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Summary Nutrition And The Ageing Body (HNH34106)
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Nutrition and the ageing bodyLecture 2 Nutrition and the ageing body
Life span
In Europe, life expectancy increases
- +5.7 years between 2000 and 2019
- 21% of Europeans > 65 years (n=106M)
- Projection for 2050:
o 30% of Europeans > 65 years o ~ 150 M Europeans
The proportion of older people in the society increases.
Maximum life span
The maximum life span does not increase. The maximum life span is the highest age recorded in
documents among the worlds. The highest age that was documented goes slightly up but seems to
go down again. The oldest person ever lived: Jeanne Calment (122 years, died in 1997). There seems
to be a cap on maximum life span, but that is unknown yet.
Healthy lifespan
The health span represents the healthy life span of a person and is the years of life spend in good
health. It is a bit controversial because what if a person is born with diabetes type 1? Does this
person than has a healthy lifespan of 0? The controversy in healthy lifespan is that they make healthy
binary; it is either healthy or unhealthy, but in real-life health is more on a spectrum. Still, it can be a
helpful concept e.g., for interventions preventing ageing-related deterioration. Because what we
don’t want is that we make people life longer, but we want them to life longer in health.
If we plot life expectancy and healthy life expectancy, you see that the lines are moving apart from
each other. The gap between healthy life expectancy and total life expectancy increases, that means
that we nowadays live longer in poor health. We want to increase life span, but we want people to
live a high quality/a healthy life for the extra years that they add to their lives.
The main reason of this gap is that cardiovascular diseases, diabetes, cancer, and neurological
diseases are the main reasons for decreased health span – gap between healthy life expectancy and
life expectancy. Because people suffer a lot from cardiovascular diseases, diabetes, cancer, and
neurological diseases, like Alzheimer diseases and dementia.
Health gap variation
Recently in the Dutch news (“Gezondheidsverschillen tussen Nederlanders terugdringen moet
wettelijke plicht worden”) – “We must close the health-gap between people in the Netherlands”.
Because Dutch people with a low income and practical education versus high income and theoretical
education have a:
- 7-year gap in lifespan - 15-year gap in health span
Prevention
On front page: “Health care insurance companies demand focus on prevention”. The current health
care system with the focus on curative medication is not helping and not sustainable and we should
move to prevention driven health care.
,Policy movement towards prevention
- National Prevention Agreement
o Smoking o Alcohol abuse
o Obesity
- Advice Council for Public Healthy & Society
o Sugar levy, lower tax on fruits and vegetables, ban commercials for unhealthy foods
o Less fast-food shops in certain areas, such as around high schools
A focus more on prevention instead of curation. This is not only seen in the Netherlands, but also in
the UK, which is mainly driven by the Corona pandemic.
- “UK set to bring in strict new junk food rules including pre-9pm ad ban”
- “UK to ban all online junk food advertising to tackle obesity”
Influence COVID-19 on
- Maximum lifespan - Health span
- Average lifespan - Socio-economic gap in health span
Genetics and lifespan
Lifestyle versus genes
Lifestyle and environment are more important for longevity than genetics.
Health gap variation
Recently in the Dutch news (“Gezondheidsverschillen tussen Nederlanders terugdringen moet
wettelijke plicht worden”) – “We must close the health-gap between people in the Netherlands”.
Because Dutch people with a low income and practical education versus high income and theoretical
education have a:
- 7-year gap in lifespan - 15-year gap in health span
This is a case of lifestyle and environment.
Blue zones
Blue zones are zones in the world with extreme longevity. There are different areas, which are
characterized by
- Areas of exceptional longevity - Strong community
- Highly active - Locally produced food, non-processed
- Low levels of stress
Loma Linda
Loma Linda is an area in California. The people who live here are 7th day Adventists (religious
community), strict vegetarians, don’t drink alcohol, and have a strong community feeling. They life 10
years longer than normal American people and seem to be protected against chronic diseases.
Sardinia
In Sardinia there is a region where people reach high ages way more frequently than in other regions
in the surroundings. The average number of centenarians (people above 100) is much higher in this
region.
,Okinawa
Okinawa is an island south of Japan, where people also reach exceptional high ages.
Blue regions
There are a lot of lifestyle factors that seem to be affecting
the longevity in these regions. If people from different
regions move to such a region, they also experience the
benefits and if people move away from such a blue zone to
elsewhere, they see more cardiovascular disease and bowel
cancer. Thus, if it would be the genes protecting, it would not
matter where you live, but it is really the environment and
the lifestyle that plays a role here.
Effect lifestyle on lifespan
- Large multi-cohort study in high-income countries (Stringhini et al., 2017)
o Smoking: -4.8 years o Alcohol abuse: -0.5 years
o Physical inactivity: -2.4 years
- Impact of diet was not assessed, but intermediates:
o Diabetes: -3.9 years o Hypertension: -1.6 years
o BMI: -0.7 years
A clear effect of lifestyle on lifespan.
Genetics
If you have a sibling of > 100 years old, you have a 4-8 times higher chance to reach 100 year
yourself.
Genetics versus lifestyle
- Long-lived sibling increases change to reach high age
- Parents and offspring of long-lived persons also reach higher ages
- However, also spouses of long-lived persons reach higher ages
- Spouses are not genetically similar, but share
o Traits o Environment
o Behaviour
- Longevity families: combination of genetics, environment, and cultural factors
Twin studies
Twin studies are used to unravel the true genetics determinants from environmental determinants.
Also, comparison of monozygotic versus dizygotic. The estimation of true heredity of lifespan:
- Max. 25% - Most recent estimates: around 12%
Genes that play a role in longevity
Many studies have tried to explore associations between variations in the genome and longevity, but
only two gene locations (loci) have been identified in multiple studies:
- APOE (ε2 protective, ε4 deleterious)
o Apolipoprotein E: a cholesterol carrier in peripheral tissues and the brain. Associated
with susceptibility to cardiovascular diseases and Alzheimer’s diseases
- FOXO3A
o Trigger for apoptosis (programmed cell-death)
, Evolution of ageing
Why does ageing exist? Is there an evolutionary benefit?
Human species experience ageing mainly after their reproductive fitness – the lifespan you live until
you have offspring. This is called ELS = Essential Life Span: the period of survival of the body until
reproduction, for which evolutionary forces and natural selection have resulted maintenance
mechanisms protecting structural and functional designs of the organism. For human beings, what
would be the:
- ELS: menopausal age (around 50 years) - Maximum lifespan: 122 years
- Average lifespan: 80 years
There is no evolutionary advantage of ageing and limited lifespan, there is no need for nature to
remove organisms from the population. Under natural conditions death will occur before old age
(accidents, diseases, predation). There were no mechanisms ever needed to ‘make room for new-
borns’. Ageing is result of absence of natural selection pressures. After you have reproduced, there
are no evolutionary pressures selecting genes that promote lifespan and health at later age.
Verdict
Lifestyle and environment are more important for longevity than genes, at least 75% versus 25%.
Wrap-up
- Lifespan increases, but gap with health span increases
- Large gap in lifespan and health span between people of different socioeconomic classes
- The focus on preventive medicine is increasing
- There is no evolutionary benefit of ageing
- Lifestyle and environment are more important than genetics
Lecture 3 Nutrition and the ageing body
What is ageing and when does it start?
What is ageing?
Definition
Ageing is the process during which structural and functional changes accumulate in an organism
because of the passage of time. The changes manifest as a decline from the organism’s peak fertility
and physiological functions until death.
Accumulation of damage
- Partly inevitable, from the inside
o Metabolism o Genetic predispositions
o DNA replication damage
- Preventable from the outside
o Exposure to toxins o Smoking
o Sunlight o Radioactivity
o Alcohol
Ageing is an accumulation of damage.
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