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Biological Age versus Chronological Age: How Old Are You Really?

“Let us never know what old age is.  Let us know the happiness time brings, not count the years”

Ausonius

At the simplest level, aging is the process of becoming older. For most people, age itself is an uncomplicated matter: it’s the number we see on our birthday cakes – the difference between the current year and the year of our birth. Yet, from a scientific standpoint, age is far more than just a number. It’s also defined as the progressive deterioration of a living thing, in which the risk of mortality increases exponentially. [1]

This definition may seem a bit morbid, but now, experts are exploring new ways to look at aging. We know, for example, that one 65-year-old may not be as healthy as the next, just as 40-, 50-, and even 25-year-olds can have varying degrees of health. To get a better understanding of how health differences can be so vast among individuals of the same chronological age, experts are looking at biological age instead.

Science Supports Biological Age Management!


In particular, Yale Medical School researcher, Morgan Levine, PhD, recently published findings on the matter, in which they developed an equation to combine an individual’s blood measures with advanced algorithms. Called DNAm PhenoAge, this process yields a biological age reading which they call “a new epigenetic biomarker of aging.” The test reveals predictions for age-related outcomes, such as all-cause mortality, physical functioning, cancers, and Alzheimer’s disease, determining age at a cellular level. [2]

Because not everyone of the same age faces the same risk for these conditions, evaluating risk on a more individualized basis can provide a telling account of where you stand in terms of both current and future health.

As pioneers in age management, Cenegenics has remained at the forefront of closely studying biological aging factors and helping our patients reduce this critical measure for 23 years. In fact, we pioneered the medical specialty of Age Management, and one of our physicians even wrote the textbook used to teach other doctors the key theories behind optimal health through aging. We therefore support Yale Medical School research in their findings and believe that biological aging is one of the most important factors for individuals to understand and address. Here, we discuss the principles behind biological age and why they’re essential for telling the true story of our health, no matter what our birth certificates say. 

What Is Biological Age?


Biological age combines specific physiological measures to determine a person’s status of health relative to individuals of a certain chronological age. For instance, if a person is 30 years old chronologically but their biomarkers bear a closer resemblance to those of the average 40-year-old, it would indicate that the individual is aging at a quicker rate than the norm. [3] Biological age therefore looks at the pace at which we’re aging, and ultimately determines our current levels of health while helping to predict our lifespan.

While most experts agree that measuring biological age has its benefits, there have been challenges in terms of reaching an agreement on which factors to look at when assessing it. For example:

  • Some researchers define biological age as a marker of “aging, stress, and frailty,” in which factors like molecular markers of inflammation (including C-reactive protein), sleeping difficulties, and smoking are analyzed.[4]
  • Others state that the three aspects of aging should encompass survival or mortality, one’s ability to function, and the need for therapies or interventions to extend one’s health span. [5]
  • Others still claim that biological aging includes four key bodily changes:
  • Persistent, low-grade inflammation which occurs without any known pathogens
  • Dysfunction at the cellular level, including DNA damage, dysfunctional telomeres, and protein aggregation
  • Stem cell changes which impede the ability to repair or replace tissue
  • Cellular senescence, in which cells’ ability to proliferate and certain metabolic activities are altered. [6]

Clearly, finding a single measurement for biological age is much more complex than simply counting years, as we do for chronological age. Researchers have posited that, regardless of which factors are used to measure biological age, to be considered viable, they should:

  • Produce measurements which are realistic and are within the limits of a recorded lifespan
  • Be able to identify individuals who are at risk before they contract a disease
  • Predict age-associated biological and functional outcomes more effectively than chronological age
  • Predict remaining longevity and mortality in populations of which 90% of individuals are still alive. [7]

Most recently, Yale Medical School’s publication has emerged as perhaps the most comprehensive and well-researched approach to biological aging. The research drew on data from 10,000 participants in a study which ran from 1988 to 1994 in which they sought to identify the key metrics that could forecast life expectancy most accurately. Based on those findings, they created a subsequent study of 11,000 people, which ran from 1999 to 2010. After looking at 42 different clinical measures, they ultimately pinpointed nine biomarkers with the greatest influence on lifespan, including inflammatory, immune, blood sugar, kidney, and liver measures. [8]

Obviously, biological age is an area of interest which draws many researchers across various disciplines. But the question remains: Why is biological age such a hot topic?

What Is Chronological Age? 


Chronological age is the number of years for which you’ve been alive. It’s a straightforward calculation which has been the gold standard for estimating the risk of certain ailments and conditions in individuals. For example, the risk for chronic and neurodegenerative diseases, cardiovascular disease, and most types of cancer increases with chronological age. Increasing chronological age also corresponds with increased risk of geriatric syndromes, such as immobility, frailty, and diminishing physical resilience. [9]

Yet, while we know that disease risk increases with chronological age, and that physical and mental function declines with it, the rate at which these changes take place can differ significantly from one person to the next. This is because numerous factors make up the aging process, and can be impacted by influences such as lifestyle, the environment, and genetics. To measure the rate at which aging takes place for a more concrete idea of where a person is on the trajectory of aging (versus simply how many years they’ve been alive), experts have developed biological age.

Why Is Biological Age So Important?


Understanding the breakdown of biological ages within a certain population can give us some information about the group’s future. For instance, an aging population will most likely require increased health care support. Yet, chronological age only tells us one piece of the story. With a look in to biological age, we can better understand the pace of aging to determine whether we’re becoming healthier as a population, or if our choices are actually aging us at a faster rate.

For instance, while fewer people in the U.S. are smoking now than in the 1980s, obesity rates have more than doubled within the same time frame. [10] No matter how you choose to measure it, factors like obesity and smoking are sure to have an effect on biological age, as both have body-wide implications.

In fact, one of the main reasons studying biological age is so important is because there’s a good chance many factors that impact it are within our control to change. While we can’t change our genetic factors, for instance, lead Yale researcher Morgan Levine explains that the newest equation for biological age can give patients a concrete idea of what they can do to reduce their risk for disease and “show you how you can reduce your risk because you can plug all the numbers in to see how the risk drops if they bring their glucose down, for example.” [11]

Similarly, telomeres, the end of chromosomes which aid in the regulation of cellular aging, can be affected by habits and factors such as:

  • Stress
  • Exercise
  • Diet, and
  • Sleep patterns[12]

Moreover, traditional medicine often comes up short in terms of accurately predicting serious disease risk in populations with no prior signs of disease. This isn’t the fault of medical practitioners; after all, treating issues after they emerge has been a standard in medical care for decades. Yet, blood pressure and similar readings aren’t always enough to determine who could be at risk for heart disease in groups who are presumably healthy. Detecting biological age is therefore more than just a way to determine who’s aging quickly and who isn’t; it’s also a powerful means of determining who is at risk for diseases which may have otherwise gone undetected. Yale’s study is the first to determine that biomarkers of biological aging are “highly predictive of cardiovascular and coronary heart disease,” for instance. With these findings, interventions such as lifestyle changes can be introduced long before disease actually develops. [13]

What Can Be Done to Control Biological Age?


With the help of Cenegenics, it’s entirely possible to start reversing your biological clock now. While the aging process is complex and still being studied, we know that minimizing the risk of disease, frailty, and disability can be achieved through healthy lifestyle practices, including:

It isn’t a coincidence that these very factors are the pillars of the Cenegenics program. Not only do our experts take a research-based approach to help our patients reach and maintain a healthy weight, improve their sleep quality, and optimize their health in many other important ways, but we also look at each individual’s biomarkers for a better understanding of their biological age. We take a highly scientific approach to work toward getting a body perfectly tuned at the cellular level so that it functions ideally, thereby reversing your biological age and rebalancing your body to where it was in your 20s or 30s. We tailor recommendations to your precise needs, allowing you to feel your best both now and at every age. 

You Can Feel Younger Than You Think - In Conclusion


Man on sailboat

As you can see, there’s more to think about when it comes to age than your chronological age alone. Understanding where you fall on the trajectory of aging allows you to make the choices that can preserve optimal health no matter what your chronological age may be, and in some cases, may even allow you to slow or reverse the aging process. In doing so, you can minimize your risk for disease, stave off geriatric conditions such as frailty and diminished physical resilience, and enjoy a richer quality of life.

Yet, to achieve these goals, you need the help of experts who not only understand but actually specialize in age management. Read through Cenegenics reviews and you’ll discover stories about how we’ve helped countless patients feel years younger. In fact, our patients feel dramatically better within 30 to 60 days on the program. That’s because we’re giving them the tools and guidance they need to improve their health at a cellular level, thereby prompting better wellness now and into the future. We’re even the physicians most trusted by other medical providers; we’re considered the “doctor’s doctor,” as 25% of our patient base is made up of doctors and their family members. So, whether you have questions about Cenegenics’ cost, are wondering what our exclusive Elite Health Evaluations include, or you’re simply ready to find out how our team can help you slow or reverse your biological clock, don’t hesitate to contact your nearest Cenegenics location for more information.

Next Steps – Turn Back the Hands of Time Now

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About the Contributor

Rudy Inaba 
Global Director of Nutrition & Exercise

Rudy Inaba is Cenegenics’ Global Director of Nutrition & Exercise. He is a recognized fitness and sports nutrition consultant with nearly 15 years of experience in clinical exercise physiology and lifestyle management. After pursuing his Master of Science in Clinical Exercise Physiology at the University of Nevada Las Vegas, Rudy joined Cenegenics where he leads 20 clinical locations nationwide in their advancements in kinesiology, nutritional biochemistry, and their analyses of industry research & market trending.

Key Resources

This guide was produced with contributions from the following key resources: 

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 1: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

The Cenegenics Education and Research Foundation  

The Textbook of Age Management Medicine Volume 2: Mastering Healthy Aging Nutrition, Exercise and Hormone Replacement Therapy

Click to purchase

Textbook Authors:

Jeffrey Park Leake, M.D., CPT

Dr. Jeffrey Park Leake is a Partner and Director of Education at Cenegenics Elite Health specializing in age management and wellness. Having trained hundreds of physicians worldwide, Dr. Leake is also the Director of Education for the Clinical Strategies for Healthy Aging course at AMM Educational Foundation.

Todd David Greenberg, M.D., CSCS

Dr. Todd Greenberg is a practicing physician with a broad range of expertise, including wellness, exercise, sports injuries, and MRI of sports injuries. He is a Radiology Clinical Associate Professor at the University of Washington.

References

[1] Michael D. West, et al. “Toward a unified theory of aging and regeneration.” Regenerative Medicine. 28 Aug. 2019.

[2] US National Library of Medicine National Institutes of Health, “An epigenetic biomarker of aging of lifespan and helathspan.  Derived from:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5940111/

[3] Levine, Morgan E. and Crimmins, Eileen M. “Is 60 the New 50? Examining Changes in Biological Age Over the Past Two Decades.” Demography. 1 April 2019.

[4] Pyrkov, Timothy V. and Fedichev, Peter O. “Biological age is a universal marker of aging, stress, and frailty.” Biomarkers of aging. March 2019.

[5] Jazwinski, S. Michal and Kim, Sangkyu. “Examination of the Dimensions of Biological Age.” Frontiers in Genetics. 26 March 2019

[6] Tchkonia, Tamara, PhD, and Kirkland, James L., MD, PhD; see above.

[7] Levine, Morgan E. and Crimmins, Eileen M; see above.

[8] See above. Derived from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5940111/

[9] Tchkonia, Tamara, PhD, and Kirkland, James L., MD, PhD. “Aging, Cell Senescence, and Chronic Disease.” JAMA. 2 Oct. 2018.

[10] Levine, Morgan E. and Crimmins, Eileen M; see above.

[11] Sample, Ian. “Is the end nigh? New blood tests can reveal your life expectancy.” The Guardian. 9 Jul 2018. 

[12] Sifferlin, Alexandra. “3 Simple Lifestyle Habits That May Slow Aging.” Time. 29 July 2014.

[13] See above. Derived from:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5940111/

[14] Michael D. West, et al; see above.

[15] Fan, Shelly. “The First Evidence That Drugs Could Turn Back the Clock on Our Biological Age.” SingularityHub. 17 Sept. 2019.

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