Promoting optimal function throughout life

Aging is not a disease, it's a measurement of function, said Jeffrey Bland, PhD at the 2018 Integrative Healthcare Symposium in New York City.

Healthcare is a self-consistent syllagism and we're stuck in it. We have to change the framework for the whole model, said Bland. "It's hard to study health in a system [designed] for disease, so it's like it's not in the light—you can't see it."

Everything is connected in the concept of aging, he said. Part of aging is genetics, but beliefs, environment, and lifestyle also matter. "We can change the means," Bland said.

In an analysis of 12 industrialized counties looking at healthcare expense and performance, the U.S. ranked last—high expense and poor performance. For the first time in history, the mean age for life expectancy is going down in the U.S. A revolution in healthcare is desperately needed, and Bland offered six concepts that are driving this change:

  • Convergence
  • Emergence
  • Systems
  • Expression
  • Signals

Functional medicine shows that comorbidity and disease are just placeholders for lack of understanding, said Bland. When it comes to aging, we are moving fro the "age of the average" to the "age of the individual." Specifically, genetics, systems biology, and immunology.

This "gene environment" is freeing, said Bland. Genes are laden with signals, whether they express encouragingly or discouragingly. We are able to use these signals to develop and optiml environment and protocol for our patients, through technologies such as genomics, informatics, biometrics, and even social media.

The future is precision, personalized lifestyle medicine—and it's accessible and affordable for all, said Bland. However, practitioners must focus on resilience, not profiling risk. "Patients don't want to know how they're going to die," he said. "They want to know how they are going to live."

Wellness can be tailored to the individual, and healthy aging is the ultimate preventative medicine. How do you measure biological versus chronological age? Telomere length, epigenetic alterations of DNA, mutation markers in the genome, damaged proteins, and metabolites of aging can all be used, said bland.

To slow aging, Bland offered six interventions:

  1. Pharmacological inhibition of the GH/IGF-1 axis
  2. Protein restriction and "fasting mimicking diets"
  3. Pharmacological inhibition of the TOR-S6K pathway
  4. Pharmacological regulation of certain sirtuin proteins and the use of spermidine and other epigenetic modulators
  5. Pharmacological inhibition of inflammation
  6. Chronic metformin use

Diet is a central component of these interventions. There's no one-size-fits-all approach, said Bland, but the focus should be on eating a balanced diet, high quality foods, mostly plants, no processed foods—essentially, eliminating the "bad" and adding in the "good."

"The simple rule of improving function is to take out the bad stuff and put in the good stuff. It's our job to find out for our patients what the bad stuff is and give them the good stuff. That's the future of personalized medicine."