March 1, 2021

Seven pillars of aging

Hi, I'm Charlene

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The 7 Pillars of Ageing

GeroScience is a scientific journal leading the charge in the biological study of ageing and chronic age-related diseases. GeroScientists conceptualize biological ageing into 7 pillars, that are separate but interconnected.

Ageing is a multi-dimensional process, meaning that one pillar can affect another or many pillars; these effects can compound over time, often exacerbating ageing systematically across all pillars.

The connectedness between the pillars was described by researchers as ‘striking’, because, these seven pillars are…

“not seven independent factors driving aging; rather, they were highly intertwined processes, and understanding the interplay between these seven pillars is critical”.

Optimal functionality requires overall health, thus, there is a great need to understand the systemic relationships of ageing, to develop best practices that work across all seven pillars of ageing to mitigate the detrimental biological effects of ageing.

If the COVID-19 pandemic has proven anything, it is the extent to which health vulnerable persons tend to not only have one underlying health condition but have multiple underlying health conditions – exacerbating morbidity. Thus, targeting diseases individually is often ineffective because the presence of multiple health conditions interact and have a confounding effect on therapeutic strategies.

E.g. once one thing goes wrong, everything else starts to go wrong.

The connectedness between the ageing pillars will enable new therapeutics to arise that will work for multiple chronic diseases by targeting ageing directly at the network level.

Macromolecular Damage

Macromolecular Damage can be understood as the deterioration of the building block cells of the body. These cells are known as macromolecules: DNA, lipids, proteins (amino acids), and carbohydrates (polysaccharides). As we age, these macromolecules deteriorate and accumulate in and around our cells.

Proteins involved with visual aesthetics such as skin, hair, and muscle tone, will over time deteriorate – wrinkles are a classic sign of ageing. This deterioration is the protein not forming correctly and is characterized by the protein misfolding, oxidizing, or when glycation goes array, creating advanced glycation end-products. This is when sugar molecules incorrectly attach to a protein or other macromolecule. Over time these junk proteins build up and start to take up space, and interfere with our body’s ability to effectively clear these damaged cells from our body – a process known as autophagy. imagine you are in a room, and there’s a thousand bits of paper on the floor and one bin in the corner. You are tasked to pick up one bit of paper, take it to the bin and dispose of it. However, every minute, one person enters the room and this continues until the room is saturated with people – all getting in your way. How difficult is it for you then to make your way around the room, pick up each piece of paper, and then dispose of it. Over time it becomes near impossible. This is akin to how the body struggles as it ages to remove junk proteins. The accumulation of junk proteins then exacerbates other ageing factors.

Epigenetics

The epigenome consists of chemical compounds that can tell the genome what to do. The genome – your DNA – is the blueprint for how your cells are put together and how they should function. The epigenome sits alongside your genome and can turn genes on or off. The epigenome does not alter your DNA blueprint – that is fixed – but it alters how your cells interpret the DNA’s instructions.

For example, a captain sailing a ship acts like an epigenome. The ship, it’s the crew and the charted root is the DNA blueprint – the fixed factors. The captain can sense and interpret the environment and respond by giving orders – turning genes on or off – to adjust certain factors with the ship, such as the deck numbers, sail configurations, and heading to complete the voyage.

As we age, our cells are continually put under stress from the environment and this changes the body’s epigenome; this environmental stress can change your epigenome both positively and negatively. The negative changes are what result and exacerbate ageing, and are often triggered by environmental toxins, chemicals, drugs, pharmaceuticals, infectious diseases, and lifestyle factors. These stressors cause changes in the epigenome which then alter signals that interfere with DNA methylation, RNA, and histone. Over time these changes start to impact the other pillars of ageing and increase the likelihood of diseases like diabetes and cancer occurring.

Inflammation

Inflammation in regards to ageing refers to body-wide low-level chronic inflammation. The exact ways in which inflammation is a causal or contributing role in ageing is still unknown, however, it can be said with certainty that all age-related diseases – think, diabetes, heart disease, cancer, and dementia – are strongly associated with body-wide low-level chronic inflammation – technically known as inflammatory pathogenesis.

Inflammation is not a bad thing in and of itself; in fact, many of the health benefits we get from exercise are as a result of the inflammatory response. Similarly, the way we build a strong immune system is by exposure to pathogens, followed by an inflammatory response by your immune system. For example, a doctor, if they suspect infection or disease will likely test for inflammation. They will test for the elevation in serum levels of several cytokines and acute phase factors. Three of the most commonly tested for are: C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α).

As we age, this inflammatory response by your immune system can become dysfunctional, and instead of turning off after pathogen exposure, can remain on, meaning your body remains in a constant stressed state. This overactive immune system state accelerates ageing throughout the body, impacts the other pillars of ageing, and can result in the onset of age-related diseases.

Adaptive Stress

This pillar of ageing refers to how we adapt to stress both at a psychological and molecular level and recognizes the influencing inter-connection between psychological stress and molecular stress. For example, psychological stress can lead to the release of cortisol in the body – a molecular response – which if chronic can exacerbate ageing. The influence also works in reverse; for example, if you are exposed to environmental toxins, the molecular response can cause a psychological response, which can then become a vicious cycle of compounding psychological and physical stress.

However, not all stress is bad; it is important to differentiate between toxic stress and hormesis. If the stress is of an optimal level for you to recover from, the stress or toxin can have a positive effect on your physiology and psychology, which extend the life and slow the effects of ageing.

People’s adaptive stress levels are what differentiate one’s anti-ageing potential. For example, some people can naturally train physically a lot, just as some people can take on a lot of psychological stress and still function – they have a higher hormetic zone for certain stress. Whereas others can’t function at similar or lower stress levels. This variation affects whether the stress effect becomes chronic or acute. Chronic being the worst for ageing-related effects and diseases.

Proteostasis

Proteostasis is the process that oversees the regulation and maintenance of all proteins in the human body – also known as the proteome. Proteins in the body are not just essential to building muscles and skin, proteins are utilized in many life-sustaining processes throughout the body. Pretty much all cellular activity requires proteins at one point. Proteins firstly need to be assembled correctly so that they work, and secondly, they have a shelf life, and once expired they need to be removed before they become junk and cause havoc.

Proteostasis is the quality control mechanism that oversees the body’s protein lifecycle. The technical names for some of these quality control mechanisms are chaperones, autophagy, proteasomal degradations, endoplasmic reticulum (ER), and mitochondrial unfolded protein responses (UPRs).

However, sometimes these mechanisms go array the proteins get assembled incorrectly – misfolded. Misfolded proteins become junk cells and will often clump together with other damaged cells. This accumulation of junks cells accelerates ageing; the term garb-aging has been coined to describe it, which is the combination of garbage and aging. Garb-aging interferes with correct cell function and also triggers chronic inflammation, which was discussed in an earlier section.

Ageing presents two challenges to proteostasis: the first, is body’s quality control mechanisms worsen with age and therefore garb-aging increases with age; the second, is garb-aging exponentiates garb-aging, thus, your body as you age needs to deal with more and more junk cells, all while the body’s quality control mechanisms are a decrease in effectiveness over time.

Using Alzheimer’s disease as an example, the loss in the effectiveness of autophagy (cellar cleaning) leads to garb-aging in the brain. Amyloid plaques are junk cells, strongly associated with Alzheimer’s disease that build-up due to poor autophagy in the brain.

Stem Cells

Of all the anti-ageing and next-generation medical treatments, stem cells have to be the most widely known and purported of the last twenty years. At times being touted as a potential cure-all and at other times being demonised as an immoral baby-killing procedure. Despite this, stem cells have over the last few years, with the help of Joe Rogan, become popular as a means to recover from injury and bring function and vigour back to ageing persons.



Their specific role in ageing is recognized, but it is not fully understood. Their role in ageing is not quite as straightforward as first thought. The role of stem cells in ageing depends a lot on the specific area of the body, for example, with muscles, stem cells are present even in the advanced years of ageing, so this says it is not a declining number of stem cells which is causing ageing. Instead, something is going on in the local tissue environment that means present stem cells are not being activated. This is why the effectiveness of injecting stem cells as a strategy to heal and regenerate tissue has not been as effective as first thought – the local tissue environment is not responding by activating the stem cells.

So what is it about the local tissue environment of younger people that activates the stem cells? It appears to be some specific component – special blood factor – in the blood that is present in younger people but not in older people. Over the last few decades, a series of parabiosis experiments (which is where they inject the blood of young mice into older mice and vice versa and observe tissue changes) have taken place to try to locate this special blood factor, but have so far been unsuccessful.

Currently, scientists are in a race to find out what this special blood factor is because if they can locate it as a specific compound this changes the anti-ageing and regenerative health game when it comes to stem cells.



Metabolism


It is quite a well-known trope with those over thirty that the metabolism slows as it ages. It is not uncommon to look back on teenage years and early twenties and reminisce at the amount of sh*t food you could eat and not get fat… whereas after thirty, a moment on the lips becomes a lifetime on the hips.

The metabolism slows as we age because of deregulated nutrient sensing. In more common parlance this means our cells don’t respond to/partition nutrients as effectively as they once did. The slowing of the metabolism not only makes one more prone to weight gain and muscle loss (higher levels of lean body mass is a strong indicator of longevity), it also means the body becomes more susceptible to chronic diseases, which then exacerbates the other pillars of ageing. Some of the most common age-related diseases are metabolic diseases, such as a variety of cancers, cardiovascular disease, type-2 diabetes, and neurodegenerative diseases.

Our cells need the energy to function and that energy is delivered into the cells through different nutrient-sensing pathways with the assistance of enzymes that will up and down-regulated in number depending on the energy demands and fuel sources available. Some of the most important nutrient-sensing pathways are:

  • Insulin and IGF-1 signaling pathway (IIS): glucose-sensing
  • mTOR: senses high amino acid concentrations
  • AMPK: senses low energy states by detecting high AMP levels
  • Sirtuins: senses low energy states by detecting high NAD+ levels

With the declining ability of our cells to partition nutrients as we age, our cells become worse at assimilating key nutrients they need to work effectively. These three key nutrients are:

  • Coenzyme Q10: essential for generating cellular energy.
  • Cardiolipin: optimizes the function of numerous enzymes that are involved in cell energy production.
  • Carnitine: Transports fatty acids into cells to be oxidized for energy production, and also participates in removing waste products from cells.



Imagine how hard it is to perform well in a running race when you are undernourished; this is the state of your cells when they lack these three key nutrients. And as we have seen with many of the other pillars of ageing, stress creates stress, which exacerbates the other pillars of ageing. There is also evidence that metabolic changes impact the micro-biome and the body’s circadian rhythm which can trigger metabolic irregularities and pro-inflammatory effects. Closing Thoughts… Ageing isn’t all bad news; yes, we are facing a demographic time-bomb that could lead to some dire economic and societal impacts (we might already be there with COVID-19), and yes, modern medicine is incredible at decreasing morbidity, but fails to prevent or reverse the decline in healthy life expectancy years – it can keep you alive but are you ALIVE? These issues are starting to be felt and this will hopefully lead to increased funding and research; therefore, the future is optimistic for anti-ageing therapies. We are not that far off – currently, ageing can be delayed with genetic, dietary, and pharmacologic approaches; which will be discussed in the next blog post in this series. So stay tuned and make sure to check back, because I may just show you what tools, supplements, and procedures you can use to create your very own fountain of youth.

Written by Let’s Eat Meat




The pressure to succeed in a high-functioning profession like law can throw your personal wellness into a sort of dark tunnel. Perhaps what lawyers should be told when they pass the bar is “welcome to the dark side, we’ve been expecting you.” Luckily, there are ways that lawyers can find their way out, with the right kind of light. 

Many lawyers have been crushed by the dark side of law. In fact, lawyer wellness, on average, is so poor that lawyers rank fourth in suicide rates by profession, according to CNN.

The truth cannot be ignored any longer. Personally, I burned out and saw many of my colleagues burn out as well. The only way our profession can work to make it better is by confronting the dark side. In my case, I knew there had to be a way to bring light to the dark side of law and make it better, which is what drove me to become a life coach for lawyers.

Life Coach for Lawyers


Why such a ‘dark’ side? The answer is: Intense career-induced stress. When my own practice pushed me hard against the wall, I did something radical so I would not break; I decided to step away from my legal practice and step into a wellness quest to become the coach I wish I had when I was practicing law. 

I knew there had to be a way to bring light to the dark side of law and make it better, even though it was bold and risky to leave behind a prestigious career. I went on a journey that encouraged me to become a wellness coach. Now, I help design and implement bespoke programmes that help lawyers who face the same health-impacting struggles that lawyers tend to face in the profession. Contact me online to set up a chat with me if you are interested in receiving the coaching I wish I had while I was a lawyer!

Why is Personal Wellness for Lawyers So Hard? Every Profession Has Health Challenges

The world is not perfect, and neither is any job. The health issues that lawyers face are neither new nor unique to them, but what is unique is the frequency and susceptibility. Considering that self-sufficiency is a professional obsession, lawyers are less inclined than others to seek help, especially when it comes to mental health.

The most common profession-induced health issues lawyers struggle with include:

Excessively Sedentary Lifestyle

Movement is incredibly important to both physical and mental health and is one of the most powerful tools to slow down the negative effects of ageing. Sadly, lawyers’ work is often bound to the desktop and tends to reinforce a sedentary lifestyle, both in the short and long run. This can be very dangerous as it sets off a cascade of negative biological effects. Long stressful hours in front of a computer screen erodes one’s mental sharpness. Where long workdays become long work weeks, and long work weeks blend into months, brain performance can deteriorate.

Some of the major issues with extended screen time and sedentary sessions are:

  • Poor posture and sedentary behaviour
  • Chronic back, neck and shoulder pain
  • Poor nutritional choices
  • Lack of proper breaks or healthy food
  • Chronic stress and anxiety
  • Metabolic diseases (diabetes, excess weight, high blood pressure).

Law is a high-pressure field and combined with a lack of regular cardio training that gets to the heart. A study in Nepal showed that nearly 19% of lawyers have challenges with physical activity, with 70% of them being previously unaware of their situation.

Poor Sleep and Excessive Exposure to Artificial Lights

Most clients suffer from chronic stress and elevated cortisol (stress hormone), which negatively impacts sleep. Sleep is essential for lawyer wellness, health, and performance – health can’t be optimal if your sleep quality is poor. Poor sleep can disrupt the overall metabolism, which can lead to weight gain and poor digestion and nutrient absorption. Optimal sleep, on the other hand, improves mental health, promotes weight loss, and wards off metabolic diseases. 

Lawyers spend most of their day indoors, in front of a screen, and under fluorescent light. This type of light is known as blue light, a potent disrupter of the hormones regulating our circadian rhythm. The average office worker will spend almost 1,700 hours a year in front of a computer screen, according to a poll conducted by ACCUVUE in 2018. Due to the fact that most workers now work from home, it is likely this number is much higher, and also does not include out-of-hours and mobile screen time. Spending this much time in front of a screen defies human biology, and it is starting to impact our eye health. Including red light therapy in daily work schedules is a cutting-edge way to help offset the negative effects long screen time is having on our eye health.

Light exposure plays a vital role in affecting the biological pathways that impact your sharpness of mind. Light to the brain is a key signal of when you should be awake or asleep. Most of us spend hours and hours in front of or under blue light, and that can seriously impact the biological signals our brains need to function and age optimally. Chronic exposure to blue light means the biological pathways needed for mental rest and recovery are not being activated optimally.

Many of the clients and lawyers I work with suffer from headaches, dry eyes, and migraines, and these are remedied only a few weeks into my programme thanks to the biohacking tools I recommend.

Frequent ‘Social Drinking’

Alcohol has a relaxing effect, and most people will reach for their favourite bottle to help them forget about their problems. Now imagine when in addition to personal problems, your job requires you to handle other people’s problems.

The Journal of Addiction Medicine reveals that 21% of United States lawyers struggle with alcoholism. Some estimates even suggest that as many as one in three lawyers are “problem drinkers.” The desire to quickly relieve the enormous stress they face contributes significantly to “the professional legal disease.”

Alcoholism is one of the key disorders that the American Bar Association highlights in its mental health awareness campaign. Each state in America also offers a lawyer assistance program to support those in the legal profession facing mental health and substance abuse problems.

In the UK, LawCare provides fantastic support for lawyers.

Problem Drinking--Lawyers' Health | Charlene Gisele

Substance Abuse

Stress is a progressive chronic disease for lawyers because intense deadlines are a constant noose around lawyers’ necks. People’s lives and livelihoods depend on these deadlines. It’s a lot of pressure!

 Other than alcohol, many lawyers tend to abuse substances like nicotine, stimulants, Valium, or sleeping pills to find a sense of relief. Substance abuse issues even begin as early as law school, with more and more studies, like this one from the Postgraduate Medical Journal, revealing the extent of substance abuse in the legal profession.

The problem starts well before lawyers enter the legal profession. According to the American Addition Centers, one in five lawyers who say they have a substance abuse problem report that it began while they were in law school. Part of the problem is the stigma. Up to 72% of law students who reported substance abuse felt that they would be more likely to be admitted to the bar if they did not seek help or admit their issues.

Further, the working conditions in the legal profession lead to a higher likelihood of a co-occurring disorder, such as depression, stress and anxiety. Sixty percent of attorneys receiving substance abuse treatment also had a co-occurring disorder. 

Anxiety

The legal profession is one of the most competitive fields. Aside from this, the law is intrinsically competitive, and many times adversarial. In litigation and transaction proceedings, lawyers have to ‘fight’ each other, not only for their client’s sake but also to safeguard their professional prestige. There is always one winner, and every lawyer wants to be that one.

In addition to this, lawyers have to be extremely careful to ‘cover themselves’ when involved in any case. The ease of bringing up malpractice claims, especially out of spite is something they have to protect themselves against. Additionally, there is always ‘Murphy’s law’ to contend with in the life of a lawyer. The anxiety that anything can go wrong and WILL go wrong affects their quality of life. Nineteen percent of lawyers show signs of an anxiety disorder, which is one of the most pressing issues relating to the mental health of lawyers. Anxiety is one of the most common co-occurring disorders of substance abuse – in fact, 19% of lawyers receiving substance abuse treatment also have anxiety. It’s critical to get anxiety under control to help curb the impulses that may lead to longer-term mental health conditions.

The dark side of law | Wellness and Practice| Charlene Gisele

Depression

Sometimes, for lawyers, it can seem as though there is nowhere to turn. At work, your head feels like it’s in a hydraulic press, and then outside of work, your profession is stigmatized and distrusted. Lawyers are often the butt of jokes, but beyond that, they are often unfairly believed to be dishonest. Because lawyers tend to earn high incomes, society cannot always understand what drives lawyers to suffer such poor mental health.

Remember what I said about lawyers ranking fourth in suicide rates by profession? Lawyers are the most depressed occupational group in the United States and are 3.6 times more likely to suffer from depression than non-lawyers. Similarly, 28% of lawyers receiving substance abuse treatment are also diagnosed with depression. This means that depression is heavily linked to many other adverse health consequences.

So, in spite of what wealth some may accumulate, no amount of money can compensate for the stress and pressure of moving ahead in a legal career. Even when at the zenith, the pressure remains. And, because of the ‘fix-it’ attitude and self-sufficiency of the profession, most don’t seek help, and many end up becoming another sad statistic. There are also well-grounded fears of being considered ‘unfit for practice,’ which may prevent lawyers from seeking help.

 

Post-Traumatic Stress Disorder (PTSD)

A study in the Psychology, Crime, and Law Journal states that “lawyers who’re exposed to trauma in their practice are 2.62 times more likely to meet the probable post-traumatic stress disorder (PTSD) diagnostic criteria than their unexposed colleagues.” Working on traumatic issues, like criminal lawyers often do, can be traumatic in itself, especially when visual evidence of gruesome crimes are considered.

However, there is an incredible stigma around mental health in law that even symptoms of PTSD are often ignored. Criminal lawyers are especially prone to this devastating condition, and many lawyers simply fail to seek the help they need.

Vicarious Trauma

Vicarious trauma is an indirect experience of trauma and distress. This type of trauma is more common than most people think. I remember how emotionally invested I came to be in some of my client’s cases and lives. What affected them, affected me. It is impossible to be 100% detached from 100% of cases, lawyers are not robots, after all. Additionally, research from Maguire and Bryce’s shows that vicarious trauma greatly contributes to disrupting beliefs about trust, intimacy, control, safety, and esteem

Let’s Make it Better! Optimising Personal Wellness of Lawyers


On the upside, more and more firms and organisations are addressing the toll that legal practice has on practising lawyers. Management is beginning to recognize that these interventions need to happen on the institutional scale to address the root causes of these disorders, such as a competitive, draining, and toxic work culture.

Thankfully, organisations such as the American Bar Association (ABA) have been actively working to dismantle the stigma, especially related to mental health.  The ABA provides useful resources, which tend to mirror the strategies found in the corporate wellness section of my blog.

Optimsing Lawyers' Health | Charlene Gisele

Customised Solutions

The solutions addressing mental health are never one-size-fits-all. Each person and law firm is unique and needs a tailored approach. My wellness packages include comprehensive strategies to address the overall well-being of lawyers. These strategies leverage biohacking techniques to optimise lawyers’ health and wellness. Most of my clients (individuals and organisations) are immersed in the high-functioning world of law, so no matter how high-pressure or busy your job is, there is a solution for you.

A healthier lawyer is a better lawyer. This is something many young lawyers neglect when they first start practising. By developing healthy habits early on, the goal is to put lawyers in a better position to optimise their health and improve their performance.

There are solutions to help you keep doing the extraordinary work you do as a lawyer while looking after your health. With the right method and blueprint, you can have it all – a thriving career in law and outstanding health.

What to Expect in a Lawyer Wellness Workshop

As a law firm wellness coach, some of the healthy habits included in my workshops, seminars, and coaching programme are:

  • Sleep optimisation and recovery
  • Mindfulness, breathwork and mindset
  • Movement and exercise
  • Nutrition choices and eating habits
  • Mental and metabolic health optimisation
  • Awareness of the environment (light, air, water, indoors vs outdoors)

By teaching breathwork, meditation, and other flexible tools, these workshops are designed to teach you methods to relax, stay mindful, and disconnect from work when needed. They are flexible and quick tools that fit easily into your busy schedule.

 

Contact a Lawyer Wellness Coach

 

Always remember that it’s okay to ask for help. It does not make you less qualified to practice the law. Instead, it reflects your self-sincerity and inner strength. These programs are designed to be flexible and “meet you where you are.” If you’d like to know more about my VIP individual coaching or firm-wide workshops and events, check here. You can also subscribe to my life optimisation newsletter so you never miss an opportunity to improve your quality of life! If you would like to reach me directly and find out how a lawyer wellness coach can help you with your specific challenges, you can contact me online to set up a consultation.

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