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From the Townsend Letter
December 2015

Anti-Aging Medicine
An Anti-Aging Approach for Men's Health
by Ronald Klatz, MD, DO, and Robert Goldman, MD, PhD, DO, FAASP
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Warning that physical inactivity is the fourth leading risk factor for death worldwide, the World Health Organization (WHO) issued Global Recommendations on Physical Activity for Health – in an effort to provide guidance on the frequency, duration, intensity, type, and total amount of physical activity needed for the prevention of noncommunicable diseases. Among adults ages 18 to 64 years, the recommendations are fourfold:
1.  Adults aged 18–64 should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week, at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.
2.  Aerobic activity should be performed in bouts of at least 10 minutes' duration.
3.  For additional health benefits, adults should increase their moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity activity.
4.  Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.
Indeed, physical activity is the quintessential anti-aging practice. Ulf Ekelund and colleagues from the University of Cambridge (UK) assessed the link between physical inactivity and premature death. The team analyzed data collected on 334,161 men and women across Europe, enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study. Over an average of 12 years, the researchers measured height, weight, and waist circumference, and used self-assessment to measure levels of physical activity. Data analysis revealed that the greatest reduction in risk of premature death occurred in the comparison between inactive and moderately inactive groups. The investigators estimated that daily exercise burning between 90 and 110 kcal ("calories") – roughly equivalent to a 20-minute brisk walk – would take an individual from the inactive to moderately inactive group, and reduce their risk of premature death by between 16% to 30%. The impact was greatest amongst normal-weight individuals, but even those with higher BMI saw a benefit. In further calculations, the team reveals that 337,000 of the 9.2 million deaths amongst European men and women may be attributed to obesity (classed as a BMI greater than 30) – with double this number of deaths (676,000) attributable to physical inactivity. The study authors report: "The greatest reductions in mortality risk were observed between the 2 lowest activity groups across levels of general and abdominal adiposity, which suggests that efforts to encourage even small increases in activity in inactive individuals may be beneficial to public health."
The role of exercise as an anti-aging approach is biological, as postexercise levels of irisin, a hormone released from muscle after exercise, correlate to telomere length. James Brown and colleagues from Aston University (UK) enrolled 81 healthy men and women, aged 18 to 83 years with a mean body mass index (BMI) of between 20 and 30 kg/m2, in a study to assess whether a molecular link exists between circulating irisin levels and the length of telomeres – the end caps of chromosomes which are thought to be a marker of aging. The team found that those subjects with higher levels of Irisin also had longer telomeres. Writing, "relative telomere length can be predicted by age and plasma irisin levels," the study authors conclude: "Irisin may have a role in the modulation of both energy balance and the ageing process."
This month's column reviews recent studies that reinforce the life-enhancing, life-extending importance that physical activity confers – particularly among men.

Ekelund U, Ward HA, Norat T, et al. Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC). Am J Clin Nutr. January 14, 2015.

Global Strategy on Diet, Physical Activity and Health
. World Health Organization. 2010. Available at Accessed 27 August 2015.
Rana KS, Arif M, Hill EJ, et al. Plasma irisin levels predict telomere length in healthy adults. Age. January 2014.

Daily Exercise Lowers Death Risk
Exercising for 30 minutes a day, 6 days a week, is linked to a 40% lower risk of death from any cause in older men. Professor Ingar Holme and colleague Sigmund Alfred Anderssen of the Department of Sports Medicine at the Norwegian School of Sport Sciences (Oslo, Norway) studied data obtained from men taking part in the Oslo Study, which began in the 1970s. A total of 14,846 men born during 1923–1932 took part in the first study (Oslo I) in 1972–1973. Participants had their height, weight, cholesterol, and blood pressure assessed, and they were asked whether they smoked. They were also asked to respond to a validated survey (Gothenburg questionnaire) on their weekly leisure time physical activity levels. In 2000 the 5738 surviving men repeated the process (Oslo II) and were then monitored for almost 12-years to determine whether physical activity level over time was associated with a lowered risk of death from cardiovascular disease, or any cause. Results showed that during the 12-year follow-up, 2154 participants died. Further analysis showed that 30 minutes of physical activity, regardless of intensity, 6 days a week, was associated with a 40% lower risk of death from any cause. In addition, men who regularly engaged in moderate to vigorous physical activity during their leisure time lived 5 years longer on average than those who were classified as sedentary. The researchers say that the impact of regular exercise in elderly men seems to be as good for health as quitting smoking. "Public health strategies in elderly men should include efforts to increase physical activity in line with efforts to reduce smoking behaviour," they concluded.

Holme I, Anderssen SA. Increases in physical activity is as important as smoking cessation for reduction in total mortality in elderly men: 12 years of follow-up of the Oslo II study. Br J Sports Med. 2015;49:743–748.

Tai Chi Linked to Longevity
Chinese men who practiced tai chi, a form of mind-body exercise that originated in ancient China, were less likely to die over a 5-year period, as compared with sedentary men. Xianglan Zhang and colleagues from the Vanderbilt University School of Medicine (Tennessee, US) studied data collected on over 61,000 middle-aged and elderly men in Shanghai, China. Researchers tracked their health and lifestyle for more than 5 years: nearly 22,000 participants reported that they exercised at least once a week, and the rest were considered nonexercisers. Factoring in the men's age, health conditions, and whether they smoked, exercise was tied to a 20% lower likelihood of dying. Similarly, whereas 6.2% of the nearly 10,000 men who practiced tai chi died during the study, after adjusting for confounding factors, the team found that they were 20% less likely to die than men who didn't exercise. Further, the researchers observed that men who walked regularly were 23% less likely to die during the study, and men who jogged were 27% less likely to die. The study authors write: "The present study provides the first evidence that, like walking and jogging, practicing Tai Chi is associated with reduced mortality."  

Wang N, Zhang X, Xiang Y-B, et al. Associations of Tai Chi, walking, and jogging with mortality in Chinese men. Am J Epidemiol. June 27, 2013.

Two Bone-Building Exercises 
Weight-lifting and jumping exercises may improve bone density and reverse age-related bone loss among middle-aged men. Pam Hinton and colleagues from the University of Missouri (US) enrolled 382 physically active, middle-aged men who completed either a weight-lifting program or a jumping program for a year. Both programs required participants to complete 60 to 120 minutes of targeted exercises each week. The participants took calcium and vitamin D supplements throughout their training programs. The researchers measured the men's bone mass at the beginning of the study and again at 6 and 12 months using specialized X-ray scans of the whole body, hip, and lumbar spine. The researchers found that participants' bone mass of the whole body and lumbar spine significantly increased after 6 months of completing the weight-lifting or jumping programs, and this increase was maintained at 12 months. Hip-bone density only increased among those who completed the weight-lifting program. As well, the participants reported minimal pain and fatigue after completing their exercises, and these ratings decreased over the year. The study authors write: "[Resistance training] or [jump training], which appeared safe and feasible, increased [bone mineral density] of the whole body and lumbar spine, while [resistance training] also increased hip [bone mineral density], in moderately active, osteopenic men."

Hinton PS, Nigh P, Thyfault J. Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: A 12-month randomized, clinical trial. Bone. 2015 Oct;79:203–212.

Taking Up Exercise Late in Life
Fortunately (for many of us), it is never too late to start exercising. Mark Hamer and colleagues from the University College London (UK) assessed data collected on 3454 healthy senior men and women, enrolled in the English Longitudinal Study of Ageing. Participants reported how much they exercised at the start of the study, with researchers following them via regular health surveys for the next 8 years. At follow-up, 90% of the subjects were considered to be healthy agers, as they did not develop any major chronic diseases and had not experienced deterioration of their physical or mental status during the study period. The men and women who were active at least once a week at the study's start and remained active were the most likely to age healthily. Additionally, those who started exercising during the study period enjoyed health benefits as well: they were 3 times more likely than inactive adults to age well. Overall, men and women who remained active during the full 8 years of the study were over 7 times more likely to be aging well. Observing, "Sustained physical activity in older age is associated with improved overall health," the study authors conclude: "Significant health benefits were even seen among participants who became physically active relatively late in life."   

Hamer M, Lavoie KL, Bacon SL. Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing. Br J Sports Med. 2013 Nov 25.

To stay updated on the latest natural approaches that may help to promote men's health, visit the World Health Network (, the official educational website of the A4M and your one-stop resource for authoritative anti-aging information. Be sure to sign up for the free Longevity Magazine e-journal, your weekly health newsletter featuring wellness, prevention, and biotech advancements in longevity.

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