. They act as a type of enzyme, a kinase, which adds phosphates to molecules and are especially active in anabolic metabolism. Lower activity of mTOR lengthens lifespan, although very low activity can reduce healing and decrease insulin sensitivity. Higher levels of mTOR, which are more common, can promote late-life obesity. Abdominal obesity is a major contributor to insulin resistance, metabolic syndrome, and chronic inflammation. Both obesity and aging are conditions leading to serious health problems and increased risk for disease and death.

Sirtuins (SIRT) are a family of seven signaling proteins involved in metabolic regulation that appear to maintain their basic structure and function throughout all kingdoms of life. Sirtuins are implicated in influencing cellular processes like aging, transcription, apoptosis, inflammation, and stress resistance, as well as energy efficiency and alertness during low-calorie situations. Several SIRT are involved in DNA repair, particularly recombination repair in the case of DNA breaks. Over 25 naturally occurring chemicals, which are obtained from diet or herbs, stimulate SIRT including flavonoids, polyphenols, curcumin, paeonol, pterostilbene, berberine, and several other antioxidants.
Adenosine monophosphate-activated protein kinase (AMPK) is a group of twelve proteinaceous enzymes that activate glucose and fatty acid uptake and oxidation when cellular energy is low and when nutrients are scarce. The action of AMPK inhibits synthesis of fatty acids, cholesterol, and triglycerides, activates fatty acid uptake and utilization, stimulates the uptake of glucose in skeletal muscle, and activates autophagy. AMPK inhibits the energy-intensive protein biosynthesis process and activates pathways that generate energy to restore appropriate energy levels in the cell, even in cases of low nutrient availability. Some evidence indicates that AMPK may have a role in tumor suppression. AMPK activity is stimulated by both single bouts of exercise and long-term training. Metformin, a diabetes drug that appears to have a life extension effect, activates AMPK. Calorie restriction, which is believed to increase lifespan, can also increase the activity of AMPK.

Mitochondrial Dysfunction

Mitochondrial dysfunction describes an aging phenomenon in which the efficacy of the respiratory chain tends to diminish, thus increasing electron leakage and reducing adenosine triphosphate (ATP) generation. The mitochondrial free radical theory of aging proposes that the progressive mitochondrial dysfunction that occurs with aging results in increased production of reactive oxygen species (ROS), which in turn causes further mitochondrial deterioration and global cellular damage. It should be understood that mitochondria possess DNA (mtDNA) that is independent of nuclear DNA and is subject to the same mutations, deletions, and telomere shortening that are described above, any of which may impair function.

Cellular Senescence

Cellular senescence describes a phenomenon wherein a cell ceases to divide. This can be caused by random DNA damage, ROS/oxidative stress, or telomere shortening. Usually, cells can divide only a finite number of times before being removed (by the immune system) and replaced in tissues. In young organisms, cellular senescence prevents the proliferation of damaged cells, thus protecting from cancer and contributing to tissue homeostasis. During aging, the pervasive damage and deficient clearance and replenishment of senescent cells results in their accumulation, and this has many harmful effects on tissue homeostasis. Primarily, this may be due to exhausted regenerative capacity of progenitor cells and particularly stem cells. The accumulation of senescent cells leads to chronic inflammation, which can extend to adjacent cells, and decreased tissue function. Senescent cells contribute to the aging phenotype, including frailty syndrome, sarcopenia (loss of skeletal muscle), and other aging-associated diseases. For example, senescent nerve cells contribute to neurodegeneration, perhaps contributing to decreased motor skills or cognition.

Stem Cell Exhaustion

Stem cells (SC) are mostly undifferentiated cells that can be modified into diverse types of cells and proliferate indefinitely to produce more of the same stem cell. They are the earliest type of cell in a cell lineage. They are found in both embryonic and adult organisms. They are the source of progenitor cells, which cannot divide indefinitely, and precursor of blast cells, which are usually committed to differentiating into one cell type. Commonly, in adults, they are found in the bone marrow or gonads. They are pluripotent, able to replenish rapidly nearly any cell type including blood and immune cells, basal (skin epithelium) cells, and mesenchymal (bone, cartilage, muscle, and fat) cells. Stem cells are vital for self-renewal, cell replacement, and proliferation. Ideally, stem cells remain quiescent until needed because this promotes the long-term functionality of stem cells.

Stem cell exhaustion is the consequence of the multiple types of aging-associated damage to cells already described and likely constitutes one of the ultimate culprits of tissue and organismal aging. Recent promising studies suggest that stem cell rejuvenation may reverse the aging phenotype at the organismal level. One method of SC rejuvenation involves the introduction of “fresh” stem cells from embryos or young organisms. Stem cells derived from an individual’s own tissues can be harvested and grown in vitro and these SC can provide anti-aging effects.

Altered Intercellular Communication

Primarily the result of cellular senescence, altered intercellular communication refers to degraded endocrine, neuroendocrine or neuronal communication between cells and the extracellular milieu. Neurohormonal signaling (e.g., renin-angiotensin, adrenergic, insulin-IGF-1 signaling) tends to be deregulated in aging as inflammatory reactions increase, immunosurveillance against pathogens and premalignant cells declines, and the composition of the peri- and extracellular environment changes, thereby affecting the mechanical and functional properties of all tissues. Senescent cells are known to secrete an inflammatory, immunosuppressive, and harmful mixture that has been shown to encourage neighboring cells to become senescent (the by-stander effect) and may contribute to multiple age-related diseases.

Chronic Inflammation

Acute inflammation is indispensable for immune responses to invading pathogens or acute traumatic injuries. This process enables repair and cell turnover in multiple tissues. Chronic inflammation normally causes low-grade and persistent inflammation, leading to tissue degeneration and is a crucial contributor to aging and age-related pathologies. Age-dependent chronic inflammation is called “inflammageing”. Aging correlates with high levels of inflammatory mediators in the blood (cytokines), such as IL-1 (IL= interleukin), IL-6, C-reactive protein, IFNα (interferon alpha), TNFα (tumor necrosis factor) and several others. Chronic inflammation is thought to be a risk factor for a broad range of age-related diseases such as hypertension, diabetes, atherosclerosis, and cancer. Factors that initiate and maintain a low-grade chronic inflammatory response include aging (immune and cellular senescence), an “unbalanced” diet, low levels of sex hormones, accumulation of visceral fat (overweight or obesity), ROS, accumulated cellular debris, pro-coagulation factors, gut dysbiosis, and smoking (cigarettes, cannabis, fire smoke). Most if not all age-related diseases share an inflammatory pathogenesis.

Dysbiosis and Microbiome Disturbance

The barrier of the oral and gut mucosa against bacterial invasion deteriorates with age. Periodontal disease has also been demonstrated to cause chronic low-grade inflammation. The gut microbiota of elderly people displays decreased diversity which may lead to increased susceptibility to infectious agents and anti-inflammatory microbiota are diminished. The causes of this dysbiosis, besides the actions and interplay of the other hallmarks of aging, include pathogens (and the use of broad-spectrum antibiotics), environmental pollution, hormonal variations, genetic pre-disposition, unbalanced nutrition, and onset of various diseases, including allergies and auto-immune. Diseases such as cancer, irritable bowel syndrome, rheumatoid arthritis, acne, gastric ulcers, obesity, hypertension, some pulmonary disorders, other digestive complications, and neurological abnormalities can ensue. Rebiosis, the re-establishment of the native microbiota is an excellent remedy against this condition. Probiotics, prebiotics, and synbiotics are potent therapeutic tools designed to rectify this situation. Probiotics such as Lactobacillus spp. act like stem cells in replenishing and rejuvenating the microbiome, while prebiotics like fructose oligosaccharides (FOS) are microbiome fertilizers, promoting the proliferation of select microbes.

Striving for Longevity

Finally, how does one mitigate the hallmarks of aging, support Essence, and promote longevity while maintaining a certain quality of life? First, it helps to have acquired strong Jing from one’s parents. Longevity does run in families. Avoidance of communicable disease is paramount. What else?

Certain significant risk factors can be eliminated, especially smoking, and limiting alcohol consumption.
Maintaining a healthy weight, although unintentional weight loss is a risk factor. Studies show that maintaining a healthy weight increases one’s chance to living to be 90 years old by 50-100%
Eating a restricted calorie, balanced diet, heavy in whole foods, legumes, fruits, and vegetables, with the Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diets suggested. The importance of eating organic food as much as possible and avoiding highly processed foods cannot be underemphasized. Drinking clean water and avoiding sweetened drinks such as soda (soft drinks) and fruit juices are likewise recommended.
Exercise (although not too much) with qigong or yoga playing a prominent role. Muscle mass is a better predictor of longevity than one’s weight or body mass index (BMI), so strength training should also be a focus.
Adequate rest and sleep (although not too much) is required to maintain homeostasis. One should shoot for 7-9 hours each night. Poor sleep and trying to make up the deficit by napping come with a greater risk of premature death.
Exercise your cognitive skills by reading, writing, and playing games. Engage a new skill such as taking up a musical instrument, expand your computer knowledge by learning new software program, learn to sew, knit, or quilt. Keep your mind active and stop watching television.
Maintaining your mental health. Meditation or contemplation helps with maintaining mental fitness, as does avoiding social isolation, stress, and depression. Participating and volunteering in your community can foster a sense of purpose and create a positive mental affect. Having gratitude for your relative health and longevity makes every day worthwhile. Enjoy the wonder of Nature.
Engage in leisure activities and hobbies. Hiking (or walking), biking, traveling, music, theater, dance, creative writing, and other participatory arts improve older adults’ quality of life and well-being. It is so important to have fun and to stay involved in life.
Go to your doctor, especially your acupuncturist, for regular treatment and health screenings that are essential for healthy aging. Early intervention can be critical to arrest the deterioration of one’s health. And do not forget that Chinese herbs and acupuncture can offer significant adjunctive therapies in the aging process.

Having reached elderhood, I find myself intimately contemplating the challenges of aging. I am lucky to have a bunch of old codgers in my family tree, especially the men. My grandmother used to say that most were “too mean to die”. I am not sure that it is a necessary component, but I am committed to doing what I can to remain as healthy as possible. Will I make it to 115 though? Perhaps, 90? I will let you know how it goes.

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About the Author

Skye Sturgeon, DAOM is the Quality Assurance Manager and Special Consultant for Mayway, USA. Skye was the former Chair of Acupuncture & East Asian Medicine and core faculty member at Bastyr University, core faculty member and Faculty Council Chair at the American College of Traditional Chinese Medicine, and President and Senior Professor of the Acupuncture & Integrative Medicine College, Berkeley. Before making Chinese medicine his career choice, Skye held various positions in the Natural Foods Industry for 12 years and prior to that was a clinical biochemist and toxicologist.