Expert Interview: Nutrition and Nutrients in the Context of Longevity

“While traditional preventive medicine focuses on risk factors, functional longevity medicine focuses on optimizing cellular functions, metabolic pathways, and hormonal regulatory loops with the goal of maintaining vitality and quality of life well into old age—in other words, specifically extending the healthspan.”

The Fundamentals of Functional Longevity Medicine

1. What does “functional longevity medicine” mean to you, and how does it differ from traditional preventive medicine?

Functional longevity medicine also incorporates elements of traditional preventive medicine, but it is more of an indicative approach because its primary focus is on intervening in active biological processes of aging: When a specific measure is applied, it must be individually measurable and, ideally, also perceptible.

While traditional preventive medicine focuses on risk factors, functional longevity medicine focuses on optimizing cellular functions, metabolic pathways, and hormonal regulatory loops with the goal of maintaining vitality and quality of life well into old age—that is, specifically extending the healthspan.

“A major advantage I have as a doctor compared to theoretical scientists is that I learn directly from my patients exactly which measures work for them individually—and which do not.”

Why Nutrition and Metabolism Are So Important

2. Nutrition and metabolism are considered key factors for health and vitality. Which research findings do you find particularly exciting—and what does that mean in everyday life?

Medical research is so complex that it’s impossible to keep track of all new findings in detail. A major advantage for me as a doctor is that I learn directly from my patients exactly which measures work for them individually—and which don’t. Many “non-practitioners” in the field of longevity—from researchers to influencers to university professors—don’t have this direct feedback.

Especially when consulting with my patients, I benefit greatly when they ask me questions: I do the research to find the answers, since I can’t possibly know every detail myself. This gives me a broad overview of what’s currently happening in research. Additionally, I receive important information about conferences.

If it becomes clear in my practice that, for example, a nutritional approach such as metabolic flexibility—more specifically, the occasional separation of carbohydrates and fats—works well for an individual, meaning it is measurable, this can be integrated into daily practice as needed, taking the overall situation into account.

“Whereas in the past, for example, a blueberry was very small and had an extremely high polyphenol content, the blueberries cultivated today are large […]. For this reason, there is discussion about the extent to which appropriate dietary supplements can make up for insufficient intake to meet recommended requirements.”

Hormonal Balance and Cell Health Over the Years

3. Over the years, hormonal balance changes, as do many cellular processes. How can a healthy lifestyle—supplemented by a balanced diet and targeted nutrients within the scope of their approved effects—help maintain the balance of bodily functions?

In the hunter-gatherer era, to which we all trace our origins, people had a completely different access to vital nutrients: Although food was significantly scarcer, berries, for example, contained significant amounts of micronutrients. Today, agriculture can feed far more people, but nutrient levels can vary depending on the variety, soil, ripeness, and processing.*

Whereas, for example, a blueberry used to be very small and have an extremely high polyphenol content, the blueberries cultivated today are large but have white flesh due to their low polyphenol content. Such differences in nutrient density can also be found in other foods.

Due to the lower content of micronutrients, people may consequently consume less magnesium or folic acid than recommended; to meet these needs, significantly more green leafy vegetables such as spinach or Swiss chard would need to be eaten than is currently the case. For this reason, there is ongoing discussion about the extent to which appropriate dietary supplements can help meet recommended intake levels when dietary intake is insufficient—taking individual circumstances into account and in consultation with a healthcare professional.

* Side Fact: The nutrient content of many fruits and vegetables has dropped significantly over the decades. A critical review shows that, for example, mineral content in some crops has decreased by between 25 and 50%—as a result of high-yield breeding, intensive agriculture, and changes in soil quality.

Source: https://www.mdpi.com/2304-8158/13/6/877 

“Most people today have a sleep deficit […]; sleep is not a privilege, but an important foundation for recovery and daily well-being.”

Sleep as the Key to Regeneration and Longevity

4. You are deeply involved in the study of sleep and dream physiology. What significance does restorative sleep have in the context of longevity?

We live in an industrial world where sleep is often viewed as undesirable. In the past, people had a completely different life cycle. A “hunter-gatherer” worked about three hours a day and then rested. In nature, there is also the general phenomenon that animals typically sleep as much as their biological makeup dictates—unless external conditions such as food availability influence their behavior. Even when camping without a cell phone or electric light, people tend to fall asleep more easily or sleep longer than in their usual daily routine.

Most people today suffer from sleep deprivation, which can affect various bodily functions.* Consequently, scientific research is currently investigating the relationship between sleep duration and nutrition. Studies also reveal links between sleep deprivation, energy intake, and weight changes. Sleep is therefore not a privilege, but an essential foundation for recovery and daily well-being.

This is why sleep plays such an important role in longevity and is far more than just a luxury. Additionally, this is where dream physiology comes into play, which explores what we experience during sleep—and what we don’t miss—contrary to what many people fear. This opens up the potential to view sleep as a valuable resource and to learn to recall exactly what we have dreamed or experienced.

* Side Fact: Studies show that adults who regularly sleep 7–8 hours have better cognitive performance and metabolic regulation than people with chronically reduced sleep.

Source: https://www.sleephealthjournal.org/article/S2352-7218(15)00015-7/fulltext 

“Regular habits such as healthy eating, exercise, and sleep, as well as therapeutic approaches like breathing therapy—when integrated into daily life—are particularly valuable, as they improve well-being in the long term and are considered the method of choice for longevity.”

How Daily Life and Prevention Are Connected

5. In your experience, which everyday factors—from exercise to stress management—make the biggest difference when it comes to long-term health and well-being?

In our world, we often believe that “more”—including when it comes to longevity—is better. This leads to people purchasing dietary supplements based on their own research without consulting a doctor and combining them without knowing whether the supplements are even beneficial or perhaps even harmful. The latter point, in particular, should be given greater consideration, and the individual focus should primarily be on whether there are actually nutrients that are not being consumed in sufficient quantities as recommended.

Regular habits such as healthy eating, exercise, and sleep, as well as therapeutic approaches like breathing therapy—when regularly integrated into daily life—are particularly valuable, as they improve well-being in the long term and are considered the treatment of choice for longevity.

“All nutrients that can be obtained through food should be prioritized. If that is not possible—keyword: vitamin D—supplemental intake can be considered in consultation with a doctor.”

The Importance of High-Quality Supplements

6. For many people, dietary supplements are part of a holistic approach to health. Which nutrients or supplements can—within the scope of their scientifically proven and approved effects—meaningfully support normal bodily and metabolic functions?

Studies have examined and continue to examine which essential nutrients—that is, those not produced by the body itself—may be beneficial as supplements, taking into account the individual’s situation and following consultation with a doctor. Some substances, in turn, can be obtained through a healthy lifestyle.

Accordingly, all nutrients that can be obtained through food should be prioritized. If that is not possible—keyword: vitamin D—supplemental intake can be considered after consulting a doctor. The latter is so important because excessively high doses of vitamin D or omega-3 fatty acids, significantly exceeding the recommended levels, are risky.*

* Side Fact: The EFSA defines reference values (DRVs) and “upper levels” for vitamins and minerals. This helps to better classify requirements and safety limits.

Source: https://www.efsa.europa.eu/en/topics/topic/dietary-reference-values 

“I think it’s important to look at what’s already available rather than chasing every trend.”

A Look into the Future of Longevity Research

7. Which developments in functional medicine or longevity research do you currently find particularly exciting?

I find the things that are not yet known particularly exciting. The meaning of the American word “research”—to rediscover something—is also particularly exciting, since there are many things that have not been newly discovered scientifically but can already be found in older literature.

I believe it’s important to look at what already exists rather than chasing every trend. For example, respiratory therapy, which I view as a component of modern approaches to health promotion, was already extensively researched in the 1950s and 1960s. Furthermore, the first scientifically grounded anti-aging diets date back to the 1970s.

That is why I find it particularly exciting to take a fresh look at an older concept and test it using today’s measurement methods—for example, how parameters such as individual coenzyme Q10 status can be assessed.

Note: This interview is intended solely for general information and does not replace individual medical advice. Statements regarding micronutrients refer exclusively to their effects as authorized under EU Regulation (EC) No. 1924/2006. Dietary supplements are not a substitute for a varied and balanced diet and cannot replace medical treatment. For health-related questions, please consult a healthcare professional.