You are what you eat. You aren't if you eat too much.
Of all the potions and pills, schemes and dreams that claim to
possess the secret of living longer, only one method outside actual
genetic manipulation has been scientifically proven to extend life:
It's eating less, a lot less. Everything else – from herbal supplements
to hormones – is wishful thinking at best, life threatening at worst.
"There is no anti-aging medicine in existence in the world
today," says S. Jay Olshansky, a demographer and biologist at the
University of Illinois at Chicago. "There may be some value to some
products, but until they're thoroughly, scientifically tested, I
wouldn't use them."
Caloric restriction, what advocates and scientists call CR, is
the exception. In numerous studies dating back decades, CR has been
shown to significantly extend the lives of test organisms, sometimes
doubling their life spans.
But CR is no mere diet. It is not simply a matter of skipping the
daily doughnut or swapping out that burger for a salad. For most
people, particularly overfed and overweight Americans, CR constitutes a
radical transformation of lifestyle, a feels-like-starvation diet for
the rest of one's extended life.
"Few of us, I think, would voluntarily forgo a third of our daily
calories for the rest of our lives," notes Dr. David Lipschitz, a
professor of geriatrics at the University of Arkansas for Medical
Sciences and author of "Breaking the Rules of Aging."
"We simply don't have the stamina, or the desire, to go hungry all the time."
Which brings us to the obvious and much more desirable
alternative: Why doesn't somebody invent a pill that would reproduce
the life-lengthening effects of CR but without extreme dieting? In
fact, a lot of people are trying to do just that, though it's proving
to be a very tall order. Caloric restriction may be simple to describe,
but how it works turns out to be awfully hard to explain.
Follow the rats
The idea of caloric restriction extending life spans isn't new. A
Cornell University nutritionist named Clive M. McCay first tinkered
with it in the 1930s, discovering that lab rats on a low-calorie diet
lived an average of four years, compared to three for their freely fed
brethren.
But the possibilities of CR languished until the 1960s when Roy
Walford, a gerontologist at UCLA, repeated McCay's experiments with
mice to similar dramatic effect. A typical lab mouse has a life
expectancy of 39 months. Walford's test mice, eating just 60 percent of
their preferred diet, lived up to 56 months – the equivalent of 165
years for humans.
But Walford earned the most attention for his work and the
potential of CR by using himself as a guinea pig. For 30 years, Walford
subsisted on a daily diet of no more than 1,600 calories. The average
American consumes roughly 2,500 calories per day, most from high-fat,
processed foods.
By comparison, Walford's diet was decidedly Spartan. A typical
breakfast consisted of a protein shake and banana; lunch was a
vegetable salad; dinner a piece of fish or lean meat.
(Interestingly, Walford got a chance to observe how
others fared on his CR diet in the 1990s while participating in the
Biosphere 2 experiment. When plans to grow their own food went awry,
the Biosphereans resorted to an extreme low-calorie diet that lasted
almost two years. Walford later noted that despite significant weight
loss, all eight participants remained in excellent health.)
The 5-foot-9 Walford weighed just 130 pounds. He told people his
goal was to live to be 120 years old. He died earlier this year of
amyotrophic lateral sclerosis, or Lou Gehrig's disease, an incurable
neurological condition. He was 79, about five years older than the
average American male's life expectancy.
Walford's death, however, has not dimmed enthusiasm for CR. It
remains among the hottest subjects in longevity research. Since
Walford's work, caloric restriction studies have been conducted – and
are being conducted – on a wide variety of organisms, from yeast and
spiders to fish and dogs. Most of these studies have reported
significantly longer life spans in CR models.
More profoundly, writes Richard Weindruch, a geriatric researcher
at the University of Wisconsin at Madison, caloric restriction appears
to consistently increase not just the average life span of a subject
population, but also the maximum life span or lifetime of the
longest-surviving members of a group or species. In other words, CR
seems to alter some basic process of aging.
Of course, studies of worms or flies reveal only so much. The big
question is whether CR is effective in humans. Finding out is
problematic, not least because people are already a relatively
long-lived species. Getting significant data on whether CR extends
human lives will take years, perhaps decades.
Nonetheless, the first controlled, large-scale studies of the
effects of CR in humans have begun – a coordinated effort at the U.S.
Department of Agriculture's Human Nutrition Research Center on Aging at
Tufts University, the Pennington Biomedical Research Center in Baton
Rouge and Washington University's School of Medicine in St. Louis.
In the meantime, researchers are plenty busy trying to figure
exactly how CR boosts life span. Numerous theories have been proffered
over the years. Among them:
CR slows the
rate of cell division. In the 1960s, UC San Francisco gerontologist
Leonard Hayflick discovered that cells, at least in the laboratory,
appear to contain a finite number of divisions. After a cell divides 50
or so times, it dies. Researchers have speculated that CR slows
cellular metabolism enough that those divisions occur less frequently,
effectively slowing the cell's rate of aging. A reduced rate of cell
division might also help explain why lab animals on low-calorie diets
seem to suffer less from late-life cancers.
Contrarily, several studies have shown that, at least at the level of individual cells, CR may slightly boost metabolic rate.
"There is strong evidence that decreasing cellular metabolism is
not involved in CR-induced life extension," said Edward Masoro, a
professor of physiology at the University of Texas Health Science
Center at San Antonio.
CR lowers
glucose or sugar levels in the blood, reducing the accumulation of
sugar on long-lived proteins, an effect that tends to disrupt cellular
functions.
CR boosts
immunological response and increases levels of protective hormones.
Some scientists have noted that CR seems to work, in part, by alerting
the body that food is scarce. The body responds by slowing its
metabolism, boosting internal efficiencies, releasing energy stores in
fat and upping the production of protective hormones that allow cells
to withstand greater stress.
In roundworms, for example, starvation (or overcrowding) prompts
the microscopic animals to slip into a kind of suspended animation, in
effect shutting down until better times.
CR reduces
mitochondrial damage. This view currently enjoys the greatest support,
a fact not without some irony since the damage appears to be an
unavoidable consequence of simply being alive. In every cell, there are
tiny factories called mitochondria that convert raw fuel into usable
energy. In the course of doing so, they produce molecules called free
radicals as a by-product.
In modest numbers, free radicals are essential to carrying out
necessary biochemical reactions. But they are highly reactive,
oxidizing and destructive. Bruce Ames, a professor of biochemistry at
UC Berkeley, estimates DNA in every cell in the human body experiences
at least 100,000 "hits" or instances of free radical damage each day.
Most of the time, the damage is quickly repaired. But mitochondria are
particularly vulnerable to free radicals. They lack the protein shield
of nuclear DNA and depend largely upon a single enzyme to make all
repairs.
As people get older, their ability to internally fix free radical
damage diminishes. Repairs go unmade; cellular injury piles up.
Eventually, the theory goes, the accumulated, unfixed damage undermines
a cell's ability to work efficiently, leaving it vulnerable to disease
or death.
Less is more
Clearly, eating less produces measurable health benefits.
Scientists at the Albert Einstein College of Medicine in New York
have reported that calorie restricted rats had just one-fourth the body
fat of their freely fed counterparts. That's significant because fat is
not simply an inert, unsightly annoyance. It is an active substance
that produces its own hormones and influences bodily functions. The
fatter the rats, the researchers said, the harder it was for their
bodies to efficiently metabolize sugar.
In addition, blood sugar levels were elevated and insulin
sensitivity lowered – both factors linked to increased risk of
diabetes.
A human study by John O. Holloszy, a professor of
medicine at Washington University in St. Louis, published earlier this
year noted that 18 people who had been practicing CR for three to 15
years showed dramatically reduced risk of developing diabetes or
clogged arteries.
"It's very clear that calorie restriction has a powerful,
protective effect against diseases associated with aging," Holloszy
said. "We don't know how long each individual actually will end up
living, but they certainly have a much longer life expectancy than
average because they're most likely not going to die from a heart
attack, stroke or diabetes."
Meanwhile, Mark P. Mattson, a neuroscientist at the National
Institute on Aging in Baltimore, has published several papers reporting
improved brain protection in monkeys fed a reduced-calorie diet. He
believes that CR prompts increased production of proteins and nerve
growth factors that shield brain cells from harm. Other studies suggest
that CR may elevate cellular resistance to diseases like Alzheimer's
and reduce age-related deterioration of synapse transmissions in the
hippocampus – a neural center for emotion and memory.
Never say dietFor maximum benefit, experts
say people on CR would probably have to reduce their caloric intake by
roughly one-third, from 2,500 calories per day to 1,750 for a
moderately active person. Special care would have to be given to make
sure nutritional needs were met. Less active people would eat even
fewer calories each day.
In laboratory studies, CR appears to be most effective when begun
early in life. In mice, CR works best when begun just a few months
after birth. Yet, some researchers have noted that CR seems to affect
life span even when introduced much later. For example, Weindruch at
the University of Wisconsin has noted that lab mice placed on a CR diet
in early middle age lived 10 to 20 percent longer than control mice,
and they suffered less frequent development of cancer.
Weindruch suggests consuming 10 to 25 percent less calories than
an individual's personal set point – the genetically programmed body
weight of a person. But finding that set point, he concedes, is
difficult. Instead, dieters might try (with the assistance of a doctor
or health adviser) to establish a calorie consumption level that
reduces their blood glucose, cholesterol or other measure of health by
a predetermined amount.
No one advocates CR for children, who require steady and
substantial amounts of nutrients and calories to fuel growth and
development. Christiaan Leeuwenburgh, director of the Biochemistry of
Aging Laboratory at the University of Florida, doesn't recommend
practicing CR until age 30 or older.
"Aging really becomes apparent after age 35 or 40," he said.
"Younger people do well without CR in terms of repairing damage due to
aging."
Caloric restriction may also pose problems for some women.
Depending on the severity of the calorie reduction, resulting weight
loss could affect fertility or increase the risk of osteoporosis or
sarcopenia (muscle mass loss) in later life.
One proposed CR regimen recommends a daily intake of
approximately one gram of protein and no more than half a gram of fat
for every 2.2 pounds of current body weight. In other words, a
180-pound man should eat no more than 81.8 grams (3.2 ounces) of
protein and 40.9 grams (1.6 ounces) of fat daily. A single Big Mac
contains 25 grams of protein and 30 grams of fat.
Leeuwenburgh pursues a moderate form of CR, roughly limiting his
daily intake to 2,000 calories. He says his diet is not extraordinary.
It emphasizes chicken, fish, lots of vegetables and fruits and soy
milk, but no red meat.
"And it's variable. I do a lot of strength training to maintain
muscle mass. On days when I exercise hard, I eat more. On days when I
don't, I eat less. I also believe in occasionally fasting, which gives
the cells some feedback and stress that's helpful."
Indeed, regular fasting produces at least some of the benefits of
CR. The National Institute on Aging found that the time between meals
might be more important than their size. Specifically, lab mice kept on
an every-other-day feeding schedule with no reduction in calories
boasted reduced glucose and insulin levels similar to or better than
mice on CR diets.
Pills, not mealsFor most people, though, a
CR pill is a better bet than either eating less or fasting more. But
developing such a magic bullet requires understanding the underlying
mechanisms involved in life extension. And here, experts are agreed,
there is no single, simple answer. The length of our lives depends upon
myriad factors, known and unknown, controllable and not.
But some CR researchers have highlighted specific components as promising. In a paper published online last month in Nature, David
Sinclair, an assistant professor of pathology at Harvard Medical
School, reported that a chemical called resveratrol, found in red wine
and some vegetables, triggers the same biological mechanisms as CR does
in fruit flies and roundworms, lengthening the organisms' life spans an
average of 20 percent without causing lethargy or infertility.
Sinclair reported similar findings last year in experiments with yeast.
A number of scientists have investigated 2-deoxy-D-glucose or
2DG, a compound that was first tested as an anti-cancer drug in the
1950s, but turns out to produce many of the classic responses of CR:
reduced tumor growth, lower body temperature and higher levels of
certain protective hormones.
Experiments suggest 2DG interferes with the way cells process
glucose and their ability to manufacture internal fuel. As a result,
scientists hypothesize, cells exposed to 2DG seem to downshift into a
self-preserving, antiaging mode.
But 2DG's potential as an alternative to CR is practically nil.
The compound has proven to be toxic at some doses in animals.
Nonetheless, a full understanding of how 2DG works, say scientists,
might lead them to equally effective but safer alternative compounds.
"If you look at all of the effects of CR, they're so complex that
it's almost impossible to think that a single compound will have an
effect. Maybe a cocktail, but I don't think there will ever be a
magical pill," said Leeuwenburgh. "Genetic modification may be more
promising."
At least eight genetic mutations have been discovered to reliably
extend life in yeast, roundworms and mice. Indeed, many scientists have
turned their focus toward identifying so-called "longevity genes,"
genes directly linked to significant aspects of aging, such as sugar
metabolism, hormone signaling and cellular death.
For example, Lenny Guarante, a professor of biology at the
Massachusetts Institute of Technology, and colleagues have determined
that the Silent Information Regulator 2 gene, or SIR2, determines the
life span of both yeast cells and roundworms. Add an extra copy of
SIR2, the scientists found, and the organisms live longer than normal.
Delete SIR2, and they die sooner than normal.
The SIR2 gene is not unique to yeast and roundworms. It is found
in mammals, too. While there's no proof yet that SIR2 – or an analog –
has a direct role in human longevity, the evidence seems to point that
way, heightening hopes that genetic therapies may eventually be
developed to either fight age-related diseases or slow the aging
process itself.
But that's not going to happen soon, maybe not even in your lifetime.
Which leaves CR. If cutting calories by 30 percent sounds
unappetizing, remember that even modest calorie reductions – Steven
Austad at the University of Texas says 10 percent seems to be the
effective minimum – can help.
According to the World Health Organization, there are more than 1
billion adults in the world who are overweight (28 percent of American
men; 34 percent of American women). One-third of these billion people
are considered obese.
Eating less certainly won't hurt them, and it may give them a few additional years to complain about what they're missing.