Published in the 2023 March/April issue of Cityview Magazine, the premier lifestyle publication for Knoxville, TN and surrounding area, this article is the first in a series on the topic of aging well. Aging is inevitable. However, there are numerous options for making healthier choices, in addition to products and medical procedures to help us live well regardless of our age.
Aging Gracefully
What to Expect When You’re Aging
By Oana Harrison
As a kid, I thought being 40 was old. Fast forward to present time and I’m, well, old by that definition—and lucky to have that option! Someone wise once said that getting old beats the alternative, and although I agree, I am now adjusting to a new physical reality of myself and making conscious efforts to stay healthy inside and out.
Nostalgically, many of us can recall the days when we could scarf down an entire pizza or donut dozen without any or much detriment to our waistline, or when we could run for miles without getting winded, or when we kneeled and bounced back up without sound effects—you get the idea. As we age, our capabilities diminish naturally. However, as 19th century French writer Jules Renard eloquently put it: “It’s not how old you are. It’s how you are old.” Our focus should be on living the best and healthiest life at any age.
What is aging?
So, what is aging? Aging is commonly defined as the accumulation of various destructive changes occurring in cells and tissues that are responsible for the increased risk of disease and death. While the human life span remained unchanged for the past 100,000 years (around 125 years), life expectancy has increased by 27 years during the last century, especially in Western countries (Hayflick 2000). In addition, our quality of life improved as we eliminated infectious diseases occurring in our youth, and as we continue to learn more about age-related degenerative factors.
Ancient philosophers like Aristotle pondered on the nature of dying, and theorized that aging was a process by which bodies gradually become dry and cold—moisture, he postulated, was the key to staying young. If only that were true, Southerners would be forever young! Emperors also searched for youth elixirs unsuccessfully, some of them managing to poison themselves in the process. Alas, scientists stepped in and started researching the matter in the 1900s. In the process they discovered that there wasn’t a sole culprit and generated more than three hundred theories on how we age! (Medvedev 1990). Here are a few popular ones:
The evolutionary senescence is the most accepted theory of aging. Itstates that genes that are beneficial early in life and support the reproductive success of an individual are favored over genes that are beneficial later in life; the body doesn’t have the capacity to repair age-induced cellular damage (American Federation of Aging Research 2016).
The free radical theory of aging blames oxidative free radicals, the toxic byproducts of cell metabolism. Free radicals that are not neutralized by antioxidants can damage DNA, proteins, and mitochondria.
The cross-linking/glycation hypothesis states that with age, our proteins, DNA, and other structural molecules develop inappropriate cross-links to one another (American Federation of Aging Research 2016). Enzymes normally neutralize damaged proteins but not the cross-linked proteins. Cross-linking is at least partially responsible for our wrinkles, age-related cataract, atherosclerosis, and Alzheimer’s disease.
The neuroendocrine hypothesis looks at the connection between the nervous system and endocrine glands, which produce hormones. The hypothalamus in our brain controls the pituitary gland, which regulates other major glands and their release of hormones. Age reduces this system’s functionality, which can negatively affect our metabolism, insulin processing power, blood pressure, and sleep quality.
According to the telomere theory of aging, our cells have a limited number of divisions. As we age, the telomeres—specialized DNA sequences responsible for cell renewal—shorten and eventually disappear, as cells run their course.
The Inflammation hypothesis of aging—known as inflamm-aging—focuses on acute and chronic inflammatory responses to stressors, which lead to aging, in addition to diseases, such as atherosclerosis, diabetes, and dementia.
Caloric restriction is the only nongenetic intervention that has consistently shown to slow the rate of aging in mammals (Dirks and Leeuwenburgh 2006), even if results wouldn’t necessarily translate in humans. Experiments where the caloric intake was reduced by 40%, while maintaining essential nutrient requirements, resulted in a 30–40% increase in maximum lifespan (Weindruch et al 1986). Scientists looked at Okinawa, the Japanese island with the greatest percentage of centenarians in the world. Their diet consists of vegetables, grains, soy, fruits, fish and seaweed; they consume 20% less than the rest of Japan and 40% less than United States (Clin Interv Aging 2007).

Slowing down the aging process
The bottom line is that there are many causes for aging and more research is necessary to gain a deeper understanding of this intricate process. The human body is complex, and as such, any changes we make might have both desired and undesired effects. Gerontologists and biogerontologists “have an obligation to emphasize that the goal of research on ageing is not to increase human longevity regardless of the consequences, but to increase active longevity free from disability and functional dependence” (Hayflick 2000b). In other words, quality of life comes first, rather than longevity.
It is important to keep in mind that aging is a natural stage in one’s life, and not a disease. We should familiarize ourselves with what is a normal part of the aging process and what we can do to help ourselves stay in optimum shape. So, what can we expect when aging? The first thing that most of us notice as we age is how our skin changes, particularly the appearance of wrinkles and sunspots. Internally, our cardiovascular system is at the top of the list: as we age, the arteries get stiffer and the heart needs to work harder. We lose bone density and muscle strength, we might experience troublesome digestion, and our metabolism slows down. Joints get less nimble and sore. Our eyesight and hearing might slip, and our memory too.
Since aging is inevitable, what can we do to experience a healthy aging process? The overall advice is nothing surprising: get regular health checkups, stay physically and mentally active, choose your caloric fuel wisely, protect your skin, hydrate, manage stress, and avoid alcohol and tobacco.
For most of us, the first thing that comes to mind when we think of anti-aging help is cosmetics, since our exterior appearance is what people notice first. But there is much more to keeping youthful, and a lot of it can be addressed internally.

Beyond our physical being, a healthy mind and happy soul play a crucial role in our overall well-being. A Harvard medical study that started in 1938 and span over a period of 80 years revealed that being joyful and having good human relationships had a significant impact on longevity and health. “Good relationships don’t just protect our bodies; they protect our brains,” said Professor Robert Waldinger, the latest director of the Harvard Study of Adult Development. Those who kept warm relationships got to live longer and happier. “Loneliness kills,” he added. “It’s as powerful as smoking or alcoholism.” Psychiatrist George Vaillant, who joined the team as a researcher in the 60s said: “When the study began, nobody cared about empathy or attachment. But the key to healthy aging is relationships, relationships, relationships.”
In our following Cityview magazine issues, we dig deeper into the subject of aging, talk with experts, and explore different anti-aging tools available to you in the Knoxville and East Tennessee Area, such as:
Nutrition and supplements: An unhealthy diet that is rich in fats and sugars causes inflammation of neurons and inhibits the formation of new neurons. This can affect brain power and contribute to brain disorders like depression. Adding the right supplements to a healthy diet can provide antioxidants to fight off damaging free radicals.
Physical and mental fitness: We look at great low-impact exercise options to help us stay in shape, like walking, swimming, and social dancing. Some ways to flex our mental muscle are: learning new skills, reading, and playing mind games—well, games that sharpen cognitive abilities, that is.
Hormone replacement therapy (HRT) started in the 60s and gained popularity in the 90s. Initial studies showed that the detriments outweighed the benefits; however, new studies showed that the use of HRT in younger women or in early postmenopausal women had a beneficial effect on the cardiovascular system, reducing coronary disease and all-cause mortality.
Osteopathic esthetics provide nonsurgical holistic anti-aging treatments, like manual lymphatic drainage and craniofacial technique to fight wrinkles and broken capillaries; IV therapy can deliver hydration, vitamins, minerals, and antioxidants directly into the bloodstream, giving your body a boost of health.
Skincare is a must even when young. As we age, our skin loses collagen and elastin, becoming thinner and more prone to wrinkles. We explore different ways to help us save face, from facial creams laden with peptides or retinoids, to cleansers, toners, masks, exfoliators, and more. The options can be overwhelming while the results might not. We talk with experts to help us navigate the beauty counter wisely.
Aesthetic medicine provides cosmetic procedures such as dermal fillers, chemical peels, microdermabrasion, Botox, and laser skin resurfacing.
Surgical options include body contouring or liposuction, neck lifts, eyelid or chin surgery that can minimize the effects of aging and offer a more youthful look.

Resources
- The aging process and potential interventions to extend life expectancy – Matteo Tosato, Valentina Zamboni, Alessandro Ferrini, and Matteo Cesari
- Developmental Biology, 6th edition by Scott F. Gilbert 2000
- THEORIES OF AGING An introduction to aging science brought to you by the American Federation for Aging Research
- chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.afar.org/imported/AFAR_INFOAGING_GUIDE_THEORIES_OF_AGING_2016.pdf
- Aging: What to expect – By Mayo Clinic Staff
- Good genes are nice, but joy is better – Liz MineoHarvard Staff Writer, The Harvard Gazette, April 11, 2017