Can Meditation Delay Aging?

by Brad and Nina 

Gaudi Ceiling by Brad Gibson

Since the early days of Yoga for Healthy Aging, we’ve been blogging about the research of Dr. Elizabeth Blackburn, who studies the effects of stress on cellular aging (see Stress, Telomeres and Aging). Dr. Blackburn is so convinced that chronic stress affects aging on a cellular level that she is studying the effects of meditation and yoga on aging, thinking that these practices might actually slow aging and lengthen life.

In particular, Dr. Blackburn has been studying the affects of meditation and yoga on telomere length. Throughout your life, your cells may reproduce many times to repair and strengthen their host organs, to grow or to fight disease, and the telomere at the end shrinks each time the cell divides and duplicates itself. A chemical called telomerase helps restore a portion of the telomere with each division, but after 10 to 50 divisions or so (the number varies by tissue type and health, and biologists still do not understand the system well), the telomere gets so short that the cell is no longer able to replicate. Because some cells or tissues in our body (skin, blood cells, etc.) continue to replicate and be replaced as we age, or to be repaired after injury, if the progenitor cells needed for these processes cannot replicate due to telomere shortening, this can contribute to the aging process and increase our susceptibility to disease.

Dr. Blackburn’s research has demonstrated that chronic stress actually accelerates telomere shortening and that anti-stress practices such as meditation and yoga can in turn slow the process by “boosting” telomeres. A recent BBC article Can Meditation Delay Aging?  gives a good overview of Dr. Blackburn’s current research. Here’s an excerpt that explains why meditation and yoga might boost telomeres.

Theories differ as to how meditation might boost telomeres and telomerase, but most likely it reduces stress. The practice involves slow, regular breathing, which may relax us physically by calming the fight-or-flight response. It probably has a psychological stress-busting effect too. Being able to step back from negative or stressful thoughts may allow us to realise that these are not necessarily accurate reflections of reality but passing, ephemeral events. It also helps us to appreciate the present instead of continually worrying about the past or planning for the future.

But while telomeres are still getting a lot of buzz these days, I for one know that this is only one of many theories of aging out there (see What is Aging, Anyway?). So I turned to Brad for his take on the article (and the issue of telomeres in general). 

—Nina

Overall, this a reasonable, well-written and—for the most part—balanced article. I think when it gets into how the established medical profession and scientists are reluctant to get into this area, it is largely correct. However, there is so much confusion and outright snake oil sales in the “anti aging” field right now that it’s no big mystery why people (and scientists) are cautious. In addition, it is important to keep in mind that the role of telomeres in aging is still very controversial. This statement late in the article is a bit problematic:

"Conventional medical tests give us our risk of particular conditions - high cholesterol warns of impending heart disease, for example, while high blood sugar predicts diabetes. Telomere length, by contrast, gives an overall reading of how healthy we are: our biological age. And although we already know that we should exercise, eat well and reduce stress, many of us fall short of these goals."

For one, the role of cholesterol levels is (surprise!) being hotly debated again. And some of the longstanding wisdom about what levels are good or bad—especially for women—may be wrong.  The idea that telomere length is a read-out of our “biological age” is simply not supportable by solid scientific evidence. It is telling us something, but it’s not exactly clear what that is precisely. There are some big efforts going on right now to identify new “biomarkers” of aging, and I'm under the impression that telomere length is no longer being considered as major player in these efforts.

—Brad

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Aging, Telomeres, and Yoga: New Study by Elizabeth Blackburn and Dean Ornish

by Baxter

A while back, we reported on an interesting potential marker in the body for aging of the cells connected to the genes called a telomere (see Stressed Mind, Stressed Cells and Science, Aging and Yoga). A telomere is like a tail on the end of DNA strands found in our cells, and an enzyme called telomerase influences the length and activity of the telomere. Studies done a few years ago by a Dr. Elizabeth Blackburn at UCSF in San Francisco began to show a connection between telomeres and cell longevity—the longer the telomere, the longer the cell life. Her work garnered her a Nobel Prize in Medicine.

Telomere Caps

Now Dr. Blackburn has teamed up with Dr. Dean Ornish to see what effect his life-style changes approach to prostate cancer has on telomeres and telomerase activity. Dr. Ornish has already shown that a combination of dietary changes (vegan diet with less than 10% fat per day), exercise in the form of walking for 30 minutes most days, and stress management tools that include regular yoga asana and breath work, mindfulness meditation and once a week group stress reduction sessions can reverse heart disease and diabetes, and can stabilize prostate cancer and stop its progression.

In their most recent study, published in Lancet Oncology (see Effect of comprehensive lifestyle changes on telomerase activity and telomere length in men with biopsy-proven low-risk prostate cancer: 5-year follow-up of a descriptive pilot study), the two researchers looked at how the lifestyle program impacted the cellular genetic level in regards to telomere length and enzyme activity. What they found was that the 10 men studied had longer telomeres in the short (as quickly as three months!) and long run, if they stuck to the program, and the 25 men who were controls had shorter telomeres. And they also looked at gene activity in their ten study subjects, and found that 500 genes were turned on, and all were beneficial, according to Ornish. 

Even though telomeres may be an indicator of longer cell life, and by extension, longer overall lifespan, this has not been definitively concluded, so more studies will need to be done, looking at much larger numbers of people. But the early evidence is promising, and even if the telomere/aging cell theory does not pan out, it seems evident that yoga, diet, exercise and stress management do have significantly positive impacts on health, disease progress or remission, and are therefore worth the effort. And as Dr. Ornish noted, his study participants found the lifestyle plan easy to follow, with 85-90% compliance, much better than most pharmaceutical based treatment plans. Why, you might ask? Well, has he says, it’s because it’s pleasant and comprehensive and “most people feel so much better they change their lifestyle.”

To read more, you can check out articles at ucsf.edu and today.com—among others—which reported these new findings.

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Stressed Mind, Stressed Cells?

by Brad

Ferns by Joan Webster

Last Friday I attended a talk by Dr. Elissa Epel called “Telomeres, telomerase and mental states: Stressed mind, stressed cells?” According to the abstract Dr. Epel supplied in advance of her seminar:

"I will discuss our UCSF research on the telomere/telomerase maintenance system and relationships to stress and other psychological states and lifestyle factors. The length of our telomeres is a predictor of health status – early disease and mortality, and may serve as an index of biological aging. We now know from 8 years of research that shorter telomere length is related to states of suffering—anxiety, depression, trauma exposure, and chronic stress. Just how much can people stabilize their telomere length through interventions such as exercise and meditation? I will discuss initial findings, suggesting that this marker appears somewhat malleable."

Dr. Epel is an Associate Professor in the Department of Psychiatry at UCSF.  She is also a co-founder of Telome Health, Inc., a relatively new company located in the Bay Area to promote the use of telomere testing as a measure of biological age and overall health status. The basic idea that Dr. Epel was promoting is that chronic stress has a negative impact on telomere length, and that stress reduction through diet, exercise, and possibly other lifestyle changes can have preserve telomere length.

You may remember I posted a piece on this subject a couple months ago that discussed telomeres, yoga and aging ("Science, Aging and Yoga"). As a recap, telomeres are sequence of nucleotides or base pairs at the ends of your DNA that serve cap off and protect DNA integrity. One of the theories of aging asserts that decreased telomere length resulting from the failure of certain cell type in the body (immune cells, stem cells, etc.) to properly renew their telomere length after rounds of cell division via the action of telomerases (enzymes that add back lost telomere DNA) can lead to cellular senescence (a terminal, not dividing state) that could play a role in aging, acting as a sort of molecular clock. The question as to whether a reduction or low telomere length is responsible human aging or diseases is still hotly debate (see NY Times article here), despite many studies showing a correlation of shortened telomeres with cancer, diabetes, osteoporosis, Alzheimer’s and other chronic diseases of aging.

Personally, I found much of the data presented by Dr. Epel not especially convincing, as it was mostly correlative, and did not provide much if any mechanistic insight. However, I was intrigued by her attempt to link the physical and mental state of “stress” that we experience daily (you know, “I’m so stressed out”) to cellular stress and damage (alteration in the physiological state of cells or tissues that can lead to damage at the molecular and cellular level). Although we are all familiar with the former use of the term “stress,” this second usage of the term “stress” is quite different, and its effects can remain hidden until it manifests into a pathological or disease state.

It is well known that emotional stress can lead to an increase in cortisol and insulin levels, as well as increases in catecholamines and inflammatory cytokines. What is less clear is how these signals are integrated at the cellular and tissue level, especially under chronic stress, some of which are not at all obvious. Most studies measuring telomere length are on carried out on immune cells present in blood, as these cells are relatively easy to collect and originate from actively dividing cells. 

The notion that chronic stress could alter telomerase activity in these proliferating immune cell types, resulting in the shortening of the telomeres and causing these cells to lose their capacity to divide (“Immunosenescence”) is certainly an interesting hypothesis. Indeed, immunosenescence is increasingly being seen as a new target for drugs and/or biologics therapy by both pharmaceutical and biotech companies. According to data presented by Dr. Epel, one group of people that apparently has a statistically significant decrease in telomere length are long-term primary caregivers, a group that is regarded as suffering from chronic stress. People with long-term depression apparently also have a similar phenotype.

And as I have discussed in an earlier post, meditation and mindfulness practices have been proposed as ways to ward off the presumed negative effects of telomere shortening. (I say presumed, because it’s still not clear to what extent shortened telomeres are by definition a bad thing, or how much shortening of telomeres is required for any negative consequences.) The science on all this is still in the very early days. It may turn out that telomere length will be one more false lead in the ongoing search for biochemical measures of biological aging. And I would be extremely wary of any company advertising to measure your telomere length or that suggests that taking supplements to increase telomere length makes any sense at all. Unfortunately, there are a growing number of companies out there they do indeed make such claims. (To their credit, Telome Health appears to be considerably more circumspect in their claims and services than most.)

I suppose what interested me the most from Dr. Epel’s seminar is that it once again reminded me of the many avenues of medical research that are converging on the notion that chronic stress is a negative factor in human health and possibly a driver in premature or accelerated aging. While the details of how this actually happens is unclear, it is interesting to consider that one of the main, if not primary, benefits of practicing yoga might be to reduce stress.  Who knows, maybe it will turn out that yoga reduces stress at both the psychological and cellular level? Too early to tell, but stay tuned….

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Science, Aging, and Yoga

by Brad

Paris in the Rain by Brad Gibson 

So I promised I would get back to the question of how one would use science to study the effects of yoga on aging. As a starting point, let’s look at one highly publicized study that appeared a few years ago in Lancet Oncology (see here).

This work was collaboration between Elizabeth Blackburn, a prominent and highly respected biochemist at UCSF and recent Nobel Prize winner in Medicine, and Dean Ornish, a clinician at UCSF and well-known author of books and articles linking better nutrition to health and disease prevention, especially for coronary heart disease. The basic premise of their 2009 Lancet study was to examine whether relatively short-term lifestyle changes consisting of a low-fat diet, moderate exercise and yoga-based stress management could effect telomerase activity in circulating blood peripheral blood mononuclear cells (PBMCs) that are largely cells involved in immunity. 

The authors enrolled 30 men with a pre-diagnosed low-risk for prostate cancer for a three-month regimen. They measured telomerase activity, an enzyme present in certain class of replicating cells that maintains the length of telomeres. Telomeres are repetitive stretches of DNA at the ends of chromosomes that protect the integrity of chromosomes, and with each cell division gets shorter. Telomere shortening has been shown to negatively affect a cells capacity to replicate and general maintenance. Telomere shortening has been suggested as a biomarker of aging, acting as a type of clock for cellular aging. This so-called “telomere theory of aging” has gone out a favor among some scientists in recent few years, and its role in aging is controversial. Nonetheless, the basic premise underlying this study is that higher telomerase activity will lead to longer telomere lengths, which will set back the aging clock a bit in some way, or at least lead to healthier immune cells.

The author’s conclusions were as follows: “Comprehensive lifestyle changes significantly increase telomerase activity and consequently telomere maintenance capacity in human immune-system cells. Given this finding and the pilot nature of this study, we report these increases in telomerase activity as a significant association rather than inferring causation. Larger randomized controlled trials are warranted to confirm the findings of this study.”

What they mean here is that the number of patients in the study was low (N=30 is very small for a study of this type, and only 24 of these could actually be followed up the multiple times needed over this three-month period for technical reasons), the patients were pre-selected as having a clinical diagnosis of possible “low-risk prostate cancer” (that is, not a random group and probably motivated for a positive outcome), and that the results can at best be interpreted as an association and not necessarily a cause of the three-month lifestyle change (that is, just because thus group showed an increase in their telomerase activity, it doesn’t mean it resulted from the lifestyle intervention, but it could be the result of any one of a number of variables that were unaccounted for during this period, sometimes referred to as “confounders”).

But larger randomized properly controlled trials are expensive to run, and without a serious backer—the government or a drug company—don’t expect to see a follow-up any time soon. Just think about the large-scale trails of vitamin E that after many years and millions of dollars not only failed to establish a link but also showed a possible negative association. This is part in parcel of the tough love and art of large-scale clinical trials that are required if you want to prove something using rigorous scientific methods. 

So what did this study actually show? At minimum they showed what was needed for carrying out a larger study (power calculation) to actually determine a causal relationship. No mechanism was defined for why telomerase activity increased, although several were suggested (reduction in oxidative stress and inflammation, for example). Otherwise one shouldn’t draw too many conclusions from this study, especially since three independent variables were introduced (diet, exercise and yoga) and the study group was so small and biased. And one has to also keep in mind that the telomere length was not directly measured, as the authors themselves pointed out that telomere length changes would likely to be too small to measure in such a short time (three months). So I guess there’s another message to take home: some things take time.

Reports like these remind me of one of the reasons I have sympathy for the “N of 1” studies, that is, experimenting on yourself. Not real science, but you’ve got to try something. Take up yoga, improve your diet, have a walk everyday, and see what happens. 

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Stress, Telomeres, and Aging

by Nina

In his next post, Brad will be writing about one of the several competing theories about aging: Nobel Prize winner Dr. Elizabeth Blackburn’s theory of the relationship between aging and telomeres (the protective caps at the ends of our chromosomes). Dr. Blackburn believes that telomere length is an indicator of the age and vitality of a cell, and that psychological stress actually ages cells, which can be seen when telomere length is measured.

We thought you might be interested in Dr. Blackburn’s work because she is so convinced about the effects of stress on cellular aging that she is studying the effects of meditation and yoga on telomeres. So for those of you who would like to learn a bit about her work before Brad’s post, here is a little background information. As a start, you can find a brief interview with Dr. Blackburn here. If you’ve got an hour or so, you can listen to her lecture on “Chromosome Ends and Diseases of Aging” here.

Gaudi Mosaic by Brad Gibson

Throughout your life, your cells may reproduce many times to repair and strengthen their host organs, to grow or to fight disease, and the telomere at the end shrinks each time the cell divides and duplicates itself. A chemical called telomerase helps restore a portion of the telomere with each division, but after 10 to 50 divisions or so (the number varies by tissue type and health, and biologists still do not understand the system well), the telomere gets so short that the cell is no longer able to replicate. Because some cells or tissues in our body (skin, blood cells, etc.) continue to replicate and be replaced as we age, or to be repaired after injury, if the progenitor cells needed for these processes cannot replicate due to telomere shortening, this can contribute to the aging process and increase our susceptibility to disease. See here for a short article on this.

For several years, Dr. Blackburn has been conducting research on the relationship between stress and telomere length. According to her, there is so much evidence that psychological stress actually ages cells that she and her colleagues have been studying the effects of mindful meditation on telomere length. See here for a full academic paper entitled “Can meditation slow the rate of cellular aging?” I've read that as a result of these studies, Dr. Blackburn has taken up meditation as regular practice.

To be continued....

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