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There are few things we can be sure of in life. One of them is that we will all age. Understanding the process can help one stay healthier for longer and cope better with the effects.

Ageing can be very concrete, identifiable by greying hair and wrinkled skin; in other ways, it is intangible, a feeling, a state of mind.

Dr Ivor Lim of Ivor J. Lim Plastic Surgery explains it clearly. “In a nutshell, ageing is stem cell failure,” he says. “At the cellular level, the absolute number of stem cells, whose function is to produce new cells for tissue regeneration and repair, falls below the number required for youthful maintenance, or fails to produce sufficient stem cell proteins for repair and regeneration. When that slows down or stops, tissues—which make up the organs—start to function less efficiently or fail, resulting in a domino effect that ultimately produces visible, structural changes in the skin and musculoskeletal system, which we interpret as ageing.”

Numerous factors affect how we age and at what pace we age. Says Dr Ann Tan, an obstetrician and gynaecologist at the Women and Fetal Centre, “Chronologically, all of us will age. However, physiologically, we age at different rates, and this is determined by our genetic makeup, diet, lifestyle and whether there are any medical illnesses or accidents affecting us. Stress and how we cope with it mentally and physically can also affect us physiologically.”

Zhou Yan, a Senior Physician at Eu Yan Sang Premier TCM Centre, clarifies that, from the TCM perspective, ageing is not a disease. “It’s considered a natural process, but illnesses can cause it to speed up,” she says. Zhou warns that stocking up on qi doesn’t necessarily delay ageing. “If the supplements taken to increase qi upset the yin-yang balance, then it could actually speed up the ageing process.”

Lim elaborates, “External factors like pollution, habits such as smoking and/or excessive alcohol consumption, and excessive UV irradiation are factors that injure tissues. The body may or may not be able to bounce back, depending on its ability to repair and regenerate.” She continues, “Of course, a good diet will produce the nutritional building blocks (proteins and amino acids) as well as the energy (carbohydrates) and trace elements required for growth, repair and regeneration. A diet lacking in these elements will affect repair and regeneration and therefore accelerate ageing.”

Men and women age differently, primarily because of the difference in male and female hormones. “For women, the stage of menopause is distinct—their periods stop,” reveals Tan. “For men, the equivalent, andropause, is real too but not as evident, as sperm production carries on throughout life, though it wanes.”

Ageing is of concern in Singapore more than ever because people are living longer. “Longer life expectancy has to do with advancements in all fields of medicine,” explains Dr Suresh Mahtani, a GP with training in Geriatric Medicine and Aesthetic Medicine who practises at SG Clinic Family Practice and Reflections Medi-Aesthetics. “The real challenge with increasing life expectancy is to keep people free from illnesses.”

Mahtani discloses that there is research looking into stopping or slowing ageing via a process called life extension. “Two main approaches to this are calorie restriction and strategies for engineered negligible senescence,” he reveals. By reducing calorie intake (around 30% below the current recommended amounts), we can live longer because the more calories the body metabolises, the more harmful by-products are produced, which quickens ageing. On the second point, strategies include exercise, genetic changes and cleaning harmful toxins and by-products from the body.

There is a smiliar theory in TCM. “We recommend eating till you’re about 70% full; being too full hurts the spleen and stomach, which may lead to illnesses,” explains Zhou. “If both organs are functioning well, the body will be able to absorb the goodness and excrete the harmful by-products from foods consumed.”

As extended old age is something many of us have to contend with, understand the ageing process and how best to deal with it is crucial and something well worth paying attention to— however old you are now.

The Battle of the Sexes

Beside menopause, there are other major factors that impact how men and women age differently. According to Dr Suresh Mahtani, these are:


“Generally women tend to go and see a doctor more readily than men. So if a woman has an illness, she is more likely to get it diagnosed and treated early. On the other hand, men see the doctor less readily.”

Brain Ageing

“In men, the risk factors for developing cognitive impairment (loss of brain function with ageing) are obesity, diabetes and stroke. Women, on the other hand, develop cognitive impairment if they lack a strong social network or if they are dependent on others for daily tasks or have poorer overall health or depression. Somehow, factors that adversely affect women’s cognition do not have any impact on the men.”


Photo courtesy of Thinkstock. This article first appeared in NATURA magazine issue No.2. Find NATURA at Eu Yan Sang retail outlets, newsstands and major bookstores in Singapore.