Old on the inside

A scientific test shows how your cells are ageing, but your ‘biological age’ may not match your birthday. reports.

Kate Percival thought she was doing everything right when it came to her health and wellbeing. At 57, she was slim, ate a fresh, wholefood diet, and monitored her health with twice-yearly blood tests. She knew that more women die of cardiovascular disease than cancer, so wasn’t going to let either of those diseases creep up on her, if regular screening could help it.

As her mother and grandfather had both had bowel cancer, she also had regular colonoscopies. And as co-founder of London members’ club Grace Belgravia, with a health clinic specialising in preventive medicine, she took full advantage of its elite nutrition experts, chefs and doctors.

When she tried a new telomeres test to determine how well she was ageing, she expected to breeze through it. However, the result shocked her. Her ‘‘biological age’’ was 63 – six years older than her chronological age.

‘‘I honestly thought that I would be younger, not older. I was not overweight, nor unfit. I’d done such a lot to keep myself healthy and thought, what more could I do?’’

Telomeres are the end caps of our chromosomes – the parts of our cells that carry genetic information and are responsible for cell division. Every time a cell divides, the caps shorten, until they are too short for the cell to replicate and it dies – otherwise known as ageing. In some people, they shrink faster than in others and lifestyle plays a major part.

‘‘Thirty per cent of how we age is related to our genes, which we can do nothing about, but 70 per cent is related to lifestyle,’’ says Dr Tim Evans, who carried out Percival’s test at the Grace Medical Clinic.

‘‘Research suggests that premature telomere shortening is associated with smoking, being overweight, inactivity, stress, poor sleep, presence of cancer and even trauma.’’ Shorter telomeres put you at greater risk of age-related diseases than someone with a lower biological age.

Percival’s elevated score was put down to stress and lack of sleep. ‘‘Looking back, I was working 60 hours a week, on call 24/7. On holiday, I was always on email or a phone. I never escaped the pressure.’’

She was also sleeping less than six hours a night.

‘‘I’m incredibly resilient at work, but the truth is that even if emotionally one can cope with it, what is it doing to your body?’’

Women with the highest stress levels had shorter telomeres, equivalent to at least a decade of additional ageing, compared to women with low stress, in a study by the department of psychiatry at the University of California.

‘‘Stress is inflammatory and inflammation shortens telomeres,’’ explains Evans.

Coming face-to-face with the science of senescence has been a powerful motivator for Percival. She now prioritises her sleep, aiming for eight hours, and tries to switch off her screen by 10pm. She also puts exercise in her diary, something she’d previously neglected because she was too busy.

‘‘I know the irony of owning a fitness club and gym, and not taking exercise,’’ she says.

A 2017 study published in the journal Prevention showed that people who exercised five times a week (jogging for 30-40 minutes) had longer telomeres than sedentary people – and a nine-year difference in biological ageing.

‘‘The ‘outwardly youthful, inwardly old’ profile is not uncommon among stressed-out high-achieving midlifers and this applies to both men and women,’’ says Evans.

‘‘I see people who are super-lean and super-fit, everything seems perfect. It is often the younger ones that expect to have the superhuman result. Yet they can come back with a result that’s significantly older than their chronological age.’’

How significant? Are we talking a decade? ‘‘We don’t go as far as that,’’ he says. ‘‘The test has a coefficient variance of

5 per cent, so anything plus or minus two years in a 40-year-old patient is acceptable to me as a doctor. However, try telling that to the patient whose test result suggests that they are two years older than their chronological age.’’

But a negative differential of six years does raise a red flag for Evans.

‘‘Then, I go back and ask the same questions. Only then might they reluctantly admit they are having a horrible time at work, their marriage is in ruins, they are having counselling, perhaps on medication, and did not want to admit to appalling sleep and constant stress.’’

A very bad result can also indicate asymptomatic cardiovascular disease. A patient who was clearly not stressed and whose result was bad was referred to a cardiologist, who discovered three narrowed coronary arteries of which the patient was completely unaware.

‘‘Fifty per cent of heart attacks occur in people with normal cholesterol,’’ he says. Telomeres, and the way they shorten, are relatively new to science. British scientist Elizabeth Blackburn, author of The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer, was awarded the 2009 Nobel Prize for Medicine for discovering exactly how telomeres protect chromosomes and the importance of the enzyme telomerase in building telomeres.

It’s a potential new biomarker in our quest not just to live longer, but extend our ‘‘healthspan’’, the years we live actively and disease-free. It’s also part of a rising demand for personalised medicine, based on our genetic profile.

It’s also big business. The global genetic testing market is estimated to be worth nearly US $10 billion (NZ$14.7 b), and set to grow 10 per cent by 2020. When commercial telomere tests first appeared eight years ago, they cost in the thousands. But now, with a price tag of less than US$500, they’re in line with other popular anti-ageing treatments, such as a couple of rounds of Botox or a weekend detox retreat.

Not everyone agrees that a telomere test is money well spent. Thomas von Zglinicki, professor of cellular gerontology at Newcastle University’s campus for ageing and vitality, was the first to propose telomere length as a biomarker of ageing in humans. He says: ‘‘There is no doubt that telomere length can predict ageassociated risks for big cohorts, but it is also very clear that its precision for an individual is very low – only slightly better than throwing a dice.’’

But Percival sees her results as a wake-up call, and has made some key lifestyle changes ahead of a second test.

‘‘I was slim and ate healthily and thought that was enough. One of the biggest changes I’ve made since the telomere test is prioritising my sleep.

‘‘When you sleep properly, it gives you a new perspective on life. I have also been exercising at least three times a week.

‘‘I used to walk everywhere and think that was enough, but it’s not. I also carve out an hour’s quiet time to myself in the morning to get ready – that’s my meditation.’’

– The Daily Telegraph