HEALTH| 05.11.2021
“New GrimAge Tests Now Capable of Accurately Predicting Life Expectancy”
Marta Villalba
Ángel Durántez (1963) is one of the pioneering doctors in Spain in Age Management Medicine. Author of the book Jóvenes a los 100 (“Young at 100”), his 11 years of experience have placed him at the cutting edge in the use of what is considered the “healthcare paradigm of the 21st century,” also known as 7P Medicine, as it is preventive, proactive, predictive, personalized, participatory, pleasant, and precise. Still not included as a specialization in university studies, it is an area of health knowledge that brings together many other professionals who are not necessarily working in healthcare. All of them work together—representing the P for participatory—to act ahead of the arrival of a disease before symptoms appear. To that end, it is broadly based on living a healthy lifestyle and measuring biomarkers.
As a complement to conventional medicine, the objective of antiaging medicine is not so much to lengthen life as it is to live that final stage illness-free. “With reactive medicine, life expectancy has been lengthened by 30 years, but less has been done with quality of life in those extra years. We have to try to delay the onset of an illness to a time closer to our death and, if possible, postpone the time of our death,” Dr. Ángel Durántez explained. The illnesses of aging include cancer, cardiovascular diseases, neurodegenerative diseases (particularly Alzheimer’s), and musculoskeletal system diseases (osteoarthritis, osteoporosis, and others). “In advanced societies, they are known as chronic non-transmissible diseases and/or aging-related diseases. In other words, over time, they will occur no matter what. If we lived to 150 years old, we would end up having one of them.”
In contrast to classical medicine, in which the patient follows the instructions given by the doctor, in specialized medicine that prevents aging, you act ahead of the disease and everything depends on you yourself. “You must have a proactive attitude and take your health into your own hands” to enjoy a healthy lifestyle. In other words, maintaining a healthy weight, not smoking, not drinking alcohol, eating well, and so forth. The best age to start? The doctor recommends when you are in your 40s, because that (or even before) is when we begin to become ill. But it is never too late to get started. Exercise, nutrition, nutritional supplements, sleep and rest, avoiding toxic habits, controlling stress, hormonal optimization, and monitoring biomarkers are the basic pillars of preventive medicine.
Without the patient’s self-control and willingness, antiaging medicine is not possible. Nor is it possible without the tools that help a specialist doctor to learn more about a person’s condition. The key to predicting, personalizing, and being precise with health in order to slow aging lies, then, in measuring and interpreting biomarkers associated with longevity. Because what is normal is not always optimal, according to Ángel Durántez: “What can be good for everyone, may not be enough for you.” He offered the example of someone who thinks that it is good to have systolic blood pressure at an average of 135 (below 140 is considered normal). However, that is considered pre-hypertension.
Among the hundreds of biomarkers that can be measured, Ángel Durántez noted those associated with carbohydrate metabolism, inflammation, and cardiovascular risk, in addition to genetic, adiposity (percentage of body fat, BMI, etc.), and arteriosclerosis biomarkers. One of the most innovative tests is measuring the epigenetics of aging. Just as a birth date determines chronological age, and the epigenetic clock indicates an organism’s biological age—at the cellular and tissue level—which “may not be the same as the chronological age,” the doctor explained.
These types of tests measuring biological age have advanced so much that “the new GrimAge tests are now capable of accurately predicting life expectancy” (at 96%). It is a theoretical age, calculated mathematically assuming that lifestyle is maintained. “If you modify it, that longevity can be longer or shorter.” The GrimAge state-of-the-art epigenetic clock is the most advanced that currently exists for this purpose. It was developed by Steve Horvath, one of the recruits of multimillionaires Jeff Bezos and Yuri Milner for the company Altos Labs, along with Spaniards Manuel Serrano, of the Institute of Biomedical Research of Barcelona, and Juan Carlos Izpisúa, a biologist at the Salk Institute in La Jolla, California, among other researchers who are experts in longevity and human rejuvenation.
Therapy against hormone decline: a dual function
Preventive medicine for aging also focuses on the decline in hormone levels that occurs as we age. Lack of strength, vitality, neurocognitive capacity, sexual function, artery elasticity and sleep are some of the symptoms of this hormonal decline. To restore lost hormone levels, the doctor administers bioidentical optimization therapy. With this treatment “you can recover part of the lost functionality. And this hormonal restitution is also known to prevent diseases related to the aging process.” Ángel Durántez regrets that this type of treatment is only integrated into conventional medicine when a disease is present: “Like hormonal decline, it is also natural to suffer from cataracts, which do get treated.”
In terms of nutrition, the biggest mistake for Dr. Durántez is the progressive abandonment of the Mediterranean diet. “We are losing the habit of cooking, of going to the market to shop, to the fruit and vegetable store, to the seafood store… Instead, we opt for processed and ultra-processed products.” The doctor warns that, in general, we are eating more carbohydrates than we should, but “we should not be absolutist or dogmatic. We are not all the same, we each have our own epigenetics. Some people feel great doing intermittent fasting by not eating dinner, others can’t stand it. Some people tolerate a diet with a carbohydrate restriction perfectly well, others do not like to eat meat. If you want to know how well you eat, take a look at the carbohydrate metabolism biomarkers.”
The doctor explains that, although there are no human studies yet, calorie restriction appears to turn on longevity genes. “We have repair mechanisms that are activated by fasting. However, excess calories produce an overload. It’s like an engine, if you put 50,000 kilometers a year on your car it will probably last less than if you put 5,000 kilometers a year on it. Fasting or calorie restriction is like putting fewer miles on your car.”
Geroprotectors to cure old age
Not without controversy, the World Health Organization plans to include old age as a disease in the International Classification of Diseases. Scientific advances are changing aging. There are already senolytic drugs that reduce it by clearing out the accumulation of senescent or zombie cells. Other substances prevent epigenetic DNA damage over time, such as metformin. These are known as geroprotectors.
“Right now there is quite a lot of investment going into laboratories that are researching what to do to directly address the root causes of aging, because it would be a way to prevent those cells from deteriorating and many diseases from occurring. María Blasco herself, director of the CNIO (Spanish National Cancer Research Center) has said a thousand times that, if we were able to cure aging, we would cure all these diseases at once”.
A strong advocate for personalized supplementation prescribed by a professional to correct deficits, according to Ángel Durántez’s experience, the nutrients that we tend to have the lowest of in Spain, in general, are vitamin D and omega-3 fatty acids. Regarding melatonin, he specifies that it is a magnificent cell cytoprotector and is not only beneficial for sleep, but also acts as a geroprotector. Although “to increase the intracellular levels of melatonin, doses of 25, 30, 40 mg or even more than 100 mg daily should be taken.”
Dr. Durántez is hopeful about advances in gene therapy and regenerative therapy to cure diseases and prolong life. Also with nanorobotics, which fuses technology and biology: “There will be therapeutic strategies with nanobots the size of a hemocyte or red blood cell that can clean an artery or have a targeted therapeutic effect on a part of our bodies.” The specialist believes it is possible that some of these advances will become available—such as gene therapy to treat heart attacks, diabetes, or osteoarthritis—but others “we will probably not see.”
Until that future arrives, the formula for healthy aging is clear: do what we already know works, such as controlling your weight, exercising, not smoking, and avoiding alcohol and stress. For those who are already committed to this behavior or lifestyle and want to take the next step, “have biomarkers measured to keep them at the optimal levels.” Although at the moment there are not many sites that measure and interpret these parameters, they are becoming more and more accessible through the Internet, since “there is an interest among young people in all this,” stressed Ángel Durántez, who believes this whole movement and this approach to health are unstoppable.