Aging is unavoidable, yet most people can maintain and even improve their health and well-being as they grow older if they commit to making lifestyle changes that align with an integrative health approach, a medical expert says.

Recently, Dr. Karen Koffler, medical director for the Osher Center for Integrative Health at the University of Miami Miller School of Medicine, offered the 17th Biennial Ralph H. and Ruth F. Gross Endowed Lecture. Her talk, “Stronger Aging: An Integrative Health Approach to Preventing Decline,” was hosted by University Libraries. 

Koffler, who is a Miller School of Medicine alumna, recounted an experience early in her career that shifted her life trajectory and approach to medicine. 

On duty as an intensive care unit doctor, Koffler took care of a patient who seemed immediately familiar. She soon realized that she had treated him six previous times for the same problem. That same night, as she glanced around the ICU, Koffler realized that she knew half the patients from previous admissions. 

“I sensed that what I was doing was futile. In the long run basically stabilizing him, getting him out to the floor to be discharged, and then only to welcome him back in six months or three months,” she said. “I came to the conclusion that we were not getting at the root of the problem and that began an existential crisis for me.” 

She was fortunate to be awarded the fellowship in integrative medicine, which was just starting at the time, and went on to work with Andrew Weil, considered to be the father of integrative medicine. 

“Integrative health is a healing-oriented approach to medicine, different from the way we are trained as physicians in disease management,” Koffler explained. “Our first goal is to help people realize that they need to take responsibility in their own health care.” 

The generally accepted perspective on aging is for people to decline until they finally die. At the Osher Center, Koffler noted that the intent is “to keep people as robust and healthy as possible until one day at 102 we just don’t wake up—and hopefully we were playing tennis the day before.” 

Her own experience has taught her that there are many things (in terms of health) that we can’t control, but some things we can. 

“Once we have cleared a path toward that understanding, it’s incumbent on us to look at how we’re living our lives to figure out whether that is bringing us closer to our goals of being healthy for as long as possible.” 

Koffler highlighted the “tremendous focus” on longevity studies today and that the science of aging has shifted radically from when the National Institutes of Health founded the National Institute of Aging in 1974. 

When meeting with patients, Koffler explained that integrative health doctors strive to discern if there is disruption in one of seven body systems. 

“Because our belief is that what shows up on the outside that we may label rheumatoid arthritis or cardiovascular disease actually has an origin internally and an imbalance or loss of homeostasis,” she said. “And so, in this person, due to genetics or lifestyle, a condition has resulted that we label whatever it is. Our question is: Can we go upstream from that?” 

In her talk, Koffler detailed aspects of those seven systems: digestion and absorption, energy production, immune function, hormonal health, detoxification and biotransformation, vascular health, and sarcopenia or muscle loss. 

She highlighted the role of microbiome or “gut” in the first system of digestion and absorption. The microbiome, which many researchers refer to as “the organ we didn’t know we had,” generates 10,000 research publications a year, according to Koffler. 

“The gut plays a pivotal role in terms of optimum aging as it influences so many functions in the body—absorbing nutrients, fighting off pathogens, protecting our bodies, regulating our immune function, and much more,” she said. 

Koffler pointed out that while there are approximately 20,000 genes only about 20 to 30 are responsible for a person’s lifespan. 

“When you consider about 16 govern your eye color, that is not a lot of real estate that our physiology devotes to longevity,” she said. 

“We’re finding that epigenetics, which are those factors that influence the expression of genes, are more important—and that’s where lifestyle plays a huge role,” Koffler said. 

Behaviors, not pills, have a bigger impact on longevity than anything else, she concluded. 

A typical day for someone who’s committed to optimizing their well-being? 

“A cup of green tea sitting outside in the sun so that they’re producing melatonin, getting their Vitamin D. Taking a moment before they dive into their day to reflect on their lives and be intentional about how they would like the rest of the day to look,” Koffler suggested. “And activate a practice of centering and grounding, stretching the body so that you awaken your fascia and include time to meditate.” 

In terms of food, Koffler is a proponent of the diet espoused by Michael Pollan, Harvard professor, author, and journalist: “Eat food. Not too much. Mostly plants.”