Talking with Telomeres
Listen to Your Telomeres
One of the reasons cardiology tends to advance so rapidly compared to other medical disciplines- with very noteworthy benefits, such as marked declines in both premature death and disability related to heart disease- is because of the power of surrogate markers. Surrogate markers in medicine are generally things we can measure in the short term that tell us with at least reasonable, and sometimes excellent, fidelity about likely outcomes in the long term. Cardiology’s cup is full to the brim with good surrogate markers, such as LDL cholesterol, blood pressure, and heart rate.
We should distinguish, however, the value of surrogate markers from what we might call “duplicative markers.” Just because we can measure something doesn’t mean there is always much value in doing so.
In medicine, we rely at times on technology to tell us what we already know. Consider, for instance, the burgeoning array of studies using some cutting edge technology, like fMRI, to study brain responses to food. You already know that when you eat, say, French fries, you experience intense but probably rather fleeting pleasure. Do we really need cutting edge technology to show us changes in metabolic activity in the pleasure center of our brain to tell us we found something…pleasurable?
Surrogate markers are different, because they tell us something we otherwise couldn’t know unless we waited for the outcomes they predict, and then-it would be too late. It’s not helpful to find out after a heart attack that we are at risk for heart disease, for instance. It’s even less helpful to find out after we die that our life expectancy isn’t everything we might wish.
Imagine, then, if we had a surrogate marker for healthy life expectancy itself. Imagine how powerful it would be if something we could measure that changed rapidly in response to influences both good and bad, reliably predicted the length of healthy life. That would be quite a boon, since otherwise, the only way to show changes in the length of life would require waiting lifetimes. I suspect we can all agree it would be something of an anti-climax to learn only on your hundredth birthday that you were likely to live to 100.
It turns out, there is just such a surrogate marker for the length of life. Telomeres are, structurally, caps at the ends of our chromosomes- they have been compared to the plastic caps at the ends of shoelaces. Health-promoting exposures, or alternatively the slings and arrows of outrageous fortune, can lengthen or shorten telomeres, respectively. The length of telomeres, in turn, predicts the length of healthy life.
Not perfectly, of course; even with gloriously long telomeres, it would be imprudent to stand in the path of a moving train. But powerfully. Imagine, then, how great it would be if we could talk directly to our telomeres, and find out how they’re doing.
Now, we can. In a newly released book called The Telomere Effect, two leading experts, one of them a Nobel Prize winner, go carefully through the science enumerating the effects of diverse exposures on telomere length and function. Drs. Elizabeth Blackburn and Elissa Epel proceed study by study, and cover everything from stress to diet, exercise to sleep, the influences of environment when we are just in the womb to those of social interactions throughout life. They then translate each cluster of studies into practical tips you can apply.
If telomeres could talk, and tell us what makes them lengthen or shrink, what makes them happy or unhappy, they would provide us compelling, powerful, actionable intelligence and a measure of control over our longevity. Conversing with telomeres would be the next best thing to sipping from the fountain of youth.
The length of telomeres is predictive of the length of healthy life, while providing the lead-time necessary to do something about it. And, in fact, they are not just markers of health span, but actual mechanisms of it; vital telomeres transmit that vitality to the cells in which they reside. Drs. Blackburn and Epel speak up for telomeres, and provide guidance in nurturing that very vitality.
Of course, the lifestyle prescription that’s good for our telomeres is one we already knew was good for us in general. But a vivid view of aging itself at the cellular level that does not require years and decades to elapse is a rarefied vista indeed, a truly unique window of opportunity. This book opens that window to us all.
If only telomeres could talk to us, they would provide unique insights into human aging, with the time to do something about it. It turns out they can, in the authoritative voices of Drs. Blackburn and Epel, on the pages of The Telomere Effect. Telomeres are talking now; I think everyone should listen.
-fin Dr. David L. Katz;www.davidkatzmd.com; founder, True Health Initiative
