6.12.1913  -  12.12.2002

Books of N.M.Amosov

Digression. About old age

Every birthday is as another painful injection: old age is coming! Memento mori. No, I'm not afraid of death or illness. I'm not accustomed to either of them, but I can endure without losing face. What I'm scared of is senility: the loss of intellect and resulting imbecility, disintegration of personality.

Therefore, I'm trying to refresh my knowledge about aging, measuring myself, as it were. Have I lost something of myself? Or not?

There are many hypothesis about the mechanism of aging: more than two hundred, and I'm not going to dwell on them now. One of them appeals to me — the hypothesis of "accumulation of noise" and adaptation to it. Medics tend to call this phenomenon "accumulation of errors," but "noise" is a more appropriate word from the jargon of technicians: something begins to interfere with the performance of a brilliant mechanism, and its operation goes from bad to worse.

An organism is a huge chemical plant that maintains life through the interaction of numerous chemical processes made possible by enzymes. All of them (or almost all) are based on proteins, which are both the structure and enzymes.

The most remarkable thing about an organism is its ability to adapt itself to changes from within and without. Changes in the environment lead to new responses which are subordinate to instincts: to preserve life, to procreate, to contribute to the preservation of the pack or even to improve the species. That's what we see in animals.

The mechanism of adaptation is training and detraining: the ac­quisition of skills and the gradual loss of them. This phenomenon ensures the operation of the memory, immune system, and muscle building process. It's the basis of upbringing, education and health. It even affects evolution. I admire this mechanism and, therefore, can't stop myself from saying more about it.

The meaning of any training is to change a function that depends on the function itself. This idea can be better explained with a chart. The one below shows the relationships between an irritant and its function for a cell (organ or organism) depending on the level of training. The curves show the relationship between the irritant's strength and the function. Point a on the vertical coordinate is the value of the function required by organism in the state of rest. For a detrained cell, this point is almost the maximum level of normal performance. For one with average training, there is a threefold reserve, and in the case of a high level of training, the reserve is six times more. Point p on the horizontal coordinate indicates the strength of the irritant. For a detrained cell, it is the maximum point. A powerful external irritant will result in pathological performance for a detrained cell (organ or organism) while for a trained one, it is nothing more than a normal intensive mode of operation. Why do these characteristics go from one to the other, depending on exercise or rest? The answer is simple: everything depends on the protein.


Levels trenirovannosti structure


A trained cell with higher performance characteristics has a larger mass of functional protein; it is hypertrophied. A detrained one, on the contrary, has a smaller mass of protein; it is atrophied, and therefore, its functional curve is low.

Biochemists have found that a protein molecule in the live cell is doomed to decomposition and disappearance. If there are many molecules, only a certain portion of them will decompose during a fixed time unit. Radioactive elements have half-life periods during which half of atoms revert to another state. A similar picture is observed in the case of protein: there is also a half-life during which half the molecules of a given protein will decompose into aminoacids. We may continue our parallel with radioactive isotopes: some proteins have short half-life periods of several days or even hours, others have longer periods of several months. For instance, there are proteins of the heart muscle the half-life of which is 10 days. This means that only 50 grams of these proteins will remain alive out of 100 grams after a period of 10 days, 25 after another 10 days, then 12.5 grams, etc. This is a form of decay. But life is metabolism, continuous formation of new molecules, including proteins. The synthesis of new molecules compensates for the breaking down of "old" ones in order to maintain a constant mass of a certain protein responsible for one function of an organism or another for example, heart beat or excretion of hormones into blood.

Molecular biology came to understand the fine mechanisms of synthesis not so very long ago. These mechanisms are complex, and I'm unable to describe them here in detail. The thing is that the structure of every type of protein — and there are thousands of them in an organism — is coded into one structural gene (one gene, one protein).

New protein molecules are synthesized in two stages: first, a copy is made of the necessary gene, producing a RNA molecule. It is then forwarded to the special cell organoid, the ribosome, where new copies are made. These are going to be protein molecules proper.

It has been found that this copying is not a continuous process as is the process of decay. Copies are issued in portions, as it were, when the peripherical sections of a cell responsible for specific functions make special requests to the "centre" or the cell nucleus where the genes are kept. In other words, the higher the load is, the more new protein molecules you'll get.

Thus, metabolism — i.e., the relationship between decay and synthesis — is not an automatic process. It is based on the functioning of an organism.

Let's consider two cases. In the first one the function is not strained and the cell's structural unit is operating under its rated capacity. Few requests are made to the "center," and synthesis is done in small, rare portions. At the same time, decay continues at its usual pace: more protein mass, more molecules decay per unit of time. (When the protein mass is 100 grams, 50 will decay in 10 days, when the mass is 10 grams, only 5 will decay during the same period. This is very important!) If the mass is large, the pace of the decay will exceed that of synthesis, and the amount of protein will continually decrease. A reduction in the mass weakens this function. So, small loads at present reduce the possibility of intensive activity in the future. In fact, the process of detraining takes place, leading to athrophy.

In the second case, the cell with a small protein mass and limited functional potential begins to work intensively, say, because of powerful external irritants. The number of requests to the "center" will increase, and, accordingly, new copies will arrive at shorter intervals. Synthesis will race ahead of decay, and the protein mass will grew larger. Hence, the function will be more pronounced. This is hypertrophy, and the process in question is called training.

Training and detraining are universal processes in all cells — muscular, nerve, glandular, etc. Naturally, their ability to alter their mass are not equal. For example, muscles subject to training will increase their mass manyfold, while nerve cells will grow insignificantly. This is due to the specifics of the cells' functional structures. Muscle function is related to the conversion of tremendous amounts of energy, while a nervous impulse carries little energy and does not require massive structures for its conversion. This is the mechanism that accounts for changes in the performance parametres of cells, organs and entire organism under the impact of varying loads.

The pace of training and detraining depends upon the properties of the proteins which are responsible for a given function. If the proteins are short-lived, the processes of training and detraining are faster. If they are long-lived, the processes slow down, and their scope will probably be smaller. This is another important factor, since in the organism, there are tissues which perform a support (i.e., skeletal function); for them, training, is of secondary importance. Muscles, on the contrary, must react quickly and adapt to changes in life and external conditions. Therefore, they must have a larger training potential.

The "quality of health," including the risk of disease, can be measured in terms of range of loads and conditions within which all functions are normal. (This state is indicated by the normal performance curve on the above chart.) Health is determined by the reserve capacities of organs, which are built up by training. Just a simple example: in a state of rest, the heart will pump out 4 litres of blood per minute. The heart of a detrained person under stress will pump 6 litres per minute, but an athlete's heart can pump 16—20 litres. In short, the corresponding reserve capacity is 1.5 or even 4—5-fold. Even under the effect of powerful irritants, an athlete's heart functions normally.


What about aging? Like detraining, it is manifested by a reduction in the characteristics of cells and organs (the lower curve on the chart) when they easily slide down to the pathological performance mode even when subject to small loads and slightly deteriorated conditions.

Most scientists tend to believe that the cause of aging lies in the accumulation of noise. Hence comes the question: when and where does it occur, and by what mechanisms it is governed?

There are numerous hypotheses which claim to answer this question. Here is their essence, without going into greater detail.

Noise is localized in the working portions of cells (i.e., mitochondria, lysosomas, membranes, and protoplasm). It is represented by molecules of modified proteins or conglomerations of other inactive molecules of various origins. When accumulated, the noise slows down all chemical reactions, degrading the cell characteristics or performance parametres.

The changes which occur pertain mostly to genes. They are manifested, above all, in a reduced pace of protein synthesis and, consequently, by decreased training abilities. Hence, the usual loads do not ensure the required training level, the performance parametres of an organism deteriorate and diseases become more probable. Besides, modifications of genes lead to the production of "substandard" proteins which also constitute additional noise.

The age-induced changes unevenly affect various tissues and systems of an organism, disrupting the harmonious relations between tissues or even causing "belligerency" among them. For instance, enormous expansion of connective tissues in some organs or the reaction of the immune system to its proteins.

In one way or another the functional characteristics of organs worsen; in some cases, this deterioration is primary, due to noise, in other, it is secondary, due to disturbed relationships. As the result, diseases start to develop. In old people, they are more dangerous, since the protective and compensatory mechanisms are weakened by the interfering noise and cannot ensure adequate self-treatment. For instance, suppressed immunity to microorganisms or tumors...

In other words, aging is a fatal process; there is no remedy for it. Gerontologists' dreams about noise elimination are still unrealizable. Prospects for the future are also quite limited, since the interfering noise may be of different origins and is hard to detect. Aging is a process with positive feedback; it gains momentum like an avalanche. The deficiencies of one organ accelerate the aging of another, a third one, etc. The fourth and the fifth, like the first three, attempt to combat this process, switching on the mechanisms of compensation via training. They manage to slow down the process somewhat, but they are unable to arrest it completely. This makes aging different from disease, where protection often wins out.

I don't like to take passive stand on this issue: it's impossible to escape old age, but one can delay it. And quite significantly, I believe. Nature is not so cruel as to let us die at the age of seventy. It controls and slows down aging by switching on mechanisms of adaptation in cells, organs and central (but not random) regulators, to put it in the words of Vladimir Frolkis. Aging can be slowed down even further, if one adds "higher adaptation" through the rationality that governs our behaviour.

My reasoning is as follows: one has to preserve the harmony of all functions of organism. In simpler language, one must choose a modus vivendi that will ensure that in the case of a detrained person, only small irritants allow for the maintainance of normal performance, while in the case of trained people, even significant external irritants do not yield pathological reactions.

What does it mean to create a modus vivendi? The first alternative is to lead a life in which all irritants remain within certain limits of the norm. For example, one can live a calm and quiet life, guarding oneself against all external effects or internal stresses and loads. However, this may not be adequate for some reasons: it is difficult to foresee all accidental overloads, flu, for instance. Besides, the lack of training results in a decline of all characteristics along with the aging process, and even the slightest irritant will cause pathological effects. Diseases will do the rest: death is inevitable.

The other alternative: do training while alive and maintain all performance parameters above the average level. Then, all the usual hardships of life and stresses will not yet cause disease. However, there is one little "but." In order to maintain a sufficient level of training, an old man has to train more than a younger one due to the accumulation of interfering noise. Protein synthesis slows down, while protein decay continues at the same pace. So, the old man must overstrain more to preserve the required amount of functional proteins. At the same time, he has to refrain from exceptional loads: they are harmful for the organism, particularly for an old one.

Here I will add my old tenet: "The regime of limitations and loads" which I have been defending for a long time. It must not only preserve health and safeguard against disease but must also slow down the process of aging. I'm not one hundred per cent sure of the latter, but let's indulge in wishful thinking. Nevertheless, there are grounds for hope. The thing is that the accumulation of interfering noise is faster during disease when organ functions are disrupted, homeostasis undergoes profound changes, and, consequently, the processes of self-purification of cells are affected. In fact, this hypothesis has no credibility, except the logic and observations of old people who have rarely gotten ill during their lifetimes.

The philosophy of my regime runs counter the old-fashioned theory about the need of rest and fewer stresses in old age. People tend to think of their health as a sort of capital that was given to them free at the moment of birth. Less work means less waste and the capital will last longer. Actually, the picture is different: training will not diminish the capital but increase it, up to a certain limit, at least.

I shall innumerate some of the elements of the proposed regime without going into further detail as I'm tired of writing on the subject.

The first and second places are divided between physical fitness activities and rational nutrition. The third is accorded to exercises that make the organism more hardy or perhaps to psychological autotraining and sleep. Much depends on the psyche.

The core issue is a share of each of the components: to get a sufficient amout of everything, no more. To determine what is needed and in what proportions.

First is goal formulation. If the task is to preserve the health of a young man, physical fitness must be accorded top priority. Thus you'll preserve strength and good looks. Nutrition is of lesser importance: an extra five kilos will do no harm at that stage.

If you're an egg head and you're not getting any younger, the main objective is to preserve a clear mind. Nerve cells age slowly if they are subject to continuous exercise. Here, everything depends on the blood vessels. Therefore, a struggle with sclerosis comes to the forefront. The risk factors for it are known: improper nutrition, smoking and high blood pressure. Let's not exaggerate the scientific credibility of these factors, but they must be taken into account. Smoking is clearly forbidden, and that's it! The problem of nutrition is a much more complex one. I was unable to find any convincing scientific advice concerning what to eat and in what amounts. Normal weight, the thickness of the fat layers under the skin, the number of calories, recommended menus — everywhere we find a confusing and contradictory picture. One fact is known for sure, however: if smaller animals are underfed but provided with vitamins and proteins, they are runts — skinny but very active (MacKey et al.). Moreover, they live 30— 40 per cent longer than the average animal. At the same time, if an adult rat is put on the same diet, an increment in the weight will be insignificant. Another fact: the development of sclerosis is connected with an increase of lipids and their complexes with proteins in blood. There are even age-related norms for these products which are claimed to be recorded in the genes like increase of blood pressure and sugar content of the blood.


All these considerations prompt the idea that to prevent sclerosis, one must remain lean and not eat fats. In fact, I've been living this sort of life for two decades. Here's the outcome of my efforts: the level of cholesterol and other fat-like substances in my blood corresponds to that of a thirty-year-old man. This has been confirmed by regular check-ups at a good laboratory for the last four years. The same picture is for the blood pressure and the level of sugar. No age-related norms which provide for an increase in these parametres have affected me (or not yet, to be on the safe side). Oddly enough, there are also age-related norms for height decreases: they are quoted in an encyclopaedia along with the appropriate formula. According to it, I should have been three centimetres shorter by now. This hasn't happened, thank God, as I'm not very tall to start with.

Obviously, limited rational nutrition should be supplemented by other things: physical fitness programmes, swimming and exercising in the fresh air. This trains not only the muscles but blood vessels as well. Together, they keep us alive.

No, I'm not trying to endure in wishful thinking. No, I don't feel myself getting older. But this does not imply that the life will go on forever. Alas, an inner revolt is inevitable, and it will wipe out everything sooner or later. The interfering noise continues to ac­cumulate; proteins keep disappearing like snow in the spring, and the functional parametres are quite logically showing a decline.

There's no other choice; but my daily regime enables me to enjoy life. So I need not exaggerate the difficulties I encounter in observing it. I'm accustomed to sports and exercise; they have become my alter ego. I'm not on a starvation diet. There are no sweets in it, but bread and potatoes without butter seem to be tasty. I don't go into extremes, and when I'm eating out or at friends', I eat everything I'm treated to.


Back to the mechanism of aging. The hypothesis about the interfering noise should be supplemented with some ideas about detraining in behaviour patterns. Maybe it is psychology rather than physiology that plays the role of leading factor (up to a certain age, of course). Let's examine this tenet.

To preserve one's health and extend one's active life, one must apply his will: exercise, limiting food intake, controlling sleep, and even freezing. The older the man, the stricter the limitation should be and the more will should be applied. Any strain needs stimuli, desires. But stimula are from the domain of emotions. In the younger years, biology is very strong: the drive for leadership, the opposite sex, etc. The main areas in which stimuli operate are work and society. Something remains for a regime, of course. In old or advanced age (to put it cautiously) many of our desires become less pronounced, but the worst two — eating and resting — remain. This results in a deficit of stimuli for working and sticking to a regime for living. But in fact, we need more of these stimuli, because the entire mechanism of our life is operating with increasing interferences. To maintain the training level, one has to exert more and more effort... At this age, a retirement pension is usually offered: retire and relax as much as you wish. Hence, the detraining of all functions, the will above all. The fashions for old age are also instrumental here: all people of advanced age retire, all wear warm clothes, all put on some weight, all enjoy their meals and walk slowly. "I'm like the rest," think most people.

Needs, emotions, and stimuli are reflected in the brain (cerebral cortex) in the activity of the nerve structures or models. This activity also tends to subside, again because of the interfering noise. To combat degradation, extremely active models should exist in the brain (i.e., complexes of neurons trained by continuous exercise and operation). This training may be provided by ideas or serious concerns. The latter are usually based on instincts: hunger, danger, family, or lack of support. In this case, man will not spare himself, and there's no time to relax. However, this stressful situation is fraught with danger, and deprivations don't help one live to an old age: hardships and difficulties speed up the aging process.

Thinking, creative work, and enthusiasm are much better concerns. First of all, they imply an intensive mental activity, and neurons are the cells which are most sensitive to training. This ability remains to a very old age, if sclerosis of the cerebral arteries does not disrupt their nourishment. True, the number of the nerve cells will be somewhat reduced, but there's no need to worry about this. Even half of what man has is enough if they are properly trained by exercise.

Naturally, high activity of the cerebral cortex models may be entirely directed towards something useful (or totally useless) completely ignoring the regime. There'll be a certain gain in any case — the clever ones live longer! — but bodily weakness and old age will take over. Sclerosis of the blood vessels will cut off the system feeding the brain, therefore, part of the brain's activity should be directed at a strict observance of daily exercise. Then, an old age will be held at bay for a while. It must be held at bay! Unfortunately, the regime has no visible pleasant effect, and even most rational people prefer to waste their energy on "business," disregarding their health. Medics must share the blame here: they still proclaim rest, rich diets and warmth for old people instead of the opposite.

It's a pity that no one has yet investigated the role of psychology in bodily aging. Gerontologists confine themselves to references to artists and scientists who have their creative mentality and energy to a very advanced age. Alas, this concept cannot be tested on rats.

Who knows, maybe my addition (detraining) to the hypothesis of aging based on the "accumulation of noise" are silly. I can't prove the contrary. After my books and journal publications, I receive many letters. The elderly bless daily exercise, claiming it is making them younger. But those who write are 60 to 70, very rarely above 80. At the same time, such an age is not a rarity without the exercise I suggest. Some people tend to age slowly because of hereditory factors. Therefore, there are still no fine experiments and statistical data which confirm that limitations, self-restrictions and loads affect the pace of aging. Special studies are needed, but there are no hopes that they will be done... Gerontologists also grow old in the way fashionable at present, and don't wish to experiment with substantial self-imposed restrictions.

What is man's biological age limit in the long run? Scientists have not been able to establish it for sure. The late Professor Urlanis analyzed demographic statistics and defined it as around 85 years for men and slightly longer for women. This is not very convincing, since this judgement is affected by "vogue" ideas and physchological considerations: people wish to get more from nature. Everyday observations show that below 70 to 75 people are normal, while after 80, they are obviously old and rapidly grow decrepit. It seems, after all, that Urlanis was right... But none of the people known to me who are members of this age group have followed a regime including daily exercise and proper diet from a young age. It's their genes that have helped them to survive.

I've reread my thoughts and imagined the reader's impression: "How afraid is he of dying! Ready to torture himself if only to survive a bit longer..."

A mistaken view. I don't have an animal fear of death; life has long ago ceased to look beautiful and desirable to me; my biological needs are minimal, and stimuli are few and far between... Still, it's interesting to be alive. So why should I terminate my life prematurely when I can continue it, paying very little?

I'll stop here without quoting any famous elders or advertising any specific beauties of the old age. They do not console me at all.