Are you ageing healthily, or are you inflammageing?

Until fairly recently, older people were the invisible demographic. But now, if you are aged sixty or above, the spotlight is on you.

We have an ageing global population, coupled with a dramatic reduction in birth rates, especially in developed countries. According to the World Health Organization, between 2015 and 2050 the proportion of the world’s population aged over 60 will rise from 12% to 22%.

It’s unlikely that this ageing population group will be in robust health. It’s more likely that ageing global health systems will struggle under the burden of rising chronic diseases.

And therein lie so many opportunities.

Nature abhors a vacuum, and so too does industry. The pharmaceutical giants have run out of new diseases requiring new drug treatments, so now the focus is on creating vaccines against every eventuality. Babies are already vaccinated up to their eyeballs, but there are fewer babies and plenty more old folk around. Hence a slew of new vaccines ‘targeting aging and age-related diseases’ are now in the pipeline.

Meanwhile, food and nutrition corporates like Nestlé are racing to get a foot in this lucrative door. Nestlé is perhaps best known for its baby milk formulas. But the company has already closed a formula plant in China and is heading straight to the other end of the lifespan spectrum and ‘now prioritizing products for the elderly.’

Ageing is a primary risk factor for many chronic diseases, from Alzheimer’s to cancer. And Nestlé certainly did some excellent research in this area, having identified four age-related areas of interest: musculoskeletal health, immune defence, metabolic health and cognitive function.

I see nothing to disagree with there. These four, apparently distinct areas have one commonality among older people: inflammation. So pronounced is this commonality that in 2000, Italian ageing researcher Claudio Franceschi coined the phrase ‘inflammageing’. It’s now widely used in research.

‘Most older individuals develop inflammageing, a condition characterized by elevated levels of blood inflammatory markers that carries high susceptibility to chronic morbidity, disability, frailty, and premature death.’

Inflammation is an essential part of the body’s immune response, as a defence mechanism against infection. It’s when inflammation is sustained and prolonged that it becomes a threat to health.

As we age, we tend increasingly towards systemic inflammation, identifiable by high levels of multiple inflammatory markers in blood and cells. This inflammageing is a risk factor for cardiovascular disease, diabetes, cancer, chronic kidney disease, depression, and sarcopenia. In the brain, neuroinflammation contributes to the development of Alzheimer’s and other neurodegenerative diseases.

What causes this age-related, dismal state? There are plenty of contributing factors. A major cause is central, or visceral obesity. Abdominal fat is infiltrated by immune cells, including T lymphocytes, macrophages and monocytes, and these create inflammatory compounds.

‘Obesity — particularly central obesity — is strongly associated with a pro-inflammatory state’

Closely linked to obesity is hyperinsulinemia.  High circulating insulin creates inflammation and leads to insulin resistance, metabolic syndrome and diabetes, inducing obesity, especially central obesity.

Poor gut health is another significant factor. The role of the gut microbiome in initiating inflammation is a relatively new finding. With age comes a reduction in beneficial bacteria, include the Lactobacillus bacteria, and the result is dysbiosis, itself an inflammatory state.

“Dysbiosis seems to be more severe in conditions in which prevalence increases with ageing, such as obesity and type 2 diabetes.”