What is PhenoAge?
PhenoAge is an algorithm that is used to give a measurement of biological aging. It takes into account basic lab data from your annual physical and estimates your phenotypic age- how old you are at a cellular and organ system level. This may be the same or very different from your chronological age (how many birthdays you have had!)
We care about this because the PhenoAge correlates with the risk of chronic disease, cardiovascular disease and even mortality. These clinical biomarkers are predictive of differences in all cause mortality, cause specific mortality (such as heart disease and cancer), physical functioning, cognitive performance measures and even facial aging!
What tests are needed to calculate your PhenoAge?
You need to have results from the following tests to calculate your PhenoAge:
- Complete Blood Count (CBC)
- Complete Metabolic Panel (CMP)
- hsCRP (high sensitivity C-Reactive Protein)
There is a published paper by the creators of PhenoAge that compared to DNA based methylation clock algorithms and telomere based estimates and PhenoAge does seem superior to those biological age tools. I looked into the math involved and it wasn’t trivial so it makes sense to use a free online calculator to do the calculations. I found this free private calculator using this data rather than attempting to build a spreadsheet to do the calculation!
https://www.longevity-tools.com/levine-pheno-age
The best part about this tool is that you can compare interventions easily over time without expensive testing. So for example, if you decide to start a new lifestyle change or supplement known for its impact on aging, you can now actually test it and see if your biological age improves. This tool also gives an estimate of 10 year mortality risk so for sure this is not a calculator for the faint of heart or health anxious. Even so, knowledge is power and this is all modifiable- that is the point. The body has an incredible ability to change and adapt and heal when our cellular terrain is optimized.
What strikes me about the PhenoAge is that four out of nine biomarkers used to calculate this are connected to the immune system. A fifth is related to inflammation which is also connected to the immune system. So this suggests that the health and function of the immune system is critical for aging well. The remaining biomarkers are related to the liver and kidney – which is part of our detoxification and ability to biotransform. Therefore supporting these systems could be really helpful for improving our biological age.
What are the Factors that can influence your PhenoAge?
Factors Associated with Younger PhenoAge
- Higher income and educational status
- Increased Exercise
- Increased Vegetable and Fruit Consumption
- Higher levels of HDL
Factors Associated with Older PhenoAge
- Increased Waist to Hip Ratio
- Increased hsCRP
- Increased Insulin
- Increased Glucose
- Increased Triglycerides
- Increased Blood Pressure
- Tobacco Use / Smoking
What about genetics and hereditary factors?
It turns out that the difference in an individual’s Phenotypic Age compared to their Chronological Age is moderately influenced by hereditary factors associated with the ability to repair DNA and oxidative stress. Again the immune system is the system of “Defense and Repair” and efficiency is influenced by our genetics.
What else can we do to reduce our PhenoAge?
I would hypothesize that lifestyle measures, supplements and even medications that reduce chronic inflammation and is in support of our immune system and detoxification systems will reduce PhenoAge and what is more, given genetic and exposure differences this needs to be personalized. For example, one person may respond to Sulphoraphane and the next person Curcumin. A functional medicine approach that takes into account the clues and biomarkers and clinical patterns to understand which tools to choose for a given individual with a unique history, symptoms and lab values is the art and the key to using PhenoAge effectively in your own personal aging experiment.
“You are only as old as you feel”. That is how the saying goes but based on this paper let’s adjust that to “You are only as old as your immune system”.
Reference
Levine ME, Lu AT, Quach A, Chen BH, Assimes TL, Bandinelli S, Hou L, Baccarelli AA, Stewart JD, Li Y, Whitsel EA, Wilson JG, Reiner AP, Aviv A, Lohman K, Liu Y, Ferrucci L, Horvath S. An epigenetic biomarker of aging for lifespan and healthspan. Aging (Albany NY). 2018 Apr 18;10(4):573-591. doi: 10.18632/aging.101414. PMID: 29676998; PMCID: PMC5940111.
