Anti-Aging from Within: The Science of Telomeres
We all know those people who seem young beyond their years—the types that stave off grey hair and wrinkles the longest, and who somehow exude the energy of a twenty-year-old well into middle age. Common sense dictates that exercise, diet, and sleep can influence aging, but the research of biologist/psychologist/Nobel Laureate Elizabeth Blackburn and psychologist Elissa Epel, sheds light on why. In their new book The Telomere Effect, Blackburn and Epel outline that the key to understanding the aging puzzle is telomeres—tiny caps on the ends of our DNA strands that protect cells from premature aging. The good news? They can be manipulated through simple lifestyle and perceptual changes, with some mind-blowing results. Below, Epel explains their fascinating research in layman’s terms, with brilliant tips for living healthier, longer.
A Q&A with Elissa Epel, Ph.D.
What is the disease-span, and how should we think about it in the context of aging?
The years of healthy life make up our health-span. Once we develop chronic, age-related diseases like the ones listed above, we are living in our “disease-span.” Quality of life is greatly reduced in the disease-span—no one wants to live that way for long. We also know that when one disease sets in, others are close behind. We call this “multi-morbidity”—the co-occurrence of diseases. Aging tissue creates ripe conditions for any number of diseases to set in. For example, people with diabetes often also have heart disease. And depression is a very common unwelcome companion to many chronic diseases.
So we want to increase our health-span, and decrease our disease-span. Telomere length appears to be a weak predictor of when we actually die, but a more reliable predictor of when we get diseases, so, how long we stay healthy—our health-span.
How long has this research been underway?
Liz Blackburn, who co-wrote the book with me, made seminal discoveries about telomere length and telomerase around thirty years ago, in single-celled organisms. When telomerase was high, the organism became immortalized, and lived on and on. When telomerase was blocked, the telomeres shortened, and the organism died.
“When telomerase was high, the organism became immortalized, and lived on and on. When telomerase was blocked, the telomeres shortened, and the organism died.”
Research in people shows that telomeres in our immune cells can predict our health-span, and sometimes our lifespan. I wanted to know if stress could speed up the aging process, leading to faster shortening of the telomeres. Liz and I started collaborating together around fourteen years ago, examining telomeres in humans in relation to the things we can modify—stress, mindset, and lifestyle. There are several trials now by different research groups that show that a range of mind-body activities like meditation, yoga, and more, might stabilize telomeres.
We are now studying dementia caregivers, reducing their stress in various ways, and seeing how this may improve their sharpness of thinking and the biomarkers of aging (including telomere length). We are also building a platform to help people increase their stress resilience and purpose in life, overall and each day.
What can we do to protect our telomeres?
It’s important to recognize that our telomere health is influenced by many things, not just our health behaviors. For example, telomeres are associated with:
Levels of antioxidants in our blood (which reflect our diet)
Chemical exposures to toxins like cadmium and lead
Level of belly fat, because it reflects underlying insulin sensitivity
The way we view stressful situations (as a threat vs. a challenge)
For men, level of hostility
For older people, how much social support they feel
Each of us has an opportunity to personalize our own telomere renewal plan: Take a close look at how you live your day, and what you might change to shift your biology toward slower cell aging. We’ve found the easiest way to do this is to find critical periods in your day that make the most difference to you. For example:
How do you wake up in the morning? Many of us are not aware of our mental state as we wake up—we just automatically rush into the day. Can you wake up looking forward to something that day and experience joy? Even if it’s just for a few minutes, before you mentally rehearse your to-do list, it may make a difference in your waking physiology, reducing the stress hormone (cortisol) spike we usually have at that time, especially when we are feeling stressed.
Is there a particular time of day, or common situation each day, when you tend to get stressed out? It might be getting kids out the door, dealing with certain people or situations at work, or being stuck in rush hour traffic. There are things we can do right before or during these peak moments that change our response to the stress and build stress resilience. We suggest choosing a type of mind-body activity that suits you, and these days there is quite a menu to chose from—tai chi, qi gong, and different types of meditation have all been associated with increases in telomerase or telomere maintenance—and practicing that as well.
“Even if you have only five minutes, you can change your presence of mind, your autonomic nervous system stress arousal, and over time, this may add up to have protective effects on your mood, and likely your cell aging.”
Even if you have only five minutes, you can change your presence of mind, your autonomic nervous system stress arousal, and over time, this may add up to have protective effects on your mood, and likely your cell aging. Implementing a new behavior, even if small, takes effort. Try the new behavior, and “staple” it to the typical habit or routine that always comes right before it.
There are also pills you can take that appear to increase telomerase. However, it will be important to first know if they have long-term effects on the risk of cancer, and those studies have not been done yet.
How can the way we perceive stress and challenges (as opposed to the existence of stress and challenges themselves) change the way those disruptions influence our telomeres?
Early research suggests that mindfulness training studies may be helpful in terms of stabilizing telomeres. Mindfulness training also helps people respond constructively to the challenges we face, and have healthier physiological responses to acute stress. Mindfulness fosters an awareness of our stress responses so we can manage them better.
For example, we can notice when we are ruminating, then interrupt that rumination with a breathing awareness break. We can also notice when we are criticizing ourselves and do a self-compassion break. These interrupt the stress process and give the body a restorative period. We can notice when we are criticizing others—also a bad place to be. Stress is not just within one person; it can live between people. We can shape our micro-environment to be positive, supportive, and compassionate. Believe it or not, how we feel about our neighborhood is associated with our telomere length!
You can interrupt the body’s stress response and slow telomere damage, and awareness is the first step to change. If you’d like to dig deeper, our book and my lab website both provide personal assessments that help you become aware of your own stress response style and examples of practices you can try out to build stress resilience.
You did much of your telomere research by tracking telomere length in mothers of chronically ill children. Can you tell us more about why you chose to work with this group?
Caregivers are often studied in stress research because they are so stressed out—and don’t have time to take care of themselves. If we want to study how cells age, in the absence of disease, we can study women before menopause (before common conditions like hypertension or high cholesterol set in). Premenopausal mothers of young children turn out to be a very high-stress group, especially if their child has special needs. We are now studying mothers of children with autism because we found they were among the highest-stress group of parents.
Can telomere damage be reversed? Should the focus be on protecting them as they are, or on rebuilding them?
There is a small meditation study suggesting that telomeres can lengthen in the short-run, but we don’t know enough about whether telomeres can lengthen for the long-run in humans. Our focus should be on stabilizing them—let’s preserve what we’ve got, so it can help us in our ninth decade of life!
Most of the advice you give in The Telomere Effect is in line with general health guidelines: stress reduction, better eating habits, increased exercise, etc. Are there any that it overturns?
Telomere science confirms that what is good for the heart and the brain is also good for the telomere. There are no big contradictions. However, there are more specific recommendations from telomere science on aspects of health behaviors that we can work on improving. For example, it’s not just how many hours of sleep that matters, but also quality of sleep. We can improve quality of sleep through managing stress well, or having a relaxing ritual before sleep.
We have also learned more about what types of personalities and stress responses are associated with shorter telomeres. This gives us a lot of good targets for individuals to work on. “Renewal labs” give people little experiments to try on themselves, to see if they are helpful.
You and Dr. Blackburn have relatively different backgrounds. How did you come to work together on this research?
When I was a postdoctoral fellow, I was searching for a measure of aging inside the body. Telomeres are like clocks inside our cells that make aging somewhat elastic. Telomeres shorten with age, but this relationship is weak, because so many other factors affect them besides age. Liz, having helped identify telomeres decades earlier, was still doing important work, but most of it not in people; I wanted her to measure telomeres in the caregiving moms I was studying.
“There are now many interesting links between cell aging and the mind, behavior, and social environment, emerging from many different research groups. The main message we need to embrace is that we have some control over our rate of telomere shortening. Rate of aging is somewhat elastic.”
I approached Liz and asked her to collaborate on examining the effect of stress on telomeres, and I am lucky she said yes. It has since been a packed decade of one study after another with colleagues all over the world. There are now many interesting links between cell aging and the mind, behavior, and social environment, emerging from many different research groups. The main message we need to embrace is that we have some control over our rate of telomere shortening. Rate of aging is somewhat elastic. Let’s take advantage of that!
Elissa Epel, Ph.D., is a leading health psychologist who studies stress, aging, and obesity. She is the director of UCSF’s Aging, Metabolism, and Emotions Center and is associate director of the Center for Health and Community. She is a member of the National Academy of Medicine and serves on scientific advisory committees for the National Institutes of Health, and the Mind and Life Institute. She has received awards from Stanford University, the Society of Behavioral Medicine, and the American Psychological Association.
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