Triage Theory and Longevity

There has been a lot of talk about longevity lately, with the understanding of telomeres, sirtuins, and the rise in popularity of the work of David Sinclair. An interesting theory has arisen from Dr. Bruce Ames, who has been a molecular biologist and in the nutrition space for decades. He came up with the term “Triage Theory” as a way to understand how the body uses micronutrients.

First, a reminder; macronutrients are your fats, proteins, and carbohydrates. Micronutrients are your vitamins and minerals. For this conversation, we are interested in the micronutrients only. 

Dr. Ames postulates that you can group micro’s into 2 buckets…survival, and longevity. As the theory goes, the body will prioritize survival over longevity. The body will ration the micronutrients it needs to avoid things like rickets or beriberi. Then the rest is used for things that promote longevity such as DNA. If we are deficient, the processes that promote longevity will be sacrificed for survival. 

If this theory is correct, this is a massive paradigm shift in how we think about micronutrients. This means that a moderate deficiency may not kill us in the short term, but will be reducing our life expectancy.

There are about 40 micronutrients that we know of that are required to sustain life. Most reference ranges reflect a minimum to survive. But is this optimal? Are these the levels we need to thrive, not just survive? Are we shortening our lifespan? 

Let’s look at vitamin K for example. Vitamin K has several functions. A key function is in coagulation, which is vital for life. If you get a cut, the wound needs to coagulate to heal. If it doesn’t, you’ll bleed out and die. 

Vitamin K also is important for calcium metabolism and transport. We all know that calcium is important for bones and teeth. However, just taking a calcium supplement alone may be a bad idea (Tankeu et. al, 2017) because the calcium will end up in the tissue and bloodstream causing calcification of arteries because it needs vitamin K to transport it to the skeletal system. 

So if we have just enough vitamin K, we can survive a wound. That is the lower limit for survival. If we accept the lower limit, we risk calcification of the arteries. We should be asking not only how much do we need to survive, but how much do we need to thrive? 

If you are looking for a reliable source of information on micronutrients, check out the Linus Pauling Institute.

Reference:

Tankeu AT, Ndip Agbor V, Noubiap JJ. Calcium supplementation and cardiovascular risk: A rising concern. J Clin Hypertens (Greenwich). 2017 Jun;19(6):640-646. doi: 10.1111/jch.13010. Epub 2017 May 2. PMID: 28466573; PMCID: PMC8030811.