The Principles and Practice of Antiaging Medicine for the Clinical Physician
The Human Genome Study
The human genome study has recently outlined the map of these key genes. In essence, it also contains an “aging code.” The genome was originally thought to contain approximately 100,000 genes; it is now known to contain approximately 30,000 genes. It is also now known that only a few thousand of these genes (perhaps 10%) may be active at any certain time during a specific period of our lives and that which set of genes are active changes as we grow, mature and age.
Each gene may code for not one but many purposes. It will be perhaps several decades before we can use this genetic information clinically, in the form of gene therapy, to intercede in the aging process and to see and feel the difference in our health and life spans.
But what information do we have from aging research and the human genome study right now that we can use to make a difference in how we age and, perhaps, improve both our health span and longevity?
In this book, I answer this question and also present a new paradigm on how we age. This is a model that can easily be incorporated into your practice or into your own personal lifestyle as a basis for improving how we age. I also present to you the radical concept that “we are built for self-repair and not programmed to die,” in contrast to how we currently think. Information gathered during the 1990s seems to indicate that the number of cell divisions within our organs need not be finite.1This may mean that we have a potential to live longer, healthier lives under the right circumstances and in the right environment.
These first pieces of information from the human genome study have already revealed important information about what we may call the aging code.
Telomeres, located on the end of each chromosome, are now thought to be one of the central clocks that control the cellular aging process. They have been shown to still be present in humans alive at 90 years of age and older. These studies on “ancient cells” indicate telomere positions that certainly should be able to undergo many more cell divisions. These “control clocks” are not located at the end of the chromosome as in “old age” but are positioned in such a way as to indicate the potential of many more cell divisions.1 Obviously, there occur cellular events that have not allowed us to reach our full potential as far as cell division repair and aging are concerned.
At the center of this new model of aging is the thought that if we can repair damage to DNA, as well as limit the damage in the first place, we would be able to allow genetic potential to reach its maximum. This should allow for a significantly longer period of health and a longer life span than is generally experienced at present.
The second most important piece of information that I focus on in this book has to do with the fact that embedded within our 46 chromosomes lies a “genetic code” that forms what can be viewed as an aging equation (Diagrams 4a and b). This equation seems to be responsible for controlling the cellular rate of aging, at least on a clinical observation level.
This code controls four main processes within the cell, which make up the basis of the aging equation. A review of the latest information3 revealed that the genes of these four main processes, to date, are located on chromosomes 1, 2, 8, 14, 17, 19 and 22.
The equation and these genetic codes can be manipulated right now to successfully treat age-related changes that we observe in the body. They are also responsible for controlling the age-related disease processes we all experience as we grow older.4 (For more detailed effects of these processes, see Diagram 5.)
Clinical anti-aging medicine now is, and for the next few decades will be, concerned with improving and controlling how efficiently the inherited genes that make up our individual aging codes actually function. To explain it in a more technical manner, what level of optimal genetic expression we are able to maintain, or induce, with age-management programs and anti-aging therapy will determine how we age, the quality of health of our lives and how long we live. From the viewpoint of cosmetic surgeons and physicians, it also determines how we physically look and how our appearance changes as time goes by.
Next, I would like to present a few facts that help emphasize why we need to focus now on anti-aging therapy and age-management programs. This is important, not just for our cosmetic patients, but in helping address a major world problem that is already presenting itself in every industrialized country throughout the globe (Diagram 6).
Fact: Every second, a baby boomer turns 50.
Fact: In 1995, the baby boomer generation saved $15 trillion for retirement. If the same disease patterns of aging continue, they will actually need $184 trillion to maintain their health as they age. There is not that much money on the planet.
Fact: Current medical anti-aging technology has the capability to provide at least 50% of the 76 million baby boomers with a healthy life expectancy of 90 to 100 years (Diagram 7a, 7b).5
Fact: A child born in 1997 in the U.S. can expect to live 76.5 years, which is 29 years longer than a child born in 1990.
Fact: Once we reach age 65, men can expect to live an additional 15.8 years, whereas women can expect to live an additional 17.6 years4 (Diagram 8).
Fact: By the year 2003, 14% of the budget of the United States will be spent on geriatric medicine.6
Fact: If the health span—that is, maintaining a healthy productive condition without disease—of every American could be extended one year, the U.S. economy would save $1–3 trillion.
Fact: By the year 2025 in the U.S., there will be two 65-year-olds for every young teenager.4
Fact: By 2030, the elderly population in the United States will grow to between 59 and 78 million, or one fifth of the total U.S. population (United States Census Bureau).4
Fact: By the year 2050, there will be as many as 2.2 million Americans over the age of 100 (Diagram 9). The global population will total 9.3 billion (Diagram 10).
Fact: If the same disease patterns continue in the next 20 years, the health care system of the United States will become bankrupt! (Laurence Kotlifoff, Economist, Brown University.)
Cosmetic surgeons and physicians see the middle-aged population increase year after year. We are in a unique position not only to offer this population cosmetic procedures to slow and reverse the effects of aging but also to introduce to them the ongoing science and programs to slow the causes of aging. We will become the source of age-management information and define its therapeutic goals (Diagram 11).