The Life Extension Revolution
by Philip Lee Miller, M.D. with Monica Reinagel
Bantam, 2005
As technologically advanced as we are, why hasn’t conventional medicine been able to cure many of today’s diseases? Because many scientific findings never make it into mainstream medicine, the result is that millions suffer and die while proven therapies exist. The good news is that a leading anti-aging physician and the renowned Life Extension Foundation are revolutionizing medicine by combining modern medical discoveries and novel natural therapies. Now, reaching 40 no longer means inevitable weight gain, joint pain, and cognitive decline. In the not-so-distant future, diseases will be cured, and the human life span will be measured in centuries rather than decades.
Experience The Life Extension Revolution
This groundbreaking book uses cutting-edge anti-aging advances for a practical program that will maximize your chances of living not only a long life—but a healthy, vibrant life. Drawing on his own clinical experience as well as the latest research from the Life Extension Foundation, Dr. Miller demystifies the aging process and provides you with:
- Detailed strategies integrating the most advanced mainstream therapies with nutrients, hormones, and holistic approaches from around the world.
- How to prevent cancer, heart disease, arthritis, and Alzheimer’s by controlling inflammation and oxidation—two degenerative processes that cause us to age prematurely and have been linked to disease.
- A guide to individualizing this lifesaving program, including specific dietary and supplement suggestions, plus how to use medical tests to monitor your progress.
- A powerful vision of what your future will be like without disease, premature death, and aging, and novel strategies to help you get there.
This comprehensive anti-aging program will change your life forever. Diseases and conditions you once feared will hardly be a passing thought. Like many of Dr. Miller’s patients, your physical and mental health will soar as you age chronologically. Your new life begins now as you embark on the Life Extension Revolution.
About the Authors
Phillip Lee Miller, M.D., is the founder and Medical Director of the Los Gatos Longevity Institute. A practicing clinician for more than 30 years, he is a Diplomate of the American Board of Anti-Aging Medicine and serves on the Medical Advisory Board of the Life Extension Foundation.
Monica Reinagel is a writer specializing in nutrition and holistic medicine. She has served as Editorial Director of the Health Sciences Institute and as Managing Editor for the American Academy of Environmental Medicine's Medical Digest.
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The Life Extension Revolution
By Matt Sizing
Stopping Disease at the Cellular Level
“To maintain our youthful vitality as we get older, we also want to take care that the bright future is not dimmed or diminished by disease,” says Dr. Miller. Thus, the second part of The Life Extension Revolution presents a multifactorial approach to disease prevention extending all the way down to the human cells, the smallest units of living matter capable of functioning independently. Separate chapters are devoted to four key molecular or biochemical processes—oxidation, inflammation, methylation, and glycation—that are central to aging and many diseases of aging.
Curtailing Oxidation
More than 50 years ago, Dr. Denham Harman’s “free radical theory of aging” dramatically altered how people think about aging. In studying radiation sickness in laboratory mice, Dr. Harman noticed that radiation exposure produced an onslaught of unstable molecules known as free radicals. Over time, free radicals can disrupt the functioning of cells and tissues, causing severe symptoms and even death. Oxidation caused by free radicals can impair the functioning of cell membranes, DNA, enzymes, protein synthesis, and mitochondrial function. Poor diet, aging, intense exercise, exposure to toxins, and illness all increase the risk of oxidative stress. In the last half-century, countless studies have implicated cumulative free radical damage in the development of common diseases of aging such as cancer, heart disease, diabetes, and Alzheimer’s.
Preventing free radical damage is a cornerstone of any program to prevent disease and forestall the aging process. Key strategies to reduce oxidative stress include consuming chemical-free foods and liquids, and limiting exposure to ultraviolet radiation and other environmental toxins. An overlooked yet essential tool in counteracting free radical damage is to increase the body’s store of antioxidants, which quench free radicals before they can cause harm. Supplementing with potent doses of gamma tocopherol, lycopene, and green tea, with minerals such as selenium, zinc, and manganese, and with mitochondrial energizing agents such as coenzyme Q10, lipoic acid, and acetyl-L-carnitine, is essential to counteracting free radicals. Antioxidant phytochemicals such as resveratrol, grape seed, lutein, and zeaxanthin afford additional protection against free radicals. While these phytochemicals are contained in fruits and vegetables, most people cannot possibly hope to derive from dietary sources the amounts required for optimal antioxidant protection. Thus, Dr. Miller offers a compendium of antioxidants and the recommended dosages of each needed to “rust-proof” your cells and provide the best possible protection against the damaging effects of cellular oxidation.
Cooling Inflammation
Life Extension has long warned its members about the lethal dangers of systemic inflammation, yet this precipitator of diseases such as cancer, Alzheimer’s, heart disease, and even arthritis is only now gaining widespread attention. Controlling inflammation is central to disease prevention and life extension. The good news is, inflammation itself is a highly treatable, correctable condition.
Keeping inflammation in check requires careful and ongoing monitoring of critical blood markers such as C-reactive protein and fibrinogen. Undisputed yet often ignored research shows that even slightly elevated levels of these blood markers can double heart disease risk, even in those with no other risk factors such as high cholesterol. A comprehensive program for controlling inflammation has as its foundation regular blood testing to assess and monitor these and other important markers of inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin can play a critical role in reducing inflammation and lowering risks for inflammation-implicated cancers of the colon, prostate, breast, and esophagus by a remarkable 50-90%. With about 150,00 Americans dying each year from these four cancers alone, the cancer-preventive effects of these NSAIDs cannot be underestimated.
After examining the benefits and potentially lethal side effects associated with controversial COX-2 inhibitors and statin drugs, Dr. Miller offers supplemental and dietary strategies demonstrated to markedly reduce inflammation. Supplements such as omega-3 fatty acids, bromelain, ginger, curcumin, DHEA, vitamin K, and ginkgo biloba all have shown powerful anti-inflammatory effects. Likewise, a diet that emphasizes monounsaturated fats (such as those found in fish and olive oil) and low-glycemic foods (such as whole grains and vegetables), while limiting foods that are high in arachidonic acid (such as fatty cuts of red meat), can provide powerful protection against the insidious consequences of chronic inflammation.
Enhancing Methylation
Until recently, few outside the field of molecular biology were familiar with the process of methylation, which involves the transfer of a methyl group (one atom of carbon attached to three atoms of hydrogen) from one molecule to another. Today, every health-conscious adult has good reason to be familiar with it. “Your body depends on methylation to detoxify carcinogens and other poisons, to repair damaged DNA, to form new cells, and to manufacture important anti-aging hormones,” explains Dr. Miller. “Inadequate methylation is one of the primary preventable causes of premature aging and disease.” For example, when healthy methylation patterns are disrupted, homocysteine levels increase. Fortunately, we can greatly enhance methylation by arming our bodies with several nutrients that support this critically important process.
All the way back in 1981, Life Extension advised its members to take steps to lower blood levels of an amino acid called homocysteine. Overlooked research begun in the late 1960s by Harvard pathologist Kilmer McCully argued that elevated homocysteine is a more accurate, meaningful predictor of heart attack and stroke risk than is cholesterol. Homocysteine provokes chemical reactions that damage the endothelial cells lining arterial walls, thus encouraging the formation of cholesterol deposits. As Dr. Miller deftly explains:
“McCully pointed out that cholesterol begins to build up inside blood vessels only if the blood vessel walls have been damaged. Lowering cholesterol may slow the accumulation of cholesterol deposits on the walls of the damaged arteries, but it does nothing to stop the initial damage from occurring. As such, focusing heart disease prevention efforts on lowering cholesterol is like trying to prevent rain with an umbrella.”
Countless clinical studies over the last two decades have borne out McCully’s research and Life Extension’s pioneering advocacy. Today we know that elevated homocysteine not only elevates cardiovascular risk factors, but also is linked to Alzheimer’s disease, osteoporosis, Parkinson’s disease, depression, and other potentially lethal conditions. The first step in controlling homocysteine is to have your blood tested for it. While low homocysteine indicates healthy methylation, high homocysteine signals impaired methylation and elevated disease risk. Even so-called “normal” levels of homocysteine elevate risk; in fact, a person with a “normal” homocysteine level of 10 mcmol/L of blood has twice the risk of heart disease as someone with an optimal level of 6.3 mcmol/L or lower.
Aggressive supplementation with folic acid and vitamins B6 and B12 is usually enough to keep homocysteine from posing an extreme risk. To bring your levels into the optimal range, Dr. Miller recommends an “advanced pro-methylation protocol” including trimethylglycine (TMG), a methyl donor that helps to remethylate homocysteine back into methionine. After debunking common myths about cholesterol and cholesterol-lowering drugs propagated by pharmaceutical companies, Dr. Miller demonstrates how nutrients can safely and effectively optimize levels of total cholesterol, LDL (low-density lipoprotein), and other blood lipids without the potentially harmful side effects of prescription drugs.
Preventing Glycation
Glycation is another overlooked biochemical process that, like methylation, is critical in determining how quickly our bodies age and their ability to stave off the diseases of aging. Specifically, glycation “is a chemical reaction in which molecules of sugar and protein get tangled up, resulting in deformed and nonfunctioning molecules.” Glycated proteins then fuse together in a process known as cross-linking. As more glycated proteins cross-link, body tissues become increasingly stiff and tough. Glycation damages organs such as the heart, eyes, and skin, which require flexibility for optimal functioning.
“Glycation is now known to be a primary factor in the development of many age-related diseases, including atherosclerosis, heart failure, Alzheimer’s disease, complications of diabetes, cataract formation, and premature aging of the skin,” explains Dr. Miller. While glycation can never be entirely prevented, the overconsumption of sugary foods that typifies the modern American diet “promotes glycation like pouring gasoline on a fire, directly contributing to the modern epidemics of obesity, heart disease, and [type II] diabetes.”
In addition to avoiding sugary foods and refined carbohydrates, we can protect against glycation by supplementing with nutrients such as carnosine. By offering itself as a target for glucose molecules that normally would cross-link to proteins in the process of glycation, carnosine may be one of the most-effective anti-aging nutrients available today. Carnosine protects proteins in the eye against glycation, shields tiny blood vessels in the brain from damage that can lead to Alzheimer’s disease, relaxes and dilates blood vessels leading to the heart (thus increasing blood flow and enhancing the heart’s ability to contract and pump blood), and prevents skin aging and wrinkling by inhibiting the cross-linking of collagen, thus preserving the skin’s elasticity. Carnosine is also a strong antioxidant, and particularly potent against the destructive hydroxyl radical. Also addressed are anti-glycation drug therapies such as aminoguanidine, which inhibits glycation and is approved for use in Europe, and alagebrium (formerly known as ALT 7111), a newer drug under development.
Dr. Miller concludes his discussion of glycation and other correctable risk factors by pointing out that “these silent cellular mechanisms can undermine the body’s function and erode your health. By taking steps now to prevent oxidation, reduce inflammation, enhance methylation, and prevent glycation, you can improve your chances of living a long and healthy life.”
Individualizing Your Anti-Aging Program
This section of The Life Extension Revolution integrates the anti-aging and disease-prevention therapies discussed earlier into “a complete program of supplements, dietary recommendations, and lifestyle habits that will help you grow old without aging.” Detailed testing protocols, supplement regimens, and lifestyle recommendations provide a foundation that will enable every reader to develop a customized anti-aging program: “your passport to a long and vibrantly healthy life.”
Medical Testing for Aging and Risk Factors
Medical testing is an integral part of a successful anti-aging program. “Testing allows us to assess your aging status and identify risk factors for disease, customize your protocols, and monitor your ongoing progress and the effectiveness of your program,” explains Dr. Miller. “To implement an anti-aging program without benefit of this information is like driving with a blindfold on.”
Detailed testing protocols are organized into three categories:
- hormone profiles (thyroid function, adrenal function, DHEA, and male and female hormone profiles and ratios)
- reversible risk factors (including inflammatory markers such as C-reactive protein and fibrinogen, homocysteine to assess methylation, and blood lipids such as total cholesterol, LDL, HDL [high-density lipoprotein], and triglycerides)
- blood chemistry (similar to Life Extension’s Complete Blood Count/Chemistry Profile, these tests measure blood glucose, liver and kidney function, red and white blood cell profile, and iron and mineral levels).
For each testing protocol, “normal” reference ranges (used by conventional medicine to signify the absence of disease) and “optimal” ranges (used by anti-aging medicine to promote and preserve health) are provided. “The goal of this program is for you to enjoy vibrant good health throughout a long lifetime,” explains Dr. Miller. “That means that most of the standard reference ranges must be discarded in favor of optimal ranges.”
Working with a qualified physician to measure, assess, and correct your medical tests is strongly recommended. This emphasis, Dr. Miller says, “is not meant to discourage or disempower you—quite the opposite”; obtaining the best results from your anti-aging program simply means working “with a doctor who understands the difference between normal and optimal and is willing to take preemptive action against aging.”
Also included is valuable information on when to have your testing done (to establish a baseline, during the implementation phase to fine tune protocols, and annually to monitor your progress). Because different testing laboratories use different reference ranges, information is provided on how to make sure that you are comparing “apples to apples” in interpreting your test results.
Designing Your Supplement Program
An aggressive nutritional supplementation program is another cornerstone of any comprehensive anti-aging and life extension program. Even if we were to eat a precisely balanced diet comprising only highly nutritious foods,it would still be impossible to consume the variety and amounts of nutrients needed for optimal health.
The Life Extension Revolution’s step-by-step guide to building a customized dietary supplementation program begins with a “comprehensive regimen of vitamins, minerals, and essential fatty acids.” The vast majority of daily multi-vitamin/mineral formulas conform to nutritional guidelines propagated by the federal government and thus fail to offer adequate nutritional support. “Instead of trying to determine what amount of nutrients will maximize health, the government instead has determined the minimal level of nutrition required to prevent overt disease,” says Dr. Miller. Moreover, most one-per-day formulas use cheaper, synthetic vitamins and poorly absorbed mineral salts. Therefore, a true high-potency, pharmaceutical-grade multi-vitamin/mineral formula that promotes health and fights disease may supply nutrients in amounts that are 10-50 times those in the government’s inadequate recommendations. Rounding out a daily nutritional foundation are antioxidants such as gamma tocopherol, omega-3 fatty acids such as those contained in EPA/DHA formulas, carnosine to minimize glycation, bone-building nutrients such as calcium and magnesium, and vitamin K. Much overlooked, vitamin K directs calcium into the bones and away from blood vessel walls and other organs, adding to the body’s defenses against both osteoporosis and heart disease.
Step two is enhancing brain power with nutrients such as ginkgo biloba, acetyl-L-carnitine, phosphatidylcholine, phosphatidylserine, and DMAE. Step three entails testing hormone levels and, if needed, beginning a program to restore youthful levels of crucial hormones such as DHEA, testosterone, estrogen(s), and progesterone. Finally, step four proactively corrects reversible risk factors, with specific nutrients for lowering dangerous homocysteine and reducing inflammation and cholesterol as necessary.
While some readers may find such a program somewhat daunting, Dr. Miller reminds us that “we are attempting nothing less than to forestall the aging process itself—to grow older without aging.”
The Anti-Aging Lifestyle
A customized anti-aging and disease-prevention program also incorporates four essential components of the anti-aging lifestyle: diet, exercise, sleep, and stress reduction. “The foods you eat, the amount and quality of exercise and rest you get, and even your mental attitude about life make an enormous difference in your health and vitality,” Dr. Miller remarks. “More to the point, they all affect the rate at which your body is aging.”
Rather than count calories or carbohydrates or fat grams, the anti-aging diet stresses consuming roughly equal parts of lean protein, complex carbohydrates, and healthful fats. More important than quantity is the quality of the protein, carbohydrates, and fats consumed. The anti-aging diet, like other elements of the anti-aging program, naturally promotes fat and weight loss, if needed. Four basic principles characterize the anti-aging diet:
- Eliminating sugar and refined carbohydrates, which promote high blood sugar and insulin surges, provoking a cascade of debilitating effects throughout the body.
- Replacing unhealthy saturated fats and trans fats (which promote heart disease and increase the incidence of obesity, diabetes, and cancer) with foods containing healthy monounsaturated fats (such as olive oil and nuts) and essential fatty acids (such as omega-3-rich salmon and other fatty fish).
- Increasing consumption of the high-quality protein your body requires to build cells, tissues, and organs. At least one third of calories consumed should be in the form of high-quality lean proteins such as fish, egg whites, lean cuts of organically raised beef and poultry, low-fat organic dairy products, and beans and legumes.
- Eating more red, yellow, and green foods, particularly fresh vegetables that, calorie for calorie, contain more nutrients than any other kind of food. Consuming the widest possible variety of brightly colored fruits and vegetables ensures the most comprehensive intake of health-promoting phytochemicals.
Countless studies have demonstrated and confirmed the disease-preventing, anti-aging benefits of regular exercise. These include improved heart and lung function, increased bone density, reduced body fat, decreased joint pain, improved muscle strength and tone, reduced blood pressure, improved glucose tolerance, reduced anxiety and stress, and improved libido and sexual function. One example of exercising “smarter, not harder” is interval training, which alternates short bursts of intense exercise with short periods of recovery. Because of the body’s adaptive responses—what Dr. Miller calls the “efficiency trap”—long-duration exercise such as long-distance running or biking actually increases the production and storage of fat. By avoiding the efficiency trap, interval training maximizes both calorie and fat burning.
In addition to aerobic exercise, strength or resistance training should be incorporated in your exercise regimen. Strength training helps to build and maintain muscle strength, lower blood sugar, improve insulin, and maintain bone density and mass, among other benefits. Improving your flexibility by doing simple stretches at the end of your exercise regimen will help you reduce the risk of injury and discomfort from exercise and other daily activities.
Meaningful changes in lifestyle habits can have a countervailing influence on the aging and disease-promoting effects of everyday stress. While many Americans consider watching television to be a form of “relaxation,” it has no beneficial effects on stress hormones and may even adversely affect brain function and hormone levels. “The type of relaxation that has beneficial effects on the body,” Dr. Miller says, “is usually achieved through a focused and intentional practice such as meditation, yoga, or breathing exercises.” Studies have confirmed that meditation and yoga lower cortisol and raise DHEA levels, improve immune response, decrease pain, alleviate depression, and lower blood pressure.
Getting sufficient sleep should also be a priority in any serious anti-aging program. As Dr. Miller reminds us, while “you may feel that you can fit more into every day by sleeping less . . . ultimately you will fit more into your life by living longer.” Steps to better sleep include taking vitamins (which tend to be stimulating) in the morning while consuming any additional mineral supplements (which are lightly sedating) at night. Avoid exercising at night, as this can create a surge of stimulating hormones. Additionally, research has demonstrated that melatonin, a hormone produced by the pineal gland, helps people fall asleep faster, and improves the duration and quality of sleep.
The Future of Life Extension Science
As noted earlier, the Life Extension Foundation has several important missions. These include informing and educating medical professionals and the public about the state of life extension and anti-aging science, and fighting anti-consumer legislation and government bureaucracies such as the FDA that seek to deny or block access to information and novel new therapies. A third important mission is actively supporting and funding the most promising anti-aging and life extension research.
The Life Extension Revolution concludes with a look at some of the most novel anti-aging technologies currently under development, as well as a preview of therapies that many life extension scientists believe could revolutionize the practice of medicine within our lifetimes.
• Caloric restriction. In laboratory experiments involving mice, rats, and dogs, animals fed a restricted yet highly nutritious diet lived much longer than did those allowed to eat as much as they want. On average, life expectancy was increased by about one third. Caloric restriction not only increased average life expectancy but also maximum life span, by as much as 40-60%. These effects were seen even in aged animals fed a calorie-restricted diet.
Ongoing, multi-decade studies at the University of Wisconsin and the National Institute on Aging are examining caloric restriction’s effects on rhesus monkeys, which have a maximum life span of 30 years. While it is too early to know whether caloric restriction will extend the monkeys’ maximum life span (though researchers expect this to be the case), it is clear that by preventing the onset of age-related diseases such as cancer and diabetes, caloric restriction has already extended the monkeys’ average life span.
Caloric restriction appears to accomplish these effects by retarding aging and the onset of disease—the very goals of the anti-aging and disease-prevention program outlined in The Life Extension Revolution. While no data exist on the long-term effects of caloric restriction in humans, these remarkable animal studies have led some people to adopt calorie-restricted diets, and have spawned research into modified caloric-restriction regimens such as fasting and intermittent fasting.
According to Dr. Miller, some research findings suggest that caloric restriction “may actually be able to reverse some of the genetic changes of aging, effectively rejuvenating the elderly.” New areas of research such as epigenetics, which focuses on the factors affecting genetic expression, and gene chip technology, which can analyze the genetic expression of thousands of genes at once, may enable scientists to evaluate how therapies such as caloric restriction affect genetic expression, thus bringing us closer to true anti-aging therapies.
• Nuclear transfer. The process of “nuclear transfer”—commonly referred to as cloning—offers the prospect of a world in which healthy new cells, tissues, and organs could be created as needed from each individual’s very own cells, with that person’s unique genetic identity intact.
“Nuclear transfer technology can transform a mature cell into a very special and powerful type of cell called an embryonic stem cell,” notes Dr. Miller. Unlike normal cells, embryonic stem cells are immortal in the sense that they can continue to divide indefinitely and thus create infinite generations of new cells; they likewise differ from normal cells in having the potential to develop into any type of cell in the body.
Eminent scientists and leading health and medical organizations are adamant in their support for embryonic stem cell research as “our best and brightest hope for cures for today’s incurable diseases and conditions (including aging),” says Dr. Miller; however, “the future of this research is threatened because of a highly emotional and political debate over the ethics and morality of human cloning.” In exploring both the scientific intricacies of embryonic stem cell research and the political controversy surrounding it, Dr. Miller makes a compelling, clearly reasoned case for proceeding with therapeutic cloning (the cloning of very early-stage human cells, rather than human beings,) while noting “widespread scientific and popular support for regulations that would prohibit reproductive cloning of humans.”
• Cryonic suspension. The “ultimate time-buying strategy,” cryonic suspension is an often-misunderstood technology in which blood and fluids are removed from the body and replaced with solutions of cryopreservation agents that protect the body against freezing damage. The body is then cooled to subzero temperatures to arrest physical decay indefinitely.
In recent years, an advanced technique known as vitrification has enabled researchers to transform cryogenically preserved tissue into a “hard, glassy solid as it cools, with little or no ice formation.” By avoiding the formation of ice crystals that can damage cells and
tissues cooled to very low temperatures, vitrification allows scientists to preserve cellular structure virtually intact, greatly increasing the chances that organs will function normally once rewarmed. “Although it may sound like pure science fiction,” remarks Dr. Miller, “human cryonic suspension has actually been in practice since the 1960s.” Cryonic suspension involves complex philosophical and ethical issues, and several major scientific hurdles must be overcome before the successful reanimation and repair of cryonically preserved patients.
Dr. Miller concludes by noting that long-term cryopreservation, like other life extension technologies that are still in their infancy, “may be only a temporary stopgap, a bridge that may allow a generation or two of pioneers to cross from the technologically limited shores of the present to the brighter beaches of a future in which disease and aging are no longer.”
