Dr Minesh Patel
NAPC Senior Leadership Team
Introduction
During the everyday pressures of modern clinical practice, be it from the perspective of a nurse, GP, cardiologist, physiotherapist or one of the many other professionals in our complex world, we can be forgiven for focussing on the immediate objectives and drivers of our work – the ubiquitous targets!
But let’s pause a moment and consider whether we could better serve our patients and populations by focussing on the things we often take for granted and mostly don’t talk about during the millions of consultations we have every week? I’m talking about the power of healthy eating, sleeping well, moving (more) and connecting (with others) all of which are proven to enable people to create and maintain their own health and wellbeing and living well for longer.
There is a growing science around longevity medicine and biological ageing clocks, being driven by new frontiers in genomic medicine, AI and better broadband. So, what do we know about the biological ageing clock and ageing well?
The biological ageing clock concept suggests that our bodies age at different rates, which can be measured through specific biomarkers including chemical alteration of our DNA over time which can link to age-related diseases but also enable us to estimate biological age (the epigenetic clock). We already understand the impact of physical biomarkers such as blood pressure, lipid profiles and other risk factors (the phenotypic clocks) on aging and together with a better understanding of the epigenetic clock, science is progressing our understanding of aging.
One example of how these principles are being applied in practice is the Ageing Well Programme in Calderdale, where early frailty support and community-based interventions have shown measurable impact on wellbeing.
Key Factors Influencing Biological Ageing
We can’t change our genetic make-up (yet) which influences aging rate and disease susceptibility but can make informed and positive lifestyle choices around diet, exercise, sleep, and movement. Environmental exposure to pollutants and toxins also play a significant role in our ageing.
As our understanding of the biological aging clock improves, so will our ability to detect diseases earlier, tailoring interventions, and promoting lifestyle changes to slow aging. This has significant implications for personalised healthcare and preventive medicine.
So as we head for the digital prescription pad perhaps we should pay as much attention to the impact of simple advice and often simple changes our patients can make to improve their health and wellbeing.
- Physical Activity: Regular physical activity is a critical factor in slowing down the aging process. The American College of Sports Medicine emphasises that exercise can favourably influence a broad range of physiological systems and chronic disease risk factors and is associated with better mental health and social integration. Studies have shown that higher levels of physical activity are linked to lower risks of chronic diseases and slower biological ageing.
- Eating Well: A high-quality diet, such as the Mediterranean diet, is associated with healthier aging and a lower risk of age-related diseases. Good nutrition can reduce inflammation, oxidative stress, and metabolic stress, which are key processes in ageing. Adherence to healthy dietary patterns is linked to younger biological ages and reduced epigenetic ageing.
- Sleeping Well: Adequate and quality sleep is essential for maintaining health and slowing ageing. Poor sleep is associated with increased frailty and faster biological ageing. Improving sleep quality can help mitigate these effects.
- Social Connections: Maintaining strong social connections and psychological well-being is crucial for healthy ageing. High levels of social and psychological well-being are associated with a slower decline in physical function and reduced frailty. Social participation and trust in the community are important factors in reversing frailty progression.
In summary, regular physical activity, a high-quality diet, adequate sleep, and strong social connections are the biggest factors in slowing down the ageing process. These lifestyle factors collectively contribute to better physical and mental health, reduced frailty, and slower biological ageing.
But we have to stop and ask: Does it actually work. and does it save us healthcare pounds?
Blue Zones and healthcare costs
The concept of “Blue Zones” refers to regions where people live significantly longer than average, often reaching age 100 at higher rates. Research has identified five Blue Zones: Okinawa (Japan), Sardinia (Italy), Nicoya (Costa Rica), Ikaria (Greece), and Loma Linda (California). Studies have shown that lifestyle factors, rather than genetics, play a crucial role in this longevity.
Key lifestyle factors common among Blue Zones include a plant-based diet, regular physical activity, strong social connections, and a sense of purpose. For example, the Okinawans follow the “Hara Hachi Bu” principle, eating until they are 80% full. The Sardinians have a diet rich in whole grains, beans, and red wine, while the Nicoyans emphasise beans and corn tortillas.
Additionally, these populations engage in natural physical activities, such as gardening and walking, rather than structured exercise. Social engagement and community involvement are also integral, providing emotional support and reducing stress.
Overall, the evidence suggests activated people that lead a life of healthy eating, regular activity, maintaining strong social ties, and a sense of purpose contributes to the remarkable longevity observed in Blue Zones.
There are of course numerous other factors that make Blue Zones special but Blue Zones demonstrate that lower healthcare spending does not necessarily equate to poorer health outcomes. Nicoya may be an outlier but compare the £1300 per capita healthcare spend for better outcomes vs estimated spend in USA of £9600, £5000 in France, Germany and £4300 in the UK. Imagine the impact of a concerted and coordinated approach across national and local government, industry, healthcare commissioners and providers in enabling communities and individuals to become more activated in creating their own health and wellbeing and making simple things work. But perhaps in our daily conversations with our patients we simply start by talking about the power of sleeping, eating, moving and connecting?
