Midlife is an extremely active time epigenetically. Pro-inflammatory genes tend to become hypomethylated and get ramped up, tumor-suppressor genes can become progressively more silenced, genes that code for antioxidant and detoxification enzymes such as glutathione transferase (which also happens to be an important tumor-suppressor gene!) also get dialed down, and genes that promote cancer (known as oncogenes) can be turned on. It’s a milieu that we need to be paying active attention to.
Thanks to Carrie Levine, Certified Nurse Midwife and IFMCP, for contributing this month’s blog that outlines important and thoughtful interventions that will certainly do a lot to optimize epigenetic health and our aging experience. And when we combine them with a full Younger You program, we have a powerful antidote to the negative changes to DNA methylation that are ramping up now. Don’t forget to measure how fast you’re aging biologically too, with research-backed tests such as the Pace of Aging we use in our BioAge package.
ps. Carrie’s book, Whole Woman Health is a wonderful reference for women who want to be hopeful and empowered in their health care journey.
Midlife: The Big Picture
One of the psycho-spiritual tasks of midlife women is to take inventory of their lives. There is often a revisiting and final putting to bed of family of origin issues. Women transition from the childbearing years, whether they’ve had children or not, to the wise woman years. As midlife women look at their lives ahead, they are desperate to shed that which has not served them – habits, diets, practices, jobs, people – and are willing, often in unprecedented ways, to do what they can to regain, maintain, or improve their health.
If women don’t harness their lives willingly, often changes in their bodies – hot flashes, night sweats, increased anxiety, bladder issues, bowel issues, muscle loss, loss of cognition, irrefutable fatigue, new onset of disease be it autoimmune, blood pressure, cholesterol – and the subsequent decline in their quality of life force them to make lifestyle changes that ultimately are in their own best interest. Self-neglect is no longer an option. Living by other people’s universal guidelines about what creates health often don’t work. Symptoms drive women to seek and care for themselves. The way in which women’s bodies force them to take care of themselves is quite beautiful.
Considering longevity is an inherent part of taking inventory. There is the desire to live healthy and well for as long as possible, compressing the amount of life spent ill or with disease. In this post, I’ll explore labs to consider, lifestyle modifications to consider, foods to consider, and supplements to consider for women with longevity in mind.
Considerations for Successful Aging
From labs to nutrition and lifestyle, there are many tools and practices that can help you on your journey to successful aging. Here are some considerations.
Labs to consider
Check uric acid. Uric acid is a conventional blood test emerging as a clinical indicator of biological aging. Biological aging is accelerated by excessive levels of reactive oxygen species.
Uric acid is a pro-oxidant in hydrophobic environments and promotes the accumulation of reactive oxygen species and subsequent cell dysfunction. Uric acid can also act as an antioxidant capable of removing free radicals in hydrophilic environments. So, high or low serum uric acid levels could exacerbate oxidative stress thereby decreasing longevity.
VO2 max is a good marker for longevity and overall health status. Aerobic capacity generally declines with aging. In general, it declines about 10 percent per decade. VO2 max, or maximal oxygen consumption, refers to the amount of oxygen a person can use during intense exercise.
You can find your VO2 max by doing a cardiopulmonary exercise test at a physician’s office of an exercise medicine lab. Typically, a mask is worn to record oxygen consumption and carbon dioxide production while running on a treadmill or riding a bike. Alternatively, you can use this survey.
Obtain a fasting insulin level. Fasting insulin is a relatively inexpensive, accessible way to determine insulin resistance. Insulin resistance accelerates inflammation and aging, subsequently decreasing longevity.
Measure oxidized LDL (oxLDL) in serum or plasma. oxLDL is an indicator of oxidative stress. It is a biomarker for determining risk for cardiovascular disease and a marker of inflammation. oxLDL particles prompt atherosclerosis through inflammatory and immunologic mechanisms.
Measure hormones through dried urine. The accuracy of results obtained through dried urine are comparable to serum with the added benefit of getting estrogen metabolites. Estrogen metabolites are markers related to increased risk for estrogen dependent cancers and osteoporosis or increased protection. The way estrogen is metabolized can be modulated by lifestyle interventions such as aerobic exercise and dietary fiber intake.
Hormone levels decline with age, so expect levels to be low unless the woman perimenopausal. Early perimenopause is characterized by high estrogen levels, particularly relative to lower progesterone levels. Late perimenopause and menopause are characterized by low estrogen. With longevity in mind, hormone therapy may protect against neurodegenerative disease, bone loss, and heart disease.
Lifestyle modifications to consider
Strength training is crucial for midlife women. Maintaining muscle mass, let alone gaining muscle mass, is challenging in the face of declining levels of androgens. For midlife women, it is recommended to lift heavy with fewer reps.
Not only does strength training allow for maintaining functional independence, like carrying groceries into the house from the car and bending over to pick something dropped on the floor, it also helps maintain cellular receptivity to insulin. Maintaining cellular receptivity to insulin helps counter weight gain, insulin resistance, type 2 diabetes, and triglyceridemia. Strength training also encourages neuroplasticity, the ability of the brain to form and reorganize connections, preserving memory.
Increase dietary protein. Sarcopenia, the loss of muscle mass, strength, and function is a hallmark of aging. In addition to strength training, increasing dietary protein intake helps prevent sarcopenia.
Thermal stimulation, be it hot tub, Finnish sauna, or simply a hot bath. Twenty minute baths kept at 104 degrees fahrenheit, 4 times per week, have been shown to decrease depression, mimic aerobic exercise and confer the subsequent cardiovascular benefits, boost the immune system through the development of heat shock proteins, and decrease incidences of Alzheimer’s disease and dementia.
Foods to consider
Since you are reading here, I am going to assume you are familiar with Dr. Fitzgerald’s work and her research studies, and Younger You book & program. The short version: focus on foods rich in phytonutrients and healthy fats. The top of Dr. Fitzgerald’s list includes salmon, eggs, beets, dark leafy greens, nuts, seeds, and fermented foods. You can learn more about the importance of epinutrients and their best food sources in this article.
Supplements to consider
CoQ10 positively influences age-affected cellular metabolism through its function as an anti-inflammatory and antioxidant. CoQ10 has been shown to support longevity through its reduction of cardiovascular disease, diabetes, and kidney and liver disease.
B vitamin supplementation is linked to lowering plasma homocysteine levels subsequently reducing the risk of cognitive decline and dementia.
Antioxidants found primarily in fruits and vegetables, can reduce the oxidative stress responsible for the aging process by interrupting the propagation, or inhibiting the formation, of free radicals. This ultimately improves immune function or longevity. If looking to get antioxidants through supplementation, consider n-acetyl cysteine or glutathione.
Choline provides back-door methylation support. Choline requires a lot of SAMe to make. By getting enough choline through the diet and/or supplementation, more SAMe remains available for epigenetic methylation activities.
Choline can also be used in the body to form betaine. Betaine is important since it’s a cofactor for the metabolism of homocysteine to methionine, helping to reduce a compound (homocysteine) that is potentially harmful in high amounts, and form a precursor (methionine) to make more SAMe.
Midlife is an opportunity for women to care for themselves and support their longevity in ways that were neglected as they were busy raising families and/or careers. There is an opportunity for midlife women to experience the best health of their lives. It is a teachable moment, of sorts. Women are best served when the teaching takes into consideration some of the nuances of time of life as well as the individual. Rarely do blanket recommendations work – so much of the research done on men does not translate to a midlife woman. Consider the woman. Consider the individual. Consider her wholeness. Consider her best years may lay ahead of her.
Carrie E. Levine, CNM, IFMCP is a certified nurse midwife, an Institute for Functional Medicine certified practitioner, the founder of Whole Woman Health clinic in Newcastle, Maine, and author of Whole Woman Health: A Guide to Creating Wellness for Any Age and Stage.
Carrie helps women of all ages to assess and achieve their health goals. In her two decades of innovative healthcare practice, Levine has harnessed science and intuition to connect her patients’ physical symptoms and test results with their lifestyle choices and daily practices, resulting in wholly healthy and happy lives. You can find her at carrielevine.com and @carrielevine.cnm on Instagram and Facebook.