Bonking at the Ironman World Championships
Don't let this happen to you—bonking at the Ironman World Championships. Start with a sprint-distance event.

10 Tips to Help You Hold Your Edge

Getting older doesn’t have to mean getting slower. Not with a leg up from the frontiers of science.

Bonking at the Ironman World Championships

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MY SAN DIEGO “surf team” could use a little help. All of us are over 40, and our body creaks are beginning to overwhelm the power of our denial. One member has three artificial disks in her neck and two fused vertebrae. Another had his ACL removed after a mountain-biking accident. When I paddle out during our weekly morning sessions, my left shoulder feels like it’s grinding coffee. Two years ago, I slipped a disk in my lower back that pushed against my sciatic nerve, making my ass, thigh, and knee burn like I’d been stabbed with a white-hot knitting needle. I sustained this injury while brushing my teeth.

So it’s a good thing that scores of clinical trials and lab experiments are under way in an effort to reboot aging bodies with the help of exotic reparative therapies. Credit capitalism, in part: as Baby Boomers age, there’s huge money to be made by turning 100 into the new 40. The government is motivated, too. People are living longer, but with bad backs, arthritic knees, and disintegrating muscles that raise Medicare costs. So researchers in both the private and public sectors are investing in things like 3-D printing technology that might produce new cartilage—and whole organs—on demand. Scientists are also exploring ways to use repurposed cells to give you the heart, knees, and disks of a 25-year-old. The Department of Defense has even invested in a program to find out if humans can regenerate limbs the way salamanders do.

The sci-fi stuff will arrive too late for Boomers, but if you’re 25 now, some of these miracles will probably become real in your lifetime. And even if you’re 50 or over, there are plenty of things you can do to keep yourself in the game.

Get Tested for Osteoporosis
The Problem: Men over 50 suffer about 30 percent of all osteoporotic fractures. That’s right: men. After 45 or so, your body can’t generate enough new bone to keep up with natural losses. Whether you develop osteopenia, a mild-to-moderate reduction in bone mineral density (BMD), or full-on osteoporosis, your bones are becoming more porous, brittle, and susceptible to breaks. Alas, osteoporosis is symptomless in the early stages, until you’re out skiing or playing tennis, take a tumble, and suffer a break. Osteoporotic fractures can kill you sooner—through internal bleeding, blood clots, or infections—or later, by reducing your ability to stay mobile.

The Fix: Low BMD can be diagnosed using dual-energy X-ray absorptiometry, but doctors should also use FRAX, a risk-assessment profile that accounts for other bone-loss factors like smoking, drinking, menopause, and the use of corticosteroids and testosterone reducers (often prescribed for prostate problems). Mild osteopenia can be slowed and even reversed with weight-bearing exercise, as well as calcium supplements (about 1,000 milligrams per day for men, 1,200 for women) and vitamin D (at least 600 international units per day, from sunshine or a pill). Osteoporosis may require bone-building biophosphonates like Fosamax.

Lift Weights
The Problem: Beginning in your forties, you typical lose about 1 percent of muscle mass each year, leading to frailty, lack of balance, and cardiovascular problems as fat naturally replaces muscle tissue. Fortunately, simple resistance exercises can help. Whether you’re pumping iron, doing yoga, or training with resistance bands, you can add muscle and improve balance, bone density, and cardiovascular fitness even when you’re approaching 90. The exact mechanisms aren’t known, but studies have shown that strength training and other forms of exercise can also ease mild depression as effectively as prescription drugs.

The Fix: Don’t try to lift like you’re still 20. You need to be kind to your satellite cells, which help muscles heal themselves after injury and repair the tiny muscle tears that occur when you lift heavy weights. The good news is that satellite cells appear to retain this ability well into old age. But they’re more easily depleted by exercise, so factor in additional rest days. If you needed only one day between lifting sessions when you were 20, try two after 50. Lifting two or three days a week should be enough.

Eat More Protein, Fewer Carbs
The Problem: The same aging changes that lead to muscle and bone loss also help create middle-age spread. Research has shown that as we age, genes increasingly signal to muscle cells that it’s time for them to die off. It also appears that we don’t regenerate muscle as quickly as we age. Since muscle needs protein to repair itself and grow, that’s a vicious cycle.

The Fix: Dietary guidelines call for at least a third of an ounce of protein per two and a half pounds of body weight, but some experts think that’s not enough for older people, especially if they’re working out. Adding protein to your diet after exercise puts more muscle-building amino acids into your system, making weight lifting more effective. Meanwhile, reduce carb intake. Insulin response is less efficient as we age, and even active people tend to accumulate fat. Cut down on overall calories with a Mediterranean diet: fish, nuts, olive oil, legumes, fruits, vegetables, and (phew) a little alcohol.

Replace Your Hormones
The Problem: Levels of testosterone, estrogen, and insulin-like growth factor 1 drop as we age. For men, testosterone starts falling off in the early thirties, a process that speeds up after 45. For women, estrogen and progesterone levels drop significantly during menopause, at around 50. This can lead to depression, anxiety, and loss of bone density, while lower T levels in men can mean diminished libido, decreased muscle mass, testicular atrophy, and heart disease. Many so-called anti-aging strategies try to remedy all this through the use of hormone replacement, but it’s simplistic to believe that turning on the hormone tap will restore youth.

The Fix: Twenty years ago, doctors were almost unanimously opposed to hormone-replacement therapy, largely because of the worry that it could cause prostate or breast cancer. And while women on replacement therapy do appear to be more likely to develop breast cancer, recent studies have contradicted the idea that testosterone can ignite prostate cancer in men. Many mainstream doctors have cautiously come around to the idea that testosterone’s benefits—it seems to increase bone strength, muscle tone, healing, and sex drive—outweigh the risks. Some doctors won’t prescribe hormones unless your levels are catastrophically low; others believe older men and women could all use a little boost. Be sure to work with a doctor who will check for any changes in your prostate or, for women, your breasts.

Spin Your Blood

The Problem: Your joints are more prone to injury when torqued by rigorous exercise. A complicated arrangement of ligaments, tendons, and cartilage, these body parts don’t have the healing and regenerating capacity of some other tissues, and as we age that capacity is reduced even more.

The Fix: “Blood spinning,” which is used to harvest platelet-rich plasma (PRP)—a blood product with an abundance of cells that respond to injury and induce clotting—has been used mostly by professional athletes since the 1970s, and now it’s trickling down to ordinary people. Doctors draw blood, use a centrifuge to separate out the platelets and plasma from other components, and then inject this concentrated supply at the injury site. The technique, which athletes like Tiger Woods and Kobe Bryant have used, appears to rally the body’s repair mechanisms. But mixed early results show that PRP can be less effective as we age, and there are some shady practitioners out there. Seek out experts like those found at university sports-medicine centers.

Find Youth in a Pill
Future Fix: Pharmaceutical companies are racing to produce new drugs to stave off aging’s worst effects. With a few already in human clinical trials, look for them to hit the market in as early as five years.

Selective androgen receptor modulators. SARMs work like hormone therapy, triggering cells to respond as if you’ve taken testosterone—minus side effects like testicle shrinkage and female beard growth. They’re being tested to fight wasting syndromes associated with cancer, but drug companies will surely let it be known that SARMs promote youthfulness.

Growth factors. Labs are cooking up synthetic versions of natural human proteins that prompt healing. One example is the Merck prototype AS902330, a synthetic fibroblast growth factor that may repair cartilage in knees damaged by osteoarthritis or joint surgery.

Ryanodine receptor drugs. A possible heart-failure treatment, these target calcium leaks in cells. In a month-long Columbia University study, scientists gave a version to elderly mice—equivalent to 70-year-old humans—which got 50 percent stronger and ran faster and longer.

SR9009. Scientists from the Scripps Research Institute tried out this drug, which targets a gene involved in metabolism, to reduce obesity in lab mice. But it also seemed to boost their endurance by as much as 50 percent. “The animals actually get muscles,” says scientist Thomas Burris, “like an athlete who has been training.”

Order New Body Parts
Future Fix: Tissue engineering works like this—take cells from the patient, apply growth factors to coax them into forming the body part you need, then transplant. Some of these lab-grown parts (urethras, tracheas) have been successfully placed in people. And scientists have been making splashy news by exploring 3-D printing with cellular “ink” to fabricate made-to-order tissues for things like ears and noses. It may be years before “printed” organs make their way into people, if they ever do, but scientists are trying other tissue-engineering methods, like using donor cells to make new cartilage. For example,
in a cross between cell therapy and tissue engineering, a cartilage implant grown from cells donated by deceased children is being tested to fix bad knees in older people. Phase III trials are ongoing.

Inject Healing Cells
Future Fix: Almost all cells have the information they need to repair damaged parts. Doctors are already using regenerative therapy, transplanting chondrocytes—cells that turn into cartilage—to fix joint injuries. This has had mixed success, so scientists are trying more primitive cells, like mesenchymal stem cells (MSCs), which can turn into both bone and cartilage. Mixed with the right growth factors, MSCs show promise for regenerating cartilage and ligaments; they have been used to repair knee injuries (surgically created by scientists) in animals like sheep, and early human trials are under way. But a UCLA team may have found the ultimate source of cheap, plentiful cells: liposuctioned fat. Its MUSE (multilineage-differentiating stress-enduring) cells have been shown to behave a lot like embryonic stem cells, which can grow into anything.

Join the Borg Collective

Future Fix: Bionics. Already there are bionic ears, eyes, legs, even bionic exoskeletons à la Aliens, but these are typically external devices used by amputees, paralytics, or soldiers lifting heavy loads.
Yet, while Borg-esque integration is still a ways off, human neural circuits have already been grown on tiny bits of graphene. One team has made a 3-D-printed ear that could give humans doglike hearing. And in a technique called opto-genetics, nanoscale wiring and LEDs have been used to control cells, even genes inside cells, by light. Someday, bionics may be used to boost muscles (including the heart), correct gene defects, or modulate the immune system. A few dreamers have even speculated that minuscule nanobots will cruise our bloodstreams, scrubbing out the gunk left from aging and double-cheese pizzas. Don’t hold your breath.

Go Synthetic
Future Fix: Design your own biology. In the 1970s, a couple of scientists had the idea to repair genes gone bad, as occurs with cystic fibrosis, a disease that leaves sufferers unable to clear mucus from their lungs, leading to early death. The plan was to use a virus to deliver the correct copy of the gene to cells. It sounds simple and elegant but despite some successes, gene therapy has been very frustrating. Now scientists are trying to write their own DNA recipes and even create novel life-forms. This is synthetic biology, and it’s already being used in attempts to create biotech drugs like doper favorite erythropoietin (EPO), which is made from hamster ovary cells that have been genetically modified to express the human EPO protein. Someday, doctors may be able to alter our DNA, programming us to grow more muscle tissue or increase aerobic capacity. But you’re better off not waiting. Go work out.