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    Features

    Aging in Place: Healthy Lifestyles Supplement Science-Based Solutions

    In all aspects of health, prevention pays off.

    Aging in Place: Healthy Lifestyles Supplement Science-Based Solutions
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    By Sean Moloughney, Editor05.03.22
    Earth is home to about 7.8 billion people today. The global population is on course to reach 9.7 billion by 2050, a nearly 24% increase over 2020, according to the Population Reference Bureau’s (PRB) 2021 World Population Data Sheet.

    Global life expectancy today is 75 years for women and 71 years for men. Notably, the total fertility rate—lifetime births per woman—has dropped globally from 3.2 in 1990 to 2.3 today.

    Studies have reported significant decreases in U.S. life expectancy during 2020 as a result of the COVID-19 pandemic, which disproportionately affected Hispanic and Black populations. PRB’s most recent fact sheet indicated provisional 2020 data show life expectancy in the U.S. dropped for both sexes—from 81.4 to 80.2 years for women and from 76.3 to 74.5 for men.

    For perspective, average U.S. life expectancy in 1950 was 68 years, and has risen in large part due to reduction in mortality at older ages.

    The number of Americans ages 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060, according to a PRB fact sheet from 2019. Aging populations present a growing challenge for governments, healthcare systems, and families. With an aging population comes an increasing need for healthcare, long-term care, and social services to support older adults as they age.

    For example, aging Baby Boomers could lead to a 50% increase in the number of Americans 65 and older requiring nursing home care—to about 1.9 million in 2030 compared to 1.2 million in 2017.

    An estimated 90% of adults over age 65 experience one or more chronic conditions, and need specific treatments and medical care.

    Demand for elder care will also be driven by a steep rise in the number of Americans living with Alzheimer’s disease, which could more than double by 2050 to 13.8 million, from 5.8 million in 2019.

    A larger share of older adults also means that Social Security and Medicare expenditures will increase from a combined 8.7% of GDP in 2019 to 11.8% by 2050, according to the Social Security Administration’s 2019 annual report.

    Meanwhile, regardless of age, about 42% of Americans are obese, which is associated with serious and preventable health risks like type 2 diabetes and heart disease.

    Recent Research

    Within this framework, preventive health solutions across the lifespan warrant further attention and review. At the same time, the science of aging and understanding how lifestyle, diet, and nutritional products affect health has accelerated.

    A study published in Frontiers in Aging in April concluded that daily supplementation with high-dose vitamin D3 plus omega-3s, combined with a simple home strength and exercise program (SHEP), showed cumulative reduction in cancer risk in generally healthy, active and largely vitamin D-replete adults 70 years of age and older (Bischoff-Ferrari et al., 2022).

    The incidence of most cancers increases markedly with age. The second leading cause of mortality in older adults, cancer is considered a major age-related disease in the U.S. and Europe.

    The DO-HEALTH trial was a multicenter, randomized, double-blind, placebo-controlled clinical trial designed to assess healthy aging in European adults by addressing six primary endpoints. The trial was conducted between December 2012 and December 2017 in Switzerland, Germany, Austria, France, and Portugal.

    The study randomized a total of 2,157 participants—mean age 74.9 years; 61.7% women; 40.7% with 25-OH vitamin D below 20/ml; 83% at least moderately physically active—to eight treatment groups: 2,000 IU/day of vitamin D3 and 1 g/day of omega-3s and SHEP (n = 264); vitamin D3 and marine omega-3s (n = 265); vitamin D3 and SHEP (n = 275); vitamin D3 alone (n = 272); omega-3s and SHEP (n = 275); omega-3s alone (n = 269); SHEP alone (n = 267); or placebo (n = 270).

    “This is the first randomized-controlled trial to investigate the combination of three complementary treatments for the prevention of cancer and suggest that the combination of daily vitamin D3, supplemental marine omega-3s, and a simple home exercise program may be effective in the prevention of invasive cancer among generally healthy and active adults aged 70 and older,” researchers wrote.

    They added: “These results may shape the future mind-set toward a multicomponent prevention strategy of cancer. Our results, although based on multiple comparisons and requiring replication, may prove to be beneficial for reducing the burden of cancer.”

    Meanwhile, results from the large-scale, placebo-controlled, clinical trial known as COSMOS (Cocoa Supplement and Multivitamin Outcomes Study) showed a significant 27% reduction in death from cardiovascular disease (CVD) among older adults taking cocoa extract (500 mg/d flavanols, including 80 mg (–)-epicatechins).

    Researchers also reported that a daily multivitamin-multimineral (MVM) supplement did not reduce the risk of total cancer or cardiovascular disease among generally healthy older men and women. Results for both studies were published in the American Journal of Clinical Nutrition in March (Sesso et al., 2022).

    Health, Prevention & Scientific Direction

    The World Health Organization (WHO) defines healthy aging as “the process of developing and maintaining the functional ability that enables wellbeing in older age.” Functional ability relates to having the capabilities that allow people “to be and do what they have reason to value.” This includes a person’s ability to meet their basic needs; learn, grow, and make decisions; be mobile; build and maintain relationships; and contribute to society, according to WHO.

    “Our desire for healthy aging, regardless of current age, is nearly universal,” said Jacqueline Rizo, digital engagement and communications specialist at Stratum Nutrition. “Social and health behaviors across the life course—such as diet, exercise, and engagement in the community, as well as the physical environment where we live, work, and obtain healthcare—all play a role in the development and progression of chronic diseases. For the majority of older adults, being able to do the things that they want at home and in the community is a primary component of healthy aging.”

    An Associated Press-NORC Center for Public Affairs Research poll released in April found that U.S. adults ages 65 or older feel much better prepared to “age in place” than those 50-64, who are mostly still working.

    The poll indicated greater insecurity around aging in place for older Black and Hispanic Americans, raising concerns about equity in access to resources and healthcare services.

    Aging in one’s own home, or with family or a close friend, is a widely held aspiration, with 88% of adults 50 and older saying it’s their goal, according to an earlier AP-NORC poll from last May.

    “During the natural course of aging, the accumulation of molecular and cellular damage play a significant role in one’s health over time,” said Rizo. “It’s important for healthy aging for consumers to take care of their physical, cognitive, and mental health.”

    Diversity, equity, and environment justice are all key considerations that relate to healthy aging, according to WHO.

    Consumers are “focusing more attention on how their purchasing choices impact both their health and planetary wellbeing,” said Eric Anderson, managing director, NXT-USA. “The desire for plant-based, ethically, and sustainably sourced ingredient solutions with small and versatile delivery format options to match evolving lifestyle needs is mounting.”

    Traditionally, the concept of healthy aging has related to seniors, noted Steve Fink, vice president of marketing, PLT Health Solutions, “in the sense of holding on to what we have and preventing decline. Very often, anti-aging efforts refer to chronic conditions, ending up as support for cardiovascular health, blood sugar health, cognitive health, eye health, and more.”

    But there’s been an evolution of focus on quality of life rather than the prevention of decline, Fink added.

    “Taken in this context, healthy aging does align with top consumer concerns. We are seeing the age at which people are concerned about healthy aging get lower and lower—because who isn’t interested in a better quality of life?”

    Indeed, everyone wants to stay healthy as they age. “Consumers are highly motivated to minimize the numerous age-related issues that can arise, ranging from cognitive function to the appearance of fine lines and wrinkles,” said Marianne McDonagh, vice president of sales, Bioenergy Life Science, Inc. (BLS). “These are billion-dollar categories.”

    Especially these days, you can’t talk about optimizing health without addressing “the deleterious effects of stress that can accumulate over time,” said McDonagh. “Signs of stress-related aging may be associated with elevated cortisol levels.”

    There is often a direct association between signs of aging and elevated cortisol levels as well as diminished NAD, ATP, and glutathione production, she noted.

    Two paths are emerging in aging research, according to Shawn Baier, vice president, business development, Innovative Products Division, TSI Group LTD: 1) quality of life relative to longevity, and 2) awareness of premature aging.

    “When we look at improvements in lifespan and longevity, we also need to assess what the quality of life is like for those extended years,” he said. “If we can maintain physical function (for example, our muscle health) and cognitive performance (for example, our memory and alertness), the improvements in longevity have a greater value when they come along with these measures of improved or maintained quality of life.”

    Nutritional interventions that can impact and improve these indicators of quality, like muscle health, are of great value to consumers, Baier added.

    “As for premature aging,” he continued, “we see a growing interest in the awareness of biological age versus chronological age as well as nutritional methods to impact our biological age—from food choices to dietary supplement use. Additionally, when we look at factors of premature aging, research is taking a more foundational approach by exploring nutrients that can impact our cellular health and minimize the stress and damage that occurs at the cellular level.”

    Through the natural course of time, our bodies experience free radical damage and greater oxidative stress, noted Kristin Wilhoyte, product marketing director, Deerland Probiotics & Enzymes (part of ADM), “which causes degeneration of organs and systems, hence, aging. One organ affected is the skin, beginning in one’s mid-20s, when skin begins to lose elasticity and collagen production begins to subside.”

    Skin aging is primarily the first sign of aging “and is often the most emotionally hard to accept,” she added. “Other systems that begin to break down through oxidative stress are joints, cardiometabolic function, brain function, vision, and digestion.”

    Omega Insights

    Diet plays an important role in maintaining homeostasis, noted Rick Pope, senior vice president of B2B Nutraceuticals at Norway-based Arctic Bioscience A.S., “by supplementing and replenishing key structural components in the cellular makeup of the body over time as we move through life, while helping to offset the negative effects of the typical pro-inflammatory western diet of too many carbs and omega-6 fats.”

    There is also a growing recognition that the best way to prevent or modulate the signs of aging is to minimize the incidence of chronic low grade inflammation “by supporting the normal resolution of inflammation as it occurs,” Pope added.

    “To that end, science suggests that the metabolites of EPA and DHA omega-3 fats—called SPMs (specialized pro-resolving mediators)—can play a key role in supporting normal resolution of inflammation throughout life, from life’s beginnings inside the womb through childhood and adulthood to the golden years.”

    In fact, research has indicated that people with a higher Omega-3 Index live longer and more independently than those with lower indices, he said.

    The most recent evidence came from a study published in Nature Communications last April (Harris et al., 2021). “It showed that those with a higher Omega-3 Index were 13% less likely to die of any cause vs. those who had the lowest levels,” said Pope. “In other words, those people who died with relatively low omega-3 levels died prematurely (i.e., all else being equal, they might have lived longer had their levels been higher).”

    Heart health is major area of focus in aging, said Ståle Søfting, marketing director at GC Rieber VivoMega. “Cardiovascular disease is the most common cause of death worldwide, taking an estimated 17.9 million lives each year,” he said, citing WHO statistics from 2021. “Clinical research has continually shown that the fatty acids EPA and DHA help protect the heart in a variety of ways, including inhibiting plaque formation, maintenance of healthy blood pressure, and healthy triglyceride levels.”

    Søfting also noted a 2020 analysis of 40 studies with a combined 135,267 participants that quantified the effects of EPA and DHA on cardiovascular disease, concluding supplementation with EPA and DHA is an effective lifestyle strategy to aid in the protection of heart health (Bernasconi et al., Mayo Clinic Proceedings).

    Joints, Muscles & Active Lifestyles

    Localized or systemic chronic inflammation is at the root of most signs and symptoms of aging, according to Pope.

    “One of the most common symptoms of aging is joint pain that can lead to restrictions in mobility, and that in turn can lead to a downward spiral in health due to physical inactivity. Consumers know that to stay healthy, they must remain physically active, and to support that they must choose foods and supplements that will support both cellular and organ health as well as minimizing diet-related pro-inflammatory conditions.”

    Over time, people experience more exercise-related inflammation, increased cartilage breakdown, and slower recovery times, said Anderson at NXT-USA. “More than 92 million adults experience joint discomfort. This is not just a problem for adults over 65. Younger Americans are impacted, too, with nearly one in three people aged 18 to 64 reporting joint discomfort.”

    Recovery has become an important issue for active consumers, he added. “Most consumers, depending on their level of training, will more than likely experience joint-related issues, such as pain or connective tissue problems. And rather than wait until the point of no return, they are taking supplements as a preemptive action to support their joint health.”

    Joints endure a lot of stress on a daily basis, said Rizo at Stratum Nutrition. “Injury (even minor injury), the stress of those extra 20 pounds, as well as a lifetime of wear and tear can take their toll on our joints, causing inflammation and pain, and eventually resulting in the breakdown of the cushioning cartilage,” she said. “If left unchecked, those intermittent moments of stiffness and pain become increasingly more persistent, and for many, ultimately result in the development of osteoarthritis.”

    Age-related muscle loss is inevitable and can decrease bodily function, noted Baier. “On average, people lose about 10-15% of their muscle mass per decade after the age of 35,” he said. Illness, injury, inactivity, and inadequate nutrition may accelerate the process.

    “Muscle health is part of the musculoskeletal system and while bone health and joint health are well established categories, muscle health has only recently started to gain much deserved interest,” Baier said. “The truth is bone health and joint health need the support of healthy muscles to function properly. We all want to keep our strength, mobility, and independence as we age and poor muscle health, if not addressed, can slow us down.”

    Today’s consumers strive to maintain mobility, health, and appearance and they recognize that what they do today affects their quality of life now and in the future, said Angie Rimel, marketing communications manager, North America, GELITA.

    “As consumers increase their focus on active lifestyles, they are realizing both increasing age and overuse make tendons, ligaments, and joints more injury prone and put bones at increased risk of stress fractures. So, it is no surprise that white tissue injuries today account for more than 70% of the time away from exercise regimens of athletes and physically active people.”

    Cognitive Health

    Along with lifestyle—including physical and mental exercise, stress, sleep, and more—nutrient-dense diets contribute to overall cognitive health.

    “There is no doubt that there are multiple factors that can work together to support the optimal functioning of our brains,” said Rizo.

    Increasingly, evidence suggests that cognitive health depends not only on brain tissue, but also an individual’s nutritional status, she added. “Consumer awareness and use of dietary supplements for cognitive support have also increased, which has led to the market increase in the number of ingredients being researched and marketed for support and maintenance of mental acuity. Many of these products target memory and/or mental focus.”  
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