Longevity for your parents, what to do?

Smother them with 4 year olds.

No, seriously:

>> A unique social experiment that brings together elderly people in a retirement community with a group of 4-year-olds. Could this encounter between young and old help transform the lives of the elderly?

https://thetvdb.com/series/the-old-peoples-home-for-4-year-o...

https://thetvdb.com/series/old-peoples-home-for-4-year-olds

https://iview.abc.net.au/show/old-people-s-home-for-4-year-o...

Multiple studies in both the UK and Australia demonstrate increased mobility, memory, communication, happiness, etc in older people when mixed in with young children.

Encourage them to walk as much as possible - hopefully daily.

Encourage them to shorten their feeding window. Perhaps as small as 4-6 hours but even 8 hours would be a big step up from a (typical) 12 hour feeding window.

If you wanted to be more ambitious, any kind of resistance training would be fantastic but not at the expense of the walking.

...

I notice you employing a familiar heuristic: "things doctors don't want to talk about" but I encourage you to embrace an even deeper heuristic:

If there were some natural substance, or plant extract, or pressing from (food) or (some combination of purple berries) that made people live longer, we would all know about. It would be carved into stone tablets and embedded in every religious tradition. It would not be a secret.

People have been watching and cataloging their food inputs for millennia - the pressed extracts of winegrape seeds would not have eluded their notice ...

> what to do?

I am 70 and based on my parents and my older siblings I probably have 7 or 8 years left.

Get used to the idea of dying. It's going to happen to you and everyone you know. For the living, quality of life is important. Don't scarifice quality for duration. I want to die before my mind goes. If that means sooner, so be it. When I am dead I won't have regrets, so it's ok.

My personal experience only - my grandpa lived to his mid-nineties:

Don’t bother too much with the medicines and pills. What really matters: daily social interactions (with friends and family members, not random people or nurses/doctors) and a regular schedule of “purposeful” activities to look forward to every week. Bingo every Tuesday, fish dinners on Friday, etc.

In all likelihood, diet, exercise, and sleep. Aside from managing chronic conditions through doctor’s visits this seems to be the only thing that can actually improve quality of life. High levels of physical activity seem particularly key.

If there was a magic pill, that would be great, but don’t think there is any high quality evidence.

The NMN research didn't pan out in the end, just throwing that out here.

There is something involved in NMN, but taking it (or any of the precursors or metabolites) alone doesn't actually seem to reliably cause what they were looking for.

Most likely, it's something like the curcumin vs ground turmeric issue (curcumin doesn't work alone, it combines with another chemical found in turmeric to produce the active chemical, and none of the curcumin supplements work), or with glucoraphanin and myrosinase to produce sulforaphane (popularized by Dr Rhonda Patrick; sulforaphane is short lived, and you need to package them correctly to not self-react in a supplement while it's sitting there on a shelf, so the delivery mechanism is the hard part), or with the flavor of garlic, allicin, another short lived chemical produced by alliin and alliinase (which is why crushing garlic is important instead of slicing, and ground garlic and factory produced minced garlic will never have that magical flavor).

Also, as for Omega 3, watch https://www.youtube.com/watch?v=-f-CFQxaUY4 Dr Rhonda Patrick interviews Dr Bill Harris; the main take away from this isn't that it works (we all know that already), it's what the dose range is: we're all underdosing.

Unless you're a doctor who is familiar with all the medications that your parents are currently taking, it's probably not a good idea to recommend that they take specific supplements. For example, omega 3 fatty acids can act as a mild anticoagulant, and if your parents have been prescribed blood thinners, the additive effect of the two could lead to problems.[1]

[1] https://www.mskcc.org/cancer-care/integrative-medicine/herbs... [under the heading "What else do I need to know?"]

The easiest approach is probably to avoid or reduce obviously harmful habits and behaviors that result in chronic diseases (eg: cardiovascular disease, diabetes)

- Avoid smoking and hard drugs

- Avoid excessive alcohol consumption

- Avoid fast food, excessive salt and sugar, deep fried dishes

- Avoid excessive stress and worrying

Besides that, focus on the basics:

- Consistent and restful sleep

- Healthy, balanced diet

- Regular exercise

- Novel and mentally-stimulating activities, continuous learning

- Strong social connections (not just online social networks, but actual friends and family they can hang out with in-person)

If you want even more, there have been studies about 5 blue zones where inhabitants regularly reach ages of 100 or more, and 9 habits they follow: https://www.bluezones.com/2016/11/power-9/

1. Move naturally: build exercise into your daily life

2. Purpose: a reason to wake up in the morning

3. Downshift: Routines that shed stress

4. Only eat until you are 80% full. Consider occasionally fasting.

5. Plant and bean-based diet

6. Moderate (1-2 cups/day) consumption of alcohol

7. Faith

8. Close family connections

9. Social circles that support healthy behaviors

My granddad was a teacher through his life, going ~20km every day by bike for 40 years, in rain and even in the winter. When he became retired, he started physical work of farming crops, making hay for his cows for the winter. He lived for 92 years, while he was still able to walk around and take care of himself on the basic level. He got also a type 2 diabetes around his 80's, but wasn't prescribed metformin. I strongly believe the physical work in his retirement gave him the strength to be in a good shape in his late years.

Keep them off non-essential medication for as long as possible, side effects of one medication often result in further medication and then you’re in the western geriatric medication spiral.

Do everything possible to avoid falls; remove rugs and any floor obstacles, door lips, etc from their living space. Avoid where possible any medication that causes dizziness or fainting. Metformin can cause low blood sugar and fainting if they miss a meal or have a low carb meal, or are generally unwell (eg fighting a cold virus or covid), and so should be avoided unless they have diabetes that cannot be managed through diet.

If they’re prescribed statins, make sure it’s on the basis of cardiac calcification tests and not just a blood test (latter has little to no correlation with cardiac risk)

Dehydration is a huge problem for older people in general, keep them hydrated any way possible. Dehydration leads to general poor health, digestion, dizziness and falls.

I think David Sinclair's track record of actually producing meaningful improvements in human longevity is zero. The whole sirtuin thing got big funding from pharma and then totally failed. I would remain very sceptical of what he says, as he definitely talks up his own work as high as it can go and beyond.

Personally, I doubt these supplements make any difference. I also doubt that metformin makes a big difference (as well as being poorly tolerated in many people).

This is what comes to mind:

There is one universally beneficial thing and that is exercise. What exercise? Anything is better than nothing. But doing 150 minutes per week of Zone 2 is probably optimal. Also resistance training. Don't over do it.

Second thing: screening for things that kill you. Manage modifiable cardiovascular risk factors:

- check lipid profile including Lp(a) and ApoB, manage appropriately

- inflammation, although can be hard to improve, maybe dietary changes.

- hypertension

Also do all the screening for cancer: mammogram, faecal occult blood, pap smears.

Take a thorough family history, what did people die of and at what age. There can be clues from that about what needs attention. In the extreme case, there may be a strong family history of cancer indicating need for germline testing.

Other things: Pneumococcal vaccine, shingles vaccine, flu vaccine.

If the option exists, move closer to the equator (mortality is higher further from the equator, as is cancer incidence).

Other comments mention social activities, also very important.

Thank you for bringing this topic up. I would add that an active life and a social circle would come before anything else.

Also on the natural foods side would like to add

1. Dates 2. Prunes

Lots of antioxidant rich foods based on your location - omega 3 is also a good choice as you mentioned.

I am sure you have read the article about the people who "forgot to die"

I think you'd be best off looking at family history - what caused early deaths among older generations? My shortest-lived grandparent lived well into their 80s, so my main concern is them having enough money to maintain a decent standard of living in their dotage.

Alternative.

My parents weren’t cheap. But they were responsible with their money both had pensions and retired when they were 55 and 57 respectively.

They have gone on two cross country 4-6 month road trips. They are now 78 and 80 and are still mostly healthy. They only stopped traveling because of Covid. They are slowly getting out of their bubble.

They both said that they have had a long enjoyable life and will have lived a life without regrets.

While I won’t be retiring at 55, my wife and I are planning a 2-3* year adventure where we will be traveling across the US in a method that’s comfortable for us - flying everywhere and staying in mid tier extended hotels.

We are starting this near the end of the year. We just sold our newer car to save money and we are selling our old car before we leave. We are renting out our house.

Am I worried about a long life? No. I’m more concerned with an enjoyable life with no regrets.

Yes, I see my doctor(s) regularly. We chose hotels partially because they all have gyms and most will have pools for working out

Do I eat overly healthy? Mostly no. I enjoy food. But we mostly keep our weight under control.

Longevity is not about medicine – it's about lifestyle:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125071/

Related:

https://news.ycombinator.com/item?id=29429558

A few years ago my mom was almost dying. Now she’s healthy and energetic.

The things that I’ve noticed made the biggest visible difference:

- Going to the doctors to take care of any diseases that supplements can’t fix.

- Daily exercise at home.

- Weekly physical therapy (this helps a lot with helping her be social and interact with others).

- Staying at a good weight.

- Having a hobby that gets her outside and active.

- Sleep.

wow, as a "third-world" person, this feels really dystopian to me. We as humans haven't progressed so much that we can delay death. The only way we increased life expectancy is with Healthcare. How do you know if the pills you are giving them are doing harm or good? I personally feel really terrified of these maybe because I'm from a different culture and economic status than some tech-bro from silicon valley. just my two-cents

That's exactly what my dad takes, but half that dosage for NMN and Resveratrol because of cost. He already takes metformin for diabetes in a higher dosage, and prescription fish oil (Vascepa).

But what's more important, I believe, is social connections. He claims the concoction has given him more energy, and this month alone he has traveled three times. He's got a girlfriend now. I see him in a better mood, but I'm sure it's because of his increased social connectedness.

For all we know, David Sinclair might be running the long con on us, and NMN might be worthless or even deleterious. I'm personally skeptical, and I do not take it because it is hypothesized that it may speed up the growth of existing cancers in the young, if I recall correctly.

Don't forget daily moderate exercise. It works better than any supplement for many issues of aging.

Totally feel you on the desire to help your parents take better care of themselves. Both my parents are much further along the aging process than they ought to be; my dad is 67 and in a memory unit. My mom is in bad shape as well.

The main thing I’ve found from trying to help them be healthier: trying to change other people is generally a recipe for increasing your own stress without accomplishing much else.

Instead of trying to change them, I’ve been focusing on trying to enjoy what time I have left with them. It’s bittersweet for sure, but I’m finding that knowing where this is all going accentuates the sweetness of being able to love my parents while they are still around.

Best of luck to you and yours.

Muscles and flexibility.

It won't increase your lifespan per se but it'll vastly increase your quality of life.

If you were to die at 80, you'll want to be able to do something else that sitting your last years.

I think the best you can do is not smoking, not eating garbage, not being obese, doing medical check ups constantly and having a lot of luck. In my family older folks have consistently lived to 90s-100s despite growing up poor, never exercising nor caring about hyped vitamins.

Also after living with my grandparents, etc. I'm positive it's more important to have a fulfilling life than a long one. At some point you're done, it's time to go.

Omega3s are big. Try the algae based ones, since the fish are a few steps removed from that. And you don't want more than 4x omega6s vs omega3s. Most people in US need to boost omega3s and reduce omega6s.

Can your parents get up off the floor with ease? Do they shuffle their feet? Age appropriate exercise will help them not break bones / fall, etc. Bob and Brad on youtube have some things to look at.

Do your parents have inflammation? That is, do they have joint pain? Are their faces or hands puffy? Try a gluten free diet if reducing foods with omega6s does not help. A gluten free diet can only be achieved by avoiding all foods that are not certified gluten free. Even foods that should not have gluten such as oats likely have gluten cross contamination.

For any diet change, try to limit the change and pursue it for a minimum of 2 weeks to see the impact.

In short, aging gracefully is more about keeping an eye on deficits and managing them before they become big problems.

Also, consider whether they actually want to. At some point, some people have had enough of life and don't want anymore, even if they're healthy (I'm not 40 yet and start to feel it ;))

But as mentioned before, get some kids, sure they will make YOUR life comparatively miserable, but your parents will love it ^_^

My suggestion: don't fall for super foods or similar promises.

"Dietary supplement companies have aggressively marketed NMN products claiming those benefits"

No single food is a super food.

And yes the hard things are the things which help not the easy things.

Make sure they have good balance, engaging environment and normal health food.

Something plenty of people gave up on

I don't think there really is anything one can do. We don't have the medical technology yet to significantly improve someone's health to a consistent degree beyond the average limit. Sure, some centenarians in Japan might live quite a while (given their birth records are correct, yet there is a growing suspicion that they may not be [0]), but I'm not sure if we can reliably, and to a statistically significant degree, make people live beyond such an age.

[0] https://www.vox.com/2019/8/8/20758813/secrets-ultra-elderly-...

Move to the Mediterranean. Eat olive oil based diet. Exercise every single day (nordic walking)

There's still an open question as to whether NMN accelerates the growth of pre-existing tumours. I would be weary of recommending it to older family members unless they have a really good handle on their health and are getting regular checkups.

I got my mother listening to The Drive with Peter Attia. https://peterattiamd.com/podcast/

It's probably her personality type, but she's taken to completely binging the episode archive.

As for your parents (and anyone else honestly): major in the majors and minor in the minors. Get your diet, exercise, and sleep right first. Only then start looking for pills and supplements.

Nothing will be as effective as these three.

Avoid sugar as much as possible, especially liquid sugar (soda, fruit juice, icecream). Do resistance training and zone 2 cardio several days a week. Get blackout curtains.

How much they buy into the idea - or not - is going to impact effectiveness.

https://hiddenbrain.org/podcast/reframing-your-reality-part-...

p.s. Moi? There's also the issue of quantity v quality. In short, keep them away from the TV, social media, etc. Aging has an emotional / psychological impact. Given the current state of high profile happenings (e.g., pandemic, war, mass shootings, climate change) it's easy to get worn down and the willingness to persist goes with it.

Humans need a minimum amount of UV exposure. Glass blocks almost all UV.

Don't retire...

I have a sincere question for people that are into longevity: Why?

Staving off mental decline makes perfect sense, that’s not what I’m referring to.

There are some people that seem excited to simply push the envelope as to how long they can live for through diet and pharmaceuticals, and I personally don’t really understand that.

What is the particular appeal of e.g. living to be 130 years old?

I'll mention, regarding metformin, that although it's useful for longevity (my father is on it for diabetes and seems well), it can create some significant GI issues. If your parents are not firmly convinced of the benefits of what you're suggesting, you may encounter resistance because of those issues.

Rapamycin will probably be more effective than any of those. Also, resveratrol has very low bioavailability (<1%) since it has extremely low water-solubility and also doesn't survive first-pass metabolism

Also, get them to a healthy body fat % (as measured by dexa) which is like 15% or less imo, and have them doing regular cardio.

My mother (59 years old, so not so old yet) frequents the gym (at least 2 times a week). Typically for some active stretching, body-pump and body-combat group exercises. Diet helps too.

She has a moderate heart\vessels condition so she intakes some pills prescribed.

D3 is the only addition to this I thing.

I think you better ask a food expert or at your local pharmacy :) I mean if there is serious concern they are low on certain nutrients, they should make a blood test. Then it's possible to change the diet if needed or add food supplements.

Have good genes, eat well, sleep well, exercise and have a good social circle. Just have a healthy lifestyle basically.

For exercise I think it is more important to do weight training than cardio, to increase or retain bone strength as this diminishes with age.

The biggest thing is exercise. At least an hour a day. Mostly low impact.

Being social is also huge.

Consistent exercise and quality food (meats and veggies). And lots of thoughts and prayers.

I wanna second tarun's comment. Being physically active and having social baseline helps a lot on their general well being.

Is what you're trying to sell them what you want or what they want?

I guess they’re adults who can make up their own mind. If so, let them. Either way, feel free to talk with them, but don’t force your idea about what they should do onto them.

Have you asked them if they want to live longer? And if so, do they want your help extending their lives?

If not, start there. You might be surprised by their answers.

What a strange perspective! My parents are adults; they are responsible for their own health decisions, and will do as they please.

Every cancer screening you can get. Keeping at a low body fat and healthy blood pressure.

hyperbaric oxygen therapy

Full disclosure: I have no medical training whatsoever.

Exercise (a combination of cardio and resistance training) seems to be a very, if not the most important thing. That's the takeaway from two podcasts I listened too recently.

In the first one[0] Stuart Phillips talks about how important resistance training is for older people. He also says that if you exercise then supplementing your diet with protein is really just the "sprinkling on top". Doing the exercise is far more important.

In the second[2] one the author (who was diagnosed with MS in her 20s but is not taking any medication and is now 58) exercises every day (mostly running, 3-4 miles). The podcast was about her book in which she sums up a lot of research on diet vs exercise. The conclusion is that as long as you exercise it's not very important what you eat. You don't have to be vegan, vegetarian, or follow any other special diet. They talked about, e.g., world class athletes with completely different diets, all performing at peak levels. Again, exercise seems to be the far more important, common, denominator.

Regarding supplements: (I took this from my personal notes, that's why there are recommendations, they are for myself [a healthy adult in middle age]. Also, I have no affiliation with any companies/products mentioned):

# Resveratrol

Source for Resveratrol: Source: https://podcastnotes.org/2020/01/07/dr-rhonda-patrick-resver...

Resveratrol exists in two molecular arrangements: trans- and cis-

- Trans-resveratrol is the predominant form found in most supplements, and also the more stable (but if exposed to light, it can convert to the less-active cis-resveratrol) - Trans-resveratrol is more bioavailable if taken both in the morning and with food - More data is needed to determine resveratrol’s effect on exercise - Resveratrol activates a variety of anti-inflammatory and antioxidant response pathways - Resveratrol is a calorie-restriction mimetic

## Resveratrol in exercise

The data surrounding Resveratrol and exercise is contradictory

- At a low dose, resveratrol acts as s a mild direct antioxidant (which bind to and sequester reactive oxygen species) - This isn’t preferable – the reactive oxygen species generated during exercise are essential for cardio-respiratory adaptations - At higher doses, resveratrol seems to act as an indirect antioxidant (which activates the body’s own endogenous antioxidant systems, like glutathione)

## My takeaway

- Take a higher (500mg or more per day) dose of Trans-resveratrol with lunch (because I'm currently 01/2020 still sticking to my time-restriced eating; no food between 8 PM and 12 PM).

# Nicotinamide riboside/Nicotinamide mononucleotide

Source: various podcasts with Rhonda Patrick, PhD.; also https://podcastnotes.org/2019/11/12/nad-nr-nmn-supplements/

Nicotinamide riboside combined with Pterostilbene is better than N mononucleotide.

## Bottom line for NR

Ideally, get Elysium Basis. https://www.elysiumhealth.com

# Omega-3 fatty acids EPA and DHA

https://n.neurology.org/content/early/2020/07/15/WNL.0000000...

https://www.doctorslounge.com/index.php/news/pb/96975

Pure encapsulations EPA DHA essentials twice daily.

Or maybe get https://www.purecaps.net/produkte/dha-ultimate

[0]: Building Muscle with Resistance Exercise and Reassessing Protein Intake | Stuart Phillips, PhD FoundMyFitness https://podcasts.apple.com/at/podcast/building-muscle-with-r...

[1]: Anastacia Marx de Salcedo — Eat like a Pig, Run Like a Horse The Michael Shermer Show https://podcasts.apple.com/at/podcast/290-anastacia-marx-de-...

Longevity is wrong for the economy and for politics. Ask Prince Charles if you don't trust me.

Just let them go, we are all going the same way anyway. Very little of value comes out of one's mind after a certain age.

The most immediately effective thing parents (or anyone) could do for longevity is begin to see the ground of being itself as divine, and then join a religious community of other people who see the divine life in a similar sort of way. People who belong to these kind of transcendentally oriented communities enjoy longer lives....according to SCIENCE itself.