In older people, chronic diseases tend to come in a package, with more than 70% of people over the age of 65 years having at least two age-related disorders (eg, arthritis, diabetes, cancer, heart disease, and stroke).1
While eating well and exercising regularly can help extend a healthy life, studies suggest that it may be possible to make even more improvements by slowing the metabolic and molecular causes of aging.
“You don’t have to be a mathematician or an economist to understand that our current health care approach is not sustainable,” said Luigi Fontana, MD, PhD, Professor of Medicine and Nutrition at Washington University in St. Louis, and Brescia University, Italy.
Although the approach of "targeting diseases has helped people live longer, they are spending more years being sick with multiple disorders related to aging,” Dr. Fontana said, lead author of an article in Nature.2
Dr. Fontana and colleagues believe that more focus should be placed on preventing these chronic diseases from developing in the first pace, and note that treatments that delay one age-related disease often prevent other conditions as well.
“Heart failure doesn’t happen all at once,” Dr. Fontana said. “It takes 30 or 40 years of an unhealthy lifestyle and activation of aging-related pathways from metabolic abnormalities such as high blood pressure, high cholesterol, and type 2 diabetes to give a person heart failure in his or her 60s. So we propose using lifestyle interventions—such as a personalized healthy diet and exercise program—to down-regulate aging pathways so the patient avoids heart failure in the first place.”
Research by Dr. Fontana and colleagues suggest potential benefits from dietary restriction in extending healthy life span. For example, mice that are given healthy, low calarie diets live up to 50% longer. Likewise, people who eat significantly fewer calories, while still getting optimal nutrition, have healthier hearts and less inflammation (markers of aging) in their bodies, and skeletal muscles that function like those in people who are younger.3
Dr. Fontana and his co-authors also note that several pathways shown to promote long and healthy lives in animals are affected by medications that are already on the market, such as rapamycin (approved to treat cancer and prevent organ rejection in transplants) and metformin (used to treat type 2 diabetes).
While testing strategies for extending a healthy life are needed, funding for these studies is challenging, according to the authors. Currently, funding is primarily given to research on treatment for age-related diseases rather than to research disease prevention, they explained. Given the aging of the United States population, this sets the stage for a country with rising disability rates and increasing health care costs, the authors noted.
“The combination of an aging population with an increased burden of chronic diseases and the epidemic of obesity and type 2 diabetes could soon make healthy care unaffordable for all but the richest people,” Dr. Fontana added.
Joanne Gallivan, MS, RD, Director of the National Diabetes Education Program offered the following tips for delaying or preventing type 2 diabetes: