By Jennifer Pearlman, MD, CCFP, NCMP, FAARM, ABA, ABAARM

Science is shedding new light on healthy aging, with a renewed emphasis on wellness. Forget aging gracefully. Our generation can choose to take charge and age proactively during the second half of our lives.

To age well, we must first understand why we are aging. As we approach midlife, we begin to face accelerated loss of vital factors: our hormones, our nutrients, our sleep and our telomeres. Rapid aging ensues as a result of these losses. Between the ages of 40 and 50, women age twice as fast as any other decade. While men's aging speeds up too, by about 60 percent, they do not face the same cliff in the aging process.

The rapid loss of ovarian hormones, estrogen and progesterone, during a woman's menopause contributes to this accelerated aging. By age 50, many other critical hormones have dwindled including melatonin (which sets our sleep-wake cycle), the adrenal hormone DHEA (which has been linked with vitality and libido in women) and other hormones regulating our metabolism.

Our nutritional status also begins to fail. Even if we take in the required nutrients in our diet, we are not as efficient in absorbing them. Acquired deficiencies in essential minerals and vitamins may arise interrupting key pathways and functions.

Just a few years ago, Nobel prize winning research unlocked the code to our biological aging. The discovery of telomeres and an enzyme telomerase, has shed light on cellular aging. Telomeres are protective caps on the ends of our chromosomes that shorten as we age and place a finite limit on our lifespan. Telomerase is a housekeeping enzyme that functions to preserve telomeres. With defects in the enzyme and shortening of our telomeres, cells face programmed senescence. More recently, it has been shown that telomere length can be improved with comprehensive lifestyle changes including; diet, exercise, stress management and social support.

Supplementation may also help. Our bodies are equipped with a type of protein, called sirtuins, science suggests are involved regulating our lifespan. A lot of attention has been given recently to the role of sirtuins in aging, because they play an essential role in the cellular response to environmental and physiological stress and in helping maintain healthy DNA.

For sirtuins to work, they depend on a co-enzyme called NAD+. And to effectively and efficiently make NAD+, there is a specialized form of vitamin B3 called Nicotinamide Riboside, as found in a health supplement called Tru Niagen. As we age, our NAD+ levels decline. Supplementing with Tru Niagen helps to ramp up your NAD+ production.

A careful balancing of key lifestyle factors is, not surprisingly, also vital to healthy aging. While hormones and telomeres are important, so too are nutritional factors. Dietary factors may determine approximately 30 percent of how long we live and add as much as a decade to our life. Animal models have shown caloric restriction to have anti-aging effects related to sirtuin activation. Mice fed low-calorie diets remain more youthful; both on the inside and out. They have longer life expectancies and are also less likely to have cancer, diabetes, and heart disease. They look younger to, with fewer wrinkles and less body fat.

Clearly, it is not just how much you eat but what you eat that matters.

So, is there a longevity diet? To design one, it is instructive to look at populations who boast the highest proportion of centenarians and longest life expectancy. With an average lifespan of 81-years. Okinawa islanders of Japan are considered the oldest demographic in the world. Compared with other Japanese diets, theirs is lower in calories, carbs and salt and higher in nutrients such as calcium, iron and vitamins.

The Okinawa diet is plant-based with little red meat. American gerontologist, Dr. Craig Willcox authored a book "the Okinawa Program" describing his findings of a 25-year study of Okinawan longevity and recommends that we "eat as low down the food chain as possible." According to the JAMA network, other studies have confirmed that very low meat intake may contribute to longevity. Vegetarians in three continents have been shown to live longer than people on the Standard American Diet (SAD), high in refined sugars, trans fats and meat products.

Life stress, especially when it is chronic and extreme, works like the common denominator when it comes to aging. Stress shortens telomeres, depletes the pool of precursors needed for healthy hormone balance, impedes nutrient absorption in the gut and leads to inflammation. It is estimated that chronic stress may shave more than seven years off the lifespan due in part to the shortening of telomeres. Proven stress-management techniques such as yoga, meditation and tai chi may favorably affect cellular aging by reversing the deleterious effects of stress.

The emerging field of "epigenetics" is revealing how our lifestyle, our stress and environmental exposures can affect the expression of our genes. Our DNA is not our destiny but rather a roadmap for a journey that can be largely influenced by our lifestyle and life choices. The understanding of how these gene-environment interactions shape our health is the new frontier of Personalized Medicine.

The science of healthy aging is complex and evolving rapidly. Achieving a lifestyle optimal for your genes and body type is the cornerstone to maintaining health and vitality through the ages. We can now choose to take charge of our aging and live longer better.

About the author

Dr. Jennifer Pearlman is a medical doctor with over 15 years of experience in the area of women’s health and wellness. Combining integrative medicine with aesthetic expertise, Dr. Pearlman helps her patients achieve optimal health and wellbeing from the inside out.

She is a NAMS Certified Menopause Practitioner (NCMP) certified by the North American Menopause Society (NAMS) and is attending staff physician at the Menopause Clinic at Mount Sinai Hospital in Toronto, the largest in Canada.

Dr. Pearlman created PearlMD Rejuvenation as a State-of-the-Art Medical Vitality Clinic devoted to helping her patients successfully navigate the aging process by delivering comprehensive medical care and cosmetic enhancement employing the very best treatments, technologies, and techniques for mind, body and beauty.

Dr. Pearlman is a board certified Fellow of Functional, Anti-Aging and Regenerative Medicine (FAARM), and is a recognized expert in the area of women’s health and mental health, designated by the Ontario Medical Association to work as an expert consultant to other physicians. With a cultivated expertise in the art and science of cosmetic medicine, Dr. Pearlman is a sought after expert called to train other physicians on the latest cosmetic techniques using injectable fillers (Restylane, Juvederm), neuromodulators (Botox, Dysport), and regenerative therapies (Selphyll) and technologies (Venus FREEZE). She has had the opportunity to work and train with leading experts in this field across North America.

Dr. Pearlman is a frequently published health expert with articles appearing in the Globe and Mail national newspaper, The Huffington Post, Canadian Living Magazine, Elle and more. She has appeared as an invited speaker on television shows such as Rogers’ Daytime Toronto and frequently lectures to public and professional audiences. She lectures and trains other physicians in the area of menopause, hormone therapy, and cosmetic medicine. She was awarded the Enterprising Woman of the Year award in 2013, named as a Women of Distinction in 2012 and 2013 and is an invited member of several prestigious organizations committed to supporting women entrepreneurs including, the Women’s President Organization and United Success.

Dr. Pearlman is an active member of the Canadian and Ontario Medical Associations, the College of Physicians and Surgeons of Ontario, and the College of Family Physicians of Canada and the Federation of Medical Women of Canada.

She is an active member of the North American Menopause Society (NAMS) and the American Academy of Anti-Aging Medicine (A4M) and is a board certified physician in Anti-Aging and Regenerative Medicine (ABAARM).