Ed i to r ia l

Anti-ageing – fact, fiction or faction?

Interest in this area is never far below the surface

with more people living longer and wishing to

continue doing all the activities they have always

done, social and physical, wanting to retain their

‘good looks’ and also, in many cases being prepared

to spend their earnings in order to achieve these

ambitions. Since telomeres were first observed over

50 years ago, these structures have taken on

increasing importance in studies of a cell’s health

and continued functioning. These structures are

found at the ends of our chromosomes and it has

been known from the work of Harley and Greider in

the 1990s (Nature, 345; 458–460, 1990) that they

shorten over time and that these play a significant

role in cellular ageing. It was also shown that the

enzyme, telomerase can prevent this happening.

Research by Epel et al. (PNAS, 101; 17312–17315,

2004) indicated that stressful events both perceived

and chronic, such as depression and traumatic

events can reduce telomerase activity as well as

lifestyle events including obesity, sedentary life-

style, smoking, high blood pressure and lack of

certain nutrients such as antioxidants and certain

fatty acids (Epel et al. Psychoneuroendocrinology, 31;

277–287, 2006). They found that women with high

levels of stress have shorter telomeres equivalent to

at least a decade of additional ageing compared to

women with low levels of stress. The group pro-

posed that these results could explain how stress

could lead to potential early onset of age-related

disorders and that telomerase could be an important

mediator of the effects of stress on general health

and well being. From research on mice where the

effect of the enzyme was enhanced genetically, age

related changes were reduced (Jaskelioff et al., Nat-

ure, 469; 102–106, 2011). The group noted that telo-

mere loss lead to progressive atrophy of important

tissues, depletion of stem cells and a reduced tissue

response to injury. However, if the telomerase

activity was reactivated, neural degeneration was

reversed and therefore maintaining telomere

integrity could be a key factor in reducing the ageing

process. Hence the proposal is if this could be rep-

licated in humans such that increased telomerase

activity and therefore telomere length maintained,

a longer life expectancy beckons. However, a word

of caution needs to be considered as we would also

have to deal with our stressful lifestyle which could

easily undo all these advantages.

An interesting article was written by John Naish

(The Times, 23.07.11) asking the key question ‘Just

how far will you go for a longer life?’ One of the

key elements he referred to was a food supplement

called TA-65 which can be extracted from the dried

root of Astragalus membranaceus, a herb which is

harvested from certain parts of China and has been

used in Chinese medicine for many years. This

extract has been found to restore DNA damage and

promote elongation of shortened telomeres and

researchers propose that its mechanism is through

the telomerase pathway (de Jesus et al. Aging Cell, 10;

604–621, 2011). They found from their study in

mice that TA-65 produced an improvement in

glucose tolerance, osteoporosis and health of the

skin, all of which would impact on life expectancy

issues.

It has been reported that the anti-ageing industry

in America is worth $88 billion (The Observer, Sep-

tember, 2010) but that there are very few regulations

to protect the public. Much of this appears to be

related to replacing and maintaining hormonal

levels in the ageing body, particularly testosterone

and oestrogen. It is possible to obtain these in tablet

form from the internet for as little as £50 for a

month’s supply or as an injectable solution for

much the same price This may sound very simple

in theory but can present enormous problems in

reality as there appears to be virtually no control

over the amount that can be ordered. Also the use

of Botox is now common place and is provided by

many dental practitioners as an adjunct to the

range of cosmetic treatments they offer to their

patients. Botulinum toxin is a protein produced by

the bacterium Clostridium botulinum, and is consid-

ered one of the most powerful neurotoxins dis-

covered but is now used under the trade name of

Botox. Since 2002, it has been licensed by the Food

and Drug Administration (FDA) for use in the

cosmetic treatment of wrinkles and facial frown

lines. Again this line of treatment is readily avail-

able and relatively cheap at around £150 per

session. However once the process has started, it

needs to be repeated every 6–8 months to maintain

the effects. Unfortunately many of these protocols

are touted by people in the media and they have a

significant influence over some of the general

public who wish to replicate their ‘star’s’ appear-

ance and youthful looks. In relation to TA-65, there

are now some companies offering to measure your

telomeres, evaluate your life expectancy and then

develop a plan to co-ordinate a range of food sup-

plements, with the view of prolonging your life. Of

� 2011 The Gerodontology Society and John Wiley & Sons A/S, Gerodontology 2011; 28: 163–164 163

course there is a fee for this which amounts to

$11610 for 6 months. However if you don’t want

to go down that line, you can purchase your own

supply of TA-65 from the internet for $2200, again

for a 6 months’ supply but you also need to pay

$2800 for the doctor’s fee and some essential test-

ing. This may seem expensive but to many ‘baby

boomers’ who want to prolong their life and life-

style this may be a price worth paying.

As well as these, there are the anti-ageing diets

which suggest that you should take steps to reduce

your body weight to 10% below your ideal body

weight by restricting salt, sugar and saturated fat

intake and increasing oily fish, fresh fruit and

vegetables. These caloric restriction diets have been

shown to enhance life expectancy and improve

health in many animals such as mice, rats, fish and

dogs. Research is being carried out on primates to

investigate its effects and the results to date are

positive but these are longitudinal studies which

will take time to complete (Heilbronn and Ravussin,

Am J Clin Nutr 78; 361–369, 2003; Anderson et al.

Toxicologic Pathology, 37; 47–51, 2009). Some research

has already shown that the risk of cardiovascular

disease is reduced. In addition, various lists of the

top 10 anti-ageing foods have been produced. These

include; avocado as a source of vitamin C and

unsaturated fat, high in potassium which are

thought to maintain healthy skin, prevent fluid

retention and high blood pressure; nuts as a source

of potassium, magnesium, iron zinc, copper and

selenium which may help the immune system;

soya which may protect against Alzheimer’s disease

and osteoporosis; berries which contain flavonoids

which protect the tissues from damage by free

radicals and cruciferous vegetables such as cabbage,

broccoli, kale, cauliflower and turnip which are said

to protect the body from cancer. There are many

more but a balanced diet with all foodstuffs in

moderation and a sufficient level of exercise would

seem to be a sensible approach to healthy living

without the need for expensive diets or restrictive

regimens.

So where do we go from here? One of the key

questions that must be addressed is whether all or

some of these ‘treatment’ regimens or lifestyle

proposals actually provide improved quality of life

to our patients and society at large. If they do, then

the changes to society will be profound and a

whole new series of issues will arise which will

impact significantly on all age cohorts. Recent

studies by Professor Caspari have suggested that in

the advancement of Homo sapiens, enhanced lon-

gevity of older members of the clans allowed

experiences and skills to be passed on the future

generations. However, in modern society, the evi-

dence for the positive effects is not yet proven and

there are those who believe that all we may do is

extend life but with an even longer period of

debilitation, ill health and fragility.

‘Beautiful young people are accidents of nature, but beau-

tiful old people are works of art.’

Eleanor Roosevelt (1884–1962)

James P. Newton

Editor

� 2011 The Gerodontology Society and John Wiley & Sons A/S, Gerodontology 2011; 28: 163–164

164 Editorial