Aging: An equalizer

Last February 28, 2018, my wife, Farida, and I arrived at the Los Angeles International Airport from Manila, following our two medical missions in the Philippines. While waiting at the lounge for our flight back to Las Vegas, we received a call from our friend, Lynn Santos, a nurse, who relayed to us the sad news that a close mutual friend, a medical colleague who was 84 and recovering well from a stroke, had collapsed in a grocery store. About half an hour or so later, while we were on board American Airline’s flight to Vegas, Lynn called again, this time to inform us that he had passed away.

A testament

Our friend’s departure was a devastating loss to his family, friends, and the community. The health issues this physician and his wife of 53 years had experienced as they grew older were a testament to the realities of aging. This natural part of life, aging, is inescapable and an equalizer, as much as death is a part of life, without exception or exemption. In certain ways and instances, we could perhaps alter the progress and reduce the odds to some degree, but the inevitable end is obviously beyond us.

As the clock ticks, we are older by the second. As we grow older, the expected normal wear and tear in our body progress faster and faster, including the reduction in the secretion of our various essential glands and the weakening of our immune system.

Our telomeres – caps at the ends of each strand of DNA that protect the chromosomes, similar to plastic tips at the end of shoelaces, which prevents them from fraying – get damage and the telomeres become shorter as our body is subjected to all assaults internally and externally. The shorter the telomeres, the shorter the life span.

The speed of the degenerative changes in us depends on our genes and to a great significant degree, on our lifestyle. That’s why the aging process varies in different individuals. While we cannot (yet) do anything about our genes at this stage in science and technology to extend longevity for everyone, we have enough evidence-based medical data today on how to achieve maximal health benefits through healthy lifestyle and extend our life, our telomeres, to the fullest possible.

 Physiology of deterioration

The degeneration starts in the basic cellular foundation of our body as we grow older, varying in different individuals since persons age at different speed, but in general the physiological changes start  to manifest when we reach about 40 years of age, more obvious when we reach about 65. As we age, all the systems and essential functions of our body work less efficiently, at suboptimal level. Inflammation, the precursor of almost all diseases, invades the entire body. All the glands in the body secrete significantly less, if not meager, hormones and other essential substances that regulate the various vital organs in the body. Arteries lose their elasticity and hardened, causing high blood pressure and arterial blockages. The blood gets thicker, increasing the risk for blood clots, coronary heart disease and stroke. Joint lubricants decrease causing aggravating arthritic pains. Male and female hormones drop and lessen sex drive. The dermal collagen and oil production slow down and the skin loses turgor and moisture, becoming thinner and thinner, and wrinkles form.

Most of our biologic functions peak at age 30, declining in a linear fashion thereafter. This, however, does not materially affect our daily activities at this stage. Only stresses and diseases, and not aging, impact the physiology negatively during this period.

Theory of aging

            There are a few, but the prominent one is the Free Radical Theory where oxygen-containing molecules called free radicals, with a life span of one-millionth of a second, and are toxic, are damaging our body. Free radicals attack the cell’s DNA, causing the cells to prematurely die. Our body’s natural antioxidant (defense) system mops up free radicals before they could cause damage, but as we grow older, and continue to abuse our body through unhealthy lifestyle and behavior, our body’s immune system becomes less efficient, allowing the free radical level to increase. This negatively impacts the normal cellular regulation and function, which leads to aging and its physical and physiologic consequences, as well as weaker defense system to diseases. On top of the damages from free radicals, external assaults are caused by sunlight, environmental pollution, stress, unhealthy lifestyle (high carbohydrate-low vegetable-low fruit and low nut diet, smoking, alcohol, soft drinks, lack of exercise, and substance abuse). Just to illustrate the damage: From using a single stick of cigarette alone, trillions of free radicals are generated. And if we added all the assaults listed above, many of which are self-inflicted, it would be clear why our body deteriorates as we grow older. The human body is fundamentally a unqiue, amazing, efficient, and tough, machine, that can withstand a lot of abuses, but it also has its limit.

Discipline and resolve

The harder part of the equation in slowing down aging and avoiding preventable diseases to solve is our lack of personal discipline and resolve. Today, most, if not all of us, know which items are good and which ones are unhealthy to eat or drink, and also know that regular physical exercise and de-stressing are fundamental to our health and longevity. Yet, somehow, we seem to always find enough reasons or excuse to justify our non-compliance with these known and proven scientific principles of healthy living.

As alluded to in the book Let’s Stop “Killing” Our Children, inflicting harm to our body with self-abusive behavior and by living an unhealthy lifestyle is masochistic. Some of us appear to have programmed our mind to an auto self-destruct or suicidal mode and continue to do things, or perpetuate bad habits, that we know could maim or kill us.

The book also proposes healthy lifestyle and disease prevention should begin at the cellular (DNA) level starting in the womb and in the crib, to protect the integrity of the DNA as early as possible. Damaging the DNA-telomeres with our unhealthy habits and insults from our environment lead to major metabolic (diabetes, thyroid illness), pulmonary, cardiovascular (heart attack and stroke), and, especially cancer.

With volumes of evidence-based medical data on healthy lifestyle and with our more informed selves today, disease prevention is much easier to achieve compared to five or more decades ago. We no longer have any excuse not to maximize our health and longevity. To do otherwise is simply asinine.

Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is a medical lecturer/author, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Websites:,   Email: [email protected]