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The Four Horsemen of Longevity:Understanding illness to increase healthspan (Part 2)

Welcome back to the second part of our series on 'The Four Horsemen of Longevity: Understanding Illness to Increase Healthspan'.



In the previous blog post, we discussed atherosclerosis and cancer, two of the biggest barriers to attaining a healthy and long life. Today, we continue learning about two other crucial horsemen: neurodegenerative diseases and diabetes, pillars that significantly impact health and well-being as we age. In this edition, we will explain what lies behind these health problems, allowing us to gain a better understanding and empowerment for living a longer, healthier life.


3. Alzheimer’s and Neurodegenerative Diseases

What are Neurodegenerative Diseases?


Neurodegeneration is a major pathophysiological process in brain illnesses, presenting a challenge to modern medicinal therapies.


Neurodegeneration involves the progressive loss of neurons and their functions, playing a central role in various brain disorders. Common neurodegenerative disorders include Alzheimer’s disease, Parkinson’s disease, and others. Age is a significant risk factor, but genetics and environmental factors also contribute. These disorders affect multiple aspects of human functioning, both basic and complicated, with varying progression and severity.


What is the prevalence of degenerative brain diseases in the USA?


It is estimated that these conditions affect more than 50 million people globally, with a strong connection to age, especially in individuals over 65. The increasing aging population is expected to lead to a substantial rise in the number of people affected by neurodegenerative conditions.


Between 2016 and 2017, approximately 4.7 to 6.0 million people in the United States have been affected by neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and motor neuron diseases.

The annual economic impact of these chronic diseases in the United States, taking in notice direct medical and non-medical costs (costs from lost productivity for example), was a remarkable $655 billion in 2020 USD.


What are the causes of Neurodegenerative Diseases?


Neurodegenerative diseases often have multiple contributing factors. Age is a significant factor, with a strong genetic connection through mutations and family history. Environmental factors such as pollution, infections, and location of residence can also play a role. Medical history, lifestyle choices, and habits (e.g., diet, physical activity, tobacco, alcohol use) are additional influences.

Furthermore, it is important to consider the role of inflammation in the genesis of neurodegenerative disorders. Inflammation is a critical biological response that the body employs

to address injuries and infections, aiming to eliminate the underlying cause of cell injury and facilitate healing. While acute inflammation is advantageous, chronic inflammation can lead to tissue damage. Prolonged neuroinflammation, particularly, can be detrimental to the nervous system and is associated with various disorders in both the peripheral and central nervous systems. Here is a short list of some of these disorders:


  • Alzheimer's Disease (AD) is a prevalent chronic neurodegenerative disorder, the leading cause of dementia. The disease's pathogenesis involves interactions with immunological mechanisms within the brain. AD brains exhibit regional inflammatory responses around Aβ deposits, marked by increased expression of pro-inflammatory cytokines, acute phase proteins, and complement components. Additionally, some brain cells become overactive, leading to more problems..

  • Parkinson's Disease (PD) is a common brain disorder that affects movement and is one of the most prevalent neurodegenerative diseases. It's known for the gradual loss of specific brain cells and the buildup of abnormal protein clumps called Lewy bodies. Besides movement problems, people with PD also experience other symptoms related to brain function. Inflammation in the brain seems to worsen the progression of PD. Microglial cells, a type of immune cell in the brain, may become overly active and contribute to this inflammation. Recently, researchers have been exploring the role of mast cells, another type of immune cell, in PD. Some studies suggest that mast cells might release substances that contribute to the progression of PD, although further research is needed to fully understand this aspect.

  • Multiple Sclerosis (MS) is a disorder that affects the central nervous system, damaging the protective covering of nerve fibers. It's a major cause of lasting neurological issues in young adults. The disease involves the immune system mistakenly attacking the protective covering, starting with immune cells called T cells that target this covering. This attack damages the covering and affects brain functions. Mast cells are believed to play a significant role in the disease. They can cause inflammation and harm to the protective covering by presenting specific parts of it to the immune system, and they may also disrupt the protective barrier around the brain, allowing harmful substances to enter. Mast cells release certain substances that promote inflammation and might contribute to the disease's progression. Additionally, other molecules like IL-1 and IL-6, produced by mast cells, can change the behavior of certain immune cells, further fueling inflammation. These inflammatory processes can impact various types of brain cells and potentially contribute to the symptoms and progression of MS.

  • Amyotrophic lateral sclerosis (ALS) is a serious neurodegenerative disease that mainly affects the nerves controlling muscles, leading to muscle weakness and eventually death within a few years of diagnosis. One of the significant aspects of ALS is neuroinflammation, where the brain's immune cells (microglia and astrocytes) become overactive. This inflammation can affect the barriers protecting the brain and spinal cord, allowing immune cells to enter, potentially worsening the disease. Mast cells may also play a role in this inflammation, releasing substances that contribute to barrier dysfunction. In ALS, mast cells are found in high numbers in the areas where nerve-muscle connections (neuromuscular junctions) are breaking down, and they may worsen muscle problems.


How to Prevent them and lower the risk?


Neurodegenerative diseases are generally unpredictable and not entirely preventable due to complex and often poorly understood reasons. However, there are measures to lower the risk, including maintaining a balanced diet, staying physically active, maintaining a healthy weight, using safety equipment to prevent head injuries, and regular annual check-ups with a primary care provider. Additionally, for individuals with a family history or other risk factors, considering genetic testing and counseling can provide valuable insights into potential genetic predispositions and help guide personalized preventive strategies.


4. Diabetes and Foundational Disease


What foundational diseases are?


Foundational diseases are chronic diseases that affect multiple body systems and can lead to other chronic diseases. They are often caused by genetic, environmental, and lifestyle factors.


In this blog post, we will focus on a specific type of foundational disease: metabolic disorders. Metabolic disorders are a group of conditions that affect how the body uses energy. They are often characterized by insulin resistance, which is a condition in which the body's cells do not respond normally to insulin. Insulin is a hormone that helps the body use glucose, a type of sugar, for energy.


Some common examples of metabolic disorders include:

  • Hyperinsulinemia: This is a condition in which the body produces too much insulin.

  • Insulin resistance: This is a condition in which the body's cells do not respond normally to insulin.

  • Non-alcoholic fatty liver disease (NAFLD): This is a condition in which fat builds up in the liver.

  • Type 2 diabetes mellitus (T2DM): This is a chronic condition that affects how the body uses insulin.

How do they impact our health?


Metabolic disorders can have a significant impact on health, both physical and mental. They can lead to a number of complications, including:


  • Heart disease

  • Stroke

  • Kidney failure

  • Blindness

  • Neurological disorders

  • Mental health conditions


How do they affect the body's systems?


Metabolic disorders can affect multiple body systems, including:


  • Cardiovascular system: Metabolic disorders can increase the risk of heart disease, stroke, and other cardiovascular problems.

  • Endocrine system: Metabolic disorders can affect how the body produces and uses hormones, which can lead to a number of health problems.

  • Metabolic system: Metabolic disorders can disrupt the body's metabolism, which can lead to weight gain, obesity, and other health problems.

  • Respiratory system: Metabolic disorders can increase the risk of respiratory problems, such as asthma and chronic obstructive pulmonary disease (COPD).

  • Digestive system: Metabolic disorders can affect the digestive system, which can lead to a number of health problems, such as fatty liver disease and gastroparesis.


How can it be prevented and treated?



It is possible to put Metabolic Disorders into remission, meaning patients can maintain blood sugar levels without needing medication. Evidence suggests that remission is more likely if the patient loses weight. The chance of remission is higher when weight loss efforts start sooner after diagnosis.


Studies show that a 10-15% loss of healthy body weight within 2 years of the diagnosis can lead to the remission of type 2 diabetes. However, in later stages of type 2 diabetes, where the body can lose its ability to produce insulin, people may achieve remission with a 20-25% loss of body weight.


Some of the most important things people can do to prevent metabolic disorders include:


  • Eat a healthy diet

  • Get regular exercise

  • Maintain a healthy weight

  • Avoid smoking

  • Limit alcohol consumption


As we explore the challenges of The Four Horsemen of Longevity, we realize the magnitude of their impact on our society and individual health. These conditions not only represent a significant burden on health and quality of life, but also apply a significant economic cost on society, emphasizing the critical need to understand and effectively address them.



At METSI Care, we recognize the crucial importance of prevention and informed management of these diseases. That's why we take pride in providing our patients access to specialized laboratories such as Micronutrient Testing and Genetic Predisposition Tests. These advanced tools offer individuals valuable insights into their current health status, enabling them to make informed decisions. By understanding the genetic foundations underlying these conditions, we can personalize more effective preventive and management strategies. This brings us one step closer to a future where personalized prevention and well-being are central to a long and healthy life.


At METSI Care, we are committed to leading this shift towards more precise, informed, and patient-centered healthcare.


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