EVERFIT book review : The Telemere Effect

Book Reviews, August 11, 2019

This book co-authored by the talented Elizabeth Blackburn and Elissa Epel unpacks the best daily habits, plus the way our communities should interact to ensure we continually encourage WELLNESS rather than disease. It is a revolutionary approach to living younger, healthier, and longer.

Telemeres are repeating segments of non-coding DNA at the ends of our chromosomes. A protective "cap" much like the end of a shoelace. These plastic caps are called "aglets" and they stop the shoelace from fraying.  The telemeres shorted with each cell division and determine how quickly our cells age and when they die. Important discoveries have shown that certain conditions actually promote lengthening - so aging is a dynamic process that can be slowed and even reversed in some cases.


This book is co-authored by Elizabeth Blackburn (PhD) a molecular biologist, and Elissa Epel (PhD) a health psychologist. They joined forces in research almost 20 years ago and the product of it is this extraordinaire book outlining how our thoughts and habits along with the communities we live in effect our cellular make up and our WELLNESS.
In 1961 biologist Leonard Hayflick showed that normal human cells will divide a certain number of times before they die. Early on in a cells lifespan they divide (mitosis) rapidly - this is termed "luxuriant growth". After some time they slowed in division and reached a stage termed "senescence" - they were alive but stopped dividing (senescence is like senile. It is a good thing they stop dividing otherwise cancer can ensue). The stop switch was the telemores becoming critically shortened. All types of human cells have different lifespans, and some like stem cells - if kept healthy, and with enough telomerase* can keep dividing through our entire lifespan.


*don't try to extend life through using artificial methods of telomerase - if you get too much of it at the wrong time telomerase can fuel uncontrolled cell division that could promote cancer. 


These senile cells are bewilded and weary and when you get too many of these "non-functioning" cells your tissue starts to age. For example if you have too many in your artery walls they start to stiffen. These cells get communication with other cells, create confusion, and they can't do their jobs well. They leak pro inflammatory substances that make you susceptible to more pain, and illness. If you have more senescence infection fighting cells# in your bloodstream they can't recognise when a virus is present so you will be more likely to catch the flu. When we get too many of these dysfunctional cells within our system then our "disease span" begins after our "health span". 

#T - cells (one type is the CD8 cell) leave the thymus and circulate the body, each cell has a receptor like a searchlight on a police helicopter looking for "criminals" (cells that are infected or cancerous) . We have many different types of T-cells with the ability to recognise just one type of antigen or virus so when we become infected with a particular virus the few T-cells that have that receptor can replicate to fight the infection. The CD8 T-cells are vulnerable to stress. When the telemeres of aging CD8 cells wear down they send out proinflammatry cytokines (creating systemic inflammation) until they finally become senescent, refusing to die and accumulating in the blood. Normally they they die by a natural cell death called apoptosis - this rids the body of the dead or damaged cells so they don't overwhelm the body. It has been found that people that wake up with joy have more telomerase in thier CD8 immune cells than those waking up with a feeling of dread. The fourteenth Dalai Lama wakes up "Everyday, think as you wake, today I am fortunate to be alive, I have a precious human life, I am not going to waste it."


Just like one rotton apple in a barrel can send out gases that rot the other apples - one "senescent" cell will signal to surrounding cells promoting inflammation and other factors that negatively impact function and flow at a cellular level. This very broad chronic inflammation is a factor in heart disease, brain disease, gum disease, crohns disease, rheumatoid arthritis, asthma, cancer, and more. Scientists talk about INFLAMM-AGING. We need to put out the fires of inflammation if we want to stay in healthspan rather than shift into disease span too early in our life. Short telemeres don't predict death in every study as there as many other factors involved but they do predict death in 50% of studies including the largest yet, a 2015 Copenhagen study of 64,000 people showing that short telemeres predict early mortality. One of the most important take aways from this book is WE HAVE THE POWER through our daily habits to effect the rate of our telemeres shortening. Our life experiences and the way we respond to them can change the lengths of the telemeres. Cultivating a Challenge (hopeful, excited, confident - I have what it takes) rather than a threat (anxious, fearful, uncertain - I don't have what it takes) response to a stressful situation is very important. Keeping threat responses in proportion at least is a good start. Using stress to help you perform is another positive way of looking at it. As sports psychologist Jum Afremow said "Yes I need this - don't make the butterflies in your stomach go away, make those butterflies line up and fly in formation." A challenge response doesn't make you less stressed - your sympathetic N/S is still aroused - but it's more positive, creating a more powerful focused state allowing for flow rather than freeze.

Mind Wandering
The more wind wandering you do especially if it's negative, the shorter your telemeres. Harvard psychologists Matthew Killingsworth and Daniel Gilbert discovered that we spend half of our waking hours thinking of something other than what we are doing. "The human mind is a wandering mind". Their studies showed that when people were not thinking about what they are doing - they are not as happy as when they are engaged. "A wandering mind is an unhappy mind.........especially negative mind wandering e.g wanting to be somewhere else." As Jon Kabat-Zinn (founder of the programme Mindfulness Based Stress Reduction - MBSR) has stated "when we let go of wanting something else to happen in this moment we are taking a profound step toward being able to encounter what is here now." I would add that is means you are giving the flow state to start and you are then giving the present moment justice. Mindfulness, purpose, and joy all create healthier telemeres. 
Check out www.trackyourhappiness.org to download the app and see how your mind wanders.
Shortened telemeres are also a result of Rumination - rehashing problems over and over without constructive thought in solution. Thought suppression - process of pushing away uncomfortable thoughts and feelings. If we try and sink our thoughts into the depths of our subconscious it will fester. The brains resources are already taxed (cognitive loading) making it unhelpful to suppress thoughts - actually increasing chronic stress. Telemeres will become shorter quicker with negative thinking, but they can be stabilised or even lengthened with habits that promote stress resiliency e.g meditation, yoga, exercise, cold therapy, fasting, and robust real discussion with loved ones. 
Stronger feelings of purpose help with a more resilient stress response, and less reactivity. Other studies have shown that having life purpose also relates to a reduced risk of stroke and improved functioning of immune cells. It's also linked to less belly fat and lower insulin sensitivity.
"The purpose of life is not to be happy - but to matter, to be productive, to be useful, to have it make some difference that you lived at all." Leo Rosten. Life purpose gives us eudaemonic happiness, this isn't transient (like eating or buyng something we want), it's the healthy over arching feeling that we are involved in something bigger than ourselves.
Where you place your attention matters- There are two basic modes of thinking. The "doing mode" which is what we do when we are trying to get out of the gap between how life is, and how we want it to be. Living in this gap or grey zone wishing things could be different is not really living to your full potential.  The other mode is the "being mode" - this mode is easier to fix attention and allow flow, and connection to the task or person. This state brings people the most joy and contentment.  Mindfulness interventions can help shift us from the common doing mode to a being mode and reduce rumination, thought suppression, and exaggerated forms of negative thinking. 

Your WELLBEING (current stressful exposures, clinical levels of emotional distress, social support), and LIFESTYLE (exercise/sleep, nutrition, chemical exposure) effect your telemere health. 


The cellular benefits of exercise- People who exercise spend less time in the toxic state termed "oxidative stress" - begins with a free radical (molecule missing an electron and tries to swipe one from surrounding molecules) this stress can create havoc in our cells molecular population and is associated with aging - an onset of "disease span" : CV disease, cancer, arthritis, diabetes, and neuro-degenerative disorders.
Our cells also contain "anti-oxidants" - these are molecules that can donate an electron to a free radical and still remain stable. The whole situation is a normal process and we need a certain number of free radicals for normal communication between our cells. BUT radicals can be created in excess through TOO MUCH EXERCISE, ANXIETY, SMOKING, HYPERPROCESSED FOOD etc so will create an imbalanced state. When the correct balance of exercise is reached the increase in free radicals with exercise is met with the body producing anti oxidants - improving your cellular health. People who exercise regularly have LOWER inflammatory cytokine levels, enjoying a more robust immune system.


"Habitual exercise is capable of regulating the immune system and delaying the onset of immunosenescence" (when you get higher circulatory levels of proinflamatory cytokines - increasing more T-cells to go toward senescence - leaving you more open to sickness)

Intracelluar benefits of exericse- Exercise induces autophagy - this is a pac man like process that eats up damaged molecules (I have discussed this in regards to fasting and cold therapy). Later in the same session when there is too many damaged molecules and the autophagy process can't keep up the cell dies a quick death (apoptosis) in a cleaner way that decreases the collateral damage of debris and inflammation. Exercise also increases the number and quality of mitochondria. Post exercise the body is still cleaning house - reducing cellular debris increasing cell health and robustness. 

The right amount of exercise is dependent on the amount of rest you have to allow absorption and safe adaptation. 1-2hrs a day of flexibility, cardio, and full body strength is a rough gauge. Mix it up - yoga, running, walking, push ups, swimming, tennis, dancing, pilates - DO WHAT YOU ENJOY and be consistent. Don't aspire to extremes. 


Sleep- Poor quality sleep, sleep debt, and sleep disorders are all linked to shorter telemeres. Sleep is the rejuvenating time to set your internal biological clock - it helps regulate appetite, consolidate and order memory (sleep creates new connections between brain cells so stabilisers memories learnt, also reduces emotional intensity on painful memories) , and refreshs your mood. During REM sleep cortisol is suppressed, and your metabolic rate increases. If you don't get quality sleep you get higher levels of cortisol and insulin - which in turn stimulates appetite, and a greater insulin resistance. BAD sleep can put you in a pre diabetic state.
"We sleep to remember, and we sleep to forget." Matt Walker (sleep researcher, Uni of California)
With sufficient sleep you will feel less hungry, less emotional, and keep telemeres from shortning.

Aim for 7-9hrs on average, and try to keep to same routine daily with protected transition time (no eating, soothing music, stretching,  blue light, or stimulating behaviour). Regularity will help the brain know when to release melatonin. 


It's the BELLY not the BMI- Subcutaneous fat (fat under skin and in limbs) carries fewer health risks than high intra abdominal fat which is metabolically troublesome and indicates some level of poor glucose control. Abdominal fat is more inflammatory than say thigh fat. The fat cells secrete pro inflammatory substances damaging the cells of the immune system making them senescent. Dieting will more than likely cause "weight cycling". Lifestyle changes are the best way to lose belly fat and keep it off. Eat more plant based whole food that is kcal sparse and nutrient rich. Don't become stressed about counting kcal, just eat quality food.  Your diet should reduce inflammation and oxidative stress. 


Anti-inflammatory foods include nuts, flax seed and oil, oily fish, and leafy vegetables - all rich in omega 3's. Omega 3's help form cell membranes in the body, keeping the cell structure fluid and flowing. The cell in turn converts the omega-3's into hormones that regulate inflammation, blood clotting, and ensure the artery wall are pliable rather than becoming rigid.  Thomas Sydenham, an English physician (1624-1689) stated, “A man is only as old as his arteries.” The books authors "strongly" suggest vegetarian alternatives for Omega - 3. A mixture of EPA and DHA due to sustainability reasons. Fish have Omega-3 due to consuming algae. So cut out the "middle animal", eat lower on the food chain. Save the ocean by doing more than cutting down on plastic (40% of all plastic waste is derived from the fishing industry anyway), stop eating it's inhabitants that are essential for the biodiversity. The DHA from algae promotes CV health just as good quality DHA from fish. To keep your Omega 3 and 6 in a more healthy balance eat less fried foods, packaged crackers, chips and processed snacks. Eat more real whole foods from plant sources. 


Oxidative stress can be managed with antioxidants from plant sources - beans, nuts, seeds, whole grains, leafy green vegetables, and green tea. The authors don't advocate getting antioxidants from supplements as the research is mixed (as my "End of Illness" book review showed - increasing vitamin supplementation can actually increase the incidences of cancer). When vitamins, minerals, and antioxidants are packaged in real food the body can recognise, and process them with greater health effect. 



New habits
  1. Small changes - slip in painlessly, small steps work better most of the time and allow good traction for new habits to hold.
  2. Tack it - tack the new habit on an already established habit. This will help with making it established routine also. eg lunch break for 15min power walk with bare arms.
  3. Mornings are GO - schedule change for the morning, the earlier in the day the less chance other priorities will nudge it out of the way.
  4. Just DO it - don't mull over change behaviours over when decided, jsut get into it - that first 5sec of behaviour change can catapult momentum e.g rip the covers off and get out of bed DON"T lay there and think about it. 
  5. Celebrate it - give your self a mental pat on the back, reward yourself after completing it 10 times. 
Breaking OLD habits
  1. Help the brain execute plans - we need to activate analytical thought patterns not emotional ones. So more activity in the prefrontal cortex rather than the amygdala. Exercise, downshifting, meditation, and highly nutritious foods help this propagate this state. 
  2. Don't change when feeling depleted - Low sleep, low blood sugar, or emotional stress will deplete will power for change.
  3. Shape your environment to decrease temptation - Don't buy crap food so it's not in your home. Stimulus control is very important in establishing good habits. 
  4. Follow your individual rhythms - This is when you will have MORE power to stoke the willpower. If you are a night owl you will be more able to resist temptation in the evening and likely to "slip up" in the morning. Plan accordingly 
  5. ASK your support network to support - tell friends and family your goals. Get a training buddy, check in, be accountable to someone. Keep moving your behaviour change to front of mind. 
Psychological Restoration (NATURE heals) 
Being in nature provides a change in context, it inspires us with natural beauty, it expands our small thinking, it removes noisy unnatural urban stimuli that keeps our sympathetic system on "alert". Our system gets a natural reset, defrag, NATURE nourishes the body, mind and soul. Exposure to green space is associated with lower stress and healthier regulation of cortisol  (stress response hormone) secretions (Roe. J.J et al, "Green space and Stress : Evidence from cortisol measures in deprived urban communities," International Journal of Environmental research and Public health 10 no. 9 (Sep 2013) : 4086-4103). People in the UK who are economically deprived have almost double the early mortality of the wealthiest in the country - EXCEPT when they live in neighbourhood's  surrounded by greenery. Nature halves their comparative risk (Mitchell, R., and F. Popham, "Effect of Exposure to Natural Environment on Health Inequalities : An observational population study." Lancet 372, no 9650 (Nov 8, 2008): 1655-1650)


Chemicals that are toxic to telemeres and WELLBEING.

Carbon Monoxide is odorless, flavourless, and colourless and is part of our physical surroundings and is a silent assassin. Talk about "killing us slowly". Cadmium is a heavy metal with LARGE effects on our health (found in cigarettes, and created from the burning of fossil fuels, and municipal waste). Lead was used extensively in fuel and paint and is still in some cities pipes. Another category of chemicals POLYCYCLIC AROMATIC HYDROCARBONS (PAHs) is airbourne - these are byproducts of combustion around industry, traffic, and grilled food. There are many chemicals that are around that shorten our telemeres. Seven pesticides have been linked to poor health outcomes - they cause oxidative stress. Even though some of these pesticides have been banned  they live on in the food chain (bio-accululation) - there is an accumulation of toxins within our cells even if you live like a vegan "wahoo" hippie. This is why we need to not add to the environmental loading by minimising EXTRA toxin intake so be careful with food intake (plant based organic), minimise other culturally accepted toxins e.g alcohol, saturated animal fat, and allow the body to flush the toxic build up daily with exercise, meditation, yoga, cold therapy, and sauna work. 
  • Eat less animal (including large, long lived fish) and dairy fat - the fatty parts of meat is where certain bioaccumulative compounds collect and concentrate, especially in close proximity industrially farmed animals.
  • Avoid cooking meat on an open flame and don't eat charred food.
  • Avoid pesticides - Try and purchase organic food, at least wash your produce before eating. Grow your own.
  • Use personal care and cleaning products that are as organic and "natural" as possible.
  • Buy more house plants to filter air and lobby local council to plant more urban trees.
  • Add art - a mural, a beautiful poster can infuse colour, hope, truth, and a sense of positivity. There have been studies showing economic growth in areas where more beautiful art is displayed. 
  • Get GREENER - more green spaces and trees is associated with lower cortisol (stress response hormone), and lower rates of depression and anxiety. In the US "greening" a vacant lot has been associated with a reduction in gun violence, vandalisim, and an increase in a residents feeling of safety. 
  • Warm your tone - social capital is an invaluable resource that predicts good health. The definition is the level of community engagement, positive activities, resources, and meeting places that exist in your neighbourhood - one important ingredient to allow this to thrive is TRUST. So be the change, smile (this is powerful to aid connection - an "air gaze" increases disconnection), engage, share your home grown vegetables, invite neighbours for a meal, start a book swap club - the positive connection possibilities are endless.
  • Show gratitude and appreciation
  • Be present - put the screen away when engaging to give sincere authetic attention.
  • Hug or touch more - this helps release oxytocin. We touch our phones far more than the people we love. 
Orchid Children
Certain environments allow stress sensitive individuals to thrive. Studies have shown that children who are stress sensitive do poorly when in large, crowded, chaotic classrooms or harsh family environments. When they have nurturing adults around them they do better than the average child - they are sick less, have fewer symptoms of depression/anxiety.
Without exquisite care and attentions an orchid won't bloom - place it in optimal conditions and it produces flowers of stunning beauty. Round 20% of kids have an orchid like temperament.
Tune into your childs feelings - vulnarable kids need sensitivity and parental attunement. Soothe frustration by focusing on feelings. Labelling feelings and putting together a story helps "turn down" the effect of emotions. Daniel Siegel (author of "The whole brain child" and co-author of "Brainstorm") calls this strategy NAME it to TAME it. If you want to reach the childs (or adults for that matter) rational thinking you have to meet the them emotionally first with empathy. Siegel calls this CONNECT and REDIRECT. 
I love this quote and I think it encompasses the interconnection of EVERYTHING.

"A human being is part of the whole, called by us "Universe", a part limited in time and space. He/she experiences him/herself, thoughts and feelings, as something separated from the rest - a kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task much be to free ourselves from this prison by widening our circle of compassion to embrace ALL living creatures and whole of nature in it's beauty. Nobody is able to achieve this completely, but the striving for such an achievement is in itself a part of the liberation and a foundation for inner security." Albert Einstein March 29, 1972 in the New York Times.


Our genes are like computer hardware - we can't alter them. Our epigenome (telemeres or a part) is more like software which responds to programming. WE programme the epigenome with our habits. We influence the chemical signals that create change. Our individual actions along with policy that nudges communities and countries towards WELLNESS habits is the way forward. The authors of this book want to add a new phrase to policy making - SOCIETAL STRESS REDUCTION. We need broad social policy that have a goal of buffering the socioeconomic and environmental chronic stressors faced by so many in this beautiful country. The worst stressors (exposure to violence, trauma, abuse, and mental illness) have an over arching common factor. Income inequality in a region. Countries with the biggest gap between the richest citizens and the poorest have the worst health and the most violence. NZ is one of the worst.

We are connected to one another and to all living things at EVERY level - from the macro to the micro. Separation is indeed a "delusion" as Einstein stated. The reality is that we all share SO much, we share the ability to shape the future. We are deeply interconnected with each other and the natural world in majestic and mysterious ways #allone #saveourplanet #everfit