How to Look and Feel Your Best As You Age

How to Look and Feel Your Best As You Age| Women's Health | Sara Gottfried MD

Do you want to feel your best as you age? What are the secrets to improving your healthspan and better aging? Here are the main steps I recommend to turn back the clock from the inside out. There are three main building blocks to slow down the aging process: sleep, food and exercise.

Improve your sleep with Vitamin D supplementation

It’s difficult to gain a sufficient amount of it through your diet. The best food sources are liver and low-mercury fish such as herring, sardines, and cod. Sunshine is still the best way to get vitamin D, but if you have a genetic defect in your vitamin D receptor, like I do, it may be almost impossible to get enough sunshine to keep your vitamin D in the optimal range of 60 to 90 ng/mL (the optimal range for sleep and achieving a healthy weight).

Vitamin D is good for your bones, thyroid, and sleep. It influences thousands of genes. Vitamin D appears to have direct brain effects on your regulation of sleep, specifically in the diencephalon (the part of your brain that contains the hypothalamus and regulates hormones) and brain stem (trunk of the brain). Some hypothesize that sleep disorders have risen to epidemic levels because of widespread vitamin D deficiency, and I agree. Vitamin D has hormonal, neurological, and immunological influences on pain in the body, playing a key role in the cause and continuation of chronic pain and associated problems such as insomnia. Lack of sleep, disrupted circadian rhythms, and low vitamin D levels can impair healing and repair[1].

Generally, I recommend about 2,000 to 5,000 IUs/day, but the best strategy given the multiple genes involved in vitamin D metabolism is to track your blood level over time.  As you’ll find with many nutrients, there is a U-shaped curve between vitamin D and health, so too little is unhealthy, and too much may be unhealthy too. You want just the right amount for your biology. That’s precision health.

Eat more vegetables

When you eat more foods that detoxify your body, such as cruciferous vegetables, fruits, and nuts, you turn on nutrigenomic pathways, or the interactions between your individual genetic makeup and dietary components that result in modulation of genetic expression. Eat mostly plant-based food, with animal-based food as a condiment, and choose anti-inflammatory forms of protein and dairy. Moreover, there’s been some research proving that eating more fruits and vegetables can actually change and improve skin tone. The carotenoids, the orangey-red pigments found in fruits and vegetables, yield the way for a healthier glow. The scientists found that eating an extra two pounds of fruits and vegetables daily caused a detectable sparkle in patients after only six weeks. There are two ways that carotenoids and other nutrients in vegetables improve your skin tone: first, eating carrots changes skin color, making it more bronze, which is perceived as a healthy and attractive glow. Second, colorful vegetables like carrots increase skin reflectance, or glow. In the study, this is due to carotenoids, not melanin (pigment in the skin). You need a minimum dose of 3 servings per day for six weeks to achieve a measurable difference.

Another study suggests carotenoids may reduce collagen degradation[2], and anxiety[3]. Those are biological and psychological mechanisms for increased glow!  Make wise choices with food, and pick up colorful, fresh produce.

Exercise smart

Make sure to apply a smart regimen to your life. Lengthen your healthspan with moderate exercise 1-2 hours per day. Walk, hike, go chi running, practice yoga, or go to barre class. Add burst training, also known as “high intensity interval training,” to your routine. (Burst training involves short periods of high intensity exercise with moderate-level exercise as recovery.) No chronic cardio or running a marathon; these popular regimens put too much stress on the body by raising the wear-and-tear hormone cortisol.

I suggest to burst-train in the morning or before 1:00 in the afternoon two to three times per week, an exercise where you focus on fast-twitch muscle bers. Cavemen and -women tended to exercise in bursts: a quick run to the river to fetch water and carry a bucket back to the tribe, a jog with a sick infant to a neighbor’s dwelling for help. Our bodies perform well with burst training, and then recover at a moderate intensity for one to three minutes. Protocols vary; use one that makes the most sense for you. Burst training can be applied to cardio exercise (e.g., intermittently sprinting on a trail alternating with a jog) or weight lifting (lifting a weight, such as with a biceps curl, as many times as you can with good form for one minute, followed by a one minute of rest). Other examples:

  • Walking three minutes fast (approximately 6 or 7 on an exertion scale from 1 to 10, or the green zone of 70 to 80 percent of your maximal exertion), then alternating with three minutes at a normal pace
  • Chi running with sprint intervals,or regular running with 30-second sprints
  • High-intensity interval training with weights or cardio (stationary bike, elliptical, treadmill), alternating two to three minutes at a moderate pace with one to two minutes at maximal pace for you.

So if we’re talking about aging… how might we target specific signs of aging? Is it hormones?

With age, both men and women make less testosterone, leading to more fat deposits at the breasts, hips, and buttocks. Women produce less estrogen, which normally protects the hair follicles and skin–and reduces appetite. Lower levels of estrogen and testosterone may weaken your bones and your sex drive, and furthermore, lower estrogen-to-testosterone ratios may trigger hair loss and heart disease. Unfortunately, your thyroid gland slows down and, along with it, your metabolism, so the bathroom scale climbs a few pounds per year (or even per month). You get cold more easily. Your cells become increasingly insensitive to the hormone insulin, which leads to rising blood sugar in the morning. As a result of higher blood sugar, you may feel foggier and experience stronger cravings for carbs, then notice more skin wrinkling along with an older-looking facial appearance.

Combine that with worsening gut health, from the lack of diversity of microbes and the rise of bad microbes, and you’re set for accelerated aging from imbalanced hormones.  About 70 percent of your immune system lies beneath your gut lining, so it’s the place where your immune system can get overstimulated, leading to excess inflammation and even autoimmune conditions. Furthermore, your gastrointestinal tract contains three to five pounds of microbes. The DNA from your microbes outnumber your human DNA a hundred to one and are collectively known as your microbiome. Imbalanced microbes and their DNA may cause you to make more enzymes such as beta-glucuronidase, which raises certain bad estrogens and lowers your protective estrogens. Excess stress raises corticotropin-releasing factor, which pokes holes in your gut, leading to food intolerances, more stress, and lower vagal tone, an indicator that your nervous system is out of whack. Finally, high stress can make you absorb nutrients poorly, especially B vitamins.

The key point is that the right food, sleep, exercise, and support for detoxification can reverse many hormone problems associated with aging.

What are some of the best practices to tackle aging from the outside in?

  1. Improve your exposome with positive exposures such as saunas (dry saunas and infrared) or heat, (hot tubs or steam rooms). Of all these forms of heat, dry saunas have the most evidence that they help you age well, but infrared saunas are not far behind. If you want to live long and healthy, you need molecular chaperones to tend to your DNA, and that’s what sitting in a sauna provides. Sauna bathing is also relaxing; it eases stress while adding to your healthspan.
  2. One of my best strategies for increasing healthspan is flossing. Flossing fosters longevity, independent of brushing one’s teeth, as does seeing the dentist at least twice per year (I go quarterly). If you don’t floss, your risk of mortality is 30 percent higher and if you see the dentist only once per year, you raise mortality by 30 to 50 percent. Flossing can prevent periodontal disease after as little as one month of regular use. I recommend flossing at least twice a day. No one does it right, so get a reminder on good form.
  3. Schedule in some meditation or other ritual for clearing stress. Anything that helps reduce perceived stress, be it relaxation or meditation or visualization, is extremely important for your hormonal harmony. I recommend barre fitness plus yoga. After trying for years to meditate regularly to lower stress and cortisol, I finally found the solution: I use the Muse brain-sensing headband. It gamifies meditation so it’s more fun, and works with a Calm app on your smartphone. As you sit and listen to nature sounds–I like the beach waves–you get immediate feedback. The waves get louder if you’re distracted and quieter as you reach a more zen state. If you can hold the calm state for a few beats, you hear bird sounds. So you become very competitive at generating bird sounds. It’s a bit ironic to get so competitive about creating calm, yet this device has helped me create the deepest meditation states of my life, which silences many faulty genes.

And what should we avoid to prevent a tsunami of aging?

Insufficient sleep: Poor sleep quality is an epidemic that so many people simply take for granted as part of a busy lifestyle. Yet not having healthy sleep patterns can contribute to a host of health problems: accelerated aging, high cortisol, weight gain and depression, just to name a few.

Studies show a link between weight gain, lack of sleep, and insulin resistance. Furthermore, sleep debt leads to dietary indiscretion and weight gain in women because you’re too tired to make wise food choices. In other words, get that solid seven to nine hours that your body really needs. Regardless of your ability to seemingly function on less sleep, odds are that you need it: only 3 percent of the population has a gene allowing them to function well on less sleep.

Getting better shut eye is such a crucial part of overall health and well-being. Two tactics to improve yourself: turn off electronics at least one hour before better and cut back on caffeine.

High stress: Nothing wrecks your health faster than unmananaged stress. The key is to manage your stress so that it doesn’t spiral out of control, and cause all sorts of health and hormonal havoc. The body is designed to release cortisol in order to cope with stress– like when you’re in fight or flight mode– but the problem is that most of us run around stressed constantly. In addition to controlling how you cope with stress, cortisol governs digestion, cravings, sleep/wake patterns, blood pressure and physical activity.  It’s basically a spiral: when you get stressed, cortisol rises, you overeat, you drink coffee, cortisol rises higher, and then you get fat. Stress makes most women become hypervigilant and struggle with sleep. Coffee, excess cortisol, and even cortisol resistance are the most common hormonal reasons for slow metabolism in women.

It’s no surprise that there are lots of different ways to address it, but I have found that when it comes to high cortisol, lifestyle and supplemental strategies are powerfully effective for most. As always, I recommend a whole-foods diet, appropriate exercise (did you know that running raises cortisol?) and stress management techniques such as meditation, deep breathing, and yoga.  

Exposure to mold and toxins: When you’re trying to preserve your youth and health, toxins from the environment accumulate in your fat. Turns out that your exposure to toxic chemicals, pollution and mold around your home and in your daily life could also be contributing adversely to your general health, weight, and aging. Hazards can be found in toothpaste, deodorant, sunscreen, food preservatives, the lining of cans that hold food, and many kinds of plastic. The list goes on and on. Toxins are found in our homes from lead or mold, in the water we drink and the products we buy. Polymorphism in the GSTM1, or glutathione S-transferase, gene, which codes for an enzyme that makes the most powerful antioxidant in the body, glutathione, means you could be prone to accumulate mercury. There is hope, as you can make some simple modifications to cut down on toxicity by avoiding heavy metals. Test your tap water, and swap your household cleaning products for organic versions. Discard any plastic containers and Teflon-lined pans; use glass, ceramic or stainless steel for storing or preparing foods. Pick salmon instead of tuna. Remove any amalgam. When choosing makeup, find an organic lipstick to reduce exposure to lead, and select a low-toxicity nail polish.                                     

Mold is serious business. One in four people has a mold susceptibility gene (HLA DR), meaning you could be sick from mold and not even know it! The genes that make you susceptible to mold illness are the same genes that control your sensitivity to other issues, such as a propensity for collagen breakdown in your skin (the foundation that keeps your skin firm and plump), allergies, plus yeast infections and an inability to process alcohol well, which leads to the formation of acetaldehyde, a toxin. It is often difficult to diagnose a mold illness, because the symptoms are extensive and nonspecific, similar to many other conditions. Memory problems, fatigue, weakness, numbness, headache, light sensitivity, excessive thirst; honestly the list goes on!

I am one of the 25 percent of the population with mold sensitivity, and mold exposure makes me inflamed, fat, and age fast.

Mold can grow anywhere that is wet and not well ventilated. It circulates your air system and your immune system is supposed to attack it successfully by making antibodies. But if you have a genetic susceptibility, you lack the protection of antibodies, and the toxins get recirculated in your body.  This is an unfortunate example of when illness is built into our DNA and, once triggered, the inflammatory response and resulting symptoms can last for years and will continue unless treated.

Want to look and feel your best as you age? Check out my New York Times bestselling book, Younger, for more secrets on improving your healthspan and better aging.

[1] Musiek, E. S., et al. “Sleep, circadian rhythms, and the pathogenesis of Alzheimer Disease.” Experimental and Molecular Medicine 47, no. 3 (2015): e148.

[2] Meinke, MC; et al. Influences of Orally Taken Carotenoid-Rich Curly Kale Extract on Collagen I/Elastin Index of the Skin. Nutrients, 2017 vol. 9(7)

[3] Li, DG; et al. Dermal carotenoid measurement is inversely related to anxiety in patients with breast cancer. J. Investig. Med., 2017