A Unifying Hypothesis of Chronic Disease and Aging

By William H. Bestermann, Jr., MD

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ccelerated aging and disease in the skin are largely driven by excess oxidative particles generated by sun exposure and other environmental factors.

Look around. You can see differences in the rate of aging everywhere. Some 50-year-old people look 80 and some 80-year-old people look 50. It’s just the way they look. The 80-year-old people who look 50 are more active, have fewer chronic diseases, and their biological age in terms of cellular function is younger than their actual age in years. A compelling body of emerging scientific evidence can finally help us understand how this works.

You don’t have to age or die prematurely. You don’t have to develop chronic disease early. You can extend your healthy lifespan in ways that allow you to continue to contribute and function in the way that you want to — and you don’t have to eat sticks and grass to do it! But there are a few things that you must do. First of all, you should maintain your body just like you maintain your car.

Aging skin

Let’s get started by talking about something that you can see for yourself: your skin. Your skin is an organ where you can readily see the effects of aging. Unlike the skin of children that is smooth and tumor-free, older skin is wrinkled and is likely to be diseased with malignant and benign growths.

Sunbathing without skin protection and cigarette smoking combine to accelerate skin aging so that a 50-year-old person may have skin like an 80-year-old. More importantly, skin age and overall health age are equally out of sync. Other environmental factors like poor diet and pollution may also come into play.

Reactive oxygen species

New science provides compelling evidence of why this occurs at the level of molecular biology. Accelerated aging and disease in the skin are largely driven by excess oxidative particles generated by sun exposure and other environmental factors. Those reactive oxygen species (ROS) in turn activate signaling pathways that degrade the elastic fibers and other components that create a youthful skin appearance and texture.

These same signaling pathways account for the relationship between accelerated skin aging and benign or malignant growths on the skin. Cigarette smoke contains 1015oxidative particles per puff. Adding more oxidative particles from cigarette smoke accelerates skin aging and increases the likelihood of skin cancer.

The same genes that cause accelerated skin aging, skin cancer, and chronic skin diseases like psoriasis, are also required for normal skin development. Those same genes are activated at just the right time, in just the right place, for just the right duration in the fetus to develop normal skin. They become much less active in the 20-year-old with perfectly normal skin. Then environmental factors, like sun exposure and cigarette smoking, later in life reactivate those genes and contribute to accelerated aging, skin cancer, and benign growths. This information is not a matter of belief. We all know people who love to smoke and lay out in the sun. You can see with your own eyes that they look older.

The good news is this. The mechanisms that cause these changes are becoming clear and you can reduce your risk of chronic disease and slow aging with a few simple measures that are easy to understand.

You can see these changes in the skin but that is not the main story. The changes are not limited to the skin, the acceleration of aging occurs in every cell in the body. Although normal genes and oxidative particle signaling are critical to normal fetal development and growth, when growth and development are complete in the normal 20-year old, those genes become much less active. Later in life, aging, overeating, abdominal obesity, and cigarette smoke reactivate those genes to accelerate aging and increase the incidence of premature chronic disease.


Some foods can also be an important source of oxidative particles. Over thousands of years, humans have eaten real whole foods. That has changed, and it is making us older and sicker faster. Many Americans today are eating products from big food companies that combine sugar, processed carbohydrate, fat, salt, and flavorings.

Many people will eat them when they are not hungry and the more they eat, the more they want. These foods are literally addictive. As with any addictive substance, it is very difficult to cut down on consumption. The processed carbs turn to sugar very quickly.

The body converts food to energy via oxidation that occurs in the mitochondria, but this is not a perfect process. Some oxidative particles always leak out, even with healthy food. Think of these leaks like a hose and the excess sugar is like increased pressure in the hose. That excess pressure increases the leaks dramatically, producing many more oxidative particles that contribute further to accelerated aging and chronic disease.

To make it worse, the processed foods have lost all the beneficial imbedded antioxidants in the milling process. Eating fast food and processed food regularly has the same type of impact as smoking and exposes the body to large numbers of damaging oxidative particles.


Aging itself contributes to the problem because antioxidant defenses deteriorate with time. Aging, cigarette smoke, and too much food create a vicious cycle of increased oxidative stress, increased cell damage, chronic disease, and accelerated aging.

Chronic disease

Addictive food leads to increased abdominal fat accumulation which activates genes that produce still more oxidative particles while increasing the blood pressure, cholesterol, and glucose. These factors damage the body further still.

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Taken together, all these elements combine to create a vicious cycle producing oxidative particles, accelerating aging, and contributing to chronic diseases like high blood pressure and diabetes.

Protective clothing, sunscreen, whole foods, smoking cessation, exercise, metformin, ACE inhibitors, statins, aldosterone blockers, all reduce oxidative particle generation thereby slowing aging and reducing chronic disease development and progression. Precision medicine and molecular medical management can be available to you today.


Powerful evidence exists today that shows simple treatments that interfere with ROS generation can make a big difference.

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Type 2 diabetic patients with small amounts of protein in the urine are already high risk. A multifactorial intervention combining diet, smoking cessation, metformin, a statin, an ACE inhibitor (lisinopril), or an ARB (losartan), and aspirin was highly effective when compared with usual care using any medication approved to treat the risk factor. There was a 4-fold reduction in heart attack, a 5-fold reduction in stroke, and a 6-fold reduction in dialysis etc. All these treatments are antioxidants that work.

Type 2 diabetic patients in usual care lose 10 years of life expectancy — unless they are on metformin. Diabetics on metformin live a little longer than normal people. We now have proof that medications and lifestyle interventions that reduce oxidative stress have a dramatic impact in combination. You can be healthier longer and live much more normally as you age. Simple, inexpensive interventions can make a difference.

Originally published at thedoctorweighsin.com on November 1, 2018.

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Dr. Patricia Salber and friends weigh in on leading news in health and healthcare

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