Kopp Wolfgang
Aging Dis. 2024 Jun 28;16(3):1316-1346. doi: 10.14336/AD.2024.0570.
The study explores the intricate relationship between aging and the development of noncommunicable diseases [NCDs], focusing on whether these diseases are inevitable consequences of aging or primarily driven by lifestyle factors. By examining epidemiological data, particularly from hunter-gatherer societies, the study highlights that many NCDs prevalent in modern populations are rare in these societies, suggesting a significant influence of lifestyle choices. It delves into the mechanisms through which poor diet, smoking, and other lifestyle factors contribute to systemic physiological imbalances, characterized by oxidative stress, insulin resistance and hyperinsulinemia, and dysregulation of the sympathetic nervous system, the renin-angiotensin-aldosterone system, and the immune system. The interplay between this pattern and individual factors such as genetic susceptibility, biological variability, epigenetic changes and the microbiome is proposed to play a crucial role in the development of a range of age-related NCDs. Modified biomolecules such as oxysterols and advanced glycation end products also contribute to their development. Specific diseases such as benign prostatic hyperplasia, Parkinson's disease, glaucoma and osteoarthritis are analyzed to illustrate these mechanisms. The study concludes that while aging contributes to the risk of NCDs, lifestyle factors play a crucial role, offering potential avenues for prevention and intervention through healthier living practices. One possible approach could be to try to restore the physiological balance, e.g. through dietary measures [e.g. Mediterranean diet, Okinawan diet or Paleolithic diet] in conjunction with [a combination of] pharmacological interventions and other lifestyle changes.
该研究探讨了衰老与非传染性疾病(NCDs)发展之间的复杂关系,重点关注这些疾病是衰老的必然结果还是主要由生活方式因素驱动。通过研究流行病学数据,特别是来自狩猎采集社会的数据,该研究强调现代人群中普遍存在的许多非传染性疾病在这些社会中很少见,这表明生活方式选择具有重大影响。研究深入探讨了不良饮食、吸烟和其他生活方式因素导致全身生理失衡的机制,这些失衡表现为氧化应激、胰岛素抵抗和高胰岛素血症,以及交感神经系统、肾素 - 血管紧张素 - 醛固酮系统和免疫系统的失调。这种模式与个体因素(如遗传易感性、生物变异性、表观遗传变化和微生物群)之间的相互作用被认为在一系列与年龄相关的非传染性疾病的发展中起着关键作用。修饰的生物分子如氧化甾醇和晚期糖基化终产物也促进了它们的发展。通过分析良性前列腺增生、帕金森病、青光眼和骨关节炎等特定疾病来说明这些机制。该研究得出结论,虽然衰老会增加患非传染性疾病的风险,但生活方式因素起着关键作用,通过更健康的生活方式提供了预防和干预的潜在途径。一种可能的方法是尝试恢复生理平衡,例如通过饮食措施(如地中海饮食、冲绳饮食或旧石器时代饮食)结合药物干预和其他生活方式改变。