Can Biological Age Help Predict Disease?

by Sasha Reddy

Meet the Docs

Two leading physicians in the field of anti-aging and integrative medicine will join us to cover a range of topics. These articles will review new research and provide tips on advocating for your health from a holistic perspective.
Dr. Robert Brookman is board-certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine, and Anti-aging/Regenerative and Functional Medicine.
Dr. Allan Redash is a board-certified
OB/GYN, Diplomate with The American Board of Obstetrics, and a former Fellow of The American College of Obstetrics and Gynecology.

“You’re only as old as you feel.” There’s a lot of truth to that statement – how young or old you perceive yourself to be has little to do with the number of birthdays you’ve celebrated. That’s why scientists have devised a new way of differentiating chronological vs biological age.

“There has been tremendous research over the past several decades over how we determine someone’s health age,” says Dr. Brookman. “And that’s really what we’re talking about when we talk about biological age.” While chronological age tells us the number of years that have passed since birth, biological age measures the effectiveness of our body’s DNA repair and cell duplication mechanisms. Quantifying these processes is essential because they can tell us a lot about our risk of developing many conditions associated with aging.

Early anti-aging science looked at telomere length to determine a person’s biological age. Telomeres are caps at the ends of our chromosomes that protect our DNA; they are the longest when we are first born and slowly degrade as we age, though some studies have found that healthy lifestyle interventions can even increase telomere length1.

Scientists believed that having longer telomeres indicated a significantly lower risk of developing chronic degenerative diseases such as cardiovascular disease, cancer, diabetes, and various autoimmune diseases. However, researchers have since discovered telomere attrition to be just a piece of the larger age puzzle. Now, we’ve come to recognize nine major hallmarks of aging2.

While none of the nine hallmarks are things we can directly observe or experience without lab testing, our everyday activities significantly impact them. How we feel on a daily basis is even tied to these biological processes.

The Nine Hallmarks of Aging

  1. Genomic instability – Though DNA is damaged hundreds of thousands of times each day, genomic instability is the accumulation DNA damage over time as our bodies lose the ability to self-repair.
  2. Telomere attrition – The loss of telomeres at the ends of our chromosomes due to DNA deterioration.
  3. Epigenetic alterations – Changes to the methylation patterns of DNA (more on this later)
  4. Loss of proteostasis – Loss of the ability to conduct protein folding.
  5. Deregulated nutrient -sensing – Cells lose the ability to respond to changing levels of nutrients available in the body.
  6. Mitochondrial dysfunction – Mitochondria are the energy factories of the body. Failures in mitochondrial function can result in reduced longevity on several fronts. (fun fact: mitochondrial functionality is always inherited from the mother)
  7. Cellular senescence – The slow loss of our cells’ ability to divide.
  8. Stem cell exhaustion – A deficiency of stem cells, resulting in a loss of regenerative potential.
  9. Altered intercellular communication – a breakdown in communications between cells, commonly caused by excess inflammation.

How To Determine Biological Age

Today, biological age and pace of aging are often calculated by evaluating DNA methylation. Though we have many types of cells in our bodies, all cells in an individual are created using the same DNA sequence. DNA methylation is an epigenetic process that determines gene expression, allowing one genetic sequence to produce skin cells, brain cells, liver cells, and many other cell types.

“We have 26 million of these methylation sites on our DNA,” the Docs say. When these sites become deregulated, the risk of developing ALL chronic degenerative diseases (as previously mentioned) appears to increase. Several epigenetic studies have found DNA methylation data to be a reliable predictor of biological age and disease risk3. By evaluating our DNA methylation sites early, we can even take preventative measures before various aging-related diseases present themselves.

So, how can you determine your biological age? There are a few independent labs that offer epigenetic testing, but TruDiagnostic is one of the leading laboratories in the industry. In order to make the most of this test, the Docs recommend ordering and reviewing test results with a physician.

Age Applied

A person whose biological age is younger than their chronological age is less likely to develop age-associated diseases such as diabetes or heart disease. To be specific, Dr. Brookman says that for individuals whose biological age is seven or more years younger than their actual age, the risk of developing any chronic degenerative disease decreases by 50 percent. Additionally, for every year your biological age exceeds your chronological age, your chance of developing cancer over the next three years increases by six percent. For example, a 55-year-old man with the DNA methylation of a typical 60-year-old will have a 30% greater chance of developing cancer by age 58.

The Docs agree that there are plenty of steps you can take to markedly decrease your biological age. And it should be no surprise that these steps predominantly center around healthy lifestyle changes. Exercising regularly, reducing stress, restricting caloric intake, and optimizing sleep and diet have all been observed to decrease biological age.

Genetics Aren’t Everything

With the popularity of at-home DNA kits like 23 and Me®, information regarding health predispositions is more accessible than ever. But often, when people see that they have genetic markers for specific diseases or review their family history, they feel they are doomed to develop the illnesses they are at heightened risk for.

“Just because you have the gene for a specific disease doesn’t mean you are going to get that disease,” Dr. Redash reasons. What the Docs want to emphasize is that genotype doesn’t guarantee phenotype; in simplest terms, your genetics don’t determine your fate. Your epigenome, influenced by your environment and lifestyle, plays a significant role in determining whether various diseases actually develop and at what stage of life.

Think of your DNA as a piano and yourself as the pianist. The notes that the piano makes – or, in a biological sense, how our genes are expressed – largely depend on the musician. Just as a skilled musician can make beautiful music even with a toy piano, through healthy lifestyle choices, anyone can slow their biological aging regardless of genetic risk factors. It’s never too late to start.


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