In the 1840s, which in the grand scheme of human existence is not that long ago, parents in the UK would routinely set aside money for their children’s burial fund. Due to the huge number of infectious diseases that prevailed, the infant mortality rate was incredibly high – around one third of children below the age of five died. Once past this perilous period of youth, life expectancy rose significantly, and those who lived past childhood were likely to make it into their fifties and beyond. Now, though, thanks to vaccinations and a hugely improved understanding of illness and healthcare, we take it for granted that our children will live to see the birth of their own children, grandchildren, and even great-grandchildren.

“Over the past 100 years, we have indeed made great progress towards eliminating ‘low-hanging fruit’ diseases, including many infectious diseases,” says Alberto Perucchini, Next Generation Research Analyst at Julius Baer. “Now people live for longer, which increases the likelihood that they are exposed to diseases which are more insidious and more related to lifestyles.”

Seeing as we are already struggling to remain healthy and live well as we age, the focus now should be on increasing the number of healthy years we have, rather than simply pushing the limits of our lifespan.

So how can we improve quality of life as we live longer? First, we can play a more active role in our healthcare, which will in turn help to reduce the increasing cost of caring for an ageing population. Perucchini suggests this is where technology will play a significant role: “One way to reduce medical costs is with intelligent AI bots placed within an app, so that rather than go straight to your doc-tor, you’d access a chatbot, who is permitted to give you a prescription, decreasing the use of expensive physical facilities and the variable costs related to doctors’ fees.” The consumer of healthcare can also wear tech such as a diabetic monitor or an activity tracker – making it possible to collect invaluable data, which the wearer can use to take ownership of issues such as high sugar levels or low step counts.

The Blue Zones
However, the key will be taking a proactive approach to safeguarding good mental and physical health – something that students of longevity are well aware of. This is where the Blue Zones of the world come into play. The collection of five geographic areas where people statistically live the longest comprise Okinawa in Japan, Sardinia in Italy, Nicoya in Costa Rica, Icaria in Greece, and a community in Loma Linda, California – and they are of enormous interest to those looking into the current insatiable appetite for wellness.

Maintaining social engagement and physical activity, ensuring stress remains at low levels, and avoiding smoking and alcohol are all contributing factors to the long lives enjoyed by these communities. But it is the dietary habits of those in the Blue Zones that most stand out. Stephanie Moore, Clinical Nutritionist at Grayshott Health Spa, explains why this may be the case: “There are two sides to our nervous system – fight and flight, or rest and digest. In order to absorb nutrients, repair, and sleep well, we have to turn off the chronic stress that’s in part a result of our grab-and-go culture, where we simply don’t sit down to eat. There is a ritual and reverence surrounding eating in the Blue Zones – as well as a wider range of fare, which often contains anti- inflammatory properties and anti- oxidants that abound in foods like olive oil, richly coloured vegetables, and fresh fish.”

Hostile Agents
Poor food choices have the converse effect: “IGF-1, one of the most ageing and chronic-disease-causing agents in the body, for example, comes from too much milk and sugar,” says Moore. Dr Sepp Fegerl, Medical Director of VIVAMAYR Altaussee, corroborates this fact, adding that “ageing on a cellular level is related to three main factors: the number of free radicals which affect cells throughout one’s life, the performance of the DNA-copying process known as RNA transcription, and the number of micro- inflammatory processes taking place inside the body – all of which can be positively affected by a rich-in-nutrition but poor-in-calorie diet.”

Changing our diet can only get us so far in the battle against ageing, though. Genomics, on the other hand, could take us quite a bit further. “We’re at the cusp of a new era,” says Perucchini. “We’ve gone from pharma to biotech and the big leap now is to genomic therapies, whereby genes are altered to various ends.” Genomics holds the promise of being able to prevent, or at least control, many diseases that tend to occur in later life such as cardiovascular disease, cancer, and diabetes. Hardly surprising, then, that genetics-based biotechnology is evolving into a billion-dollar industry, with cell and gene therapy (CGT) proving to be the most commercially successful subsector. In 2017, the US Food and Drug Administration (FDA) gave its first ever approval, according to its own definition, to a cell and gene therapy combination – Novartis AG’s Kymriah CAR-T solution for blood cancer – opening the door for further approvals in the near future.

While it may still be some time before genomics and its related therapies trickle down to the mainstream, initial results are promising. If we combine these new, powerful technologies with simple changes to our diets and everyday routines, we may be able to remove some of ageing’s most unpleasant side effects and in doing so not only increase the number of years we live, but also improve the quality of life we enjoy well into our twilight years.

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