Age Wave: Shot of Vigor or Quackery? -- In-Depth Doctor's Interview
Tom Perls, M.D., director of the New England Centenarian Study at Boston Medical Center, talks about the latest in aging research.
What is the study that you are currently working on?
Dr. Tom Perls: The New England Centenarian Study has been going on now for about 15 years. We have close to 2,000 subjects in the study of people over the age of 100. We now have 100 people over the age of 110 in the study – very, very rare individuals. It’s because of their rarity that we think that there’s something about these folks, from a genetic and environmental point of view, that allows them to get to such old age, compressing the time that they have any kind of disability towards the very end of their lives. We’re hot on the trail of these factors that allow these people to just live these incredibly long times, most of it with very healthy aging.
What are some of the things that allow these people to live younger longer?
Dr. Perls: I wouldn’t say live younger longer, but to age very, very well for a very long time. We know that they probably do a couple of things. They probably have some genes that help protect them, to help decrease their rate of aging and decrease their risk for age-related diseases. They may also lack some genetic variations or environmental factors that are really bad for them, as well, so it’s a combination of these things. I would say it’s very clear to us that it isn’t one magical factor, that what makes these individuals rare is that they have to have a combination of a large number of factors, and that has to be just the right combination.
What are some of those combinations of factors?
Dr. Perls: I think from the centenarians, we don’t learn that much, in terms of the things to avoid. We actually have centenarians who’ve done really bad things to themselves, in terms of smoking history, not exercising, maybe rotten diets, but those are just the very people we want to study, in terms of their genetics, because what protective factors do they have that allow them to get away with such bad habits compared to other people? In terms of what I think most of us should be doing in terms of healthy aging, a lot of that information I think comes from the Seventh Day Adventist Health Study. These people have the highest average life expectancy of any group I know of in the United States – about 88 years – and it’s probably by virtue of some very good health habits. What are those? Well, they’re vegetarian, they regularly exercise, they don’t smoke, and they because of being vegetarian and the exercise, they tend to be at healthy weights as well. They spend a lot of times with family and religion, which may help them manage their stress very, very well, so really, just five or six things, I think, can make a huge dent in a person’s ability to live to about 88, 89 years, much of it in very good shape.
What role do you think stress plays in aging people?
Dr. Perls: I think there’s quite a bit of evidence now showing that stress is what we call an aging accelerator. There are some good biology studies to support that, in terms of increasing the generation of these things called free radicals that damage our cell membranes. Our DNA can accelerate aging, and we know that can translate into things like higher blood pressure, more heart attack, more stroke, maybe even things like increased risk for things like Alzheimer’s disease. What we’re gathering from the Centenarian Study is that it isn’t so much the amount of stress that you’re exposed to, what seems to be much more important is how well you manage that stress. If you have a personality like the centenarians, many of them have a personality that’s quite conducive to managing their stress well. They score low in something called neuroticism, meaning that they don’t dwell on things, they don’t internalize things that are stressful; they seem to be able to just naturally let go. They also tend to be quite extroverted, so they develop friendships with people. That can be, of course, an important social safety net. It’s cognitively stimulating, and it’s another way of managing one’s stress, so even if it doesn’t come naturally for you to try and come up with some strategies that help you manage the stress, not internalizing it, but being able to let go – for me that happens to be physical exercise – then that’s very, very important.
What can you tell us about your patients, the Hurlberts, that are part of your study?
Dr. Perls: These eight siblings, all alive from their early 80’s up to late 90’s, are absolutely remarkable. None of them uses a cane, and they’re all really in amazing shape. The family is very rare, because to have so many individuals at such old ages is really a treasure trove for us in terms of a family study of exceptional longevity, and it just speaks to how strongly longevity can run in a family. It’s our studies, really, that have shown that exceptional longevity runs very, very strongly in families, so that if you have long lived individuals in your family, that probably bodes very, very well for you.
What do you think it is about that family that makes them all older?
Dr. Perls: If you have exceptional longevity running strongly in a family, you’ll see all kinds of traits that are conducive to their aging well, but they may also have personalities that are, in their cases, I mean, they tend to be a lot of fun – they tend to have a lot of humor in their lives, they seem to be very easygoing, they’re a lot of fun to be around. Those personality traits are probably very good for their managing their stress well. It’s very good for them being dependent upon one another when they need to be, so they, for sure have a formula conducive to exceptional longevity.
Just exactly what is that formula, if you could crack that code?
Dr. Perls: What’s pretty complicated for the work that I do is that the formula for one person to get to very old age can be very, very different for another. That does not seem to be so much the case for the most extreme ages that we study – people who live to 110 and older, what we call super centenarians. That’s a very homogeneous group. They’re very rare, about one per seven million in the population, but we’ve recruited over 100 of them now in this study, and we think that they are our best bet at understanding genetic and environmental factors that are conducive to that kind of exceptional survival.
Do you have any clues as to why they’re living so long?
Dr. Perls: One thing that is really interesting is that they do incredibly well at least through 107, 108, in terms of basically living independently. If they do start to have problems, it’s really at the very end of their lives. I’m sure that there are some really important genetic mechanisms underlying that, in terms of being protected from a whole range of age-related problems, both biological and clinical in terms of disease, so we’re very, very anxious to try to understand what those genetic factors may be.
What are your thoughts on donating blood?
Dr. Perls: Well, I have been quoted in weird magazines and at other places for saying that I menstruate once every eight weeks, and the way that I do that is to donate a unit of blood, and that sounds very odd. There are a couple of reasons why I think donating blood for me is important. One is I have quite a rare blood type, so I think that as a physician that’s an important altruistic thing to do. The other is that one reason why women might age better than men, why they delay the onset of things like heart disease or stroke by 10 or more years compared to men, it may not just be estrogen – we’re not even sure what role estrogen plays in a woman’s advantage in terms of the longevity marathon – but one of the other things that women obviously do different from men is that they menstruate, and that they’re relatively iron deficient for about 30, 40 years compared to men. That iron, it turns out, plays a very important role in our cells’ ability to produce these free radicals, these caustic molecules that can glom onto our membranes, our DNA, and really can accelerate the aging process. It may be as simple as less iron in your system means producing fewer free radicals, so it might be an advantage to be a bit iron deficient. Obviously, if you’re having symptoms from iron deficiency, like being short of breath or tired or what have you, as you would see in heavily menstruating teenage girls, then being on some iron is probably good for you. Otherwise, I don’t see a role for iron, and if you’re not menstruating, like you’re a man and you’re post-menopausal and you’re iron deficient, well, that may be a sign that there may be some blood loss that’s bad for you, and then that needs to be hunted down.
Have you found any correlation with people who don’t eat red meat and living longer, since they tend to have less iron?
Dr. Perls: Yes, probably one of the really important reasons why red meat is bad for you is not so much the cholesterol or fat that one might get with red meat, but red meat is by far and away the main source of iron in our diets. Spinach and other vegetables, those are bio-unavailable forms of iron. We really get very little, if any, iron out of green vegetables. On the other hand, red meat – and then interestingly, the other major source is oysters – is really our main source of iron in our diets. By decreasing the consumption of those things in our diet, maybe that makes us a little bit iron deficient, or certainly have less iron in our bodies, so that might be very good for us.
How often do you donate blood?
Dr. Perls: Maybe once every eight weeks is about what blood banks allow you to do.
Why do you donate blood on a regular basis?
Dr. Perls: Donating a unit of blood, maybe once every eight weeks, might make me a little iron deficient because that’s really where iron resides is in the hemoglobin of our red blood cells. By having a little bit less blood might mean that I have a little less iron circulating in my system.
How will tweaking genes and new anti-aging medicine change the way we age?
Dr. Perls: I don’t really think it’s a matter of tweaking genes. The reason that we are looking for genetic variations associated with exceptional longevity is when you discover these variations, they may be clues to the biochemical pathways that are playing a role and protecting us from things that cause aging and age-related diseases. If we can discover those bio-chemical pathways, then we have what are called drug targets, or to develop drugs that might do the same thing that is occurring naturally in some of these, for example, super centenarians. With regard to what is out there on the market these days, in terms of what could slow down or reverse aging, it’s a resounding nothing. The anti-aging industry that professes things like human growth hormone or other hormones, I view as not only just quackery, but downright dangerous, so I implore people to stay away from anything that somebody is saying is stopping or reversing aging. That means things like these bio-identical hormones, things called testosterone, or growth hormones or DHEA or melatonin. The last few things are less dangerous, but things like human growth hormones, to me, are akin to pouring gasoline on the fire called cancer. It’s very, very important to stay away from this stuff where there is really very little in the literature to support these claims. It’s just a way for these people to make a lot of money with very little, if any, kinds of scientific foundation for their claims.
When you’re talking about the human growth hormones, are you talking about prescribed types of medications that people would take?
Dr. Perls: Right, there are age-management clinics, the Internet, where people can go to actually get prescriptions for what amount to injectable drugs, and it’s really modern-day quackery and hucksterism, in my opinion. Now, there are some things people can do, in terms of at least decreasing risks for things like cardiovascular disease, stroke, perhaps even Alzheimer’s disease, and that would be, in my opinion, if your physician allows you and thinks it’s a good idea –maybe a low dose aspirin a day, there are these things called three omega fatty acids that one can get a capsule to take, it comes from either fish oil or flaxseed oil, those probably play an important role in decreasing your cardiovascular risk. Taking calcium with vitamin D, I think, is very important for decreasing your risk for osteoporosis, and then beyond that, I’m not sure that anything else that’s on the market, in terms of decreasing risk for age-related disease or just aging itself makes any sense.
What do you think of resveratrol?
Dr. Perls: Resveratrol has been touted as perhaps playing a role in decreasing risk for heart disease. Only a limited number of animal studies have shown the possibility of that. There are other studies that show there’s no effect at all, and there aren’t any human studies as of yet, so you may just be paying a lot of money for something that does you no good, and we don’t know if there’s any long term side effects.
Do you think HCG, the hormone for pregnant women, will play a role in helping people to live longer?
Dr. Perls: Manny Ramirez, the baseball player, was caught taking HCG. HCG is a hormone that can be given to men to stimulate the testicles to make testosterone. If a man has testicular hypo-function, where the testicles aren’t working properly and they have low testosterone levels, they need to be worked up by an endocrinologist and determine if there is any kind of problem that needs to be addressed. I think that is my general advice about hormones in general, is go to a specialist, an endocrinologist, and find out if you have a problem that needs addressing, but these other anti-aging doctors, or even just non-doctors who are advertising hormones, I think that they are advertising a toxic soup for you, and it’s really something to avoid at all costs.
Do you think that helping to deplete your iron may be a better idea?
Dr. Perls: I don’t see a drawback to donating a unit of blood every eight weeks. I think it’s a good altruistic act. I think most people, if they can, should donate blood for other people. If a side benefit may be that it helps decrease my risk for cardiovascular disease, then that’s great.
What do you think of people who take injections of HCG?
Dr. Perls: I think any of these hormones are just hucksterism and quackery.
Is DNA your destiny, or has science surpassed nature?
Dr. Perls: I think knowing your genetics is very powerful and helpful information. I don’t think you need to get your DNA sequenced – just look at the longevity in your family. Are people dying in their 90’s, maybe even early 100’s? Well, then you’re very, very lucky. You might even be able to indulge in some things that might otherwise be bad for you. On the other hand, if people are dying in their 60’s or 70’s, if they’re smoking, you certainly know you shouldn’t be smoking, but you don’t know, and if they could be dying from other things. It’s really important to look at your family history, what other people have died from, and learn those lessons, and avoid the health related behaviors that could’ve contributed to what I would call premature deaths. If they’re getting adult onset diabetes, that’s very important to know, in terms of trying to keep your weight down to a healthy weight. If again, they were smoking and they died of a smoking related illness, you certainly should not be smoking. If they have a history of colon cancer, maybe you need to get a colonoscopy sooner than other people, and so on.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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