Key Points:
- The Triage Theory states that even if we think we are getting enough nutrients, we may not be, and this may be shortening our lifespan.
- The “longevity vitamins” are as follows: vitamin K, selenium, vitamin D, magnesium, omega-3 fatty acids, choline, taurine, ergothioneine, pyrroloquinoline quinone, queuine, and, carotenoids.
The triage theory states that in response to moderate nutrient deficiencies, enzymes necessary for longevity shut off in favor of enzymes necessary for survival and reproduction. That is, sufficient intake of the known 30 vitamins and minerals will lead to a longer life. However, deficiencies will lead to an insidious accumulation of clinically undetectable biological damage that promotes diseases of aging. Based on this concept, in addition to ample supporting research, Dr. Ames suggests eleven compounds he thinks should be considered longevity vitamins.
Triage Theory Explained
Together, vitamins and minerals are classified as cofactors — non-protein molecules needed for enzymes to function. Enzymes speed up chemical reactions and without them, life would not exist. This explains why when an organism doesn’t consume enough vitamins and minerals, it dies.
Still, our body houses thousands of different types of enzymes, with some supporting short-term survival and others supporting longevity. Triage Theory states that our body preferentially allocates vitamins and minerals to the survival enzymes in situations of scarcity. This means that mild vitamin and mineral deficiencies can go unnoticed, as short-term enzymes are prioritized.
Moreover, without sufficient vitamins and minerals, the longevity enzymes are not activated. These longevity enzymes repair the biological damage that occurs with aging, thus slowing the aging process. When these enzymes are inactive, biological damage is allowed to accumulate, eventually leading to diseases of aging. Considering the insidious nature of biological aging, manifestations of inactive longevity enzymes may be undetectable until old age. Triage Theory would say that some of the manifestations of inactivate longevity enzymes are chronic disease and early death.
Longevity Vitamins
Vitamin K and Selenium
Four of the eleven longevity vitamins/minerals (V/M) are established essential V/Ms, meaning they activate short-term survival enzymes. Research suggests that vitamin K preferentially activates survival enzymes associated blood clotting and only higher doses activate longevity enzymes associated with long-term heart health, which promotes longevity. Similar results have been observed with selenium. Thus, Dr. Ames considers both vitamin K and selenium longevity V/Ms.
Vitamin D and Magnesium
The other two longevity V/Ms that are also essential V/Ms are vitamin D and magnesium. Approximately 70% of Americans are deficient in vitamin D and 45% are deficient in magnesium. Alarmingly, deficiencies in either vitamin D or magnesium are associated with an increased risk of early death. Moreover, magnesium deficiency may be an unrecognized principal driver of heart disease, the leading cause of death worldwide. For these reasons, Dr. Ames argues that vitamin D and magnesium are longevity V/Ms. Notably, magnesium is needed to activate vitamin D in the body, suggesting combining the two could have an additive or synergetic effect.
Omega-3 Fatty Acids
Most of the country is deficient in the omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), the omega-3s found in fish and other seafood. Studies have shown that for each 1% increase in blood DHA/EPA, there is a 20% decrease in early death. While not technically V/Ms, omega-3s are important components of the nervous system, aiding in the prevention of cognitive decline and neurodegeneration. They also play an important role in vitamin D’s effectiveness.
Choline and Taurine
Choline and taurine are considered conditional vitamins because they can be synthesized in the body but not to optimal levels. Ergo, similar to essential V/Ms, they should be consumed from the diet or supplemented. Choline is important for brain function and pristine DNA. Taurine has been shown to prevent health problems, including heart disease, brain dysfunction, and diabetes. In a worldwide population study, the Japanese were shown to have the lowest rates of mortality from heart disease, which was associated with higher taurine levels.
Ergothioneine and Pyrroloquinoline Quinone
Ergothioneine is synthesized by some types of mushrooms and bacteria but not plants or animals. It is a specialized antioxidant implicated in protecting against heart disease and lower levels are associated with cognitive impairment. Pyrroloquinoline Quinone (PQQ) is another antioxidant, implicated in protection against decrements in attention and working memory. In animal studies, PQQ has been shown to enhance the production of new mitochondria, important for healthy biological aging and longevity.
Queuine and the Carotenoids
Queine is an ancient compound, the deficiency of which may lead to a reduction in neurotransmitters like serotonin, which Dr. Ames calls a social hormone, involved in executive function. Carotenoids are a class of over 600 pigments known for giving fruits and vegetables their yellow, orange, and red hue. Low intake of these powerful antioxidants is associated with early death, macular degeneration, blindness, cognitive decline, heart disease, cancer, and inflammation. One of the carotenoids, astaxanthin, was shown to prolong the lifespan of mice.
Practical Implication of Triage Theory
Dr. Ames, who has discussed Triage Theory with biochemist and science communicator Rhonda Patrick, does not appear to advocate for supplementation of V/Ms. Instead, he suggests consuming a nutritious diet consisting of higher levels of V/Ms and fiber. Such a diet would include foods like nuts, seeds, eggs, seafood, vegetables, and fruits. Moreover, these foods should be eaten over a lifetime to maximize potential longevity and long-term health benefits. Still, supplementation of these compounds could offer the same benefits as if consumed in foods. However, without knowing our levels of each vitamin, it may be diffcult not to overdose.
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