How Metformin Slows Aging

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Metformin And How It Slows Down Aging

That’s a bold claim for a title, but the scientific consensus is clear, and this Research Review Monday we’re going to take a look at exactly that!

Metformin is a common diabetes-management drug, used to lower blood sugar levels in people who either don’t have enough insulin or the insulin isn’t being recognized well enough by the body.

However, it also slows aging, which is a quality it’s also been studied for for more than a decade. We’ll look at some of the more recent research, though. Let’s kick off with an initial broad statement, from the paper “The Use of Metformin to Increase the Human Healthspan”, as part of the “Advances in Experimental Medicine and Biology” series:

In recent years, more attention has been paid to the possibility of using metformin as an anti-aging drug. It was shown to significantly increase the lifespan in some model organisms and delay the onset of age-associated declines. Growing amounts of evidence from clinical trials suggest that metformin can effectively reduce the risk of many age-related diseases and conditions, including cardiometabolic disorders, neurodegeneration, chronic inflammation and frailty.

~ Piskovatska et al, 2020

How does it work?

That’s still being studied, but the scientific consensus is that it works by inducing hormesis—the process by which minor stress signals cells to start repairing themselves. How does it induce that hormesis? Again, still being studied, but it appears to do it by activating a specific enzyme; namely, the AMP-activated protein kinase:

Read: Metformin-enhances resilience via hormesis

It also has been found to slow aging by means of an anti-inflammatory effect, as a bonus!

Any bad news?

Well, firstly, in most places it’s only prescribed for diabetes management, not for healthy life extension. A lot of anti-aging enthusiasts have turned to the grey market online to get it, and we can’t recommend that.

Secondly, it does have some limitations:

  • Its bioavailability isn’t great in tablet form (the form in which it is most commonly given)
  • It has quite a short elimination half-life (around 6 hours), which makes it great to fix transient hyperglycemia in diabetics—job done and it’s out—but presents a logistical challenge when it comes to something so pernicious as aging.
  • Some people are non-responders (a non-responder, in medicine, is someone for whom a drug simply doesn’t work, for no obvious reason)

Want to know more? Check out:

Metformin in aging and aging-related diseases: clinical applications and relevant mechanism

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  • Climate Change Threatens the Mental Well-Being of Youths. Here’s How To Help Them Cope.

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    We’ve all read the stories and seen the images: The life-threatening heat waves. The wildfires of unprecedented ferocity. The record-breaking storms washing away entire neighborhoods. The melting glaciers, the rising sea levels, the coastal flooding.

    As California wildfires stretch into the colder months and hurricane survivors sort through the ruins left by floodwaters, let’s talk about an underreported victim of climate change: the emotional well-being of young people.

    A nascent but growing body of research shows that a large proportion of adolescents and young adults, in the United States and abroad, feel anxious and worried about the impact of an unstable climate in their lives today and in the future.

    Abby Rafeek, 14, is disquieted by the ravages of climate change, both near her home and far away. “It’s definitely affecting my life, because it’s causing stress thinking about the future and how, if we’re not addressing the problem now as a society, our planet is going to get worse,” says Abby, a high school student who lives in Gardena, California, a city of 58,000 about 15 miles south of downtown Los Angeles.

    She says wildfires are a particular worry for her. “That’s closer to where I live, so it’s a bigger problem for me personally, and it also causes a lot of damage to the surrounding areas,” she says. “And also, the air gets messed up.”

    In April, Abby took a survey on climate change for kids ages 12-17 during a visit to the emergency room at Children’s Hospital of Orange County.

    Rammy Assaf, a pediatric emergency physician at the hospital, adapted the survey from one developed five years ago for adults. He administered his version last year to over 800 kids ages 12-17 and their caregivers. He says initial results show climate change is a serious cause of concern for the emotional security and well-being of young people.

    Assaf has followed up with the kids to ask more open-ended questions, including whether they believe climate change will be solved in their lifetimes; how they feel when they read about extreme climate events; what they think about the future of the planet; and with whom they are able to discuss their concerns.

    “When asked about their outlook for the future, the first words they will use are helpless, powerless, hopeless,” Assaf says. “These are very strong emotions.”

    Assaf says he would like to see questions about climate change included in mental health screenings at pediatricians’ offices and in other settings where children get medical care. The American Academy of Pediatrics recommends that counseling on climate change be incorporated into the clinical practice of pediatricians and into medical school curriculums, but not with specific regard to mental health screening.

    Assaf says anxiety about climate change intersects with the broader mental health crisis among youth, which has been marked by a rise in depression, loneliness, and suicide over the past decade, though there are recent signs it may be improving slightly.

    A 2022 Harris Poll of 1,500 U.S. teenagers found that 89% of them regularly think about the environment, “with the majority feeling more worried than hopeful.” In addition, 69% said they feared they and their families would be affected by climate change in the near future. And 82% said they expected to have to make key life decisions — including where to live and whether to have children — based on the state of the environment.

    And the impact is clearly not limited to the U.S. A 2021 survey of 10,000 16- to 25-year-olds across 10 countries found “59% were very or extremely worried and 84% were at least moderately worried” about climate change.

    Susan Clayton, chair of the psychology department at the College of Wooster in Ohio, says climate change anxiety may be more pronounced among younger people than adults. “Older adults didn’t grow up being as aware of climate change or thinking about it very much, so there’s still a barrier to get over to accept it’s a real thing,” says Clayton, who co-created the adult climate change survey that Assaf adapted for younger people.

    By contrast, “adolescents grew up with it as a real thing,” Clayton says. “Knowing you have the bulk of your life ahead of you gives you a very different view of what your life will be like.” She adds that younger people in particular feel betrayed by their government, which they don’t think is taking the problem seriously enough, and “this feeling of betrayal is associated with greater anxiety about the climate.”

    Abby believes climate change is not being addressed with sufficient resolve. “I think if we figure out how to live on Mars and explore the deep sea, we could definitely figure out how to live here in a healthy environment,” she says.

    If you are a parent whose children show signs of climate anxiety, you can help.

    Louise Chawla, professor emerita in the environmental design program at the University of Colorado-Boulder, says the most important thing is to listen in an open-ended way. “Let there be space for kids to express their emotions. Just listen to them and let them know it’s safe to express these emotions,” says Chawla, who co-founded the nonprofit Growing Up Boulder, which works with the city’s schools to encourage kids to engage civically, including to help shape their local environment.

    Chawla and others recommend family activities that reinforce a commitment to the environment. They can be as simple as walking or biking and participating in cleanup or recycling efforts. Also, encourage your children to join activities and advocacy efforts sponsored by environmental, civic, or religious organizations.

    Working with others can help alleviate stress and feelings of powerlessness by reassuring kids they are not alone and that they can be proactive.

    Worries about climate change should be seen as a learning opportunity that might even lead some kids to their life’s path, says Vickie Mays, professor of psychology and health policy at UCLA, who teaches a class on climate change and mental health — one of eight similar courses offered recently at UC campuses.

    “We should get out of this habit of ‘everything’s a mental health problem,’” Mays says, “and understand that often a challenge, a stress, a worry can be turned into advocacy, activism, or a reach for new knowledge to change the situation.”

    This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

    This article first appeared on KFF Health News and is republished here under a Creative Commons license.

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  • Rethinking Exercise: The Workout Paradox

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    The notion of running a caloric deficit (i.e., expending more calories than we consume) to reduce bodyfat is appealing in its simplicity, but… we’d say “it doesn’t actually work outside of a lab”, but honestly, it doesn’t actually work outside of a calculator.

    Why?

    For a start, exercise calorie costs are quite small numbers compared to metabolic base rate. Our brain alone uses a huge portion of our daily calories, and the rest of our body literally never stops doing stuff. Even if we’re lounging in bed and ostensibly not moving, on a cellular level we stay incredibly busy, and all that costs (and the currency is: calories).

    Since that cost is reflected in the body’s budget per kg of bodyweight, a larger body (regardless of its composition) will require more calories than a smaller one. We say “regardless of its composition” because this is true regardless—but for what it’s worth, muscle is more “costly” to maintain than fat, which is one of several reasons why the average man requires more daily calories than the average woman, since on average men will tend to have more muscle.

    And if you do exercise because you want to run out the budget so the body has to “spend” from fat stores?

    Good luck, because while it may work in the very short term, the body will quickly adapt, like an accountant seeing your reckless spending and cutting back somewhere else. That’s why in all kinds of exercise except high-intensity interval training, a period of exercise will be followed by a metabolic slump, the body’s “austerity measures”, to balance the books.

    You may be wondering: why is it different for HIIT? It’s because it changes things up frequently enough that the body doesn’t get a chance to adapt. To labor the financial metaphor, it involves lying to your accountant, so that the compensation is not made. Congratulations: you’re committing calorie fraud (but it’s good for the body, so hey).

    That doesn’t mean other kinds of exercise are useless (or worse, necessarily counterproductive), though! Just, that we must acknowledge that other forms of exercise are great for various aspects of physical health (strengthening the body, mobilizing blood and lymph, preventing disease, enjoying mental health benefits, etc) that don’t really affect fat levels much (which are decided more in the kitchen than the gym—and even in the category of diet, it’s more about what and how and when you eat, rather than how much).

    For more information on metabolic balance in the context of exercise, enjoy:

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  • How Healers Heal – by Dr. Shilpi Pradhan

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    First note: the listed author here is in fact the compiler, with the authors being a collection of no fewer than 33 board-certified lifestyle medicine physicians. So, we’re not getting just a single person’s opinions/bias here!

    But what is lifestyle medicine? This book holds the six pillars of lifestyle medicine to be:

    1. Nutrition
    2. Physical activity
    3. Stress management
    4. Restorative sleep
    5. Social connections
    6. Avoidance of risky substances

    …and those things are what we read about throughout the book, both in highly educational mini-lecture form, and sometimes highly personal storytelling.

    It’s not just a “do these things” book, though yes, there’s a large part of that. It also covers wide topics, from COVID to alopecia, burnout to grief, immune disorders to mysterious chest pains (and how such mysteries are unravelled, when taken seriously).

    One of the greatest strengths of this book is that it’s very much “medicine, as it should be”, so that the reader knows how to recognize the difference.

    Bottom line: this book doesn’t fit into a very neat category, but it’s a very worthwhile book to read, and one that could help inform a decision that changes the entire path of your life or that of a loved one.

    Click here to check out How Healers Heal, and learn to recognize the healthcare you deserve!

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  • Top 10 Unhealthy Foods: How Many Do You Eat?

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    The items on this list won’t come as a shocking surprise to you, but it can be a good opportunity to do a quick tally and see how many of these have snuck into your diet:

    The things that take away health instead of adding it

    Without further ado, they are…

    • Alcohol: not only is it high in empty calories, but also it’s bad for pretty much everything, especially increasing the risks of liver disease, high blood pressure, and stroke.
    • Processed snacks: low in nutrition; contain unhealthy fats, refined sugars, and artificial additives that often aren’t great.
    • Potato chips: get their own category for being especially high in fat, sodium, and empty calories; contribute to heart disease and weight gain.
    • Processed cheese: some kinds of cheese are gut-healthy in moderation, but this isn’t. Instead, it’s just loaded with saturated fats, sodium, and sugars, and is pretty much heart disease in a slice.
    • Donuts: deep-fried, sugary, and made with refined flour; cause blood sugar spikes and crashes, and what’s bad for your blood sugars is bad for almost everything else.
    • French fries & similar deep-fried foods: high in saturated fats and sodium; contribute to obesity and heart issues, are not great for blood sugars either.
    • White bread: made with refined flour; cause blood sugar spikes and metabolic woes.
    • Sodas: high in sugar or artificial sweeteners; can easily lead to weight gain, diabetes, and tooth decay.
    • Processed meats: high in calories and salt; strongly associated with heart disease and cancer.
    • Hot dogs & fast food burgers: get their own category for being the absolute worst of the above-mentioned processed meats.

    This writer scored: no / rarely / no / no / no / rarely / rarely / rarely / no / no

    How about you?

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  • The Most Underrated Hip Mobility Exercise (Not Stretching)

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    Cori Lefkowith, of “Redefining Strength” and “Strong At Every Age” fame, is back to help us keep our hips in good order:

    These tips don’t lie

    It’s less about stretching, and more about range of motion and “use it or lose it”:

    • Full range of motion in lifting exercises enhances joint mobility and stability, whereas strengthening muscles through a limited range of motion (e.g., half squats) can cause tightness.
    • Lifting through a larger range of motion may result in faster strength gains too, so that’s a bonus.
    • Customize your range of motion based on your body type and capability, but do try for what you reasonably can—don’t give up!
    • Lower weights and focus on deeper movements like split squats or single-leg squats, but work up slowly if you have any difficulties to start with.
    • Using exercises like the Bulgarian split squat and deficit split squat can improve hip mobility and strength (you’ll really need to see the video for this one)
    • Fully controlling the range of motion is key to progress, even if it means going lighter; prioritize mobility over brute strength. Strength is good, but mobility is even more critical.
    • Adding instability, such as raising the front foot in lunges, challenges muscles and increases mobility. Obviously, please be safe while doing so, and slowly increase the range of motion while maintaining control, avoiding reliance on momentum.
    • Final tip that most don’t consider: try starting exercises from the bottom position to ensure proper form and muscle engagement!

    For more on each of these plus visual demonstrations, enjoy:

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  • The Wandering Mind – by Dr. Michael Corballis

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    Our mind’s tendency to wander can be a disability, but could it also be a superpower? Dr. Corballis makes the case for such.

    While many authors focus on, well, how to focus, Dr. Corballis argues in this book that our wandering imagination can be more effective at problem-solving and creative tasks, than a focused, blinkered mind.

    The book’s a quick read (184 pages of quite light reading), and yet still quite dense with content. He takes us on a tour of the brain, theory of mind, the Default Mode Network (where a lot of the brain’s general ongoing organization occurs), learning, memory, forgetting, and creativity.

    Furthermore, he cites (and explains) studies showing what kinds of “breaks” from mental work allow the wandering mind to do its thing at peak efficiency, and what kinds of breaks are counterproductive. Certainly this has practical applications for all of us!

    Bottom line: if you’d like to be less frustrated by your mind’s tendency to wander, this is a fine book to show how to leverage that trait to your benefit.

    Click here to check out The Wandering Mind, and set yours onto more useful tracks!

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