Jerusalem Post

ByPROF. TZIPI STRAUSS

The director of the Sheba Longevity Center at Sheba Medical Center explains what happens in the body during aging and how it affects each and every one of us.

Most people perceive aging as an inevitable result of the passage of time. Something that begins “Somewhere in older age”, and that there is not much that can be done about it. However, the science of recent decades presents a different, sharper and far more troubling picture – but also an optimistic one.
Aging is not merely a result of the years that pass, but an active, cumulative, and measurable biological process – and it is the central mechanism that leads to most chronic diseases of older age.

High blood pressure, diabetes, heart disease, stroke, cognitive decline, cancer, and loss of function are not “Separate diseases”, but different manifestations of the same underlying process: Biological aging of cells, tissues, and systems.

What Is Biological Aging, Exactly?

Biological aging describes gradual changes in the functioning of the body, including among other things:
Accumulation of low-grade chronic inflammation
A decline in the ability of cells to repair themselves
Impairment of blood vessel function
Changes in metabolism and insulin response
A decrease in muscle mass and fitness
Weakening of the immune system

These changes do not occur in a single day. They build slowly, sometimes decades before the appearance of the first clinical disease. This is why many people “Feel healthy” – but in practice are already in a biological process that increases their future risk.

Chronological Age Versus Biological Age

The age that appears on the ID card is a technical datum, the time that has passed since birth. In contrast, biological age reflects the actual condition of the body’s systems.
Two people aged 60 can have completely different biological profiles: One with young blood vessels, functioning muscle, and normal metabolism – and the other with chronic inflammation, insulin resistance, and functional decline.

This gap is not accidental. It is the result of exposures, habits, environment, and decisions accumulated over the course of life.
So When Does Aging Really Begin?

One of the most significant insights of modern science is that aging does not begin at age 60 or 70.
In fact, it begins much earlier – already in the earliest stages of life.
DOHaD studies (Developmental Origins of Health and Disease) have shown that conditions during pregnancy and early childhood affect future risk for chronic diseases and accelerated aging. Maternal nutrition, stress, smoking, gestational diabetes, infections, and birth weight – all of these “Program” the body systems of the fetus and influence:
Blood pressure regulation
Metabolism
Immune system function
Future risk for diabetes, heart disease, and obesity
In other words: Longevity does not begin in older age – it begins in the womb.
Why Is Aging the Basis of Disease?

In the past, medicine treated each disease as a separate entity. Today it is increasingly clear that most chronic diseases share common biological mechanisms.
Accelerated aging creates a biological ground in which diseases develop more easily:
Chronic inflammation damages blood vessels and the brain
Loss of muscle mass worsens insulin resistance
Impaired DNA repair increases cancer risk
Immune weakening increases infections and diseases
This is why many patients suffer from several diseases at the same time – not because “Everything happened to them”, but because the aging process is advancing.

Why Must the Medical Approach Change?

Medicine that waits for disease to appear and then treats it acts too late relative to the biological process. If aging is a long, cumulative, and influenceable process – then the most effective intervention is not only pharmacological, but early, continuous, and systemic.
This is the basis of longevity medicine: Not an attempt “To extend life at any cost”, but to extend the years of healthy, active, and functional life, and to reduce disease, suffering, and medical costs. And we already have ways today to prevent and to begin working on our healthy years of life.