We spend much of our lives being told we will fall apart as we get older. Now, science and a new regard for a healthy lifestyle are beginning to change that dialogue. Healthy aging can mean many things to different people. Whether you think of wrinkles or cognitive function, mobility or energy, Dr. Tieraona Low Dog, author of Fortify Your Life (National Geographic Books, 2016), says, “We want to help people live a life that is fulfilling and independent as long as they can—physically, functionally, emotionally, cognitively. Healthy aging should be about having a life that is fulfilling and meaningful, no matter what you are struggling with.”
There are some realities to aging. For starters, our bodies become less responsive to insulin, the hormone that regulates blood sugar. This can be problematic for people who have diabetes and is a reason why, Low Dog explains, incidence of the disease increases over the age of 60. She adds that we also store more fat with age—fat in our livers, around the tummy and in places where we are not supposed to be storing fat, which can ultimately contribute to heart disease.
Changes occur on a cellular level, too. “Our mitochondria, the little machines that generate chemical energy inside of our cells, begin to not work as well and drive the aging process. This is why people talk about antioxidants, to protect mitochondria from aging,” Low Dog says.
Yet health specialists are asking: Do things inevitably happen because of age, or can we modify the aging process by the way we live? A recent study on self-efficacy and aging showed that positively changing our expectations of how we think we will age makes a difference and influences how we do indeed age. As Low Dog says, “Active older people actually still remain responsive to insulin. And people who have a diet rich in whole foods have better mitochondria. If you are not loading up on carbs and fats, you don’t store so much fat.
“Part of what we are trying to counter is the dogma that we are all not going to age well,” Low Dog continues. She concedes that aging will inevitably bring changes, but contends that we may be able to delay a lot of the challenges that come with aging through our lifestyle choices. “The way we live our lives influences the expression of our genes. The way we live is the nurture part of nature, and lifestyle does matter.”
Her lifestyle recommendations will sound familiar—get enough exercise and sleep, eat whole foods, limit intake of sugary carbs, manage stress, and nourish relationships. She emphasizes to not take the importance of relationships for granted. “If you are exercising and you are all alone, that is really hard on your heart. In a recent study, depression and social isolation were more predictive of a woman having a heart attack than smoking, being obese or never exercising.”
Low Dog adds that you’ll need to fill gaps in your diet. “If you are low on certain micronutrients, it impacts your mood, immune response and bone health.”
As part of a daily routine, she advises that a good multivitamin formulated for people over 50 to 60 years of age should cover most nutrient needs, and that probiotics and fermented foods can boost immune response and a healthy microbiome. She also recommends herbs and foods like turmeric, garlic, onion and green tea—which offer health benefits and bridge the gap between supplements and food—and suggests considering supplements for the following nutrients, which can be challenging to get enough of from food alone.
A National Health and Nutrition Examination Study found that 15 percent of people age 70 and older are highly deficient in vitamin B12. As stomach acid declines with age, it’s harder to absorb B12—found in foods such as dairy, meat and poultry—thus increasing risk of deficiency. Many older people also use medications that lower B12 levels.
“The problem with deficiency is that the signs and symptoms often get written off as old age,” Low Dog says. These include depression, joint pain, cognitive decline and difficulty walking. Low Dog suggests looking for a multivitamin designed for people over the age of 50 or 60 that contains 100 to 500 percent of the daily value. “It sounds like a big range, but it’s still a low amount of B12.” If you are on medications, consult with your doctor.
“A lot of older people don’t spend as much time outdoors, and there is a decreased synthesis of vitamin D in the skin as you get older,” Low Dog says. She adds that vitamin D helps regulate absorption and homeostasis of calcium, which is necessary to maintain strong bones. Yet, as we age, it also is harder to absorb calcium and activate vitamin D in the kidneys. (Magnesium can help; see the next section). Low Dog recommends taking no less than 1,000 IU daily; ideally, 2,000 IU a day.
Low Dog suggests taking a calcium-magnesium citrate at night before bed and at a separate time than when you take your multivitamins. “These two are big compounds that can interfere with the absorption of iron, zinc and other nutrients.” According to Low Dog, magnesium is required to activate vitamin D in the kidneys.
Low magnesium is associated with ailments, such as metabolic syndrome, osteoporosis, inflammation, diabetes and low blood pressure. The citrate form is easier on the gut, which magnesium can sometimes irritate. For everyday use, Low Dog recommends taking 300 to 400 mg. But she suggests conferring with your doctor first if you are on medications.
This nutrient is important across the lifespan—from pregnancy and breast-feeding to healthy aging—says Low Dog, who suggests men take in 550 mg daily, women 425 mg. But, if you don’t eat eggs (one large hard-boiled contains 147 mg), meat (3 ounces beef contains 117 mg) or liver (3 ounces beef liver contains 356 mg), choline is hard to get.
Low Dog suggests looking for a supplement that has 100 to 200 mg of choline to top off your food intake. “Choline is important for cognition, the nervous system and healthy brain power. You don’t want to overdo it, but studies show we don’t get enough in our diet.”