Managing the Curse of the 50s

Published on Nov 1, 2022

Credit: Shutterstock

As a physician, I have observed over my career what I call the curse of the fifties. Meaning that this is when bad things happen or begin to happen. Sometimes it’s a heart attack, the first appearance of cancer, or chronic musculoskeletal problems that begin to hit our ability to stay active. Hence, as my fifties progressed I decided to make a serious change. I “refined” my anti-aging game plan. Today I’ll go over what I did.

The Curse of the 50s

As a doctor, I get to observe people who are in medical trouble, so I see a concentration of the general population needing assistance. What I have observed for decades is that for most of us, this trouble begins in our 50s. This is when bad medical things begin to pop up and also when intervention makes the most sense to avoid irreversible damage.

For example, things like early heart disease begin to slow people down in their 50s and then become entrenched by the time they enter their 60s. Or small tumors begin to form that often get ignored until they can no longer be ignored. Or things like cognitive decline begin which becomes a bigger deal when the patient is in their 60s and 70s. Finally, our musculoskeletal system begins to fall apart with all of those old injuries starting to become severe enough that many patients seek help.

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Meeting a Colleague

Over the past year, I resolved to take the curse of the fifties seriously because as a physician, I knew the biologic clock was ticking. The biggest change was losing about 40 pounds. As a result, I have felt better than I have in 20 years.

While in Europe, I met a colleague in his early 60s who was beginning to struggle with the curse. He noticed my transformation and we discussed his early cognitive decline causing him to consider early retirement. Given his family medical history (and mine as well), I recommended that he begin to implement an anti-aging plan as quickly as possible. While I didn’t know if this would help him, I know it helped me and that most of the plan is backed by reasonable science at this point. Hence, I told him I would write it all down and turn it into a blog.

The Goals

This plan has a couple of key goals:

Lose weight
Reduce chronic inflammation
Stay active

The Plan

First I’ll describe in general terms what I did and why and then give specific advice on how to initiate this plan. First, this is what worked for me:

Sleep

Regular sleep hours are key. Sleep accounts for about 1/3 of our lives, so if it’s not dialed in, then nothing else in this plan will work. This means that you need to control:

Total Hours in Bed
Sleep Schedule
Sleep Quality

On total hours in bed, this needs to be at least 8-9 per night. Closer to 9 seems to be a consensus in the literature. Your sleep schedule of when you go to bed and wake up MUST be consistent. For example, I head to bed between 8-9 pm and wake up between 4-5 am every day. Finally, if you snore, that’s a problem that needs to be looked at medically, as it means your brain is being deprived of oxygen. For example, I know that if I sleep on my side, my sleep quality is good and when on my back I snore and it’s poor. Hence, I have turned into a side sleeper. I also know that using a Netti pot to clear my sinuses before bed improves snoring, so I have also instituted this as well.

To keep my sleep cycle regulated, I use both melatonin and GABA taken at the exact same time every night.

Blood Sugar Control

This is key to living longer and avoiding heart attacks. Forget cholesterol levels, where the scientific support that lowering them helps reduce heart attacks has been collapsing of late. It’s really about making sure you don’t become a type II diabetic or have insulin control issues. Hence, the most important number to track is HBA1C, which is the amount of blood sugar instability that you have. Keeping this number between 5.1 and 5.5 should be the goal. More on how that’s done is below.

Senolytics

A senolytic is a drug that we know likely reduces the effects of aging. There are many that have been proposed and studied, but the one with the biggest evidence base that also helps keep your blood sugar under control is Metformin. Hence, I’m on this drug.

Testosterone

Remember, I’m writing this from the male perspective, so for women, this discussion would include not only testosterone but also progesterone and estrogen. However, for men, there is no single injectable that will have a bigger profound impact on aging than testosterone. That means measuring and bringing these levels back to normal 18-25-year-old levels. That not only helps with mental clarity, but it will also increase muscle mass which helps to burn calories as well as improve libido.

Muscle Mass

If you’re going to be taking testosterone to restore and keep muscle, you also need to lift heavier weights to maintain that muscle mass. This is based on studies that show that elderly people who work out with weights have muscles that are biologically closer to their younger counterparts than those that don’t. Here I would suggest hiring a personal trainer at least for the first 6 months to a year so that you can understand what this means at a high level. While I no longer use a personal trainer, that’s based on learning from these experts for many years about what a good weight workout looks like.

Increase HGH

The missing piece for weight control for me was HGH or Human Growth Hormone levels. For me, that means taking Semerollin injections once a day. This growth hormone-releasing peptide will restore your HGH levels back to younger levels. For me, it’s also helped to tame my appetite.

Thyroid

Think of thyroid hormone as the spark that kindles the fire that burns fat and keeps you sharp. Low thyroid levels are common as we age, which causes all sorts of issues like weight gain and dull wit. Hence, I take a thyroid supplement every morning when I first wake up.

Exercise

You MUST get significant age-appropriate exercise 6 days a week. That means that you should be targeting 10,000 steps or about 30-60 minutes of vigorous exercise. That doesn’t mean a light saunter outside, but hiking uphill or walking at a brisk pace. Or lifting weights hard enough that you begin to lose your breath. You get only one day a week off.

When I say “age appropriate” I mean exercise that works for your body. My colleague is a runner, but that has long since passed him by as a way to get aerobic exercise. There are many other ways to get at it, however, so replacing running with cycling or even swimming would be a better match.

Diet

This is both what you eat and how much. For me, it meant going to a shake-based plan that I’ll describe below.

What?

Forget fat, carbs kill. That means that all bread, pasta, and potatoes are out of your regular diet routine. The same goes for most slow-burn grains like oatmeal, quinoa, and others. These slow-burn grains should be limited to small amounts like garnishes. Your main carb-based fuel needs to be fruit and vegetable-based.

There are no fried foods. The only fats you should consume are plant-based.

How much?

I can’t overemphasize that keeping track of everything that goes into your mouth is key. Meaning that you can eat all of the right stuff, but eat way too much of it and you still have an aging problem. Meaning that you can get by with way fewer calories than you’re currently consuming and you need to make that your new normal.

Alcohol

Alcohol, based on the existing science, is a two-edged sword. On the one hand, it may have cardioprotective effects, on the other, it’s a brain cell poison. For our purposes, it’s empty calories. Hence, I cut my drinking back to only on Friday and Saturday and got rid of all drinking during the week.

Supplements

The goal here is reducing inflammation and supporting your hormonal plan. I will link to what I take every day:

Fish Oil — 4 pills every morning – Nordic Naturals ProEPA
DHEA — 1 pill every morning – Vital DHEA 10 mg
Vitamin D3 — 2 pills every morning – Now 5,000 IU
Multivitamin

Keep Your MSK System Going

This last one is key, as making this anti-aging plan work depends heavily on your ability to keep exercising and not get taken out of the game by a painful shoulder, knee, or back. That’s what we do at Regenexx, we keep aging people from getting big surgeries by using orthobiologic injections to treat small problems while they’re still small. So find a local Regenexx physician.

How Can You Do This?

How can you actually implement this plan? After all, reading about what Dr. Centeno did is great, but getting the same plan put in place for yourself is another story. Here’s how that works:

Things You Can Do Right Now

Changes You Can Make

Control your sleep
Get rid of the carbs and control your diet
Lift weights with a personal trainer
Get proper exercise
Control your alcohol intake
Get your painful joints or spine treated with orthobiologics
Lose weight

For #7, you can begin to implement the Dr. Centeno diet plan. This is as follows:

Breakfast — Matcha Avocado Protein Shake
Lunch — Salad with Chicken
Dinner — Matcha Avocado Protein Shake

Matcha Avocado Protein Shake Recipe:

This is what’s in my shake this morning:

This will make 2-3 large glasses, which is what you get for that meal. There is no snacking.

Changes You’ll Need Help With

The key next step here is finding an expert Age Management Medicine doctor. Mine is Julie McCalen here in Denver. There is an excellent national group called Cenegenics that has doctors in most major cities. There is also an army of qualified physicians out there that have taken coursework in this area.

The goal here is to find a doctor who can begin to prescribe the hormonal supplements and several times a year blood work you will need. This is NOT CHEAP. My guess is that you’ll spend a few thousand a month for the right qualified doctor. I would also seriously consider enrolling your spouse in the same program as these changes are far easier to make as a team.

How Long Does this Take?

This is NOT a rapid weight loss program or something that will change your life in 30 days. I’ll leave those crazy claims for the guys on social media hawking supplements and super green mixes. This is a lifestyle change. Hence, I would expect to see significant changes in weight and how you feel in 3 months with more happening at 6 months and a year.

The upshot? I wrote this blog for my colleague, but at the same time, I also wanted to put all of this in writing for my readers. Please take the time to avoid the curse of the 50s!