Practitioner Perspective: Exploring How Immunity Impacts Healthspan
Longevity is the epicenter of health, and at the crux of that is the immune system, according to Robert Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, FAKTR.
“Without the three barriers of our immune system—our skin and digestive system, innate immune system, and adaptive immune system—we are never going to get the kind of longevity that we hope to have,” said Silverman.
According to Silverman, in recent years, the longevity concept has taken integrative medicine by storm. A measurement of both health and lifespan, longevity is what just about every patient yearns for and every practitioner hopes to facilitate, he said. And while the quest for longevity may seem like a modern-day phenomenon, it prompts an age-old question, “why do some people live longer than others?”
To Silverman, who practices integrative medicine in Westchester, New York, and recently authored the book, Immune Reboot, the “secret sauce” to longevity is a robust, optimally functioning immune system. The immune system, Silverman said, has a direct correlation to mitochondrial function. Consequently, a decline in immune health can lead to mitochondrial dysfunction, which then results in accelerated aging.
“The bottom line is that if you get a chink, a break, a breach in your immune system, you will categorically age, extremely quickly,” said Silverman.
The Immune System as it Ages
Over time, immune system functioning naturally declines, Silverman said. When a person ages, senescent cells, which would usually be cleared out and replaced by the immune system, begin to accumulate in local tissues, turning into what are referred to as “zombie cells.” This buildup of zombie cells then contributes to tissue dysfunction, and chronic inflammation due to age associated decline in immune function, according to Silverman.
“Inflammation is the byproduct of our immune system functioning properly,” said Silverman. “When inflammation goes too high, or lasts too long, that's when we start burning up and we start damaging structures which leads us down a slippery slope to localize systemic inflammatory response.”
This inflammation, he said, ultimately leads to autoimmunity, which “obviously is not going to lead into some strong longevity.”
Biomarkers for Longevity
According to Silverman, there are several methods of testing a patient’s biological age. The first tests Silverman suggested were inflammatory markers including interleukin 1 beta, interleukin 6, interleukin 8, tumor necrosis factor (TNF) alpha, and C reactive protein.
Additionally, Silverman stressed the importance of testing a patient’s uric acid levels. When elevated, uric acid can contribute to a host of health problems such as gout, diabetes, and cardiovascular disease. A patient’s Omega-3 to Omega-6 ratio is also helpful in determining biological age, Silverman said.
“Studies have shown that increased Omega-3 polyunsaturated fatty acid levels are associated with increased large artery elasticity,” said Silverman. “And you want arteries and cell membranes to be fluffy and elastic.”
When it comes to immune health, Silverman explained that he’s a big believer in testing the gut, where 80 percent of the body’s immune cells are located. Silverman often tests patients for zonulin and occluden, which are tight junction markers that when elevated over a duration of time can cause a breach in epithelial cells in the gut.
Blood pressure, Silverman said, is also important when determining a patient’s biological age. “It’s a basic test,” he said, “but man if a patient’s blood pressure is high, they’ve got a problem.”
Silverman urged practitioners to test for apolipoprotein E (APO E), which he said can predict a patient’s chances of developing Alzheimer’s, one of the top ten leading causes of death in America today.
Diet and Lifestyle Interventions to Increase Healthspan
To increase a patient’s health span, the first thing Silverman focuses on is diet. He said he suggests patients avoid all gluten, processed foods, sugar, dairy, nicotine, and artificial sweeteners, as well as foods they are sensitive to. In addition, he said it’s helpful to avoid vegetable oils, which are highly inflammatory, deep-fried food, starch, and fructose, which he said, elevates uric acid levels.
For a longer, healthier life, Silverman said he often points patients to a Mediterranean diet. Research indicates the Mediterranean diet results in a 51 percent increase in quality of life, 11 percent decrease in cognitive impairment, and 10 percent higher odds of successful aging, according to Silverman.
Silverman also instructs patients to make clean eating a priority by buying organic, local foods. Even a simple switch to organic coffee, for instance, can make a difference, as coffee is one of the most pesticide sprayed items in America today, he said.
Intermittent fasting can also increase the resilience of the immune system. According to Silverman, intermittent fasting stimulates autophagy, which allows the body to get rid of immunosenescent cells and dysfunctional mitochondria, replacing them with immune rejuvenated cells. Other lifestyle interventions include long-term resistance training, which Silverman said is beneficial for longevity as it can also elevate autophagy. Sleep, he said, is also crucial for longevity.
Common supplements for immunity, according to Silverman, include zinc, vitamin C, vitamin D3 with K2, turmeric, and palmitoylethanolamide (PEA). Often overlooked supplements include BCP-157, NAD+ (precurses), and resveratrol, Silverman said.
As for when to start talking to patients about their healthspan, Silverman said it’s always better to be proactive than reactive.
“Healthspan is not just being healthy, but it's also living a fruitful, enriching life,” he said. “So, I would start right now. I've talked to 20-year-olds about it. I think even talking to teenagers about getting them out on the right path is a good idea.”