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“You can actually prevent aging — no matter how old you are.” So says functional-medicine doc Sara Gottfried, MD, in her insightful new book, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, & Turn Back the Clock 10 Years (HarperOne).

The same factors that drive chronic disease — sitting too much, carrying excess weight, sleeping less, feeling stressed out — accelerate aging, Gottfried notes. That’s actually good news because it means, in essence, we have the ability to stay younger longer by changing our lifestyle.

After all, Gottfried reminds us, we are not prisoners of our genes. “Only 10 percent of disease is caused by your genes, while 90 percent is caused by environmental factors, including the environment you create with your lifestyle choices,” she tells Experience Life.

“When I start to wonder why it’s so freaking hard to stay mentally and physically fit at 50, I remind myself that my genes program me to be a 200-pound anxious diabetic with thinning hair. All things considered, maybe I’m not doing so badly.”

In the book, Gottfried, who is the New York Times best-selling author of The Hormone Cure and The Hormone Reset Diet, outlines a seven-week program designed to tackle the five key factors that lead to accelerated aging after age 40: the muscle factor, the brain factor, the hormone factor, the gut factor, and the toxic fat factor. The goal? Not just increased lifespan, but a prolonged “healthspan.”

“The goal of the Younger protocol is to lengthen healthspan, the period of time in which you live in fantastic, robust health,” Gottfried says. “The key to avoid feeling tired, burned out, and infirmed is to leverage epigenetics, the turning on and off of certain genes that age you prematurely. You have the power to increase your healthspan and get your body to work for you instead of against you. It’s about the daily choices that defy your genetic tendencies and fight diseases of aging by turning on the right genes at the right time and in the right sequence.”

We talked to Gottfried about her new book and tips on turning back the clock. Here’s what she had to say:

Experience Life | So many people believe that genes determine their health. Why is this not true?

Sara Gottfried | I was taught at Harvard Medical School 25 years ago that we were probably prisoners of our DNA, but the past few decades have proven otherwise. Only 10 percent of disease is caused by your genes, while 90 percent is caused by environmental factors, including the environment you create with your lifestyle choices.

I call this the 90/10 rule: Genetics loads the gun, and the environment pulls the trigger. This gives you an incredible opportunity to change the course of disease and aging in your body, with the goal to upgrade that 90 percent to affect the genetic 10 percent. That’s a premise of functional medicine.

There is tremendous power to have the 90/10 rule work for or against you. You control your exposures, whether it be diet, environment, movement, or behaviors, by your daily habits of body and mind, both conscious and unconscious. The sum of all these exposures over your lifetime, how they relate to your health and how your body responds to them, is called exposome. This includes how often you move and what form that movement takes, what environmental exposures you have in your home and office, what you eat and drink, and how you manage or mismanage your hormones. Managing your exposome by making practical lifestyle tweaks allows for a more personalized approach to preventing disease and unnecessary aging.

EL | You make the point that the same things that drive aging drive all chronic disease, including cancer, Alzheimer’s, arthritis, etc. Can you talk a little more about why getting younger is simply a byproduct of getting healthy? What are the root causes that drive both aging and chronic disease?

SG | Science proves that diseases like Alzheimer’s and cancer begin in the body decades before symptoms. You can learn to interpret the warning signs of age in your body — the worsening vision, the thinner skin, the weaker lungs, the faulty memory — and turn them around to help you feel healthier and stronger. Moreover, you can overcome and transform your genetic history and tendencies, particularly when it comes to aging, and to expand both your lifespan and your healthspan, the period of your life during which you are able to thrive, free from disease, in hormonal harmony, looking and feeling young. It goes beyond lifespan, which is defined by the physical years of your life and most likely includes years of “diseasespan.”

Five key factors make aging more pronounced after 40, leading to “inflammaging” — the unfortunate hybrid of increasing inflammation, stiffness, and accelerated aging. In Younger, you’ll discover how to disarm, prevent, and reverse these five factors and change the expression of genes that influence them.

The Muscle Factor. Your metabolism slows down with age, which means you accumulate more fat and lose muscle. Think of aging as beginning in your muscles. The decline may not be noticeable at first, but on average, you lose 5 pounds of muscle every decade and gain fat, so you definitely start to observe the change over the course of middle age. The key is to focus on preserving and building your muscle mass as you age past 40.

The Brain Factor. Your neurons lose speed and flexibility as you age. Connections between neurons, called synapses, are not what they used to be, so finding words may become an issue. The balance shifts toward more forgetting and less remembering. Part of the problem is that your brain gathers rust like an old truck left in the rain; free radicals induce damage to cells, DNA, and proteins in a process called oxidative stress if you don’t have antioxidant countermeasures in place (like vitamins A, C, and E). Your hippocampus — the part of your brain involved in memory creation and emotional control — may shrink, especially if you’re stressed. The aim is to keep your brain regenerating and malleable (or “plastic”) as you get older.

The Hormone Factor. With age, both men and women make less testosterone, leading to more fat deposits at the breasts, hips, and buttocks. Women produce less estrogen, which normally protects the hair follicles and skin. Lower levels of estrogen and testosterone may weaken your bones and your sex drive, and furthermore, lower estrogen-to-testosterone ratios may trigger hair loss and heart disease. Unfortunately, your thyroid gland slows down and, along with it, your metabolism, so the bathroom scale climbs a few pounds per year (or even per month). You get cold more easily. Your cells become increasingly insensitive to the hormone insulin, which leads to rising blood sugar in the morning. As a result of higher blood sugar, you may feel foggier and experience stronger cravings for carbs, then notice more skin wrinkling along with an older-looking facial appearance. The key point is that the right food, sleep, exercise, and support for detoxification can reverse many hormone problems associated with aging.

The Gut Factor. About 70 percent of your immune system lies beneath your gut lining, so it’s the place where your immune system can get overstimulated, leading to excess inflammation and even autoimmune conditions. Your gastrointestinal tract contains 3 to 5 pounds of microbes. The DNA from your microbes outnumbers your human DNA a hundred to one and are collectively known as your microbiome. Imbalanced microbes and their DNA may cause you to make more enzymes such as beta-glucuronidase, which raises certain bad estrogens and lowers your protective estrogens. Further, excess stress raises corticotropin-releasing factor, which pokes holes in your gut, leading to food intolerances, more stress, and lower vagal tone, an indicator that your nervous system is out of whack. Finally, high stress can make you absorb nutrients poorly, especially B vitamins. But don’t get lost in the details; just know that your gut can accelerate or decelerate your clock.

The Toxic Fat Factor. When you’re trying to preserve your youth and health, toxins from the environment accumulate in your fat. Scientists call them gerontogens. They are similar to how carcinogens increase your risk of cancer, and they can work against you and cause premature aging. Pollution, cigarette smoke, heavy metals, UV rays, chemotherapy, contaminated drinking water, preservatives, and pesticides can all conspire against you. While exposure to certain poisons are inevitable, we can attack the genetic flaws that cause you to accumulate them.

EL | You have a fascinating bit about how “many of the adaptations that helped your ancestors survive are now making you fat and wrinkly and are no longer needed.” Can you talk about a few examples of something that was good for our ancestors but not so good for us modern-world dwellers?

SG | You’re the result of millions of years of evolution, but many of the adaptations that helped your ancestors survive are now making you fat and wrinkly and are no longer needed. The famine genes are a great example, as is APOE.

Famine genes: One theory holds that some people gain more weight compared with other people from eating the same amount of calories because it was once an evolutionary advantage. Food was often scarce for our distant ancestors, so being able to gain weight from very few calories could have meant the difference between life and death. Now, food is plentiful. Yet, these “thrifty” or famine genes persist in some people’s genomes, like the genes for insulin resistance. For example, I have thrifty genes in spades because I’m half Irish (potato-famine genes) and half Ashkenazi Jewish (pogrom-survivor genes).

These famine genes may have evolved to help people survive long periods without food. People who have their famine genes turned on, such as the Irish who outlived the potato famine or Ashkenazi Jews who survived pogroms in Eastern Europe, are gifted at banking fat. They stay alive during times of hardship, when food is scarce. Fast-forward to modern life and our surplus of food; the genetic tendency to bank fat starts to work against them. The very genes for insulin resistance that allowed them to survive a famine now makes them chubby, no matter what they try. Just because the famine ends doesn’t mean the genes switch off. The key is to understand the workings of the famine genes (if you have them, as not everyone does) and to override them (i.e., turn them off) so you can remain lean even when food is plentiful.

Another example is reproduction genes. The genes that help you grow and reproduce are at odds with the genes that help maintain and repair your cells —almost like a double cross later in life. Consider a man with high testosterone at age 30. He has a better chance of impregnating a woman than a man with lower testosterone does, but the man with lower testosterone will live longer.

Finally, ApoE4 is the gene associated with a greater risk of Alzheimer’s disease. Yet it probably conferred a survival advantage to our ancestors, because ApoE4 is associated with higher IQ scores, better stress resilience, and lower rate of miscarriage. Surviving long enough to develop Alzheimer’s was a more recent phenomenon.

EL | How on board do you think conventional medicine is with using lifestyle changes as a first line of defense against aging and chronic disease? Has it gotten better over the last decade?

SG | Root-cause analysis and personalized lifestyle medicine are the tools of functional medicine. The only progress I’ve seen to date is that a conventional medical center, Cleveland Clinic, invested in a new Center for Functional Medicine and is performing clinical trials comparing head-to-head the standard medical treatment versus functional-medical care for asthma, in inflammatory bowel disease, migraines, and type 2 diabetes. Watch for results in the years to come. These results, if they favor functional medicine, will start to turn the tide.

But conventional medicine will be slow to change. Meanwhile, the Centers for Disease Control and Prevention reported that in 2015, for the first time in several years, longevity declined, due to an uptick in heart disease, diabetes, stroke, and Alzheimer’s. If those diagnoses seem abstract and irrelevant to you now, consider that by the year 2030, 20 percent of the population will be 65 or older (compared with 13 percent in 2010). New cases of Alzheimer’s will rise by 35 percent, while new cases of breast cancer are expected to rise by 50 percent.

While we think we might be better off than our predecessors from last century, there is a real urgency when nearly everyone is affected by someone else suffering from degenerative or terminal disease.

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