Healthspan: Living Long and Well

When we think about some of the greatest human achievements over the past century, we commonly refer to the moon landing, the discovery of penicillin or the creation of the internet. However, there can be little doubt that the remarkable increase in human life expectancy holds a well-deserved place near the top of the list.

In 1920, the global average life expectancy of a newborn was 32 years.1 The main causes of death during that time included infectious diseases such as pneumonia, tuberculosis and influenza, childbirth-related complications, malnutrition, accidents, and injuries.

By 2021, the number of years a person was expected to live had increased to 71 years.2 This significant increase in life expectancy is largely attributed to advancements in medicine, public health initiatives, improved sanitation, better access to healthcare, and overall improvements in living standards and nutrition.

While these achievements are rightly celebrated as a remarkable testament to human ingenuity and progress, it is worth noting that, over the last century, there has also been a significant decline in the number of years that individuals can expect to live in good health without the burden of chronic diseases or disabilities. This rise in chronic health conditions, such as cardiovascular diseases, diabetes, mental health disorders, and musculoskeletal conditions, has contributed to a higher prevalence of long-term health issues that can impact an individual's quality of life and overall well-being.

Lifespan vs Healthspan

By prioritising life expectancy, the importance of healthspan, that is the period of an individual's life during which they remain in good health, free from significant chronic diseases, has largely been overlooked. This imbalance in focus has led to missed opportunities for promoting preventative healthcare, wellness, and vitality throughout the human lifespan, resulting in a situation where people are living longer but experiencing a significant portion of their lives in poor health. This not only impacts the overall well-being of individuals, communities and societies at large but also results in a significant financial burden on healthcare systems, reduced productivity, and economic output. 

It’s hard to overemphasise just how extensive the rise in chronic illness has been over the last several decades. Obesity rates among adults have nearly tripled since 1975, and those among children and adolescents have increased almost five times.3 The number of people living with diabetes worldwide has more than doubled, with an estimated 529 million adults affected in 2021.4 The incidence of cardiovascular diseases has been increasing steadily with the World Health Organisation (WHO) estimating that 17.9 million people died from cardiovascular diseases in 2016, representing 31% of all global deaths. Mental health disorders have seen a significant rise in prevalence with depression being a leading cause of disability worldwide, affecting more than 280 million people in 2023, an increase of over 25% since 2005.5 The incidence of cancer has also increased globally over the past several decades. By 2030 the number of new cancer cases is expected to rise by about 70% from 2010 levels.6

Modern medicine commonly struggles to respond with adequate care and treatment when confronted with these conditions. The medical paradigm that gave rise to the successful management of acute diseases caused by infections and injuries typically finds itself wrong-footed when presented with long-lasting conditions that are attributed to a combination of interconnected factors. In these cases, treatment commonly focuses on symptom control and palliation, not prevention or cure. Consequently, we now find ourselves in societies with ageing populations, suffering from more and more chronic illnesses, managed almost entirely with the use of prescription drugs that come with their own set of health risks.

To properly address this issue a shift in thinking is required. Improving healthspan means the focus needs to be on extending the period of healthy and active living, thereby compressing the time spent in a state of frailty or illness towards the end of life. This involves various factors, including maintaining a healthy lifestyle, engaging in regular physical activity, adopting a balanced and nutritious diet, managing stress, getting adequate sleep, and avoiding harmful behaviours such as smoking and excessive alcohol consumption. Preventive healthcare measures, early detection and management of chronic conditions, and access to healthcare services also contribute to promoting a longer and healthier life.

While these are certainly critical factors, recent research has also identified several prescriptive measures that play crucial roles in promoting healthspan. Incorporating these into one’s lifestyle can support overall health and potentially extend healthspan. Some of these measures known for their beneficial effects include:

Exercise

It is well known that regular exercise can improve wellbeing, especially cardiovascular fitness, muscular strength, bone health, metabolic wellbeing, and mental health. Now, a recent massive study involving 116,221 adults, has demonstrated just how much exercise is needed to increase lifespan and lower the risk of age-related diseases. This research showed that those who worked out two to four times above moderate physical activity recommendations (about 300 to 599 minutes each week) had a 26% to 31% lower all-cause mortality.10

When we look at what happens when we exercise this makes perfect sense.

Exercise requires muscle contraction, which uses sugar and fats as fuel. By removing excess sugar and fat from the bloodstream, certain metabolic pressures are lifted reducing the risks of type 2 diabetes, insulin resistance, cardiovascular disease, and chronic inflammation.

Aerobic exercise also improves cardiovascular wellbeing. Increasing the demand for oxygen to working muscles produces more capillaries, resulting in greater oxygen utilisation and a stronger heart muscle.

Magnesium

Magnesium is an essential mineral that plays a role in over 300 enzymatic processes in the body. Some of these reactions involve DNA and RNA synthesis, energy production, nerve and muscle function, cellular metabolism, sleep, heart function and the stress response.

It is therefore of great concern that magnesium intakes have been gradually falling over the last century. This, in part, is due to the loss of magnesium in soils resulting in a significant decline of magnesium in vegetables, meats and dairy foods. Also, the typical Western diet, high in processed foods, fat, refined flour, and sugars, is devoid of magnesium which further contributes to deficiency.11

As a result, most Australians do not meet the recommended daily dose of magnesium of 320mg/day for females and 420mg/day for males. 

Assessing magnesium status is difficult because only 1% of the body’s magnesium is found in the bloodstream with the remaining 99% found in bones and soft tissue. Nevertheless, estimates based on intake have magnesium deficiency rates among Australian adults lying between 30 – 75%.12

Chronic magnesium deficiency increases the production of free radicals which have been implicated in the development of several chronic age-related disorders. Numerous human diseases have been associated with magnesium deficiency, including cardiovascular diseases, hypertension, stroke, cardio-metabolic syndrome, type 2 diabetes mellitus, asthma, depression, stress-related conditions, psychiatric disorders, Alzheimer’s disease, muscle pain, chronic fatigue, fibromyalgia, bone fragility, and cancer.13

Not only can maintaining optimal magnesium levels help protect against these conditions but recent research from Peking University discovered that a higher dietary magnesium intake is associated with longer telomere length. This serves as a measure of cellular health and biological ageing and is conducive to a longer life expectancy.14

Importantly, magnesium may also promote better sleep, a key factor in determining healthspan and longevity. By helping to regulate GABA, a neurotransmitter in the brain that calms the nervous system, magnesium can reduce mental and physical stress, favouring sleep. It also promotes melatonin production, which is responsible for maintaining our sleep-wake cycles, known as the circadian rhythm. Magnesium has also been shown to reduce cortisol, known as the stress hormone. Elevated cortisol levels, often due to stress, can disrupt sleep by delaying melatonin release, causing restlessness, and reducing sleep quality.

Read more on the Role of Magnesium in Sleep

Nicotinamide Riboside 

Nicotinamide riboside (NR) is a nutrient belonging to the vitamin B3 family. However, it is unique in that it can directly promote the production of NAD+, an essential biological activator central to the production of ATP, the principal energy molecule in the body.

Research has shown that NAD+ levels decline as a function of the ageing process, free radical damage, chronic inflammation, and excess consumption of calories. 15-19 

One study involving aged participants showed that supplementing with NR increases the levels of NAD+ and significantly reduces the levels of inflammation.20 In another study, NR also restored muscle function and mitochondrial health.21

NR supplementation can therefore play an important role in boosting blood levels of NAD+ to provide a range of benefits including promoting cellular energy and promoting healthspan and longevity.22

Read more on Extending Healthspan with Liposomal NR

Good Hydration

Sometimes, it’s the simple things that make the biggest difference. Recent research has shown that adults who stay well-hydrated are healthier, develop fewer chronic conditions, such as heart and lung disease, and live longer compared to those who may not get sufficient fluids.

The research was conducted over 25-30 years and included more than 11,000 adult participants. It was found that those with higher serum sodium levels, which increase as fluid levels go down, were more likely to show signs of advanced biological ageing. They also had a greater chance of dying prematurely.23

The challenge is, as we age, it gets harder to stay hydrated. Several factors contribute to this, including changes in how we regulate body temperature, reduced sensitivity to dehydration and increased water loss.

One way that is particularly helpful for staying hydrated, especially as we age, is ensuring we get the right balance of electrolytes. While drinking enough water is critical, electrolytes play a central role in enabling your body to retain and use the water you drink, keeping you more hydrated compared to plain drinking water. While electrolytes can be found in our food, a convenient way we can get these essential minerals in the right balance is through a good electrolyte formula that contains all the required electrolytes, including sodium, potassium, magnesium, calcium, and chloride.

Read more on FAQs Hydration and Electrolytes

Omega-3 Fatty Acids – The Elixir of Youth?

Most of us have heard of omega-3 fatty acids, particularly about their benefits for inflammation and cardiovascular health. However, recent research has also found that omega-3s may be central to slowing ageing by extending the life and length of telomeres. Telomeres are the ends of DNA strands that shorten over time reflecting the ageing process. Shortened telomeres are associated with age-related diseases, as they contribute to cellular dysfunction and may limit the ability of cells to regenerate, impacting overall health.

Researchers reviewed cross-sectional studies and randomised controlled trials consisting of over 3,000 human participants and discovered that omega-3s can inhibit the enzyme that acts to shorten telomeres, known as telomerase, as well as reduce oxidative stress and inflammation that also affect telomeres over time.24

Fish, especially cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines are rich sources of omega-3 fatty acids. The Heart Foundation recommends all Australians should aim to include 2–3 servings of fish (including oily fish) per week. This provides around 250 – 500 mg of marine-sourced omega-3s per day. Only 20% of the population meets the recommended omega-intake.25

If eating oily fish 3 times per day is unrealistic for you, you may want to consider omega-3 oils as a convenient alternative.

Read more on Omega 3 – The Elixir of Youth?

Vitamin D3

When vitamin D was first discovered, it was primarily understood to be responsible for the absorption and mobilisation of calcium and phosphorus and its contribution to bone health.

However, over the last several decades, vitamin D3 has been recognised as an essential nutrient required for a range of critical biological processes including normal immune function, regulating mood and nervous system function, and promoting gut health.

As a result, deficiency is associated with several disease states including autoimmune diseases, allergies, osteoporosis, rickets, various cancers, infections, schizophrenia, and depression.26

Furthermore, vitamin D has been shown to play a critical role in modulating the body's immune response. There is mounting evidence that improvement in vitamin D status reduces risk for autoimmune diseases including type 1 diabetes, multiple sclerosis, inflammatory bowel disease and other inflammatory disorders such as type 2 diabetes and cardiovascular disease.27

Now, several clinical trials have found that low levels of vitamin D3 are associated with increased mortality, while supplements can extend our lifespan. These trials have repeatedly demonstrated that one of the reasons why vitamin D3 boosts longevity is that it also works as a natural antioxidant and anti-inflammatory, helping repair damaged DNA.28

Another study showed that vitamin D promotes protein homeostasis and slows ageing by inducing the expression of target genes associated with longevity.29

Conclusion

In the pursuit of not just a longer life but a healthier and more vibrant one, the distinction between lifespan and healthspan becomes paramount. As we've explored, longevity alone does not necessarily equate to a life well-lived. It is the quality of those years that truly matters. The holistic approach to healthspan involves multifaceted strategies, and our exploration of exercise, magnesium, nicotinamide riboside, hydration, omega-3s, and vitamin D3 underscores the profound impact these factors can have on our overall well-being.

As the scientific landscape advances, and our understanding of the intricate interplay between lifestyle and longevity deepens, the choices we make today resonate profoundly in shaping our tomorrows. By acknowledging the significance of healthspan and actively engaging in practices that enhance our vitality, we lay the groundwork for a future where not only do we live longer, but we live better.

 

Written by, Danny Urbinder. 

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