Living longer, ageing healthier: learning to age better

Every day, dermatologist Dr Yael Adler answers questions like these: what helps fight wrinkles? How can I firm up my connective tissue? What do you recommend to look younger?

There is, of course, no ultimate advice. But it is useful to first understand certain interactions in your body so that you can then help it to age. In very practical terms, this works with many "health tips". The doctor and bestselling author reveals some of them in her latest book Genial vital! Wer seinen Körper kennt, bleibt länger jung and here in interview:

**Dr Adler, let's talk about ageing. What happens with ageing, in simple terms? **

Cells age, some more rapidly than others. Function and regeneration age and with them the organs of the human being. We are not all equal in the face of age: a person with wrinkles and grey hair may still have good muscles. Or a person with dementia may still be completely mobile. What's more, ageing is also linked to our mental state. Many people have difficulty with the appearance of infirmities and wrinkles. It brings us closer to our end and reminds us of our mortality. You feel like you're 30, but you look in the mirror and see that you're not. It can be oppressive. Added to this is a growing social aspect: the fact that the people around us are ageing is no longer as visible and even encouraged not to be by social media with the use of filters and Photoshop. Not to mention the growing number of anti-ageing treatments such as Botox or hyaluronic acid injections, laser and surgical procedures on offer.

**You've titled your new book Genial vital. Why "vital", what does it mean to you? **

In my consultation, I see people every day who are ageing with health and vitality. It's the latter that allows them to feel and look young. And that's why, in the book, I've embarked on a journey through cells and organs. I want to make people responsible and give them knowledge about the body. Vitality is something to aspire to. Without giving in to the anti-ageing craze. I'm not defending the "forever young" principle and the over-used procedures for looking younger. I don't want to encourage anyone to invest more in the beauty industry. Some people don't want to spend their money on anti-wrinkle creams, but still want to age with vitality. I look in detail at common measures with their chances and risks, including false promises.

Non-fiction

Ingeniously vital!

German, Yael Eagle, 2023

1

Non-fiction

Ingeniously vital!

German, Yael Eagle, 2023

1

**Many people are afraid of ageing. A whole industry has grown up around this fear. Whether it's micronutrients, creams containing special active substances or beauty operations: what do you think is unnecessary? ** If you want to look young and follow these trends, you can. However, no one should believe that tablets, creams and injections can counteract an unhealthy lifestyle. Much of what is seen as a promise of anti-ageing cures is simply a myth. Take, for example, the trend of Gua Sha. You can do it for reasons of well-being or to reduce stress. But don't think that it will allow your skin to accumulate hyaluronic acid or collagen and lift itself. That's a false promise. It is possible to provide support with food supplements, particularly when the substances they contain are lacking in the blood. Here, too, they can be measured and targeted help provided.

**So even creams containing active substances such as hyaluronic acid and vitamin A are money down the drain? **

Skin is built from the inside out. Substances such as fats, proteins, vitamins and others, like water, have to be supplied. All this only works from the inside. From the outside, the skin is already "constructed". It has a skin barrier to keep pathogens and chemicals out. So the skin barrier also keeps anti-ageing agents outside. To have a real effect, the active substances need to penetrate to the second layer of the skin, the dermis. But cosmetics are not allowed to do this. Of course, the industry is working to make its active ingredients penetrate deeper into the skin. But the effects are marginal. And, very importantly, it's not just the skin that ages. Fat, muscles and bones also age. So when it comes to anti-ageing, it's not enough to act on a single organ, such as the skin, using a few highly fashionable active substances like vitamin C or coenzyme Q10. People don't shirk responsibility for their bodies by buying a cream.

**So food supplements aren't a good idea either? They work from the inside out, don't they? **

I absolutely recommend micronutrients and food supplements. But only on medical advice. We can measure in the blood where the deficiencies are. There are certain diseases, for example skin diseases, for which it is useful to take selenium or zinc. You can easily consume selenium by eating two Brazil nuts a day. Food supplements can also be useful when you're getting older, doing a lot of sport, suffering from an illness or under stress. But I don't recommend taking micronutrients all the time. Vitamin B12, for example, can cause acne, and studies are under way to see whether it might promote lung cancer. Or take sportsmen and women: when a person trains, free radicals are formed. The body wants to neutralise them with antioxidants it has produced itself. If they are given a mixture of vitamins, their body is no longer sufficiently able to do this.

**If coloured pills aren't the panacea for ageing, then where to look for the latter? **

I would say just one thing: lifestyle. The way we age depends for 10 to 30 per cent on genetics. The rest is a matter of lifestyle. Most people only think about pills or cosmetic surgery when they feel pain. When they could be doing something preventive by making healthy, conscious food choices and taking regular exercise. And by physical activity, I don't just mean strength training and endurance, but also coordination, movement sequences, rhythms, stretching and variable training intensities. Vital ageing means taking a holistic approach. So we need to work on several fronts. There isn't just one measure, there are several. This also means that you can vary the pleasures.

**Lifestyle can still even have a positive influence on the elderly, research provides a clear example. Keyword telomerase... **

The lifespan of every cell in our body is determined. Our chromosomes carry protective caps at their ends, called telomeres. These are considered to be a biological clock for the body's cells and shorten with each cell division. But our bodies can produce an enzyme called telomerase, which can partially rebuild worn telomeres. Research has taught us that lifestyle can support telomerase. In a research group led by Elizabeth Blackburn, winner of the Nobel Prize for Medicine, the telomerase activity of men who ate mainly plant-based foods for three months and walked for half an hour a day was increased enormously: between 30 and 80 per cent. In the men who had maintained a healthy diet, not only had telomeres not shrunk after five years, they had actually lengthened. This means that by adopting a healthy lifestyle, we can slow down the burning of these strands of ageing and extend our lives by several years.

**What can we do in practical terms to live longer? **

By giving up sugar and animal products, we manage to rejuvenate our cells without too much effort. Studies have shown that plant-based diets can slow down the ageing switches in cells. If we look at the gut microbiome, where we are still far from having reached the end point of research, it appears that human well-being is very strongly linked to the gut. And we can strengthen the intestinal flora with soluble fibres, for example with linseed, root vegetables or bitter salads, or consume acacia fibres: by taking a tablespoon a day in a liquid, you massively improve the growth of microbiotics in the intestinal flora. As well as plant food, there's another important factor that slows down ageing: fasting."

**Does this mean everyone should fast a few times a year? **

No, it's not necessary, nor is a complete fast a good thing, as it stimulates hunger hormones. To lose weight sustainably, it's better to use calorie deficits, of 300 to 500 calories a day. A healthy and interesting option is to follow the Fasting Mimicking Diet (FMD) of 800 calories from plant foods and no sugar or alcohol for a few days; this already has a measurable effect. You can also do intermittent fasting, the ideal being to practise "dinner canceling", i.e. not eating meals on certain evenings. Fasting triggers autophagy in the cells, which are de-encumbered and thus rejuvenated. Autophagy begins especially after 48 to 72 hours. Intermittent fasting is therefore not ideal for achieving this timeframe. However, opt for foods associated with a low increase in insulin, such as lentils or pseudo-cereals like buckwheat, quinoa and amaranth. Fat cells can then open up easily. If we also reduce calories, the body learns to burn more fat than sugar, enabling us to lose weight.

**In the book, you describe in great detail the processes that take place in the body. This is where the technical jargon comes in: AGE, sirtuin, mTor ... **

This book is different from my other books. It's just as entertaining, but closes fewer stories, because there are so many important facts that should be written. I explain the anti-ageing processes for a normal body: many people don't know about these relationships. So, mTor (mechanistic target of rapamycin) is a nutrient sensor present in the cell, which is activated when nutrients are supplied. It triggers cell division and tissue growth. The result: obesity, diabetes and inflammation. If mTor is at rest, thanks to fasting and plant food, autophagy can take place. Fat cells can then get rid of their storage energy. AGE stands for Advanced Glycation Endproducts. These are new combinations of amino acids and sugars created by industrial foods. These AGEs prevent our body's proteins from functioning properly. Sugar, for example, sticks to haemoglobin, reducing the oxygen in the blood. AGEs are therefore also responsible for skin ageing.

**How do we absorb EFAs? **

Through cold meats, fast food, grilled meats, cheese. They form themselves through sugar, fructose, white flour and milk. People who like milk should not drink more than 200 millilitres a day. Indeed, when consumed in excess, milk is suspected of increasing the risk of obesity, diabetes, dementia and certain cancers. Fermented products such as kefir or original Greek yoghurt are better than milk. Sirtuins, the proteins that keep us young, are also important for anti-ageing. We can activate them by fasting. Or through secondary plant substances, such as grapes, turmeric mixed with pepper, peanuts, apples, broccoli, cashew nuts and many others.

**What other elements are part of a healthy lifestyle: what are the "ageing accelerators", as you call them in the book, to avoid? **

In any case, too much sun. It is the sun that ages the skin the most. It influences external ageing. Sunlight increases the risk of skin cancer, causes age spots to appear, dilated veins, wrinkles ... To illustrate my point, I like to use this phrase: look at your buttocks, they're as old as your face, but they don't have the spots and wrinkles. Precisely because they don't get as much sun. So, in the strictest sense of the word, "butt-head" is a compliment. Tobacco, alcohol or fine particles are other accelerators of ageing, along with stress, lack of sleep or lack of social relationships.

**We've barely mentioned sport so far.... Yet physical exercise is considered to be one of the ultimate anti-ageing remedies. What do you recommend for people who are lazy? **

These days, there are lots of tricks you can use to motivate yourself to do sport. Think of all the technical or social devices. Apps can measure performance during training, you can measure yourself against your friends or listen to podcasts while you do sport.... Our bodies function according to rhythms, and they need habit. However, it also needs different stimuli. This means changing sports and sequences. Successful training works measurably at any age.

**Summing up, you could say that not only does no one want to grow old, but it also takes a lot of work? At least, if you want to age with vitality.... **

The body needs maintenance. It's like a house. The facade crumbles gently, but at some point it's windows that break or pipes that clog and mould that sets in. People who want to live longer have every reason to play the prevention card. And to look after their bodies as if they were loved ones. Taking care of yourself improves your quality of life. It's not about investing money in your body, but about understanding what's going on inside it and the decisions it makes on a daily basis. Then the "maintenance work" can be done effortlessly. What's more, everyone can choose what they want to invest in. You can't always apply all the measures we've just talked about perfectly. You just have to hang on to them to be able to afford stress factors. I think that people who understand everything that's going on in their body and who know how to support it with certain tricks have more fun growing old.